Jan Pascal

Developing critically reflective practice

Reflective practice has become an influential concept in various forms of professional education, for example, in nursing and social work. However, there has been a common tendency for it to be oversimplified in practice, and, furthermore, dominant understandings of reflective practice can themselves be criticised for lacking theoretical sophistication in some respects – particularly in relation to the social and political dimensions of learning and professional practice. This paper therefore seeks to clarify the theoretical underpinnings of reflective practice and to propose developments in relation to the missing sociological elements. It briefly reviews current dominant understandings of reflective practice before proposing developments in the theory base to make it more theoretically sophisticated in general and more sociologically informed in particular. In this way, the foundations for a critically reflective practice are sketched out.

Reflective practice: an existentialist perspective

There has been an increasing interest in reflective practice in recent years, but the theory base underpinning it remains relatively underdeveloped. We have seen a move away from essentialist ‘technicalism’ to a more constructivist exploratory approach consistent with existentialist philosophy. This paper therefore explores how existentialism can be used as a more sophisticated and wide‐ranging theory base to underpin the future development of reflective practice.

Reimagining the relationship between social work and information communication technology in the network society

Abstract Australia is experiencing a period of immense cultural change predicated on the use of Information and Communication Technology (ICT). New devices such as smartphones, tablet computers, and the social iterations of the internet are impacting on communication patterns and contributing to the merging of peoples online and offline lives. Using Spanish sociologist Manuel Castellss theory of the Network Society as a theoretical foundation, this issues paper posits that social work must overcome its historical reluctance to embrace ICT if it is to remain relevant in the era of the network society. In particular, we argue that social work professionals need to begin a dialogue with IT developers, social service managers, and funding bodies about the need for practice-led ICT systems. This paper examines the turbulent history social work has had with technological change, and concludes that the adoption of a practice-led approach to ICT use in education, practice, and research provides a strong foundation for reimagining the relationship between social work and ICT.

Ethical and existential challenges associated with a cancer diagnosis

Background At the point of cancer diagnosis, practitioners may wrestle with ethical dilemmas associated with medico-legal implications of diagnosis, treatment options and disclosure to family members. The patients perspective can take a different route, focusing on ethical and existential questions about the value and purpose of life, culminating in the question: how do I lead my life after diagnosis? Objective To explore the ethical and existential challenges associated with a cancer diagnosis from the perspective of cancer survivors. Design Qualitative design using specifically phenomenological methods to enable focus on subjective experience. Two in-depth interviews were conducted over a 6-month period. Setting Bendigo, Victoria, Australia. Participants 15 participants (n=11 women and n=4 men) volunteered to be interviewed. Age ranged from 32 to 85 years of age; length of survival 0.5–25 years; with a range of cancer diagnoses. Results Findings demonstrated that participants experienced existential and ethical challenges associated with a cancer diagnosis and subsequent survivorhood. These challenges were present regardless of cancer stage or diagnostic type and pervaded throughout length of survival. The existential challenges included the experience of anxiety and uncertainty about recurrence and metastatic disease. In particular, participants reported iatrogenic uncertainty induced by tests and treatment with follow-up regimes underscoring the fragility of survivor status. Uncertainty served as a ‘wake-up call’ and precipitated ethical challenges. Such challenges involved making meaning of survivorhood and questioning of morals, values and relationships. At times these questions were painful and difficult, creating unease about leading a ‘good’ and purposeful life. Entering ethically rocky terrain was also considered identity enhancing, with reports that a cancer diagnosis could have benefits as well as challenges. Conclusion This study identified a number of challenges associated with a cancer diagnosis; these have implications for the preparation of medical, nursing and social work practitioners and should be considered during the design of follow-up support for cancer patients and those in recovery.

The Lived Experience of Doing Phenomenology Perspectives from Beginning Health Science Postgraduate Researchers

This article provides a reflective account of the lived experience of undertaking phenomenological research. Three postgraduate health science researchers and their supervisor share their experiences of understanding phenomenological theory, study design and application of phenomenological principles to a range of research topics including: first time motherhood, community singing and familial breast cancer. The article commences with the theoretical context; however, the main intention is to reveal the development of the students’ thinking and experience of doing phenomenological research. Such revelations are intended to encourage future social work and health science postgraduate researchers to consider phenomenology as having direct practical application for real life experience.

