Developing user involvement in a UK cancer network:professionals’ and users’ perspectives

This paper explores the results of a consensus development exercise that explored diverse perspectives and sought to identify key principles for the development of user involvement in a cancer network. The exercise took place within one of 34 UK cancer networks and was a collaboration between the NHS, two universities and two voluntary sector organizations. The paper explores professionals’ and users’ perspectives on user involvement with reference to the current sociopolitical context of user participation. British policy documents have placed increasing emphasis on issues of patient and public participation in the evaluation and development of health services, and the issue of lay participation represents an important aspect of a critical public health agenda. The project presented here shows that developing user involvement may be a complex task, with lack of consensus on key issues representing a significant barrier. Further, the data suggest that professional responses can partly be understood in relation to specific occupational standpoints and strategies that potentially allow professionals to define and limit users’ involvement. The implications of these findings and the impact of the consensus development process itself are discussed.

Patients' and health professionals' views on primary care for people with serious mental illness:focus group study

Objective: To explore the experience of providing and receiving primary care from the perspectives of primary care health professionals and patients with serious mental illness respectively. Design: Qualitative study consisting of six patient groups, six health professional groups, and six combined focus groups. Setting: Six primary care trusts in the West Midlands. Participants: Forty five patients with serious mental illness, 39 general practitioners (GPs), and eight practice nurses. Results: Most health professionals felt that the care of people with serious mental illness was too specialised for primary care. However, most patients viewed primary care as the cornerstone of their health care and preferred to consult their own GP, who listened and was willing to learn, rather than be referred to a different GP with specific mental health knowledge. Swift access was important to patients, with barriers created by the effects of the illness and the noisy or crowded waiting area. Some patients described how they exaggerated symptoms ("acted up") to negotiate an urgent appointment, a strategy that was also employed by some GPs to facilitate admission to secondary care. Most participants felt that structured reviews of care had value. However, whereas health professionals perceived serious mental illness as a lifelong condition, patients emphasised the importance of optimism in treatment and hope for recovery. Conclusions: Primary care is of central importance to people with serious mental illness. The challenge for health professionals and patients is to create a system in which patients can see a health professional when they want to without needing to exaggerate their symptoms. The importance that patients attach to optimism in treatment, continuity of care, and listening skills compared with specific mental health knowledge should encourage health professionals in primary care to play a greater role in the care of patients with serious mental illness.

Putting children forward for epilepsy surgery:a qualitative study of UK parents' and health professionals' decision-making experiences

Background Against a backdrop of recommendations for increasing access to and uptake of early surgical intervention for children with medically intractable epilepsy, it is important to understand how parents and professionals decide to put children forward for epilepsy surgery and what their decisional support needs are. Aim The aim of this study was to explore how parents and health professionals make decisions regarding putting children forward for pediatric epilepsy surgery. Methods Individual interviews were conducted with nine parents of children who had undergone pediatric epilepsy surgery at a specialist children's hospital and ten healthcare professionals who made up the children's epilepsy surgery service multidisciplinary healthcare team (MDT). Three MDT meetings were also observed. Data were analyzed thematically. Findings Four themes were generated from analysis of interviews with parents: presentation of surgery as a treatment option, decision-making, looking back, and interventions. Three themes were generated from analysis of interviews/observations with health professionals: triangulating information, team working, and patient and family perspectives. Discussion Parents wanted more information and support in deciding to put their child forward for epilepsy surgery. They attempted to balance the potential benefits of surgery against any risks of harm. For health professionals, a multidisciplinary approach was seen as crucial to the decision-making process. Advocating for the family was perceived to be the responsibility of nonmedical professionals. Conclusion Decision-making can be supported by incorporating families into discussions regarding epilepsy surgery as a potential treatment option earlier in the process and by providing families with additional information and access to other parents with similar experiences.

Human resource development professionals' perceptions about the Academy of Human Resource Development Standards on Ethics and Integrity

Professional standards of ethics proclaim the core values of a profession, describe expected professional duties and responsibilities, and provide a framework for ethical practice and ethical decision-making. The purpose of this mixed, quantitative and qualitative, survey study was to examine HRD professionals' perceptions about the AHRD Standards on Ethics and Integrity, how HRD professionals used the Standards for research and decision-making, and the extent to which the Standards provided guidance for ethical decision-making. Through an on-line survey instrument, 182 members of AHRD were surveyed. The open-ended questions were analyzed using thematic analysis to expand on, inform, and support the quantitative findings. The close-ended questions were analyzed with frequency distributions, descriptive statistics, cross tabulations, and Spearman rank correlations. The results showed a significant relationship between (a) years of AHRD membership and level of familiarity with the Standards, (b) years of AHRD membership and use of the Standards for research, and (c) level of familiarity with the Standards and use of the Standards for research. There were no significant differences among scholars, scholar practitioners, practitioners, and students regarding their perceptions about the Standards. The results showed that the Standards were not well known or widely used. Nevertheless, the results indicated overall positive perceptions about the Standards. Seventy percent agreed that the Standards provided an appropriate set of ethical principles and reflected respondents' own standards of conduct. Seventy-eight percent believed that the Standards were important for defining HRD as a profession and 54% believed they were important for developing a sense of belonging to the HRD profession. Fifty-one percent believed the Standards should be enforceable and 61% agreed members should sign the membership application form showing willingness to adhere to the Standards. Seventy-seven percent based work-related ethical decisions on personal beliefs of right and wrong and 56% on established professional values and rules of right and wrong. The findings imply that if the professional standards of ethics are to influence the profession, they should be widely publicized and discussed among members, they should have some binding power, and their use should be encouraged.

