Dissertations / Theses on the topic 'Service users'
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Hudson, Diane C. "Learning to involve sevice users: can mental health service users influence the quality of services they recieve?" Thesis, University of Salford, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.490528.
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This thesis explores a project I set up in 1999 to help service users with mental health problems become more involved with the design and provision of the services offered to them. I involved service users in the planning, design and evaluation of the services they received from my department, by offering them training in research and evaluation skills. My aim was to empower service users so they could feel valued and confident about playing a central role in the research evaluation of the service provision of Bolton Social Services.
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Holgersson, Jesper. "User Participation In Public e-service Development : Guidelines for including external users." Doctoral thesis, Högskolan i Skövde, Institutionen för informationsteknologi, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-10169.
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Reader, Helen. "Service users' experience of voice hearing : the interface between the service user and the health care provider." Thesis, University of Leicester, 2003. http://hdl.handle.net/2381/31181.
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There is an increasing body of literature to suggest that service users should be more involved in their care, and work more collaboratively with professionals within mental health services. One way of achieving this is for professionals to be more mindful of the experiences of voice hearers. The aims of the present study were to gain insight into the subjective experience of voice hearing and in particular, to explore this in relation to interactions between professionals and voice hearers. In depth interviews were conducted with six voice hearers. The resulting narratives were analysed using the qualitative methodology of grounded theory. A core category termed 'Reconstructing a sense of identity' was identified. This highlighted the different ways in which voice hearers attempted to assimilate the experience of hearing voices into their sense of identity. A process model was developed to describe the factors influencing the core category. Five main categories were identified in relation to this: 'being psychotic', 'disclosing information', 'receiving treatment', 'attempting to make sense of experience' and 'sense of self in relation to the psychiatric system'. The core category and the process model are discussed in relation to existing literature in this area. It is suggested that clinicians should focus greater attention on accessing and working within voice hearers' frames of reference in order to maximise positive outcome. The implications of the present study in terms of clinical practice and policy development are discussed. Finally, methodological considerations are explored and reflections on the research process are provided.
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Ahmed, Mohamed Ali. "Video indexing and summarization service for mobile users." Thesis, University of Ottawa (Canada), 2002. http://hdl.handle.net/10393/6358.
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Image processing, video analysis and computer vision techniques are presently developing rapidly because of the availability of acquisition, processing and editing tools which use current hardware and software systems. However, problems still remain in conveying this video data to the end users. Limiting factors are the resource capabilities in distributed architectures, and the features of the users' terminals. The efficient use of image processing, video indexing, and analysis techniques can provide solutions or alternatives. This thesis presents a new algorithm for video segmentation, indexing and key framing tasks. The algorithm is based on color histograms, and uses a binary penetration technique. Although a lot of work has been done in this area, most does not adequately consider the optimization of timing performance and processing storage. This is especially the case when the techniques are designed for use within run-time distributed environments. A main contribution of this thesis is to blend high performance and storage criteria with the need for effective results. The algorithm uses the temporal heuristic characteristics of the visual information in a video stream. It considers the issues of detecting false cuts and missing true cuts due to the movement of the camera, the optical flow of large objects, or both. We discuss the merits of the new algorithm compared to the existing one, supporting the discussion both with results from experiments and from the implementation of our application. We also propose a video event modeling mechanism to intelligently parse, analyze and extract the significant content information from digital video libraries or video mails. This also requires an adaptation stage in order to react to the status, policies and configuration of the end user environment. In order to build robust and extendable systems capable of dealing with future new devices that may have new specifications, we consider devices by their characteristics rather than their type (PDA, PC, cellular phone, etc). We designed and developed a video key framing and summarization service within an overall agent-based architecture that negotiates the different factors autonomously and dynamically at run-time in order to provide the service to the user in an efficient and secure manner.
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Chihani, Bachir. "Enterprise context-awareness : empowering service users and developers." Phd thesis, Institut National des Télécommunications, 2013. http://tel.archives-ouvertes.fr/tel-01048688.
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Context-aware applications must manage a continuous stream of context according to dedicated business logic. Research was limited on proposing frameworks and platforms that have predefined behavior toward applications. This thesis attempts to extend background works by proposing new concepts serving as foundation for a flexible approach for building context-aware applications. The thesis examines the state of the art of context-aware computing, then adopts well-established software design principles and a functional decomposition for designing a reference model for context management enabling seamless integration of context-awareness into applications. Also, the thesis studies the use of context in common applications and proposes a context-centric modeling approach which allows the creation of a graph-based representation where entities are connected to each other through links representing context. Furthermore, the context graph decouples the presentation and the semantics of context, leaving each application to manage the appropriate semantic for their context data. Case studies are conducted for the evaluation of the proposed system in terms of its support for the creation of applications enhanced with context-awareness. A simulation study is performed to analyze the performance properties of the proposed system. The result of this thesis is the introduction of a novel approach for supporting the creation of context-aware applications that supports the integration of context-awareness to existing applications. It empowers developers as well as users to participate in the creation process, thereby reducing usability issues
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Eales, S. J. "Service users' experiences of liaison mental health care." Thesis, City University London, 2013. http://openaccess.city.ac.uk/13073/.
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Liaison mental health services provide mental health care, including assessment, interventions and sign posting to further specialist care, for those who present with mental health needs in non-mental health settings. Liaison mental health services in the United Kingdom most frequently exist within, but are not limited to general hospital provision. The commissioning of these services is however inconsistent, having developed in an ad hoc manner, and the evidence base for an appropriate structure remains limited. This thesis reports an extensive literature review which identifies that to date there has been no published detailed exploration of the experiences of service users of liaison mental health care. Only recently has research been published which tentatively identifies the ability of liaison mental health services to reduce costs to general hospitals of mental health presentations and co-morbidity. The empirical element of this programme of research is a study of the experiences of service users of a liaison mental health service, offered within a general hospital setting. The service users have experiences of both inpatient and emergency department care. The study utilises a secondary data analysis methodology to provide an in depth interpretation of these experiences. Data were analysed using a grounded theory constant comparative method. A core category of ‘negotiating and navigating the system’ emerged as service users’ experienced psychological distress as they attempted to manage their own resources and expectations as a personal safety net. It is only when this personal strategy fails to alleviate their symptoms that they attempt to find help from professional services within the general hospital. Gaining access to assessment by the liaison mental health service requires the service user to negotiate a complex system of care. This experience is represented in the study utilising a conceptual map of their journey, using the analogy of a road to explore the enablers and barriers to an effective experience of liaison mental health care. A model of liaison mental health care is required that ensures provision of educational support for non-mental health professionals within the general hospital setting. This education needs to acknowledge that those who are having their first experience of a mental health issue often do not know where else to seek help, other than the emergency department, because it represents the ‘front door’ of health care. The adoption of a comprehensive model of liaison mental health care is a priority for all general hospital settings in order to achieve improved service user experience, cost efficiency and integrated health care provision.
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Sutherland, Sophie. "Forensic mental health service users' narratives of recovery." Thesis, Staffordshire University, 2018. http://eprints.staffs.ac.uk/4904/.
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This thesis aims to explore the recovery experiences of forensic mental health service users. In doing so, it seeks to add to the small but growing field of literature exploring the application of recovery principles in forensic settings. Paper one is a review of the current literature, synthesising the recovery experiences and perceptions of forensic mental health service users. A total of 10 papers were included in the thematic review. Five themes were identified; hope; connecting with others; meaningful occupation, roles and identity; the powerful environment of the hospital; and coming to terms with the past and diagnosis. Paper two is an empirical paper which explores the recovery stories of five male participants who had been detained in a low secure forensic service and discharged into the community. A narrative analysis reveals the shared personal, community and dominant cultural recovery narratives. Counterstories were also identified. The findings are discussed in relation to the clinical implications, in particular how to work within a cultural narrative of openness about mental illness stories, but secrecy around offending narratives. Further research implications are also discussed. Paper three is an executive summary which seeks to provide an accessible summary of the empirical research paper. This provides an overview of the research, highlighting the key points and salient information in terms of clinical implications for service delivery in a forensic context.
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Turner, Roisin. "Psychiatric diagnosis : views of service users and professionals." Thesis, Lancaster University, 2015. http://eprints.lancs.ac.uk/75555/.
