• Delivering informed measures of patient centred care in medical imaging: What is the international perspective?

      Hyde, Emma; Hardy, Maryann; University of Derby (Elsevier BV, 2021-06-25)
      Focus on patient experience and patient centred approaches within healthcare has substantially increased since the Picker Institute (a not for profit organisation) was established in the 1980’s (Picker Institute, 2021). Picker’s founding principles have been adapted from their original form, to keep pace with changes in health and social care, but remain the cornerstone of research and guidance on person-centred approaches. Organisations such as the National Health Service (NHS) in the UK, the Australian Commission on Safety and Quality in Health Care, and the Canadian Patient Safety Institute, have developed their own guiding principles for patient centred care, reflecting the nature of the health care systems in their respective countries. In the UK professional, statutory and regulatory bodies governing health care professionals, such as the Health & Care Professions Council (HCPC) and College of Radiographers, have also incorporated patient centred approaches and care into their Standards of Proficiency for registrants (HCPC, 2013; CoR, 2018). As guidance and regulation linked to patient care and patient experience has become more widespread, interest in research into patient centred care and approaches has developed. Publications sharing the findings of research projects carried out to investigate patient experience during medical imaging examinations and radiation therapy have also increased. In our research we have sought to define informed measures of patient centred care for medical imaging technologists, and to date have reported the findings from our UK based participant’s (Hyde & Hardy, 2020; Hyde & Hardy, 2021a; Hyde & Hardy, 2021b; Hyde & Hardy 2021c). In this commentary we would like to open up debate about the similarities and differences between UK and international views about patient centred care in medical imaging, and invite expressions of interest from potential collaborators.
    • Delivering patient centred care (Part 2): a qualitative study of the perceptions of service users and deliverers.

      Hyde, Emma; Hardy, Maryann; University of Derby; University of Bradford (Elsevier, 2020-10-07)
      There is growing awareness of the importance of patient centred care (PCC) in health care. Within Radiography in the UK, elements of PCC are embedded within professional body publications and guidance documents, but there is limited research evidence exploring whether perceptions of PCC are equivalent between those delivering (radiographers) and those experiencing (patient) care. This study aimed to address this gap by determining compatibility in perceptions of PCC between those using and those delivering radiography services in order to develop measurable indicators of PCC. This project was funded by the College of Radiographers Industry Partnership Scheme. Ethical approval was granted by the University of Derby College of Health & Social Care Ethics committee. This paper reports Stage 2 of the project, which was a series of focus groups and telephone interviews to enable deeper discussion and exploration of PCC. Situational vignettes were used to promote discussion and debate and encourage suggestions for PCC approaches. Audit tools to assess engagement with PCC were developed at individual and organisational level. Four focus groups and six telephone interviews were carried out in total. Focus groups were held in a variety of locations to promote attendance. Telephone interviews were used to capture participants who could not attend a focus group in person. Disparity between perceptions of service users and those delivering radiography services on what constitutes high quality PCC was evident. Perceived levels of care and the effectiveness of communication appeared to be the key influences on whether PCC was delivered. It is evident from the results of Stage 1 and Stage 2 that we have some way to go before we have parity in how care within diagnostic radiography is perceived, experienced and delivered. Audit tools and an educational toolkit are offered as ways to support increased PCC within diagnostic radiography practice. Several service improvements and audit tools are offered to support the increased delivery of PCC.
    • Developing a whole-school mental health and wellbeing intervention through pragmatic formative process evaluation: A case-study of innovative local practice within the School Health Research Network

