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The decision to request an assessment for dyslexia whilst at university is often one of the most complex decisions a student has to make. It involves careful examination of the implications; balancing any perceived benefits, against actual or potential disadvantages. Despite this, very little is known about factors which influence students making this decision. A two-phase exploratory qualitative approach was selected to identify how many university students consider being tested for dyslexia, how they proceed and reasons behind this. Phase 1 consisted of an online survey available to all students registered at one UK University. Data was obtained from 674 students at all stages of their educational journey, across 8 different faculties, including 533 on Undergraduate; 54 on Post-graduate taught and 85 on Post-graduate research programmes. Of these 310 students had considered being assessed and explained why they had chosen not to go ahead. In depth interviews with 6 of these students, and a further 5 who had been assessed then provided a greater understanding of the factors involved. Results revealed a myriad of reasons, with some considered pivotal. Students had to have reached a tipping point before they were sufficiently motivated to seek an assessment. Reaching this point was largely determined by their academic self- concept and how well they perceived that they were doing. When students did acknowledge that they were struggling, often after prompts by others; whether or not they recognised dyslexia as a possible explanation was influenced by their understanding of the condition. This in turn was heavily influenced by how they saw it manifest in others. All of the students who had been assessed did so following a prompt by a member of academic staff. There are clear implications for educational practice arising from this research, which need to be supported by policy change. These focus on the need to enhance understanding of dyslexia in both students and academic staff. Strategies to raise student awareness, alongside more in-depth staff development initiatives are proposed. There is also a need for future research to explore in detail factors influencing specific professional groups and postgraduate students.

Articulating what nursing is and what nurses do, has been a challenge since the creation of the profession. This research draws on technology to solve the issue of revealing and investigating the tacit nature of nursing through the concept of the nursing gaze. Drawing on the visual attention of nurses, this two-phase experiment identified that the nursing gaze is complex but can be identified with eye tracking and verbal utterances. Both phases of the study utilised videos of simulated nursing practice that acted as the stimulus for viewing. The practical challenges of tracking eye movement and verbal utterances when stimulus is video was identified and led to the development of Gaze-to-Text to solve these. This novel method drew on ethnographic techniques to combine both eye movement and verbal utterances of novice identifying the tacit nature of the gaze. Concurrent eye tracking and recording of the viewers ‘think aloud’ commentaries led to the identification of eight verbal performative signifiers used by nurses to judge the behaviour and actions. Analysis of both novice and expert nurse’s eye movement demonstrated areas of convergence and divergence and when combined with the verbal utterances, allowed conclusions to be drawn about the cognitive and perceptive processes involved in the nursing gaze. The findings of the study have implications for developing novice nurses through the articulation of expert nurses gaze. The method of Gaze-to-text offers potential for understanding visual attention and the tacit elements of professionals in other fields.

Background: Job satisfaction is a vital concept in nurse retention. Two reasons are thought to contribute to the severe scarcity of nurses in Saudi Arabia: (a) the nursing profession is considered a low status profession with associated negative public perceptions; and (b) cultural barriers that restrict female access to education and employment, particularly in jobs that require contact between genders. The substantial shortage of Saudi nurses in the Saudi Arabian health system has led to a heavy reliance on foreign nurses. This historical dependence on massive numbers of non-Saudi nurses from countries around the globe, and a fragmented approach to their recruitment, has led to inequalities in the remuneration and treatment of nurses. The multicultural nature of the workforce and its potential impact on job satisfaction renders an investigation into the role of nationality a research priority. Aim: To examine whether nationality has an effect on job satisfaction and 'intention to leave' among nurses in Saudi Arabian government hospitals. Methods/Design: A design of mixed quantitative and qualitative methods was utilised in this study. The quantitative element utilised a survey approach; this approach consisted of McCloskey and Mueller's Satisfaction Scale, which was used to measure nurses' job satisfaction across eight types of satisfaction. Additional questions addressed their intention to leave and demographic variables. The qualitative approach utilised semi-structured interviews to further explain any identified associations. The study was conducted in three major government hospitals in Saudi Arabia. The study sample consisted of 747 participants who completed the questionnaire, of whom 26 also participated in semi-structured interviews. Data were collected over a nine-month period between May 2014 and February 2015.

