Cultivating Compassion through analysis of online patient narratives

Compassion is at the forefront of national and international healthcare policy, practice and educational debates as a result of a series of recent reports (Mid Staffordshire NHS Foundation Trust Inquiry, 2010, Lown et al 2011, Mannion, 2014). Arguably, this emphasis on compassion is in juxtaposition to an increasingly complex technological healthcare system focused upon outcomes, efficiency, productivity and competence. Within this fast paced and time pressured environment innovative strategies are required to cultivate and sustain compassion among healthcare professionals.

Understanding the person’s experience of illness and making an emotional connection are key processes in cultivating compassion (Dewar, 2013). The exponential growth in unsolicited patient narratives has the potential to provide invaluable insight into what matters to patients and their experience of illness. For many patients these stories ‘reclaim’ their illnesses from the traditional biomedical model of disease and reveal otherwise hidden aspects of their experience. The content though freely accessible, is however unedited and lacks safeguards in relation to the quality or accuracy of the information provided. Despite these concerns, healthcare professionals are now challenged to pay attention to these unsolicited patient stories and to consider how they can inform and improve patient care.

This paper discusses the use of online patient narratives in undergraduate nurse education to cultivate compassion. Critical analysis of online patient narratives is advocated as a potential educational strategy to cultivate compassion among future health care professionals.

References
Dewar,B. (2013) Cultivating compassionate care Nursing Standard 27, (34) 48-55

Lown B, Rosen J, Martilla J.(2011) An agenda for improving compassionate care: a survey shows about half of patients say such care is missing. Health Affairs (Millwood) 30, 1772–8.
Mannion,R. (2014) Enabling compassionate healthcare: perils, prospects and perspectives International Journal of Health Policy and Management 2, 115-7
Mid Staffordshire NHS Foundation Trust Inquiry (2010). Independent Inquiry into care provided by Mid Staffordshire NHS Foundation London: Stationery Office.

Female narratives of ‘new’ citizens’ belonging(s) and identities in Europe: case studies from the Netherlands and Britain

Public discourses on citizenship, identity and nationality, which link geographical borders and the political boundaries of a community, are infused with tensions and contradictions. This paper illustrates how these tensions are interwoven with multilayered notions of home, belonging, migration, citizenship and individual’s ‘longing just to be’, focusing on the Dutch and the British context. The narratives of a number of Dutch and British women, who either immigrated to the respective countries or were born to immigrants, illustrate how the growing rigid integration and assimilative discourses in Europe contradict an individual anchoring in national and local communities. The narratives of women participating in these studies show multilayered angles of belonging presenting an alternative to the increasing strong argument for a fixed notion of positioning and national belonging. The female ‘new’ citizens in our study tell stories of individual choices, social mobility and a sense of multiple belonging in and across different communities.

Museum City - Improvisation and the narratives of space

This paper provides four viewpoints on the narratives of space, allowing us to think about possible relations between sites and sounds, reflecting on how places might tell stories, or how practitioners embed themselves in a place in order to shape cultural, social and/or political narratives through the use of sound. I propose four viewpoints that investigate the relationship between sites and sounds, where narratives are shaped and made through the exploration of specific sonic activities. These are:
- sonic activism
- sonic preservation
- sonic participatory action
- sonic narrative of space

I examine each of these ideas in turn before focusing in more detail on the final viewpoint, which provides the context for discussing and analysing a recent site-specific music improvisation project, entitled ‘Museum City’, a work that aligns closely with my proposal for a ‘sonic narrative of space’.
The work ‘Museum City’ by Pedro Rebelo, Franziska Schroeder, Ricardo Jacinto and André Cepeda specifically enables me to reflect on how derelict and/or transitional spaces might be re-examined through the use of sound, particularly through means of live music improvisation. The spaces examined as part ‘Museum City’ constitute either deserted sites or sites about to undergo changes in their architectural layout, their use and sonic make-up. The practice in ‘Museum City’ was born out of a performative engagement with[in] those sites, but specifically out of an intimate listening relationship by three improvisers situated within those spaces.
The theoretical grounding for this paper is situated within a wider context of practising and cognising musical spatiality, as proposed by Georgina Born (2013), particularly her proposition for three distinct lineages that provide an understanding of space in/and music. Born’s third lineage, which links more closely with practices of sound art and challenges a Euclidean orientation of pitch and timbre space, makes way for a heightened consideration of listening and ‘the place’ of sound. This lineage is particularly crucial for my discussion, since it positions music in relation to social experiences and the everyday, which the work ‘Museum City’ endeavoured to embrace.

