Browsing by Person "Dewar, Belinda"

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Beyond tokenistic involvement of older people in research - a framework for future development and understanding.
(2005) Dewar, Belinda
Research and development work in health and social care are increasingly required to involve users at all stages of the research process yet there is scant empirical evidence to support the justification of this laudable aim. Evidence does suggest that at present efforts to achieve this are primarily tokenistic and that more work is needed, both to examine what user involvement in research activity actually means, and how this can best be supported. This paper sets out to describe developments to support involvement of older people through work at the Royal Bank of Scotland Centre for the Older Person's Agenda and to identify a number of challenges that this has raised for researchers. These challenges have arisen out of a number of assumptions that underpin the process of user involvement. The paper discusses some of the benefits of working in partnership with older people and identifies strategic issues for consideration in order to promote future partnership working.
Care provision in Scotland: background, policy context and research.
(RCN, 2003-02) Dewar, Belinda; O'May, Fiona; Walker, Esther
In a two-part article about care of older people in Scotland, Belinda Dewar and colleagues report on a study designed to explore the views of specific groups on the provision of free personal care for older people.
Care provision in Scotland: experiences of services and priorities for improvement.
(Royal College of Nursing, 2003-03) Dewar, Belinda; O'May, Fiona; Walker, Esther
Last month Belinda Dewar and colleagues gave the background and policy context of a research study looking at the views of recipients of free care. This month they consider older people's accounts of care tasks important to them and suggest priorities for change.
Direct payments: the views of older people from rural communities and ethnic minority groups.
(Queen Margaret University College, 2005) Dewar, Belinda; O'May, Fiona; Donaldson, Caroline
The origins of the direct payments scheme lie with the Disabled People’s movement and the revolutionary idea of providing disabled people with cash to pay directly for their assessed care and support needs. Authorisation was given in 1997 to local authorities in England to offer cash payments to purchase care and support services through the implementation of The Community Care 1996 (Direct Payments) Act. This scheme was initially restricted to those aged between the ages of 18-65 years. However since February 2000 (July 2000 in Scotland) this has been extended to include disabled people aged 65 and over, and further expanded in 2001 to include young disabled people between the ages of 16 and 18 years. Prior to the implementation of the Community Care Act, procedures following a community care assessment placed the local authority in complete control regarding arranging and coordinating an individual’s care package. The local authority arranged when and where services were provided, and who would provide them. The direct payments scheme could offer an alternative, more flexible approach, with the potential to empower individuals choosing to opt into this scheme. Individuals in receipt of direct payments have control in making arrangements for the provision of services that work with their lifestyle as opposed to their lifestyle ‘fitting around’ local authority organised care and support services. Direct payments position the individual at the centre of control for their own service provision. Initially, direct payments as a scheme was relaxed and local authorities were not obliged to offer direct payments as an alternative to everyone. However, since April 2003 (June 2003 in Scotland), local authorities are now obliged to offer direct payments to all those eligible. Key criteria for eligibility to opt into this scheme are that direct payments in the form of cash can only be offered to those deemed able to consent and manage the direct payment, either alone or with support
Evaluation of workbased learning in a community nursing health degree programme: the student's perspective on the impact on practice.
(2002) Dewar, Belinda
Experiential learning: issues for supervision
(1999) Dewar, Belinda; Walker, Esther
This paper reports on an evaluation of work-based learning within a postregistration community health nursing degree programme. Work-based learning is primarily concerned with the process of learning and with encouraging the individual to be explicit about how and what they learn so that their experiential learning may be assessed and accredited. The methodology of Illuminative Evaluation was adopted, with case studies (n=6) used as the means of exploring in depth the different perspectives of the major stakeholders (that is, the students, their workplace supervisors and their academic supervisors). The data comprised documentation, participant and nonparticipant observation, interviews and focus groups. The initial aim was to examine the potential benefits of work-based learning to students and to describe its impact on their practice. However, what emerged through the course of inquiry was a gap between the educational philosophy of work-based learning and the way in which work-based learning was delivered within the department concerned. Work-based learning provides educators with an opportunity to debate openly fundamental issues about the nature of educational practice; in particular, about the role of the supervisor in facilitating students' learning. As the evaluation highlights, if this debate does not occur, existing educational practice remains unchanged and the potential benefits to students of this new educational philosophy are not realized. Furthermore, it is by engaging in a reflective process in relation to their own experience that educators can begin to understand how to facilitate that process in others
Guidelines to Facilitate the Involvement of Lay Carers in the Care Planning of the Person with Dementia in Hospital.
(Queen Margaret University College, 1999) Walker, Esther; Dewar, Belinda; Riddell, Helen
How do we facilitate carers' involvement in decision making?
