			Home About us Contact

User Involvement (user + involvement)

Distribution by Scientific Domains

Medical Sciences	74%
Information Science and Computing	12%
Business, Economics, Finance and Accounting	7%
2 Other Domains	7%

Distribution within Medical Sciences

Consumer Health General	68%
Nursing General	31%

Kinds of User Involvement

service user involvement

Selected Abstracts

User involvement, research and health inequalities: developing new directions

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 4 2007
Peter Beresford BA(Hons) PhD FRSA AcSS DipWP
Abstract Placed in the context of broader discussions and developments about service user involvement in research and evaluation, this paper looks at the role that user involvement research may play in health inequalities research. It examines the pressures for and against such user involvement research, its different expressions and ideological relations, and what particular contribution it may have to offer in researching health inequalities. In considering how it may help in developing substantive understandings of these issues and the role it may play in the future, particular attention is paid to the issue of enabling the diverse involvement of service users in order not to reinforce existing exclusions and barriers in research, policy and practice. [source]

Getting ready for user involvement in a systematic review

HEALTH EXPECTATIONS, Issue 2 2009
Elizabeth Smith BSc MSc PhD
Abstract Objective, This paper aims to support the critical development of user involvement in systematic reviews by explaining some of the theoretical, ethical and practical issues entailed in ,getting ready' for user involvement. Background, Relatively few health or social care systematic reviews have actively involved service users. Evidence from other research contexts shows that user involvement can have benefits in terms of improved quality and outcomes, hence there is a need to test out different approaches in order to realize the benefits of user involvement and gain a greater understanding of any negative outcomes. Design, Setting up a service-user reference group for a review of user involvement in nursing, midwifery and health visiting research involved conceptualizing user involvement, developing a representation framework, identifying and targeting service users and creating a sense of mutuality and reciprocity. Setting and participants, Recruitment was undertaken across England by two researchers. Members from 24 national consumer organizations were selected to participate in the review. Main variables studied, Learning was gained about finding ways of navigating consumer networks and organizations, how best to communicate our goals and intentions and how to manage selection and ,rejection' in circumstances where we had stimulated enthusiasm. Results and conclusions, Involving service users helped us to access information, locate the findings in issues that are important to service users and to disseminate findings. User involvement is about relationships in social contexts: decisions made at the early conceptual level of research design affect service users and researchers in complex and personal ways. [source]

User involvement in developing mobile and temporarily interconnected systems

INFORMATION SYSTEMS JOURNAL, Issue 2 2010
Ola Henfridsson
Abstract Information systems (IS) research on user involvement has primarily theorized relationships between developers, managers and users in systems development. However, so far, marginal attention has been paid to differences in user involvement practices between information systems. This paper explores user involvement in developing mobile and temporarily interconnected systems (MTIS). We refer to MTIS as heterogeneous systems that rely on network technologies for increasing the ubiquity of information services for users on the move. Such systems are becoming increasingly important in leveraging, e.g. car infotainment, supply chain management and wireless e-commerce. With particular emphasis on the nature of MTIS and its implications for user involvement, the paper analyses the systems development process of an action research project. The findings suggest that user involvement practices need to be adapted to accommodate features of this class of systems. Being an early attempt to trace the implications of technology features such as use context switches and temporary system relationships, the paper contributes to the development of an updated theory of the user role in an era of increased system complexity and stakeholder ambiguity. [source]