Charting Cartographies of Resistance: Line of Flight in Women Artists’ Narratives

In this paper I chart lines of flight in women artist’s narratives. In focusing on the complex interrelations between the social milieus of education and art, what I suggest is that they should be analysed as an assemblage where power relations and forces of desire are constantly at play in creating conditions of possibility for women to resist, imagine themselves becoming other and for new possibilities in their lives to be actualised. As a novel approach to social ontology the theory of assemblages offers an analytics of social complexity that accounts for open configurations, continuous connections and unstable hierarchies, structures and axes of difference. In reconsidering resistance as immanent in dispositifs of power and assemblages of desire, what I finally argue is that women artists’ narratives contribute to the constitution of minor knowledges and create archives of radical futurity.

Civil defence pedagogies and narratives of democracy: disaster education in Germany

‘Disaster education’ is a fledgling area of study in lifelong education. Many countries educate their populations for disasters, to mitigate potential damage and loss of life, as well as contribute to national security. In this paper, which draws on interview data from the German Federal Office for Civil Defence and Disaster Assistance and the Federal Agency for Technical Relief, archival research, analysis of websites and promotional materials as well as relevant academic literature, I examine disaster education and preparedness for national emergencies in Germany. I argue that it is not generally extended to the general public, rather confined to trained experts, decentralised, localised and exclusive. Theorising disaster education as a ‘civil defence pedagogy’ (Preston, 2008), a type of public pedagogy, which contributes to shaping narratives of national identity, I argue that it is unlikely that Germany will develop a more inclusive, universal, formalised, nor high-profile campaign in disaster education in the foreseeable future. This, I suggest, is due to narratives of the German democratic nation state as secure, federal, peaceful and unified, which originated at the founding of West Germany in 1949, and continue to shape contemporary political narratives.

‘It's been hell.’ Italian and British practice educators’ narratives of working with struggling or failing social work students in practice learning settings

Periods of assessed learning in practice settings are common requirements for social work students world wide. The ‘practice learning opportunity’ as it is known in the UK, and ‘tirocinio di servizio sociale’ as it is referred to in Italy, are important sites of gatekeeping in preventing unsuitable people from becoming social workers. The experience of assessing failing students in practice learning settings however, has been found to be particularly stressful and challenging for practice educators. This article documents findings from two qualitative studies that explored field educators’ experiences of working with struggling or failing social work students in Italy and England. The study finds both similarities and differences in the narratives of the assessors from the two countries Similarities include, unpleasant emotional experience of working with a failing student, internalisation of the students failing as the practice educators’ own failing, perceptions that the universities may hide negative information about students and lack of acknowledgement of the gatekeeping function inherent in the practice educator role. Differences include the level of emotionality experienced by educators, the way students are spoken about and the perceived role and responses of the university. Further comparative European research which focuses on practice education is indicated.

Narratives of Variation in Teacher-Pupil Relationships Across a Career

This paper reports on the findings of a research study focused on teacher perceptions of their relationships with pupils over three phases of a career. Data collected from thirty primary school teachers using a critical event narrative approach were coded and compared across the three groups of teachers at different points in their careers; 0-7 years, 8-23 years, and over 24 years. The study, based in the United Kingdom, highlighted a complex development amongst teachers which centres on five key areas identified as differentiating between the three career phases; interaction, behaviour, expectations, proximity and control. Results indicate that teachers go through a series of relationship transitions in relation to these five areas, and that these transitions can often confront teachers with conflicting views of what positive teacher-pupil relationships are and create personal dissonance as they try to make sense of their role in these relationships. Based on empirical evidence, this paper argues that positive relationships with pupils are not necessarily associated with experience and that the transitions teachers experience through their career is of concern given the centrality of teacher-pupil relationships to effective teaching.

'Anyone But England‘, Glasgow 2014 and the Independence Referendum: Exploring the Role of Narratives in the Sociological Study of Scottish Sport.

Drawing upon the findings of my MSc dissertation and the proposed methodology for my current PhD thesis, this paper will critically reflect upon the potential uses of narrative analysis within the sociological study of sport. The majority of this paper will consider the expression of anti-English sentiment by Scots in relation to both sporting and wider social contexts. Drawing upon the conceptual framework of ‘narrative identity’ proposed by Somers (1994), data was generated through semi-structured interviews focusing upon the ‘ontological’ and ‘public’ narratives of Scottish identity as expressed by Scots living in England. The relationship between Scotland and England is argued to be heavily influenced by the existence of an ‘underdog mentality’ grand ‘public narrative’ for Scots in relation to their English neighbours, based on perceived differences in economic and sporting resources. This ‘underdog mentality’ is argued to act as a legitimating force for the expression of anti-English sentiment within an individual’s ‘ontological narrative’ in both a sporting and wider social context. The paper concludes by reflecting upon the benefits of adopting a narrative analysis approach, and outlining the proposed use of similar methods within my PhD research on the 2014 Glasgow Commonwealth Games and the Scottish independence referendum.