1,721,052 research outputs found
Research Governance and changes to the procedures for local research ethics committees
No full textThis leading article draws on the Research Governance Framework and the new governance arrangements for National Health Service research ethics committees to highlight the implications of these documents for physiotherapy researchers. It focuses on the domains highlighted in the Research Governance Framework: ethics, science, information, health and safety, and finance. It concludes by summarising the responsibilities of researchers within the Research Governance Framework and how these relate to the responsibilities of other individuals and organisations involved with research
The experience of being disabled and obese
No full textPurpose. This qualitative study was designed to explore the experiences of disabled and severely obese people living in the community. The challenges that their size and disabilities posed within their homes and in accessing community facilities were explored, with particular reference to the provision and use of assistive technologies.Methods. The study comprised in-depth interviews with a sample of six severely obese, disabled people using a grounded theory approach.Results. Three key themes emerged: the experience of daily life; accessing services; and responses to challenges. The study participants found that their home and community environments were seldom adequate for their size. Difficulties were identified in relation to accessing and using NHS services and negative attitudes and treatment from staff. Assessments and quality of assistive devices and housing adaptations received were criticised by some. Participants identified a range of responses to these challenges.Conclusion. The challenges that obesity bring are compounded by disability, including the need for higher levels of care and the higher costs of assistive devices for this client group. The study suggests there may be a need for training for professionals who work with obese, disabled people to ensure their needs are met in appropriate and cost-effective ways
Managing anonymity and confidentiality in social research: the case of visual data in community research
Full text linkAnonymity and confidentiality of participants are central to ethical research practicein social research. Where possible, researchers aim to assure participants that everyeffort will be made to ensure that the data they provide can not be traced back to themin reports, presentations and other forms of dissemination. The primary methodresearchers use to preserve anonymity and confidentiality is the use of pseudonymsfor participants and also for the location of the research. In addition, other practices,such as changing the reported characteristics of participants (such as gender oroccupation) are also used by some researchers to conceal identities and therebymaintain the confidentiality of the data provided by participants. There are severalissues that such practices raise. One is that it is difficult for researchers to know howfar to take anonymisation of individuals in order for them not to be identifiable, giventhat research findings may be presented to a variety of audiences, including membersof participants’ communities. A second issue is that research participants holddiffering views about the desirability of anonymisation, presenting researchers withdifficult choices between respecting the preferences of those participants who wish tobe identifiable and those who prefer to remain anonymous. A third issue is that ofwhether or not to attempt the anonymisation of the location of the research, whichmay be adjudged more or less practical or impractical (depending on itsdistinctiveness) and more or less desirable (depending on its importance in providingthe social context of the analysis that is being developed). This paper explores theseissues by looking at how they have been handled by researchers in the field ofcommunity sociology (broadly defined) who have used visual data in their reports.This analysis allows the argument to be developed that although the issues themselvesare not new, the ways in which they are handled by researchers are necessarilyevolving in the context of technological change, the growth of research regulation,and shifts in the expectations of research that participants hol
Evidence based physiotherapy: physiotherapists' attitudes and experiences in the Wessex area
No full textThis study sought to explore physiotherapists' views and experiences of evidence-based practice (EBP). Focus groups and interviews were held with 56 physiotherapists of all grades, working in a variety of different NHS settings in the eastern part of the South and West Region. The aims were to identify physiotherapists' understanding of EBP and their views as to its appropriateness in physiotherapy and what factors they felt promoted or discouraged its development. Focus groups and interviews were tape-recorded and transcribed before thematic analysis. The findings were discussed at a consensus conference. Various recommendations emerged.The study found that physiotherapists' definitions of EBP varied depending on their understanding of the term ‘evidence'. Views ranged from evidence being only those facts emerging from robust research to personal or anecdotal evidence from clinical practice – with most people seeing it as a mix. Junior physiotherapists and others working within university hospital settings felt they had the skills necessary to appraise research findings prior to implementation in practice. Others, particularly senior physiotherapists working in community settings, felt they did not. Community physiotherapists also felt a lack of engagement with EBP activities such as journal clubs and development of clinical guidelines due to poor access to library facilities and difficulties in meeting with peers.All participants felt EBP to be important to the continuing development of the profession. In order to facilitate this it is important to develop a culture that promotes critical appraisal and a willingness to look further than personal experience. Physiotherapy managers and the professional body have a role to play in the development of these skills through the provision of resources and training. However, individual physiotherapists have a responsibility to provide the best treatment for their patients through reflective consideration of all available evidence
Physiotherapists and evidence based practice: an opportunity or threat to the profession?
No full textThe profession of physiotherapy in the UK is undergoing a period of change. Prominent among these aspects of change is the movement to evidence based practice (EBP). EBP is a central element of policy in the National Health Service (NHS). It is being implemented in physiotherapy as a means of securing contracts with purchasers but also as a means of contesting challenges from alternative practitioners and health professionals to the areas of work that physiotherapists view as their territory. Using data collected from a qualitative study of 56 physiotherapists of different grades working in different sectors of the NHS, this paper explores physiotherapists' views of EBP and the impact that they expect it to have on professional boundaries and on the status and practice of physiotherapy. The study indicated that physiotherapists' views may differ according to their position in the profession. Senior physiotherapists appeared to view the development of EBP as a threat to the profession which would decrease professional autonomy and the status of the profession. In contrast, junior and superintendent physiotherapists appeared to view EBP as an opportunity for strengthening the profession. The impact EBP will have on the profession of physiotherapy and its relationships with a range of health professionals is as yet unknown as are the responses that physiotherapists are likely to have to this development. This study identifies the areas in which conflicts are likely to be played out. A focus for future research analysing the impact of EBP is suggested
Resisting blame and managing emotion in general practice: the case of patient suicide
No full textUK Governing bodies are imposing increased forms of regulation on General Practitioners (GPs). This paper explores one example of such governance – the audit of GP practice through Critical Incident Reviews (CIRs) following patient suicide. Drawing on interviews with 16 GPs about their involvement in a CIR of a patient's suicide, we found that the review process initially provoked strong emotions of sadness and guilt as well as fear of blame. Ultimately, however, most GPs felt comforted by the CIRs because their findings confirmed that they were not responsible for the suicide. At the same time, the GPs indicated that such comfort was tenuous due to the broader blame culture and because they foresaw many future audits as part of an inflationary spiral of surveillance and risk management. While the GPs adopted strategies to manage and resist surveillance, the effects of CIRs on patient care may be mixed, with the potential both to improve clinical practice and contribute to adverse outcomes. We argue that CIRs paradoxically contain and create anxieties about suicide among GPs and society more broadly
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