Manchester through the Ears

ABSTRACT

As part of a wider sensory ethnography on the development of place attachments and situated knowledge amongst international newcomers to a city (Manchester, England), this article tells the story of my collaboration with Phoebe, a student of acoustics from bandung, Indonesia. Using a participatory sensory ethnographic method, Phoebe was encouraged to devise her own contribution to my project, which was modeled around her own sensory preferences and technological expertise. Our work together took place over a period of 4–5 months and yielded a series of soundscape compositions and accompanying narrative texts, all of which conveyed Phoebe's newly acquired sound-based knowledge, or acoustemology, of Manchester. Using narrative textual accompaniments to her recordings, Phoebe ascribes qualities to her surroundings that overlap with her own personal qualities, in effect showing how much she blends with her new city. As Phoebe and I subsequently listened to and “talked over” her soundscape compositions, they evoked sound marks, or sensory memories, of the landscape, sounds and music that Phoebe left behind in Indonesia. these sound-elicited interviews added further layers of emplaced knowledge to both of our constructions of the city.     

A qualitative inquiry into women’s experiences of severe maternal morbidity

Severe acute maternal morbidity (SMM) is a near-death experience during pregnancy, childbirth or termination of a pregnancy. Nine women recruited from hospital intensive care or high dependency units following the birth of their baby participated in two qualitative interviews about their SMM experience. The interpretative phenomenological analysis led to the identification of three superordinate themes related to participants: moving from a state of normal pregnancy to being severely unwell, being in critical care and returning to normal. Participants’ transition to a SMM event occurred quickly and was frightening, with participants expressing concerns about their husbands/partners’ trauma. Participants’ time in hospital was particularly hard for those separated from their baby, with this eased by staff kindness and family support. After discharge participants continued to seek explanations for their SMM. Implications include more formal support for mothering when women are in maternal critical care, and support for husbands/partners following a SMM event.     

Creating Supportive Environments for LGBT Older Adults: An Efficacy Evaluation of Staff Training in a Senior Living Facility

ABSTRACT

Supportive housing later in life tends to be a key concern for lesbian, gay, bisexual, and transgender (LGBT) elders. Most senior care providers are un(der)prepared to meet the needs of older LGBT adults. This study evaluated the efficacy of a 4 hours, face-to-face, research-based, LGBT-diversity training designed to improve senior housing facility staff’s cultural competency regarding the needs of LGBT elders. Findings from this study found a significant increase in LGBT content knowledge between pre- and post-intervention assessments and a significant decrease in perceived preparedness when working with LGBT elders. These effects remained significant after controlling for staff designation, religion, educational attainment, and training session. Findings suggest that staff’s cultural competence affected their perceived readiness to address LGBT elders’ needs. Implications are related to the concept of cultural humility or the lifelong process of understanding others’ experiences based on the recognition of lack of un(der)preparedness to create a culturally supportive residential environment.     

The Administrative and Posthospital Care Outcomes of Discharge Planning

Early and comprehensive discharge planning is a widely accepted and anticipated social work role. It is generally supposed that discharge planning has positive implications for both the hospital and the patient. A research project was designed to assess the effects of a staff development program aimed at instituting a comprehensive discharge planning model by social workers in a general hospital in Israel. One group of patients received social work services based on the discharge planning model. A comparison group of patients received the standard services provided by the department. No differences between the groups were found in time elapsed before first social work contact or in length of stay. However, patients in the study group were likely to be released to a more appropriate and stable setting than were patients in the comparison group. Furthermore, there was a greater likelihood that their posthospital care plans involved a combination of services from both formal and informal settings. Implications of the findings are discussed as well as the integration of research into ongoing social work practice.     

What should we call our kids? Choosing children’s surnames when parents’ last names differ

We examine the last and middle names given to first-born sons and daughters in a sample of 600 married women selected from the staff directory of a university system. Women with unconventional marital surnames were more likely to include their birth surname in their child’s name than were women who took their husband’s last name at marriage. Around 90% of women with an unconventional marital surname still gave their children their husband’s surname. Among women who selected an unconventional last name, a number of variables correlated with whether or not the child’s name contained the mother’s birth surname, including type of last name used, gender role attitudes, political liberalism, religiosity, importance of last name to the woman’s self-concept, feminist motivations for the woman’s last name choice, and education of the mother and her husband. Logistic regression analysis found that self-identification on political liberalness and husband’s education were the most powerful predictors, reducing the other effects to nonsignificant levels.     