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This thesis explores services users’ and General Practitioners’ (GPs’) views regarding psychiatric diagnosis. These have been written within a literature review and research paper, and I have shared my own views regarding diagnosis within the critical review. The importance of sharing and hearing narratives have been highlighted throughout all three papers. The aim of the literature review was to synthesise the qualitative findings of studies which explored GPs’ views of psychiatric diagnoses and the barriers they face in supporting clients with a diagnosis. This resulted in five overarching themes being identified: Reluctance to use the medical model; The language of diagnosis; Powerlessness; Threats to a GP’s role; and Difficulties negotiating and accessing support. The findings highlighted the reluctance of GPs to use psychiatric diagnosis, and how increased support from other services would assist them in their role. The aim of the research paper was to conduct an in-depth exploration of service users’ narratives regarding their journey to and following receiving a diagnosis of bipolar disorder. Twelve individuals were interviewed and a narrative approach was used to analyse the interview data. The findings are presented as a shared story and involve five phases: Life before diagnosis; The journey to diagnosis; Receiving a diagnosis; Since diagnosis; and The future. The findings highlighted that participants found receiving a diagnosis brought them relief due to acknowledgement of their difficulties, but created additional challenges for them. Finally, the critical review discussed my reflections on my own stance of psychiatric diagnosis and how this has changed and been challenged over the course of the study. This is presented in four sections: Reflections upon my own stance of psychiatric diagnosis; Privileged position and power; Narrative approaches; and Future practice and research. This paper is based on the reflections I made throughout the research process.
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Riddington, Megan. "Rethinking rehabilitation : the lived-experience of service users in mental health rehabilitation services." Thesis, University of East London, 2009. http://roar.uel.ac.uk/3736/.
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Introduction: Community-based mental health rehabilitation is increasingly viewed as occupying a central position within the spectrum of care available to people with 'severe mental illness' (DH, 1999, pp.5). The definitions of rehabilitation informing this care primarily originate from service providers; service user understandings and experiences of rehabilitation have been inadequately explored, and the relationship between it and the potentially related concept of 'recovery' has not been examined. This study begins to address these issues by exploring the lived-experience in mental heath rehabilitation services, with specific attention to understandings and experience of rehabilitation. In doing so, it seeks to promote a fuller understanding of rehabilitation, benefiting the development and delivery of services, whilst providing a foundation from which the desirability of a unified definition of rehabilitation can be considered. Method: Semi-structured, audio-recorded interviews were undertaken with eight participants (seven men and one woman) recruited from 24-hour nurse-supported community mental health rehabilitation provisions. Interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis (Smith & Osborn, 2003). Results: Analysis yielded the three master themes of (i) 'Positioning of Power'; (ii) 'Moving Forward' and (iii) 'A Conducive Setting'. Within these themes respectively, the six subordinate themes of (i) 'Control' and 'Meeting Standards', (ii) 'Being Involved in a Process' and 'Independence through Skills' and (iii) 'Relationships, Re-engagement and Togetherness' and 'Nurturing Environment' were identified. Discussion: The analysis is discussed in relation to the extant literature base, with particular focus on relationships, power, independence, and moving on through services. Implications are identified and recommendations for clinical practice and research are considered. Critical review: The study is reviewed with specific attention to its limitations, quality and control, and the impact of researcher factors on the research process.
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Findlay, Helen. "Sanctuary versus business culture : perspectives of service users and professional staff towards service user involvement at a UK hospice." Thesis, Brunel University, 2018. http://bura.brunel.ac.uk/handle/2438/17563.
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AIM - To explore the perspectives of service users and professional staff towards service user involvement within the context of a changing cultural environment at a UK hospice. METHOD - Case study and thematic analysis including interviews with 16 staff including the CEO and 6 service users at a UK hospice. FINDINGS - Three overarching themes were identified: involvement and disempowerment in decision-making; belonging and alienation in a period of organisational change; struggle to maintain wellbeing and identity in a changing culture. A key finding is that service users receiving care from the hospice wanted their voices to be heard, valued and respected for their personal care and issues affecting the hospice. Service users did not consider it a burden to be asked for their views. They felt disempowered by a consultation process about organisational changes that appeared not to take their views on board. There is a need to consider whether a reliance on surveys for involving service users is sufficient or can become tokenistic. External social-political-economic pressures plus increasing privatisation of public services could influence the way that hospices operate in future. This could involve moving from a sanctuary to a business culture and potentially towards managerialism by adopting a regulatory rather than rights-based approach with an emphasis on increasing reach, measuring numbers and hitting targets. Service users being viewed as consumers with a focus on reablement/rehabilitation activities and less on psychosocial support could also serve to push hospices to start behaving more like hospitals. CONCLUSION - More qualitative research is needed to ensure the voices of service users living with a life-limiting illness are heard. The contributions they make towards co-production of services and research should also be heard and influence practice and policy. Service users should also be more involved in education and training of staff.
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Magnusson, Peter R. "Customer-oriented product development : experiments involving users in service innovation." Doctoral thesis, Stockholm : Economic Research Institute, Stockholm School of Economics [Ekonomiska forskningsinstitutet vid Handelshögsk.] (EFI), 2003. http://www.hhs.se/efi/summary/618.htm.
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Monero, D. "Discrepancies between service users' and care coordinators' views of need and service engagement." Thesis, University College London (University of London), 2005. http://discovery.ucl.ac.uk/1445700/.
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Service engagement is paramount in ensuring effective services are delivered to help people with long-term mental health problems. Another important issue is the extent to which service users and professionals agree on recovery priorities so that these can be translated into needs to be met. Although the disagreement between service users and clinicians on opinions of need status (met or unmet) has been related to several clinical and functional outcomes the impact of discrepant views on service engagement has not been fully explored. This pilot study aimed to examine the association between differences in care coordinator and service user views of "Getting Better", need status and service engagement. A total of 30 service users with a psychotic diagnosis and their care coordinators completed a What Getting Better Means Questionnaire and the Camberwell Assessment of Need Short Appraisal Scale to compare their recovery priorities and beliefs about need status. Service engagement as was measured by the Service Engagement Scale alongside the helping alliance (Helping Alliance Scale) and services users' adjustment to psychosis (Recovery Style Questionnaire) were assessed. The result of this pilot investigation failed to support the main hypothesis that higher disagreement between staff and services users on recovery priorities and need status could lead to lower levels of service engagement. However a statistically significant correlation between staff-client agreement and the helping alliance was detected. In addition it was found that higher unmet needs and service engagement were correlated. Findings were understood in terms of health belief models. Clinical implications for the experimental results were explored.
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Latham, Linda. "Methadone in Irish general practice : voices of service users." Thesis, University of Bath, 2010. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.528127.
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This study sets out to make a meaningful and useful contribution to the discussion surrounding the treatment of heroin addiction in the Republic of Ireland. The exploration describes the experiences of service users who are receiving methadone treatment in general practice in Dublin and provides recommendations for practice. A Husserlian phenomenological approach drawing on the psychological research methods of Colazzi informed this study. This qualitative descriptive genre was coupled with the genre of reflexive methodology and utilised the techniques of bracketing interviews and polyvocality. The study took place in nine urban general practices in Dublin city. Twenty five service users were interviewed indepth. The data were analyzed using the methodology espoused by Collazzi (1978). Four themes emerged from the data: Service users’ experience of attending general practice for methadone maintenance; The significance of methadone for the service user; Service users’ understanding of the Methadone Treatment Protocol and The experience of addiction and it’s effect on families. Service users’ accounts traced the historical steps that influenced the introduction of the MTP. Their depictions of their experience of treatment shed light on the process of care in general practice and how clinical guidelines have been interpreted and developed locally. The study identified what it is that affects the delivery of methadone treatment from the users’ perspective. It provides insight into the harm reduction policy of methadone maintenance and highlights how, from the service users’ own experience, the implementation is falling short. The data identify that the delivery of methadone treatment requires a sustained policy review, informed by a clinical perspective on all issues related to regulations, practice guidelines, and treatment resourcing. The recommendations suggest that to be truly effective, strategies which recognize the importance of user involvement need to be addressed.
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Cossar, Jeanette. "Service users' perspectives in child protection and adoption research." Thesis, University of East Anglia, 2015. https://ueaeprints.uea.ac.uk/53470/.
