Using Social Worlds Theory to Explore Influences on Community Nurses’ Experiences of Providing Out of Hours Paediatric Palliative Care

Abstract Background: Paediatric oncology palliative care in the community is rare and nationally there is a lack of standardisation of out of hours nursing service provision. Objectives: This paper seeks to explore influences on the experiences of paediatric nurses providing out of hours palliative care within the family home to children with cancer. The study used social worlds theory to aid identification and demonstration of the findings. Methods: Twelve community-based palliative cases were purposively selected from children with cancer treated at one regional centre. Tape-recorded interviews were undertaken with 54 health professionals (general practitioners, community nurses and allied health professionals) involved in providing their palliative care and five facilitated case discussions completed. Data analysis followed a grounded theory approach; chronological comparative data analysis identifying generated themes. Social worlds theory was used as a framework to examine the data. Results: Nurses’ experiences are shaped by their social world and those of the nursing team,child and family and the inter-professional team providing the care. The lack of a formalised service, sub-optimal inter-professional working and impact of social worlds influence the experience of the nurse. Conclusions: Social worlds theory provided a new perspective in understanding these experiences based within a paediatric palliative care setting, knowledge that can be used to inform service provision.

The Working Group on Scottish Sport and the Scottish Independence Referendum: an Unrealised Political 'Imaginary'?

In September 2014, a historic referendum on the issue of Scottish independence was held, with the potential to dissolve the political union between Scotland and the other constituent nations of the United Kingdom which had survived intact since the 1707 Act of Union. On a significantly high electoral turnout of 84.6%, the Scottish electorate opted to reject the proposals of the governing party in the devolved Scottish Parliament, the pro-independence Scottish National Party (SNP), to create an independent Scottish state, with 55.3% of the electorate voting ‘No’ to Scottish independence against a 44.7% ‘Yes’ vote. In the grand scheme of the Scottish independence referendum campaigns, sports policy remained a somewhat peripheral issue within the arguments forwarded by the Yes Scotland and Better Together campaigns. Nonetheless, developments such as the formation of the 'Sport for Yes' campaign sub-group, the inclusion of sport within the Scottish Government’s White Paper on Scottish independence and the establishment of the Working Group on Scottish Sport demonstrated that the potential implications of independence were still deemed significant enough to merit a degree of policy planning by the Scottish Government (Lafferty, 2014; Scottish Government, 2013; Working Group on Scottish Sport, 2013, 2014). This paper will critically consider the implications of the 'No' vote in the Scottish independence referendum for the latter of these developments, the policy proposals of the Working Group for Scottish Sport. Drawing upon the principles of critical discourse analysis, specifically the analytical framework proposed by Fairclough and Fairclough (2012), the content of this group's proposal will be examined in order to critically explore the policy for Scottish sport it envisaged for an independent Scottish state. The paper will then conclude by reflecting upon the extent to which elements of this political 'imaginary' (Fairclough and Fairclough, 2012) of Scottish sport remain a possibility for future sports policy in Scotland following the eventual 'No' vote in the referendum.