Mary Dixon-Woods
Dados Biográficos
| ID | 1357054 |
|---|---|
| NOME | Mary Dixon-Woods |
| PRENOMES | Mary |
| SOBRENOME | Dixon-Woods |
| ASSINATURA | DIXON-WOODS M |
| AFILIAÇÕES | University of Leicester |
| ORCID | 0000-0002-5915-0041 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 45 |
| TOTAL DE CITAÇÕES | 362 |
| TOTAL COMO AUTOR | 45 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2001 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 13 |
An ethnographic study of diagnosis of physical illness in people with mental health conditions in the emergency department
People living with mental health conditions face reduced life expectancy, largely associated with under-diagnosed and under-treated physical illnesses. Inequalities in the way physical symptoms are diagnosed may be implicated in these outcomes, but, to date, studies have primarily understood these inequalities in terms of 'diagnostic overshadowing': the misattribution of physical symptoms to mental health conditions. In this paper, we use the can…
Mixed‐methods exploration of views on choice in a university asymptomatic Covid‐19 testing programme
Asymptomatic COVID‐19 testing programmes are being introduced in higher education institutions, but stakeholder views regarding the acceptability of mandating or incentivizing participation remain little understood. A mixed‐method study (semi‐structured interviews and a survey including open and closed questions) was undertaken in a case study university with a student testing programme. Survey data were analysed descriptively; analysis for inter…
Concordance of Hospital Ranks and Category Ratings Using the Current Technical Specification of US Hospital Star Ratings and Reasonable Alternative Specifications
In this cross-sectional study of data on US hospitals, CMS Hospital Compare star ratings were found to be highly sensitive to how performance ratings are calculated, demonstrating the need for transparent justification of the technical approaches used in calculating composite performance ratings
Guiding organisational decision-making about Covid-19 asymptomatic testing in workplaces
The consultation, together with other inputs, informed an ethical framework intended to support employers. The framework may support organisational decision-making in areas ranging from design and operation of the programme through to choices about participation. The framework is likely to benefit from further consultation and refinement in new settings
Qualitative study of candidacy and access to secondary mental health services during the Covid-19 pandemic
Candidacy, a construct describing how people's eligibility for care is negotiated between themselves and services, has received limited attention in the context of mental health care. In addition, candidacy research has only rarely studied the views of carers and health professionals. In this article, we use concepts relating to candidacy to enable a theoretically informed examination of experiences of access to secondary mental health services d…
What can data trusts for health research learn from participatory governance in biobanks
New models of data governance for health data are a focus of growing interest in an era of challenge to the social licence. In this article, we reflect on what the data trust model, which is founded on principles of participatory governance, can learn from experiences of involving and engagement of members of the public and participants in the governance of large-scale biobanks. We distinguish between upstream and ongoing governance models, showi…
Uncovering, creating or constructing problems? Enacting a new role to support staff who raise concerns about quality and safety in the English National Health Service
Employee voice is an important source of organizational intelligence about possible problems in quality and patient safety, but effective systems for encouraging and supporting those who seek to speak up have remained elusive. In the English National Health Service, a novel role known as the ‘Freedom to Speak Up Guardian’ has been introduced to address this problem. We critically examine the role and its realization in practice, drawing on semi-s…
Why do systems for responding to concerns and complaints so often fail patients, families and healthcare staff? A qualitative study
Healthcare organisations' responses to concerns and complaints often fall short of the expectations of patients and staff who raise them, and substandard responses to concerns and complaints have been implicated in organisational failures. Informed by Habermas's systems theory, we offer new insights into the features of organisations' responses to concerns and complaints that give rise to these problems. We draw on a large qualitative dataset, co…
The role of the informal and formal organisation in voice about concerns in healthcare
How to be a very safe maternity unit
Maternity care continues to be associated with avoidable harm that can result in serious disability and profound anguish for women, their children, and their families, and in high costs for healthcare systems. As in other areas of healthcare, improvement efforts have typically focused either on implementing and evaluating specific interventions, or on identifying the contextual features that may be generative of safety (e.g. structures, processes…
Taking the heat or taking the temperature? A qualitative study of a large-scale exercise in seeking to measure for improvement, not blame
