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Available from: Fiona Ross
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ABSTRACT: This paper aims to support the critical development of user involvement in systematic reviews by explaining some of the theoretical, ethical and practical issues entailed in 'getting ready' for user involvement.
Relatively few health or social care systematic reviews have actively involved service users. Evidence from other research contexts shows that user involvement can have benefits in terms of improved quality and outcomes, hence there is a need to test out different approaches in order to realize the benefits of user involvement and gain a greater understanding of any negative outcomes.
Setting up a service-user reference group for a review of user involvement in nursing, midwifery and health visiting research involved conceptualizing user involvement, developing a representation framework, identifying and targeting service users and creating a sense of mutuality and reciprocity.
Recruitment was undertaken across England by two researchers. Members from 24 national consumer organizations were selected to participate in the review.
Learning was gained about finding ways of navigating consumer networks and organizations, how best to communicate our goals and intentions and how to manage selection and 'rejection' in circumstances where we had stimulated enthusiasm.
Involving service users helped us to access information, locate the findings in issues that are important to service users and to disseminate findings. User involvement is about relationships in social contexts: decisions made at the early conceptual level of research design affect service users and researchers in complex and personal ways.
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ABSTRACT: Increasing mobility of healthcare professionals has led to concerns that certain countries or regions are depleted of sufficient staff to meet healthcare needs. In formulating appropriate strategies to ensure better retention locally, human resource managers are hindered by lack of information about migration patterns. PURPOSE AND AIMS: Purposes included studying movement of diploma nurses qualifying in England and contributing to literature on developing methods for obtaining migration data. Specific aims ascertained: regional variation in retention of locally trained nurses; associations between nurses' profile and retention in training region; and impact on each region of inter-regional movement of nurses.
Questionnaires sent to a nationally representative cohort of adult branch nurses at qualification (n=1596) and at subsequent intervals thereafter provided data on all employment and other activities and geographical location of each. Event histories constructed from chart data were used to analyse length of retention in region of training and movements between regions. Retention was operationalised through developing the construct 'engagement with nursing'.
Older entrants and those with children were more likely to nurse in their training region than younger and childless counterparts. Regions differed in retention of locally trained nurses and in the impact on their diplomate workforce of inter-regional movement. Regional variations were insufficiently explained by differences in nurses' profiles; hence influences of regional characteristics were also considered.
Retention strategies should include maintaining the policy of recruiting greater diversity of entrants, particularly mature entrants and those who have children. In developing local strategies, each region needs: information about retention of different components of their workforce; and an understanding of how regional characteristics can facilitate or constrain retention. National and international workforce organisations need to plan how best to obtain accurate and comparable nurse migration data.
Available from: onlinelibrary.wiley.com
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