Lucy Bray - Academia.edu (original) (raw)
Papers by Lucy Bray
Parents of children with complex healthcare needs take parenting to higher levels using extraordi... more Parents of children with complex healthcare needs take parenting to higher levels using extraordinary skills. Parents persevere, they are tenacious, resilient and amazing, but we musn’t forget that these parents can also feel isolated and lonely. And it is by reaching out that we can help these parents to feel less alone in the day to day challenges that are being a parent.
Sociology of Health & Illness, 2013
This article reports on data from a qualitative interview study that sought to understand the exp... more This article reports on data from a qualitative interview study that sought to understand the experiences, choices and actions of children and young people undergoing surgery for a long-term condition and that of their parents. Using the concept of biography the article examines how the biographies of children, young people and their parents can be influenced by surgery and the ongoing management of a long-term continence condition. This article challenges previous work that characterises the presence of a condition from birth as a continuous and normal part of the illness experiences of these patients. Although this may be the case in some instances, children, young people and their parents can experience diverse and changing experiences associated with ongoing condition management as well as surgery. Biographical continuity, enrichment and disruption are all relevant concepts for such patients living with a long-term continence condition. These can be influenced by their previous experiences of their condition, their expectations, and dynamics with parents, including changes associated with development and the increasing independence of young people.
Journal of Paramedic Practice, 2015
Abstract: The number of children with complex health care needs continues to rise and they often ... more Abstract: The number of children with complex health care needs continues to rise and they often have prolonged hospital stays with their discharge home being delayed by a range of factors, despite the fact that, except in extraordinary circumstances, a child's home is the most appropriate place for them to receive long-term care. The aim of this appreciative, qualitative interview-based study was to explore the work of nurses whose main role is supporting children and families move from an institutional place of care to long-term care within the family home. Analysis of interview transcripts was collaborative, interpretive and thematic. Forty-six participants (9 nurses and 37 local stakeholders) engaged in the study. Findings reflect the ways in which the nurses facilitated transition of children with complex needs from hospital to home and the journeys the nurses took to develop the skills, knowledge and networks needed to support this transition. 'Knowing the places of care' was fundamental to success of the nurses' work. As the nurses' knowledge of the places (and processes) of care deepened, they were better able to act as informed guides to families and other professionals and to improve care. The nurses' practice was driven by the belief that the place where care occurs matters. Home was seen as a transformative and sustaining place where caring practices could become incorporated into an environment in which the family could exist and be nurtured together.
Nurse Education in Practice, May 1, 2011
Background: This study aimed to explore the factors which influence student nurses' ability to ur... more Background: This study aimed to explore the factors which influence student nurses' ability to urethrally catheterise children in their care. This aimed to inform current pre-registration clinical skill training and education. Methodology: A mixed method study using focus groups and written questionnaires. Results: The students identified that being able to competently carry out urethral catheterisation was influenced by a lack of exposure to the clinical skill and a need for specific paediatric focused training. Evaluation of current catheterisation training highlighted that, even after training, only a small proportion of the student nurses (24%, n ¼ 12) felt confident to catheterise children in practice. Conclusion: Student nurses infrequently witnessed paediatric urethral catheterisation in clinical placements which impacted on their ability to consolidate their learning and build competency in this clinical skill. Limited exposure to some clinical skills in practice, may mean that student nurses' education should focus on skills they are more likely to witness in order to optimise their learning opportunities.
Sociology of Health and Illness 2014 36 823 839, Apr 1, 2014
British Journal of School Nursing, Sep 27, 2013
ABSTRACT Faecal incontinence can have a serious impact on the emotional wellbeing of children and... more ABSTRACT Faecal incontinence can have a serious impact on the emotional wellbeing of children and young people. The school nurse is ideally placed to help support them and their families to manage and cope with the complex issues related to soiling.
Research in nursing & health, Jan 17, 2015
Children in acute care often need procedures and interventions, and they are frequently held, oft... more Children in acute care often need procedures and interventions, and they are frequently held, often against their wishes, to enable these procedures to be completed. This report is from a qualitative investigation in which we sought to explore what happens when children undergo clinical procedures within an acute hospital, with a focus on the use of holding for procedures. Qualitative data were generated through non-participant observation of clinical procedures (n = 31) and semi-structured interviews with health professionals (n = 22), parents (n = 21), and children (n = 4) to explore the event from the participants' perspective. Data were analyzed using constant comparison. Through the central theoretical concept of perseverance, we examined the actions, inactions and interactions of health professionals, parents and children during a clinical procedure. Two broad trajectories were noted: "perseverance in spite of," when the procedure was completed despite a child...
