Matthew Callender

Exploring the decision to participate in the National Health Service Bowel Cancer Screening Programme

Cancer is a leading cause of mortality and one of the most feared diseases in modern society. A combination of early detection, accurate diagnosis and effective treatment provides the best defence against cancer morbidity; therefore, promoting cancer awareness and encouraging cancer screening is a priority in any comprehensive cancer control policy. Colorectal cancer is the third most common form of cancer in the UK and in an effort to reduce the high incidence, prevalence, morbidity and mortality rates, the National Health Service (NHS) has introduced the NHS Bowel Cancer Screening Programme (NHS BCSP). For the NHS BCSP to succeed in its goal of reducing the incidence and prevalence rates for colorectal cancer, individuals need to be persuaded to complete the test. Since it was first introduced in 2007, however, participation rates have been low. In an effort to understand why participation rates remain low, this article reports on the findings of a series of focus groups conducted in the East Midlands of England. These focus groups were designed to explore the factors that influence an individual’s decision to participate in cancer screening. The findings revealed eight factors that affected participation in the NHS BCSP: (i) the association of screening with entry into old age; (ii) prior experience with health systems; (iii) the support of a significant other; (iv) individual perceptions of risk (and benefit); (v) fear of becoming a cancer patient after the screening test; (vi) lack of disease symptoms; (vii) embarrassment associated with completing the test and (viii) messages that adopt a paternalistic ethos. Overall, our results suggest that more people may participate in the screening programme if it was more sensitive to these psychosocial and contextual factors that shape an individual’s decision to be tested.

Implementing the National Service Framework for Long-Term (Neurological) Conditions: service user and service provider experiences.

Abstract Purpose: This research explored the experiences of service users and providers during the implementation of the National Service Framework (NSF) for Long-Term (Neurological) Conditions (LTNCs). Method: A participatory qualitative research design was employed. Data were collected using 50 semi-structured interviews with service users, 25 of whom were re-interviewed on three occasions. Forty-five semi-structured interviews were also conducted with service providers who worked with individuals with LTNCs. Interviews focused on health, well-being and quality of life in relation to service provision, access and delivery. Data were thematically analysed individually and collaboratively during two data analysis workshops. Results: Three major themes were identified that related to the implementation of the NSF: “Diagnosis and treatment”, “Better connected services” and “On-going rehabilitation”. Service users reported that effective care was provided when in hospital settings but such treatments often terminated on return to their communities despite on-going need. In hospital and community settings, service providers indicated that they lacked the support and resources to provide continuous care, with patients reaching a crisis point before referral to specialist care. Conclusion: This research highlighted a range of issues concerning the recent UK-drive towards patient-centred approaches within healthcare, as service users were disempowered within the LTNC care pathway. Moreover, service providers indicated that resource constraints limited their ability to provide long-term, intensive and integrated service provision. Implications for Rehabilitation Our research suggests that many service users with long-term neurological conditions experienced disconnections between services within their National Service Framework care pathway. For health and social care practitioners, a lack of continuity within a care pathway was suggested to be most pertinent following immediate care and moving to rehabilitative care. Our findings also indicate that service providers lack the necessary financial resources and staffing capacity to provide on-going and comprehensive rehabilitation. This article aims to help practitioners better understand particular issues during the implementation of the National Service Framework for long-term neurological conditions from the perspectives of service users and service providers.

Exploring traditional end-of-life beliefs, values, expectations, and practices among Chinese women living in England: Informing culturally safe care.

OBJECTIVE This study explores the end-of-life (EoL) beliefs, values, practices, and expectations of a select group of harder-to-reach Chinese women living in England. METHOD A cultural safety approach was undertaken to interpret 11 in-depth, semistructured interviews. Interviews were conducted in Mandarin and Cantonese. Transcripts were translated and back-translated by two researchers. Findings were analyzed using the technical analytical principles of grounded theory. RESULTS The key themes generated from our analysis include: acculturation; differential beliefs and norms in providing care: family versus health services; language and communication; Eastern versus Western spiritual practices and beliefs; and dying, death, and the hereafter. SIGNIFICANCE OF RESULTS End-of-life discussions can be part of an arduous, painful, and uncomfortable process, particularly for migrants living on the margins of society in a new cultural setting. For some Chinese people living in the United Kingdom, end-of-life care requires attention to acculturation, particularly Western versus Eastern beliefs on religion, spirituality, burial practices, and provision of care, and the availability of culturally specific care, all of which encompass issues related to gender. Stories of a purposive sample of Chinese women were viewed through a cultural safety lens to gain a deeper understanding of how social and cultural norms and expectations, in addition to the pressures of acculturation, impact gendered roles and responsibilities. The analysis revealed variations between/within Eastern and Western culture that resulted in pronounced, and oftentimes gendered, differences in EoL care expectations.

Exploring the police support volunteer experience: findings from a national survey

ABSTRACT There are an estimated 8000 Police Support Volunteers (PSVs) in England and Wales, contributing around 650,000 hours each year to an expanding variety of tasks to support their local constabularies. Despite this, the evidence base around the experiences of being a PSV is remarkably limited. Drawing on findings from the first national survey of police volunteers in England and Wales, undertaken in the early 2016 with just over 1000 PSV responses, this article explores key factors that are associated with the overall experience of being a PSV pointing towards the significance of management, support, supervision, connection, contribution and development on volunteer morale. The article sets these findings within the strategic context of future developments for PSVs, considers practical actions for improving volunteer experience, and highlights the importance of further research into being a volunteer in policing.

Financial incentives reduce smoking and improve wellbeing in pregnant women.

Limited data is available on the effectiveness of financial rewards to aid smoking cessation and abstinence in women who are pregnant. In the UK a key milestone is achieving abstinence at four weeks following an initial meeting with midwife and support from stop smoking services. The aim of this study was to evaluate the effects of a generous scheme which provides incentives in a staged schedule, amounting to a total reward of £145 for setting a quit date and staying abstinent for 4 weeks. This pilot feasibility study recruited successfully to target (n = 50 women), focusing on those from disadvantaged backgrounds.

Understanding dementia within national dementia policy in England: a critical discourse analysis

Dementia is recognised as a public health priority globally. There are around 800,000 people with dementia in the UK and by 2040; this figure is expected to double. Since the publication of the ‘Living Well with Dementia’: A National Dementia Strategy’ in 2009 in England, a series of dementia policies have been established to improve the lives of people with dementia through increased societal awareness of dementia, earlier diagnosis and a cultural change in health and social care. This research aimed to identify dominant discourses underpinning national policy and consider their implications on the development of health and social care training.