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This critical commentary is based on four research studies and associated publications. The studies are all concerned with researching service users’ perspectives and with service user involvement in the research process. Two of the studies examined adults’ perspectives on adoption, focusing on support for birth relatives and on post-adoption contact. Two of the studies focused on the perspectives of children and young people on seeking help with abuse and neglect, and on their experiences of child protection services. The commentary begins with a literature review which sets the context for the studies. It covers the development of service user participation in social work practice and in research, and existing research on the perspectives of service users on child protection and adoption services. The second chapter explores methods of involving service users as participants in research and as co-researchers in child protection and adoption research. The final chapter discusses the contribution of the studies, focusing both on the subject matter and the process of research. It is argued that service users’ perspectives can address a need identified within relationship-based practice to pay attention to power differentials in social work relationships. Service users’ perspectives highlight the value service users accord to the relationships they form with social workers, and suggest ways in which practice could be improved to avoid the experience of child protection and adoption services compounding the effects of a difficult life history. Involving service users in the research process can allow service users a distinctive platform. It is argued that building collaborative relationships between academic and service user researchers can enable service users’ perspectives to contribute to the construction of social work knowledge, in a manner that contrasts with the inevitable constraints in service user involvement in child protection and adoption practice.
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Kendall, Marilyn. "Lost in space : service users' experience of mental illness." Thesis, Durham University, 2000. http://etheses.dur.ac.uk/1524/.
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Harris, Katy. "Service users' experiences of an early intervention in psychosis service : an interpretative phenomenological analysis." Thesis, University of Nottingham, 2010. http://eprints.nottingham.ac.uk/11490/.
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Objectives: Previous research regarding Early Intervention in Psychosis (EIP) has mainly adopted quantitative methodologies, in order to study the effectiveness of EIP services. Research studies which have explored service-users’ experiences of EIP services are small in number. This research aimed to explore service-users’ experiences of being in contact with an EIP service, its impact of their experience of psychosis and current life situation. Design: Interpretative Phenomenological Analysis (IPA) was used to conduct an in-depth qualitative study of a small sample of EIP service-users, in order to explore their experiences of being in contact with the service. Method: Semi-structured interviews were conducted with eight service-users who had been receiving a service from an EIP team for more than two years and were recruited using a purposive sampling method. Verbatim interview transcripts were analysed using IPA. Results: Five super-ordinate themes, developed from the analysis, are discussed under the headings: Stigma, Relationships, Understanding the experiences, Sense of agency and Impact on sense of self. Sub-themes of these super-ordinate themes are also discussed. Conclusions: The themes developed from the analysis were envisioned as representing an overarching theme of ‘A personal journey of recovery’, which was influenced by participants’ involvement with the EIP service. Clinical implications include the need for EIP services, as with other mental health services, to find ways to promote recovery and create opportunities for agency and control. Future research directions are also discussed.
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McGibbon, Emma. "Relationships with staff in a community-based forensic personality disorder service : service users' perspectives." Thesis, University of East London, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.532696.
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Researchers return again and again to the therapeutic relationship as it is such a fundamental part of any type of therapeutic work. However, developing relationships with individuals diagnosed as having a `personality disorder' has been considered to be difficult. Those thought to be particularly difficult to engage in relationships are those within the forensic population who have attracted a diagnosis of `personality disorder' and who have histories of reoffending. This study attempts to understand the experiences of therapeutic relationships of these individuals in a community-based forensic personality disorder service. As much of the current research points out problems and negative experiences of relationships, this study aims to explore positive examples of relationships as well. Six male service users from a community-based forensic personality disorder service were interviewed using semi-structured interviews. An interpretative phenomenological analysis (IPA) was used to develop four themes from the interview data. The analysis revealed that relationships between participants and staff were complicated by their own concerns about engaging in close relationships ('stopping myself from getting close'). Difficulties also arose due to how staff were experienced ('other people stop me from getting close'). However, more positive experiences of relationships were talked about ('working the relationship out together') and participants found themselves to be active in their own rehabilitation when they felt empowered by relationships ('now I can make it happen'). The findings are discussed in relation to other research with this client group and theoretical understandings of relationships. Recommendations are made for how clinical psychologists can work directly with these clients and support others working with them. It is suggested that future research into relationships could focus on positive as well as more problematic experiences of relationships.
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Pearce, Rebecca Elizabeth. "How can healthcare service engagement be supported for service users with complex healthcare needs?" Thesis, Lancaster University, 2015. http://eprints.lancs.ac.uk/79123/.
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By 2033 the number of elderly people in England and Wales is expected to exceed 16.4 million. The consequent increase in prevalence of chronic illness and demand on the health and social care services are major causes of concern for healthcare practitioners and policy-makers alike. In response, calls for greater service user autonomy, involvement, and self-care all indicate a shift away from existing paternalistic models of care to a model where service users knowledgably and competently manage their own healthcare and wellbeing. To equip healthcare professionals implement these fundamental changes, this thesis aims to capture, analyse, and articulate the process of healthcare service engagement. To investigate how healthcare services can be better designed to support healthcare engagement for service users with complex needs, this thesis conducts an empirical ethnographic study of a UK-based falls prevention service. Mixed methods were used to collect data from a wide range of sources, including twenty semi-structured interviews with healthcare professionals and service users, ninety-two surveys, referral forms, assessments, and healthcare promotional materials. The data were coded, conceptualised, and categorised to produce a grounded theory of healthcare service engagement represented in a specifically designed model. Key findings show that healthcare service engagement in the context of the chronically ill elderly needs to be understood as an interconnected, emergent, nonlinear, and situated process. It recommends that engagement should be supported in a more user-centric and personalised manner, assessing and responding to service users’ engagement needs as they emerge concurrently with the service’s pathway, integrating assessment practices within a wider healthcare context, and simplifying the existing multidisciplinary and multi-phase falls prevention pathway. Resulting from this thesis, healthcare professionals can more accurately, completely, and confidently reflect on the complex process of healthcare service engagement; better equipping the community for challenges it will face in the future.
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Wilkinson, Catherine Elizabeth. "An exploration of service users' experiences of a low secure forensic mental health service." Thesis, University of Leeds, 2008. http://etheses.whiterose.ac.uk/428/.
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This is an exploratory study of the experiences of service users in forensic mental health settings, including how service users make sense of these experiences and their link to identity. Current research into forensic mental health services is very limited (Coffey,2006). Research has focussed on describing specific events but has not explored how service users have experienced their environment, relationships, and treatment. The information that has been gathered has focused on medium and high secure settings with very little research having been conducted in low secure setting settings. There was therefore a need for further research to inform clinicians and influence their practice so as to reduce psychological distress and risky behaviour, and to work towards recovery and reintegration into the community. Semi-structured interviews were conducted with six service users from a low secure forensic mental health service to explore experience. These accounts were analysed using Interpretative Phenomenological Analysis (Smith, 1995) to create themes that reflected experiences, understanding of these experiences and identity. Individual cases and group themes have been presented. Service users described a range of experiences such as feeling vulnerable, experiencing life as having been interrupted and valuing positive experiences with other people. Their understanding of these experiences fell into four categories: biological, psychosocial stress, behavioural and experience as being senseless. Participants used a range of ways from each category to make sense of their experience and these were sometimes contradictory. There was also a theme of participants trying to make sense of other people's thinking. Each participant had a combination of ways of understanding that was individual to them. Participants evaluated their character, ability and affiliation to help define their identity. These evaluations had an interpersonal aspect. The findings of the study have been discussed in relation to research from settings with different levels of security. They have also been discussed in relation to social psychological frameworks such as Symbolic Interaction (Blummer, 1938,1969), Social Representation Theory (Moscovici, 1973) and Social Identity Theory (Tajfel and Turner, 1986) to help understand meanings and how identity is shaped by experience. Clinical implications have been discussed. These include increasing opportunities for meaningful activities and relationships, and working with service users to help them to find ways of coping with their internal experiences, to feel empowered and take an active role in their recovery, and to build positive identities.
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Blakey, Heather. "Participation¿why bother?: The views of Black and Minority Ethnic mental health service users on participation in the NHS in Bradford. Report of a community research process undertaken by the International Centre for Participation Studies, University of Bradford and Sharing Voices (Bradford)." International Centre for Participation Studies, 2005. http://hdl.handle.net/10454/3798.