Heart & Lung: The Journal of Acute and Critical Care, 2015
The purpose of the study was to investigate children's perspectives of li... more The purpose of the study was to investigate children's perspectives of living with chronic lung disease (CLD) and their parents' long-term experiences of caring for them. CLD caused by prematurity of birth is associated with continuing respiratory, neuro-developmental and psychosocial issues. 10 children (6-15 years old) with CLD and 12 parents were involved in semi-structured qualitative interviews. Data were analyzed using thematic analysis. CLD was described as 'getting easier over time' and that you 'learnt to live with it.' Expertise was acquired in controlling symptoms and recognizing the onset of illness, despite expressed uncertainty of the nature of the condition. Children experienced difficulties engaging in peer activities and encountered cases of teasing and isolation at school. CLD was reported as becoming easier over time to live with. Despite this, children experienced challenges engaging in peer activities and families described difficulties interacting with health and education services.
British journal of nursing (Mark Allen Publishing), Jan 10, 2015
The importance of providing compassionate care to patients is well established. While compassiona... more The importance of providing compassionate care to patients is well established. While compassionate care can be understood as an individual response to others' vulnerability, it is acknowledged that healthcare environments can impact significantly on this aspect of practice. This study sought to explore how health professionals and pre-qualifying healthcare students (HCS) understand compassionate care and factors that hinder or enable them to practice compassionately. The perceptions of health professionals (n=146) and HCS (n=166) registered at a university in Northwest England were explored using mixed methods. This article reports on the data gained from the qualitative interviews and responses to open-text questions from the mainly quantitative questionnaire. The findings are discussed under the following themes: individual and relationship factors that impact on compassionate care practice; organisational factors that impact on the clinical environment and team; and leadersh...
Emergency medicine journal : EMJ, 2015
- Accepted for publication in Journal of Paramedic Practice.
International Journal of Urological Nursing, 2015
The objective of this study is to review published literature on bladder augmentation in children... more The objective of this study is to review published literature on bladder augmentation in children and young adults (C&YA) with a neuropathic bladder following a neural tube defect or spinal cord injury to inform nursing practice and patient education. Medline, Embase, CINAHL, PsycINFO and the British Nursing Index were systematically searched to identify studies. The papers reviewed were case studies and medical note review in single centres regarding outcome and post-operative complications. This limits the generalisability of the findings surrounding outcome and risk of bladder augmentation surgery in C&YA. Evidence suggests irrigation has a role in ongoing bladder management to reduce complications such as bladder calculi. However, data are sparse regarding both appropriate irrigation solutions and the frequency of irrigation necessary to minimise calculi formation. A statistically significant increase is noted in the risk of perforation following bladder augmentation when associated with bladder neck surgery at the time of primary surgery. Limited evidence exists regarding longer term systemic implications of bladder augmentation, such as malignancy or impact on bone mineral density. None of the studies demonstrated an overall improvement in health-related quality of life (HRQoL) following bladder augmentation. Discrepancies exist between parental and children's HRQoL scores. Bladder augmentation is clinically the standard surgical treatment used to manage refractory neuropathic bladder. However, current evidence demonstrates no improvements to HRQoL following surgery and also describes various complications. Future research in this area is necessary to explore standards of care and most importantly long-term outcome measures from the patient and professional perspective.
Nurse education in practice, 2008
This paper reports on a multi-professional research study, which aimed to explore mentee and ment... more This paper reports on a multi-professional research study, which aimed to explore mentee and mentor perceptions of the mentorship role within nursing, midwifery and medicine. The specific focus of the study was on the conceptualisation of mentoring within the health setting, the factors that influence the mentor-mentee relationship in a positive/negative way, what the professional and personal needs of the mentees are and what are the training and development needs of mentors. This paper will focus on the nursing responses from both questionnaire and interview data highlighted by the responses from the other healthcare professions. The changing nature of the role may be preventing mentors from providing adequate support to students, this is especially relevant in view of the recent concentration on failing students and ensuring trainees are fit for practice at the point of registration. Additionally data suggests that nurse mentors are struggling to fulfil the role with minimal form...