Activation,Public Employment Services and their Clients: The Role of Social Class in a Continental Welfare State

This article fills a gap in the existing literature by investigating how public employment service (PES) staff actually deal with their clients under a continental regime of activation. The results reported here are based on interviews both with PES staff and their unemployed clients in Germany. We argue that due to its Bismarckian origins as an insurance‐based system of ‘unemployment protection’, Germany's system of unemployment compensation is attractive not only for the marginalized, but also for core workers. As a result, PES staff deal with clients from very heterogeneous class backgrounds. We demonstrate that social class is a significant factor in client outcomes, and that earlier research has perhaps overemphasized the role of frontline staff as ‘street‐level bureaucrats’. While staff do have considerable power, the result of the encounters between the administration and clients also depends on the capabilities of the clients, which, in turn, are strongly related to social class.     

Utilizing a Continuing Education Workshop to Increase Knowledge of Documentation Among Hospital Psychosocial Staff

ABSTRACT

Hospital-based psychosocial staff including social workers, mental health counselors, and marriage and family therapists utilize documentation skills to assess, treat, and manage patients admitted to inpatient settings. Little research exists that examines the impact of continuing education on documentation skills. This study examined changes in hospital-based psychosocial staff perceptions of their documentation skills after attending a two-part continuing education documentation workshop. The quantitative, pretest–posttest design utilized a convenience sample that included 32 staff members at pretest and 30 staff members completing the posttest. Results from the 51-item pretest and posttest survey indicate that the continuing education workshop statistically increased participants’ knowledge of progress notes and termination summaries. Findings did not indicate any differences when comparing knowledge, at the start of the workshop, for employees with prior documentation training, longer work experience, or different license groups. The authors discuss implications for practice, continuing education, and future research.     

Rethinking the Soundscape

ABSTRACT

This article takes critical issue with the well-circulated but often misapplied term “soundscape.” Coined by Canadian composer Murray Schafer in his book “The Soundscape,” the term has become one of the keywords of sound studies, but in its wide circulation it has become disconnected from its original scholarly concept and used broadly to apply to nearly any sonic phenomenon. Scholars either misapply it or redefine it to suit their needs. This article is an attempt to trace an intellectual history or genealogy of the term, and to open a conversation about the term's use, application, and utility for scholars of sound. This article draws on Schafer's work in an attempt to ground the term in its own intellectual history, and then traces the use of the term in a variety of sound studies works. The term “soundscape” emerges as at once indispensable and elusive, provocative and limited. By calling attention to background sound, Schafer shaped the field in ways that exceeded his own contribution.     

The Experience of Nurses Working with Hospitalized AIDS Patients

Twenty nurses were interviewed about their experiences of caring exclusively for AIDS patients. A qualitative analysis of the data revealed that group identity, social support, social stigma, identification with patients, and burnout were important to the experience. The process of identification with patients was a significant source of distress which affected the male homosexual staff more than other staff. Yet working in the AIDS unit also had its rewards with some male homosexual staff expressing relief at not having to conceal their sexuality. Nurses' experiences in the AIDS unit were somewhat differentiated by their ability to identify with the male homosexual group. Those who identified strongly with the group were more at risk of over-identification with patients yet seemed likely to receive recognition and support from colleagues. Many staff suffered due to the stigma attached to caring for AIDS patients and often reported not telling people where they worked. A significant number of staff are said to have already left the unit due to AIDS burnout.     

Quality of Work Life of Teaching Staff Working at a Higher Education Institution in Saudi Arabia: A Cross-sectional Study

A cross-sectional survey design was adopted to study the quality of work life (QoWL) of the teaching staff employed at a Saudi higher education institution, focusing on their ethnic backgrounds and the academic clusters in which they were employed. A total of 360 teaching staff were randomly selected using a two-stage cluster sampling method, and a self-structured quality of work life questionnaire was used to collect data. Statistical analysis was done using SPSS 19.0. The results indicated that 71% of the respondents were satisfied with their QoWL at Imam Abdulrahman Bin Faisal University (IAU), Saudi Arabia. A significant difference of opinion was observed among the teaching staff on two dimensions of QoWL, viz. ‘working conditions’ and ‘psychosocial factors’ (p < 0.05). However, no significant difference was observed on other QoWL attributes, such as ‘opportunity for training and development’ and ‘job satisfaction and job security’ (p > 0.05). Given that all public universities in Saudi Arabia are governed by regulations framed by the Ministry of education, this study provides important indicators to educational policy planners on understanding the QoWL of teaching staff employed in universities across Saudi Arabia.     