The uptake of applied ecology

JOURNAL OF APPLIED ECOLOGY, Issue 1 2002
S. J. Ormerod
Summary 1We asked 229 authors who have published recently in the Journal of Applied Ecology (1999,2001) whether their papers made management or policy recommendations and whether they had evidence of consequent uptake. 2A total of 108 respondents working in the UK (34%), Europe (30%), the Americas (12%), Australasia (11%), Asia (7%) and Africa (6%) reported on 110 papers. They represented agro-ecosystems (35%), temperate forests or woodlands (16%), savanna, grass or arid lands (11%), rivers or wetlands (10%), estuaries or marine systems (7%) and tropical forests (5%). The major organisms were invertebrates (27%), birds (24%), mammals (21%) and higher plants (21%). Topics apparently under-represented in recent coverage include ecosystem science, urban areas, soils, mountain systems, fish, amphibians and lower organisms such as algae. 3Almost all papers (99%) carried recommendations and for 57% there was evidence of uptake in the broad categories of ,environmental management or models', ,information, training and education' and ,monitoring and assessment'. Most uptake involved large geographical scales through habitat or species management plans (32% of cases), effects on reserve design or designation (6%), and effects on agri-environmental policy (5%). The development of further research (11%), the communication of methods to other ecologists (9%), the dissemination of recommendations to practitioners or agencies (7%), and uptake in training or education (5%) were important uses of information. 4Prestige from publication in the Journal of Applied Ecology aided several authors in convincing end-users of research value. User involvement in research as participants or funders was widespread (> 42% of papers), a fact which almost certainly promotes uptake along with the parallel dissemination of management messages. We view applied issues as an important interface between end-users and ecologists of value to ,both' communities but suggest that improved communication will further benefit the sponsorship and application of ecological science. 5The major reason offered for lack of uptake was that it was still too soon after publication (21% of respondents). Costs, difficulty of implementation, the scale of the problem, and ,challenges to existing thinking' each figured in more than one response. 6For some respondents, papers were led by curiosity rather than the need for direct application. Several authors published in the Journal to share ideas internationally, or said that recommendations were general, conceptual or long-term rather than specific. The editors of the Journal of Applied Ecology recognize the seminal importance of contributions that affect policy incrementally and conceptually as much as those with specific application. 7These data provide evidence that ecological science is aiding environmental management and policy across a wide range of regions, ecosystems and types of organisms; rather than merely detecting problems, applied ecology is offering solutions both directly and more diffusely through conceptual advance. We invite the user community to offer their own perspectives about the value of research-led publications such as this Journal, about how links between researchers and users might be strengthened, and about how the uptake of applied ecology might be further advanced. [source]

Harnessing the Creative Potential among Users,

THE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 1 2004
Per Kristensson
User involvement in the development of new products may offer a novel approach to improved methods of meeting customer needs. These users are considered to offer possibilities for generating original, valuable, and realizable ideas leading to successful innovation. However, the merit of users' ideas compared to ideas generated by the company itself has not been investigated empirically. In the present study, advanced users, ordinary users, and professional product developers were given the task of creating ideas for future mobile phone services. The main purpose was to examine the benefit of involving users in suggesting new product ideas in an innovation project. An experimental three-group design was used in order to assess the output in terms of its original, valuable, and realizable merit. The results indicated that ordinary users create significantly more original and valuable ideas than professional developers and advanced users. Professional developers and advanced users created more easily realizable ideas, and ordinary users created the most valuable ideas. The results were discussed from the viewpoint of divergent thinking. It was suggested that divergent thinking was facilitated through the opportunity to combine different information elements that appeared separate at the outset, such as personal needs coupled with the functionality of mobile phone services. [source]

Usability levels for sparse linear algebra components,

CONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 12 2008
M. Sosonkina
Abstract Sparse matrix computations are ubiquitous in high-performance computing applications and often are their most computationally intensive part. In particular, efficient solution of large-scale linear systems may drastically improve the overall application performance. Thus, the choice and implementation of the linear system solver are of paramount importance. It is difficult, however, to navigate through a multitude of available solver packages and to tune their performance to the problem at hand, mainly because of the plethora of interfaces, each requiring application adaptations to match the specifics of solver packages. For example, different ways of setting parameters and a variety of sparse matrix formats hinder smooth interactions of sparse matrix computations with user applications. In this paper, interfaces designed for components that encapsulate sparse matrix computations are discussed in the light of their matching with application usability requirements. Consequently, we distinguish three levels of interfaces, high, medium, and low, corresponding to the degree of user involvement in the linear system solution process and in sparse matrix manipulations. We demonstrate when each interface design choice is applicable and how it may be used to further users' scientific goals. Component computational overheads caused by various design choices are also examined, ranging from low level, for matrix manipulation components, to high level, in which a single component contains the entire linear system solver. Published in 2007 by John Wiley & Sons, Ltd. [source]