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YesThe International Centre for Participation Studies and Sharing Voices Bradford (for information on these organisations, see Appendices 3 and 4) maintain that participation is an important part of a healthy democracy, with benefits for all. However, participation can be anything from empowering to tokenistic, and must be critically examined if we are to understand how to use it effectively. This paper considers the contribution of participation to improved service delivery in the health service. For beneficiaries, participation can be about ownership and responsibility for the services we use, as well as rights and the chance to express what we want from them. For service providers, participation is widely recognised as an effective way of tailoring services to the needs of the different communities they serve. The NHS and other service providers have made great strides in developing mechanisms for participation by service users. However, these do not always reach all sections of the community. Many individuals feel sceptical about getting involved, unconvinced that their contribution could make a real difference. Through the Participation ¿ Why Bother? workshops, we set out to explore these feelings, to reflect on perceived barriers and identify changes that might help overcome them. The aim was not to look at the substance of service delivery issues, but to try and work out how the process of involving people in decision-making in the NHS could be improved, to make it easier for voices from Black and Minority Ethnic (BME) communities to be heard.
Bradford District Care Trust; South and West PCT; City tPCT
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Cortis, Natasha. "Challenging the 'new accountability'? Service users' perspectives on performance measurement in family support." Thesis, The University of Sydney, 2006. http://hdl.handle.net/2123/1913.
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After two decades of public management reform, the ‘new accountability’ of performance measurement is a routine feature in the relationships between Australian government agencies and the non-profit organisations they fund to provide child and family services. While performance measurement offers to resolve tensions about how governments manage the quality and productivity of contracted services, the indicators they commonly adopt raise well-documented practical, political and epistemological challenges in social services. Left unresolved, these challenges risk biasing representations of service performance, by emphasising the most tangible dimensions of service activities (such as measures of client throughput) over relationship building and care. Capturing only part of service activity compromises the usefulness of performance data for managing quality and outcomes, and denies policy makers critical information about the value and meaning of care in users’ lives. This thesis identifies and critically explores one set of challenges for performance measurement: the role of service users. Uniquely, I explore how user involvement in social service evaluation can make visible how these services enhance the quality of family and personal life. Using a case study of family support services in New South Wales, the research makes a series of empirical and theoretical contributions to problems of user involvement in social service evaluation. Firstly, the research examines the performance indicators currently used by government to monitor the efficiency and effectiveness of family support services in NSW. This shows that performance indicators in family support capture output more thoroughly than outcome, and confirms the minimal role that service users play in assessing service quality and outcomes. But while service users are largely excluded from participation in performance measurement, theoretical perspectives as diverse as managerialism and feminism treat service users as well placed to capture and report otherwise elusive information about care quality and outcomes. Further, participation in evaluation facilitates the exercise of users’ rights to self-expression and self-determination in the social service delivery and policy process. After identifying the widespread exclusion of service users’ perspectives from performance measurement in NSW family support, the thesis makes its more substantial contribution, in documenting findings from a detailed study involving adult family support service users (parents) and their workers (the ‘Burnside Study’). This qualitative study was conducted in four socio-economically disadvantaged service delivery sites located around New South Wales. Using focus group, interview and observational methods and a modified grounded theory approach, the study contributes exploratory evidence of what these service users think of, and how they think about service quality, outcomes, and evaluation in family support. The parents’ accounts of using family support capture their unfulfilled social ideals and the broader visions of the justice they hoped these social services would help them achieve. Their criteria for measuring service outcomes and service quality, and their views on evaluation methods embody core themes that social theorists have struggled to analyse, about the purpose of social services and the nature of ‘a good life’. The theoretical framework I develop highlights the role of family support in the context of service users’ struggles for social justice, and in particular, their struggles for self-realisation, recognition and respect (Honneth, 1995). The research extends theories of recognition beyond publicly articulated social movements to those struggles in social life and social politics that exist in what Axel Honneth terms the ‘shadows’ of the political-public sphere (2003a: 122). After establishing a conceptual framework that facilitates deeper interpretation of users’ perspectives, I present the findings in three categories: users’ perspectives on service outcomes; users’ perspectives on service quality; and users’ perspectives on evaluation methods. The findings show how service users define ‘service outcomes’ in the context of their struggles for recognition and respect, highlighting the contribution welfare services and welfare professionals make beyond the managerial ‘Three E’s’ of economy, efficiency, and effectiveness. Further, the findings confirm the importance of ‘helping relationships’ to the quality of service delivery in family support, despite the invisibility of service relationships in existing performance indicators. The complexity of worker-client bonds highlights the difficulty of evaluating social services using simple numerical counts of client or service episodes, and plays into broader debates about strategies for revaluing care work, and the role of care recipients. Finally, the findings show the role performance measurement processes and methods might play in facilitating users’ struggles for recognition. Users identified a role for evaluation in making visible the contribution of family support in pursuing their social justice goals, and saw evaluation as an opportunity in itself to facilitate recognition and respect. Overall, the thesis offers concrete evidence about how family support service users experience and define service quality and outcomes, and how they see their own role in evaluating the services they use. The research shows how users’ perspectives both contest and confirm the ‘new accountability’ of performance measurement, pointing to new directions, and further challenges, for conceptualising – and evaluating – social services.
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Cortis, Natasha. "Challenging the "new accountability"? service users' perspectives on performance measurement in family support /." Connect to full text, 2006. http://hdl.handle.net/2123/1913.
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Doctor of Philosophy (PhD)After two decades of public management reform, the ‘new accountability’ of performance measurement is a routine feature in the relationships between Australian government agencies and the non-profit organisations they fund to provide child and family services. While performance measurement offers to resolve tensions about how governments manage the quality and productivity of contracted services, the indicators they commonly adopt raise well-documented practical, political and epistemological challenges in social services. Left unresolved, these challenges risk biasing representations of service performance, by emphasising the most tangible dimensions of service activities (such as measures of client throughput) over relationship building and care. Capturing only part of service activity compromises the usefulness of performance data for managing quality and outcomes, and denies policy makers critical information about the value and meaning of care in users’ lives. This thesis identifies and critically explores one set of challenges for performance measurement: the role of service users. Uniquely, I explore how user involvement in social service evaluation can make visible how these services enhance the quality of family and personal life. Using a case study of family support services in New South Wales, the research makes a series of empirical and theoretical contributions to problems of user involvement in social service evaluation. Firstly, the research examines the performance indicators currently used by government to monitor the efficiency and effectiveness of family support services in NSW. This shows that performance indicators in family support capture output more thoroughly than outcome, and confirms the minimal role that service users play in assessing service quality and outcomes. But while service users are largely excluded from participation in performance measurement, theoretical perspectives as diverse as managerialism and feminism treat service users as well placed to capture and report otherwise elusive information about care quality and outcomes. Further, participation in evaluation facilitates the exercise of users’ rights to self-expression and self-determination in the social service delivery and policy process. After identifying the widespread exclusion of service users’ perspectives from performance measurement in NSW family support, the thesis makes its more substantial contribution, in documenting findings from a detailed study involving adult family support service users (parents) and their workers (the ‘Burnside Study’). This qualitative study was conducted in four socio-economically disadvantaged service delivery sites located around New South Wales. Using focus group, interview and observational methods and a modified grounded theory approach, the study contributes exploratory evidence of what these service users think of, and how they think about service quality, outcomes, and evaluation in family support. The parents’ accounts of using family support capture their unfulfilled social ideals and the broader visions of the justice they hoped these social services would help them achieve. Their criteria for measuring service outcomes and service quality, and their views on evaluation methods embody core themes that social theorists have struggled to analyse, about the purpose of social services and the nature of ‘a good life’. The theoretical framework I develop highlights the role of family support in the context of service users’ struggles for social justice, and in particular, their struggles for self-realisation, recognition and respect (Honneth, 1995). The research extends theories of recognition beyond publicly articulated social movements to those struggles in social life and social politics that exist in what Axel Honneth terms the ‘shadows’ of the political-public sphere (2003a: 122). After establishing a conceptual framework that facilitates deeper interpretation of users’ perspectives, I present the findings in three categories: users’ perspectives on service outcomes; users’ perspectives on service quality; and users’ perspectives on evaluation methods. The findings show how service users define ‘service outcomes’ in the context of their struggles for recognition and respect, highlighting the contribution welfare services and welfare professionals make beyond the managerial ‘Three E’s’ of economy, efficiency, and effectiveness. Further, the findings confirm the importance of ‘helping relationships’ to the quality of service delivery in family support, despite the invisibility of service relationships in existing performance indicators. The complexity of worker-client bonds highlights the difficulty of evaluating social services using simple numerical counts of client or service episodes, and plays into broader debates about strategies for revaluing care work, and the role of care recipients. Finally, the findings show the role performance measurement processes and methods might play in facilitating users’ struggles for recognition. Users identified a role for evaluation in making visible the contribution of family support in pursuing their social justice goals, and saw evaluation as an opportunity in itself to facilitate recognition and respect. Overall, the thesis offers concrete evidence about how family support service users experience and define service quality and outcomes, and how they see their own role in evaluating the services they use. The research shows how users’ perspectives both contest and confirm the ‘new accountability’ of performance measurement, pointing to new directions, and further challenges, for conceptualising – and evaluating – social services.