Returning home: psychosocial care during the re-entry phase of cancer survivorship in rural Australia.

The purpose of this research was to highlight gaps in formal psychosocial care for cancer survivors in rural communities. The study was conducted in rural Victoria, Australia, and involved interviews with people with various stages of cancer progression, cancer diagnoses and survival times, who were interviewed about their experiences of psychosocial cancer care. Interviews focused on their experience of psychosocial care and were audio-recorded and transcribed verbatim. Data were thematically analysed to identify key themes. Findings demonstrate that psychosocial care is essentially informal within the re-entry period after cancer diagnosis and treatment. Despite current Australian clinical guidelines on psychosocial care for people with cancer, which indicate the need for the provision of formal psychosocial care, participants in this study largely cared for themselves, or received informal support from family, friends and community members. Many psychosocial needs remained unmet and professional support was lacking. While this study was conducted in rural Australia, many of our findings have been echoed in studies from other countries. The findings have implications for treatment protocols and discharge planning, health professional-patient-family relationships, and the long-term well-being of cancer survivors living in rural communities. A model for understanding the experience of formal supportive care during the re-entry phase of survivorship is proposed.

Space, place and psychosocial well-being : Women's experience of breast cancer at an environmental retreat.

Psychosocial oncology research has highlighted the complex experience of living with cancer, encompassing personal and emotional, as well as family, social and community experiences. This article seeks to extend the concept of “psychosocial” to include therapeutic landscapes, and to understand in what ways space and place shape the experience of living with cancer. These ideas are explored with reference to a qualitative study that explored womens experience of breast cancer at an environmental retreat in Victoria, Australia.

Using the F-word: feminist epistemologies and postgraduate research

This article reports on the ways in which feminism has led to and influenced the unfolding of our three separate doctoral research journeys. In writing about this choice, we suggest that the epistemology of feminism is compatible with qualitative methods, as well as with the social work discipline, within which we all practice. The article reports on the impact of feminism on this journey from the perspective of three different stages of doctoral research, beginning, middle, and ending.

Understanding receptivity to informal supportive cancer care in regional and rural Australia: a Heideggerian analysis

The concept of receptivity is a new way of understanding the personal and social factors that affect a person living with and beyond cancer, and how these factors influence access to formal supportive care service provision and planning. This article contributes to new knowledge through applying the concept of receptivity to informal supportive cancer care in regional Australia. Literature indicates that a cancer diagnosis is a life-changing experience, particularly in regional communities, where survival rates are lower and there are significant barriers to accessing services. Heideggerian phenomenology informed the design of the study and allowed for a rich and nuanced understanding of participants lived experiences of informal supportive cancer care. These experiences were captured using in-depth interviews, which were subsequently thematically analysed. Nineteen participants were recruited from across regional Victoria, Australia. Participants self-reported a range of stages and types of cancer. Significantly, findings revealed that most participants were not referred to, and did not seek, formal supportive care. Instead, they were receptive to informal supportive care. Understanding receptivity and the role of anxiety and fear of death has implications for partners, family, community members, as well as professionals working with people with living with and beyond cancer.

The supportive network: rural disadvantaged older people and ICT

ABSTRACT The rapid development of Information and Communications Technologies (ICT) is profoundly transforming the social order, into what Spanish sociologist Manuel Castells calls the network society. Mobile technologies, such as smartphones and tablet computers, are perhaps the definitive tools of the network society; however, cultural and economic barriers exist that restrict access to these transformative tools and to the information networks in which they operate. One group that is particularly at risk is rural older people from disadvantaged backgrounds. This paper reports on one aspect of a larger action research project that involved working with a small group of rural, socially isolated older people with histories of homelessness and complex needs (N = 7) and their social workers. This paper focuses on the older participants who, having been provided tablet computers, were then supported to use the device in their homes over the course of eight months. Despite most participants having never used a computing device of any kind prior to the research project, findings suggested that participants gained confidence, independence and social engagement as a result of their ICT use. Results also highlighted that they experienced challenges in utilising ICT, specifically technical, economic and social barriers. Findings highlight the individual and structural issues that must be addressed to enable all citizens to participate fully in the network society.