User involvement, research and health inequalities: developing new directions

Stakeholders' views on measuring outcomes for people with learning disabilities

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2006
Anita F. Young PhD DipCOT
Abstract What works and how do we know? These are recurring questions for health and social care professionals, although mediated through differing philosophies and historical perspectives. The aims of the study reported here were to discover views of managers and commissioners of services for people with learning disabilities in Scotland regarding (a) current approaches to service evaluation (as an indication of what is to be measured) and (b) healthcare outcome measurement (as an indication of preferences regarding how this should be measured). A postal questionnaire was used to survey 94 stakeholders from the NHS, Local Authorities, and non-statutory organisations across Scotland. Respondents' views were sought on current approaches to service evaluation within learning disabilities; outcome measurement; appropriateness of specified methods of measuring health outcomes; desired future methods of outcome measurement within learning disabilities; and service user involvement in care. A 77% (73/94) response rate to the questionnaire was achieved. Different methods of service evaluation were used by different stakeholders. Staff appraisal was the most frequently identified method (used by 85% of respondents). Specific outcome measures were used by 32% of respondents although there were differences of opinion as to what constitutes specific outcome measures. Overall there was strong support for goal-setting and reviewing (83%) and individualised outcome measures (75%) as appropriate methods for use with people with learning disabilities. The hypothetical question asking what outcome measures should be introduced for this client group had by far the lowest response rate (51/73). The overwhelming majority of all respondents, 68 (92%), reported user involvement in their service. Staff ambivalence to outcome measurement was evident in the research and respondents highlighted the complexity and multidimensional nature of outcomes for this service user group. Managers recognised that outcome measurement was expected but were uncertain how to go about it. [source]

Young adults' (16,25 years) suggestions for providing developmentally appropriate diabetes services: a qualitative study

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 5 2005
Gail Dovey-Pearce BA (Hons) D Clin Psychol
Abstract Managing the multiple demands of a chronic condition whilst negotiating the developmental tasks of adolescence and young adulthood is a process that is neither well described nor understood, particularly in relation to providing developmentally appropriate health care for young people. The importance of this issue is starting to be reflected within the literature, and although research into models of service delivery is emerging, a lack of user involvement in service development is apparent. This qualitative, user involvement study aimed to describe and understand the considered opinions of 19 young adults with diabetes who were receiving secondary care services about the provision of diabetes services for young people. The findings, gathered using semistructured interview and focus group methods, have potentially wide-reaching implications across primary and secondary health care, and across agencies providing services to children and young people, in terms of facilitating a person's transition through adolescence and into young adult life. Participants suggested key issues to address when developing services for young people, including staff consistency, civility, clinic structures which help a person navigate the health care system, provision of age-specific information, and support in relation to a range of health, emotional, social and developmental needs. Health care professionals can help young people to meet the expectations upon them as autonomous service users by modelling appropriate relationships, helping them to acquire skills and knowledge, and overcome barriers to them becoming active participants in their health care and achieving social participation in a fuller sense. It is somewhat arbitrary to delineate between adolescence and young adulthood in terms of age alone, but in this paper, ,adolescence' refers to the period between 11 and 15 years of age, and ,young adulthood' between 16 and 25 years of age. The phrase ,young people' will also be used to refer to people between 11 and 25 years. [source]

Research and development at the health and social care interface in primary care: a scoping exercise in one National Health Service region

