This article reports the qualitative element of an observational study that examined whether an e... more This article reports the qualitative element of an observational study that examined whether an extended alarm service using fall detectors and bed occupancy sensors could reduce fear of falling among community-dwelling older people who had recurrent falls. The 17 participants in the intervention group used the extended alarm service while the 18 in the control group used a standard pendant alarm. Individual interviews were tape-recorded and transcribed. The participants' fall history and whether they were afraid of falling were also explored. Interview questions were grounded in theories relating to falls and queried participants in the intervention group about their expectations of and experiences with the use of telemonitoring devices; those in the control group were asked whether they would consider using such devices in the future. Key themes from the analysis were expectations, feelings of security, call center support, barriers to using assistive devices, and adherence and likelihood of using telemonitoring devices. Older people found that the use of telemonitoring gave them "a greater sense of security" and enabled them to remain in their home. However, some found the devices "intrusive" and did not feel they were in control of alerting the call center, which played a key role in their adherence to using the devices.
How nursing as a profession is valued may be changing and needs to be explored and understood in ... more How nursing as a profession is valued may be changing and needs to be explored and understood in a global context. We draw on data from two empirical studies to illustrate our argument. The first study explored the value of nursing globally, the second investigated the experiences of overseas trained nurses recruited to work in a migrant capacity in the UK health care workforce. The indications are that nurses perceive themselves as devalued socially, and that other health care professionals do not give nursing the same status as other, socially more prestigious professions, such as medicine. Organizational and management structures within the NHS and the independent care home sector devalue overseas nurses and the contribution they make to health care. Our conclusions lead us to question the accepted sociocultural value of the global nursing workforce and its perceived contribution to global health care, and to consider two ethical frameworks from which these issues could be discussed further.
This thesis explores the ways in which gender impacts upon the construction of the meaning and ri... more This thesis explores the ways in which gender impacts upon the construction of the meaning and risk of falling among older people who have had recurrent falls, and their key family members. Older people aged 65 and over, who have had two or more falls in the past 12 months were studied. In depth interviews were conducted with 40 older people, consisting of twenty older men and twenty older women, and 35 key family members. The family members consisted of mainly sons (n=ll) and daughters (n=17); the remainder comprised wives (n=4), a brother (n=l), and nieces (n=2). All interviews were tape-recorded, fully transcribed and analysed using NUD*IST. The social meaning of falls constructed by older people who have had falls revolves around three inter-related components: the language of falls, gendered stigma associated with private and public falls, and gendered disruption. Risk perception of falls by older people is linked to gendered notions of how 'at risk' they were, their awareness of risk, and the responsibilities attached to risk taking. Older men were more likely than older women to see themselves as rational individuals who would not deliberately put themselves at risk. The subsequent actions taken by older people to prevent future falls were gendered; older men were not only more pro-active in that they initiated more actions but were more often encouraged by family members to make decisions. Older men drew upon their gender identity and social position within the family, to exert control over what should or ought to be done, in order to minimise their risk of falling. In contrast, older women's exertion of control was less evident. The gender of the older person and their key family member influenced their respective actions. The power imbalance between men and women resulted in the younger male within the older female/younger male dyads undertaking 'protective' actions and 'coercive' actions. Within the older male/younger female dyads, the power imbalance resulted in daughters undertaking 'engaging' and 'negotiating' actions. Similarly 'negotiating' as well as some 'engaging' actions were taken by the younger female member within the younger female/older female dyads, but these were explained as reflecting feminine sensitivity among women. The presence of 'mutual respect' within father/son and brotherlbrother dyads resulted in minimal actions being taken by both members of the dyad, due to the potential conflict arising from each trying to retain power and control. This study indicates that gender impacts upon the meaning of falls and the risk of falling with more older men perceiving falls to be discrediting. This, in tum, impacts upon the subsequent actions taken by older people and their key family members. However, older men who had had falls continue to retain their power resulting in more empowering types of actions taken by their key family members.
