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ABSTRACT: The importance of increasing exercise to prevent falls among older adults remains a key worldwide public health priority. However, older adults do not necessarily take up exercise as a preventative measure for falls. This qualitative study aimed to explore the beliefs of community-dwelling South Asian and White British older adults aged 60 to 70 about falls and exercise for fall prevention through 15 focus groups (n = 87) and 40 in-depth interviews. Data were transcribed verbatim and analyzed using a framework approach. Data analysis identified six salient beliefs that influenced older adults' intention to exercise for fall prevention. In general, older adults aged 60 to 70 did not acknowledge their risk of falling and were not motivated to exercise simply to help prevent falls. Positive beliefs were found to be an unlikely barrier to taking up exercise for fall prevention for those who had experienced a fall. The implications for health promotion and health professionals with this group of older adults are discussed.
Clinical Nursing Research 06/2013; · 0.88 Impact Factor
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ABSTRACT: BACKGROUND: Encouraging the uptake of physical activity among a culturally diverse elderly population presents a challenge for health-care providers across the world. Little is known about the health-care needs of these populations, for example the increasingly ageing group of Chinese elders in many parts of the world who are now facing later life and increasing challenges to their health. OBJECTIVE: This study aimed to explore behaviours and attitudes towards exercise among older Chinese immigrants in the UK to provide insights into the health of Chinese populations in the UK and elsewhere. DESIGN: A Grounded Theory approach using purposive and theoretical sampling with in-depth semi-structured interviews. SETTING AND PARTICIPANTS: Chinese elders were recruited from Chinese communities in the North West of England. Thirty-three participants were interviewed face-to-face and audio-recorded. RESULTS: Participants self-managed exercise based on cultural perceptions of health and ingrained Chinese values. Professional support and information was lacking and relied on folk norms rather than person-centred recommendations for healthy living. Inappropriate exercise regimes could act as a substitute for seeking health-related advice when exercise was often used as a self-monitored barometer to assess their perceived health status. DISCUSSION AND CONCLUSION: Chinese elders may undertake inappropriate exercise, leading to high-risk situations, if appropriate professional information is not provided. Health-care practitioners should devote attention to understanding Chinese elders' attitudes towards exercise, as this may ultimately lead to successful health promotion activities. A person-centred approach that acknowledges and works with self-management practices is advocated.
Health expectations: an international journal of public participation in health care and health policy 12/2012; · 1.80 Impact Factor
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ABSTRACT: There is an impetus to involve service users and carers in the education of nurses and a general consensus in the literature about the benefits that this brings to all involved. Whilst these benefits are well rehearsed in the literature there is little written about the potential barriers to service user and carer involvement in nurse education.
The objective of this study was to investigate service users, carers and staff views on the potential barriers to becoming engaged in nurse education.
A qualitative study using focus group discussions (FGD) was used to canvas the views of service users, carers and teaching staff.
A large school of nursing in the North West of England.
38 service users and carers recruited from the North West of England and 23 nursing and midwifery teachers and lecturers.
Focus group discussions were employed as the main data collection method. The data were analysed using thematic analysis.
Six themes occurred in the data as being negatively associated with potential and actual involvement: not knowing the context of the group, lack of preparation of the group, not being supported, not being allowed to be real, not receiving feedback, not being paid appropriately.
The process of involvement is not without difficulties. These data show that some consideration needs to be given to the potential barriers to involvement if the engagement of service users and carers is to be effective.
Nurse education today 05/2012; 32(7):829-34. · 0.91 Impact Factor
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ABSTRACT: Diabetes is a chronic condition requiring lifelong self-management. Patients are encouraged to access appropriate services to facilitate optimum management of diabetes. Although equitable access to healthcare in the United Kingdom is a legal right, not all groups and individuals in the community experience equity. Despite various equality laws and numerous efforts to minimise health inequalities related to access, particular community groups are more likely to experience inequitable access than others. The Bangladeshi community are one such community who experience some of the worst diabetes-related health outcomes in the United Kingdom. Little is known about their experiences and preferences in accessing diabetes healthcare information and services. Consequently, we undertook a scoping review of the literature by following the York Scoping Reviews Framework to identify the experiences and preferences of Bangladeshi patients and carers when gaining access to diabetes-related healthcare information and services. We identified eight articles and reported our results in relation to four domains of access: health service availability, health service utilisation, health service outcomes and the notion of equity. The review identified that language and literacy issues were the most common barriers hindering access to information and services. Patient knowledge regarding diabetes and its management was generally low, and friends and family were frequently being used as information sources and as informal interpreters. Additionally, there were feelings of isolation from mainstream information and services possibly resulting in the high prevalence of depression in the Bangladeshi community with women more affected than men. Social networks combined with religious and cultural beliefs as well as wider societal duties played a crucial role in accessing information and services for this population, and the identification of these issues merit further research and are possible avenues towards improved access to healthcare information and services for the Bangladeshi population.
Health & Social Care in the Community 08/2011; 20(2):155-71. · 0.86 Impact Factor
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ABSTRACT: With the publication of the new NMC standards for pre-registration nursing education, undergraduate curricula are being written in universities across England. There are many drivers for the curricula but one that has until recently received scant attention is the service user's and carer's voice. This paper discusses the findings of a qualitative study that asked 52 service users and carers about the qualities they sought in nurses and their views on nurse education. Eight focus groups were conducted with a broad range of service users and carers from primary and secondary care, and voluntary organisations. Data were analysed using the framework approach facilitated by a qualitative analysis software programme. The sample was diverse, but there were similarities in the qualities they valued in nurses. They sought technical competence, knowledge and willingness to seek information, but overwhelmingly prioritised 'a caring professional attitude'. This was articulated as empathy, communication skills and non-judgmental patient centred care: major themes in the new NMC standards. Our participants also expressed concern about whether the educational preparation of nurses can develop these caring qualities. We discuss this concern, the challenges for nurse educators it presents and how we can engage service users and carers in shaping and delivering our new curricula.
