Search

This portfolio thesis has three parts. Part one comprises a systematic literature review, wherein the effectiveness of psychological interventions that integrate religion or spirituality are considered. Part two is an empirical research paper, wherein the role of spirituality is explored when individuals are making sense of hearing voices. Part three collates the appendices, containing supporting documentation and information for the systematic literature review and empirical research paper, as well as epistemological and reflective statements.

This thesis portfolio is comprised of three parts: Part One – Systematic Literature Review The systematic literature review explored adoptees’ experiences of reunions with birth relatives in adulthood. Thirteen studies were identified to be reviewed through a systematic search of electronic databases. A narrative synthesis of the findings related to the types of relationships developed, impact of the reunion and factors that facilitated or hindered this process is provided. A review of methodological quality of the research is also offered. Important clinical implications, including a role for clinical psychologists, and recommendations for future research are identified. Part Two – Empirical Paper The empirical paper explored social workers’ experiences of deciding how to place siblings for adoption using Interpretative Phenomenological Analysis (IPA). Four superordinate and twelve subordinate themes were identified, which describe participants’ experiences of making decisions, and the role of their experiences and beliefs in the decision-making process. The findings are discussed in relation to theory and a decision-making model. Clinical implications and suggestions for future research are discussed. Part Three – Appendices The appendices provide supporting documentation that are important for the systematic literature review and empirical paper, plus a reflective statement and an epistemological statement.

This thesis portfolio comprises of three parts: Part one – Systematic Literature Review The systematic literature review explored the effectiveness of interventions to change negative perceptions of adults with intellectual disabilities. A systematic search identified 19 studies detailing various interventions. A narrative synthesis of the findings is presented, incorporating methodological critique throughout. Conclusions from the evidence base are drawn, with implications for future research. Part two – Empirical Paper The empirical paper explored the impacts of a theatre company on perceptions and understandings of intellectual disabilities from multiple perspectives including; members of the theatre company with intellectual disabilities, significant people in their lives, and members of the wider community. A qualitative approach was adopted, particularly thematic analysis. Four superordinate and nine subordinate themes were identified, acknowledging the connectivity, normality and growth associated with the theatre company, and offering recommendations for similar organisations. The findings are discussed relative to theoretical and empirical literature, culminating in implications of the results and avenues for future research. Part three - Appendices The appendices provide supplementary information for parts one and two, and also includes an epistemological statement and a reflective statement.

This portfolio thesis has three parts. Part one is a systematic literature review in which an analysis is conducted on existing research exploring asylum seekers’ and refugees’ beliefs and experiences of interventions for trauma-related distress. A systematic database search identified 18 studies to be reviewed. Narrative Synthesis is used to analyse the findings, and methodological quality is evaluated. The clinical implications for service design and directions for future research are also discussed. Part two is an empirical paper which uses Interpretative Phenomenological Analysis to explore interpreters’ experiences of working in mental health settings and how compassion may be experienced in their role. The findings are discussed in relation to psychological frameworks of compassion, and implications for practice and training, as well as recommendations for future research, are considered. Part three comprises the appendices supporting the systematic literature review and the empirical paper. A reflective statement considering the process of the research, as well an epistemological statement, are also included.

This portfolio thesis is comprised of three sections: a systematic literature review, an empirical study and a list of appendices. Part one is a systematic literature review in which a thematic synthesis has been completed to interpret and outline the data from studies which have highlighted positive states and experiences qualitatively reported by non-disabled relatives of people with an intellectual disability (ID). This review rejects the pathological and negative theme across much of the ID literature and, particularly, the literature around family members of people with ID. A systematic search of several electronic databases was completed and 15 studies were included in the review based on a set of inclusion criteria. Three superordinate themes were generated: ‘growth’, considered change from a subjectively less desirable state to a more desirable state; ‘joy’, which describes participants’ positive, joyous and proud moments associated with their disabled relative and ‘developing ways to cope’, which describes mechanisms participants use to help them cope with the inherent stresses associated with ID. The implications of these findings are discussed and an assessment of methodological quality is completed to contextualise the findings. Part two is an empirical paper exploring the lived experiences of personal growth for adult siblings of people with ID. Interpretative Phenomenological Analysis (IPA) was used to understand the participant’s subjective experience and how they made sense of it. Seven semistructured interviews were completed. Three superordinate themes emerged from the data: ‘developing strength’, which describes participants developing acceptance and resilience and advocating for their sibling; ‘learning opportunities’, which described participants learning skills and developing values and ‘family closeness’, which describes participants’ closeness with their families and pride in their disabled sibling. These findings are discussed in relation to implications for the literature in ID and the wider societal context. Part three is a list of appendices from both the literature review and empirical paper.

