School of Nursing and Midwifery

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    Health Provider or Debt Collector? The Unintended Consequences of Integrating Income-generating Activities with Community Health Interventions in Kenya
    (Emerald, 2025-04-11) Ogenda, Kenneth Ngari; Block, Emily; Marquez, Andrea Caldwell; Ochieng, B.
    This study explores the challenges faced by community health promoters (CHPs) in Kenya as they attempt to couple income-generating activities with their public health duties. Drawing on qualitative data from in-depth interviews and focus groups discussions (FGDs) across three counties, we investigate why many CHPs ultimately abandoned health-related entrepreneurial ventures despite initial optimism. Our findings reveal two key challenges: (1) a volatile institutional environment created by shifting government policies and nongovernmental organization (NGO) interventions that destabilized markets for health products, and (2) role conflicts arising from community expectations and eroding trust when commercial transactions were introduced into health service relationships. These tensions compromise household visitations potentially impeding universal health coverage efforts. Our findings contribute to research on necessity entrepreneurship by highlighting the critical importance of institutional stability and role compatibility when designing entrepreneurial initiatives in resource-constrained contexts. It also extends institutional theory in entrepreneurship by demonstrating how institutional complexity can create irreconcilable tensions rather than opportunities for hybrid organizing.
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    Role of admiral nurses in supporting people with learning disabilities and dementia
    (RCNi, 2022-05-12) Knifton, Chris; Lyons, Victoria; Oliver, Emily; Molesworth, Sue
    The average age of people with learning disabilities is increasing, meaning that the number of people with learning disabilities and dementia is also rising. The care trajectory for people with learning disabilities and dementia is complex, starting with challenges in obtaining an appropriate diagnosis through to receiving appropriate and high-quality end of life care. The charity Dementia UK recognises the issues that families experience when someone in their family has a learning disability and dementia, and has developed a model of care in which Admiral Nurses, who are specialist dementia nurses, work in learning disability services. This article explores the role of the Admiral Nurse in learning disability services and examines the areas in which these specialist nurses provide tailored support. The article also outlines the expected outcomes of the service provided by these nurses.
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    Law and accountability for PNA practice
    (Nursing Times, 2024-07-07) Knifton, Chris; Hart, T.
    This article is the fifth in a series of discussion papers that outline how the professional nurse advocate role can strengthen their restorative clinical supervision practices. This article focuses more specifically on their legal responsibilities. It discusses the importance of professional nurse advocates having a clear and robust legal understanding so that their practice is safe and better informed. A special emphasis is placed on restorative clinical supervision confidentiality and record keeping. What aspects of the law a professional nurse advocate should consider is discussed and relevant guidance they should follow is highlighted.
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    Equity, diversity and inclusion: principles and prompts for PNA practice
    (Nursing Times, 2024-06-10) Knifton, Chris
    This article, the sixth and final in a series of discussion papers, outlines how the relatively new professional nurse advocate role can be strengthened. It focuses on the equity, diversity and inclusive aspects of the role and includes the use of prompts that have been developed and can help to guide quality review and monitoring. A four-sphere model for equity is proposed to thematically discuss these prompts in greater detail, as part of regular quality review discussions and service development.
