Biomedical subjects

Alison Shaw

Publications and source records attributed to Alison Shaw.

8 recordsLinked to original sources

PubMed2006

Complementary therapy use by patients and parents of children with asthma and the implications for NHS care: a qualitative study.

BACKGROUND: Patients are increasingly using complementary therapies, often for chronic conditions. Asthma is the most common chronic condition in the UK. Previous research indicates that some asthma patients experience gaps in their NHS care. However, little attention has been given to how and why patients and parents of children with asthma use complementary therapies and the implications for NHS care. METHODS: Qualitative study, comprising 50 semi-structured interviews with a purposeful sample of 22 adults and 28 children with asthma (plus a parent), recruited from a range of NHS and non-NHS settings in Bristol, England. Data analysis was thematic, drawing on the principles of constant comparison. RESULTS: A range of complementary therapies were being used for asthma, most commonly Buteyko breathing and homeopathy. Most use took place outside of the NHS, comprising either self-treatment or consultation with private complementary therapists. Complementary therapies were usually used alongside not instead of conventional asthma treatment. A spectrum of complementary therapy users emerged, including "committed", "pragmatic" and "last resort" users. Motivating factors for complementary therapy use included concerns about conventional NHS care ("push factors") and attractive aspects of complementary therapies ("pull factors"). While participants were often uncertain whether therapies had directly helped their asthma, breathing techniques such as the Buteyko Method were most notably reported to enhance symptom control and enable reduction in medication. Across the range of therapies, the process of seeking and using complementary therapies seemed to help patients in two broad ways: it empowered them to take greater personal control over their condition rather than feel dependant on medication, and enabled exploration of a broader range of possible causes of their asthma than commonly discussed within NHS settings. CONCLUSION: Complementary therapy use reflects patients' and parents' underlying desire for greater self-care and need of opportunities to address some of their concerns regarding NHS asthma care. Self-management of chronic conditions is increasingly promoted within the NHS but with little attention to complementary therapy use as one strategy being used by patients and parents. With their desire for self-help, complementary therapy users are in many ways adopting the healthcare personas that current policies aim to encourage.

Adult↗

PubMed2006

'Two sides of the coin'--the value of personal continuity to GPs: a qualitative interview study.

BACKGROUND: Continuity is thought to be important to GPs but the values behind this are unknown. OBJECTIVES: To explore the values that doctors working in general practice attach to continuity of patient care and to outline how these values are applied in practice. METHODS: In-depth qualitative interview with 24 GPs in England. Participants were purposefully sampled according to personal and practice characteristics. Analysis was thematic, drawing on the constant comparative method. RESULTS: The majority of doctors valued doctor-patient, or personal, continuity in their everyday work. It was most valued in patients with serious, complex or psychological problems. GPs believed that through their personal knowledge of the patient and the doctor-patient relationship, personal continuity enabled them to provide higher quality care. However, the benefits of personal continuity were balanced against problems, and GPs identified personal, professional and external constraints that limited its provision. GPs seemed to have resolved the tension between the benefits, limits and constraints they described by accepting an increased reliance on continuity being provided within teams. CONCLUSION: Personal continuity may offer important benefits to doctors and patients, but we do not know how unique its values are. In particular, it is not clear whether the same benefits can be achieved within teams, the level at which continuity is increasingly being provided. The relative advantages and limits of the different means of delivering continuity need to be better understood, before further policy changes that affect personal continuity are introduced.

Adult↗

PubMed2006

Evaluating complementary and alternative therapy services in primary and community care settings: a review of 25 service evaluations.

OBJECTIVES: To review evaluations of primary and community care complementary therapy services. To explore the impact evaluation reports may have had on funding decisions taken by NHS commissioners. DESIGN: We collected 32 reports for 25 services, principally in England. Reports were analysed for content using the structure-process-outcome model. Modified BESTCAM guidelines, which came out of a Delphi consensus exercise rating the ability of reports to address commissioners' priorities, were used to address the second objective. RESULTS: Most commonly, evaluators carried out data extraction of referral forms (10), costings of the service (9), patient satisfaction questionnaires (9) and patient health status questionnaires (8). Five service evaluations addressed NHS cost pressures, with another carrying out a cost effectiveness assessment with QALY. CONCLUSION: Addressing commissioners' priorities (e.g. GP consultations rates, prescription rates, secondary care referrals) in complementary therapy service evaluations may bolster chances of securing funding, but are unlikely to be enough on their own.

Biomedical Research↗

PubMed2006

Expectations of patients and parents of children with asthma regarding access to complementary therapy information and services via the NHS: a qualitative study.

