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Biomedical subjects

V Woodward

Publications and source records attributed to V Woodward.

12 recordsLinked to original sources
PubMed2001

Women's anxieties surrounding breast disorders: a systematic review of the literature.

A systematic review of the research literature published in English between 1990 and 1999 was carried out to discover whether women with benign breast disorders suffer similar amounts of anxiety to women with breast cancer in the time between discovery of the problem and receiving a diagnosis, to include the immediate postdiagnosis phase. The study was limited to primary research papers with explicit methodology applicable to hospital specialist breast clinics where the main focus of the papers was anxiety and/or psychological distress. Studies focusing exclusively on routine breast screening or exclusively on women with previously diagnosed breast cancer were omitted. A protocol for the review was agreed at the outset, addressing selection criteria, search procedures, methods of data extraction and analysis, and dissemination. Search terms were refined as the study progressed. A data extraction tool was constructed based on Benton and Cormack's framework (Benton & Cormack 1996, pp. 80-81). An initial search revealed 89 papers. Fourteen papers were found to meet the criteria for inclusion. The main findings were that women with benign breast disorders and those with breast cancer suffered from similar levels of anxiety and psychological distress in the period from first being aware of the problem up to the time of receiving a diagnosis. Anxiety levels were found to fall more quickly in women with benign disorders postdiagnosis. Methodological flaws were detracted from the rigour of many of the studies. Implications for practice are discussed.

Adaptation, Psychological↗
PubMed2000

Caring for women: the potential contribution of formal theory to midwifery practice.

OBJECTIVE: To explore the interpretations midwives and nurses attach to the concept of caring, how caring values are manifest clinically and might be encouraged educationally. DESIGN: Ethnographic fieldwork was undertaken in UK National Health Service palliative and maternity-care hospital settings for 12 and 10 days respectively. This involved non-participant observation, semi-structured, audio-taped interviews with seven midwives and six nurses. Ad hoc conversations with service-users were also undertaken and contextual information, such as staffing levels, was collected. The data were thematically analysed against a conceptualisation of caring developed from nursing and philosophical literature. FINDINGS: Comparison of observational and interview data across the settings identified qualitative differences in care delivery. In the palliative care setting, practice was other-centred, receptive, responsive and attentive to the patient's person and experience. In comparison, caring values appeared eroded in the maternity setting, where practice was often routinised, task-orientated and, on occasions, unresponsive to women's needs. Features existed in the palliative care setting which appeared instrumental in facilitating a caring practice culture. In particular, clinical leaders facilitated team cohesion through daily 'debrief' meetings and care enhancement against theoretical frameworks. These encompassed caring values and provided the source of problem identification and remedial strategy. No such collective, theoretical perspectives were evident in the maternity setting. DISCUSSION AND IMPLICATIONS FOR PRACTICE: Whilst acknowledging the limitations of formal theory, it is suggested that midwifery goals and priorities of care could be utilised to theoretically frame, critically evaluate and guide practice. This has the potential to heighten awareness of care deficits and enable midwives to work collectively to enhance women's experience of childbirth at both clinical and political levels.

Empathy↗
PubMed1999

The decision to resuscitate: older people's views.

The aim of this study was to explore how a healthy sample of the older population feel about resuscitation and the decision not to resuscitate certain patients. Their views were sought on whether a Do Not Resuscitate decision is appropriate in certain circumstances, whom they think should be involved in the decision, whether they think patients should be consulted, and if they would like to be involved in the decision themselves. Two focus groups were held in a day care setting in order to collect data, and a thematic analysis was conducted. Participants thought that a Do Not Resuscitate decision should be discussed with patients and also with relatives if appropriate. However, there was ambivalence about whether individuals would like to be involved personally in such a decision because of the anxiety this would produce.

Aged↗
PubMed1999

Achieving moral health care: the challenge of patient partiality.

Illness and hospitalization are sources of vulnerability; they arguably endow nurses and midwives with the moral obligation to develop caring relationships with patients. Fairness and the equal treatment of patients are central to moral practice; current government publications are giving this political emphasis. This article argues that patient partiality is one factor that may result in insidiously unequal caregiving. Data generated during a qualitative study into professional caring suggest that patient partiality is an accepted part of everyday practice. Factors such as the patient's personality, nurse-patient familiarity and the perceived level of patients' understanding and interest in their illness emerged as possible sources of partiality and influence on practitioners' interactions with patients. The article argues that patient partiality can be managed morally if practitioners develop self-awareness and constantly reflect on the moral integrity of everyday practice. Throughout the article, unless it is stated that specific reference is being made to either nurses or midwives, reference to a nurse or practitioner denotes both. It is also emphasized that no implication is intended that any study participants provided unequal care. Rather, data are utilized solely to generate focused discussion around the concept of patient partiality.

Attitude of Health Personnel↗
PubMed1996

Midwifery degrees--will they deliver?

Midwifery education is in a process of change; links to higher education are being encouraged. Degrees should provide a greater theoretical base from which to practise. Degrees may improve practitioners' confidence, self-worth and negotiating skills. There are fears that graduates may become distanced from basic care provision. Perceptions exist that degree education is cut off from practice reality. Degree courses should be questioning, reflective, research-based and woman-centred.

Clinical Competence↗
PubMed1995

Measurement of psychological distress in asthma and asthma management programmes.

The Asthma Bother Profile assesses one of the components of asthma experience: asthma distress. An initial questionnaire was constructed from the content of earlier asthma quality of life research and modified by comments of 32 asthmatics in focus groups. Psychometric analysis of responses of 131 asthmatics to the final questionnaire showed that the 15 ¿bother items' constitute a unidimensional measure of asthma distress with high internal consistency, and the seven ¿management items' assess the patient's confidence of asthma knowledge, perception of the quality of care and confidence in managing asthma attacks. Patients who had attended a self-management clinic reported more knowledge of asthma, more bother from treatment but not significantly less bother in other contexts. Knowledge about when to call the doctor but not knowledge about medicine or asthma was correlated with total bother. Self-management programmes that encourage problem-focused coping strategies may not reduce asthma distress unless distress reduction counselling is included within the education programme.

Adaptation, Psychological↗