  • ItemOpen Access
    The Perceptions of Male Accessibility to the Fields of Nursing Practice by Those Studying or Teaching Nursing in England: Cross‐Sectional Survey
    (Wiley, 2025-02-03) Carter, Daniel; Milasan, Lucian Hadrian; Clifton, Andrew; McGill, George; Stribling, Julian; de Vries, Kay
    Aims: Investigate the perception of male accessibility to the fields of nursing practice by those studying or teaching nursing in England. Design: Cross-sectional survey. Methods: Online questionnaire with three closed-scale questions and two open-text questions designed to elicit perceptions on the accessibility of men to the fields of nursing practice. The questionnaire was distributed to the staff and students at 61 nursing schools in England. Inferential and descriptive statistics were used to analyse the closed questions data and inductive content analysis was used to analyse open-text questions data. Results: Students (n = 52) and staff (n = 51) responded to the survey. Adult (Mdn = 6, IQR = 2) and mental health (Mdn = 6, IQR = 2) were perceived as the most accessible fields of nursing practice to men, and child (Mdn = 4, IQR = 2) the least. Specialised practice areas in acute and emergency (Mdn = 6, IQR = 2), education (Mdn = 6, IQR = 2), leadership (Mdn = 7, IQR = 1), prison services (Mdn = 7, IQR = 1), and research (Mdn = 7, IQR = 2) were rated the most accessible to men and neonatal care (Mdn = 3, IQR = 3) the least. Societal stereotyping and stigma were seen as barriers to men entering the nursing profession. The perception that nursing is a feminised profession persists and a distrust of men is associated with child nursing. Men were viewed as progressing to leadership roles with greater ease than women. Conclusion: Societal level stereotyping and stigma are perceived as prevalent in nursing practice areas considered less accessible to men entering the nursing profession. Impact: This study adds insight into the gendered nature of nursing and highlights the barriers to men entering a profession with a workforce crisis. Reporting Methods: STROBE cross-sectional studies guidelines. COREQ guidelines for content analysis. Patient or Public Contribution: No patient or public contribution.
  • ItemOpen Access
    Health care assistant and registered nurse dyads, working together and apart – a qualitative study
    (Springer Nature, 2024-12-30) Carroll, Rachael; de Vries, Kay; Goodman, Claire; Brown, Jayne
    Background This study was undertaken to understand the role of the Health Care Assistants and how they negotiate roles and responsibilities with registered Nurses in adult acute hospitals. Methods The qualitative approach of focused ethnography used non-participant observation and interviews with staff from four acute wards. Field notes and interview data, analysed using NVIVO10, moved data from description through explanation, interpretation and identification of themes. Results 148 h of observations and 108 interviews were conducted in dyads comprising 22 Health Care Assistants and 33 Registered Nurses. Health Care Assistants worked non-dependently from, and inter-dependently with Registered Nurse dyad partners. Dyads relied on demarcation of responsibilities by task, established and reinforced by ward culture. Demarcation enabled Registered Nurses to oversee care but could create false divides between observing and recording patients’ conditions and interpreting findings. Interdependent working only happened when two staff members were needed for care. Involvement in fundamental care by the Registered Nurse was unpredictable and discretionary. There was limited evidence of how dyads supported person-centred approaches. Conclusion The physically-boundaried, close working of the Health Care Assistant and Registered Nurse had an isolating, task driven impact on Health Care Assistants’ work. Recognising the dyad did not foster shared goals, learning or review of care.
  • ItemOpen Access
    Using AI-based Technology To Enhance Discharge to Assess Services
    (CPC, 2024-08-30) Wardell, George; McLorg, Alizée; Das, Debayan; Flashman, Clive; Gongora, Mario; Leveque, Rachna; Maluf, Adriano; Ochieng, B.; Wong, Richard
  • ItemOpen Access
    Addressing racial disparities in maternal outcomes for the population of Leicester, Leicestershire and Rutland
    (Leicester City Council, 2024-07-01) Rajangam, Akshaya; Doshani, Anji; Ochieng, B.; Cowlishaw, Beverley; Siddiqui, Farah; Ruddock, Faye; Cox, Floretta; O'Brady-Henry, Gillian; Chapman, Maxine; Bhavsar, Mina; Darko, Natalie; Archer, Natasha; Ayaz, Rabina; Howard, Rob; Abeyratne, Ruw; Etheridge, Sally; McCue, Steve
  • ItemOpen Access