Measurement of quality and safety has an important role in improving healthcare, but is susceptible to unintended consequences. One frequently made argument is that optimising the benefits from measurement requires controlling the risks of blame, but whether it is possible to do this remains unclear. We examined responses to a programme known as the NHS Safety Thermometer (NHS-ST). Measuring four common patient harms in diverse care settings with…
A qualitative study of speaking out about patient safety concerns in intensive care units
Much policy focus has been afforded to the role of "whistleblowers" in raising concerns about quality and safety of patient care in healthcare settings. However, most opportunities for personnel to identify and act on these concerns are likely to occur much further upstream, in the day-to-day mundane interactions of everyday work. Using qualitative data from over 900 h of ethnographic observation and 98 interviews across 19 English intensive care…
What is the role of individual accountability in patient safety? A multi-site ethnographic study
An enduring debate concerns how responsibility for patient safety should be distributed between organisational systems and individual professionals. Though rule-based, calculus-like approaches intended to support a 'just culture' have become popular, they perpetuate an asocial and atomised account. In this article, we use insights from practice theory - which sees organisational phenomena as accomplished in everyday actions, with individual agenc…
Demystifying theory and its use in improvement
The role and value of theory in improvement work in healthcare has been seriously underrecognised. We join others in proposing that more informed use of theory can strengthen improvement programmes and facilitate the evaluation of their effectiveness. Many professionals, including improvement practitioners, are unfortunately mystified—and alienated—by theory, which discourages them from using it in their work. In an effort to demystify theory we …
Why is patient safety so hard in low-income countries? A qualitative study of healthcare workers’ views in two African hospitals
BACKGROUND: The views of practitioners at the sharp end of health care provision are now recognised as a valuable source of intelligence that can inform efforts to improve patient safety in high-income countries. Yet despite growing policy emphasis on patient safety in low-income countries, little research examines the views of practitioners in these settings. We aimed to give voice to how healthcare workers in two East African hospitals identify…
Consent revisited
BACKGROUND: Increasingly, the sharing of study results with participants is advocated as an element of good research practice. Yet little is known about how receiving the results of trials may impact on participants' perceptions of their original decision to consent. OBJECTIVE: We explored participants' views of their decision to consent to a clinical trial after they received results showing adverse outcomes in some arms of the trial. METHOD: Se…
Beyond metrics? Utilizing 'soft intelligence' for healthcare quality and safety
Professionalism Redundant, Reshaped, or Reinvigorated? Realizing the 'Third Logic' in Contemporary Health Care
Recent decades have seen the influence of the professions decline. Lately, commentators have suggested a revived role for a 'new' professionalism in ensuring and enhancing high-quality health care in systems dominated by market and managerial logics. The form this new professionalism might take, however, remains obscure. This article uses data from an ethnographic study of three English health care improvement projects to analyze the place, poten…
Better reporting of interventions
Without a complete published description of interventions, clinicians and patients cannot reliably implement interventions that are shown to be useful, and other researchers cannot replicate or build on research findings. The quality of description of interventions in publications, however, is remarkably poor. To improve the completeness of reporting, and ultimately the replicability, of interventions, an international group of experts and stakeh…
Optimizing patient involvement in quality improvement
INTRODUCTION: Patient and public involvement in healthcare planning, service development and health-related research has received significant attention. However, evidence about the role of patient involvement in quality improvement work is more limited. We aimed to characterize patient involvement in three improvement projects and to identify strengths and weaknesses of contrasting approaches. METHODS: Three case study quality improvement project…
Between surveillance and subjectification
Do informed consent documents for cancer trials do what they should? A study of manifest and latent functions
Though patient information leaflets (PILs) are provided to those invited to take part in medical research, they usually fall short in facilitating informed decisions about participation. We aimed to explore why there is an enduring requirement for a process that seems not to 'work', and to explain why the problems have proven resistant to correction. We analysed applications for ethical approval for 13 oncology trials and related official guidanc…
Using framework-based synthesis for conducting reviews of qualitative studies