      Gobat, Nina; Littlecot, Hannah; Williams, Andy; McEwan, Kirsten; Stanton, Helen; Robling, Michael; Rollnick, Stephen; Murphy, Simon; Evans, Rhiannon; University of Oxford; et al. (BMC, 2021-01-18)
      The evidence-base for whole school approaches aimed at improving student mental health and wellbeing remains limited. This may be due to a focus on developing and evaluating de-novo, research led interventions, while neglecting the potential of local, contextually-relevant innovation that has demonstrated acceptability and feasibility. This study reports a novel approach to modelling and refining the theory of a whole-school restorative approach, alongside plans to scale up through a national educational infrastructure in order to support robust scientific evaluation. A pragmatic formative process evaluation was conducted of a routinized whole-school restorative approach aimed at improving student mental health and wellbeing in Wales. The study reports seven phases of the pragmatic formative process evaluation that may be undertaken in the development and evaluation of interventions already in routine practice: 1) identification of innovative local practice; 2) scoping review of evidence-base to identify existing intervention programme theory; outcomes; and contextual characteristics that influence programme theory and implementation; 3) establishment of a Transdisciplinary Action Research (TDAR) group; 4) co-production of an initial intervention logic model with stakeholders; 5) confirmation of logic model with stakeholders; 6) planning for intervention refinement; and 7) planning for feasibility and outcome evaluation. The phases of this model may be iterative and not necessarily sequential. Formative, pragmatic process evaluations support researchers, policy-makers and practitioners in developing a robust scientific evidence-base for acceptable and feasible local innovation that does not have a clear evidence base. The case of a whole-school restorative approach provides a case example of how such an evaluation may be undertaken.
    • Does recovery in mental health need professionals?

      Carter, Sarah; University of Derby (Sage, 2017-08-01)
      The aim of this work is to explore the role of the occupational therapist within recovery-orientated mental health services and how it fits with the notion of giving the service user control. The concept of recovery is now stated within much health and social care policy, legislation and guidelines across the UK, and it is an approach that is widely implemented by occupational therapists in mental health services. However, the recovery paradigm poses complex and multifaceted challenges to mental health professionals and there is growing concern over the ability to overcome the inherent barriers present in today's health and social care structure and culture (Slade et al., 2014). This literature review explores these barriers in relation to the professional concept and power theory using a critical realist approach (Edgley et al., 2016). The findings reveal there is an issue of power that undermines recovery implementation by occupational therapists within mental health services. The review concludes that the recovery paradigm needs to shift its focus off service provision and onto influencing societal change by using the power already available to it in the form of community. This calls for action from occupational therapists to unite with service users and other professionals to come together in community to fight for their right to occupational recovery at a societal level rather than focusing on service level implementation.
    • Drama Education and Dramatherapy - Exploring the Space Between Disciplines

      Holmwood, Clive; University of Warwick (Routledge, 2016-04)
      Dramatherapy is a relatively new field which has its routes within special education and is increasingly used in schools and educational establishments as a way of supporting young people’s emotional needs. This book examines the space between drama education and dramatherapy, examining the historical roots of drama education and dramatherapy, discussing how they are intrinsically linked, and exploring the social, political, therapeutic and artistic influences that have influenced these two professions over the last century.
    • Dramatherapy & theatre : current interdisciplinary discourses

      Holmwood, Clive; Sue Jennings (Routledge, 2016-04)
      This chapter seeks to update current thinking around the interdisciplinary connections between dramatherapy and theatre, by re-examining some of the great theatrical innovators and looking at current literature that connects theatrical approaches to dramatherapy.
    • Dramatherapy Tai Chi & Embodiment

      Holmwood, Clive; University of Derby (Quotus Publishing, 2015-12)
      This paper will consider potential theoretical, philosophical and pragmatic connections between Dramatherapy (Jones: 1996) and Tai Chi (Pang Jeng & Inn: 1985); I will specifically consider these connections from the Western perspective of embodiment (Shaw: 2003, Jones: 1996). Dramatherapy is a creative drama based psychological therapy. Tai Chi is an ancient form of martial art. Both approaches use movement and from a Western perspective that ‘embodiment’ could be central to both disciplines. I am interested in how embodiment through movement is a potential connection between these two seemingly very different disciplines, and how these may offer shared knowledge. I will acknowledge that the two disciplines come from very different backgrounds and philosophies and recognise that it is impossible not to generalise in a short article such as this. The aim is to compare and contrast these two disciplines based on my empirical experience of them. As a European trained Dramatherapist I approach this paper from a Western perspective, acknowledging the differing opinions and viewpoints between Eastern and Western philosophies and practice. The aim is to begin to consider some synthesis between a Western creative based therapy and an Eastern form of martial art; acknowledging that both use movement at their core.
    • Easing the transition from classroom to clinical placement

      Hyde, Emma; University of Derby (European First Year Experience conference, 2014-06-11)
      The findings of my research around the transition first year student radiographers undergo when they start their first clinical placement.
    • Easing the transition: the importance of high quality mentorship in placement support

