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Biomedical subjects

Gavin J Andrews

Publications and source records attributed to Gavin J Andrews.

At least 19 recordsLinked to original sources
PubMed2006

Geography: research and teaching in nurse education.

This paper outlines how geography might be integrated into nurse education. At one level, researching nurse education geographically could add to the current academic understanding of the many transitional places that make educational experiences and influence outcomes. At another level, as part of a nursing curriculum, teaching geographical concepts and issues to students might provide them with unique insights into core subjects.

Attitude of Health Personnel↗
PubMed2006

Writing place: a comparison of nursing research and health geography.

The concept of 'place', and general references to 'geographies of ...' are making gradual incursions into nursing literature. Although the idea of place in nursing is not new, this recent spatial turn seems to be influenced by the increasing profile of the discipline of health geography, and the broadening of its scope to incorporate smaller and more intimate spatial scales. A wider emphasis within the social sciences on place from a social and cultural perspective, and a wider turn to 'place' across disciplines are probably equally important factors. This trend is raising some interesting questions for nurses, but at the same time contributes some confusion with regard to imputed meanings of 'place'. While it is clear that most nurse clinicians and researchers certainly understand that place of care matters to their practices and patients, many diverse uses of 'place' are found within nursing literature, and contemporary understandings of the term 'place' within nursing are not immediately clear. It is in this context that this article plans to advance the discussion of place. More specifically, the aims of this paper are threefold: to critique 'place' as it appears in nursing literature, to explore the use of 'place' within health geography, whence notions of place and 'geographies of' have originated and, finally, to compare and contrast the use of 'place' in both disciplines. This critique intends to address a deficit in the literature, in this era of growing spatialization in nursing research. The specific questions of interest here are: 'what is "place" in nursing?' and 'how do concepts of place in nursing compare to concepts of place in health geography?'

Body Image↗
PubMed2005

Professional roles and communications in clinical placements: a qualitative study of nursing students' perceptions and some models for practice.

BACKGROUND: Research evidence suggests that clinical placements are important to both the perceptions and outcomes of nurse education. Nevertheless, despite this knowledge, research also indicates that many students receive negative experiences whilst attending these 'remote' settings, sometimes resulting in missed opportunities for learning and negative impressions of potential places of employment. OBJECTIVE: In this context, this study investigates the experiences and perceptions of students relating to their clinical placements and, in particular, their views on professional structuring. Specifically it addresses the roles of, and communications between, the key academics, clinical professionals and institutions responsible for their organization. METHODS: Focus group discussions with students (n=7) and an interview survey of ex-students (n=30) each from two British universities in Southeast England. FINDINGS: The research highlights the diverse experiences that student receive on clinical placements, as well as their own suggestions for improvements. Student informed models of worst, minimum, current and best practice are then presented, as well as a cross-setting evaluation feedback model. These highlight responsibilities and communications across health professionals and educational sites. The models include an emphasis on the roles of ward managers, mentors, link tutors and more generally on shared but clearly delineated institutional responsibility for quality assurance mechanisms. They offer the opportunity to improve educational practice in clinically-based education and concurrently to improve student experiences and outcomes. CONCLUSIONS: Clinical placements are designed to provide practical learning through a 'slice of practice life'. However, it is necessary to maximize this learning experience. Placements certainly need not be the worst slice.

Attitude of Health Personnel↗
PubMed2005

Addressing efficiency: economic evaluation and the agenda for CAM researchers.

Considerations of efficiency are increasingly part of the broad agenda for evidence-based practice in conventional medicine. The findings of applied economic evaluations are often combined with other forms of evidence to assist clinical and wider resource decisions. It follows that as complementary and alternative medicine (CAM) strives for further integration into conventional health services, it might also be subjected to such scrutiny. In preparation for this, this paper provides a basic yet critical introduction to applied economic evaluation; the types of techniques used, their broad strengths and weaknesses, related ethical and moral debate and, in particular, specific issues concerning their application to CAM. Readers will decide for themselves whether they might be supportive of, or opposed to, economic evaluation and under what circumstances. Nevertheless, a wide-ranging agenda for research on economic evaluation and CAM is presented and some basic methodological and design issues--including place specificities and sensitivities--are highlighted.

