Michelle Pyer

Children, young people and ‘disability’: challenging children's geographies?

This editorial puts forward a selection of papers which were first presented at the 2007 Annual International Conference of the Royal Geographical Society (with the Institute of British Geographers), in a session entitled Children, young people and ‘disability’. The session drew together researchers from a range of disciplines – and with a variety of interests related to the lifeworlds of ‘disabled’ children and young people – to discuss research conducted in a range of diverse settings (including Canada, Botswana and the UK). The contributions here not only represent diversity in terms of the impairment or ‘disability’ explored, they are also cross-cut by differences in culture, focus and methodology. Essentially though, the core motivation of each of the authors represented is a collective recognition that greater attention should be paid to the geographies of children and young people who are effectively marginalised as a consequence of their ‘disability’ – even within sub-disciplinary contexts which are ostensibly committed to the inclusion of diverse younger people. In 1990, Sarah James, asked ‘is there a place for children in geography?’ (James 1990). This question was intended to draw attention to the systematic neglect of children and young people from geographical research and understandings. The proliferation of research into the lifeworlds of children and young people since 1990 has led to a realisation of the many and varied ways in which children and young people’s experiences both inform, and can be interpreted through, a geographical approach (Hopkins and Pain 2007). This collection of papers, we hope, begins to address this question in relation to the place(lessness) of disabled children in geographies with, for and of, children and childhood. As an increasing number of geographers have noted, the experiences of children and young people affected by disability have been underrepresented in the new social studies of childhood (Butler 1998, Skelton and Valentine 2003, Valentine and Skelton 2003, 2007, Holt 2004a, 2004b, 2007a, 2007b, Ryan 2005a, 2005b). The recent Children’s Geographies Vol. 8, No. 1, February 2010, 1–8

‘With us, we, like, physically can’t’: Transport, Mobility and the Leisure Experiences of Teenage Wheelchair Users

Abstract This paper reflects upon the experiences of 69 British teenage wheelchair users in their attempts to access leisure environments. Heiser’s (Heiser, B. 1995. “The Nature and Causes of Transport Disability in Britain, and How to Remove It.” In Removing Disability Barriers, edited by G. Zarb, 49–64. London: Policy Studies Institute) notion of transport disability is developed, and the concepts of transport anxiety and mobility dependency are explored. The challenges that young people in general experience when attempting to access public and private forms of transport (namely, buses, trains, taxis and private cars) are discussed, and the additional ‘layers’ of disadvantage experienced by teenage wheelchair users explored. The ramifications of barriers to transport for young wheelchair users in particular are shown.

Unintended Consequences? Exploring the un(fore)seen effects and outcomes of research

The aim of this article is to initiate discussion on the fluid boundaries of the process(es) of research. The starting point for the paper emerged during the data collection for a doctoral study, and in particular from a series of semi-structured interviews with teenagers who are wheelchair users.

The ‘other participant’ in the room: The effect of significant adults in research with children

This article discusses the practical implications and ethical dilemmas of ‘other’ adults being present in a research setting where the participant is a child. The article focuses on three key issues in relation to this theme. First, the range of ways that ‘other’ adults (for example, parents or guardians, teachers or youth workers) may become involved in the process of research is discussed. Second, the article considers how the presence of ‘other’ adults may raise ethical challenges, impact on the research process, and ultimately affect the data collected. Finally, suggestions are offered for the range of strategies open to researchers in negotiating the involvement of ‘other’ adults within a research context.

‘Going into the unknown’: Experiences of male patients in secure settings during environmental transition

Little is known about the experiences of male patients in secure mental health and intellectual disability units during environmental transition. We interviewed patients before (n = 9) and after (n = 8) a side-to-side security transition from medium-secure wards in an older building to new wards in a purpose-built building. We inquired about transitional experiences in general and about this transition specifically. We examined interview transcripts and field notes using thematic analysis, and collated routine outcome data to gauge whether transition had obvious positive or negative effects. Qualitative analysis indicated three major themes (information, transition, and behaviour) and five overlapping subthemes (positive information sharing and consultation, concerns and anxieties about lack of information, life change and opportunity, home and sense of belonging, and potential conflict). Outcome data indicated little obvious change between first and second interviews. Expressed concerns of patients about transition were largely about tangible and practical issues, including changes to rules, including smoking and prohibited items. The results highlight the need for the development of supportive patient-inclusion strategies, consistent and transparent communication processes, and a published timeframe during the planning and implementation phases of all types of transitional moves, including the side-to-side transfer of residents between accommodation buildings.