      Hyde, Emma; University of Derby (UK Radiological Congress 2016, 2016-06-06)
      Poster presented at UKRC sharing the findings of my latest research on first year student Radiographers transition to their first clinical placement. As in my previous research, the difference made by high quality mentorship, was found to be key to student's successful transition.
    • The effectiveness of intrapartum ultrasonography in assessing cervical dilatation, head station and position: A systematic review and meta-analysis

      Wiafe, Yaw Amo; Whitehead, Bill; Venables, Heather; Nakua, Emmanuel Kweku; University of Derby (2016-10-06)
    • Enabling occupation at the end of life: A literature review

      Mills, Katherine; Payne, Angela; University of Derby (Cambridge University Press, 2015-06-15)
      Objective: Occupation, or meaningful activity, can contribute to the well-being and quality of life of all individuals. It is thus a logical tautology that occupation should be enabled for those at the end of life. Our present review examines current provision of these processes by Occupational Therapist, who can be much-valued members of multidisciplinary palliative care teams. Method: Following a literature search and critical selection, 10 global papers were identified examining occupation and occupational therapy at the end of life in the acute, hospice, and community environments. Results: Universally, there appeared to be a dearth of therapists working in end-of-life care. Provision of palliative care in hospitals was found to be compensatory or rehabilitative. Hospice therapy emerged as pleasingly occupational, though the number of hospice places was disappointingly few. Community literature was sparse, so it proved challenging to draw definitive conclusions. Promising research refracted light on occupation at home; however, it also revealed stretched domiciliary services, where clients are not well informed about the potential scope of occupational therapy. Significance of Results: A “good death” involving a quality end-of-life experience is the foundational goal overarching all therapy and medicine in the provision of palliative care. Arguably, an occupation-focused approach provided by therapists meets client needs to enable meaningful experiences in the limited time left to them. Current occupational therapy practice environments are not necessarily achieving these goals in commensurate fashion. There is a need to promote the role of occupational therapy and circumscribe what therapists can offer. Further research is necessitated across all environments and future funding for therapist positions in palliative teams. End-of-life care can be complex and challenging; however, therapists can facilitate fulfillment of client-centered occupational goals. In engaging with personally constructed nuances of meaning, quality of life can be improved in those deserving of a significant and emotionally rich daily existence during their final days.
    • Engaging the hard to engage: What contribution can occupational therapy make to an interdisciplinary approach?

      Newberry, Karen; Terrington, Claire; University of Derby; Birmingham and Solihull Mental Health Foundation Trust (Mark Allen Group, 2017-08)
    • Evaluating Unity created teaching simulations within occupational therapy

      Sutton, Greg; Newberry, Karen; Threapleton, Kate; University of Derby; University of Nottingham (Emerald, 2016)
      Purpose – The purpose of this paper is to describe the evaluation of an educational occupational therapy home visit simulation newly built in Unity, compared with a previously created simulation based in the Open Sim platform. The evaluation is based on students’ preferences. Design/methodology/approach – A simulation was built in Unity in which the academic content was identical to the previous Open Sim-based simulation. Student groups used the simulations then completed a questionnaire. Numerical data and descriptive comments were analysed. Findings – Students preferred the simulation built in Unity to the Open Sim simulation. Improvements with the Unity simulation include; reduced time to gain competence to use, ease of use and fewer negative physiological experiences. The small percentage of students experiencing motion sickness is an ongoing concern and warrants further investigation. The Unity simulation may also be useful as an academic assessment tool. Research limitations/implications – Findings are limited by short time usage of the simulations in 3D virtual worlds with confined spaces and no requirement for in-world group interaction, and by some methodological limitations including the research being based within a single higher education institution, and with a profession-specific group of students. Originality/value – This paper highlights student preference for using a purpose built simulation created with Unity over a simulation built in Open Sim, showing where best to spend future development time and funding. Similar comparison research is scarce. Keywords Stroke, Second Life, Higher education, Occupational therapy, Academic assessment, Unity Paper type Research paper
    • Evaluation of shared placements between MSc Pre-Registration and BSc (Hons) Diagnostic Radiography students.