Complementary Therapies↗
PubMed2005

Everyday health histories and the making of place: the case of an English coastal town.

During recent years, health geography has focused increasingly on how people's experiences of health and places are interrelated. This has included historical research on a variety of well-known places and remarkable events. In contrast, relatively little attention has been paid to how health and health care can be influential historically to the development, image and identity of 'everyday' and ordinary places. We focus on the case of a small town in Southern England to demonstrate the long and diverse historical connections that exist between health and such places. Using both historical documents and local literature, the paper reviews early invasions and incursions, epidemics of infectious disease, the development of a therapeutic seaside resort, the impacts of the Second World War, and more recent social and economic developments associated with an ageing population. Complex and diverse health-related histories are shown to be interwoven with local and extra-local histories including those of national or international significance. We argue that health histories can be integral to shaping the past and present of places and our broader understandings and interpretations of them. From a disciplinary perspective, we contend that by adopting theoretical perspectives from cultural geography, an enhanced historical geography of health could disentangle these historical strands, tell these important stories and put everyday health histories in their place.

Community Health Services↗
PubMed2005

Life chance characteristics of older users of Swedish massage.

The characteristics of those who use complementary and alternative medicine (CAM), as an approach to chronic disease management, are poorly understood. They may however be important to nurses and other health professionals given that CAM is increasingly used by their patients with chronic disorders. In these contexts, the purpose of this study was to ascertain unique life chance population characteristics which significantly influence the use of Swedish massage therapy (SMT), a popular form of CAM, by older adults with chronic health dysfunctions. A multi-site and cross-sectional design was used, as well as a pre-tested postal questionnaire. One hundred forty-one (141) urban, non-institutionalized, English-speaking older persons participated, ranging in age from 60 to 94 years. Findings denote the essential role life chances have on individuals accessing alternative forms of care.

Aged↗
PubMed2005

Petit bourgeois health care? The big small-business of private complementary medical practice.

Although small business private complementary medicine (CAM) has grown to be a significant provider of health care in many Western societies, there has been relatively little research on the sector in business terms and on its wider socio-economic position and role. Using a combined questionnaire and interview survey, and the concept of small business petit bourgeoisie as a framework, this paper considers the character of therapists and their businesses in England and Wales. The findings suggest that typical of the core characteristics of both the petit bourgeoisie and therapists are the selling of goods with a considerable market viability, at the same time financial insecurity; the modest size of businesses; small amounts of direct employment generation and business owners undertaking everyday 'hands-on' work themselves. Certain of the therapists' and business characteristics depart from the stereotypical image of a small businesses class, such as the high incidence of part-time self-employment and incomes being supplemented often by unrelated waged employment. However, given the acknowledged diversity of the petit bourgeoisie between societies and over time, the framework is arguably appropriate in this context, and private CAM a latest guise. Indeed, just as the petit bourgeoisie have traditionally found market niches either neglected or rejected by bigger business, small business CAM has provided the forms of health care neglected and sometimes rejected by orthodox medicine.

Adaptation, Psychological↗
PubMed2005

Towards a geography of fitness: an ethnographic case study of the gym in British bodybuilding culture.

During recent years, research in health geography has engaged with peoples' health as well as diseases, an interest reflected by therapeutic geographies and geographies of public health. At the same time, studies have focused on micro-contexts such as the body, reflected in geographies of diseased and disadvantaged bodies. However, little research has combined elements of the two approaches and engaged in research on active healthy bodies and fitness. Equally the sub-discipline of sports geography provides little insight into fitness activities because this research has tended to focus on elite sports, their fans and facilities. Given these contexts, a detailed case study is presented to demonstrate the potential for geographical research on fitness. Through an observational study of a specialist gym facility, the study investigates how bodybuilding culture and place are co-produced. Indeed, the gym provides a narrative resource and a crucial setting for individual body projects and collective body culture which involve social conflicts, cohesions and hierarchies, illegal and potentially health harming activities, as well as personal comfort and therapeutic attachments. It is argued that beyond this case study, many activities crosscut health maintenance, or conversely risks to health, and the enjoyment of sports and fitness. A greater emphasis therefore at the sub-disciplinary interface of sports and health geography on hybrid 'fitness geographies' may help researchers towards a more comprehensive understanding, and coverage, of health issues in society.

