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Biomedical subjects

Fiona Brooks

Publications and source records attributed to Fiona Brooks.

8 recordsLinked to original sources

Physical activity as leisure: the meaning of physical activity for the health and well-being of adolescent women.

Globally, low participation in physical activity by adolescent young women is a major health concern. While the barriers to activity for this group are well documented, little is known about the views and experiences of nonathlete, but active, young women. In order to gain an understanding of young women's lived experiences of the relationship between physical activity as leisure and health, data were collected through focus groups. Active nonathlete young women in the United Kingdom attached significant meaning to physical activity as a space for leisure, and used it to enhance their health and well-being.

Adolescent↗

Nursing and public participation in health: an ethnographic study of a patient council.

BACKGROUND: Conceptualisations of the nurse-patient relationship tend to view nursing as embodying an empowering approach to patients, one that places the service user perspective at the centre of decision-making. However, the relationship of nursing to public participation in health service planning and development has been under examined. AIMS: The aim is to explore the relationship of the nursing profession to public participation as enacted through a UK-based patient and public council, located in an acute hospital. The council was developed by nursing staff and aimed to achieve service user participation in strategic level health care decision-making. The views and experiences of participants and the applicability of the 'nurse-patient partnership' construct to public participation are considered. METHODS: The study employed integrative ethnography, involving multiple field methods: non-participant observation of council meetings, i.e. fourteen 3 h meetings (n=42 h); in-depth interviews with councillors (n=17) and with key hospital staff (n=18). A documentary review and mapping of the actions of the council was undertaken. RESULTS: A nurse-patient partnership was not initially intrinsic to the operation of the council or embedded in the perspectives of the nurse or patient participants. Professional vulnerability and the organisational context constrained the nursing response. Councillors and nursing staff moved to create a shared set of understandings in order to progress change in service organisation and delivery. Nurses' repositioning vis-à-vis the credibility of user experiences and status was central to the effective progression of the council. CONCLUSIONS: Partnership in public participation requires a shift by nurses' towards acceptance of members of the public functioning as informed, critical and powerful agents in health care decision-making. Equipping nurses with the skills to communicate with patient representatives in a position of interactional equality is likely to be a pre-requisite for successful engagement by nursing with public participation.

Anthropology, Cultural↗

Taking part counts: adolescents' experiences of the transition from inactivity to active participation in school-based physical education.

Identifying ways to increase and sustain active living among young people represents a priority for health promotion interventions. This qualitative study explored the experiences of adolescent boys and girls in the United Kingdom (aged 14-15 years) who had made the transition from inactivity to active participation in physical education (PE). The setting was a secondary school that had modified the PE programme, with the aim of increasing participation rates. Thirty-one, self-identified, formerly 'PE adverse' students were interviewed in focus groups in the school setting. Previously, respondents felt that they had been constructed as physically marginal individuals. Having a physically 'marginal body' was perceived as being detrimental to emotional health. The new PE resulted in respondents possessing a performing and achieving physical identity. Boys gained a sense of security in their physical identity and cultural change had removed the aggression from interacting with other physically active peers. Girls spoke of increased self-confidence, including acquiring the psychological resources to participate in community-based activities. Effective health promotion interventions for inactive adolescents are likely to move beyond solely endorsing the benefits of physical activity or increasing choice and instead address the potential emotional risks and value of participation from the adolescents' perspective.

Adolescent↗

Knowledge work in nursing and midwifery: an evaluation through computer-mediated communication.

Recent changes in policy and culture require health workers to incorporate "knowledge work" as a routine component of professional practice. Innovative computer-mediated communication technologies provide the opportunity to evaluate the nature of "knowledge work" within nursing and midwifery. This study embedded an online discussion system into an acute NHS Trust to support interaction within communities of practice. The complete record of online communications was analysed. Nurses were found to predominantly engage in information work with knowledge work restricted to senior-to-senior level exchanges. In contrast, midwives were observed to employ the technology to support knowledge work between all grades. The study indicates that technology can support knowledge work, including conveying tacit knowledge effectively.

Acute Disease↗

Exploring knowledge work and leadership in online midwifery communication.