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Hu, Mei. "The impact of the new integrated older people's care services in Cambridgeshire on service users." Thesis, Anglia Ruskin University, 2011. http://arro.anglia.ac.uk/211749/.
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Social care and health services for older people in Cambridgeshire have been integrated since April 2004. This study examines the effect of the integration programme on service users. Previous research into health and social care integrations predominantly centre on process issues and pay much less attention to outcomes. No study has evaluated the impact of fully-integrated care services for the whole user group of older people. Theory-led programmatic approach was used in this study. Multi-method data collection and analysis were employed to uncover and examine the causal links, the contextual conditions, the implementation process, causal mechanisms, and intended and achieved outcomes of the integration programme. This study reveals an improvement in the physical functioning of one in three occupational equipment users; a rise in the level of satisfaction of 85% of occupational health and 82% of physiotherapy users; older people with complex problems and high-level needs were able to be helped to live at home; and waiting time for both assessment and for services within two weeks and four weeks were below the national achievement and the ministerial targets. It also reveals a lack of change outcomes in social care, and service users’ low level of satisfaction with social care services, which appear to be associated with the privatisation of long-term social care and the predominant aim in social work of achieving maintenance and prevention outcomes. The integration programme’s goals—unifying the care system, easier and simpler access to services and a single and quick assessment—were not fully reached, mainly because of users’ low awareness of the integration, incompatible ICT systems and lack of funding. This study contributes to knowledge on how the total integration in Cambridgeshire has benefited users and how theory-led programmatic approach can be used in this area and in the study of this kind of complex social programme.
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Hu, Mei. "The impact of the new integrated older people's care services in Cambridgeshire on service users." Thesis, Anglia Ruskin University, 2011. https://arro.anglia.ac.uk/id/eprint/211749/1/Mei%20Hu%20thesis%202011.pdf.
Full textAbstract:
Social care and health services for older people in Cambridgeshire have been integrated since April 2004. This study examines the effect of the integration programme on service users. Previous research into health and social care integrations predominantly centre on process issues and pay much less attention to outcomes. No study has evaluated the impact of fully-integrated care services for the whole user group of older people. Theory-led programmatic approach was used in this study. Multi-method data collection and analysis were employed to uncover and examine the causal links, the contextual conditions, the implementation process, causal mechanisms, and intended and achieved outcomes of the integration programme. This study reveals an improvement in the physical functioning of one in three occupational equipment users; a rise in the level of satisfaction of 85% of occupational health and 82% of physiotherapy users; older people with complex problems and high-level needs were able to be helped to live at home; and waiting time for both assessment and for services within two weeks and four weeks were below the national achievement and the ministerial targets. It also reveals a lack of change outcomes in social care, and service users’ low level of satisfaction with social care services, which appear to be associated with the privatisation of long-term social care and the predominant aim in social work of achieving maintenance and prevention outcomes. The integration programme’s goals—unifying the care system, easier and simpler access to services and a single and quick assessment—were not fully reached, mainly because of users’ low awareness of the integration, incompatible ICT systems and lack of funding. This study contributes to knowledge on how the total integration in Cambridgeshire has benefited users and how theory-led programmatic approach can be used in this area and in the study of this kind of complex social programme.
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Okunola, Olaseni Muritala. "Users' experience of e-government services : a case study based on the Nigeria immigration service." Thesis, Manchester Metropolitan University, 2015. http://e-space.mmu.ac.uk/612199/.
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The aim of this thesis is to contribute to a better understanding of users’ experience of e-government services in developing countries through a study of a specific e-government service, the Nigeria Immigration Service (NIS) portal. This thesis therefore encompasses both the users’ experience of e-government services and effect of the digital divide in the use of e-government services. The NIS portal was chosen as the context for this study because it is the most well-developed e-government service in Nigeria. Those seeking to travel in and out of the country have no option but to use it regardless of whether they are currently living in Nigeria. Given the importance of profiling a significant number of users to support the investigation of relationships between variables, and the geographic scatter of the respondents, snowball sampling was used for the questionnaire survey used to collect the data. The questionnaire design and subsequent analysis was informed by previous research and theory in the fields of customer satisfaction, service quality, technology adoption and the digital divide. 351 completed questionnaires were collected and analysed using Statistical Package for the Social Sciences (SPSS) and Analysis of a Moment Structures (AMOS) Software. All respondents identified themselves as having used the NIS portal, with 50% reporting their main place of residence as Nigeria, and the remainder being resident in other countries. The analysis of descriptive statistics and the responses to the open questions and statements used in the questionnaire suggested that the respondents had a low level of satisfaction with the NIS website, with much of their concern stemming from issues pertaining to security, support and trustworthiness. There were also concerns documented regarding the safety of personal and financial data. They also mentioned significant issues with the ease of use of the website and its quality. Nonetheless, users valued the quality of the content and information available through the portal and were positive about its convenience and potential to deliver benefits. In terms of usage barriers, the most significant is Nigeria’s intermittent electricity supply, closely followed by the high cost of internet access, both of which pose a particular challenge, given the high rate of unemployment in Nigeria. Exploratory and confirmatory factor analyses were used to generate an e-government user experience scale confirming the importance of dimensionsidentified by other researchers, as well as identifying new factors. These were: security and support, content and information, ease of use, benefits, barriers, convenience, trust and website quality. Structural Equation Modelling (SEM) was used to investigate the relationships between these factors. Content and information were found to have a significant effect on ease of use and convenience. Website quality was found to have a significant effect on ease of use, security and support. The website’s ease of use was found to have a significant effect on barriers and convenience to have a significant effect on perceived benefits. Meanwhile, security and support was found to have a significant effect on trustworthiness. Barriers and benefits as well as trustworthiness were all found to have a significant effect on user satisfaction. Demographic statistics supported hypotheses testing on the digital divide in the use of e-government services. Demographic (age, education, gender and income), social-economic (employment) and geographic (location: rural and urban, developing and developed countries) factors affected the e-government users’ internet experience, their access to computing facilities and their e-government experience thus confirming that a digital divide exists amongst NIS portal users. This research makes a number of contributions. Firstly, it is one of a very few significant studies to explore user experience of an e-government portal in a major developing country. As a result, it has brought to light important concerns regarding users’ security, privacy and trustworthiness as they relate to their personal information. Secondly, it compares users both inside and outside the country, thereby offering unique insights on the digital divide. Finally, it proposes an e-government user-experience model that identifies the relationships between the various factors that contribute to user satisfaction. Suggestions are offered for practitioners, e-government policymakers and researchers.
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Imtiaz-Ud-Din, K. M. "Collaboration-based intelligent service composition at runtime by end users." Thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for telematikk, 2011. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-13826.
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In recent years, technologies in the area of ubiquitous computing have experienced a great advancement. This has resulted in a wide-spread use of services in order to improve the quality of our daily life. For example, a person with a mobile device can use the services available in the ubiquitous computing environment to plan and execute his or her travel, to connect to family and friends, to perform his or her researches, even to manage his or her business. However, most of the services are dynamic in nature in terms of their availability, robustness and the mobility of the user. These services also appear impermeable to the end users i.e. the end users do not get to control and configure the services in a way so as to feel like programmers developing services to accomplish certain goals. We envisage that in such a context end users, with no programming knowledge, will have a hard time to find services of their choice and that it will be hard for these end users to derive substantial benefits from these services. Unguided automation is not the answer to this problem as a particular service suggested automatically by a dynamic composition mechanism may not be suitable for a specific user at a certain point of time and in a given context. On the other hand explicit specification of service instances will mean that the user will be bogged down with the problem of runtime optimization in a dynamic environment where several factors as indicated earlier determine the availability of the services having required functionality. In order to address this issue we introduce the notion of intelligent service composition where the end user will have a great degree of flexibility to define his or her own rules or conditions based on which an optimal composition will be made automatically from a set of collaborative services by runtime adaptation in a specific context and point in time. This is a step forward compared to the present dynamic composition mechanisms which do not facilitate end users defining their own conditions dictating the selection of specific service instance at runtime. We have developed this conceptual solution to bring end users towards adaptive use of services. We validated our conceptual solution through a scenario-based evaluation approach with an implementation of a proof-of-concept prototype.