    Improving students’ engagement during synchronous teaching sessions using interactive quiz tools: A case study of undergraduate nursing students at a university in the United Kingdom
    (2024-10-28) Oviasu, Osaretin; Coleby, Dawn; Humphrey, Sam
    A component of student engagement is the students’ willingness to respond to questions or ask questions during live teaching sessions.1 However, there is limited evidence that identifies how anonymous participation using interactive tools influences students’ engagement during teaching sessions. Therefore, this study examined how anonymous engagement with interactive tools impacts students’ willingness to respond to questions or ask questions during a face-to-face or virtual teaching session. The theoretical basis for the study is the Landers’ Theory of Gamified Learning.2 The study used a mixed-method approach as data were collected from undergraduate nursing students using a questionnaire. Also, a sample of some interaction reports from an interactive tool (Slido) on how students have engaged with an interactive tool during face-to-face and virtual teaching sessions were analysed. Overall, 145 students responded, majority were female (87.6%). Most participants said they will likely ask (73%) and answer (87.2%) questions using interactive tools if their responses were anonymous. Their reasons were around their confidence, avoiding embarrassment, avoiding being judged by their peers, and the fear of asking silly questions or giving wrong answers. The results indicates that students will engage more during teaching sessions when their questions or responses are anonymous. This is especially relevant when trying to get shy or non-engaging students to engage during teaching sessions. This approach could be useful for formative assessments during teaching sessions as it gives the lecturer an opportunity to assess the students’ understanding during the session enabling them to know where to focus on for the rest of the sessions. REFERENCE: 1. Brown EA, Thomas NJ, Thomas LY. Students’ willingness to use response and engagement technology in the classroom. J Hosp Leis Sport Tour Educ. 2014;15(1):80-85. doi:10.1016/j.jhlste.2014.06.002 2. Landers RN. Developing a Theory of Gamified Learning: Linking Serious Games and Gamification of Learning. Simul Gaming. 2014;45(6):752-768. doi:10.1177/1046878114563660
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    How do Muslim service users, caregivers, and community members in Malappuram, Kerala, use their faith to address the challenges associated with mental ill health?
    (Taylor and Francis, 2023-05-23) Raghavan, Raghu; Brown, Brian J.; Hussain, Saliah; Kumar, Sanjana; Wilson, Amanda; Svirydzenka, N.; Kumar, Manoj; Ali, Ameer; Chandrasekharan, Anagha; Soletti, Asha Banu; Lakhanpaul, Monica; Iyer, Meena; Venkateswaran, Chitra; Dasan, Chandra; Sivakami, Muthusamy; Manickam, Sam; Barrett, Andy; Wilson, Mike
    Our aim was to explore the role religion and spiritual beliefs play in dealing with the challenges associated with mental ill health among the Muslim community in Malappuram, Kerala. Twenty-four interviews were conducted with patients of Islamic faith diagnosed with a mental health condition (n = 10) in urban (Ponnani) and rural (Vailathur) area of Malappuram, a Muslim majority district in Kerala, their family carers (n = 8) and community members (n = 6). Four key themes were derived, namely (1) Attribution to supernatural factors, (2) Relying on “God’s will”, (3) Prayer, and (4) Traditional healing. Faith was seen to be a prerequisite for any treatment, including modern medicine, to work. Even within a single faith group there can be considerable variation in belief and practice, with more pious participants disapproving of the reliance on local traditional healers and belief systems, highlighting the value of paying attention to the detail of local beliefs and practices.
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    Writing for an international audience
    (2024-08-10) Hinsliff-Smith, K.; Watson, R; Oerther S; Sidebottam, M
    Nurse Education in Practice is a leading journal in nursing and midwifery education as evidenced by the rising impact factor and growing readership globally. To increase our reach and impact, as stated in the current version of our Aims and Scope: “Nurse Education in Practice aims to publish leading international research and scholarship on the practice of nurse and midwifery related education.” One of the reasons why manuscripts are rejected at desk or sometimes after review is that they do not demonstrate adherence to the requirement to be international.
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    How is men’s mental health affected within male professional football?