      Partner, Alexandra; Shiner, Naomi; Hyde, Emma; University of Derby (National Association Educators in Practice (NAEP), 2018-04-20)
      Background A new two year Masters (pre-registration) Diagnostic Radiography programme was introduced in 2016 at the University. It is one of only 4 courses of this type in the country. To date no literature has been published to evaluate the impact of such a course. The Masters students (level 7) share multiple teaching sessions with the undergraduate students (level 4); mixed level teaching is a new development for the current academic team. These cohorts undertake their clinical placement at the same NHS site over the same time period. This has provided an opportunity to evaluate the perceptions, expectations and experiences of the students learning together on placement. Aims To evaluate the shared placement experience of MSc (Pre-Registration) Diagnostic Radiography and BSc (Hons) Diagnostic Radiography from their perspective Method The study used a questionnaire design to gather quantitative and qualitative data from all groups. Both the MSc (n=5) and BSc (n=38) students were included to provide comparative data. This will be enriched with qualitative data gained from small focus groups undertaken at the end of the MSc shared placement block. Analysis: Analysis is ongoing but provisional results from the BSc students is that the presence of level 7 MSc students within the classroom is enjoyable and adds depth to the learning as they pose more challenging questions. Working together on placement has been a positive experience. Conclusion Mixed level teaching enriches discussion within the classroom, is more time and cost efficient. The addition of the MSc Pre-Registration Fast Track Diagnostic Radiography has increased student numbers without significantly impacting on capacity, whilst addressing the local workforce needs. The results of the study will form part of the programme evaluation and provides opportunity to develop the curriculum in close partnership with placement providers.
    • An examination of a recovery group in an adult community mental health team

      Bennett, Claire; Carter, Sarah; Sudan, Anita K.; University of Nottingham; Derbyshire Healthcare NHS Foundation Trust; University of Derby (British Psychological Society, 2016-10)
      The article discusses the working of group in an adult community mental health team. It mentions that many community mental health teams provide help for mental ill health, and states the concept of recovery in community mental health teams. It also mentions that equal power membership for education about healthy lifestyle choices and anxiety management..
    • Exploring well-being and creativity through collaborative composition as part of Hull 2017 city of culture

      Waddington-Jones, Caroline; King, Andrew; Burnard, Pamela; University of Hull; University of Cambridge (Frontiers, 2019-03-22)
      Several studies have highlighted the positive effects of group music-making and have suggested that it may be the creative and social aspects of such activities, which have a positive effect on participants’ well-being. Collaborative composition offers strong examples of both aspects as participants work together to create new material. However, although it seems likely that participants’ influence over and ownership of the creative material contributes to these positive effects, studies have yet to examine these elements in detail. Through analysis of video observations, pre- and post-project interviews, video recall interviews, and questionnaires, this article aims to: (1) evaluate the impact of participation in collaborative composition workshops on the subjective and psychological well-being of older adults and (2) identify skills and approaches employed by the composer-facilitators in order to understand more fully the approach and skills employed to engage participants effectively in the creative process. This second aim is of particular interest given the current movement toward social prescribing and arts and health interventions in the UK. Analysis revealed that all dimensions of the PERMA framework for subjective and psychological well-being were present in this collaborative composition project. The specific nature of collaborative composition is considered in comparison with other forms of group musical engagement. For older adults, collaborative composition has much to offer as an activity encouraging social interaction with others with shared interests, increasing positive affect, and enhancing self-esteem. Analysis of workshop videos and interviews with composers identified various facilitation skills employed by the composers to establish safe creative space and to encourage participants to engage in the process of collaborative composition.
    • Expressing suchness: on the integration of writing into a dance practice

      Collard-Stokes, Gemma; University of Derby (Intellect, 2019-07-01)
      This article details the unique pairing of dance and writing, the likes of which are often considered two very different beasts. It examines how approaches to movement improvisation have been used to form and inform innovative methods of entering into the act of writing from the experience of dance. The argument authenticates the current renewed appreciation for the possibilities of writing to enable further creative critical engagement. Consequently, the meeting of creativity and criticality is one in which the dancer playfully explores and examines the suchness of one’s dancing. Suchness is therefore understood as the unique sum of qualities experienced by the dancer – the point at which clarity and closeness facilitate connection through the images, feelings and sensations evoked by dance. In summary, the article outlines the relationship between dance and writing, before exploring the methods used to facilitate a dancer’s assimilation and validation of what happens for them when they dance.
    • Fairy tales, landscapes and metaphor in supervision: An exploratory study.

