Non-judgemental Way Research Articles

Creating a difference – a role for the arts in addressing child wellbeing in conflict-affected areas

ABSTRACT Background Details findings from a project on the potential for arts activities and art therapy to support the mental health and wellbeing of children living in Kashmir. Methods The intervention engaged 30 school children over the course of one year who produced various forms of artwork and performances. In this paper, we report on project impacts, drawing on some of our qualitative measures including observations and interviews. Results Our research details impacts and improvements in areas of emotional expression, belonging, and agency. We also found an important role for schools to create safe, secure, and caring spaces to allow students to express themselves and work through traumatic feelings in a non-judgemental way. Conclusions School-based arts interventions can play an important role in the mental health and wellbeing of children. Critical here, however, are dedicated space, time, and resources to provide a supportive environment and to sustain activity in long-term.

Childhood obesity: overcoming the fear of having healthier weight conversations with families.

Introduction Clinicians may find raising the issue of weight with patients or carers and having healthier lifestyle conversations uncomfortable, out of fear or experience of causing offence. A two-cycle audit was completed in a specialist paediatric dental service to ascertain whether healthier weight conversations were being had with patients and their carers.Materials and methods The inclusion criteria for the audit were paediatric patients who were having a general anaesthetic assessment for dental extractions as a result of dental caries. A gold standard was set that all patients having a general anaesthetic assessment should have their body mass index (BMI) calculated and healthier weight conversations should be had with patients and carers and families signposted for further support when necessary.Results Results for the first cycle found that only 7% of patients had their BMI recorded and there was no record of healthier weight conversations for any patient. After the results of the first cycle were shared and ways in which to have a helpful healthy weight conversation discussed, a second cycle was carried out. A significant improvement was made, with clinicians calculating the BMI for 65% of the patients and a healthier weight conversation being had when necessary.Discussion Many of the clinicians voiced that as calculating a BMI and having healthier weight conversations is not something that they had previously routinely done, they often forget to do this. Others stated that they felt uncomfortable bringing up the topic in a way that wouldn't offend the patient or parent, so avoided doing so.Conclusions As a result of the audit, it was strongly encouraged that all clinicians continue to calculate BMI as it was found to be a useful tool for introducing healthier weight conversations when necessary. The subject of healthier weight needs to be acknowledged in the dental setting and discussed with families in a non-judgemental and sensitive way. This paper aims to guide clinicians in how to sensitively broach this subject with children and carers and when and where to signpost if extra support is needed.

Incorporating a trauma-informed perspective in HIV-related research with transgender and gender diverse individuals.

Incorporating a trauma-informed perspective in HIV-related research with transgender and gender diverse individuals.

Providing men at risk of suicide with emotional support and advice with employment, housing and financial difficulties: a qualitative evaluation of the Hope service

Background Men at risk of suicide often face difficulties with finances, employment, or housing, yet support services are usually psychologically based. This study evaluated the Hope service which provides integrated psychosocial support alongside practical, financial and specialist advice. Aims To examine how the Hope service supports men at risk of suicide and factors that influence its impact and usefulness. Methods Twenty-six qualitative interviews with 16 service users, six Hope staff, two specialist money advice workers funded to work for Hope and two NHS referral staff, thematically analysed. Results The Hope service provided an essential service for men at risk of suicide, with complex needs including addiction, job loss, homelessness, debt, relationship-breakdown and bereavement who often would otherwise have fallen through service provision gaps. Working in a person-centred, non-judgemental way elicited trust and specialist advice tackled problems such as housing needs, debt, benefit claims and employment, enabling men to regain a sense of control over their lives. Some men shared histories of abuse, for which specialist counselling was hard to access. Conclusions Hope provides an effective integrated support package for suicidal men. Funding for services like Hope are important to tackle structural issues such as homelessness and debt, alongside emotional support.