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2002
Jo Cooke MA
Abstract The present project aimed to identify research activity at the health and social care interface in primary care within one National Health Service region, and to determine levels of research capacity and support within social services. The study was commissioned by a primary care research network (PCRN) in order to assess opportunities to increase research capacity within social services. Data were collected in two phases from 61 managers, team leaders and senior practitioners in social care, and six public health representatives in health authorities, using telephone interviews and focus groups. The findings highlighted a lack of infrastructure and support for research and development in social care. However, many social care respondents wanted opportunities to develop research skills with healthcare colleagues. Despite poor support, many small-scale projects were described, and many respondents showed an enthusiasm for engaging with research. Methods in use included surveys, action research, needs analysis and evaluation of service developments. Many examples of user involvement were given. Interface projects were usually instigated by interagency forums and funded from multiple sources. Most project work was motivated by service improvement or development, rather than aiming to produce generalisable knowledge. Barriers to conducting research included lack of confidence, research skills and time, as well as workload demands, lack of cover to release staff for research and lack of supervision. Research was not seen as legitimate work in some social care environments or as part of a career path. Existing joint working initiatives (such as the National Service Frameworks) were highlighted as flashpoints for potential research and evaluation activity. The findings suggest clear opportunities for PCRNs to develop research capacity at the interface with social care; for example, by signposting available resources, providing training grants and secondments for social care staff, and supporting interagency networks with a focus on evaluation. In turn, experience in promoting user involvement in social services could add value to research expertise at the primary care,social care interface. [source]

Experience and meaning of user involvement: some explorations from a community mental health project

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2002
Carole Truman
Abstract With an increased interest in and policy commitment to involving service users in the planning and delivery of health service provision, there is a clear need to explore both the rhetoric and realities of what user involvement entails. In the present paper, by drawing upon an evaluation of a community-based exercise facility for people with mental health problems, the authors explore ways in which the reality of user involvement is subject to a range of configurations within health services. The paper describes a piece of qualitative research that was undertaken within a participatory framework to explore the nature of user involvement within the facility. The data have been analysed using a grounded theory approach to provide insights into: the organisational context in which user involvement takes place; factors which encourage meaningful participation on the part of service users; perceived barriers to user involvement; and issues of sustainability and continuity. This research approach has enabled the authors to explore the views and experiences of users, service providers and referral agencies in relation to the nature and potential for user involvement. The findings illustrate ways in which user involvement may take place under both flexible and formal arrangements across a variety of activities. The present paper provides an account of some of the meanings and experiences of what ,successful' user participation may involve and the conditions which underpin ,success'. The authors conclude that successful and meaningful user involvement should enable and support users to recognise their existing skills, and to develop new ones, at a pace that suits their particular circumstances and personal resources. This process may require adaptation not only by organisations, but also by service providers and non-involved users. [source]

Getting ready for user involvement in a systematic review

Lay perceptions of the desired role and type of user involvement in clinical governance

HEALTH EXPECTATIONS, Issue 1 2009
Andrea Litva BA (Comb Hons) MA PhD
Abstract Objective, The aim of this paper is to explore variations in lay perceptions of user involvement in clinical governance. Context, The English National Health Service has sought to build a dependable health service through enhanced effectiveness, responsiveness and consistency. Clinical governance, a policy for improving service quality, is a key pillar of these reforms. It is a statutory duty of primary care organizations to ensure that users are involved in all service planning and decision making, including clinical governance. Yet surveys indicated that user involvement in clinical governance was underdeveloped and underutilized. Design, Focus groups were conducted with different types of lay people to explore their perceptions around public involvement in different aspects of clinical governance policy. Results, Content analysis of the transcripts reveals that different groups of lay people varied in their desired role perspective and preferred type of involvement in different aspects of clinical governance policy. Drawing upon existing models of user involvement, we identified three role perspectives that lay people could take in user involvement , consumer, advocate and citizen. We compared our findings regarding the desired type of involvement with existing models of user involvement, and identified a new type of involvement, overseeing, that is relevant to clinical governance policy. Conclusions, These findings suggest that to facilitate user involvement in clinical governance, it would be necessary to use different strategies to accommodate the differing role perspectives and types of involvement desired by different groups of lay people. [source]

