Professional Doctorate theses
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Item A qualitative study exploring the experiences of access and pathways to health care among BME community groups residing in Ayrshire(Queen Margaret University, Edinburgh, 2017) McKenzie, ElizabethA review of the literature showed that Black and minority ethnic (BME) communities carry a disproportionately higher burden of illness than the general population and experience greater inequalities in health and health care provision. A growing body of research confirms that BME groups are under-represented in research. The main objective of the present study was to gain insights into the perspectives of BME community groups' experiences of accessing general and sexual health care services in Ayrshire. Semi-structured interviews were conducted with 11 participants, n = 5 men (age range: 32-65; mean age = 52.4 years), and n = 6 women (age range: 27-60; mean age = 47.67 years). Data were analysed employing Interpretative Phenomenological Analysis (IPA). The analysis is illustrated through the use of four super-ordinate themes: ‘It’s a Trust Thing’, ‘Minding the Gap(s)’, ‘Sexual Health: a Culture of Silence’, and ‘Personal Perception of Risk’. The findings both support and add to the existing trust literature by presenting a heuristic model of trust, and by showing that participants trust is dynamic in character, has a role, and serves various roles and functions that impact decisions about accessing health services. Significant gaps in knowledge about available health services and unique communication challenges that prevent full access to health care and health promotion information were found, resulting in unmet needs. Analysis charted culturally driven factors that prohibit discussions about sexual health concerns and found complex cognitions involved in the personal perception of risk that was meaningfully understood by participants that direct towards understanding risk in terms of a heuristic model. The implications for clinical practice, health promotion, health service development, and the direction of future research will be discussed.Item Do you hear the people sing? The impact of a community choir in a forensic setting.(Queen Margaret University, Edinburgh, 2015) Robertson, JamesThis study considers the health benefits that may be experienced by patients and staff in a medium secure forensic setting when singing in a choir. It also investigates how shared participation in choral experiences might influence the relationships between patients and staff. In addition, framed within the context of Community Music Therapy1 (Pavlicevic and Ansdell 2004; Stige et al. 2010; Stige and Aarø 2012), this study explores how – and to what extent – the researcher’s identity as a music therapist may be altered as a result of including a community-based approach to his work in addition to a clinically-oriented model. The investigation was undertaken throughout a six-month period in which weekly rehearsals comprising up to eight patients and six members of staff were held; a short performance was arranged at the culmination of the project. Whilst studies exploring the use of choral singing in music therapy for people with chronic mental illness have been undertaken (Eyre 2011), there would appear to be a dearth of literature specifically investigating the potential benefits of this intervention with patients in a medium secure forensic setting. A qualitative methodological stance was adopted. Data were collected and analysed using Participatory Action Research (Stige 2005a; Elefant 2010) and key principles of grounded theory (Glaser and Strauss 1967). Findings suggest that people may experience overall feelings of wellbeing such as enjoyment, warm-heartedness, excitement and fun as well as an increased awareness of posture and breathing. A sense of belonging, hope and contributing to a group may similarly be felt. In addition, opportunities for learning are provided and a sense of empathy towards others may be fostered. The results also suggest that shared participation in choral experiences can positively influence the relationships between patients and staff through feelings of benevolence for each other, a removal of boundaries and a deeper realisation of being a person in one’s own right. Finally, results indicate that the researcher’s identity as a music therapist is altered through the inclusion of a more didactic approach, a conscious working towards musical outcomes and a heightened sensitivity regarding the needs and abilities of service-providers as well as service-users.