Jan Reed

Practitioner research in health care

SECTION ONE -BASIC ISSUES IN PRACTITIONER RESEARCH: Practitioner Research in Context, Jan Reed and Sue Procter The Nature of Practitioner Knowledge, Liz Meerabeau Practitioner knowledge in Practitioner research, Jan Reed The Contribution of Inductive and Deductive Theory to the Development of Practitioner Knowledge, Sue Procter. SECTION TWO-EXPERIENCES OF PRACTITIONER RESEARCH: Part 1 Introduction, Researching and Communicating with Children- problems and Issues of using a Randomised Controlled trial, Val Pirie, Reflections on Evaluating a Course of Family Therapy, Chris Stevenson Part 2 Introduction, The Health Bus- a Study of a developing Project, Ruth McKeown, A study of family networks and relationships in community midwifery, Jean Davies Part 3 Introduction Patients feelings about Patients, Debbie Skeil, How Adults with Learning difficulties and Their Informal carers perceive professional practice, Bob Heyman and Sarah Huckle. SECTION THREE- THE WAY FORWARD: Evaluating and Developing Practitioner Research, Jan Reed and Colin Biott.

A sampling strategy for qualitative research.

This paper discusses sampling in qualitative research, describing the principles and how different researchers have described their sampling techniques. The example of a research project in which the authors were involved ( 1 ) is used to show how a range of quantitative and qualitative sampling techniques can be combined, highlighting some of the problems. In particular, where theoretical sampling was required, we found that a systematic way of identifying theoretically useful sampling units was needed, and so a method of selection which we have called matrix sampling was devised, whereby informed and coherent choices could be made.

Older persons' experiences of whole systems: the impact of health and social care organizational structures.

AIMS An in-depth case study of whole systems working. BACKGROUND This paper reports on the second part of a two-part study exploring whole systems working. Part 1 of the study focused on an in-depth review of the literature pertaining to continuity of care and service integration. The second part, reported here, focused on an in-depth case study of one whole system. Evaluation Informed by the findings of part 1 of the study, data collection methods included in-depth interviews, real-time tracking of 18 older people, focus groups and consensus conferencing. Different data sets were analysed individually and synthesized using matrices derived from the literature review findings. KEY ISSUE Key themes from data synthesis include: (1) access to the most appropriate services; (2) service fragmentation; (3) continuity of care; and (4) routinized care. CONCLUSIONS The four themes of the case study reflect the need to address issues of demarcation of professional responsibilities, complicated channels of communication, information flows, assessment and reassessment in whole systems working. IMPLICATIONS FOR NURSING MANAGEMENT The impact of disempowering relationships on actual continuity of care and perceptions of quality among service users and providers. Lessons need to be learnt from specialist services and applied to service delivery in general.

The importance of place for older people moving into care homes

In an increasingly mobile society, the importance of place can be forgotten in the process of making decisions about where older people should receive care. There is some evidence, however, that issues of location and place are important to older people, both in the way that their sense of self is developed and maintained through identification with places and through their ability to participate in activities. This paper describes a research study which followed a group of older people through the process of moving into care homes, and discusses some of the data produced, which indicated how a sense of place shaped the process of moving.

Practitioner research in context

The problems of practitioner researchers, that is, practitioners who are involved in doing research into areas of their practice, are on first examination no different from those of any other researchers. The issues of methodology, research tools and data collection are, it would appear, universal, whatever the background of the researcher. When planning a research project, therefore, the practitioner researcher will invariably consult methodological texts for information and advice. At some levels this information is adequate — techniques such as statistical analysis, for example, seem to be easily applied to all types of research that require them. In other ways, however, most methodological texts will not be helpful to practitioner researchers, or may even serve to perplex them even more.

Services for younger people with dementia: problems with differentiating needs on the basis of age.

There is a growing movement to develop specific services for younger people with dementia. This article reports on an evaluation of one such service that was developed in response to a locally identified deficit in ‘age-sensitive’ care. The service was evaluated very positively by service users, and the staff on the project were keen to detail the differences that they had observed between the needs of their clients and older people with dementia. The clients’ responses, however, did not necessarily highlight age-specific needs; the comments were more about how the service was sensitive to individual needs. This suggests that the level of responsiveness offered by the team is much valued, but could also be a foundation for all services for all people with dementia, regardless of age. The study suggests, therefore, that the work of the team offers a model which could be applied across all client groups.

Health, well-being and older people

Introduction Ideas and models of growing older Attitudes and images The body growing older The lived environment Memory: self, relationship and society Older people, sexuality and intimacy Living in families and communities Money and financial resources in later life Safety and risk Service, satisfaction and service-user involvement Issues for discussion and practice.

Promoting partnership with older people through quality assurance systems: Issues arising in care homes:

This paper reports on a study in which a quality assurance package was introduced into 11 care homes for older people and evaluated. The package (Qual A Sess) has two features. First, it is designed to provide a mechanism for self-regulation, by providing homes with a framework for assessing care and services in a systematic way. Second, it promotes the participation of residents in the quality process, by including them as members of self-assessment teams. A case study methodology was used to evaluate the process of introduction, and this paper focuses on data from older people which describes their views about participation. The paper concludes that skills in communication and assessment, and sensitivity to individual needs and problems is required in order to facilitate meaningful participation from older people.

Older people maintaining well-being: an International Appreciative Inquiry study.

This paper reports on the progress of an international study investigating older peoples strategies for maintaining well-being in the UK, Germany, South Africa and Australia. It uses an Appreciative Inquiry framework for investigation.

Appreciating change in cancer services--an evaluation of service development strategies.

PURPOSE The purpose of this paper is to report on an evaluative study which used appreciative inquiry (AI) to explore the processes of change during the Cancer Services Collaborative Improvement programme instituted by the Department of Health in the UK. This was a three-stage programme which expanded from nine pilot projects to a national service change, focussing on improving the patients experience throughout the journey from diagnosis to treatment. DESIGN/METHODOLOGY/APPROACH The paper uses AI questions in interviews with a range of CSC staff who had had different roles and length of involvement. FINDINGS The study identified a range of strategies and skills that participants had developed in order to support and facilitate service change. PRACTICAL IMPLICATIONS The paper offers a discussion of skills and strategies that can facilitate change in health care across clinical areas, and a discussion of the use of AI as a method of evaluation. ORIGINALITY/VALUE This study is one of the first to use AI in health care evaluation in the UK, and thus makes a contribution to understanding change from an AI perspective.