Nicky Britten
Dados Biográficos
| ID | 76378 |
|---|---|
| NOME | Nicky Britten |
| PRENOMES | Nicky |
| SOBRENOME | Britten |
| ASSINATURA | BRITTEN N |
| AFILIAÇÕES | University of Exeter |
| ORCID | 0000-0002-7533-414X |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 57 |
| TOTAL DE CITAÇÕES | 700 |
| TOTAL COMO AUTOR | 57 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1981 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2022 |
| ÍNDICE H | 11 |
Epistemic justice in public involvement and engagement
INTRODUCTION: Patient and public involvement in research is anchored in moral and epistemological rationales. Moral rationales relate to the public having a right to influence how knowledge about them is generated. Epistemological rationales relate to how research design and implementation can improve when informed by experiential, as well as technical, knowledge. In other words, public involvement can increase the epistemological resources of re…
Terms of engagement for working with patients in a person‐centred partnership
Evidence is emerging of the potential of person-centred approaches to create partnerships between professionals and patients while also containing healthcare costs. This is important for enhancing outcomes in individuals with complex needs, who consistently report poor experiences with care. The shift towards person-centred care (PCC) is, however, a radical departure from the norm, with increased expectations of both professional and patient. Alt…
Can a Meta-ethnography Be Updated by Different Reviewers? Reflections From a Recent Update
Over the last decade, there has been a proliferation of published meta-ethnographies. Yet, strategies and techniques for updating have not received the same attention, rendering answers to important methodological questions still elusive. One such question has to do with who can perform an update. Although it is not uncommon for quantitative systematic reviews and statistical meta-analyses to be updated by different reviewers, qualitative synthes…
Epistemic injustices in clinical communication
The increasing popularity of the term 'person-centred' in the healthcare literature and a wide range of ideals and practices it implies point to the need for a more inclusive and holistic healthcare provision. A framework developed in a Swedish context suggested narrative elicitation as a key practice in transition to person-centred care. Initiating clinical communication by inviting people to tell their stories makes persistent yet often subtle …
The potential and pitfalls of narrative elicitation in person‐centred care
BACKGROUND: Revitalized interest in narrative has informed some recent models of patient and person-centred care. Yet, scarce attention has been paid to how narrative elicitation is actually used in person-centred care practice and in which ways it is incorporated into clinical routine. AIM: We aimed to identify facilitators and barriers for narrative elicitation and setting goals in a particular example of person-centred care practice (Universit…
How is knowledge shared in Public involvement? A qualitative study of involvement in a health technology assessment
BACKGROUND: Public involvement in research is seen as a quality marker by funders. To understand the process and impact of involvement, more in-depth studies are needed on how members of the public contribute in meetings with researchers. OBJECTIVES: This study aimed to observe and reflect on what is said by public advisers in involvement. We wanted to understand (a) what knowledge and experience is shared during research meetings, and (b) how th…
Supporting Innovative Person-Centred Care in Financially Constrained Environments
The COST CARES project aims to support healthcare cost containment and improve healthcare quality across Europe by developing the research and development necessary for person-centred care (PCC) and health promotion. This paper presents an overview evaluation strategy for testing 'Exploratory Health Laboratories' to deliver these aims. Our strategy is theory driven and evidence based, and developed through a multi-disciplinary and European-wide t…
Improving reporting of meta-ethnography
AIMS: The aim of this study was to provide guidance to improve the completeness and clarity of meta-ethnography reporting. BACKGROUND: Evidence-based policy and practice require robust evidence syntheses which can further understanding of people's experiences and associated social processes. Meta-ethnography is a rigorous seven-phase qualitative evidence synthesis methodology, developed by Noblit and Hare. Meta-ethnography is used widely in healt…
A worked example of initial theory-building
In this article, we present an exemplar of the initial theory-building phase of theory-driven evaluation for the PARTNERS2 project, a collaborative care intervention for people with experience of psychosis in England. Initial theory-building involved analysis of the literature, interviews with key leaders and focus groups with service users. The initial programme theory was developed from these sources in an iterative process between researchers …
Proxy administration
Patient involvement in qualitative data analysis in a trial of a patient‐centred intervention
