Modelling the development of an online learning resource by health care professionals

The aim of this study was to model the process of development for an Online Learning Resource (OLR) by Health Care Professionals (HCPs) to meet lymphoedema-related educational needs, within an asset-based management context. Previous research has shown that HCPs have unmet educational needs in relation to lymphoedema but details on their specific nature or context were lacking. Against this background, the study was conducted in two distinct but complementary phases. In Phase 1, a national survey was conducted of HCPs predominantly in community, oncology and palliative care services, followed by focus group discussions with a sample of respondents. In Phase 2, lymphoedema specialists (LSs) used an action research approach to design and implement an OLR to meet the needs identified in Phase 1. Study findings were analysed using descriptive statistics (Phase 1), and framework, thematic and dialectic analysis to explore their potential to inform future service development and education theory. Unmet educational need was found to be specific to health care setting and professional group. These resulted in HCPs feeling poorly-equipped to diagnose and manage lymphoedema. Of concern, when identified, lymphoedema was sometimes buried for fear of overwhelming stretched services. An OLR was identified as a means of addressing the unmet educational needs. This was successfully developed and implemented with minimal additional resources. The process model created has the potential to inform contemporary leadership theory in asset-based management contexts. This doctoral research makes a timely contribution to leadership theory since the resource constraints underpinning much of the contribution has salience to current public services. The process model created has the potential to inform contemporary leadership theory in asset-based management contexts. Further study of a leadership style which incorporates cognisance of Cognitive Load Theory and Self-Determination Theory is suggested. In addition, the detailed reporting of process and how this facilitated learning for participants contributes to workplace education theory

Men's experiences of receiving objective feedback on physical activity and other indicators of health risk, within the context of a gender-sensitised weight loss intervention

Receiving personalised feedback on body mass index and other health risk indicators may prompt behaviour change. Few studies have investigated men’s reactions to receiving objective feedback on such measures and detailed information on physical activity and sedentary time. The aim of my research was to understand the meanings different forms of objective feedback have for overweight/obese men, and to explore whether these varied between groups. Participants took part in Football Fans in Training, a gender-sensitised, weight loss programme delivered via Scottish Professional Football Clubs. Semi-structured interviews were conducted with 28 men, purposively sampled from four clubs to investigate the experiences of men who achieved and did not achieve their 5% weight loss target. Data were analysed using the principles of thematic analysis and interpreted through Self-Determination Theory and sociological understandings of masculinity. Several factors were vital in supporting a ‘motivational climate’ in which men could feel ‘at ease’ and adopt self-regulation strategies: the ‘place’ was described as motivating, whereas the ‘people’ (other men ‘like them’; fieldwork staff; community coaches) provided supportive and facilitative roles. Men who achieved greater weight loss were more likely to describe being motivated as a consequence of receiving information on their objective health risk indicators. They continued using self-monitoring technologies after the programme as it was enjoyable; or they had redefined themselves by integrating new-found activities into their lives and no longer relied on external technologies/feedback. They were more likely to see post-programme feedback as confirmation of success, so long as they could fully interpret the information. Men who did not achieve their 5% weight loss reported no longer being motivated to continue their activity levels or self-monitor them with a pedometer. Social support within the programme appeared more important. These men were also less positive about objective post-programme feedback which confirmed their lack of success and had less utility as a motivational tool. Providing different forms of objective feedback to men within an environment that has intrinsic value (e.g. football club setting) and congruent with common cultural constructions of masculinity, appears more conducive to health behaviour change.

Devotional reading and dissolving the self: a critical reading of the late medieval Scottish Legendary using Kristevan theory

The Scottish Legendary is a fourteenth century collection of saints’ lives in Older Scots. The prologue describes the lives as ‘merroure’ (mirror) to readers from which ‘men ma ensample ta’ (people may take example). Thus, the Legendary sets out to reveal how the reader is (mirror) thereby moving her to wish to become how she should be (exemplarity). This dissertation argues that, rather than encouraging devotion to saints along purely dogmatic lines, the Legendary transforms the reader’s selfhood by engaging her affectively, i.e. on an emotional and somatic level. By provoking the reader affectively, the text puts the reader into what Julia Kristeva has described as a ‘semiotic state’ which harks back to the reader’s or listener’s pre-cultural, pre-subjective self (Kristeva, 1984). Thus, the text disrupts the reader’s conception of herself as a complete, hermetic subjectivity, thereby dissolving the boundaries of the reader’s self. The Legendary most powerfully infiltrates the reader’s sense of self along these lines in the moments in which female saints’ bodies are tortured and dismembered. These scenes foreground the permeability of human flesh as well as its powerful influence over selfhood. Such images of abjection are, in Kristeva’s words, ‘opposed to I’; by confronting the reader with the disintegration of subjectivity in abjection, the text incites the reader to likewise experience herself as abject, i.e. disintegrable and permeable (Kristeva 1982). As I shall demonstrate, Kristeva’s psychoanalytic theory of the formation of the self offers a fruitful framework for understanding the processes of self-knowledge through reading that these saints’ lives inspire.