OBJECTIVE: To explore the expectations of patients and parents of children with asthma regarding access to complementary therapies via the NHS. METHODS: Fifty semi-structured interviews with adults and parents of children with asthma, from a range of health-care settings, including users and non-users of complementary therapies. Interviews were recorded, transcribed verbatim and the data were analysed thematically. RESULTS: Thirty-one patients were using complementary therapies for asthma, six were using complementary therapies for other health problems and 13 were non-users. Various therapies were used for asthma, most commonly homeopathy and breathing techniques, predominantly outside the NHS. Two broad themes emerging from the data were expectations about access to information and knowledge about complementary therapies via NHS health professionals, and expectations regarding access to complementary therapy services via the NHS. As a minimum, the majority of participants wanted NHS health professionals to be more 'open' towards and know more about complementary therapies than their patients - perceived as not currently usual. Most were positive about greater NHS access to complementary therapy services, for enhancing patient choice, improving equality in access for less affluent patients and facilitating patients' self-help. Participants who were highly sceptical about complementary therapies argued that lack of scientific evidence of effectiveness prohibited the need for greater complementary therapy knowledge or service provision within the NHS. Alongside their expectations, patients and parents expressed realistic views about facilitators and barriers to greater access. CONCLUSIONS: While health service planners and providers often express reservations about the value of complementary therapies, it is important to take patients' preferences into account if policy discourses regarding patient-centred care and choice are to be realized in practice.

Adult↗

PubMed2005

From schism to continuum? The problematic relationship between expert and lay knowledge--an exploratory conceptual synthesis of two qualitative studies.

Ideas about lay and expert knowledge increasingly underscore debates within qualitative health research. In this article, the authors develop an exploratory synthesis of two qualitative studies in which they critique the lay-expert divide, suggesting instead a spectrum of knowledge(s) about health and scientific issues. In the original studies, the researchers examined food risks and alternative medicine, and they shared an interest in the lay-expert knowledge relationship. Reinterpreting each study in the light of the other led to greater conceptual development. Three mutual themes emerged and are presented with discussion of their contribution to wider theoretical debates. This worked example indicates that researchers can achieve valuable additional conceptual development through the cross-fertilization of ideas across qualitative studies united not by common health topics but by shared conceptual concerns.

Complementary Therapies↗

PubMed2003

Fraser syndrome and mouse blebbed phenotype caused by mutations in FRAS1/Fras1 encoding a putative extracellular matrix protein.

Fraser syndrome (OMIM 219000) is a multisystem malformation usually comprising cryptophthalmos, syndactyly and renal defects. Here we report autozygosity mapping and show that the locus FS1 at chromosome 4q21 is associated with Fraser syndrome, although the condition is genetically heterogeneous. Mutation analysis identified five frameshift mutations in FRAS1, which encodes one member of a family of novel proteins related to an extracellular matrix (ECM) blastocoelar protein found in sea urchin. The FRAS1 protein contains a series of N-terminal cysteine-rich repeat motifs previously implicated in BMP metabolism, suggesting that it has a role in both structure and signal propagation in the ECM. It has been speculated that Fraser syndrome is a human equivalent of the blebbed phenotype in the mouse, which has been associated with mutations in at least five loci including bl. As mapping data were consistent with homology of FRAS1 and bl, we screened DNA from bl/bl mice and identified a premature termination of mouse Fras1. Thus, the bl mouse is a model for Fraser syndrome in humans, a disorder caused by disrupted epithelial integrity in utero.

Animals↗

PubMed2002

"It just goes against the grain." Public understandings of genetically modified (GM) food in the UK.

This paper reports on one aspect of qualitative research on public understandings of food risks, focusing on lay understandings of genetically modified (GM) food in the UK context. A range of theoretical, conceptual, and empirical literature on food, risk, and the public understanding of science are reviewed. The fieldwork methods are outlined and empirical data from a range of lay groups are presented. Major themes include: varying "technical" knowledge of science, the relationship between knowledge and acceptance of genetic modification, the uncertainty of scientific knowledge, genetic modification as inappropriate scientific intervention in "nature", the acceptability of animal and human applications of genetic modification, the appropriate boundaries of scientific innovation, the necessity for GM foods, the uncertainty of risks in GM food, fatalism about avoiding risks, and trust in "experts" to manage potential risks in GM food. Key discussion points relating to a sociological understanding of public attitudes to GM food are raised and some policy implications are highlighted.

Edible Grain↗

PubMedDate not supplied

Pilot study to show the loss of important data in nursing handover.

A good nursing handover process is a crucial part of providing quality nursing care in a modern healthcare environment. The conservation of patient data during the handover process is vital to ensure good continuity of care and safe practice. Any errors or omissions made during the handover process may have dangerous consequences. The authors observed the handover of 12 simulated patients over five consecutive handover cycles between nurses. Three handover styles were used and the amount of data loss was recorded for each style. A purely verbal handover style resulted in the loss of all data after three cycles. A note-taking style (the traditional style used in most hospital wards) resulted in only 31% of data being transferred correctly after five cycles. When a typed sheet was included with the verbal handover, data loss was minimal. Current handover methods may result in significant loss of important data that may impact on patient care. The authors recommend that prior to handover, a formal handover sheet be constructed that can be transferred as part of the handover process.

Communication↗