    (Taylor and Francis, 2024-06-26) Souter, Gary; Serrant, Laura; Haines-Delmont, Alina
    Research question: How is men’s mental health affected within male professional football? Research methods: Within this qualitative study, eighteen current first-team professional footballers were interviewed from across the English Football League (EFL) to explore how male professional footballers are affected by mental health. Braun and Clarke’s thematic analysis (2006) was applied along with “The Silences Framework” [Serrant-Green, L. (2010). The sound of “silence”: A framework for researching sensitive issues or marginalised perspectives in health. Journal of Research in Nursing, 16(4), 347–360] to allow the voices of this marginalised group to be heard. Results and findings: The five key themes of social networks, environment, masking vulnerabilities, help-seeking and support, and mental health emerged from the data. The mental health theme is split into two sub themes: impact on self and reaction of others. Implications: This study makes an original contribution to the knowledge base as it is the first study to innovatively apply The Silences Framework to a sporting context. This study has applied The Silences Framework to show that professional footballers are affected by their mental health, and without appropriate access to support they continue to suffer in silence. This is likely to have negative consequences in their personal life, their football career, and their eventual transition away from being a professional footballer
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    Emerging leaders, your universities need you
    (Times Higher Education, 2024-07-03) Allman, Zoe; Souter, Gary
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    Understanding Female Genital Mutilation (FGM)
    (The University of Nottingham, 2024-05-20) Hinsliff-Smith, K.; McGarry, Julie; Ejiroghene ogigbah Adogho, Agatha; Konstantinidis, Stathis; Langmack, Gill; Nkoyo, Valentine; Recchia, Natasha; Wathoni, Angela; Wightman, Helen; Windle, Richard
    It is estimated that more than 200 million girls and women alive today have undergone female genital mutilation in the countries where the practice is concentrated. The majority of girls are cut before they turn 15 years old. Over 200 million women and girls alive today have experienced female genital mutilation. In 2023, an estimated 4.3 million girls are at risk of being subjected to female genital mutilation , and UNFPA estimates show COVID-19-related disruptions to programming could enable 2 million more cases of female genital mutilation to occur over the next decade unless concerted and accelerated action is taken. (UNFPA-UNICEF, 2023) This statement comes directly from the World Health Organisation and whilst it remains a major issue in countries where it is traditionally practiced, increased globalisation and population movement has seen a rise in women and girls living with Female Genital Mutilation (FGM) throughout the world, including in the UK. This poses a challenge for health care professionals who must look beyond the rhetoric to provide culturally competent care, and as such need to understand FGM, its cultural background and impact, fully.
  • ItemOpen Access
    Human Factors for Healthcare. A Guide for Nurses and Allied Health Professionals
    (Elsevier, 2024-05-28) Ackbarally, Ally; Paton, C.
    Human factors as a science is key to patient safety, quality improvement whare factors such as fatigue and poor communication play a role and can increase the risk of safety incidents. This new book is the first to address the specific needs in this area of nurses and allied health professionals, who make up the majority of the workforce. The aim of the book is to support understanding of human factors and the role they play in quality and safety. It will help the reader identify risks, understand human error, and develop non-technical skills (social, cognitive and personal) that will support them in their practice across a range of clinical environments.
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    Frailty identification and management among Brazilian healthcare professionals: a survey
    (Springer Nature, 2024-06-03) Hinsliff-Smith, K.; Gordon, Adam Lee; Schmidt Azevedo, P.; Melo, R.; Souza, J. T.; Frost, R.; Gavin J.; Robinson, K.; José Fortes Villas Boas, P.; Ferreira Minicucci, M.; Aprahamian, I.; Wachholz, P.
    Background: National and international guidelines on frailty assessment and management recommend frailty screening in older people. This study aimed to determine how Brazilian healthcare professionals (HCPs) identify and manage frailty in practice. Methods: An anonymous online survey on the assessment and management of frailty was circulated virtually through HCPs across Brazil. Results: Most of the respondants used non-specific criteria such as gait speed (45%), handgrip strength (37.6%), and comprehensive geriatric assessment (33.2%). The use of frailty-specific criteria was lower than 50%. The most frequently used criteria were the Frailty Index (19.1%), Frailty Phenotype (13.2%), and FRAIL (12.5%). Only 43.5% felt confident, and 40% had a plan to manage frailty. In the multivariate-adjusted models, training was the most crucial factor associated with assessing frailty, confidence, and having a management plan (p<0.001 for all). Those with fewer years of experience were more likely to evaluate frailty (p=0.009). Being a doctor increased the chance of using a specific tool; the opposite was true for dietitians (p=0.03). Those who assisted more older people had a higher likelihood of having a plan (p=0.011). Conclusion: Frailty assessment was heterogeneous among healthcare professions groups, predominantly using non-specific criteria. Training contributed to frailty assessment, use of specific criteria, confidence, and having a management plan. This data informs the need for standardized screening criteria and management plans for frailty, in association with increasing training at the national level for all the HCPs who assist older people.
