I would characterise my DProf as a living process of work based learning and research activity. My work has been widely disseminated through my communities of practice. Reports have been sent to the NHS trusts the final project took place. My research has also been published in peer-reviewed publication and presented at national and international conferences as oral concurrent and poster presentations.
Having the research published and presented at conference has enabled it to be disseminated to a wider audience outside of the academic award. This has been a rewarding aspect of the work with the various email correspondence that I have embarked upon and the networking links I have cultivated. The list of products of this research includes;
Nash M (2012) Mental Health Service Users Experiences of Diabetes Care. Concurrent oral presentation to the National Psychiatric Nursing Research Conference Oxford 2012 (see appendix 14)
Nash M (2012) Mental Health Service Users Experiences of Diabetes Care. Peer reviewed paper submitted for publication (see appendix 15)
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Nash M (2013): Diagnostic overshadowing: A barrier to physical care for mental health service users. Peer reviewed paper submitted for publication (see appendix 1)
Nash (2011) Detecting diabetes in the mentally ill Diabetes Professional Vol.7, Iss.4, pp8-10 Autumn 2011
This article also included a front page spread and an editorial on diabetes in vulnerable groups. Furthermore it was commended by Headline (The National Media Monitoring Programme for Mental Health and Suicide) in Ireland as an article that promotes a positive image of mental health problems (see appendix 13). Following on from this I am now working on a project with Voluntary Sector Non-Governmental Organisations (NGOs) exploring MHSUs experiences of stigma and diagnostic overshadowing when seeking general/medical care in Ireland.
Nash M (2009): Exploring Mental Health Nurses Diabetes Care Skills: A Training Needs Analysis, British Journal of Nursing, Vol.18, No.10 p626 – 630 (see appendix 2)
Nash M (2009) A Training Needs Analysis of Mental Health Nurses Diabetes Care Skills Concurrent oral presentation to the National Psychiatric Nursing Research Conference Oxford 2009
Nash M (2007) A Training Needs Analysis of Mental Health Nurses Diabetes Care Skills Poster presented at International Nursing Research Conference Trinity College Dublin (see appendix 16)
Nash M (2008) Presentation for Mental Health in Higher Education Conference “Let’s Get Physical” 22nd May 2008 (appendix 17)
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Conclusion
This study has explored the training needs of mental health nurses in relation to diabetes care. The qualitative/constructive method was used as a ‘foil’ to balance the quantitative/positivist approach of the survey. This was chosen to ensure that there would be added depth to the quantitative data through MHSU experiences.
Although diabetes is a clinical practice concern in mental health, MHNs diabetes education and skills needs remains an unexamined area of research and practice. Therefore, the author makes no claims about how generalisible these results are. Richards (1999) recognises that one way we can enhance the quality of patient care is by listening to their views. I would suggest that this study has extended this sentiment by exploring the unique contribution that service users’ experiences can make to the development of education and training.
MHSUs experiences would suggest that MHNs need to reflect on stigma and diagnostic overshadowing when providing diabetes care to MHSUs. While education in clinical signs and symptoms of diabetes would be important, a reorientation in the theory of stigma and how it can affect diabetes care is also be required. There would be little point in teaching biological science and clinical theory/skills if MHNs do not act upon reported symptoms, in the presence of associated risk factors, due to diagnostic overshadowing or stigma. It would seem that stigma is a little studied risk factor in the poor diagnosis and subsequent prognosis of diabetes in MHSUs.
Caracelli and Greene (1997:5) suggest that using mixed methods is a good idea however it may not be good science. The findings of this study would suggest that using a mixed methods approach was justified as MHSUs experiences can make a substantial contribution to the evidence base of teaching and curriculum
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development in this area. While the biological science and clinical practice aspects of professional education and training are important, the unique experiences of MHSUs can help to clarify and deepen the learning and understanding in this area. This is important for developing partnership and collaboration, which are key factors of diabetes care.
The DRC (2005) found one of the most significant barriers to health care identified by respondents was the perceived negative or discriminatory attitudes of health- care staff. Lawrence and Kisely (2010) state that there is increasing evidence that disparities in healthcare provision contribute to poor physical health outcomes suggesting healthcare provider issues, including pervasive stigma associated with mental illness, a contributing factor to poor physical health. People with severe mental illness are at an increased risk of developing type 2 diabetes for a number of reasons. However, one of those reasons should not be stigma or diagnostic overshadowing.
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