      Smith, Margaret E.; Bird, Drew; University of Derby (2013-04-02)
      Objective: Supervision is an important requirement for most health professionals and finding innovative and creative forms of ensuring safe and ethical practice are helpful to practitioners. This paper explores the use of fairy tales, mental landscapes and metaphors to illuminate the therapeutic and supervisory relationship. A therapy case study was used as reference. Design: The design was based on a grounded theory methodology and qualitative‐based collaborative meetings between professionals. Both researchers/participants were from different therapeutic backgrounds; drama therapy and integrative counselling. Findings: Two main themes emerged relating to the therapeutic process: (1) Using Archetypal themes in fairy tales to enhance the clarity of the therapeutic landscape; and (2) The facilitation of the sense system through the use of small objects to reconceptualise the therapeutic dynamic. Conclusion: The use of metaphor and small objects to explore retrospective therapeutic encounters can enhance the role of supervision by broadening the cognitive landscape of the therapist. Implications for the therapist/client and supervisor relationships are considered.
    • Fears of compassion magnify the harmful effects of threat of COVID-19 on mental health and social safeness across 21 countries

      Matos, Marcela; McEwan, Kirsten; Basran, Jaskaran; Gilbert, Paul; University of Derby (Wiley, 2021-04-20)
      The COVID-19 pandemic is a massive global health crisis with damaging consequences to mental health and social relationships. Exploring factors that may heighten or buffer the risk of mental health problems in this context is thus critical. Whilst compassion may be a protective factor, in contrast fears of compassion increase vulnerability to psychosocial distress and may amplify the impact of the pandemic on mental health. This study explores the magnifying effects of fears of compassion on the impact of perceived threat of COVID-19 on depression, anxiety and stress, and social safeness. Adult participants from the general population (N = 4057) were recruited across 21 countries worldwide, and completed self-report measures of perceived threat of COVID-19, fears of compassion (for self, from others, for others), depression, anxiety, stress and social safeness. Perceived threat of COVID-19 predicted increased depression, anxiety and stress. The three flows of fears of compassion predicted higher levels of depression, anxiety and stress and lower social safeness. All fears of compassion moderated (heightened) the impact of perceived threat of COVID-19 on psychological distress. Only fears of compassion from others moderated the effects of likelihood of contracting COVID-19 on social safeness. These effects were consistent across all countries. Fears of compassion have a universal magnifying effect on the damaging impact of the COVID-19 pandemic on mental health and social safeness. Compassion focused interventions and communications could be implemented to reduce resistances to compassion and promote mental wellbeing during and following the pandemic.
    • A feasibility study of non-invasive continuous estimation of brachial pressure derived from arterial and venous lines during dialysis

      Stewart, Jill; Walker, Thomas; Eldehini, Tarek; Horner, Daniela Viramontes; Lucas, Bethany; White, Kelly; Muggleton, Andy; Selby, Nicholas M; Taal, Martin W; Stewart, Paul; et al. (IEEE, 2020)
      Intradialytic haemodynamic instability is a significant clinical problem, leading to end-organ ischaemia and contributing to morbidity and mortality in haemodialysis patients. Non-invasive continuous blood pressure monitoring is not part of routine practice but may aid detection and prevention of significant falls in blood pressure during dialysis. Brachial blood pressure is currently recorded intermittently during haemodialysis via a sphygmomanometer. Current methods of continuous non-invasive blood pressure monitoring tend to restrict movement, can be sensitive to external disturbances and patient movement, and can be uncomfortable for the wearer. Additionally, poor patient blood circulation can lead to unreliable measurements. In this study we performed an initial validation of a novel method and associated technology via a feasibility study to continuously estimate blood pressure using pressure sensors in the extra-corporeal dialysis circuit, which does not require any direct contact with the person receiving dialysis treatment.\\ The paper describes the development of the measurement system and subsequent \emph{in vivo} patient feasibility study with concurrent measurement validation by \emph{Finapres Nova} experimental physiological measurement device. We identify a mathematical function to describe the relationship between arterial line pressure and brachial artery BP, which is confirmed in the patient study. The methodology presented requires no interfacing to proprietery dialysis machine systems, no sensors to be attached to the patient directly, and to be robust to patient movement during treatment and also to the effects of the cyclical pressure waveforms induced by the hemodialysis pump. This represents a key enabling factor to the development of a practical continuous blood pressure monitoring device for dialysis patients.