  • ItemOpen Access
    A systems approach in the prevention of undernutrition among children under five in Tanzania: Perspectives from key stakeholders
    (MDPI, 2024-05-21) Frumence, Gasto; Jin, Yannan; Kasangala, Amalberga; Bakar, Saidah; Mahiti Reuben Gladys; Ochieng, B.
    Undernutrition among under-fives is one of the major public health challenges in Tanzania. However, there are limited studies assessing the contribution of cultural-related strategies in the prevention of child undernutrition in Tanzania. This study aimed at exploring participants’ experiential views regarding developing culturally sensitive strategies for the elimination of child undernutrition for under-fives in Rukwa, Iringa, Ruvuma, Songwe and Njombe regions located in the Southern Highlands in Tanzania. This study applied focus group discussions (FGDs) with forty practitioners to explore culturally-sensitive strategies for effectively preventing child undernutrition in Tanzania. The study participants were purposively selected, and thematic analysis was used to identify themes within the data. This study revealed that district- and lower-level administrative systems should prioritize nutrition interventions in their plans, allocating adequate resources to implement culturally sensitive nutrition interventions, while national-level organs need to strengthen institutional capacity and ensure the availability of funds, skilled human resources and a legal framework for the effective implementation and sustainability of nutrition interventions at the district and lower-levels. This study highlights that for the successful implementation of culturally sensitive strategies towards the elimination of child undernutrition, there is a need to use a systems approach that allows for collaborative governance whereby different sectors act together to address the persistent malnutrition epidemic.
  • ItemOpen Access
    Researching Local Public Health Priorities in The Locked Down City Using Online Community Focus Groups: Reflections and Recommendations
    (Elsevier, 2024-05-14) Williamson, I. R.; Lond, Benjamin J.; Hart, Tania; Clifton, Andrew; Ochieng, B.
    In this commentary paper we reflect on our experiences of conducting two qualitative public health projects in Leicester UK around health inequalities and marginalised groups during the Covid 19 pandemic in 2020 and 2021. To contextualise the commentary, we first provide information about Leicester and how and why it was disproportionately affected by the pandemic, as well as describing the origins, aims, and methodologies of the two projects. In the second half, we describe and evaluate some of the adaptations we made to our studies and conclude with suggestions for future qualitative community health research as we adapt to the post-pandemic research landscape.
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    Creative approaches towards protecting the planet in clinical skills and simulation in nursing education
    (Elsevier, 2024-03-12) Arden, Catherine; Taylor-Rollings, Hannah; Tremayne, Penny; Padley, Wendy; Hinsliff-Smith, K.
    As we ponder the bigger picture of environmental issues, sustainability and global challenges as a society, we note that planetary health and sustainability is a theme at the next NET/NEP conference to be held in Singapore, Oct 2024 (Elsevier 2024). We have been reviewing some of our practices, particularly within our undergraduate nursing programmes and the materials we use in our clinical skills labs to set one context and to hopefully trigger some discussion for the reader. We are also responding to the Royal College of Nursing positioning statement (2019) “recognising climate change undermines the very foundations of our health” linked to the WHO equally stating that climate change is the “defining health challenge of our time” (WHO, 2023). Within all UK undergraduate nursing programmes, the Nursing and Midwifery Council (NMC), our professional body requires all candidates to undertake 50% theory and 50% clinical practice in their curricula and this approach is common across a wide range of programmes outside of the UK (Morgan et al., 2024). We are all aware that within our programmes an element of preparation is required for the acquisition of clinical skills prior to learners going into their mandatory clinical placements. Many Faculties also provide opportunities in purpose-built simulation or clinical skills labs (Borneuf & Haigh, 2010).