Assessment of the benefits of user involvement in health research from the Warwick Diabetes Care Research User Group: a qualitative case study

HEALTH EXPECTATIONS, Issue 3 2007
Antje Lindenmeyer PhD
Abstract Objective, To assess the benefits of involving health-care users in diabetes research. Design and participants, For this qualitative case study, semi-structured interviews were conducted with researchers who had worked extensively with the group. During regular meetings of the Research User Group, members discussed their views of the group's effectiveness as part of the meeting's agenda. Interviews and discussions were transcribed, coded using N-Vivo software and analysed using constant comparative methods. Results, Involvement of users in research was generally seen as contributing to effective and meaningful research. However, the group should not be considered to be representative of the patient population or participants of future trials. An important contributor to the group's success was its longstanding nature, enabling users to gain more insight into research and form constructive working relationships with researchers. The user-led nature of the group asserted itself, especially, in the language used during group meetings. A partial shift of power from researchers to users was generally acknowledged. Users' main contribution was their practical expertise in living with diabetes, but their involvement also helped researchers to remain connected to the ,real world' in which research would be applied. While the group's work fulfilled established principles of consumer involvement in research, important contributions relying on personal interaction between users and researchers were hard to evaluate by process measures alone. Conclusions, We demonstrated the feasibility, acceptability and effectiveness of this longstanding, experienced, lay-led research advisory group. Its impact on research stems from the continuing interaction between researchers and users, and the general ethos of learning from each other in an on-going process. Both process measures and qualitative interviews with stakeholders are needed to evaluate the contributions of service users to health research. [source]

Involving mental health service users in quality assurance

HEALTH EXPECTATIONS, Issue 2 2006
Jenny Weinstein BPhil BA(Hons) Msc
Abstract Objective, This study compares the process and outcomes of two approaches to engaging mental health (MH) service users in the quality assurance (QA) process. Background, QA plays a significant role in health and care services, including those delivered in the voluntary sector. The importance of actively, rather than passively, involving service users in evaluation and service development has been increasingly recognized during the last decade. Design, This retrospective small-scale study uses document analysis to compare two QA reviews of a MH Day Centre, one that took place in 1998 as a traditional inspection-type event and one that took place in 2000 as a collaborative process with a user-led QA agenda. Setting and participants, The project was undertaken with staff, volunteers and service users in a voluntary sector MH Day Centre. Intervention, The study compares the management, style, evaluation tools and service user responses for the two reviews; it considers staff perspectives and discusses the implications of a collaborative, user-led QA process for service development. Results, The first traditional top,down inspection-type QA event had less ownership from service users and staff and served the main purpose of demonstrating that services met organizational standards. The second review, undertaken collaboratively with a user-led agenda focused on different priorities, evolving a new approach to seeking users' views and achieving a higher response rate. Conclusions, Because both users and staff had participated in most aspects of the second review they were more willing to work together and action plan to improve the service. It is suggested that the process contributed to an evolving ethos of more effective quality improvement and user involvement within the organization. [source]

Involving users in low back pain research

HEALTH EXPECTATIONS, Issue 4 2003
Bie Nio Ong BA BEd MA PhD
Abstract Objective, To involve users in the design of a research project that aims at describing a 12-month course of low back pain in an adult population sample (epidemiological strand), and to determine how patient and professional perceptions of low back pain and its treatment relate to the use of health-care and to subsequent outcome (qualitative strand). Design, Three focus groups were organized in the preparatory phase of the project with general practitioners, other health professionals and low back pain sufferers. Issues pertaining to the experience of living with, or treating low back pain were explored and users were asked to identify relevant research questions for consideration within the study. Findings, The focus groups revealed tensions between involving users as co-researchers for design issues and their role as sufferers and health professionals who want to share their narrative accounts of low back pain. The group discussions produced a wealth of material for analysis, but no explicitly stated research topics. Three key themes and the process of user involvement in the focus groups are discussed. Conclusions, The focus group format could be restrictive in that it allows for detailed exchange between participants, but is insufficiently geared towards the production of a research agenda. We draw conclusions as to possible approaches for user involvement in health services research design. [source]

