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Biomedical subjects

P Callery

Publications and source records attributed to P Callery.

At least 19 recordsLinked to original sources
PubMed2005

Weight and energy: parents' and children's perspectives on managing cystic fibrosis diet.

AIMS: To explore the meanings that parents and children attach to food and eating, and how these influence their approaches to dietary management of cystic fibrosis (CF). METHODS: Ethnographic design using in-depth interviews with 32 children with CF (aged 6-14 years) and their parents, and participant observations during visits to CF clinics with a sub-group of 21 children. Data were analysed using the constant comparative method and theoretical sampling was used to further explore and develop emergent themes. RESULTS: Dietary management was found to be a demanding task for children and their parents, and priorities differed between them. A priority of feeding for parents was to protect their children's long term physical health and survival by keeping their weight up. A challenge for parents was to ensure their children's cooperation with eating. A priority for children in being healthy was to have energy for physical activities and so energy rather than weight was of immediate relevance to their daily lives. These differences between parents and children gave rise to tensions and conflicts in their interactions with one another in managing diet. CONCLUSIONS: Healthcare professionals should take account of the meanings that children and their parents attach to food and eating that can influence their decisions about implementing CF dietary recommendations. The role of children in making food choices has implications for acknowledging them as active participants in their dietary care and for adopting child centred approaches to dietary advice for CF.

Adolescent↗
PubMed2004

Different meanings of respite: a study of parents, nurses and social workers caring for children with complex needs.

AIM: To examine the meaning of respite care to parents of children with complex conditions and providers. METHODS: In-depth interviews, participant observation and document review were used to collect data from nineteen mothers and seven fathers of children between the ages of 8 and 16 years who required complex care and from their respite providers, including thirteen nurses, and four social workers from three counties in North-west England. RESULTS: Parents described three categories of respite: short breaks provided by the extended family or friends, short breaks (3-4 h) by an outside agency, and overnight respite outside of home. They highly valued overnight respite outside the home. There was some overlap but also notable differences between parents' and providers' categorizations of respite care and the value attached to different forms of respite provision. Parents and nurses valued overnight respite outside the home unlike social workers who preferred to provide respite without separating children from their families. DISCUSSION: Appropriate provision of respite care and communication with parents requires understanding of the meaning of respite to parents. The meanings attached to respite care by parents and providers should be considered in attempts to understand and address problems of inappropriate provision and/or dissatisfaction with respite services.

Adolescent↗
PubMed2004

Re-thinking family-centred care across the continuum of children's healthcare.

BACKGROUND: The terms family-centred care (FCC) and family-centred services (FCS) are used interchangeably across the continuum of children's healthcare to encompass concepts of: parental participation in children's healthcare; partnership and collaboration between the healthcare team and parents in decision-making; family-friendly environments that normalize as much as possible family functioning within the healthcare setting; and care of family members as well as of children. However, authors from different professional and policy perspectives have used different definitions and literatures when arguing the evidence for FCC and FCS. METHOD: A critical literature review and theoretical discussion exploring common concepts and issues forming the basis for a research agenda further strengthening of the evidence base for FCC. A systematic identification of constructs, concepts and empirical indicators is developed and applied to exemplars in pain and asthma that span the continuum of children's healthcare across acute and community settings. CONCLUSIONS: The extent to which the concepts are supported by research and applied in practice remains unclear. We propose that re-thinking of FCC is required in order to develop a more coherent programme of research into the application of FCC theory in children's healthcare.

Asthma↗
PubMed2001

Enhancing the rigor of grounded theory: incorporating reflexivity and relationality.

Some proponents of the grounded theory method appear to treat interview and participant observation data as though they mirror informants' realities. Others claim that grounded theory incorporates reflexivity. It is claimed in this article that the principal texts on grounded theory do not attend to the effects of interactions between researchers and participants in interview and participant observation contexts. Descriptions of the effects of interactions on interview data and attention to relationships between interviewers and interviewees are necessary for attending to the rigor of grounded theory findings. Therefore, it is argued that reflexivity and relationality, which are defined as attending to the effects of researcher-participant interactions on the construction of data and to power and trust relationships between researchers and participants, should be incorporated into grounded theory.