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Jackson, Lynsey. "Applying social identity theory to mental health inpatient service-users." Thesis, University of Warwick, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.424177.
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White, Jane Mary. "Social prescribing : the perspectives of service users, providers and prescribers." Thesis, Glasgow Caledonian University, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.570733.
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Social prescribing aims to offer an alternative to pharmaceutical or psychological treatments for mild to moderate mental health problems that present in primary care. Social prescribing seeks to link people with community-based sources of support, which are provided outwith the traditional National Health Service (NHS). As such, it calls for collaborative working between three groups: service users, prescribers (health professionals), and providers of community-based activities. However, little is known about these stakeholders' perceptions of social prescribing as an acceptable and appropriate alternative care pathway. ~; ..• Drawing on the theory of social capital, this study aimed, firstly, to develop an understanding of the nature and potential of social prescribing as a means of health improvement. Secondly, it sought to identify factors that were likely to help or hinder' successful implementation. This qualitative, exploratory study adopted a case study methodology underpinned by a critical realist perspective. Three cases were selected purposively. Each was a community-based organisation offering activities which were being 'prescribed' by NHS health professionals. At each site, semi-structured interviews were carried out with a purposive sample of health professionals, service users and providers of the service (n=49). Findings indicate that service users were enthusiastic about the activities provided by the three community-based organisations. Processes of self-efficacy and social support appeared to have been facilitated by participatory person-centred relationships with service providers. These mechanisms were encouraged to operate by providers' creation of enabling contexts. Although challenges to the successful implementation of social prescribing were identified at individual, inter-personal, institutional and infra-structural levels, the findings suggest that social prescribing offers a promising alternative care pathway for people with mild to moderate mental health problems. It provides a holistic framework which, potentially, shifts the focus of care from an individual's deficiencies to their strengths, and from seeing people as passive recipients of services to active participants.
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West, Helen Margaret. "Service users' and providers' understanding of probabilities in prenatal screening." Thesis, University of Liverpool, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.502548.
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Pregnant women are routinely offered serum screening tests for Down's syndrome, open neural tube defects and Edward's syndrome. Informed decisions rely on health professionals communicating probabilities, and service users understanding this information. However, cognitive psychology research has established that people do not draw mathematically correct inferences from probabilistic screening information. This thesis applies this theoretical research to the context of prenatal genetic screening. The empirical work involved presenting screening scenarios to prenatal screening service users and providers in different forms (prenatal/neutral context, frequency/percentage presentation), arid assessing the effect of these manipulations on participants' ability to estimate risk probabilities. The understanding of medical students, postgraduate students, pregnant women, partners and companions,midwives, and obstetricians was investigated. The majority of responses to the scenario were incorrect. Most respondents gave extreme under- or over-estimates (close to 0 or 100). Obstetricians gave significantly more correct responses to frequency scenarios than percentages scenarios, replicating past studies. Other participants gave significantly fewer correct answers overall, and were unaffected by the change from percentage to frequency information. The reasoning of midwives and service users had not previously been investigated, and this thesis indicates that there are fundamental differences in the ways that different groups interpret probabilities, creating potential communication barriers between stakeholders.
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McCauley, Claire Odile. "Exploring young adult service users' perspectives on mental health recovery." Thesis, Ulster University, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.678024.
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Aims and Objectives: The aim of this study was to explore young adult service users' (18-35) perspectives on mental health recovery. Objectives included the exploration of factors that feature in an individual's perspective of recovery; the investigation of meaning and growth in suffering and the exploration of the 'temporality of being' within young adults' conceptualisation of recovery. Theoretical Perspective: The study was informed by a dual theoretical framework including Eriksson's (2006) theory on "The Suffering Human Being" and Kleinman's (1988) theory on explanatory models to explore young adult service user's understanding of recovery. Method: The study involved a three phased qualitative design. Phase 1: A concept analysis of recovery was conducted using Rodgers' (2000) evolutionary method. Phase 2: Two engagement groups with service users were undertaken to co-produce a semistructured interview schedule. Phase 3: Semi structured qualitative interviews with 25 young adult services users were conducted to ensure an in depth understanding of their recovery. Findings: Phase one findings propose a new conceptual definition suggesting the term "recovery" is not reflective of the identified conceptual characteristics. Phase two developed a collaborative co-production with service users of a semi-structured interview schedule used in phase three. Phase three findings revealed recovery is understood as an unchatted, timely and personal process of engaging and transcending pain. Perceived barriers to mental health recovery and the internal dynamics experienced within the process have been highlighted. Recovery acquires real life relevance when applied to the contextual factors that provide meaning in life. Conclusion: This research study has contributed to the knowledge base by revealing the hidden internal processes experienced within mental health recovery and how it is cognised. A novel comparison has been presented between the conceptual characteristics of recovery and how the concept is understood and lived by young adult service users.
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Nersveen, Espen. "End User Service Composition : Presenting a composition tool for end users with modular architecture and a graphical user interface." Thesis, Norwegian University of Science and Technology, Department of Computer and Information Science, 2007. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-8726.
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The report focuses on a possible problem to end users do to lack of control in a rapidly growing environment of computation embedded devices, and collaborative linking of various services. Such environments are often referred to as ubiquitous or pervasive computing environment. We have looked into why this problem may occur and more importantly, how to reduce the effect it may have on end users. Our work involves the process of creating a framework that can enable end users to compose services, by connecting them in a manner that allows them to become more then it's single components. We propose an architecture that can support rapid composition, and a user interface that can perform rapid end user service composition at any time. From the time that a user finds the need to connect two or more services together to the user having set up a complete composition should be a task performed as quick as drawing a composition on a sheet of paper. We therefor propose a Graphical User Interface to support the end user, and we will in this report show how it is made and how it works. We will also present the architecture needed to support such a user interface.
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Matheson, Catriona I. "Community pharmacy services for drug misusers : a study of the perspectives of service users and providers." Thesis, University of Aberdeen, 1998. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU105510.
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The aim of this research project was to investigate, in detail, all aspects of the apparently increasing role of the community pharmacist in Scotland in providing services to drug misusers. The research focused on two areas: firstly, the effect of pharmacists' attitudes on their actual behaviour (i.e. whether services are provided), the type of services provided and how these services are delivered in practice as perceived by the pharmacist and the drug misusing client; secondly, the nature of the interaction between the pharmacist and drug misuser. Drug misusers valued a good relationship with their pharmacist and this encouraged service usage. Negative attitudes from pharmacist about drug misusers were a barrier to service provision both in terms of whether services were provided and the process of service delivery to drug misusers. This could be relieved by encouragement and endorsement of the pharmacist's role. Negative attitudes are counterproductive as they promote the sense of stigmatisation of drug misusers and may precipitate negative behaviour. To some extent negative attitudes are caused by personal conflict regarding the appropriate professional role of the community pharmacists in drug misuse. Greater local networking, joint training with other service providers and active support from local health boards would encourage more pharmacists to provide the services desired by drug misusers such as greater availability of injecting equipment and methadone dispensing. This would enable the principles of the harm reduction strategy to be widely practised.
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Alderson, Hayley. "Exploring commissioners, service providers and treatment service users' views about involvement in public health commissioning : a case study of local alcohol services." Thesis, University of Newcastle upon Tyne, 2016. http://hdl.handle.net/10443/3178.
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This research investigates stakeholders’ knowledge of, and experience in, public health commissioning of alcohol services in North East England. Public health commissioning has undergone significant transformation during the course of this research. However, health policies and legislation have consistently supported the concept of stakeholder involvement in all stages of the commissioning process. Alcohol is an issue that spans health and wider public health services. On a global level alcohol is the fifth leading cause of morbidity and premature death and is causally linked to over 60 diseases. The growing recognition of both the harmful effects of excessive alcohol consumption, and the rising associated costs have made it a major public health priority in recent years, both internationally and within the UK. The North East has one of the highest prevalence rates for excessive drinking and alcohol related health inequalities. A qualitative case study approach was adopted, focussing on the commissioning of alcohol services in a specific local area. Semi structured interviews and focus groups were used to obtain the perspectives of commissioners, alcohol service providers, general practitioners and alcohol service users. Collectively, all study participants were stakeholders in the commissioning process. However, understanding about what constituted stakeholder involvement was not consistent among participants and often definitions were limited to public and patient consultation. Stakeholder participation was often viewed as an end point rather than a process, the implication being that ‘any involvement was good involvement’. Furthermore, participatory approaches did little to ensure that stakeholder involvement actually influenced planning and decision making. Arnstein’s Ladder of participation was used to examine the extent of stakeholder involvement and a revised ladder is proposed. For many stakeholders, contribution to commissioning decisions seemed to occur at a tokenistic level, resulting in minimal motivation for at least some stakeholders to become involved in the commissioning process.