BACKGROUND: We conducted a pilot study of an intervention to facilitate patients' agenda setting in clinical consultations. The primary aim of the study was to test the feasibility of running the randomized controlled trial. A secondary objective was to assess the extent to which patient and public involvement (PPI) could contribute to the process of qualitative data analysis (QDA). AIMS: To describe a novel approach to including patient partners…
Tenacious assumptions of person-centred care? Exploring tensions and variations in practice
In recent decades, the ‘tenacious assumptions’ of biomedicine regarding the neutrality and universality of its knowledge claims have been significantly challenged by the growth of new collaborative and patient-focused models of Healthcare delivery. In this article, we discuss and critically reflect upon one such alternative Healthcare model developed at the University of Gothenburg Centre for Person-Centred Care in Sweden. This centre uses three …
You're there because you are unprofessional
Patient and public involvement in health research and care has been repeatedly theorised using the metaphor of spaces, knowledge spaces and participatory citizenship spaces. Drawing on data from a three year qualitative study of people involved in health research with organisations across England, this article explores where these spaces fit in a wider social, political and historical landscape. It outlines a theme recurring frequently in the stu…
Elaboration of the Gothenburg model of person‐centred care
BACKGROUND: Person-centred care (PCC) is increasingly advocated as a new way of delivering health care, but there is little evidence that it is widely practised. The University of Gothenburg Centre for Person-Centred Care (GPCC) was set up in 2010 to develop and implement person-centred care in clinical practice on the basis of three routines. These routines are based on eliciting the patient's narrative to initiate a partnership; working the par…
Evaluating patient and public involvement in health research
BACKGROUND: There is a growing literature on evaluating aspects of patient and public involvement (PPI). We have suggested that at the core of successful PPI is the dynamic interaction of different forms of knowledge, notably lay and professional. We have developed a four-dimensional theoretical framework for understanding these interactions. AIM: We explore the practical utility of the theoretical framework as a tool for mapping and evaluating t…
Asking More of Qualitative Synthesis
We continue the conversation initiated by Sally Thorne’s observations about “metasynthetic madness.” We note that the variety of labels used to describe qualitative syntheses often reflect authors’ disciplines and geographical locations. The purpose of systematic literature searching is to redress authors’ lack of citation of relevant earlier work and to reassure policy makers that qualitative syntheses are systematic and transparent. There is cl…
"How can anybody be representative for those kind of people?" Forms of patient representation in health research, and why it is always contestable
A qualitative investigation of lay perspectives of diagnosis and self-management strategies employed by people with progressive multiple sclerosis
This article explores how people with progressive multiple sclerosis give meaning to their experiences. It builds upon the self-management literature, which has captured the tension between the desire for retaining normalcy and the increasing burden of self-management associated with chronic disease progression. This repeat interview study is empirically grounded in 28 interviews with 14 people with progressive multiple sclerosis. We identified g…
What is the nature and value of a risk management tool in a large-scale complex programme of collaborative applied health research
In this article we examine a risk management tool that was used in a pilot programme of applied health research in the south-west of England funded by the National Institute for Health Research (NIHR). During a wider internal evaluation of the NIHR Collaboration for Leadership in Applied Health Research and Care for the South West Peninsula, we became interested in how risk was being defined and managed in the programme. Our search of the empiric…
Meta-Study as Diagnostic
Having previously conducted qualitative syntheses of the diabetes literature, we wanted to explore the changes in theoretical approaches, methodological practices, and the construction of substantive knowledge which have recently been presented in the qualitative diabetes literature. The aim of this research was to explore the feasibility of synthesizing existing qualitative syntheses of patient perspectives of diabetes using meta-study methodolo…
Lay knowledge, social movements and the use of medicines
This article consists of two personal reflections about the changing status of lay knowledge over the last 20 years. The first reflection is by Nicky Britten from the perspective of a sociologist working in medical schools whose interest in this topic was motivated by my own personal experience of health care and of teaching general practitioners. Starting with the problematic deficit model of 'ignorant patients', I trace the literature on patien…
Values associated with public involvement in health and social care research
Patient involvement in drug licensing
Inside the "Black Box" of a Knowledge Translation Program in Applied Health Research
