Angela Dickinson

University of Hertfordshire | UH · Centre for Research in Primary and Community Care

Food insecurity is a public health issue in Western countries, including the UK. Being food-insecure means older adults may not access sufficient nutritious, safe, and socially acceptable food, leading to a higher risk of malnutrition. We conducted a qualitative study of 25 households with men and women aged 60–95 years to investigate how older adu...

Background to the study: The consumption of a healthy balanced diet is the cornerstone of treatment for people living with type 2 diabetes (PLWT2DM). The UK recommends a standardised voluntary front of pack food labelling system which uses the green-amber-red colour coding to indicate the presence of nutrients in a food item. Research with PLWT2DM...

In recent years, Meals on Wheels (MoW) services have been in a state of decline as austerity policies have become entrenched. However, this decline is occurring with little knowledge of the impact withdrawal of MoW services has on the health and well‐being of those who use them. The pandemic has raised awareness of precarity and vulnerability in re...

Objectives In the context of a growing number of dementia friendly communities (DFCs) globally, a need remains for robust evaluation, and for tools to capture relevant evidence. This paper reports the development of a suite of evaluation resources for DFCs through a national study in England. Methods Fieldwork took place in six diverse case study...

Measures to control the spread of COVID-19 have changed the way we shop for food and interact with food environments. This qualitative study explored food shopping practices in the East of England, a large diverse region including coastal, urban and rural settings. In 2020/2021 we interviewed 38 people living in the region and 27 professionals and...

Background Dementia Friendly Communities (DFCs) offer an approach to community engagement to improve the lives of people living with dementia and their family supporters. The involvement of those living with dementia is key to creating successful DFCs. This paper examines how people affected by dementia were involved in developing and designing DFC...

This article discusses the development and use of the solicited unstructured diary-interview method to explore the everyday tacit and mundane nutrition information activities (NIA) of people who have type 2 diabetes. Diary completion was followed by individual qualitative interviews with individuals (n = 18) and one couple. Diary entry styles range...

Currently, we know little about the role or reach of localised services supporting households experiencing food poverty across Hertfordshire. Nor do we know if or what gaps in provision exist or households’ experiences of accessing these support services. This research aims to address these issues and feed into the HCC food poverty needs assessment...

The older population is particularly susceptible to malnutrition, which currently affects 1.3 million people aged 65+ in the United Kingdom. Malnutrition is an outcome of food insecurity and despite demographic changes that have led to a rise in numbers of older people, we know very little about how older people become vulnerable to food insecurity...

Context: The work presented in this paper was undertaken during the first three months of the COVID-19 crisis in the UK. Objectives: The project is aimed to respond to questions and concerns raised by front-line care staff during this time, by producing research-based ‘Top Tips’ to complement emerging COVID-19 policy and practice guidelines. Method...

Aim The aims of the study were to describe the characteristics of meals-on-wheels (MOW) recipients, including prevalence of malnutrition amongst those who have received input from the Nutrition and Wellbeing Service (NWS) and to explore whether the NWS had an impact on the nutritional status (malnutrition risk) of recipients over time. Background...

Objectives Many patients do not meet recommended levels of therapy-based exercise. This review aims to explore how adult patients view being prescribed therapy-based exercise, the information/education they are given and receive and if/how they independently practise and adhere. Design A qualitative systematic review conducted using an ethnographi...

Introduction Men with prostate cancer may receive radiotherapy as part of their management. They encounter a range of information related to radiotherapy, and a crucial role for therapeutic radiographers and other healthcare practitioners is ensuring patients receive appropriate information related to their treatment. This integrative review aims t...

Background: Care homes provide personal care and support for older people who can no longer be supported in the community. As part of a larger study of integrated working between the NHS and care homes we asked older people how they accessed health care services. Our aim was to understand how older people resident in care homes access health servi...

Background People living with dementia often develop distressing behavioural and psychological symptoms (BPSD) that can affect their quality of life and the capacity of family carers and staff providing support at home. This systematic review of qualitative studies considers the views and experiences of people living with dementia and care provider...

Background Two-thirds of people living with dementia live at home in the UK and many experience distressing behavioural and psychological symptoms. This systematic review evaluates the effectiveness of non-pharmacological interventions for behavioural and psychological symptoms among community-dwelling people living with dementia. Methods This two...

Aim To explore the inclusion of patient and public involvement (PPI) in a qualitative study on the experiences of men with prostate cancer regarding information in radiotherapy. Method The application of PPI to one doctoral research study is explored with respect to two perspectives: firstly, involvement of a patient reference group who informed t...

Background Risks and prevalence of malnutrition and dehydration are high in older people but even higher in older people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions aiming to improve, maintain or facilitate food/drink intake indirectly, through food service...