The more-than-human sensorium: sensory engagements with digital self-tracking technologies

In this article, we draw on findings from an empirical project involving talking to Australian women about their sensory and sensemaking engagements with digital health technologies. Adopting a new feminist materialist perspective, our analysis identified a series of relational connections, affective forces and agential capacities generated when our participants came together with digitized modes of self-tracking. The agential capacities engendered through and with these technologies included discovering and uncovering information, motivation, quantifying and automating data collection, distinguishing “false” bodily sensations from “real,” discerning patterns, and enhancing sensory capabilities. Working with these technologies, the women were able to access insights into their bodies, feel more in control of bodily activities by reflecting on this information and any patterns over time it revealed. The limitations of these sensory devices were also revealed in the women’s accounts. The devices sometimes closed off or challenged women’s sensory knowledge in ways they found less than useful or helpful, due to failings in the devices’ design or functionality. Our analysis, therefore, highlights the intra-action of enactments of human sensory responses as they engage with digital devices and digital data, including the ways in which these responses were extended, facilitated, or, in some cases, challenged.     

Risk Factors and Intervention Programs for Depression in Nursing Home Residents: Nursing Home Staff Interview Findings

The in-depth qualitative interviews with 25 nursing home staff members were done to examine (a) their perceptions and experiences of risk factors for residents' depression, (b) current depression intervention programs, and (c) specific needs for staff training. The interviewees identified the residents' sense of loss and grief and feelings of isolation and loneliness as the causes of their depression and in-house activities and contract mental health services as current services aimed at reducing depression. They also pointed out the following barriers to providing effective depression interventions: too much dependence on antidepressant medication, low Medicaid reimbursement rate, staff shortage, residents' attitudes, and nursing home culture. The types of training that the staff members desired were: skills to monitor nonverbal signs and changes and to systematically screen different types of depression; education about antidepressants and their effects, side effects, and interaction effects with other medication; and systematic training in different types of psychosocial and behavioral interventions for late-life depression in residents with various levels of physical disabilities and cognitive impairments.     

The Crisis of the Forgotten Family

This aper presents the problems encountered by relatives of hospital ICU patients. A review of the literature focuses on the nature and management of acute grief in a medical crisis setting. The interface between relatives and hospital staff around patient needs and family needs for information, guidance and support is also considered. A recommendation for group work intervention is made, and the role of the social worker as the appropriate agent of change in progress toward a hospital responsive to human need is discussed.     

A family-centred practice supervision project conducted for a child welfare agency

ABSTRACT

This paper reports on a supervision project that aimed to enhance a child welfare agency staff’s professional competence in family-centred practice through a strength-based approach. A qualitative study was designed to explore the effectiveness and the change agents of the supervision. Purposive sampling was used. Two agency supervisors and two social workers participated the study voluntarily. The findings indicated that after the period of supervision, the staff had changed in three respects: their conceptualisation of the meaning of family work in the care context; their understanding of the importance of relationship-based interventions with families; and their development of alternative ways of practice. The agents of change from the supervision were the consultants’ modelling effect and the co-worker experience of the consultants and the social workers. This supervision approach can discern the synergistic effect of supervision on an agency’s routine supervision and balance the cultural beliefs in qing, yuan and ‘face’ embedded in the supervisory process.     

Sensory Work of Diagnosis: A Crisis of Legitimacy

Sensory judgments have always been a part of medical practice, as sensory studies scholars have emphasized. However, in current regulatory, management and technological contexts, there is a push toward rational decision-making procedures and test-based evidence over clinical diagnosis. Sociological scholarship highlights that in focusing on explicit medical knowledge and disembodied data we take for granted aspects of healthcare work, including the ways in which health and illness is sensed. Research in sociologies of diagnosis and social studies of science and technology has captured that while the senses continue to play a role in medical work, the status and practice of this sensory work is not straightforward as evidenced by dual use of the senses and tests and the delegation of sensory work. Based on semi-structured interviews with expert doctors in diverse specialties, this article examines the sensory work of medical decision-making, with attention to its legitimacy. It examines applications of the senses from auscultation to ongoing sensing of patients’ bodies unmediated and via technological outputs. While critical to clinical judgments, there is discomfort with this sensory work in light of medico-legal pressures. I argue that the sensory work of diagnosis is vital, to the extent that gaps in sensory information imply gaps in understanding.     