(2001) Walker, Esther; Dewar, Belinda
Background. Government health care policy urges service providers to involve service users in the decision-making process. Research studies have recommended changes to current health care practice to facilitate this involvement. However, carers' organizations continue to highlight a gap between policy and practice in relation to involvement. Aim. The aim of the study reported on in this paper was to investigate involvement in a specific health care context with a view to identifying both opportunities for change and practical, realistic ways of bringing about that change. This was a qualitative case study using a case study design. The field site selected was a respite and assessment (23 bedded) ward within the Psychiatric Unit of a hospital specializing in the care of older people. Informal carers (n=20) and members of the multidisciplinary team (n=29) were interviewed about their views and experiences. The interviews were audiorecorded and transcribed. Family meetings, multidisciplinary team meetings and ward routines were the focus of non-participant observation. Field notes from these observations, together with the interview data were analysed using constant comparative method. Results and Conclusions. The reported experiences of carers in this study highlighted four markers of satisfactory involvement: feeling that information is shared; feeling included in decision making; feeling that there is someone you can contact when you need to; and feeling that the service is responsive to your needs. The majority of carers felt dissatisfied with the level of involvement. The situation we found echoed that found in other studies, i.e. the majority of informal carers (henceforth 'carers') interviewed were dissatisfied with the level of their involvement. However, our investigation, in which the views of health care professionals as well as those of carers were sought, provided invaluable insight into why this might be the case. Two main sources of difficulty were found: hospital systems and processes, and the relationship between nursing staff and carers. The argument made is that practitioners themselves must notice and challenge these barriers if carer involvement is to be facilitated
Involving Older People: lessons for Community Planning.
(Scottish Executive Social Research, 2004) Dewar, Belinda; Jones, C.; O'May, Fiona; Scottish Executive Social Research; CoSLA
The study was commissioned by the Scottish Executive and CoSLA to provide information about the current ways in which older people are involved in the planning, delivery, monitoring and evaluation of public services throughout Scotland, and to draw some lessons for the future involvement of older people in the Community Planning process.
Moving on from interpretivism: an argument for constructivist evaluation
(2000) Walker, Esther; Dewar, Belinda
This paper examines the research process in the context of an evaluation of work-based learning. The findings of the evaluation are used to illustrate issues around roles and relationships within interpretivist research where a separation is maintained between the researcher, as investigator, and the participants, as the subject of their investigation. The discussion focuses on: the threatening nature of evaluation and the way in which that affects the process of inquiry and learning; the ways in which people's perceptions of research can act as barriers to the implementation of change; and the consequences of this role separation for practice development. In exploring these issues the paper argues for an approach to evaluation research which (a) emphasizes collaboration, (b) is orientated to change and (c) treats the evaluation process as a learning opportunity through which professionals acquire the skills and knowledge to investigate and advance their own practice
Promoting end-of-life care in nursing homes using an 'integrated care pathway for the last days of life'
(2005) Hockley, J.; Dewar, Belinda; Watson, J.
The purpose of this study was to promote quality end-of-life care in eight independent nursing homes using an ‘integrated care pathway (ICP) for the last days of life’ document. Action research methodology underpinned the design of this study in order to promote collaboration between staff in the nursing homes and the research team, empower staff in the practice of quality end-of-life care, and promote sustainable development of end-of-life care once the study finished. Considerable barriers within the nursing home context highlighted initial difficulties. This is reported elsewhere (Watson et al., in press) (Bridges Initiative, 2004). However, key champions appointed in each nursing home and their subsequent support was a major part of facilitating the ICP implementation. This paper reports the qualitative analysis from the summative evaluation of the study. One overarching pattern of ‘dying being more central to care in the nursing homes’ emerged as a result of the study; five themes that contributed to this shift were: greater ‘openness’ around death and dying; recognising dying and taking responsibility; better ‘teamwork’; critically using palliative care knowledge to influence practice; more meaningful communication.
Public Attitudes to the Provision of Free Personal Care: Focus Group Research.
(Scottish Executive Central Research Unit, 2001) Dewar, Belinda; O'May, Fiona; Walker, Esther; Machin, D.; McShane, D.
Public Attitudes to the Provision of Free Personal Care: Focus Group Research. Research Findings No.5.
(Queen Margaret University College, 2004) Dewar, Belinda; O'May, Fiona; Walker, Esther
This research, which was commissioned to inform the deliberations of the Care Development Group, explores the views of specific groups of older people regarding services and the provision of a free personal care system for older people in Scotland.
The carer's role in planning care for persons with dementia.
(2002) Dewar, Belinda; Goulbourne, Alison; Irvine, Lindesay; Riddell, Helen