In this article, we present the findings of a participatory realistic evaluation of a 5-year program of health care research intended to promote the translation of knowledge into routine clinical practice. The program was one of the nine pilot Collaborations for Leadership in Applied Health Research and Care funded by the English National Institute for Health Research between 2008 and 2013. Our aim was to delineate the mechanisms by which, and ci…
Context and complexity
Self-management policies have presented opportunities for patients with long-term conditions to take control and actively improve their health. However, the work of self-management appears to be packaged in the form of essential and desirable skills and attributes required for success. This article presents the findings of a qualitative study, employing longitudinal diary interviews with 21 patients aged between 60 and 85 years diagnosed with cor…
Evaluating meta-ethnography
Resisting medicines
Giving voice to the lifeworld. More humane, more effective medical care? A qualitative study of doctor-patient communication in general practice
Using Reflexivity to Optimize Teamwork in Qualitative Research
Reflexivity is often described as an individual activity. The authors propose that reflexivity employed as a team activity, through the sharing of reflexive writing (accounts of personal agendas, hidden assumptions, and theoretical definitions) and group discussions about arising issues, can improve the productivity and functioning of qualitative teams and the rigor and quality of the research. The authors review the literature on teamwork, highl…
Doctor-patient communication about drugs
Hearing children's voices
Children are increasingly acknowledged to have rights in the determination of decisions that affect them. This has encouraged research to be undertaken with children themselves to understand their own views, experiences and relationships, and has demonstrated a considerable gulf from parental concerns and observations. Methods for research with children are, however, relatively under-developed. This article reflects on our experience of conductin…
Prescribing and the defence of clinical autonomy
The medical profession has an almost exclusive right to prescribe medicines, but this right is being challenged by the State, patients and other health care professionals. It is argued that, in British general practice, prescribing is a battleground on which the cause of clinical autonomy is defended. It represents a particular context for assessing the theories of proletarianisation and deprofessionalisation. The historical conflicts between the…
Women's Jobs do Make a Difference
This paper uses fresh data to confirm and extend our original findings (Britten and Heath, 1983) which were criticized by Goldthorpe ( Sociology, November 1983). Given that the manual/non manual divide has little relevance for women's jobs, we demonstrate that office work and sales work entail very different conditions of employment for women, although the market situation of both groups is inferior to that of men in manual work. The career paths…
Theoretical directions for an emancipatory concept of patient and public involvement
Patient and public involvement (PPI) is now firmly embedded in the policies of the Department of Health in England. This article commences with a review of the changing structures of PPI in English health and social care, largely in terms of their own explicit rationales, using that as a spring board for the development of a general theoretical framework. Arguing that all democratic states face major dilemmas in seeking to meet conflicting demand…
Self-treatment and its discussion in medical consultations
You're there because you are unprofessional
Patient and public involvement in health research and care has been repeatedly theorised using the metaphor of spaces, knowledge spaces and participatory citizenship spaces. Drawing on data from a three year qualitative study of people involved in health research with organisations across England, this article explores where these spaces fit in a wider social, political and historical landscape. It outlines a theme recurring frequently in the stu…
Decision-making and hormone replacement therapy
The expression of aversion to medicines in general practice consultations
Context and complexity
Self-management policies have presented opportunities for patients with long-term conditions to take control and actively improve their health. However, the work of self-management appears to be packaged in the form of essential and desirable skills and attributes required for success. This article presents the findings of a qualitative study, employing longitudinal diary interviews with 21 patients aged between 60 and 85 years diagnosed with cor…
Negotiating the boundary between medicine and consumer culture
Genomics researchers and policy makers have accused nutrigenetic testing companies--which provide DNA-based nutritional advice online--of misleading the public. The UK and USA regulation of the tests has hinged on whether they are classed as "medical" devices, and alternative regulatory categories for "lifestyle" and less-serious genetic tests have been proposed. This article presents the findings of a qualitative thematic analysis of the webpage…
Perceptions of Legitimacy
The terms non-compliance or non-adherence, in relation to medicine taking, contain the assumption that prescribers' actions are legitimate and should be perceived as such by patients, and that non-adherence is deviant. Yet the high level of non-adherence suggests that patients do not necessarily perceive prescriptions in this way. We consider the relevance today of viewing non-adherence in terms of Weber's concept of legitimacy. We also consider …