This portfolio thesis consists of three parts: a systematic literature review, an empirical paper and a set of related appendices. The thesis as a whole considers what gratitude means and how it is experienced by individuals living with a diagnosis of a chronic condition. The first section is a systematic literature review that explores how gratitude is experienced by individuals living with a diagnosis of cancer, and critically examines how gratitude as a concept is understood and discussed within the cancer literature. Eighteen papers were reviewed. The data were synthesised using a meta-ethnographic approach, which took a critical interpretivist stance to consider how findings were structured and interpreted by researchers. The findings indicate that people living with cancer encounter positive experiences related to gratitude, which have multiple aspects, and co-occur with difficult experiences. The findings are discussed within the context of wider literature, and the implications for future gratitude research are considered. The second section of the portfolio is an empirical study that explores the meaning of the concept of gratitude for people who are living with dementia in the community, and the experience of this concept. A secondary aim of the study was to explore the usability and acceptability of a diary as a data collection method for this group. The research used a mixed-methods approach, primarily collecting qualitative data using interviews and diaries, and analysing this using Interpretative Phenomenological Analysis. Secondary quantitative data were collected via a questionnaire and summarized using descriptive statistics to assess the usability of the diary method. Eight participants aged over 65 and living in the community were interviewed, and six of these participants kept a gratitude diary for a week following interview. Two superordinate themes and seven subthemes emerged from the data. These findings indicate that gratitude has meaning as a multidimensional construct and is experienced in life with dementia, influenced by and balanced with the changes of dementia and ageing. Descriptive statistics indicate that a diary may be an acceptable method of data collection for this group. The findings are discussed in the context of wider literature, and the implications for dementia care generally and the specific application of positive psychology interventions are discussed. The third section consists of a set of appendices relating to both the systematic literature review and the empirical paper. Also contained within these appendices are a reflective statement and an epistemological statement, which consider the researcher’s experience of conducting the research and the philosophical position and assumptions underlying the research.

This portfolio thesis is divided into three parts; a systematic literature review, an empirical paper, and a set of appendices. The thesis as a whole seeks to understand positive experiences of professional caregivers, in order to provide a more holistic understanding of caregiving in residential dementia care settings. Part one is a systematic literature review which explores and reviews the literature relating to positive and negative aspects of caregiving experienced by professional caregivers in residential dementia care settings. Factors associated with positive and negative experiences of caregiving are also examined. Fourteen papers were identified and reviewed using a narrative synthesis approach; three themes and six subthemes were identified. The findings are considered and discussed in the context of previous literature relating to caregiving in addition to clinical and research implications. Part two is an empirical paper exploring hope in professional caregivers in residential dementia care settings. The investigation includes the experience of hope, facilitators/barriers of hope and the role of hope in caregiving. Using a constructivist Grounded Theory approach a focus group consisting of six participants was conducted, and purposive theoretical sampling was used to conduct nine individual interviews. Data were analysed using constructivist Grounded Theory and nine categories emerged which were organised into three theoretical concepts. The emergent theory is discussed in the context of previous literature relating to hope and caregiving in addition to clinical and research implications. Part three is a set of appendices for both the systematic literature review and empirical paper, and includes an epistemological statement and reflective statement.