Framework analysis is a technique used for data analysis in primary qualitative research. Recent years have seen its being adapted to conduct syntheses of qualitative studies. Framework-based synthesis shows considerable promise in addressing applied policy questions. An innovation in the approach, known as 'best fit' framework synthesis, has been published in BMC Medical Research Methodology this month. It involves reviewers in choosing a concep…
Why is UK medicine no longer a self-regulating profession? The role of scandals involving "bad apple" doctors
Design-based regulation and patient safety
How can systematic reviews incorporate qualitative research? A critical perspective
Systematic review has developed as a specific methodology for searching for, appraising and synthesizing findings of primary studies, and has rapidly become a cornerstone of the evidence-based practice and policy movement. Qualitative research has traditionally been excluded from systematic reviews, and much effort is now being invested in resolving the daunting methodological and epistemological challenges associated with trying to move towards …
Parenting in a crisis
Why is UK medicine no longer a self-regulating profession? The role of scandals involving "bad apple" doctors
"Beyond "misunderstanding
Why do women consent to surgery, even when they do not want to? An interactionist and Bourdieusian analysis
Written work
Beyond metrics? Utilizing 'soft intelligence' for healthcare quality and safety
Professionalism Redundant, Reshaped, or Reinvigorated? Realizing the 'Third Logic' in Contemporary Health Care
Recent decades have seen the influence of the professions decline. Lately, commentators have suggested a revived role for a 'new' professionalism in ensuring and enhancing high-quality health care in systems dominated by market and managerial logics. The form this new professionalism might take, however, remains obscure. This article uses data from an ethnographic study of three English health care improvement projects to analyze the place, poten…
Between surveillance and subjectification
Doing accountability
Research ethics committees (RECs) are charged with adjudicating the ethical status of research projects, and determining the conditions necessary for such projects to proceed. Both because of their position in the research process and because of the controversial nature of ethical judgements, RECs' views and decisions need to be accountable. In this paper we use techniques of discourse analysis to show how REC decision letters 'do' accountability…
Representing childhood cancer
We present an analysis of newspaper accounts and parents' accounts of childhood cancer. Newspaper accounts construct cancer as a threat to the entitlements and category-bound activities of childhood. Newspaper discourses around children with cancer are predominantly eulogising, constructing children as courageous, stoical and inspirational. Parents are characterised as confederates in the 'battle' against cancer; as fund-raisers; and as guardians…
Writing wrongs? An analysis of published discourses about the use of patient information leaflets
Qualitative study of candidacy and access to secondary mental health services during the Covid-19 pandemic
Candidacy, a construct describing how people's eligibility for care is negotiated between themselves and services, has received limited attention in the context of mental health care. In addition, candidacy research has only rarely studied the views of carers and health professionals. In this article, we use concepts relating to candidacy to enable a theoretically informed examination of experiences of access to secondary mental health services d…
Why do people cooperate with medical research? Findings from three studies
An ethnographic study of classifying and accounting for risk at the sharp end of medical wards
Breaking the ceremonial order
The removal of patients from general practitioners' (GPs) lists in the UK offers important sociological insights into what happens when the doctor-patient relationship 'goes wrong'. An interactionist analysis shows how removers (doctors) and removed (patients) strategically invoke 'rules of conduct' to account for difficulties in the doctor-patient relationship and for GPs' decisions to end their relationships with patients. In this paper we exte…
What is the role of individual accountability in patient safety? A multi-site ethnographic study
An enduring debate concerns how responsibility for patient safety should be distributed between organisational systems and individual professionals. Though rule-based, calculus-like approaches intended to support a 'just culture' have become popular, they perpetuate an asocial and atomised account. In this article, we use insights from practice theory - which sees organisational phenomena as accomplished in everyday actions, with individual agenc…
Commodification of Body Parts
Commentators frequently point to the involvement of biomedicine and bio-science in the objectification and commodification of human body parts, and the consequent potential for violation of personal, social and community meanings. Through a study of UK media coverage of controversies associated with the removal of body parts and human materials from children, we argue that an exclusive emphasis on the role of medicine and the bio-sciences in the …
Gender and access to healthcare in the UK