Background: Eating and drinking difficulties are recognised sources of ill health in people with dementia. In the EDWINA (Eating and Drinking Well IN dementiA) systematic review we aimed to assess effectiveness of interventions to directly improve, maintain or facilitate oral food and drink intake, nutrition and hydration status, in people with co...

In 2013 the Mediterranean Diet was recognized by UNESCO as an intangible cultural heritage of Spain, Greece, Italy and Morocco. Conviviality – the pleasure of eating together – was recognized as the cornerstone of food culture in the region. Although the concept of commensality has been explored widely in the literature, studies on conviviality and...

Background: Public involvement in research (PIR) can improve research design and recruitment. Less is known about how PIR enhances the experience of participation and enriches the data collection process. In a study to evaluate how UK care homes and primary health-care services achieve integrated working to promote older people's health, PIR was i...

Objectives: There is an urgent need to improve the care of older people at risk of falls or who experience falls in mental health settings. The aims of this study were to evaluate the individual falls risk assessment tools adopted by National Health Service (NHS) mental health trusts in England and healthcare boards in Wales, to evaluate the compr...

Understanding everyday social practices is challenging as many are mundane and taken for granted and therefore difficult to articulate or recall. This paper reflects on the challenges encountered in a qualitative study underpinned by current theories of practice that incorporated visual methods. Using this approach meant everyone in a sample of 20...

Food stored, prepared, cooked and eaten at home contributes to foodborne disease which, globally, presents a significant public health burden. The aim of the study reported here was to investigate, analyse and interpret domestic kitchen practices in order to provide fresh insight about how the domestic setting might influence food safety. Using cur...

Abstract: Mighty oaks from small acorns grow: The development and maturation of public involvement in research in Hertfordshire. The Public Involvement in Research (PIRG) at the University of Hertfordshire now forms an integral part of research activities within the institution. Over the last decade, the group has developed into a highly proactive...

Falls, slips and trips are a major patient safety concern in hospital settings accounting for 26 per cent of all reported patient safety incidents in England. Mental health conditions and their treatments add further to fall risk but we have little information regarding who falls, where and when within mental health settings. Methods: This paper pr...

Foodborne illness (FBI) is a major public health problem in the UK. Recent increases in cases of listeriosis in older people have focused attention on consumer food-related practices. Previous studies highlight poor relationships between what people know, what they say they do and what they actually do in the kitchen. The aim of the Kitchen Life st...

In 2007, the UK government set performance targets and public service agreements to control the escalation of emergency bed-days. Some years earlier, nine English local authorities had each created local networks with their health and third sector partners to tackle this increase. These networks formed the ‘Improving the Future for Older People' in...

http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014007611 http://www.crd.york.ac.uk/PROSPEROFILES/7611_STRATEGY_20140118.pdf

Falls are a leading cause of mortality and morbidity in older people and the risk of falling is exacerbated by mental health conditions. Existing reviews have focused on people with dementia and cognitive impairment, but not those with other mental health conditions or in mental health settings. The objective of this review is to evaluate the effec...

Nutrition misinformation can be harmful. Within dietetics there is an acknowledgement that nutrition information should be consistent, science-based and made relevant to different segments of the population. This paper reports on a study, conducted in Scotland, which involved focus groups and interviews with consumers and health professionals to ex...

This article explores the content of discussion by patients and practitioners where they were invited to talk about food and diet. A qualitative methodology using focus groups was employed within one Primary Care Trust in the east of England. Patients described their desire for access to nutritional guidance in primary care and their feelings of po...

Background: Non-cognitive behavioural and psychological symptoms of dementia affect up to 90% of people with dementia during the disease course and result in distress, increased carer burden, high service utilization and unwanted moves to care homes. Research has focused on long-term settings and has not considered people with dementia living at h...

Good integration of services that aim to reduce avoidable acute hospital bed use by older people requires frontline staff to be aware of service options and access them in a timely manner. In three localities where closer inter-organisational integration was taking place, this research sought patients' perceptions of the care received across and wi...

Information about health is gained from various sources but little is known about the health information-seeking behaviours of older people and what factors affect this. This pilot study aimed to explore older people's experiences and views on their health information-seeking behaviours and to gain a better understanding of these. A qualitative stu...

Information about health is gained from various sources, but little is known about the health information-seeking behaviours of older people and what factors affect this. This pilot study aimed to explore older people's experiences and views on their health information-seeking behaviours and to gain a better understanding of these. A qualitative st...

Background Older people living in care homes in England have complex health needs due to a range of medical conditions, mental health needs and frailty. Despite an increasing policy expectation that professionals should operate in an integrated way across organisational boundaries, there is a lack of understanding between care homes and the Nationa...

Survey questions.pdf, 287K.

