Masculinities and Narrating the Past: Experiences of Researching White men who Refused to Serve in the Apartheid Army

This article reflexively analyses the construction of identity and the representation of the past in qualitative interviews with white men who refused to serve in the apartheid-era South African Defence Force (SADF). The contribution that white male objectors made to the anti-apartheid struggle occupies an ambivalent and increasingly forgotten aspect of South African liberation history. In a reflexive research story, I argue that the gendered, sexual and raced subjectivities of the researcher and researched are central to the joint construction of meaning in the interview and in the creation of self-narratives. The article also analyses how the narratives of white men's involvement in resisting apartheid are defined by their perceived position and wider power struggles in contemporary South Africa.

Organisational and systems factors impacting on patient safety in acute care organisations: lessons from four multi-site research studies

Background Patient safety is concerned with preventable harm in healthcare, a subject that became a focus for study in the UK in the late 1990s. How to improve patient safety, presented both a practical and a research challenge in the early 2000s, leading to the eleven publications presented in this thesis. Research question The overarching research question was: What are the key organisational and systems factors that impact on patient safety, and how can these best be researched? Methods Research was conducted in over 40 acute care organisations in the UK and Europe between 2006 and 2013. The approaches included surveys, interviews, documentary analysis and non-participant observation. Two studies were longitudinal. Results The findings reveal the nature and extent of poor systems reliability and its effect on patient safety; the factors underpinning cases of patient harm; the cultural issues impacting on safety and quality; and the importance of a common language for quality and safety across an organisation. Across the publications, nine key organisational and systems factors emerged as important for patient safety improvement. These include leadership stability; data infrastructure; measurement capability; standardisation of clinical systems; and creating an open and fair collective culture where poor safety is challenged. Conclusions and contribution to knowledge The research presented in the publications has provided a more complete understanding of the organisation and systems factors underpinning safer healthcare. Lessons are drawn to inform methods for future research, including: how to define success in patient safety improvement studies; how to take into account external influences during longitudinal studies; and how to confirm meaning in multi-language research. Finally, recommendations for future research include assessing the support required to maintain a patient safety focus during periods of major change or austerity; the skills needed by healthcare leaders; and the implications of poor data infrastructure.