From the President and IFST News

From the President and <scp>IFST</scp> News

BOHIE: Art for the Environment

In this article, artist BOHIE discusses her work in the public art formats of street art, murals and fine art murals, and the messages they convey. Her work is a gentle, research-inspired representation of the natural world; inclusive with a sense of belonging, but also challenging social constructs and gender stereotypes. Through her fascination and engagement with sciences – including the science of emotions – BOHIE communicates in a kind, non-judgemental way, which inspires reverence for, and connection with, animals and the environment around us. The conversation delves into our environment, the science of emotions in street art and her collaborations with researchers and research institutions.

Information-giving: an approach for contemporary practice

ABSTRACT Information-giving, a relevant approach for contemporary practice, is a method of communication and a skill whose purpose is to develop client’s abilities to distinguish between truthful information and inaccurate information. Building clients’ trust in a non-judgemental way, and avoiding being over-authoritative, are necessary precursors to using information-giving. The negative legacy of the class system imposed harsh discipline on children, failed to build their self-esteem, and led to their lack of trust in authority. A democratising movement beginning in the 1970s resulted in more paraprofessionals being employed in community-based charities. They drew on their own lived experiences and used information-giving to support clients who experienced poverty, violence, discrimination and low self-esteem. Information-giving’s theoretical influences include person-centred, constructive approaches, empathy, empowerment, resilience and self-actualisation. Information-giving is an effective approach that can help counter the growth of ‘fake news’ and false beliefs about the Covid-19 pandemic.

Child and adolescent obesity

<h2>Abstract</h2> Obesity and overweight are a pandemic that has been building since the 1980s. The causes are multi-factorial, and the solutions are ultimately political. The consequences, however, are medical. Admissions to hospital with obesity-related illness increased 4-fold between 2000 and 2009, and paediatricians regularly see comorbidities in their clinics and on their wards. Broaching the subject of obesity and overweight when we are talking to young people and their families is difficult. Detailed history and examination, in a systemic and non-judgemental way can identify these comorbidities so that they may be treated. Not to do so is a missed opportunity. Interdisciplinary working can support the child and their family to manage their weight. This article offers some personal experience and practical advice for health care professionals who want to make a real difference to the children in their care.

Reviewing the cases of Nanoscale Heterogeneity in Ceramics: Boon or Bane?

Size-dependent properties and their enormity of change make the whole domain of nanoscale materials exciting like anything; the fact that such property changes can be achieved with very small fractions of nanomaterials also helps the issue further. The same fact, however, is not so straightforward when it comes to ceramic materials. Ceramic phases changing their stabilities at the nanoscale and ceramic processing being known for complex high temperature operations – are the two key reasons why nanoceramic sector could not always deliver the results in an expected way. Whether it is the unexpected phase, microstructure or local compositional fluctuation/s – all can make a ceramic system heterogeneous at nanoscale. The important objective, however, remains to identify them (i.e., heterogeneities), understand them (i.e., reason/s behind their genesis) and use them (if possible) to advantage. In this review, numerous case studies on the factors influencing the nanoscale heterogeneities in ceramics have been presented. The role of raw materials, their synthesis, and processing factors have been emphasized along with the capability and limitation of conventional analytical tools in examining such complexities. Impacts on selected properties (i.e., as barrier or boon) have been discussed in connection to these heterogeneities. The case studies on nano-heterogeneities have been presented in a non-judgemental way so as to illustrate their impacts in both ways (i.e., either as a barrier or boon). Since heterogeneities in nano-ceramics have not been studied methodically (unlike polymers or metals) over the past, this article is expected to provide a background for starting the same.

Exploring the experiences of changes to support access to primary health care services and the impact on the quality and safety of care for homeless people during the COVID-19 pandemic: a study protocol for a qualitative mixed methods approach