Testing Methodological Guidance on the Conduct of Narrative Synthesis in Systematic Reviews
The objective was to assess the impact of new guidance on the conduct of narrative synthesis in systematic reviews of effectiveness, by means of a blinded comparison of guidance-led narrative synthesis against a meta-analysis of the same study data.The conclusions of the two syntheses were broadly similar. However, differences between the approaches meant that conclusions about the impact of moderators of effect appeared stronger when derived fro…
Class Imagery in a National Sample of Women and Men
Lay knowledge, social movements and the use of medicines
This article consists of two personal reflections about the changing status of lay knowledge over the last 20 years. The first reflection is by Nicky Britten from the perspective of a sociologist working in medical schools whose interest in this topic was motivated by my own personal experience of health care and of teaching general practitioners. Starting with the problematic deficit model of 'ignorant patients', I trace the literature on patien…
Menorrhagia in general practice - disease or illness
"How can anybody be representative for those kind of people?" Forms of patient representation in health research, and why it is always contestable
Pharmaceuticals and Society
S.J. Williams, J. Gabe and P. Davis ( eds ). Pharmaceuticals and Society: Critical Discourses and Debates . Chichester, West Sussex : Wiley-Blackwell 2009 viii+160 pp. £19.99 (pbk) ISBN 9781405190848 The publication of an SHI monograph provides the opportunity to overview a sociological field, and this one brings together a diverse range of contributions. Recent years have seen the publication of many popular and critical books about pharmaceutic…
Epistemic injustices in clinical communication
The increasing popularity of the term 'person-centred' in the healthcare literature and a wide range of ideals and practices it implies point to the need for a more inclusive and holistic healthcare provision. A framework developed in a Swedish context suggested narrative elicitation as a key practice in transition to person-centred care. Initiating clinical communication by inviting people to tell their stories makes persistent yet often subtle …
The experience of using complementary therapies after a diagnosis of cancer
This article describes a qualitative synthesis of published research on cancer patients' experiences of complementary therapies. We conducted a systematic search for qualitative studies on this subject published between 1998 and 2007. Twenty-six refereed journal articles met the inclusion criteria. These 26 articles were repeatedly read by the research team and key concepts emerging from them were identified. Differences and variations were exami…
The challenges of evaluating large-scale, multi-partner programmes
The limited extent to which research evidence is utilised in healthcare and other public services is widely acknowledged. The United Kingdom government has attempted to address this gap by funding nine Collaborations for Leadership in Applied Health Research and Care (CLAHRCs). CLAHRCs aim to carry out health research, implement research findings in local healthcare organisations and build capacity across organisations for generating and using ev…
Models of Intergenerational Class Mobility
Mobility data from the National Survey of Health and Development, deriving from the occupations in 1977 of the male survey members, are presented. Multiplicative models of the intergenerational mobility table, developed by Goodman, are described and fitted to the National Survey data. The models include parameters which measure the extent of upward and downward mobility, crossings between adjacent classes, and distance moved. The results suggest …
Women's Jobs do Make a Difference
This paper uses fresh data to confirm and extend our original findings (Britten and Heath, 1983) which were criticized by Goldthorpe ( Sociology, November 1983). Given that the manual/non manual divide has little relevance for women's jobs, we demonstrate that office work and sales work entail very different conditions of employment for women, although the market situation of both groups is inferior to that of men in manual work. The career paths…
Stigma in patients with early epilepsy
Forty six cases of epilepsy were identified from the National Survey of Health and Development. An index of social visibility at school was constructed from teachers' reports of survey members' behaviour at 15 years of age. For the sample as a whole this index was significantly associated with poorer educational outcomes, after adjusting for social background and measured attainment, but was not associated with poor occupational achievement. Howe…
Class Imagery in a National Sample of Women and Men
Hospital consultants' views of their patients
A sample of 24 hospital consultants was interviewed and asked for their opinions about a proposed policy of patient access to their own general practice records. Tape recordings of 20 recorded interviews were analysed in order to obtain data about consultants' views of their patients. Consultants were divided into two main groups: those opposed to and those in favour of the proposed policy.Three factors were identified which discriminated between…
