Our PhD students engage in a wide range of research projects, some of which are listed below.
|Understanding how facilitation impacts on the implementation of The Gold Standards Framework in Care Homes (GSFCH) programme|
|For more information contact: Julie Kinley|
This part time PhD arose from a Cluster Randomised Controlled Trial (CRCT) that I am undertaking at St Christopher's hospice http://www.stchristophers.org.uk/care-homes/research/crct. The PhD commenced, in 2010, embedded in this CRCT which was looking at outcomes when different of facilitation of the GSFCH programme were provided. This PhD arose from the recognition that how these facilitation models impacted on those receiving and those providing facilitation was as important as the outcomes that were achieved.
The study adopts a mixed methods design. The participants include nursing care home managers (45), GSFCH coordinators (64) and GSFCH facilitators (17). Data collection is now complete and includes: 17 interviews: 139 surveys: 33 Facilitator Activity Logs: and, a research diary. Quantitative data analysis has been completed and the qualitative data analysis is just starting. Checklands (1999) Soft Systems Methodology is being used as a template for this analysis.
Following this initial analysis it is hoped that integration of the data by 'following a thread' will generate further knowledge by looking for evidence of resonance across findings (Moran-Ellis et al 2010). A decision was made to use 'following a thread' to analyse the study data was made because it acknowledges that different knowledge arises from different paradigms. However, it also respects the fact that the totality of this knowledge can be increased by interweaving the findings that emerge from both data sets.
The findings of the PhD will support recommendations about models of facilitation to support the sustainable implementation of the GSFCH with a better facilitation process for GSFCH coordinators, facilitators and nursing care home managers who attend future programmes.
|Academic Supervisors:||Dr Katherine Froggatt, Dr Nancy Preston|
|Funded by:||Help the Hospices and St Christopher's Hospice|
|Project start date:||January 2010|
|Project end date:||June 2014|
|A Europe-wide approach to improving access to palliative care - common goals and consensus building in a multinational context of health care|
|For more information contact: Saskia Jünger|
The aim of my PhD research is to provide insight in the opportunities and barriers to a common European approach in palliative care. Palliative care is becoming a more and more acknowledged area of health care, going along with a growing body of knowledge and evidence on effective therapies and essential services. In the last few years, the European Association for Palliative Care has published several White Papers or clinical guidelines such as a recommended framework on sedation , a White Paper on Standards and Norms for Hospice and Palliative Care in Europe [2, 3] or a clinical guideline on depression ; a White Paper on Palliative Care for Dementia Patients is currently under development.
For a common approach, agreement on common terms, definitions, and concepts is needed. Consensus regarding common goals and a common strategy must be achieved. Moreover, intellectual, ethical, and cultural challenges of a uniform approach in the light of a multinational context need to be taken into account. Also methodological challenges have to be taken into consideration: How can beliefs regarding high quality health care be assessed validly and reliably? Which methods are suitable for achieving consensus and implementing common Europe-wide strategies?
My motivation for this research project is to undertake health services research with a Europe-wide focus and hereby provide a scientific contribution to health policy decisions. I am a health scientist and psychologist, working as a research associate at the Department of Palliative Medicine at the University Hospital Bonn in Germany. I am doing this part time PhD via publication, comprising three papers reporting on empirical studies, a theoretical paper on a Europe-wide approach to palliative care, as well as methodological reflections on the use of consensus building methods in the field of palliative care.
|Academic Supervisors:||Professor Sheila Payne, Dr Sarah Brearley|
|Funded by:||Klinik für Palliativmedizin, Universitüatsklinikum Bonn|
|Project start date:||October 2010|
|Project end date:||September 2014|
|Understanding the use of out-of-hours services by older people and their families: A mixed methods study|
|For more information contact: Wendy Lambert|
I am a nurse practitioner working within general practice and an out-of-hours organisation, and am undertaking this study for my PhD. Whilst working for the local out-of-hours service, I regularly visit older people, many aged 85 years and above. Through discussion with them and their families, I have become increasingly aware (from a service delivery viewpoint) that there is a real lack of understanding of their health care needs. This invariably means the care that they receive is reactive rather than proactive, and lacking in continuity. Continuity of care is a key policy in the NHS and is extremely important for older people, especially those with serious or chronic health conditions. The out-of-hours period is clearly a time when continuity of care is essential. To date, there is limited understanding of the experiences of older people and their families when they access out-of-hours services.
This mixed methods study will provide a meaningful way of understanding the use of out-of-hours services by older people and their families. Phase 1 is a retrospective review of the use of the service at two out-of-hours organisations. The study will assess the age distribution of those contacting the service, reasons for contacting the service and outcome of their consultation. In phase 2, I will aim to conduct up to 24 in-depth interviews with older people and family members who have accessed these services. These interviews will explore the unique experiences of each older person and family member. Thematic analysis of the transcribed transcripts will be undertaken using Atlas ti software.
Although the principal objective of this mixed methods study is to understand the use of out-of-hours services by older people, its ultimate goal is to improve the care that older people and their families receive during the out-of-hours period.
|Academic Supervisors:||Dr Katherine Froggatt, Dr Mary Turner|
|Project start date:||September 2008|
|Project end date:||September 2013|
|The experiences of spouse caregivers of people with dementia who are nearing the end of life in nursing homes|
|For more information contact: Jean Hennings|
The focus of my part time PhD is the experiences of spouse caregivers of people with dementia who are nearing the end of life in nursing homes. This is a longitudinal study and uses narrative inquiry methodology, drawing on aspects of postmodernist feminist theory.
In May 2009 I was awarded a Cancer Experiences Collaborative Scholarship which enabled me to conduct the initial literature search and to publish the findings (Hennings, Froggatt & Keady 2010). I registered as a PhD student at Lancaster in October 2009 under the supervision of Dr Katherine Froggatt and Prof Sheila Payne. I was awarded a BUPA Foundation Grant in December 2009, which enabled me to conduct a pilot study.
I am now (May 2012) working with my data set of 27 individual interviews and 7 diaries from ten spouse caregivers of whom seven are women and three men. Narrative analysis is useful when investigating difficult life transitions such as change of living arrangements, deteriorating health and impending death of a close relative, when taken for granted assumptions are brought into question (Lieblich et al., 1998). Frank (1995) describes illness narratives as a practical resource; in the telling of the story the narrator is able to repair the damage and to restore normality. People tell their stories to make sense of their own experiences (Riessman, 1993). Building on Frank's development of illness narratives, this study will identify a new typology of caring narratives.
|Academic Supervisors:||Dr Katherine Froggatt, Professor Sheila Payne|
|Funded by:||Self-funded at present.
BUPA Foundation Grant Awarded Dec 2009. (£19,982.00 over 1 year) to perform a pilot research project- Improving end of life care for those with dementia in care homes; A pilot study.
CECo Scholarship Awarded May 2009. (£7,588) to perform an integrative literature review using structured methods entitled: Approaching the end of life and dying with dementia in care homes; the accounts of family carers. A review of the literature.
|Project start date:||October 2009|
|Project end date:|
|Resources:||Hennings J, Froggatt K, Keady J. (2010) Approaching the end of life and dying with dementia in care homes: the accounts of family carers. Reviews in Clinical Gerontology. 20(2):114-127
Click here to view the article online.
Hennings J, Froggatt K, Payne S. Spouse caregivers of people with advanced dementia in nursing homes: A longitudinal narrative study Palliative Medicine (in press)