Biomedical subjects

Chris Stevenson

Publications and source records attributed to Chris Stevenson.

7 recordsLinked to original sources

PubMed2006

Clinical supervision revisited.

AIM: The paper is a means to signpost the hazards of clinical supervision (or supervision) as it is currently understood and enacted. BACKGROUND: The interpretation or understanding given to clinical supervision by professional groups is based on several factors namely origin/history, dynamic changes, relevance in the concept, language used and the meaning attached to this language. EVALUATION: In this paper we take a position that clinical supervision is not a thing or a homogenous entity. We describe it as a 'multi-meaninged' phenomenon defined through the context of its use. KEY ISSUES: Who uses it and in what circumstances leads to different versions of clinical supervision with different enactments and functions. Practitioners and managers do not necessarily recognize this state of affairs. CONCLUSIONS: We make some suggestions for more complex versions that may be suitable as the profession develops.

Attitude of Health Personnel↗

PubMed2005

A modified grounded theory study of how psychiatric nurses work with suicidal people.

BACKGROUND: People with mental health problems continue to present a disproportionately high risk of suicide. Despite the relevance of suicide to psychiatric/mental health (P/MH) nurses, there is a documented paucity of research in this substantive area undertaken by or referring specifically to P/MH nurses; there is currently no extant theory to guide P/MH nursing care of the suicidal person. OBJECTIVES: Accordingly, this paper reports on a study undertaken to determine if P/MH nurses provide meaningful caring response to suicidal people, and if so how. DESIGN: The study used a modified grounded theory method and was conducted in keeping with the Glaserian tenets of Grounded Theory. SETTINGS: The study was conducted in two geographical locations within the United Kingdom, one in the North and the other in the Midlands; both locations contained large urban centres. PARTICIPANTS: A total of 20 participants were selected across the locations by means of theoretical sampling. All the participants were over 18 years old, had made a serious attempt on their lives or felt they were on the cusp of so doing and had received 'crisis' care from the 'emergency' psychiatric services. METHODS: The study adhered to the principle features of Glaserian grounded theory namely-(a) theory generation, not theory verification; (b) theoretical sampling, (c) the constant comparative method of data analysis; and (d) theoretical sensitivity (searching for/discovering the core variable, one which identified the key pychosocial process and contains temporal dimensions stages). Further, the authors ensured that the study was concerned with generating conceptual theory, not conceptual description. FINDINGS/CONCLUSION: The findings indicate that this key psychosocial problem is addressed through the core variable, 're-connecting the person with humanity'. This parsimonious theory describes and explains a three-stage healing process consisting of the sub-core variables: 'reflecting an image of humanity', 'guiding the individual back to humanity' and 'learning to live'.

Adaptation, Psychological↗

PubMed2005

Postmodernising clinical supervision in nursing.

Clinical supervision (CS) has been organised and conducted around specific modernist principles, despite claims of the need for, or existence of, heterogeneity. A postmodernist perspective is used to challenge the idea that there is a correct structure (hierarchical) and function (developing supervisee self-awareness, detecting and resolving "real" problems) for CS. The meaning of CS can be locally constructed. In an egalitarian consultation, expertise is shared and multiplicity in clinical stories is celebrated. Practitioners are liberated in relation to deciding what approaches fit for the person in context. They feel strengthened by the cohesion of a group with a flattened hierarchy and, within limits, able to challenge existing policy and practice.

Attitude of Health Personnel↗

PubMed2005

Practical inquiry/theory in nursing.

AIM: This paper explores a social constructionist, pragmatist approach to inquiry and theory-building with a view to exploring its relevance for nursing as a practical discipline. BACKGROUND: Positivist and postpositivist inquiry approaches in practical disciplines have produced "detached" theories that lack relevance for everyday practice and so sustain the theory-practice gap. Both meta- and mid-range theories tend to see practice as fixed or fixable rather than being enacted in a state of flux. DISCUSSION: Practical inquiry and theory are described structurally and as co-dependent processes. The research process is sensitive to the influence of context and consists of construction rather than capture. Practical theory is judged in terms of whether it helps people to "go on with" their lives. Practical inquiry/practical theory is superimposed on a previous nursing study in the field of mental health to illustrate how it can account for the processes of clinical research. In particular, the illustration demonstrates the surrender of researcher objectivity in the interests of collaborative understanding that occurs with practical inquiry/theory. Shared meaning arises as rich constructs of the research situation are developed that point to future possibilities for action for all those engaged in the research process. CONCLUSION: Practical inquiry/theory offers the means to conduct cogent, collaborative, developmental research, although further "trying out" is required.

Humans↗

PubMed2004

Theoretical and methodological approaches in discourse analysis.

Discourse analysis (DA) embodies two main approaches: Foucauldian DA and radical social constructionist DA. Both are underpinned by social constructionism to a lesser or greater extent. Social constructionism has contested areas in relation to power, embodiment, and materialism, although Foucauldian DA does focus on the issue of power Embodiment and materialism may be especially relevant for researchers of nursing where the physical body is prominent. However, the contested nature of social constructionism allows a fusion of theoretical and methodological approaches tailored to a specific research interest. In this paper, Chris Stevenson suggests a framework for working out and declaring the DA approach to be taken in relation to a research area, as well as to aid anticipating methodological critique. Method, validity, reliability and scholarship are discussed from within a discourse analytic frame of reference.

Bias↗

PubMed2002

Towards a standardised methodology for estimating alcohol-caused death, injury and illness in Australia.

Two key methodological issues underlying different methods for calculating estimates of the number of alcohol-caused deaths are identified and recommendations suggested for future work. 1. How to adjust alcohol aetiologic fractions across time and place to reflect different levels of risky drinking. A common approach is outlined for both acute and chronic alcohol-related conditions. In the absence of consistent, reliable and regionally specific measures of the prevalence of risky alcohol consumption from national surveys, the use of per capita consumption data as a means of adjusting alcohol population aetiologic fractions over time and across regions is recommended. 2. Whether abstainers or low-risk drinkers should be used as the reference group when assessing the impact of alcohol consumption and how the resulting information is best presented. It is recommended that when abstainers are used as the reference group, the costs and benefits for both 'low-risk' and 'risky/high-risk' drinking should be identified. Using this approach, it was estimated that for Australia in 1998 there was a net benefit of 5,100 lives saved due to low-risk drinking, while there was a net loss of 2,737 lives due to risky/high-risk drinking. On its own, the figure of a net saving of 2,363 lives per year is a simplistic and potentially misleading picture of alcohol as a net benefit to public health and safety. For public health communications, there is still value in providing estimates using the low-risk drinking contrast, of the number of lives saved if risky/high-risk drinkers all became low-risk drinkers (n = 3,292 in 1998). The use of the abstinence contrast, however, allows the more complex picture of alcohol's impact on public health to be apparent, e.g. including the estimated 1,505 deaths associated with low-risk drinking (mostly from cancer).

Acute Disease↗

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Humans↗