The Politics of Medical Encounters
Power and dependence
Qualitative Research
Objective To examine the association between maternal age at first birth and infant mortality, stunting, underweight, wasting, diarrhoea and anaemia in children in low- and middle-income countries. Design Cross-sectional analysis of nationally representative household samples. A modified Poisson regression model is used to estimate unadjusted and adjusted RR ratios. Setting Low- and middle-income countries. Population First births to women aged 1…
Decision-making and hormone replacement therapy
Using Reflexivity to Optimize Teamwork in Qualitative Research
Reflexivity is often described as an individual activity. The authors propose that reflexivity employed as a team activity, through the sharing of reflexive writing (accounts of personal agendas, hidden assumptions, and theoretical definitions) and group discussions about arising issues, can improve the productivity and functioning of qualitative teams and the rigor and quality of the research. The authors review the literature on teamwork, highl…
Doctor-patient communication about drugs
Menorrhagia in general practice - disease or illness
Giving voice to the lifeworld. More humane, more effective medical care? A qualitative study of doctor-patient communication in general practice
Prescribing and the defence of clinical autonomy
The medical profession has an almost exclusive right to prescribe medicines, but this right is being challenged by the State, patients and other health care professionals. It is argued that, in British general practice, prescribing is a battleground on which the cause of clinical autonomy is defended. It represents a particular context for assessing the theories of proletarianisation and deprofessionalisation. The historical conflicts between the…
Using meta ethnography to synthesise qualitative research
Objectives: To demonstrate the benefits of applying meta ethnography to the synthesis of qualitative research, by means of a worked example. Methods: Four papers about lay meanings of medicines were arbitrarily chosen. Noblit and Hare's seven-step process for conducting a meta ethnography was employed: getting started; deciding what is relevant to the initial interest; reading the studies; determining how the studies are related; translating the …
Patients' attitudes to medicines and expectations for prescriptions
Background Recent research has shown that patients' expectations for prescriptions influence doctors' prescribing decisions, but little is known of the antecedents of these expectations. Objectives To test earlier qualitative research about patients' views of medicines; to describe the demographic characteristics of those holding orthodox and unorthodox views of medicines; to investigate the relationship between patients' ideal and predicted expe…
Perceptions of Legitimacy
The terms non-compliance or non-adherence, in relation to medicine taking, contain the assumption that prescribers' actions are legitimate and should be perceived as such by patients, and that non-adherence is deviant. Yet the high level of non-adherence suggests that patients do not necessarily perceive prescriptions in this way. We consider the relevance today of viewing non-adherence in terms of Weber's concept of legitimacy. We also consider …
Perceptions of legitimacy
Hearing children's voices
Children are increasingly acknowledged to have rights in the determination of decisions that affect them. This has encouraged research to be undertaken with children themselves to understand their own views, experiences and relationships, and has demonstrated a considerable gulf from parental concerns and observations. Methods for research with children are, however, relatively under-developed. This article reflects on our experience of conductin…
Self-treatment and its discussion in medical consultations
Evaluating meta-ethnography
A systematic review of the research on communication between patients and health care professionals about medicines
Objectives We draw on a systematic review of research on two‐way communication between patients and health practitioners about medicines in order to determine the extent to which concordance is, or is not, being put into practice. Data sources Six electronic databases were searched using the following categories of search terms: health care professionals, patients/consumers, medicine‐taking/prescribing and communication. Articles were also identi…
The expression of aversion to medicines in general practice consultations
Resisting medicines
Testing methodological developments in the conduct of narrative synthesis
In the context of systematic reviews, statistical meta-analysis of findings is not always possible. Where this is the case, or where a review of implementation evidence is required, narrative synthesis of data is typically undertaken. Drawing on recently developed guidance aimed at those undertaking data synthesis - and information on the implementation of domestic smoke detectors - we present findings from a demonstration of the tools and techni…
Psychology (43 obras) · Sociology (35 obras) · Medicine (32 obras) · Political science (32 obras) · Computer Science (22 obras) · Public relations (18 obras) · Social science (18 obras) · Nursing (17 obras) · Qualitative research (17 obras) · Mental Health and Patient Involvement (16 obras)