Progress's Pilgrim: a critical narrative of research in progress

Tilley, Leann; Pollock, Linda; Ross, Linda; Tait, Louise

doi:10.1046/j.1365-2648.1999.01007.x

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…Our wider findings (Tilley et al . 1999b; Tilley & Pollock 2001a,b) suggest that these valued dimensions of ‘micro‐context’ person‐centred practice need to be supported and mediated in both the ‘meso‐context’ (Trust policy and management practice) and the ‘macro context’ (for example, the national Framework for services).…”

Section: Discussionmentioning

confidence: 65%

Person first: what people with enduring mental disorders value about community psychiatric nurses and CPN services

Adam

Tilley

Pollock

2003

Psychiatric Ment Health Nurs

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Based on a Scottish study, this article presents findings from qualitative analysis of interview data, on views of people with enduring mental disorders (people) regarding services provided by community psychiatric nurses (CPNs) and what these people value in working with CPNs. Thirteen people took part in semi-structured interviews, and data were analysed using strategies including thematic analysis. The main finding was that people value their interpersonal relationship with CPNs. This relationship has a specific function in the individual's overall social network. The CPN-person relationship forms the context of 'purposeful talk', and is shaped and developed through the talk. It provides comfort and a greater sense of confidence with which people can cope with daily life. A valued feature of the personalized relationship with CPNs is continuity, associated with regularity of contact with CPNs, accessibility (both physical and emotional) and respect for and commitment to people as individuals. We interpret CPNs, as they appear in these accounts given by people with enduring mental disorders, as 'beings-in-between', bridging symbolically the worlds of hospital and community. They are figures between 'friends' and professionals, to whom people who have been ill can relate and show feelings which would, if otherwise expressed, compromise participation in community. CPNs help sustain people experiencing 'illness in the context of life' and enhance their potential for participation in the community. In doing so they contribute to public health. Viability of sustaining relationships and personal care, valued at the micro-level of interaction, depends on support at the meso-level by managers, and at the macro-level by policy makers and funders. Health service managers who play a key role in instigating and managing service changes should engage in regular dialogue with CPNs about the impact of change on the ability of CPNs to maintain sustaining relationships with people. The adaptability of CPNs to the situation and the person-in-the-situation needs to be facilitated, not compromised, by the requirements of record-keeping and accounting systems. Practice described in this study indicates the possibility of CPNs relating to the person in ways consistent with a 'community development approach'. Limitations of the study are noted. Our findings are highly contextualized and based on a small sample. Nonetheless, they are consistent with findings from other studies also based on listening to service users' accounts of problems of living with enduring mental disorder. Implications of the analysis of peoples' perceptions of the role of CPNs are considered, with attention to service providers, policy makers and future research.

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Section: Discussionmentioning

confidence: 65%

Person first: what people with enduring mental disorders value about community psychiatric nurses and CPN services

Adam

Tilley

Pollock

2003

Psychiatric Ment Health Nurs

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“…They mainly focus on long‐term health needs and associated low technology continuing care. Such ‘little stories’ (Tilley et al . 1999) tend to be neglected in both care protocols and research.…”

Section: Discussionmentioning

confidence: 99%

The research potential of practice nurses

Davies

Heyman

Bryar

et al. 2002

Health &Amp; Social Care in the Community

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Little is known about the research aspirations and experiences of practice nurses. The study discussed in the present paper had three main aims: (1) to assess the level of research interest among practice nurses working in Essex and East London, UK; (2) to identify practice nurses' research priorities; and (3) to explore factors which facilitate and impede the development of practice nursing research. All practice nurses (n = 1,054) in the above areas were sent a questionnaire, and a total of 40% (n = 426) responded after two follow-up letters. Fifty-five respondents who volunteered for further participation were interviewed, either individually or in focus groups. About half (n = 207) of the survey respondents expressed an interest in undertaking research. One-third (n = 145) reported previous participation in research, and 20% (n = 85) had initiated their own research. Logistic regression showed that practice nurses educated to graduate level, and those working in practices with nurse training or participation in external research, were most likely to want to undertake research. Working in a medical training practice was found to be a negative predictor of research interest. Respondents prioritised research into long-term health problems with a high prevalence in the local population; for example, diabetes. Their reasons for wishing to engage in research included improving the service, career development, making work more interesting and reducing isolation. The main barriers identified were lack of time, lack of support from some general practitioners and poor access to higher education resources outside formal courses. The development of practice nurse research would provide a distinctive perspective on health need and service provision. It would contribute to the achievement of the national strategic objective of improving the quality of primary care, enhance the status of the profession, utilise the enthusiasm of individuals, increase job satisfaction and staff retention, and answer real questions.

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“…Fourth, nurses historically have used storytelling as a means of conveying, critiquing and exploring their practice (Bailey & Tilley, 2002;Barton, 2004;Frid, Ohlen, & Bergbom, 2000;Gramling, 2004;Leight, 2002;McAllister, 2001;Tilley, Pollock, Ross, & Tait, 1999;Wood & Giddings, 2003). In addition, Wood and Giddings suggest that "an understanding of a person's health needs, for example, is often gained through the stories they tell.…”

Section: Why Use Narrative Inquirymentioning

confidence: 99%

Personal and Professional Choices, Tensions, and Boundaries in the Lives of Lesbian Psychiatric Mental Health Nurses

Walsh¹

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<p>This study breaks new ground in articulating how sexual identity impacts on the therapeutic relationship between the client and the lesbian nurse in psychiatric mental health nursing. There is little consideration given in the literature or in research as to how sexuality of the nurse impacts on nursing practice. Most attitudes held by the public and nursing staff are based on the assumption that everyone is heterosexual, including nurses. Fifteen lesbian psychiatric mental health nurses from throughout New Zealand volunteered for two interviews and shared their experiences of becoming and being a lesbian psychiatric mental health nurse. The stories they told give new insights into how these nurses negotiate and position their lesbian identity in the therapeutic relationship. To work therapeutically with people in mental distress the nurse uses personal information about themselves to gain rapport with the client through appropriate selfdisclosure. Being real, honest and authentic are also key concepts in this relationship so the negotiation of reveal/conceal of the nurse’s identity is central to ongoing therapeutic engagement. One of the most significant things arising from the research is that participants areable to maintain their honesty and authenticity in the therapeutic relationship whether they self-disclose their lesbian identity or not. This is because the experiences in their personal lives have influenced how the participants ‘know themselves’ and therefore guide how they ‘use self’ in their therapeutic nursing. The concept of a ‘licensed narrative’ has also been developed during this research reflecting the negotiated understandings between the researcher and the participants. Further, the use of NVivo a qualitative software package helps to track and make transparent the research processes. These two aspects make a unique contribution to the field of narrative inquiry.</p>

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Progress's Pilgrim: a critical narrative of research in progress

Cited by 4 publications

References 10 publications

Person first: what people with enduring mental disorders value about community psychiatric nurses and CPN services

Person first: what people with enduring mental disorders value about community psychiatric nurses and CPN services

The research potential of practice nurses

Personal and Professional Choices, Tensions, and Boundaries in the Lives of Lesbian Psychiatric Mental Health Nurses

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