English Because gender traditionally has been perceived as the preserve of women, gendercomparative research in access to healthcare has been rare. We report a critical interpretive synthesis of the relevant literature, and present the outline of a theoretically grounded framework for understanding gender issues in access to healthcare in the UK. Our synthesis indicates access appears often to be relative, variable and contingent upon many factor…
Design-based regulation and patient safety
How to be a very safe maternity unit
Maternity care continues to be associated with avoidable harm that can result in serious disability and profound anguish for women, their children, and their families, and in high costs for healthcare systems. As in other areas of healthcare, improvement efforts have typically focused either on implementing and evaluating specific interventions, or on identifying the contextual features that may be generative of safety (e.g. structures, processes…
Taking the heat or taking the temperature? A qualitative study of a large-scale exercise in seeking to measure for improvement, not blame
Measurement of quality and safety has an important role in improving healthcare, but is susceptible to unintended consequences. One frequently made argument is that optimising the benefits from measurement requires controlling the risks of blame, but whether it is possible to do this remains unclear. We examined responses to a programme known as the NHS Safety Thermometer (NHS-ST). Measuring four common patient harms in diverse care settings with…
A qualitative study of speaking out about patient safety concerns in intensive care units
Much policy focus has been afforded to the role of "whistleblowers" in raising concerns about quality and safety of patient care in healthcare settings. However, most opportunities for personnel to identify and act on these concerns are likely to occur much further upstream, in the day-to-day mundane interactions of everyday work. Using qualitative data from over 900 h of ethnographic observation and 98 interviews across 19 English intensive care…
The role of the informal and formal organisation in voice about concerns in healthcare
Do informed consent documents for cancer trials do what they should? A study of manifest and latent functions
Though patient information leaflets (PILs) are provided to those invited to take part in medical research, they usually fall short in facilitating informed decisions about participation. We aimed to explore why there is an enduring requirement for a process that seems not to 'work', and to explain why the problems have proven resistant to correction. We analysed applications for ethical approval for 13 oncology trials and related official guidanc…
Writing wrongs? An analysis of published discourses about the use of patient information leaflets
Lay evaluation of services for childhood asthma
Users' views on health services are increasingly valued, but insufficient attention has been given to evaluations of childhood services. Asthma, the most common chronic childhood disease, is an significant condition around which to explore views of childhood services, especially since most care is provided in the community rather than in hospital. The aim of the present study was to investigate the views of children, young people and their parent…
Parenting in a crisis
Representing childhood cancer
We present an analysis of newspaper accounts and parents' accounts of childhood cancer. Newspaper accounts construct cancer as a threat to the entitlements and category-bound activities of childhood. Newspaper discourses around children with cancer are predominantly eulogising, constructing children as courageous, stoical and inspirational. Parents are characterised as confederates in the 'battle' against cancer; as fund-raisers; and as guardians…
Synthesising qualitative and quantitative evidence
BACKGROUND: The limitations of traditional forms of systematic review in making optimal use of all forms of evidence are increasingly evident, especially for policy-makers and practitioners. There is an urgent need for robust ways of incorporating qualitative evidence into systematic reviews. OBJECTIVES: In this paper we provide a brief overview and critique of a selection of strategies for synthesising qualitative and quantitative evidence, rang…
Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups
BACKGROUND: Conventional systematic review techniques have limitations when the aim of a review is to construct a critical analysis of a complex body of literature. This article offers a reflexive account of an attempt to conduct an interpretive review of the literature on access to healthcare by vulnerable groups in the UK METHODS: This project involved the development and use of the method of Critical Interpretive Synthesis (CIS). This approach…
How can systematic reviews incorporate qualitative research? A critical perspective
Systematic review has developed as a specific methodology for searching for, appraising and synthesizing findings of primary studies, and has rapidly become a cornerstone of the evidence-based practice and policy movement. Qualitative research has traditionally been excluded from systematic reviews, and much effort is now being invested in resolving the daunting methodological and epistemological challenges associated with trying to move towards …
Why do women consent to surgery, even when they do not want to? An interactionist and Bourdieusian analysis
Commodification of Body Parts