BackgroundDespite high level of health care need amongst people experiencing homelessness, poor access is a major concern. This is sometimes due to organisational and bureaucratic barriers, but also because they often feel stigmatised and treated badly when they do seek health care. The COVID-19 pandemic and the required social distancing measures have caused unprecedented disruption and change for the organisation of primary care, particularly for people experiencing homelessness. Against this backdrop there are many questions to address regarding whether the recent changes required to deliver services to people experiencing homelessness in the context of COVID-19 will help to address or compound problems in accessing care and inequalities in health outcomes.MethodsAn action led and participatory research methodology will be employed to address the study objectives. Interviews with people experiencing homelessness were will be conducted by a researcher with lived experience of homelessness. Researchers with lived experience are able to engage with vulnerable communities in an empathetic, non-judgemental way as their shared experience promotes a sense of trust and integrity, which in turn encourages participation in research and may help people speak more openly about their experience. The experiences of health professionals and stakeholders delivering and facilitating care for people experiencing homelessness during the pandemic will also be explored.DiscussionIt is important to explore whether recent changes to the delivery of primary care in response to the COVID-19 pandemic compromise the safety of people experiencing homelessness and exacerbate health inequalities. This could have implications for how primary healthcare is delivered to those experiencing homelessness not only for the duration of the pandemic but in the future.

Barriers and facilitators to engagement with artificial intelligence (AI)-based chatbots for sexual and reproductive health advice: a qualitative analysis

Background The emergence of artificial intelligence (AI) provides opportunities for demand management of sexual and reproductive health services. Conversational agents/chatbots are increasingly common, although little is known about how this technology could aid services. This study aimed to identify barriers and facilitators for engagement with sexual health chatbots to advise service developers and related health professionals. Methods In January-June 2020, we conducted face-to-face, semi-structured and online interviews to explore views on sexual health chatbots. Participants were asked to interact with a chatbot, offering advice on sexually transmitted infections (STIs) and relevant services. Participants were UK-based and recruited via social media. Data were recorded, transcribed verbatim and analysed thematically. Results Forty participants (aged 18-50 years; 64% women, 77% heterosexual, 58% white) took part. Many thought chatbots could aid sex education, providing useful information about STIs and sign-posting to sexual health services in a convenient, anonymous and non-judgemental way. Some compared chatbots to health professionals or Internet search engines and perceived this technology as inferior, offering constrained content and interactivity, limiting disclosure of personal information, trust and perceived accuracy of chatbot responses. Conclusions Despite mixed attitudes towards chatbots, this technology was seen as useful for anonymous sex education but less suitable for matters requiring empathy. Chatbots may increase access to clinical services but their effectiveness and safety need to be established. Future research should identify which chatbots designs and functions lead to optimal engagement with this innovation.

What is needed for implementing drug checking services in the context of the overdose crisis? A qualitative study to explore perspectives of potential service users

BackgroundThe current illicit drug overdose crisis within North America and other countries requires expanded and new responses to address unpredictable and potentially lethal substances, including fentanyl analogues, in the unregulated drug market. Community-wide drug checking is being increasingly explored as one such public health response. We explored how drug checking could be implemented as a potential harm reduction response to the overdose crisis, from the perspective of potential service users.MethodsThe research was guided by the Consolidated Framework for Implementation Research (CFIR). We conducted a qualitative, pre-implementation study to inform development and implementation of drug checking services that are acceptable to people who use substances and meet their needs. University and community researchers conducted 27 in-depth interviews with potential service users at prospective drug checking sites. We inductively developed emerging themes to inform the implementation of drug checking services within the five domains of the CFIR, and identified the most relevant constructs.ResultsImplementing community drug checking faces significant challenges within the current context of criminalization and stigmatization of substance use and people who use/sell drugs, and trauma experienced by potential service users. Participants identified significant risks in accessing drug checking, and that confidential and anonymous services are critical to address these. Engaging people with lived experience in the service can help establish trust. The relative advantage of drug checking needs to outweigh risks through provision of accurate results conveyed in a respectful, non-judgemental way. Drug checking should provide knowledge relevant to using and/or selling drugs and informing one’s own harm reduction.ConclusionsFor service users, the extent to which the implementation of drug checking can respond to and mitigate the risks of being criminalized and stigmatized is critical to the acceptability and success of community drug checking. The culture and compatibility of the service, setting and staff with harm reduction principles and practices is essential.

Effective communication with older people.