Redesigning mental health services: lessons on user involvement from the Mental Health Collaborative

HEALTH EXPECTATIONS, Issue 1 2003
Glenn Robert PhD
Abstract Objectives, To explore the involvement of mental health service users in the redesign of in-patient mental health services in six Trusts participating in a multi-regional NHS modernization programme. Design, Semi-structured interviews and observation of team meetings undertaken as part of an action research study. Participants and setting, Users, clinical, medical and managerial staff from six mental health trusts which participated in the Northern & Yorkshire and Trent regions' Mental Health Collaborative (MHC). Results and conclusions, Whilst there were some problems, user involvement was undoubtedly a strength of the MHC in comparison to other modernization programmes within the NHS we have studied. However, the particular challenges posed by the specific context of acute mental health services should not be overlooked. The initial approach taken in each of the sites was to simply invite a user or user representative to join the local project team. In the course of events, various changes were made to this initial mechanism for involving users in the ongoing work of the teams. These changes , and setbacks in some sites , make drawing firm conclusions as to the effectiveness of the various strategies employed problematic. However, our qualitative data suggest a number of broad lessons that will assist both those leading and participating in other redesign initiatives to maximize the benefits to be gained from service user involvement. [source]

Comparing senior executive and project manager perceptions of IT project risk: a Chinese Delphi study

INFORMATION SYSTEMS JOURNAL, Issue 4 2010
Shan Liu
Abstract The success rate for information technology (IT) projects continues to be low. With an increasing number of IT projects in developing countries such as China, it is important to understand the risks they are experiencing on IT projects. To date, there has been little research documenting Asian perceptions of IT project risk. In this research, we examine the risks identified by Chinese senior executives (SEs) and project managers (PMs), and compare these two groups. The importance of top management support in IT projects is well documented. Prior research has shown that from the perspective of IT PMs, lack of support from SEs is the number one risk in IT projects. Surprisingly, senior executives' perceptions towards IT project risk have never been systematically examined. One reason why lack of support from senior executives continues to represent a major risk may be that senior executives themselves do not realize the critical role that they can play in helping to deliver successful projects. In this study, we use the Delphi method to compare the risk perceptions of senior executives and project managers. By comparing risk factors selected by each group, zones of concordance and discordance are identified. In terms of perceived importance ascribed to risk factors, PMs tend to focus on lower-level risks with particular emphasis on risks associated with requirements and user involvement, whereas SEs tend to focus on higher-level risks such as those risks involving politics, organization structure, process, and culture. Finally, approaches for dealing with risk factors that are seen as important by both SEs and PMs are provided. [source]

User involvement in developing mobile and temporarily interconnected systems

,It's lots of bits of paper and ticks and post-it notes and things . . .': a case study of a rapid application development project

INFORMATION SYSTEMS JOURNAL, Issue 3 2000
Paul Beynon-Davies
This paper reports an in-depth case study of a rapid application development (RAD) project. RAD is a recent information systems development method noted for its high levels of user involvement and use of iterative prototyping. The paper develops a model of the core features of RAD gleaned from literature such as that published on the dynamic systems development method (DSDM). We report an ethnographic study of a RAD project and use this case material to contrast the theory with the practice of RAD. We conclude the paper with a consideration of a number of possible revisions to the prescriptions of RAD and also discuss the role of RAD within the broader context of IS development. ,It's lots of bits of paper and ticks and post-it notes and things . . . you'll get to understand it, it's not that bad really'. A RAD team member [source]