Fitness Centers↗
PubMed2005

Working in London hospitals: perceptions of place in nursing students' employment considerations.

During the past decade, a distinct body of research has started to investigate the dynamics between nursing and place. However, despite attention being paid to a wide-range of nursing subjects, few studies have engaged with the important topic of labour force recruitment. In this context, this study uses a combined questionnaire (n=650), interview (n=30) and focus group (n=7) survey of London-based students, and investigates the complex mix of experiences and perceptions that result in hospitals having varying degrees of popularity as potential workplaces. The findings suggest experiences and perceptions of institutions-often gained on clinical placements-to be important, particularly relating to feeling valued, the quality of patient care, clinical and educational opportunities and team cohesion. These are often combined with experiences and perceptions of locality, relating to factors such as cost of living, travel considerations and sense of personnel safety. The study demonstrates that place is relevant to employment decision-making on multiple scales from wards to regions. Furthermore, that perceptions of potential workplaces result from engagements with complex mixes of cultural, economic and physical features, many of which are the consequences of management. It is argued that in order to effectively unpack workplaces, geographical research of nursing labour may benefit from researching simultaneously both 'inside' institutions, focusing on their dominant cultures of production and sub-cultures, and 'outside', focusing on their local urban or rural contexts.

Adult↗
PubMed2005

'Airplanes are flying nursing homes': geographies in the concepts and locales of gerontological nursing practice.

With the geographical literatures and issues outlined in the first paper very much in mind, this paper focuses specifically on the places in the concepts and locales of gerontological nursing practice. Particular attention is paid to the role of nurses in the making of long-term care institutions and to some fundamental priorities of care. Consideration is also given to some broader impacts of neighbourhood and community as an important spatial context to nursing practice based both in institutions and the community. In the final section, the paper makes some observations on how place-sensitive practice and research might contribute to the uptake of evidence for practice. These discussions set the scene for the final paper in this special section focused on the future research agenda for place and older people nursing.

Aged↗
PubMed2005

Improving first-destination recruitment: nursing students' perceptions of three initiatives in London, England.

BACKGROUND: In the face of recruitment problems, managers are becoming increasingly proactive by introducing novel initiatives designed to encourage newly qualified nurses to apply to their institutions and catchment areas for employment. AIMS AND METHODS: Based on a multimethod survey of students from two British universities, this paper explores their perceptions of three very different initiatives, each at different stages of development and implementation. The 'Home Trust' initiative, provided the majority of clinical placements in one hospital. It was experienced by almost all the students who reported on it in questionnaires (n = 650), focus groups (n = 7) and interviews (n = 30). The 'On Secondment' initiative, seconded Health Care Assistants from their jobs into nurse education. It was experienced by a small number of students who reported on it in questionnaires (n = 32) and focus groups (n = 3). The 'Recruitment Clearing House' initiative planned to provide one interview for a range of hospitals and job vacancies in a large geographical catchment area. At the time of data collection, it was in a conceptual phase and was commented on in a small number of focus groups with students (n = 3). In addition, this initiative was commented on by recruitment managers in interviews (n = 3). RESULTS: Students held strong views on the positive and negative features of both current and prospective initiatives. Unique consumer insights were gained, particularly into their finer details and consequences. CONCLUSION: Student experiences and perceptions are valuable in the planning, implementation and review stages of local recruitment initiatives.

Attitude of Health Personnel↗
PubMed2005

Geography and nursing: convergence in cyberspace?

During the last 3 years the interface between geography and nursing has provided fertile ground for research. Not only has a conceptual emphasis on space and place provided nurse researchers with a robust and subtly different way to deconstruct and articulate nursing environments, but also their studies have provided a much needed focus on certain areas of health-care, and in particular clinical practice, not currently prioritized by health geographers. We argue that, as something that is forcing fundamental re-considerations of the nature of both nursing and geography, cyberspace is a particularly important phenomenon that lies comparatively under-researched at this interface. To encourage some interest in researching nursing and cyberspace through a geographical lens, and at least to showcase a range of potentially useful and transportable concepts, we provide an overview of some of the key debates pertaining to cyberspace developed by human geographers, and make some initial and tentative connections to nursing.

Delivery of Health Care↗