Focus Groups↗
PubMed2000

Training and education: an analysis of quality assurance in teaching and nursing education.

There is a continuing tension between training and education in vocational higher education courses. The debate in nursing has been heightened by the transfer of courses into higher education and staffing problems in the NHS. Comparisons with other occupations can help prevent introspection in analysis of policy issues in nursing. Teacher training is a particularly useful comparator because it entered higher education before nursing, and teachers have failed to maintain a level of autonomy that nurses would once have envied. This paper compares nursing and teacher training with particular reference to quality assurance. The UK government has adopted a centralized quality assurance and funding system for teacher training. Nursing is included in higher education quality assurance systems but funding is devolved. The tensions between training and education within nursing and teacher training are examined, and implications for the development of nursing considered.

Curriculum↗
PubMed1997

Maternal knowledge and professional knowledge: co-operation and conflict in the care of sick children.

Although it is common-place to describe mothers as 'experts' about their own children there has been little examination of the nature of mothers' expertise in the assessment of their sick children. In this paper mothers' accounts of occasions when they believed that they knew that their children were unwell are reported. Mothers also described how it could be difficult to convince health professionals that their concerns were justified. These accounts were obtained during a qualitative study of the experiences of parents of 24 children hospitalised on a surgical ward. The nature of maternal and professional knowledge is considered and it is suggested that conflicts arise from the different nature of maternal knowledge, which develops in the 'private' domain of intimate contact and professional knowledge which is based in the 'public' domain of the world of work. These differences are illustrated by problems experienced by mothers and nurses in the integration of their different knowledge in assessments of children's pain. Implications for practitioners involved in the care of sick children are considered.

Adult↗
PubMed1997

Paying to participate: financial, social and personal costs to parents of involvement in their children's care in hospital.

Parental participation now has become an accepted feature of the care of children in hospital. However, the costs to parents of their involvement in the care of their hospitalized children have received little attention. In this paper the financial, social and personal costs to a group of parents of children admitted to a surgical ward are described. Financial costs included loss of earnings, travel and subsistence. Parents' financial commitment was open-ended and the burden of financial costs was inequitable. The organization of alternative care for siblings carried social costs including loss of privacy and autonomy in family relationships. Participation in care could be distressing and so result in personal costs. Differences between the socialization of parents and health care professionals explain some of these personal costs. Implications for policy makers and practitioners are considered.

Adaptation, Psychological↗
PubMed1997

Caring for parents of hospitalized children: a hidden area of nursing work.

Children are the recognized patients when admitted to hospital but their parents can also present demands for care by nurses. Involvement in care can be stressful for parents, particularly when children are required to undergo unpleasant procedures. Parents turn to their families for support in the first instance but some also look for care from nurses. Consequently parents can present a need for care of themselves to nurses whose primary patients are children. In this paper the experiences of a group of parents who became co-clients of nurses are considered along with the views of nurses working on the same ward. The discussion arises out of a larger study of the experiences of the parents of children admitted to a surgical ward in a children's hospital. The principal purpose of the study was to examine parents' and nurses' perceptions of their participation in the care of hospitalized children. The work of caring for parents is found to be ad hoc and unpredictable. The implications of the study for practice and policy are considered.

Adaptation, Psychological↗
PubMed1996

The use of qualitative methods in the study of parents' experiences of care on a children's surgical ward.

User satisfaction with the care of hospitalized children is examined in this paper. It is argued that parents are proxy consumers but that their status is conditional on the way in which they exercise choices. Parents' involvement in the care of their children means that the term 'user' is more appropriate than 'consumer'. Methodological problems in the assessment of user satisfaction are discussed. A study of the experiences of parents of 24 children discharged from a surgical ward of a children's hospital is described and the implications for the assessment of user satisfaction reviewed. The study demonstrates that qualitative methods have value in the assessment of user satisfaction with care. A particular strength of qualitative methods of inquiry is that limitations of users' choice in care can be assessed.

Child↗
PubMed1991

A study of role negotiation between nurses and the parents of hospitalized children.