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Booi, Mpilo Henry. "Disability and service delivery perspectives of service users in a rural community in the Eastern Cape." Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/10143.
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Includes bibliographical references.Since the advent of democracy in South Africa rural and disabled people have lagged behind in terms of access to services, and that has implications on their enjoyment of socio-economic rights. Although exclusion from access to services is documented in literature, little research has been done to explore rural and disabled people's perspectives on inclusive service delivery. The purpose of this study was to contribute to the literature regarding inclusive service delivery in health, education and social development and citizen participation in rural areas. Insights into perspectives of rural citizens are pertinent for improved and inclusive service delivery. The aim of this study was to describe the perspectives of rural people regarding disability inclusive public sector service delivery in social development, health and education in a remote village in the Eastern Cape, South Africa.
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Bacha, Karin. ""Like a human being, I was an equal, I wasn't just a patient" : service users' perspectives on their experiences of relationships with staff in mental health services." Thesis, University of Manchester, 2017. https://www.research.manchester.ac.uk/portal/en/theses/like-a-human-being-i-was-an-equal-i-wasnt-just-a-patient-service-users-perspectives-on-their-experiences-of-relationships-with-staff-in-mental-health-services(97a0f8ce-ddf6-4ffa-9e11-0913fadcc53b).html.
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Background: Therapeutic relationships in psychiatry services have been shown to have a significant impact on outcomes for people in severe mental distress. Service user experience-based studies consistently show relationships are an important factor in either helping or hindering recovery. Few studies have conducted a detailed exploration into the interpersonal mechanisms within these relationships by asking service users directly about what emotional impact these relationships have had on them. This is important knowledge for improving the quality of mental healthcare for people in severe mental distress. Aims: The purpose was to co-create a piece of research with a service user organisation that explored services users' experiences and perceptions of helpful and hindering relationships with mental health practitioners. The aim was to gain a greater understanding of the components in the relationship that brought about psychological change. Little research about relationships in psychiatry settings has been conducted in collaboration with service users outside of government-led mental health services. Participants: Eight participants were recruited from the service user organisation. The participants self-reported as having a mental health problem. Seven of the eight participants had long-term experience of using psychiatry services. Method: This research was service user-informed. The data was collected using single in-depth interviews focused on service users' views of their relationships with mental health practitioners. Interpretative Phenomenological Analysis (IPA) methodology was used to analyse the data and explore the participants' lived experiences of relationships in mental health services. Findings: The main themes identified were 'Trying to survive: am I a person or just an object in the system', 'Traumatic experiences and relationships' and 'Transformative relationships'. The findings showed the transformative components of these relationships were power, security and identity. The findings highlighted how the participants experienced a relationship to the system of psychiatry through their relationships with staff. Conclusions: How the components of power, security and identity were managed by practitioners determined whether relationships helped or hindered recovery. The responsibility for relationships in psychiatry needs to be broadened beyond the interpersonal relationship provided by practitioners. The systemic institution of psychiatry based on statutory control, risk aversion, the biomedical model and under resourcing were a cause of many of the problems in relationships in psychiatry settings.
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Coates-Stephens, Sam. "What does psychosis mean? : perspectives from service users and their relatives." Thesis, University of East London, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399643.
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Seebold, Marianne. "Service users' experiences of being sectioned under the Mental Health Act." Thesis, University of Southampton, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.442868.
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Roy, Philippe. "Listen to me : experiences of recovery for mental health service users." Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/1563.
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There is increasing awareness that mental health consumers may have important information for the development of services. In this qualitative study, I interviewed 10 consumers with the purpose of exploring in depth their experiences in interacting with service providers in the greater Vancouver area. Using constant comparative analysis, I found that the data suggested participants’ experiences of recovery developed largely out of connecting with other consumers rather than with service providers. Current services were portrayed as primarily reliant on the use of psychiatric medication. Consumers pointed to numerous difficulties in seeking help, including a lack of treatment alternatives, stigma and isolation. They also presented a strong demand for services and policies that promote an individual sense of recovery and support their fundamental human rights. Mental health service providers need to critically reflect on their current practices and policies, and how they may negatively impact their clients' lives by failing to properly listen to their narratives, grievances, experiences and perceptions. This study suggests further inclusion of consumer's views and participation in services to foster collaborative, recovery-oriented practices.
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Garforth, Kara. "Service users' perceptions of change following treatment in democratic therapeutic communities." Thesis, Lancaster University, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.533082.
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Pierre, Samuel Augustus. "Psychiatry and citizenship : the Liverpool Black mental health service users' perspective." Thesis, Liverpool John Moores University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.313133.
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Fegan, Colette M. "Emerging as a worker : mental health service users' transformation through volunteering." Thesis, Sheffield Hallam University, 2014. http://shura.shu.ac.uk/20200/.
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The purpose of this research was to provide a theoretical analysis of the dynamic relationship between volunteering and personal mental health recovery. There is a gap in the literature investigating the current situation in which a substantial number of service users with enduring mental health problems remain excluded from any mainstream paid work and are unable to fulfil a role linked to work activities. This situation is informed by debates about the concept of recovery, such as what constitutes the quality of that recovery. How volunteering contributes to this process of recovery was the focus of this study. A constructivist approach to grounded theory was used to explore the impact that volunteering had on personal recovery. The research took place in England and comprised two distinct phases utilising in-depth interviews with a total of 19 volunteers. Methods consistent with grounded theory were employed. The first phase generated categories that were further explored and developed in phase 2 with the aim of theoretical saturation. Three main categories: finding meaning and challenge through volunteering; crossing boundaries from patient to volunteer and finding the right sort of work supported a substantive theory Emerging as a worker through volunteering. This proposes that volunteering when supported can enhance recovery because it fosters positive risk taking and validates a valued identity that integrates an experience of mental ill health. Volunteering provides authentic work experience, a socially valued role and it confirms capability and readiness as a worker. The findings of the study suggest that mental health professionals are in a unique position to build partnerships with service users to support their recovery and vocational aspirations by providing opportunities for volunteering. A framework for supporting volunteering is essential although different models warrant further investigation. The study has generated a new theoretical understanding of the experience of volunteering for mental health service users in relation to their recovery.
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Gieniusz, Barbara. "Being a pioneer : mental health service users' experiences of peer brokerage." Thesis, Canterbury Christ Church University, 2014. http://create.canterbury.ac.uk/12866/.
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In recent years in the UK, services introduced personalisation, allowing mental health service users to be in charge of the budgets given to them by social care. Peer brokerage is based on advice regarding the best use of personal budgets. The aim of this study was to understand the experiences of mental health service users being trained and working as peer brokers, and any role of those experiences in their recovery and identity. Six peer brokers were interviewed and the data were analysed using Interpretative Phenomenological Analysis (IPA). Five main themes were identified in the interviews: changing and growing; rewarding and challenging aspects of the role; client-centred approach to peer brokerage; importance of peer-relationships; and the pioneering nature of the role. Participants emphasised that this is a new idea in mental health services requiring commitment and determination in facing obstacles. The study concluded that similarly to previous research on the experiences of peer workers, participants spoke of challenging and rewarding aspects, including learning and benefits from helping others. New themes highlighted by this study show the importance of support from other peers and a humanistic approach to helping others. More UK-based studies are needed to understand peer workers’ experiences and their partnership with services.
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Colgrave, Sanna. "Power and the social construction of service users and clinical psychologists." Thesis, Canterbury Christ Church University, 2014. http://create.canterbury.ac.uk/13036/.
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Power issues in the relationship between service users and clinical psychologists have received little attention from a postmodern perspective. The recovery approach and the scientist-practitioner model as recommended in best practice guidelines creates an argument for investigating power dynamics in academic and practical disseminations. This study aimed to investigate the social construction of service users and clinical psychologists in articles. Twelve articles and opinion pieces written by clinical psychologists and service users were sampled from publications of the Clinical Psychology Forum. A Foucauldian Discourse Analytic method was used to identify dominant discourses and counter-discourses. The discourses were linked to the power dynamics in play between relevant institutions. The analysis identified an economic discourse, a technical-rational discourse and an expert discourse as constructing service users and clinical psychologists. Clinical psychologists were found to have more discourse availability than service users, and in a position to make choices, whereas service users were found to have availability to a limited number of discourses with fewer options of subjectivity. A need for clinical psychologists to make conscious choices in practice was implied.