For the period 2012-2016, the Thai 11th National Health Development Plan focuses on the accessibility and equity of mental health care by using community collaborations in order to ‘strengthen and empower the sub-district health system’. In reality, demands and supply should be balanced, based on available resources. Therefore, including the patients’, caregivers’ and health care providers’ perspectives for schizophrenia care improvement is considered helpful to gain an in-depth understanding of the community mental health nursing care situation; this endeavour is aimed at improving mental health nursing practices, based on available resources. There has been no previous research exploring stakeholders’ perspectives of care at the primary level in the rural Thai community. This qualitative study aims to provide an in-depth understanding of both service users’ and service providers’ views. Semi-structured interviews were carried out with 40 participants within three groups, which involved patients with schizophrenia, their caregivers, the primary care staff in the community, and the supervisory teams in the community and psychiatric hospitals. Interviews were transcribed verbatim, translated into English and analysed using thematic analysis. Each group of participants was analysed individually to provide specific and integrated themes. Three key areas relating to all three groups are 1) the lived experience, 2) the importance of medication and 3) the service and support needs. The results illustrate the complexity of the Thai situation, due to poverty within a rural environment and conflicting views regarding the need to move away from a biomedical model of care. The results will be used to inform community mental health nursing practice and education in Thailand.

The purpose of this study was to improve the care of children with VSD in rural Thailand. Based on the literature review, these children experienced long waiting times or surgery and had difficulty in gaining or maintaining optimal weight prior to surgery. An ethnographic approach was used to explore and understand the aregivers’ problems in their cultural context; especially the experiences of how the amilies managed the care of their child, in order to overcome the issues of gaining or maintaining optimal weight prior to surgery. Ten family case studies resulted from semi-structured interviews, field notes, observations, and photographs from the ten main caregivers of children with VSD. Ten health professionals who dealt with these children were interviewed to ascertain any differences in perspective between the professionals and the caregivers with respect to nutritional management. Data were collected between January and May 2012 in a egional hospital and at the homes of the participating caregivers. A thematic approach was used to analyse the data. The triangulated findings generated themes indicating hat both health professionals and caregivers had insufficient knowledge in taking care of children with VSD in rural Thailand, who were waiting for surgery. The key issues elated to the caregivers’ insufficient knowledge were the limited knowledge of health professionals, inadequate resources at the clinic and the clinical environment did not provide useful information. Furthermore, some of the knowledge the caregivers used was inappropriate for supporting weight gain in their child. Drawing on the literature and findings, the content for nutritional preoperative information package for the aregivers to help enable their child to gain or maintain optimal weight prior to surgery has been designed. The findings suggested that, particularly in the rural areas, any written materials to support the caregivers should be designed for those who have a eading age of at least primary school level.

Using Casebook Ethnography, nine registered Adult Nurses were observed and interviewed to explore the ways in which they undertook their daily work and the place of reflection in that. The participants were employed in one of two units; a surgical breast care and an acute palliative care unit, both of which were in a large National Health Service trust hospital in central England. Data collection was illuminated by the researcher’s reflective journal. The data collected, rather than simply describing reflective practice, led to wider and more broadly focussed findings which, when analysed, generated one central theme - Communication, Interaction and Discourse and three linked associate themes - Being and Caring, Practical Action, and Knowing. These themes were considered in the light of the key literature around nursing practice and reflection. The findings point to a new understanding of contemporary nursing practice, which illustrates ‘what our kind does’, amongst the groups of participants in order to deliver patient-focussed care. This practice was directed towards working with colleagues who shared the same values and understandings, and who used these shared beliefs to adapt their practice to achieve individualised and exquisite care. As they communicated and interacted with one another, the participants went about their work with attention to empathy and caring, articulated as a common humanity with their patients. They prioritised action where patient need was clear, and used a form of knowledge that was negotiated and validated within a community of practice. As they maintained a dialogue in their teams, the participants developed a sense of their professional identity and of who qualified as ‘our kind’. The implications of this study are that a fuller understanding of how nurses work in contemporary practice will inform the preparation and continuing professional development of nurses and the ways in which effective clinical leadership may be implemented.