Enabling patients with respiratory symptoms to access chest X-rays on demand: the experience of the walk-in service in Corby, UK

BACKGROUND UK clinical guidance for lung cancer (NICE 141) includes pathways for chest X-rays (CXRs). Many patients fulfilling the criteria do not receive one, either because they do not consult their doctor or because their doctor does not refer them. The town of Corby, UK, has particularly high incidence and mortality rates for lung cancer and was chosen as a pilot site for a new, patient-requested X-ray service. METHODS The number of community-initiated CXRs were compared before and after the introduction of the service and between similar geographical areas. Clinical data and patient questionnaires were analysed for those attending the service. RESULTS There was a 63% increase in the total number of community-initiated CXRs in Corby for the year following the introduction of the service, compared with the year before. This was statistically greater than in surrounding geographical areas. Corby General Practitioners also requested 47% more CXRs than in the previous year. CONCLUSIONS The implementation of the service was associated with a significant increase in the numbers of clinically indicated CXRs in an area of high lung cancer incidence and mortality. The service attracted a clinically appropriate population. The numbers of cancers detected were in line with statistical expectations.

“Am I a student or a Healthcare Assistant?” A qualitative evaluation of a programme of prenursing care experience

AIM To examine the experiences of prenursing healthcare assistants (HCA) during a 6-month programme of prenursing care experience. BACKGROUND Care experience prior to commencing programmes of nurse education is broadly considered to be advantageous. However, it is not clear how formal care experience prior to nurse education has an impact on the values and behaviours of the aspirant nurse. DESIGN A longitudinal prospective qualitative study using focus group discussions. METHODS Data were collected from 23 prenursing HCA during September 2013-February 2014. Three focus groups were held at the beginning, middle, and end of the programme of care experience at each of the participating hospitals. A thematic analysis was used to analyse data sets from each hospital. Findings from each hospital were then compared to reach final themes. RESULTS Five major themes were identified in the analysis of qualitative data: personal development; positioning of role in the healthcare team; support and supervision; perceived benefits; and advice and recommendations. These themes were underpinned by deep aspirations for better care and better nurses in the future. CONCLUSIONS Prenursing care experience can positively prepare aspirant nurses for programmes of nurse education. The benefits identified were confirmation of aspiration (or otherwise) to pursue nursing, learning opportunities, and aspiration to improve patient experience. Risks for the programme included poor supervision, role ambiguity or confusion, demotivation through a deteriorating view of nursing, and poor treatment by others. The longer term impact on values and behaviours of this cohort requires further evaluation.

Carer-centred care: general practice support to family caregivers

Rationale, aims and objectives In February 2009 the UK’s Department of Health invited bids for funding to host demonstrator sites in order to test new approaches to working with and for carers within the national Carers’ Strategy [1; 2]. This paper discusses some of the findings of the local level evaluation of one of the host sites, situated in Northamptonshire. Methods A mixed-method approach was used to gather data from a range of participant groups. This paper presents the findings of two of those methods; a postal survey of carers and an audit of support offered by general practices. Results The findings of the evaluation show a considerable improvement in the extent to which carers’ roles were identified by their surgeries, however there is a need to ensure that this information is recorded and used in ways which benefit carers. Carers noted challenges in dealing with practice staff, particularly administrative staff who were not aware of their needs. Practices noted a range of services which were offered to carers, however carers were not always aware that these were available, suggesting that further publication of these opportunities is needed. Conclusions The paper argues the importance of the role undertaken by carers, and signals the range of ways in which General Practice can support or inhibit these activities.