The role of the parent of a hospitalized child has changed considerably over the past 30 years. Where parents were previously expected to had responsibility for care over to their child's nurses, there is now an expectation that parents will be extensively involved in the care of their hospitalized children. The negotiation of roles between nurses and parents has been advocated by workers concerned about conflicts between nurses and parents. However, it is not known whether such negotiation takes place between nurses and parents. It is clear that power is not evenly distributed between nurses and parents: issues of territory, stress, anxiety, uncertainty, control and conflicts arising from parental competence all place the parent in a weaker position. It is argued that the nurse holds the initiative in the decision about whether negotiation takes place. A small study is described in which nurses were invited to describes their response to their perception that a parent wanted to increase or decrease her or his involvement in her or his child's care. The critical incident technique (Flanagan 1954) was used to collect data. Nurses' responses were categorized into categories of 'encouragement', 'explanation/advice' and 'negotiation'. Responses were then placed in more specific subcategories. The inter-rater reliability of the categorization was measured. Owing to the limitations of the study, the results can only be regarded as suggestive. Nevertheless, significant association was found between the category of response and the grade of staff, with a stratified pattern of category of response demonstrated. The implications of the study for future research are discussed.

Attitude of Health Personnel↗
PubMed1990

Moral learning in nursing education: a discussion of the usefulness of cognitive-developmental and social learning theories.

The preparation of students for ethically sound practice is an essential concern for nurse educators. The theories of cognitive development and social learning theory are discussed as explanations of moral learning. The implications of the application of each of these theories to nursing education are discussed and the usefulness of each theory to nurse educators is reviewed. It is argued that neither theory is entirely satisfactory for application to nursing education and it is concluded that a pragmatic eclecticism is desirable in the approach to moral education in nursing.

Codes of Ethics↗
PubMed1976

Development of new radiopharmaceuticals based on N-substitution of iminodiacetic acid.

A new approach to radiopharmaceutical design is demonstrated, in which small chelating groups capable of binding gamma-emitting radiometals are attached to biologically active molecules, thus producing radiopharmaceuticals based on bifunctional drug and biochemical analogs. The chelating group iminodiacetic acid has been evaluated for this role by examining two N-substituted iminodiacetic acids: methyliminodiacetic acid (MIDA) and N-(2,6-dimethylphenylcarbamoylmethyl)iminodiacetic acid (HIDA). Radiochemical and biologic studies showed that both agents were obtained in high radiochemical purity, were stable in vitro and in vivo, and possessed biologic distributions governed almost exclusively by the N-substituted group. These characteristics of 99mTc-labeled N-substituted iminodiacetic acids, prepared using an "instant kit" method, provide the basis for a valuable new class of radiopharmaceuticals based on bifunctional drug and biochemical analogs.

Animals↗
PubMedDate not supplied

The development of teachers and the problem of criteria of effectiveness: an analysis of two approaches.

Two learning packages designed for the development of teachers are discussed particularly in terms of their implicit criteria of effectiveness. The potential utility of the packages in nursing education is considered. It is argued that 'Curriculum in Action' has the advantage of providing nurse teachers with the skills to take control of their practice, whilst 'Preparing for Change' seeks to alter practice from above.

Curriculum↗
PubMedDate not supplied

Involvement and fragmentation: a study of parental care of hospitalized children in Brazil.

Parental involvement in the care of children who are hospitalized has been encouraged by the government in Brazil, as it has in the United Kingdom (UK). In this paper, key aspects of the UK, North American, and Latin American literature concerning parental participation are discussed, and implications for hospital care of children in Brazil are considered. A study of the division of work between nurses and the mothers (or other relatives) of 10 children hospitalized with chronic illnesses is reported. Data were collected by participant observation of child care in a Brazilian hospital. The results highlight some of the difficulties that arise in the integration of the work of mothers and nurses in hospital care of children and the fragmentation of care into "manual" and "intellectual" work. The results are considered within the theoretical framework of the model of technologic organization of work (Gonçalves, 1979, 1994). Implications for the organization of child care in the hospital are discussed.

Attitude of Health Personnel↗