Public partnerships, governance and user involvement: a service user perspective

INTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 5 2010
Peter Beresford
Abstract This paper explores public partnerships and governance from a service user perspective, drawing both on the author's own involvement in service user organizations and movements and on material associated with and produced by these organizations and movements. It addresses the ambivalent relationship between service user organizations and movements and the idea and practice of ,partnerships', and explores their preference for ideas of ,alliance'. It charts the different approaches to and ideologies underpinning user involvement and their implications for partnership between state and service users and their organizations. It offers a set of components for improving such partnerships as well as highlighting the growing interest of service users' organizations and movements in developing and extending alliances. [source]

Nurse staffing levels revisited: a consideration of key issues in nurse staffing levels and skill mix research

JOURNAL OF NURSING MANAGEMENT, Issue 6 2009
BSc (Hons), MARIA FLYNN RGN
Aim, This paper revisits the published evidence relating to how nurse staffing levels impact on patient, nurse and service outcomes and considers the implications of this body of research for nurse managers in their quest to determine optimum nursing numbers. Background, Within the context of the recognized global nursing shortage and particular local pressures within international health services, questions of appropriate nurse staffing levels and skill mix are once again becoming increasingly important. It would seem that the determination of optimum nurse staffing levels and skill mix is a central issue in relation to health service governance, service user involvement, as well as in the recruitment, retention and well-being of nursing staff across the service sectors. Methods, A review of published evidence was carried out, applying key principles of the systematic method, in order to facilitate the identification of current factors and issues in nurse staffing levels research. The review did not seek to address a specific research question. The search covered 10 years from 1998 to 2008 and identified more than 500 relevant papers, giving a wide international perspective. Key issues, The majority of research in the field relates to the acute service sector and there are considerable similarities in issues that transcend international boundaries. Much of the research focuses on the impact on patients and nurses of ,poor' nurse staffing levels. More recent studies have explored the impact of nurse staffing levels on the service organization itself. However, while there may be an association between models of nurse staffing and outcomes, there is insufficient evidence to establish a causal relationship between these factors. In this context it is perhaps time to reconsider how nursing outcomes are defined and measured. Implications for nursing management and conclusion, Nurse managers, commissioners of services and workforce planners need to be cognisant of key issues and analyses in the consideration of nurse staffing levels. Not least of these is the need for a healthy degree of caution regarding the supposed objectivity, scientific basis, or evidence base, for rational calculation of optimum nurse staffing levels. [source]

Ethnography and the ethics of undertaking research in different mental healthcare settings

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2010
H. ALLBUTT rgn ba msc phd
Accessible summary ,,We report our experiences of seeking regulatory approval to undertake a qualitative research study using observation and interviews in three different mental healthcare settings. ,,All users of mental health services are classified as ,vulnerable' research participants by UK regulatory research systems. We argue that this is both disempowering to users and also at odds with current health care policy to promote service user involvement in research processes. ,,Access to mental healthcare sites was difficult in spite of agreement by senior area managers. Front-line team leaders acted as gatekeepers to influence which service users could be approached to take part in the study. This type of intervention may bias research samples and dilute the knowledge claims researchers can make from research undertaken in practice settings. Abstract This paper draws on our experiences of seeking research ethics and management approval for a 1-year ethnographic research study in three mental health settings. We argue that the increased bureaucratization of research governance in the UK is paternalistic and unfit for qualitative, non-interventionist study designs. The classification of all mental health services users as ,vulnerable' is also disempowering and contrary to government calls to increase user involvement in research processes. We relate our difficulties in accessing National Health Service sites to undertake our study despite endorsement by senior managers. The current research ethics system reinforces the gatekeeping role of front-line National Health Service staff but this may work to bias samples in favour of ,amenable' service users and exclude others from having their views and experiences represented in studies over the long-term. [source]

Should service user involvement be consigned to history?