AIM: This paper reports a study to answer the following question: if given a user-friendly online system, that enabled communication across the practice community, would midwives function as knowledge workers? BACKGROUND: Globally, the demand for quality-led and innovative service delivery requires that nurses and midwives shift from being 'information workers', or passive receivers of managerial and organizational decisions, to become 'knowledge workers' who are able to create, lead and communicate service innovation and practice development. New communication technologies may offer a means for healthcare professionals to interact as knowledge workers and develop supportive communities of practice. METHODS: An online discussion forum was implemented as a low-cost technological intervention, deploying existing hardware and a standard hospital intranet. The evaluation of the forum was constructed as case-study organizational research. The totality of online communication, both traffic and content, was analysed over a 3-month period (193 messages downloaded 2003/2004), and 15 in-depth interviews were undertaken with forum users. FINDINGS: Given simple, facilitative, innovative technology, supported by a positive working culture and guided by effective leadership, midwives could function as 'knowledge workers', critically reflecting upon their practice and translating knowledge into action designed to achieve change in practice. Participation occurred across all staff grades, and midwives were predominantly supportive and facilitative towards the contributions made by colleagues. CONCLUSION; Midwives may be well placed to exemplify the 'ideal' characteristics of the knowledge worker being demanded of modern healthcare professionals. The deployment of online interactive technologies as part of strategic vision to enhance knowledge work among healthcare professionals should be given attention within health systems.

Attitude of Health Personnel↗

Nurses' responses to expert patients: the rhetoric and reality of self-management in long-term conditions: a grounded theory study.

BACKGROUND: Against the backdrop in the western world of increasing prevalence of chronic disease, active and informed patients and a policy emphasis on self-management, this English study explored health professionals' responses to expert patients. OBJECTIVES: To: DESIGN: A grounded theory approach was utilised with two concurrent data strands. SETTING: A relatively affluent English county including community, primary and secondary care settings. PARTICIPANTS: Via purposeful and theoretical sampling 100 health professionals (nurses, doctors, physiotherapists) and 100 adults affected by chronic disease participated. METHODS: Focus groups, interviews and observation. RESULTS: Nurses were found to be most anxious about expert patients when compared to other professionals, which appeared to be linked with a lack of professional confidence and unfounded fears regarding litigation. However, nurse specialists often provided a negative case for this. As a whole, nurses were most able to meet the emotional needs of patients, but apart from nurse specialists did not articulate this as a skill. CONCLUSION: Apart from nurse specialists the majority of nurses appeared limited in appropriately facilitating self-management. It is suggested that this is linked to an ongoing nursing culture of patient as passive, an over-emphasis on empirical knowledge and a feeling of vulnerability on the nurses' part towards expert patients. The findings also indicate a rhetoric rather than reality of autonomous nursing roles within the chronic disease management agenda.

Adaptation, Psychological↗

Women users' views on the role and value of the practice nurse.

Aspects of the views of women aged 16-65 years on practice nurses in the primary health care setting are explored. The extent to which women consult practice nurses and the reasons for consultation are first identified. Women's assessments of practice nurses are then examined. The findings are from a 3-year research project where 1251 women completed a postal questionnaire and 70 women were interviewed in depth about issues concerning women's perceptions and experiences of both general practitioners (GPs) and practice nurses. Two thirds of the sample had consulted the practice nurse; 22% about specific women's health issues (including 13% for cervical screening). For most women's health issues, more women expressed a preference to be seen by a general practitioner (GP) than a practice nurse, except for breast examination among women aged 49 to 65 years where 57% expressed a preference for a practice nurse compared with 43% for a GP. Women gave similarly positive evaluations of the approachability of practice nurses and GPs. Positive views of practice nurses were high among older women, women who saw practice nurses in well-women clinics and women who saw practice nurses in relation to women's health issues. Among women who had not consulted a practice nurse, there was both a lack of awareness of the level and range of expertise of practice nurses, and a perception that in the main they offered only minor routine services. Health promotion, disease prevention and family planning do not appear to feature centrally in women's expectations of services provided by the practice nurse.

Journal Article↗