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Wagle, Nazakat. "Racism in the lives of ethnic minority service-users with psychosis." Thesis, University of Leicester, 2006. http://hdl.handle.net/2381/31233.
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A literature review regarding the impact of racism upon ethnic minority clients found a small number of papers, mainly American in origin. These centred mainly in the fields of trauma and stress-coping and, aside from war veterans, upon non-clinical populations. A grounded theory investigation of the experiences of racism by ethnic minority service users with psychosis was conducted. After interviewing five participants, a 'developing' or interim model was generated that attempted to depict the processes underlying experiences of racism. Its limitations and possible future directions are discussed. A critical analysis is also presented which looks at specific problems encountered during research including the use of terminology, sampling considerations, emotional distress during interviews and the difficulties of analysis.
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Starkey, Fenella Anne. "Participatory research with mental health service users : a strategy for empowerment?" Thesis, University of Bristol, 2005. http://hdl.handle.net/1983/457c5125-d383-4ba5-88c8-ea5357e93d9f.
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Literature, including service users' own accounts, confirms that people labelled as `mentally ill' experience oppression and powerlessness both in their contacts with psychiatric services and more widely in society. There are calls to challenge this oppression by engaging in strategies for empowerment, for example via advocacy and campaigning by the mental health user/survivor movement. Research has also been identified as a strategy for empowerment for mental health service users. This dissertation proposes participatory research (PR) as a potentially empowering research methodology consisting of a process of investigation, education and action in which participants work jointly with researchers throughout. This research therefore aims to: explore the nature of oppression and power in the lives of mental health service users in Britain; assess the extent to which participatory research can function as a strategy for empowerment for mental health service users; consider the extent to which PR principles can be adhered to in research with mental health service users; and highlight issues for methodological development arising from the practice of PR. These aims were explored via a year-long PR project in which the author worked jointly with a group of mental health service users to design and undertake research, and to take action based on its findings. Fieldwork data are analysed in the context of existing theoretical, conceptual and empirical literature on oppression, power, empowerment and PR. It is concluded that PR can facilitate processes of individual and group empowerment for mental health service users, and may therefore be a first step towards the longer-term goal of achieving empowerment in the liberational sense of changing oppressive social structures. This latter goal is more likely to be achieved by combining research with other strategies for empowerment such as collective action and campaigning, and by joining together with other oppressed groups with common interests, such as the disability movement.
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Duncan, Hannah. "Experience of coercion and treatment pressures amongst mental health service users." Thesis, University of East London, 2013. http://roar.uel.ac.uk/3457/.
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The existing body of literature indicates that psychiatric service-users commonly experience treatment pressures. In the research to date there has been a bias towards investigating (often compulsory) hospital admission and treatment at the expense of finding out about the wide range of experiences that service-users potentially perceive as treatment pressures. Similarly little research has explored the effects of these experiences over time, the processes that mediate them, or how they are managed. This research sought to explore these neglected issues, which is paramount for the development of a more ethical psychiatric service provision. Ten mental health service-users were interviewed with regards to their experiences of treatment pressure; the effects of these experiences; and the processes involved in their management of them. A thematic analysis of these interviews was constructed. The overarching theme, ‘experiencing and managing treatment pressure’, was comprised of four themes: ‘A personal experience’, ‘A relational experience’, ‘A culturally bound experience’, and ‘Taking control: “it’s fight, flight or comply”’. The analysis indicated that the experiences of treatment pressure had wide reaching and enduring effects for participants in terms of: their understanding of the world; their self-identity; their relationships with others; and their social category status. In order to manage these experiences and incorporate them into narratives about themselves participants appeared to ‘take control’ of their experiences in different and multiple ways. Managing their experiences in this way seemed to ameliorate the often highly distressing and disturbing effects of treatment pressures. The thesis ends with a consideration of both clinical and research implications.
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Xu, Beijie. "Understanding Teacher Users of a Digital Library Service: A Clustering Approach." DigitalCommons@USU, 2011. https://digitalcommons.usu.edu/etd/890.
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This research examined teachers' online behaviors while using a digital library service--the Instructional Architect (IA)--through three consecutive studies. In the first two studies, a statistical model called latent class analysis (LCA) was applied to cluster different groups of IA teachers according to their diverse online behaviors. The third study further examined relationships between teachers' demographic characteristics and their usage patterns. Several user clusters emerged from the LCA results of Study I. These clusters were named isolated islanders, lukewarm teachers, goal-oriented brokerswindow shoppers, key brokers, beneficiaries, classroom practitioners, and dedicated sticky users. In Study II, a cleaning process was applied to the clusters discovered in Study I to further refine distinct user groups. Results revealed three clusters, key brokers, insular classroom practitioners, and ineffective islanders. In Study III, the integration of teacher demographic profiles with clustering results revealed that teaching experience and technology knowledge affected teachers' effectiveness in using the IA. The implication, contributions, and limitation of this research are discussed.
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Kang, Youn Ah. "Informing design of visual analytics systems for intelligence analysis: understanding users, user tasks, and tool usage." Diss., Georgia Institute of Technology, 2012. http://hdl.handle.net/1853/44847.
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Visual analytics, defined as "the science of analytical reasoning facilitated by interactive visual interfaces," emerged several years ago as a new research field. While it has seen rapid growth for its first five years of existence, the main focus of visual analytics research has been on developing new techniques and systems rather than identifying how people conduct analysis and how visual analytics tools can help the process and the product of sensemaking. The intelligence analysis community in particular has not been fully examined in visual analytics research even though intelligence analysts are one of the major target users for which visual analytics systems are built. The lack of understanding about how analysts work and how they can benefit from visual analytics systems has created a gap between tools being developed and real world practices.
This dissertation is motivated by the observation that existing models of sensemaking/intelligence analysis do not adequately characterize the analysis process and that many visual analytics tools do not truly meet user needs and are not being used effectively by intelligence analysts. I argue that visual analytics research needs to adopt successful HCI practices to better support user tasks and add utility to current work practices. As the first step, my research aims (1) to understand work processes and practices of intelligence analysts and (2) to evaluate a visual analytics system in order to identify where and how visual analytics tools can assist. By characterizing the analysis process and identifying leverage points for future visual analytics tools through empirical studies, I suggest a set of design guidelines and implications that can be used for both designing and evaluating future visual analytics systems.
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Bagger, Karin Fex-Fritz Katarina. "Ett folkbibliotek och dess användare : användares uppfattningar av service relaterade till verksamhetens intentioner = [A public library and its users] : [users conceptions of service related to library intentions] /." Borås : Högsk. i Borås, Bibliotekshögskolan/Biblioteks- och informationsvetenskap, 2004. http://www.hb.se/bhs/slutversioner/2004/04-21.pdf.
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Grinter, David John. "Non-engagement in psychosis : a narrative analysis of service-users’ experiences of relationships with mental health services." Thesis, University of Glasgow, 2012. http://theses.gla.ac.uk/3304/.
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Introduction: Non-engagement with treatment is a familiar problem for health services and has been identified as a particularly important issue for those who experience psychosis. The therapeutic relationship between service-users and clinicians is considered to be crucial to good engagement. The extent to which requirements of engagement with treatments and mental health services represent a threat to the individual’s autonomy is a potential factor in non-engagement. Reactance theory has attempted to explain this phenomenon. However, relationships are complex and reactance theory does not reflect this. The exploration of narratives is an opportunity to develop an understanding of the intricacies of these therapeutic relationships. Methods : Interviews were conducted with 11 participants who were recovering from an episode of psychosis. Narrative Analysis of the transcripts was undertaken. During the process interpretation of the transcripts required the introduction of Dialogical Self Theory. Results: Three self-positions were identified through which participant’s narrated their experiences. Defiant, Subordinate and Reflective-Conciliatory positions were described. Discussion: Narratives surrounding recovery and engagement with services can appear complex, contradictory and fragmented. They are narrated by different self-positions. This understanding of the complexity of narratives may be helpful in guiding clinicians in maintaining a wider awareness of the multidimensional nature of individuals’ understandings of their experiences of recovery and relationships with services.