In the UK there are almost three times as many beds in care homes as in National Health Service (NHS) hospitals. Care homes rely on primary health care for access to medical care and specialist services. Repeated policy documents and government reviews register concern about how health care works with independent providers, and the need to increase...

uptake of and adherence to fall prevention interventions is often poor and we know little about older people's perceptions of and beliefs about fall prevention interventions and how these affect uptake. to explore older people's perceptions of the facilitators and barriers to participation in fall prevention interventions in the UK. we undertook a...

In primary care, leaflets are often used to communicate health information. Increasingly, primary healthcare practitioners need to provide dietary advice. There is limited research exploring how nutrition information leaflets are used in primary care. The present study explored practitioner and lay experiences with respect to providing and receivin...

Background: Many older people use one or more prescribed medicines on a daily basis. Effective medicines management at hospital discharge can support appropriate use of medicines following discharge and help avoid unnecessary hospital re-admission. Many people, however, feel they receive insufficient information about medicines on discharge from h...

Partnerships for Older People Projects (POPP) was a national initiative in England aimed at improving health, well-being and quality of life (QoL) for older people by developing local services. This development paper reports the key findings of a local evaluation in relation to quality of life, well-being and health-related QoL to provide practical...

To evaluate the effectiveness of nutritional education or advice on physical function, emotional health, quality of life, nutritional indices, anthropometric indicators, mortality, service use and costs of care in people over 65 years of age living at home. Systematic review of randomised controlled trials (RCTs). PUBMED, CINAHL, PSYCINFO, the Coch...

Background: Older people are at increased risk of malnutrition. Community meals have the potential to reduce the risk of developing malnutrition. However, little is known about the nutritional content of these meals or why older people chose to eat in community lunch settings. Wilson (2009) found community meals benefited older people through incre...

Uptake of and adherence to fall prevention interventions is often poor and we know little about how older people's perceptions of and beliefs about fall prevention interventions affect uptake. This study aimed to explore older people's perceptions of the facilitators and barriers to participation in fall prevention interventions. We undertook a qua...

RÉSUMÉ Cette étude, fondée sur la grounded théorie, a exploré les perceptions des personnes âgées chinoises, vivant en Angleterre, concernant les chutes et la peur de tomber, et les animateurs et les entraves à l’intervention pour prévenir les chutes. En utilisant un échantillon de 30 personnes âgées chinoises, nous avons mené deux groupes de discu...

Introduction Within the UK health and social care policy is placing an increasing emphasis on improving the quality of care for older people in care homes through integrated working between health and social care services. This study aims to clarify the research available on integrated working and evaluate its impact on older people in order to dev...

Much skilled nursing practice is described by words that at face value appear low-tech and self-explanatory. Despite being intrinsic to practice, the term "nursing assessment" has few operational definitions. Evidence-based practice and the quality agenda makes it imperative that this term is well understood. To contribute to the evidence base and...

This paper draws on the work of Paley and Duncan et al in order to extend and engender debate regarding the use of Concept Analysis frameworks. Despite the apparent plethora of Concept Analysis frameworks used in nursing studies we found that over half of those used were derived from the work of one author. This paper explores the suitability and u...

Aim To evaluate a new service development whereby a nurse and a paramedic working in partnership attended non-urgent emergency calls.Background The demand for emergency ambulance services both nationally (in the UK) and internationally has been steadily increasing. A large proportion of calls made to the emergency ambulance service are classified a...

This study aimed to improve the mealtime experience of older people in a hospital setting through helping staff to make changes to their clinical practice and the ward environment. Poor nutritional care has been a persistent and seemingly intractable problem for many years. We used an action research design for the study, drawing on techniques from...

The prevention of falls is currently high on the health policy agenda in the United Kingdom, which has led to the establishment of many falls-prevention services. If these are to be effective, however, the acceptability of services to older people needs to be considered. This paper reports a systematic review of studies of older people’s perception...

This second interim report provides a summary of key findings from the National Evaluation of the Department of Health’s POPP Programme. These summary findings are based on data collected and analysed over the last two years of the POPP programme (April 2006 to March 2008) and are made available to support emerging learning around prevention and ea...

To explore patients' and staffs' perceptions of a pilot service which dispatched a nurse and paramedic to low-priority ambulance calls. However, Patients' opinions of both pilot and standard service groups were obtained through qualitative questionnaire data and individual interviews. Staffs' perceptions were explored via two focus groups. Question...

The Single Assessment Process (SAP) has been introduced as part of the National Service Framework for Older People and has major implications for health and social care. The aim of this study was to evaluate a pilot introduction of the Single Assessment Process in the South-East of England. A qualitative case study design incorporating observation...

Poor nutritional care within the hospital setting continues despite decades of work chronicling and measuring the problems. To address the problem changes in practice have been attempted to improve the patients' experience of mealtimes. In order to implement patient-centred mealtimes for older patients by changing the focus from institutional conve...