Paula Nicolson

It's just the worry about not being able to control it! A qualitative study of living with overactive bladder.

OBJECTIVES This study reports the perceptions of patients with a diagnosis of OAB and people with undiagnosed OAB symptoms about their health-related quality of life (HRQL) and psychological consequences. DESIGN A qualitative study which employed a series of in-depth, semi-structured individual and group interviews using thematic and interpretive techniques of data analysis. METHODS A mixture of previously diagnosed patients and people bothered by OAB symptoms were recruited from three British cities. The interviews explored issues around HRQL. Data were transcribed verbatim and analysed thematically to draw out the context in which people experience OAB. The study design was reviewed by a Multi-Centre Research Ethics Committee and subjected to local research governance. RESULTS OAB has devastating consequences for sufferers of both sexes which impact upon their HRQL, self-esteem and relationships. OAB without incontinence causes anxiety, fear of incontinence, a sense of depression and hopelessness all of which are worse for those with incontinence. Many sufferers feel too embarrassed to seek medical care. CONCLUSIONS The psychological and HRQL consequences for OAB sufferers overlap with trajectories associated with chronic illness. However, because many sufferers avoid admitting to the condition and/or seeking treatment the psychological costs to them are even greater than with a diagnosed illness because the disruption remains unacknowledged and therefore unresolved.

‘I don't think it was such an issue back then’: changing experiences of pregnancy across two generations of women in south-east England

Based upon in-depth interviews with recent mothers and their own mothers in London, England, this article uses a cross-generational perspective to examine the changing experiences/perceptions of pregnancy over the late twentieth and early twenty-first century. Pregnancy is a biological process, but exists within social, economic, political and cultural realms and is both spatially and temporally located. In this article we argue that advances in gender equality, maternity benefits, technological innovation and mass media have meant that pregnancy is now increasingly experienced in the ‘public’ sphere, whereas, in earlier twentieth century Britain at least, it was often relegated to the realm of private or domestic life. However with these changes have come new types of surveillance in the form of scientific ‘advice’, medical technologies and media dissemination of cultural ‘norms’ regarding appropriate dress, lifestyle and behaviour during pregnancy. Based upon the findings of our research we examine these changes from two different perspectives: firstly a Foucauldian notion of surveillance in relation to ‘medical’ advice on diet/lifestyle during pregnancy, and secondly new expectations regarding body image and clothing in the context of the emergence of ‘pregnancy chic’ and the figure of the ‘celebrity mum’.

Constructions of Pregnant and Postnatal Embodiment across Three Generations: Mothers', Daughters' and Others' Experiences of the Transition to Motherhood

The academic study of the ‘body’ has come to occupy the foreground over the past two decades and the differential influences of physical and social worlds particularly upon body management practices have become fundamental to the 21st-century ‘project’ of the body. In this article we explore three generations of women’s accounts of living in/with a pregnant and postnatal body which is now both visible and ‘public’ as women ‘leave’ the home for work. However this now takes place in the context of public surveillance (and self-surveillance) particularly about food/eating, ‘health’ and ‘beauty’.

Pregnancy Police? Maternal Bodies, Surveillance and Food

Drawing upon accounts of recent mothers and their own mothers in south-east England this chapter examines the ways in which experiences of pregnancy and early motherhood have changed over the past 40 years. Pregnancy is a biological process but exists within social, economic, political and cultural realms and is both spatially and temporally located (Longhurst 1999: 89) with individual women in different times and places experiencing pregnancy in a variety of different ways. In this chapter we take food as a lens to explore these changes by examining advice to mothers in relation to feeding the pregnant and infant body across recent generations. While it is clear that research evidence has identified the effects of food and drink on the pregnant and post-natal body leading to burgeoning new information and advice, women themselves have been peripheral to the evidence gathering.