A phenomenological exploration of how West Indian professionals in South Florida perceive their career construction

This phenomenological study explored how West Indian professionals in South Florida perceive their career construction. The study used Savickas’s (2005) theory of career construction as its theoretical framework. Semi-structured interviews were conducted, transcribed, and analyzed for 15 West Indian professionals, who self-identified as West Indians and met all the criteria for this study. Interview data were analyzed using inductive, deductive, and comparative analyses. Five themes emerged from the inductive analysis of the data: (a) vocational influences, (b) adjustment challenges, (c) employment patterns, (d) career mobility patterns, and (d) career success perceptions. The theory of career construction guided the deductive analysis. The deductive analysis revealed that both extrinsic and intrinsic influences were equally influential in shaping the participants’ vocational personalities. The deductive analysis also revealed that the participants used three of the career adaptive dimensions: career concern, control, and confidence. Career concern manifested as planning for the future through educational attainment and performing meaningful work. Career control manifested as continuous learning and maintaining secondary careers. Career confidence manifested as self-efficacy expectations, beliefs about one’s ability to perform a behavior that produces desired outcomes. The participants’ life themes or challenges included navigating their identity, starting over, and adjusting to their environment. The comparative analysis revealed that all five themes from the inductive analysis were evident in each of the three tenets of Savickas’s (2005) career construction theory (i.e., vocational personality, career adaptability, and life themes). Career compromises emerged as coping behavior to facilitate the participants’ social and occupational integration. The findings of this study imply that the participants constructed their sense of self in relation to those around them and that their vocational behaviors tend to mobilize and reinforce a mixture of personality and ability. The findings also imply that the participants’ decision-making style and habitual pattern of decision making, may be embedded in their culturally norms, producing a specific cognitive style. Finally, the findings imply that the participants’ career adaptive dimensions were grounded in their attitudes, beliefs, and competencies and overall self-concept. Recommendations for further research are given.

Living on both sides of the fence: A phenomenological study of human resource development professionals as downsizing survivors and strategic human resource development facilitators

This phenomenological study explored how HR professionals who identified themselves as facilitators of strategic HRD (SHRD) perceived the experience of being an organizational agent-downsizing survivor. Criterion and snowball sampling were used to recruit 15 participants for this study. A semi-structured interview guide was used to interview participants. Creswell's (2007) simplified version of Moustakas's (1994) Modification of the Stevick-Colaizzi-Keen Method of Analysis of Phenomenological Data was used to analyze the data. Four main themes and corresponding sub-themes emerged from an inductive data analysis. The four main themes were a) the emotionality of downsizing, b) feeling responsible, c) choice and control, and d) possibilities for growth. Participants perceived downsizing as an emotional organizational change event that required them to manage their own emotions while helping others do the same. They performed their roles within an organizational atmosphere that was perceived as chaotic and filled with apprehension, shock, and a sense of ongoing loss, sadness and grieving. They sometimes experienced guilt and doubt and felt deceptive for having to keep secrets from others when planning for downsizing. Participants felt a strong sense of responsibility to protect employees emotionally, balance employee and organizational interests, and try to ensure the best outcomes for both. Often being there for others meant that they put on their games faces and took care of themselves last. Participants spoke of the importance of choosing one's attitude, being proactive rather than reactive, and finding ways to regain control in the midst of organizational crisis. They also perceived that although downsizing was emotionally difficult to go through that it provided possibilities for self, employee, and organizational growth.

Tourism Professionals Indicate Research Needs

County and local tourism officials have a great need for data to help them make their decisions. The authors surveyed professionals to determine data used and needed, the types of decisions made, and where data is obtained. The results provide a profile for information sharing.

Tourism Professionals Profile: Theme Park Managers

Theme park managers are a unique group of tourism managers. Their perspectives on effective tourism management skills and abilities differ from some public sector tourism managers. The authors present the results of a study focusing on theme park managers and compare these results with those of other tourism manager groups

Assessing the effects of professionals' career decision -making on their participation reasons in continuing education in Taiwan

The purpose of this study was to assess the relationship between working professionals' Career Decision-Making Self-Efficacy beliefs (CDMSE beliefs) and their reasons for participating in in-service master's level programs in Taiwan. ^ The data collection instruments used were Grotelueschen's (1985) Participation Reasons Scale (PRS), and Betz, Klein, and Taylor's (1996) Career Decision-Making Self-Efficacy-Short Form (CDMSE-SF), and a Demographic Data Form (DDF) developed specifically for this study. ^ Surveys were administered to 800 working professionals who participated in inservice master's level programs at 22 Taiwanese universities. The survey was conducted in May 2004. Data were analyzed by simple descriptive statistics, principal component factor analysis, and multiple regression. Four factors of participation reasons were found and five components of CDMSE beliefs were scored. ^ Five components of CDMSE beliefs are structured into the CDMSE-SF instrument: Self-Appraisal, Occupational Information, Goal-Selection, Planning, and Problem Solving. The reasons for participation found in this study were: Professional Improvement and Development, Professional Service, Personal Benefit and Job Security, and Professional Competence and Collegial Interaction. Pearson-product moment correlations revealed significant positive correlations between the five CDMSE subscales and the four factors of participation reasons. Multiple regression analysis revealed that participants' beliefs in their abilities to obtain information about occupations accounted for the preponderance of variance of scores on the Participation Reasons Scale (PRS). ^ This study concluded that professionals who believed that they were efficacious in obtaining information about occupations or professions tended to believe that the four reasons for participation represented by the factors of the PRS were important to them in making the decision to participate in continuing education. Additionally, it was noted that the reasons for participations for professionals who did not feel confident in their abilities to find such information could not be determined. ^ Recommendations are offered to assist those individuals responsible for developing recruiting programs in continuing education for professionals in Taiwan. These recommendations focus only on strategies intended to attract this target population of professionals who believe that they are efficacious in obtaining information about occupations. ^