Browsing by Person "Dickson, Megan"

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Constructing spaces of authentic engagement through embodied practice: an exploration of deaf peoples’ and nurses’ experiences of interacting
(Queen Margaret University, Edinburgh, 2021) Dickson, Megan
Background: British Sign Language (BSL) is the visual-spatial language of deaf people in Scotland. For deaf, BSL users all contact with the NHS takes place in a hearing led context where spoken English is the primary mode of communication. Healthcare can therefore be challenging for deaf people to access and engage in. The implicit assumptions of the biomedical perspective, that views deafness as an illness to be ‘cured’, often underpin and shape healthcare practices. In this context, there is a lack of acknowledgement of deaf peoples’ linguistic and cultural status. There has been recognition in healthcare literature that access to healthcare is problematic for deaf people. However, the majority of this literature is informed by the biomedical perspective, privileging positivist approaches to treating deaf people. This has resulted in knowledge that does acknowledge the social world in which deaf peoples’ experiences of healthcare take place. Conceptualising healthcare as a form of social relationship, this research explored nurses’ and deaf peoples’ experiences of interacting with one another. Approach and methods: This research is situated in the critical creative paradigm and underpinned by Gadamer’s hermeneutics and Merleau-Ponty’s philosophy of embodiment. The hermeneutic perspective enabled exploration of participants’ relational and contextual experiences of interacting, and creative methods enabled access to the participants’ and researcher’s embodied knowledge of these experiences. Semi-structured interviews with deaf, BSL users and nurses who had provided care for a deaf person were undertaken over a period of 10 months. A focus group of BSL/English interpreters was also carried out. Findings: The findings revealed that nurses often articulated and embodied predominantly biomedical understandings of what it means to be deaf. Approaching care from this perspective, nurses often struggled to acknowledge or respond to deaf peoples’ visual-spatial ways of being and knowing. Healthcare environments were therefore frequently experienced by deaf people as hearing spaces in which they were systematically disempowered due to the oppression of their visual-spatial nature and language. This created divisive boundaries between deaf people and nurses that limited the potential for an effective nursing relationship to develop. Nurses who displayed qualities of openness and curiosity developed alternative ways of thinking about deafness. These had the potential to transform their approaches to practice that enabled collaborative relationships to develop. Conclusions and implications: This research has demonstrated that healthcare spaces are relational and therefore constructed by the social actions of the people in them. For nurses to construct spaces that are respectful of and embodied deaf culture, the significance of the whole body in developing relational practice must be recognised. Such understanding and knowledge could enable nurses to approach practice with an awareness of how both their own and deaf peoples’ embodied experiences can inform care. This necessitates reflexivity in which nurses recognise and question the assumptions that underpin their practice. Recognising the significance of deaf peoples’ visual-spatial experience and embodied understanding of the world has the potential to contribute to emancipatory and empowering approaches to caring for deaf people. Keywords: deaf, British Sign Language, embodiment, embodied practice, creative hermeneutics
Delivering dignified care: A realist synthesis of evidence that promotes effective listening to and learning from older people's feedback in acute care settings
(WIley, 2017-04-20) Dickson, Megan; Riddell, Helen; Gilmour, Fiona; McCormack, Brendan
Aims and Objectives This review aims to explore effective mechanisms for listening to and learning from feedback from older people in the context of acute care. Background Maintaining the dignity of older people in acute care has become an issue of international concern. In the United Kingdom, recommendations for care improvement have led to the formation of an implementation group, the 'Listening and Learning Hospitals Pilot Project'. This literature review forms phase 1 of the project. Design Realist synthesis was used to explore and synthesise wide-ranging evidence. Methods Using 12 databases, literature was scoped to propose four principles that underpin the context, mechanism and outcomes (CMO) of effective relation-based interventions with older people and their care partners in the acute care setting. A search was carried out in order to synthesise data to refute or support each principle. 137 studies and 11 sources of grey literature were appraised and included. A final synthesis of evidence across all principles identified key mechanisms for effective relation-based interventions. Results Eight essential mechanisms support effective care interventions. Conclusions This review adds depth and breadth to current nursing knowledge in this field through the process of realist synthesis. Acute care organisations need to make a commitment to supporting relational care at organisation and unit levels. Additionally, they need to value and support the well-being of the nurses delivering it so that interventions to improve care for older people can succeed.
Meeting Deaf patients' communication needs
(2014-12) Dickson, Megan; Magowan, Ruth
Effective communication between nurses and patients is a vital part of safe and effective nursing care. However, few health professionals receive training in how to communicate with Deaf people; as a result, attempts to communicate with Deaf patients is often inappropriate and undertaken without knowledge or understanding of their communication needs. This article examines the literature on ways in which Deaf patients experience communicating with, and receive care from, nurses.