Kay Caldwell

‘Individualism-Collectivism’ as an Explanatory Device for Mental Illness Stigma

The aim of this study is investigate whether the cross-cultural value paradigm ‘individualism-collectivism’ is a useful explanatory model for mental illness stigma on a cultural level. Using snowball sampling, a quantitative questionnaire survey of 305 individuals from four UK-based cultural groups (white-English, American, Greek/Greek Cypriot, and Chinese) was carried out. The questionnaire included the ‘Community Attitudes to Mental Illness scale’ and the ‘vertical-horizontal individualism-collectivism scale’. The results revealed that the more stigmatizing a culture’s mental illness attitudes are, the more likely collectivism effectively explains these attitudes. In contrast, the more positive a culture’s mental illness attitudes, the more likely individualism effectively explains attitudes. We conclude that a consideration of the individualism-collectivism paradigm should be included in any future research aiming to provide a holistic understanding of the causes of mental illness stigma, particularly when the cultures stigmatization levels are particularly high or low.

Psychological distress of cancer and clinical trial participation: a review of the literature.

The House of Commons Select Committee on Science and Technology 2000 state that currently less than 5% of adult patients with solid tumours are entered into clinical trials. They recommend that increasing the number of adult cancer patients entering clinical trials must become a high priority. Health-care providers need to prepare themselves for this proposed increase in trial participants by assessing the current status of care and implementing changes within the current infrastructure to provide optimal holistic care. Cancer can change a patient’s life either for better or for worse. At one extreme, having cancer leads to enhanced appreciation of life and closer bonds with others. However, at the other extreme, cancer combined with its treatment is viewed as an event that evokes distress and emotional anguish taxing the individual’s ability to cope. In the last 25 years, owing to the advent of clinical trials, progress has been made in cancer treatment. Clinical trials may be hailed as the saviour to many therapeutic dilemmas. Treatments are now available which can offer patients hope of cure. Nevertheless, many participants may fear, for the purpose of research, that they may be assigned to less than optimal therapy or that their care will be carried out in a sterile scientific atmosphere devoid of humane and personal consideration. These and other reasons may cause unacceptable personal distress that overrides the potential therapeutic gain. Cancer diagnosis coupled with the ramifications of clinical trial involvement can have significant psychological implications. They may trigger the onset of a mood disorder or exacerbate a present symptom. This article will identify mood disorders in the cancer population, focus on the participants’ needs in the clinical trial arena and investigate the influence trial participation has on psychological status.

Ideologicalinfluences on curriculum development in nurse education

The development of curricula in nurse education cannot be viewed in isolation from the socio-political context within which it exists. Changes in the prevailing political ideology have impacted on the social life of individuals, and the reflection of this can be traced in the curricula of nursing courses over time. To ensure that courses meet the needs of both students and society, it is important for teachers to recognize the influence of the context within which such development takes place, and to understand the ideological underpinning of that which is being both taught and learnt. It is only with adequate understanding that challenges can be presented and change promoted when necessary.

Profiting from Consensus Methods in Occupational Therapy: Using a Delphi Study to Achieve Consensus on Multiprofessional Discharge Planning

In occupational therapy, there is much debate regarding many aspects of practice. In order to make effective decisions in situations where there is contradictory or insufficient information, it is important to reach a consensus decision. The Delphi technique is a survey method of research, which aims to gain consensus among a panel of experts using repeated rounds of a questionnaire. This article is based on the first authors experience of using a Delphi survey as part of an action research project, located in a large acute National Health Service trust. This project aimed to analyse and improve multidisciplinary teamwork in discharge planning. The aim of the article is to focus on the Delphi technique as a methodological approach and, to illustrate this, examples are used from the research study. However, before using the Delphi technique, occupational therapists must understand the strengths and weaknesses of this approach.

Climate change impact: the experience of the coastal areas of Bangladesh affected by cyclones Sidr and Aila

Bangladesh is considered one of the countries most at risk to the effects of climate change and its coastal area is most vulnerable. This study tries to explore the experiences of cyclones Sidr and Aila affected people living in the coastal areas of Bangladesh. This study was conducted in the cyclone Sidr affected Amtali Upazila of Barguna District and in the cyclone Aila affected Koyra Upazila of Khulna District. Primary data collection was done using Focus Group Interview and then a thematic analysis approach was used for analysis. Three core themes emerged from the analysis and they are, firstly, impacts of climate change on the socioeconomic condition of the people, secondly, the impact on the health status of the population, and finally the impact on vulnerable people. Findings show that the effects of climate change have serious consequences on the livelihood patterns of the affected population and on their overall health status. As a result, the unfavorable health condition of these affected people makes them more vulnerable to various emerging diseases.

