• Chronic venous leg ulcer care – are we missing a vital piece of the jigsaw?

      Green, Julie; McKinley, Robert; Rebecca, Jester; Pooler, Alison (Schofield Publications, 2017-03-14)
      This project explored the lived experiences of patients with leg ulcers to ascertain impact on their quality of life. The aim was to develop a new Leg Ulcer Consultation Template (LUCT). Unstructured interviews were undertaken. Themes raised as significant were incorporated into a checklist and used to assess the extent and depth of exploration during the consultations. Several key themes were identified, including the dominance of pain. Observations revealed that issues emphasised as important by participants were not raised during consultations. A new consultation template was developed. The results of this study reveal that participants have concerns far beyond their actual wound care. Application of the new consultation template may go some way to redress the balance of the consultation.
    • Chronic venous leg ulcer care: Putting the patient at the heart of leg ulcer care. Part 1: exploring the consultation

      Green, Julie; Jester, Rebecca; McKinley, Robert; Pooler, Alison; Queen's Nurse, Royal College of Nursing, Professional Nursing Committee member, Royal College of Nursing, District Nurse, Forum Chair and member of the Association of District Nurse Educators: Director of Postgraduate Studies and Senior Lecturer, Keele University School of Nursing and Midwifery, Clinical Education Centre, University Hospitals of North Midlands NHS Trust, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent ST4 6QG; Professor of Nursing, Faculty of Education, Health and Wellbeing, Institute of Health, University of Wolverhampton, WV1 1LY; Professor of Nursing, Faculty of Education, Health and Wellbeing, Institute of Health, University of Wolverhampton, WV1 1LY; Lecturer, Director of Learning and Teaching, School of Nursing and Midwifery, Keele University, Staffordshire, ST4 6QG (Mark Allen Publishing, 2018-03-01)
      This article, the first of two, summarises a study that explored the lived experiences of patients with leg ulcers and the impact of this condition on their quality of life. The study had four study phases; phases 1 and 2 employed qualitative methods and are reported here. Initially, unstructured interviews were held; these revealed significant issues for the patients including the dominance of pain, issues relating to exudate and odour, social isolation and psychological effects. A checklist based on these issues was completed by the researcher during observations of routine care for these same patients; this revealed the extent and depth to which these matters were addressed. On many occasions, significant issues were not disclosed or explored during consultations. These findings confirmed that participants with chronic venous leg ulcers have concerns far beyond wound care.
    • Consultation for a Change? Engaging Users and Communities in the policy Process

      Cook, Dee (Blackwell Publishing Ltd., 2002)
      The process of consultation has become integral to the development, implementation and evaluation of a raft of UK health and social policies. However, the current bewildering patchwork of area–based initiatives means that, in many localities, it is impossible to evaluate the outcomes of particular targeted initiatives, let alone make sense of local planning consultations, Best Value reviews and (multi–agency) service reviews which run concurrently. The cumulative effects of this consultation "overload" threaten to swamp both local authorities and their service users. Consul–tation is itself a crucial yet deeply problematic process. There is an official view which holds that an "old" model of consultation—often tokenistic and unrepresentative—is being replaced with a "new" one. This paper examines and challenges that view in relation to the key policy areas of housing, social services and policing. It also pays particular attention to, and problematizes, the notion of "hard–to–reach groups", which is so dominant in the discourse of consultation. The paper argues that developing appropriate tools and recognizing that consultation is a process—not an event—are essential starting points in addressing these problems. The next step is to reconcile the principles of both evidence–based policy and user–led services into a strategic (and "joined–up") framework. But, when all this is accomplished, we still need to question the political and fiscal contexts in which policy–making takes place and within which the process of consultation is itself bounded.