Effective communication with older people is an important aspect of nursing practice. Ineffective communication can lead to older people feeling inadequate, disempowered and helpless. Nurses have a duty to ensure that older people think they are being listened to and that their concerns are being validated in a non-judgemental way. Central to effective communication is the ability of nurses to be self-aware, and monitor their thoughts and feelings about, for example, negative stereotypes associated with the ageing process. Effective communication can sometimes be difficult to achieve due to the effects of ageing, but nurses can overcome some barriers through thoughtful interventions. It is important to treat older people as individuals, and to monitor and adapt communication accordingly. By doing so, nurses can ensure older people feel empowered, respected and able to maintain their independence.

\u2018Sussing that doctor out.\u2019 Experiences and perspectives of people affected by hepatitis C regarding engagement with private general practitioners in South Australia: a qualitative study

BackgroundAustralians with chronic hepatitis C (HCV) can access affordable Direct Acting Antiviral (DAA) treatments with high cure rates (>90%), via General Practitioners (GPs). Benefits from this treatment will be maximised if people with HCV readily disclose and engage with private GPs regarding HCV-related issues. Investigating the perceptions and experiences of people affected by HCV with GPs can allow for this pathway to care for HCV to be improved.MethodsIn 2013–2014, 22 purposively sampled participants from South Australia (SA) were interviewed. They a) had contracted or were at risk of hepatitis C (n = 10), b) were key workers who had clients affected by HCV (n = 6), and c) met both a) and b) criteria (n = 6). The semi-structured interviews were recorded, transcribed and thematically analysed.ResultsPeople affected by HCV viewed GPs as a source of general healthcare but, due to negative experiences and perceptions, many developed a strategy of “sussing” out doctors before engaging with and disclosing to a GP regarding HCV-related issues. Participants were doubtful about the benefits of engagement and disclosure, and did not assume that they would be provided best-practice care in a non-discriminatory, non-judgemental way. They perceived risks to confidentiality and risks of changes to the care they received from GPs upon disclosure.ConclusionGPs may need to act in ways that counteract the perceived risks and persuade people affected by HCV of the benefits of seeking HCV-related care.

Chlamydia and HIV testing, contraception advice, and free condoms offered in general practice: a qualitative interview study of young adults' perceptions of this initiative.

BackgroundOpportunistic chlamydia screening is actively encouraged in English general practices. Based on recent policy changes, Public Health England piloted 3Cs and HIV in 2013–2014, integrating the offer of chlamydia testing with providing condoms, contraceptive information, and HIV testing (referred to as 3Cs and HIV) according to national guidelines.AimTo determine young adults’ opinions of receiving a broader sexual health offer of 3Cs and HIV at their GP practice.Design and settingQualitative interviews were conducted in a general practice setting in England between March and June 2013.MethodThirty interviews were conducted with nine male and 21 female patients aged 16–24 years, immediately before or after a routine practice attendance. Data were transcribed verbatim and analysed using a thematic framework.ResultsParticipants indicated that the method of testing, timing, and the way the staff member approached the topic were important aspects to patients being offered 3Cs and HIV. Participants displayed a clear preference for 3Cs and HIV to be offered at the GP practice over other sexual health service providers. Participants highlighted convenience of the practice, assurance of confidentiality, and that the sexual health discussion was appropriate and routine. Barriers identified for patients were embarrassment, unease, lack of time, religion, and patients believing that certain patients could take offence. Suggested facilitators include raising awareness, reassuring confidentiality, and ensuring the offer is made in a professional and non-judgemental way at the end of the consultation.ConclusionGeneral practice staff should facilitate patients’ preferences by ensuring that 3Cs and HIV testing services are made available at their surgery and offered to appropriate patients in a non-judgemental way.

Using psychological approaches for working with obesity and type 2 diabetes

Using psychological approaches for working with obesity and type 2 diabetes

Assessment of “corticophobia” as an indicator of non-adherence to topical corticosteroids: A pilot study