Chronic respiratory diseases, particularly asthma and COPD, cause substantial morbidity and mortality. Some individuals have features of both asthma and COPD (sometimes described as asthma-COPD overlap or ACO), and genetic risk factors for this are not fully understood. Genetic studies can identify underlying mechanisms to develop and target treatments, but require large cohorts with genotype data and phenotypic data such as self-reported diagnoses, spirometry and/or linked electronic health records (EHR). This project develops and utilises such cohorts to explore the epidemiology of asthma, COPD and ACO, and to study genetic associations with ACO. I developed recruitment to the Extended Cohort for E-health, Environment and DNA (EXCEED), a study of over 11,000 participants, and undertook descriptive analyses to produce a cohort profile paper. I undertook epidemiological analyses of linked EHR, which demonstrated the feasibility and utility of defining ACO and acute exacerbations of COPD using this data. Alongside this, I led quality control of spirometry data in the AWI-Gen-XHALE pilot study in South Africa, contributing to establishing an additional resource for respiratory genetic epidemiology in an underserved region. I identified eight signals reaching genome-wide significance (P < 5x10⁻⁸) in a genome-wide association study of ACO. None of the signals were previously associated with ACO, and one intergenic signal on chromosome 5 was not previously associated with either asthma or COPD (rs80101740). The signals suggested a spectrum of genetic influences, some predominantly influencing asthma (signals in/near FAM105A, GLB1, PHB, TSLP), others predominantly influencing COPD (IL17RD), and others intermediate (C5orf56, HLA-DQB1). Subgroup analyses suggested that the associations were not driven by smoking or age at asthma diagnosis. I showed shared genetic influences between asthma, COPD, ACO and eosinophils at the level of individual loci and genome-wide, and highlighted pathways implicating innate and adaptive immunity and potentially bone development.

According to the World Health Organisation (WHO), certain adverse pregnancy outcomes such as preterm birth, low birth weight (LBW) and caesarean section (CS) present major public health problems due to their adverse effects on maternal and child health, (i.e. poor child feeding practices, increasing perinatal mortality, child morbidity and mortality). The aim of the current work is to assess the impact of sociodemographic factors, prenatal factors and adverse pregnancy outcomes on child feeding practices and child health. The current work created an integrated maternal and child health theoretical framework aiming to improve maternal and child health. The newly-created framework is based on a thorough understanding of the existing knowledge and gaps about the main current work aim through critically reviewing the literature, including the author's prior publications (9 papers), as well as existing relevant frameworks. The significance of the newly-created framework arises from the author's prior work, creating new meaning by combining and discussing the findings from the author's published work with existing literature and comparing the findings between the studied settings (Sudan and the United Arab Emirates (UAE)), transforming the existing related frameworks forward, and addressing the social determinants of health (SDH)that can help decision makers to prioritise actions for improving maternal and child health as well as the generalizability of the findings through the application of the newly-created framework in different settings. The newly-created theoretical framework identifies particular sociodemographic factors, (i.e. nationality, residence, parental education, socioeconomic status (SES), maternal age, obesity and child gender); particular prenatal factors, (i.e. prenatal care, maternal illness, birth order, and breastfeeding education) as the main predictors of adverse pregnancy outcomes, child feeding practices, perinatal and child health. In conclusion, the current work addresses all these predictors and outcomes as well as their implications on public health and future research. Also, the current work provides recommendations for decision makers and researchers. Therefore, the current work significantly contributes to the knowledge by creating an integrated maternal and child health theoretical framework. Taking the wider scope of generalizability of the created framework into account, application of the current work findings will lead to improvements in maternal and child health in the studied settings and beyond settings.

This thesis is split into three parts; a systematic literature review, an empirical research paper and a set of appendices. Part one contains a systematic literature review of the factors which help or hinder military personnel adjusting to civilian life. Fifteen Articles published in the UK, USA and Canada were reviewed. The results are discussed in relation to one another and the psychological understanding of adjustment. The implications of the findings on clinical practice and future research are then discussed. Part two is a piece of original qualitative research exploring the experiences of ex-military amputees. It aims to consider the social and personal perspectives which influenced their adjustment and identity. Five individuals were interviewed and their transcripts were analysed using narrative analysis. The clinical implications of the findings and suggestions for future research are then discussed. Ways to build more positive societal perspectives of ex-military amputees are also considered. Part three contains a complete set of appendices, referenced throughout the previous two parts.