This article reports the qualitative element of an observational study that examined whether an e... more This article reports the qualitative element of an observational study that examined whether an extended alarm service using fall detectors and bed occupancy sensors could reduce fear of falling among community-dwelling older people who had recurrent falls. The 17 participants in the intervention group used the extended alarm service while the 18 in the control group used a standard pendant alarm. Individual interviews were tape-recorded and transcribed. The participants' fall history and whether they were afraid of falling were also explored. Interview questions were grounded in theories relating to falls and queried participants in the intervention group about their expectations of and experiences with the use of telemonitoring devices; those in the control group were asked whether they would consider using such devices in the future. Key themes from the analysis were expectations, feelings of security, call center support, barriers to using assistive devices, and adherence and likelihood of using telemonitoring devices. Older people found that the use of telemonitoring gave them "a greater sense of security" and enabled them to remain in their home. However, some found the devices "intrusive" and did not feel they were in control of alerting the call center, which played a key role in their adherence to using the devices.
How nursing as a profession is valued may be changing and needs to be explored and understood in ... more How nursing as a profession is valued may be changing and needs to be explored and understood in a global context. We draw on data from two empirical studies to illustrate our argument. The first study explored the value of nursing globally, the second investigated the experiences of overseas trained nurses recruited to work in a migrant capacity in the UK health care workforce. The indications are that nurses perceive themselves as devalued socially, and that other health care professionals do not give nursing the same status as other, socially more prestigious professions, such as medicine. Organizational and management structures within the NHS and the independent care home sector devalue overseas nurses and the contribution they make to health care. Our conclusions lead us to question the accepted sociocultural value of the global nursing workforce and its perceived contribution to global health care, and to consider two ethical frameworks from which these issues could be discussed further.
This thesis explores the ways in which gender impacts upon the construction of the meaning and ri... more This thesis explores the ways in which gender impacts upon the construction of the meaning and risk of falling among older people who have had recurrent falls, and their key family members. Older people aged 65 and over, who have had two or more falls in the past 12 months were studied. In depth interviews were conducted with 40 older people, consisting of twenty older men and twenty older women, and 35 key family members. The family members consisted of mainly sons (n=ll) and daughters (n=17); the remainder comprised wives (n=4), a brother (n=l), and nieces (n=2). All interviews were tape-recorded, fully transcribed and analysed using NUD*IST. The social meaning of falls constructed by older people who have had falls revolves around three inter-related components: the language of falls, gendered stigma associated with private and public falls, and gendered disruption. Risk perception of falls by older people is linked to gendered notions of how 'at risk' they were, their awareness of risk, and the responsibilities attached to risk taking. Older men were more likely than older women to see themselves as rational individuals who would not deliberately put themselves at risk. The subsequent actions taken by older people to prevent future falls were gendered; older men were not only more pro-active in that they initiated more actions but were more often encouraged by family members to make decisions. Older men drew upon their gender identity and social position within the family, to exert control over what should or ought to be done, in order to minimise their risk of falling. In contrast, older women's exertion of control was less evident. The gender of the older person and their key family member influenced their respective actions. The power imbalance between men and women resulted in the younger male within the older female/younger male dyads undertaking 'protective' actions and 'coercive' actions. Within the older male/younger female dyads, the power imbalance resulted in daughters undertaking 'engaging' and 'negotiating' actions. Similarly 'negotiating' as well as some 'engaging' actions were taken by the younger female member within the younger female/older female dyads, but these were explained as reflecting feminine sensitivity among women. The presence of 'mutual respect' within father/son and brotherlbrother dyads resulted in minimal actions being taken by both members of the dyad, due to the potential conflict arising from each trying to retain power and control. This study indicates that gender impacts upon the meaning of falls and the risk of falling with more older men perceiving falls to be discrediting. This, in tum, impacts upon the subsequent actions taken by older people and their key family members. However, older men who had had falls continue to retain their power resulting in more empowering types of actions taken by their key family members.
Uploads
Papers by Khim Horton