Access, Choice and Travel: Implications for Health Policy

The UK National Health Service is introducing policies offering patients a choice of the hospital where they would like to be treated. ‘Patient choice’ policies form part of a wider debate about the access to health care and the interaction between providers (including information, provision, performance and reputation) and patients (including knowledge, resources and willingness to travel). As the hospital of ‘choice’ might not necessarily be the ‘local’ provider, such policy developments are predicated on an assumption that some patients will be willing to travel further. This will, in turn, affect patients’ access to services. In general, use of services decreases with distance but this is dependent on accessibility to services, the organization of those services, the socio‐economic characteristics of the patient, perceptions of the provider and the condition for which they are to be treated. This article reviews the evidence on patients’ willingness to travel in terms of access to health care and assesses the emerging implications of and for current UK policy on patient choice.     

Exploring perceptions of mental health clients and professionals about Buddhism‐based therapies at mental health hospitals in Vietnam

With 80% of Vietnamese people holding key Buddhist beliefs, Buddhism has great impact on the thoughts, emotions, and behavior of Vietnamese people. However, almost no Buddhism‐based psychosocial interventions are offered at formal psychiatric hospitals across Vietnam, nor is there any plan to incorporate these interventions into mental health care. This exploratory study examines the perceptions of mental health clients and staff regarding the effectiveness of Buddhism‐based therapies (BBTs) in mental health treatment in Vietnam, using ethnographic observation and in‐depth interviews with 24 patients and eight professionals at the only psychiatric hospital employing BBT. Participants strongly believed in the positive impact of BBT to help clients manage or improve their symptoms. However, clients and staff advised that BBT should not be used alone; rather it should be used in combination with medication and was best employed for stress‐related disorders. They unanimously supported incorporating BBT into the formal mental health system, especially if the therapies were well developed through collaboration between Buddhist monastics and mental health professionals. Results of the paper suggest that Vietnam should think strategically about developing and incorporating BBT into the formal mental health care system.     

Ambiguity and Cooperation in the Implementation of Adult Protection Policy

Using a classification of public policy developed by Matland, we examine implementation of policy on adult protection as outlined in ‘No Secrets’, the government's guidance to local agencies. This policy appears to exemplify a ‘high‐ambiguity/low‐conflict’ model. Detailed interviews with staff charged with developing multi‐agency procedures, in local authority departments, health authorities, the police and the voluntary sector, confirmed the ambiguity of the policy and the uncertainty experienced by staff as a consequence. However, the interviews also revealed a number of areas of conflict, particularly as people gave precedence to their own professional norms and organizational priorities over partnership working.     

‘We’re Civil Servants’: The Status of Trauma-Informed Care in the Community

ABSTRACT

Trauma-informed care (TIC) in social service organizations means that the organizations operate with the understanding that everyone involved has possibly experienced trauma in their lifetime. This qualitative study examined local service organizations’ usage of the 5 main principles of TIC: safety, trustworthiness, collaboration, empowerment, and choice (as developed by Fallot & Harris, 2006). Ten focus groups (n = 69) and 6 individual interviews (n = 6) with employees from administration through management were interviewed such that almost all facets of each agency were represented. The participants were asked about their agencies’ policies and practices for utilizing the 5 principles of TIC. The results suggest that the vast majority of organizations in this study implemented many of the principles of TIC with clients, though they had not labeled their practices as “trauma-informed.” However, although clients were receiving TIC, some of the principles were neglected as they pertain to staff, such as choice and empowerment. The findings of this study suggest that agencies are unaware of the relevance of TIC as it relates to staff. It is recommended that future research examine whether the use of TIC in agencies prevents “burnout,” high turnover rates, and vicarious traumatization of staff.     

Autonomy,Choice and Control for Older Users of Home Care Services: Current Developments in Swedish Eldercare

In Sweden, a policy shift towards more individualized eldercare, with an emphasis on consumer choice, has taken place. The aim of this study was to analyze the processes and practices of individualized eldercare, focusing on preconditions for older peoples’ choice and control. Data consist of qualitative interviews with users of home care services (n – 12) and staff (n – 12) and participant observations (n – 7) of meetings between staff and older people. The choice and control available to older users emerged as decisions about ‘what’ care and services, ‘who’ should provide the care and services, and ‘how’ the care and services should be performed. Three approaches to enable older people choice and control over their home care services were revealed: test and revise, services elaborated in close collaboration between users, care managers and home care staff; choices in the moment, users could choose services at each occasion; and quality improvement through competition, competing providers develop attractive services. The findings could guide policy makers in combining the strengths of these approaches to enable older people in need of support to become co-producers in designing, managing, as well as consuming, care and services. Future quantitative research is needed to achieve generalizable knowledge about the strengths and weaknesses of different ways to organize eldercare services.