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2006
A critical realist perspective
Service user involvement in the UK healthcare agenda is now widely expected. Historically, service user groups have been increasingly successful in their demands for greater involvement. Hierarchies of involvement exist that include consultation and partnership working. Psychiatry is an archetypal arena in terms of power and control. The traditional view of interpreting the place of service users within this arena is that the service user is at the bottom of this hierarchy; involvement allows transcendence of the power hierarchy. Critical realist theory is offered as an alternative approach to understanding these complex relationships. It is argued that contemporary models of involvement perpetuate and sustain the power positions of the dominant discourse within psychiatry. It is suggested that a critical realism perspective, offers a model that does not kowtow to the dominant discourse but rather recognizes that service users now possess power, especially in terms of being able to provide services that statutory services providers now require. Is it time for service users to call the tune, and, in doing so, establish a power position outside the traditional hierarchy of power? [source]

Pedagogy, power and service user involvement

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2004
A. FELTON mn rn (mental health)
This paper explores mental health nurse educators' perceptions of the involvement of service users in preregistration nurse education. The idea for the study was developed from a local group of people including service users, lecturers and students committed to finding ways to develop service user involvement in education. This qualitative study uses semi-structured interviews to explore participants' perceptions in depth. Five lecturers who teach on the diploma programme based at a large teaching hospital were interviewed. The results suggest that the current situation of involving service users at the research site was ineffective. The concepts of ,role' and power relationships were used to explore the reasons for this. The development of service user involvement in education is complex and requires further research. [source]

Legal, social, cultural and political developments in mental health care in the UK: the Liverpool black mental health service users' perspective

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2002
S. A. Pierre BA(HONs) MSc PhD RMN
Documentary evidence suggests that attitudes among local health and social services professionals towards the concept of user involvement in health and social care remain deeply polarized, a position characterized by commentators simultaneously as praise and damnation. Perhaps user involvement in health and social care will enhance, and it appears to resonate with the logic of, participatory democracy, in localities where the centralization of power has posed questions as to the nature and purpose of local governance in public services provision. The problems experienced by Britain's black and ethnic minorities within the mental health system have been the subject of exhaustive social inquiry. This essay attempts to explore the way in which legal, social, cultural, and political developments interface with mental health care practice in the UK, in order to assist those responsible for mental health services provision to deliver services that are in line with the Government's expectation of a modernized mental health service that is safe, sound, and supportive. An exploration of these developments within the European, national (UK), and local (Liverpool) contexts is undertaken. An appropriate local response to national priorities will ostensibly cut a swathe through the barriers confronted by the ethnic minority mental health service user in the cross-cultural context, an important prerequisite for the implementation of genuine user involvement. [source]

Involving disabled and chronically ill children and young people in health service development

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 1 2003
P. Sloper
Abstract Aim To investigate the extent and nature of involvement of physically disabled or chronically ill children and young people in local health service development. Methods A postal survey of all health authorities (n = 99) and NHS Trusts (n = 410) in England. Results Seventy-six per cent of health authorities and 59% of Trusts responded. Twenty-seven initiatives involving chronically ill or disabled children and young people in consultation regarding service development were identified. Over half of these were carried out in partnership between health services and other agencies, usually local authorities and/or voluntary organizations. A variety of methods was used for consultation, including child-friendly methods such as drawing, drama and making a video. Seventeen initiatives reported that children's involvement had resulted in service changes, but only 11 went beyond consultation to involve children and young people in decision making about service development. Only a third of the organizations had someone with designated responsibility for children's involvement. Discussion The involvement of this group of children and young people in service development in the NHS is at an early stage. The failure of policy documents on user involvement to identify children and young people as a group for whom methods of consultation need to be developed, and the lack of people with designated responsibility for developing children's involvement may be a reason for slow progress in this area. The initiatives identified show that such involvement is possible and can have a positive impact on services. [source]