Background: Concerns regarding topical corticosteroid (TCS) use, broadly known as “corticophobia”, are highly prevalent among dermatology patients and often result in non-adherence to TCS. This non-adherence contributes to poor disease control and increased health care costs. However, it is unknown if assessment of these concerns might help to identify patients at risk of TCS-non-adherence. Clinical tools indicating non-adherence could be helpful to improve management of this patient group.Objective: To assess whether the available tools for measuring concerns regarding corticosteroids, the TOPICOP scale and the 0-10 Visual Analogue Scale (VAS), could help to detect non-adherence to TCS.Methods: In 75 patients with concerns regarding TCS use both the TOPICOP scale and VAS were anonymously assessed. A comparison was made between TCS-adherent and non-adherent patients regarding the intensity and characteristics of their concerns.Results: The intensity and quality of the concerns varied broadly among the patients. When using the VAS, a score of ≥5 detected 87% of non-adherent patients. The answers to the TOPICOP scale did not discriminate non-adherent from adherent patients.Conclusion: Using the VAS to assess concerns to use TCS could help identify patients at risk of TCS-non-adherence and facilitate discussion with the patient about potential non-adherence in a more substantiated, non-judgemental way.

Contraceptive care at the time of medical abortion: experiences of women and health professionals in a hospital or community sexual and reproductive health context

ObjectiveTo examine experiences of contraceptive care from the perspective of health professionals and women seeking abortion, in the contexts of hospital gynaecology departments and a specialist sexual and reproductive health centre (SRHC). Materials and methodsWe conducted in-depth semistructured interviews with 46 women who had received contraceptive care at the time of medical abortion (gestation≤9weeks) from one SRHC and two hospital gynaecology-department-based abortion clinics in Scotland. We also interviewed 25 health professionals (nurses and doctors) involved in abortion and contraceptive care at the same research sites. We analysed interview data thematically using an approach informed by the Framework method, and comparison was made between the two clinical contexts. ResultsMost women and health professionals felt that contraceptive counselling at abortion was acceptable and appropriate, if provided in a sensitive, nonjudgemental way. Participants framed contraceptive provision at abortion as significant primarily as a means of preventing subsequent unintended conceptions. Accounts of contraceptive decision making also presented tensions between the priorities of women and health professionals, around ‘manoeuvring’ women towards contraceptive uptake. Comparison between clinical contexts suggests that women's experiences may have been more positive in the SRHC setting. ConclusionsWhilst abortion may be a theoretically and practically convenient time to address contraception, it is by no means an easy time to do so and requires considerable effort and expertise to be managed effectively. Training for those providing contraceptive care at abortion should explicitly address potential conflicts between the priorities of health professionals and women seeking abortion. ImplicationsThis paper offers unique insight into the detail of women and health professionals' experiences of addressing contraception at the time of medical abortion. The comparison between hospital and community SRHC contexts highlights best practise and areas for improvement relevant to a range of settings.

Mindfulness for neurologists

After everything has been done medically to improve a patient's quality of life but they are left with a burden of symptoms and disability—and the loss, worry and stress that...

Barriers among Danish women and general practitioners to raising the issue of intimate partner violence in general practice: a qualitative study.

BackgroundThirty-five percent of Danish women experience sexual or physical violence in their lifetime. However, health care professionals are not in the practice of asking about intimate partner violence (IPV) in Denmark. It is currently unknown what hinders general practitioners from asking about partner violence and how Danish women would perceive such an inquiry. This aspect has not previously been explored in Denmark. An exploratory study was conducted to examine what hinders general practitioners (GPs) from asking and what Danish women’s views and attitudes are regarding being asked about IPV.MethodsData were collected through individual and group interviews with a sample of three GPs and a diverse sample of 13 women, including both survivors of partner violence and those without any history of partner violence. An interpretative analysis was performed with the data.ResultsThis study provides important knowledge regarding the barriers and attitudes towards inquiry about IPV in primary care in Denmark. Results indicate that Denmark is facing the same challenges when responding to survivors of IPV as other similar countries, including Sweden, Norway, the UK, USA, and Australia. Danish women want general practitioners to ask about violence in a respectful and non-judgemental manner. However, general practitioners are resistant towards such an inquiry and would benefit from training regarding how to respond to women who have been exposed to IPV.ConclusionsIt is acceptable to inquire about IPV with women in Denmark in a non-judgemental and respectful way. Informing about IPV prevalence is important prior to the inquiry. However, general practitioners require more awareness and training before a favourable environment for this change in procedure can be created. Further large-scale research is needed to support the evidence generated by this small study.