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Paul Wainwright

Publications and source records attributed to Paul Wainwright.

5 recordsLinked to original sources

Phenomenology as a paradigm of movement.

Phenomenology is a well-founded qualitative methodology that is frequently used by nurse researchers and considered of value when addressing research questions in nursing practice and nurse education. However, at present, nurse researchers using phenomenology tend to divide phenomenological methodology into the descriptive and interpretive formats. The nursing literature suggests that there is a deep divide between researchers following the methodological underpinnings and basic precepts pertaining to these two camps. If we are to reach a clearer understanding of the theory underlying phenomenological methods it would be more helpful if we started to recognise that there are also important associations between transcendental and interpretive phenomenology. One such association is that a paradigm of movement exists that is not unique to transcendental and interpretive phenomenology but is common to them, as well as being inherent within a variety of fields of study. If we consider the universality of such imagery, looking to examples through parallel texts, we can obtain insights into phenomenology and its transposition into a workable scientific method that can be of use to the nurse researcher.

Attitude to Health↗

Design and performance of a multi-centre randomised controlled trial and economic evaluation of joint tele-consultations [ISRCTN54264250].

BACKGROUND: Appropriate information flow is crucial to the care of patients, particularly at the interface between primary and secondary care. Communication problems can result from inadequate organisation and training, There is a major expectation that information and communication technologies may offer solutions, but little reliable evidence. This paper reports the design and performance of a multi-centre randomised controlled trial (RCT), unparalleled in telemedicine research in either scale or range of outcomes. The study investigated the effectiveness and cost implications in rural and inner-city settings of using videoconferencing to perform joint tele-consultations as an alternative to general practitioner referral to the hospital specialist in the outpatient clinic. METHODS: Joint tele-consultation services were established in both the Royal Free Hampstead NHS Trust in inner London, and the Royal Shrewsbury Hospitals Trust, in Shropshire. All the patients who gave consent to participate were randomised either to joint tele-consultation or to a routine outpatients appointment. The principal outcome measures included the frequency of decision by the specialist to offer a follow-up outpatient appointment, patient satisfaction (Ware Specific Questionnaire), wellbeing (SF12) and enablement (PEI), numbers of tests, investigations, procedures and treatments. RESULTS: A total of 134 general practitioners operating from 29 practices participated in the trial, referring a total of 3170 patients to 20 specialists in ENT medicine, general medicine (including endocrinology, and rheumatology), gastroenterology, orthopaedics, neurology and urology. Of these, 2094 patients consented to participate in the study and were correctly randomised. There was a 91% response rate to the initial assessment questionnaires, and analysis showed equivalence for all key characteristics between the treatment and control groups. CONCLUSION: We have designed and performed a major multi-centre trial of teleconsultations in two contrasting centres. Many problems were overcome to enable the trial to be carried out, with a considerable development and learning phase. A lengthier development phase might have enabled us to improve the patient selection criteria, but there is a window of opportunity for these developments, and we believe that our approach was appropriate, allowing the evaluation of the technology before its widespread implementation.

Adult↗

The ethical divide.

Ethics is an area of growing interest in nursing and is a compulsory part of nurse education. Yet record numbers of nurses care being removed from the register and media stories of poor practice are rife. This article explores the issues. Ethics is about how we ought to behave towards one another. Ethics can be seen as elitist and too theoretical, failing to bridge the theory-practice gap. Discussion of ethics in health care tends to concentrate on issues with a 'gee-whizz' factor. Health care is a moral enterprise and, therefore, nursing has moral ends.

Education, Nursing↗

Risk, Helsinki 2000 and the use of placebo in medical research.

There has been vigorous debate over the use of placebo controls in clinical trials in human subjects where active treatments are already in widespread use. The debate has extended from the use of placebo controls in trials of products for AIDS in developing countries to the use of placebos in trials in conditions such as mild hypertension, asthma, depression, chronic stable angina etc. Some have argued that placebos can never be justified where an active treatment exists. By contrast, we believe that minor levels of risk are justified in healthcare research under defined conditions provided there is full information and consent. The opportunities for altruism in research should neither be exploited nor prevented.

Acquired Immunodeficiency Syndrome↗