Nurse education today 07/2011; 32(2):121-7. · 0.91 Impact Factor
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ABSTRACT: To explore the influence of primary health care professionals in increasing exercise and physical activity among 60-70-year-old White and South Asian community dwellers.
Fifteen focus groups and 40 in-depth interviews with community dwelling White and South Asian 60-70-year olds. The sample was selected to include people with very different experiences of participation and non-participation in exercise and physical activity. Data were analysed using framework analysis.
Primary health care professionals' advice and support was found to be a motivator to the initiation of exercise and physical activity. However, this was usually in relation to advice on weight reduction, cardiac conditions and mobility issues, but not generally to improve or increase activity levels. An underlying attitude of genuine interest and empathy was valued and shaped decisions about initiating and/or increasing activity levels.
Primary health care professionals should be encouraged to show interest and empathy with older people about the positive benefits of exercise and physical activity to them individually. This advice needs to be tailored to the older adult's symptoms.
Primary health care professionals need to be able to provide specific advice as to the quantity (frequency, duration, intensity and type) of exercise or physical activity to undertake. Practitioners need to listen to their patients' needs, show empathy and avoid ageism during consultations.
Patient Education and Counseling 06/2009; 78(1):97-103. · 2.31 Impact Factor
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ABSTRACT: strategies to prevent falls often recommend regular exercise. However, 40% of over 50s in the UK report less physical activity than is recommended. Even higher rates of sedentary behaviour have been reported among South Asian older adults.
to identify salient beliefs that influence uptake and adherence to exercise for fall prevention among community-dwelling Caucasian and South Asian 60-70 year olds in the UK.
we undertook an ethnographic study using participant observation, 15 focus groups (n = 87; mean age = 65.7 years) and 40 individual semi-structured interviews (mean age = 64.8 years). Data analysis used framework analysis.
young older adults do not acknowledge their fall risk and are generally not motivated to exercise to prevent falls. Those who had fallen are more likely to acknowledge risk of future falls. Whilst many of the beliefs about falls and exercise expressed were very similar between Caucasians and South Asians, there was a tendency for South Asians to express fatalistic beliefs more often. Conclusion: fall prevention should not be the focus of strategies to increase uptake and adherence to exercise. The wider benefits of exercise, leading to an active healthy lifestyle should be encouraged.
Age and Ageing 12/2008; 38(1):68-73. · 3.09 Impact Factor
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ABSTRACT: This paper examines the ways in which district nurses and general practitioners interacted and influenced each other's work within primary care services. The data presented here examine how the developments in the organisation of primary care affected the work of district nurses during a time of turbulent change. Qualitative data from 300 hours of participant observation and 40 semi-structured interviews with 33 district nurses were analysed using grounded theory, after which a literature review was undertaken. The findings from this study were interpreted using a Foucauldian notion of power and Fox's (1995) analysis of 'organisation'. The shift in power to general practitioners (GPs) has meant that they can exercise ever-increasing authority over nurses in their employ. Strict rules governed the process of inter-professional work and nurses and doctors used creative strategies to overcome the problems that existed between them. The data show that nurses could and did resist the power of GPs but this resistance generally elicited other more punishing forms of authority. Direct and indirect threats were commonplace. The data suggest that district nurses were moving into a closer, more business-like and tightly-controlled working relationship with general practitioners, through which competing discourses interplayed and circulated between GPs and district nurses in the organisation of primary care services.
Sociology of Health & Illness 12/2006; 28(7):883-902. · 1.88 Impact Factor
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ABSTRACT: The objective of the study was to compare levels of satisfaction in stable drug users treated in general practice (GPTG) and a community based outpatient treatment service (OPTG). The study is in two parts. Part 1: Twenty preliminary interviews were undertaken with drug users attending treatment services at an outpatient clinic (n = 12) and with their general practitioner (n = 8). A questionnaire was developed employing a delight-terrible scale and simple agree/disagree questions based on the areas identified in the interviews. Descriptive and inferential statistics were used to analyse the data. Part 2: Subjects were recruited from eight general practitioner (GP) surgeries and two outpatient clinics in the North-west of England. Seventy-three clients cared for by their GP and 97 clients of the outpatient clinics completed the questionnaire. All clients were receiving 70 mLs of oral methadone (1 mg per ml) and no other prescribed medication. The results of these data indicate that clients managed by their GP show a greater level of 'satisfaction' with the treatment they received from their GP, the prescription they had and report a better emotional state than those treated in a specialist outpatient unit. Clients managed by their GP also reported a greater satisfaction with the relationship they had with the prescribing doctor and the contact associated with this. They perceived help to be more readily available to them than a similar group treated in a specialist service did. These differences occur even though there are only slight variations between the groups in variables related to positive outcomes in drug treatment. The results of this study represent the client's perspective on treatment, using measures that they see as important to them. As such this study adds to the growing body of information about where drug treatment services should be located.
Health & Social Care in the Community 12/2000; 8(6):436-442. · 0.86 Impact Factor
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Shaun Speed