Commentators frequently point to the involvement of biomedicine and bio-science in the objectification and commodification of human body parts, and the consequent potential for violation of personal, social and community meanings. Through a study of UK media coverage of controversies associated with the removal of body parts and human materials from children, we argue that an exclusive emphasis on the role of medicine and the bio-sciences in the …
Breaking the ceremonial order
The removal of patients from general practitioners' (GPs) lists in the UK offers important sociological insights into what happens when the doctor-patient relationship 'goes wrong'. An interactionist analysis shows how removers (doctors) and removed (patients) strategically invoke 'rules of conduct' to account for difficulties in the doctor-patient relationship and for GPs' decisions to end their relationships with patients. In this paper we exte…
Appraising qualitative research for inclusion in systematic reviews
Objective: Qualitative research is increasingly valued as part of the evidence for policy and practice, but how it should be appraised is contested. Various appraisal methods, including checklists and other structured approaches, have been proposed but rarely evaluated. We aimed to compare three methods for appraising qualitative research papers that were candidates for inclusion in a systematic review of evidence on support for breast-feeding. M…
Qualitative research on breastfeeding in the UK
English Levels of breastfeeding in the UK remain low compared with other European countries. Qualitative research is a potential source of important data on women’s infant feeding decisions and practices, but is currently omitted from systematic reviews in the area. We report a narrative review of qualitative studies of breastfeeding in the UK, and identify two main themes around which the literature can be organised: first, women’s experiences o…
Synthesizing qualitative research
Although there is increasing demand for syntheses of qualitative research, little is known about papers that aim to report such syntheses. We searched for published reports of attempts to conduct syntheses of qualitative research in health and healthcare. Papers were included if they were published between 1988 and 2004, in the English language, and in a peer-reviewed journal. We identified a modest body of literature (42 papers) reporting synthe…
Gender and access to healthcare in the UK
English Because gender traditionally has been perceived as the preserve of women, gendercomparative research in access to healthcare has been rare. We report a critical interpretive synthesis of the relevant literature, and present the outline of a theoretically grounded framework for understanding gender issues in access to healthcare in the UK. Our synthesis indicates access appears often to be relative, variable and contingent upon many factor…
"Beyond "misunderstanding
Written work
Human Tissue and ‘the Public’
Why do people cooperate with medical research? Findings from three studies
An ethnographic study of classifying and accounting for risk at the sharp end of medical wards
Doing accountability
Research ethics committees (RECs) are charged with adjudicating the ethical status of research projects, and determining the conditions necessary for such projects to proceed. Both because of their position in the research process and because of the controversial nature of ethical judgements, RECs' views and decisions need to be accountable. In this paper we use techniques of discourse analysis to show how REC decision letters 'do' accountability…
Design-based regulation and patient safety
Using framework-based synthesis for conducting reviews of qualitative studies
Framework analysis is a technique used for data analysis in primary qualitative research. Recent years have seen its being adapted to conduct syntheses of qualitative studies. Framework-based synthesis shows considerable promise in addressing applied policy questions. An innovation in the approach, known as 'best fit' framework synthesis, has been published in BMC Medical Research Methodology this month. It involves reviewers in choosing a concep…
Why is UK medicine no longer a self-regulating profession? The role of scandals involving "bad apple" doctors
Do informed consent documents for cancer trials do what they should? A study of manifest and latent functions
Though patient information leaflets (PILs) are provided to those invited to take part in medical research, they usually fall short in facilitating informed decisions about participation. We aimed to explore why there is an enduring requirement for a process that seems not to 'work', and to explain why the problems have proven resistant to correction. We analysed applications for ethical approval for 13 oncology trials and related official guidanc…
Optimizing patient involvement in quality improvement
INTRODUCTION: Patient and public involvement in healthcare planning, service development and health-related research has received significant attention. However, evidence about the role of patient involvement in quality improvement work is more limited. We aimed to characterize patient involvement in three improvement projects and to identify strengths and weaknesses of contrasting approaches. METHODS: Three case study quality improvement project…
Political science (32 obras) · Psychology (29 obras) · Sociology (29 obras) · Medicine (25 obras) · Public relations (21 obras) · Law (18 obras) · Health care (17 obras) · Social Psychology (17 obras) · Computer Science (15 obras) · Law (14 obras)