Karen Whittaker

Pragmatic randomised controlled trials in parenting research: the issue of intention to treat

Study objective: To evaluate trials of parenting programmes, regarding their use of intention to treat (ITT). Design: Individual trials included in two relevant Cochrane systematic reviews were scrutinised by two independent reviewers. Data on country of origin, target audience, trial type, treatment violations, use of ITT, and the management of missing data were extracted. Main results: Thirty trial reports were reviewed. Three reported the use of an ITT approach to data analysis. Nineteen reported losing subjects to follow up although the implications of this were rarely considered. Insufficient detail in reports meant it was difficult to identify study drop outs, the nature of treatment violations, and those failing to provide outcome assessments. In two trials, study drop outs were considered as additional control groups, violating the basic principle of ITT. Conclusions: It is recommended that future trial reports adhere to CONSORT guidelines. In particular ITT should be used for the main analyses, with strategies for managing treatment violations and handling missing data being reported a priori. Those conducting trials need to acknowledge the social nature of these programmes can sometimes result in erratic parent attendance and participation, which would only increase the chances of missing data. The use of approaches that can limit the proportion of missing data is therefore recommended.

Evaluating health visitor parenting support: validating outcome measures for parental self-efficacy

Parenting support has become an increasing feature of child health services within the United Kingdom but typically, outcome measures available for testing the effectiveness of parenting interventions have been developed and validated elsewhere. This article reports the results of a feasibility study testing the Parenting Self-Agency Measure (PSAM) and subscales from the Self-Efficacy for Parenting Tasks Index (SEPTI) as outcome measures for UK-based parenting support programmes. Forty-six mothers and 10 fathers accessing routine health visitor and school nurse services participated in the test–re-test of the scales and commented separately on the acceptability of scale questions. Very large intra-class correlation results indicated good repeatability but alpha coefficient scores and factor analysis results suggest that UK respondents may not recognize SEPTI subscales items as measuring single dimensions. The PSAM was a more stable measure of parenting self-beliefs than the SEPTI subscales when tested with a UK sample of parents.

Examining the British PhD viva: Opening new doors or scarring for life?

Abstract The PhD viva – regardless of its format – has the potential to be a significant rite of passage for the student. It is an experience that can resonate for months or years afterwards. Part of the challenge is that for everyone involved – student, supervisory team and examiners – a degree of end-point uncertainty exists. These ambiguities and tensions are perhaps an inherent part of any examination but are particularly characteristic of the examination of the individual and unique body of work that constitutes the doctoral thesis. In recent years, increased attention has been placed on the processes that surround the examination, aiming to increase transparency, consistency and fairness. However, the process of examining a student and their thesis remains challenging and is surrounded by different agendas, ideologies and practices. This paper examines some of the issues surrounding the PhD viva, primarily focusing on the British viva whilst weaving in commentary about the Australian system.

A survey ofcommunity placements for educational programmes in nursing and midwife

In this paper preliminary findings fromthe first stage of an English National Board (ENB) commissioned study investigating the educational needs of community practitioners in relation to their responsibilities for student learning are presented. A national postal survey of all educational centres offering nurse and/or midwifery education was undertaken in the latter half of 1993. Information was collected regarding the nature and planning of the community practice components of courses. The main methods of support forpractitioners included the provision of the ENB 998/997 courses and liaison meetings between educational centres and community practice areas. Practitioners were often required to both supervise and assess students on practice placements, the length of these placements varying enormously. For those centres offering the mental health and learning disability branches of the Diploma in Higher Education in Nursing Studies (Project 2000), a significant proportion lacked teachers with specialist community qualifications. The investigation took place at a time of great upheaval, with 42% of centres reporting that they were in the process of amalgamation. The findings demonstrate thatcommunity nurses and midwives undoubtedly contribute to the education of nurse and midwife students and consequently have educational needs which must be addressed if they are to continue to supervise students.

Using Emotional Intelligence and NLP Training to Promote and Sustain Relationships within KTPs

The School of Nursing and Caring Sciences at the University of Central Lancashire (UCLan) currently has 3 KTPs at various stages – one is completing year 2 of a 3 year project, another is just starting and one has experienced a delayed start because of initial problems with recruitment of an Associate. Participation in health KTPs is a new endeavour for UCLan because it only became possible to develop projects when eligibility criteria changed 3 years ago. It is also new for our partners.

Evaluating a telehealth intervention for urinalysis monitoring in children with neurogenic bladder

Telehealth as a community-monitoring project within children’s urology care is an innovative development. There is limited evidence of the inclusion of staff and parents in the early-stage development and later adoption of telehealth initiatives within routine urological nursing care or families’ management of their child’s bladder. The aim was to explore the experiences of key stakeholders (parents, clinicians, and technical experts) of the proof of concept telehealth intervention in terms of remote community-based urinalysis monitoring by parents of their child’s urine. A concurrent mixed-methods research design used soft systems methodology tools to inform data collection and analysis following interviews, observation, and e-surveys with stakeholders. Findings showed that the parents adopted aspects of the telehealth intervention (urinalysis) but were less engaged with the voiding diary and weighing. The parents gained confidence in decision-making and identified that the intervention reduced delays in their child receiving appropriate treatment, decreased the time burden, and improved engagement with general practitioners. Managing the additional workload was a challenge for the clinical team. Parental empowerment and self-efficacy were clear outcomes from the intervention. Parents exercised their confidence and control and were selective about which aspects of the intervention they perceived as having credibility and which they valued.

Inaugural meeting a success for North of England Research Group

Karen Whittaker and Sue Peckover established the North of England Research Group to provide a forum for health visitor practitioners and academics in the region to discuss research interests. Its first meeting saw lively debate and sharing of ideas.