Contemporary women's understandings of female sexuality: findings from an in-depth interview study

Based upon the findings of a qualitative in-depth interview study with 23 women aged 23–72 years recruited from members of the general public and a psychosexual clinic, this paper explores participants understandings of the term “sexuality”. The findings are set within the context of historical, prevailing and often contradictory perceptions of the term. Data were analysed thematically using the conventions of template analysis within a material discursive framework. This paper questions the assumption that sexuality is an altogether powerful and naturally occurring phenomenon. The ability to isolate and give credence to a definitive meaning of the term is, both for participants and academics alike, an arduous undertaking. Rather than focusing primarily on the material body, the extent to which ideology, culture and power intersect with the former indicate its multidimensional, constructed nature. Given the whole host of meanings evoked by the term, the paper asserts that it is more fitting to talk of multiple understandings of sexuality rather than a singular authoritative one whilst also contingent on social and historical practices. The findings have implications that should be considered when evaluating previous sexological research and conducting future research where this term is used throughout as a focus of academic enquiry.

Research Ethics in Accessing Hospital Staff and Securing Informed Consent

Qualitative researchers cannot rely on research ethics to be a static practice. In this article we discuss how observation of guidelines for inquiry and international agreements on the dignity of health care research are not sufficient on their own to ensure that the challenges inherent in the everyday management of a project are regulated. We focus in particular on ethics in accessing participants and the construction of informed consent. During our study, important contrasts emerged between the ideal presented for the standard ethics review process and practical ethics. As a result, we focused on building open communication with the participants through rigorous project management. We analyzed the data and wrote this article collaboratively to represent the empirical reality of a team of researchers aiming to take ethical challenges seriously while collecting data in three National Health Service Trusts in the United Kingdom.

How do social workers understand and respond to domestic violence and relate this to organizational policy and practice

This study explores British social workers’ abilities to recognize incidents of interpersonal violence, how much domestic violence training social workers typically receive, and how awareness of organizational policies and practice experiences impact workers’ attitudes about domestic violence. Based on our findings we suggest that traditional higher education teaching methods of lecture and seminar combined with a service-learning component to course work should be explored. Additionally, local authorities and other health and social care agencies need to take more responsibility for ensuring their employees understand agency policy regarding domestic violence and how to apply it.

The next generation of pregnant women: more freedom in the public sphere or just an illusion?

This article argues that, withstanding the liberating effects of the womens movement, the contraceptive revolution, the equal opportunities revolution, and the increase in equal access to information – which have all helped to increase womens mobility within society – is a serendipitous form of societal policing of womens actions that may be linked to ongoing patriarchal views. We attempt to explain our analysis by reviewing historical developments, such as womens movement from the private domain of domestic life to the more public domain of work as well as the many changes in the forms of mass media since the 1950s, and by presenting findings from research across generations of pregnant women who shared with us their experiences of being pregnant.

Oedipus at work: A family affair?

The ‘family’, and the Oedipus complex in particular, is alive and kicking, not only as a means and/or metaphor for explaining family relationships and dynamics, but also as a diagnostic lens for consulting beyond the family, to individuals, groups and organisations and as a means of considering defences against anxiety and gender relations. This paper examines the emotional ‘fallout’ within two organisational case studies: (a) a group relations exercise for planning an event by clinical psychology trainees and (b) consulting to a group of social work managers whose responsibility is to protect vulnerable children. The paper juxtaposes observations from these case studies with classical Freudian analysis of group behaviours and Kleinian/post-Kleinian perspectives on defending against anxiety in organisations. It suggests a reiteration of the power of both Freudian and Kleinian perspectives on the primal scene as a problem-solving focus for organisational consultancy.

Forming Impressions of People

This chapter is concerned with the way people form impressions of other people and make judgements of them, and in particular how such judgements might become more accurate. This is important for social workers and other professionals, but also for people generally, for example in choosing who to work and live with! We discuss the selective and creative nature of perception; accuracy in judging emotion and personality; nonverbal communication and how best to interpret it; and some of the influences on our liking some people more than others.