The positive impact of portfolios on health care assistants’ clinical practice

© 2008 The Authors. Journal compilation

A cross-sectional postal survey of musculoskeletal physiotherapists’ current practice of cervical pain assessment in relation to vertebrobasilar artery insufficiency, attitudes toward guidelines, and manual therapy practice

Abstract Purpose To survey the current practice of cervical spine pain assessment in relation to vertebrobasilar artery insufficiency (VBI), attitudes toward guidelines, and the practice of achieving informed consent in advance of planned orthopaedic manual therapy interventions. Method A self-administered postal survey was validated and sent to 325 physiotherapists working in the National Health Service (NHS) and private musculoskeletal practices in the Dorset and Hampshire region. Results The response rate was 53% from NHS physiotherapists and 20% from private practice, overall 34% (n = 111). Compliance rates with published guidelines were 50.4%; the sample holds them in neutral opinion (51.4%), and also holds cervical manipulation in neutral opinion (n = 50; 45.5%). Of these, 30.4% of respondents use cervical manipulation; a practice more closely associated with male practitioners (Φ = 0.35 P < 0.001), most use non-manipulative techniques such as manual traction (86.3%) or mobilizations (96.1%) with exercise (99%) as these are believed to be just as effective. Conclusions Physiotherapists in this sample do not appear to be adopting the VBI guidelines out of confidence or acknowledgment of their validity, but as a means to satisfy legality (76%) and enjoy that security (57.7%). Cervical spine assessment by a physiotherapist may be reliant on detailed subjective assessment that lacks objective testing, which could limit the scope of clinical reasoning between diagnoses of vascular (VBI, arterial dissection) and vestibular sources of symptoms. Those physiotherapists who had not attended postgraduate cervical manual therapy courses were associated with not practicing in agreement with the published evidence base; this finding lends support to the argument for a formal restriction of cervical manipulation by physiotherapists until a minimal requirement of postgraduate training is completed.

A survey to explore the current use of injection therapy as part of a conservative treatment plan for degenerative meniscal lesions within UK based, injection trained physiotherapy members of the society of musculoskeletal medicine

Objectives: To explore the current use of injection therapy as part of a conservative treatment plan for degenerative meniscal lesions (DML) within UK based physiotherapy members of the Society of Musculoskeletal Medicine (SOMM) with injection training. Methods: An online survey was distributed via email to all UK based, SOMM physiotherapists who had trained and received their injection diploma through the SOMM (n = 203) with a response rate of 32% (n = 64). The data were analysed using descriptive statistics, contingency tables and the Fishers exact test. A P value ≤0.05 was considered significant. Ethical clearance was gained through the SOMM and Middlesex University. Results: Of the respondents 98% (n = 62) of current UK based, injection trained SOMM physiotherapists utilize conservative treatment for DML of which 81% (n = 52) include injection therapy. Seventy-seven per cent (n = 49) who currently use injection therapy for DML administer a combination of 40 mg Depomedrone combined with local anaesthetic via a patellofemoral approach. Those not using injection therapy as part of their management of DML attributed this to local department restrictions and lack of evidence. Discussion: This research has helped further understand the use of injection therapy for DML and where it fits within a conservative treatment plan. The benefit from injection therapy reported by respondents is similar to previous research but could be influenced by injection exposure and potentially steroid choice. Overall a consensus is starting to appear regarding dosage, steroid, and administration; however, differences arise when comparing individual department guidelines to CSP and NICE guidelines.

An Investigation into the Impact of Religion on Health among Iranian Community Residents in the UK

The primary aim of this study is to explore the interrelationships between health, health beliefs and religious beliefs within the Iranian community resident in the UK. The theoretical framework used for this study draws on the work of the existentialists who describe human existence in terms of four dimensions — the physical world, the social world, the public world and the spiritual world. A purposive convenience sample was selected, by nominated and network qualitative sampling techniques, representing the main Iranian religious groups. A qualitative, phenomenological approach to data collection was employed, semi-structured focus group interviews being conducted with four groups, each representing one of the main religious groups within the Iranian community. All interviews were audio-recorded and transcribed, and content analysis was carried out utilising Huberman’s systematic approach as a framework. Five major themes emerged from the analysis of the focus group interviews. First was the process by which a system of values was constructed. Second was the issue of the continuum of cultural integration/isolation. Third was the level at which social cohesion or division was experienced. Fourth was the concept of spirituality as a coping strategy and fifth was the ebb and flow of religious influence over the lifespan. Consideration was given to these themes, and the ways in which they interrelated and overlapped. This led to the conclusion that cultural and religious identity were experienced and perceived differently, but recognised to be interrelated. Spirituality appeared to be more strongly related to health, in its broadest sense, than did religiosity, and well-being and health were viewed as being inextricably linked. The relevance of this study to health care practice is evident. Consideration of the spiritual dimenszon of care must extend beyond attention to religious practices, and the potential exists for the coping strategies related to spirituality to be developed as an aid to therapeutic intervention.