Nurse education in practice, 2014
Evidence suggests that nurses can struggle to care for patients with sexually transmitted infecti... more Evidence suggests that nurses can struggle to care for patients with sexually transmitted infections in a non-judgemental way. It is unknown how targeted education can influence the knowledge and attitudes of student nurses towards caring for patients with sexually transmitted infections. This study aimed to investigate how a change in curriculum influenced the reported sexual health knowledge and attitudes of pre-registration adult student nurses in a University in the UK. A two phase mixed methods study, using a sequential explanatory strategy, collected quantitative questionnaire data (n = 117) followed by qualitative group data (n = 12). Data were collected from one cohort of students before a curriculum change and then from a subsequent cohort of students. Those students who had increased educational input in relation to sexual health reported higher degrees of knowledge and demonstrated a more positive attitude towards patients with a sexually transmitted infection. Both cohor...
International journal of pediatric otorhinolaryngology, 2013
To review the published/reported experiences and views of parents' whose child has had a trac... more To review the published/reported experiences and views of parents' whose child has had a tracheostomy. To date, no review has focused specifically on parents' experiences and views of having a child with a tracheostomy. MEDLINE, CINAHL, PsycINFO and Embase were systematically searched from 1990 to 2012 and a review of reference lists was conducted. The review draws on articles where parents' views of caring for their child's tracheostomy were either the sole focus of the research or where parental views of caring for their child's tracheostomy have been sought as a subsidiary aim. Studies relating to the aims of the review were examined using quality appraisal tools and in line with criteria for inclusion of studies. Studies were excluded if findings were about adults, studies that only focused on children's or sibling's views were not based on empirical work (e.g. literature reviews or expert commentary) or were not published in the English language. Fin...
Paediatric nursing, 2007
An audit was undertaken in one children's hospital to evaluate practice relating to indwellin... more An audit was undertaken in one children's hospital to evaluate practice relating to indwelling urethral catheterisation of children. The records of 47 patients admitted over an eight-month period were reviewed to obtain information regarding catheter use. A questionnaire was sent to 384 qualified nursing staff and 174 medical staff to identify what training they had received and their level of knowledge about catheterisation practice. In the absence of national guidelines for urethral catheter care, locally developed standards were used for comparison in the audit. Timing and location of catheter insertion were noted. Duration of catheterisation ranged from one to 38 days but in 13 per cent of cases it was not possible to identify duration because of lack of documentation. Both nursing and medical staff reported low levels of training and areas of limited understanding of practice. A majority of nursing staff had never catheterised a child or did so less than once a year. Novel ...
Urologic nursing, 2007
The need to catheterize through the urethra can begin at any age and stage of development in a ch... more The need to catheterize through the urethra can begin at any age and stage of development in a child's life and may involve different strategies for teaching. Intermittent self-catheterization, as a self-management technique, can be of benefit both physically and psychologically to children and young people. Educational strategies are available to aid health care providers in teaching children and young people self-intermittent catheterization. Use of innovative techniques and resources may assist the practitioner in teaching self-catheterization successfully to this challenging population.
British Journal of School Nursing, 2009
ABSTRACT Rectal irrigation is increasingly being used as an early intervention for children with ... more ABSTRACT Rectal irrigation is increasingly being used as an early intervention for children with faecal incontinence resulting from injury or disease. Caroline Sanders and Lucy Bray discuss how it works and the impact it can have on young people and their families.
British Journal of School Nursing, 2009
ABSTRACT Faecal incontinence can have a serious impact on the emotional wellbeing of children and... more ABSTRACT Faecal incontinence can have a serious impact on the emotional wellbeing of children and young people. The school nurse is ideally placed to help support them and their families to manage and cope with the complex issues related to soiling.
Nursing Standard, 2006
This article outlines evidence-based approaches to paediatric catheterisation in acute care setti... more This article outlines evidence-based approaches to paediatric catheterisation in acute care settings. The reasons for catheterisation, anatomy and physiology of the urinary system and the procedure and potential complications are discussed.
Parents of children with complex healthcare needs take parenting to higher levels using extraordi... more Parents of children with complex healthcare needs take parenting to higher levels using extraordinary skills. Parents persevere, they are tenacious, resilient and amazing, but we musn’t forget that these parents can also feel isolated and lonely. And it is by reaching out that we can help these parents to feel less alone in the day to day challenges that are being a parent.
Sociology of Health & Illness, 2013
This article reports on data from a qualitative interview study that sought to understand the exp... more This article reports on data from a qualitative interview study that sought to understand the experiences, choices and actions of children and young people undergoing surgery for a long-term condition and that of their parents. Using the concept of biography the article examines how the biographies of children, young people and their parents can be influenced by surgery and the ongoing management of a long-term continence condition. This article challenges previous work that characterises the presence of a condition from birth as a continuous and normal part of the illness experiences of these patients. Although this may be the case in some instances, children, young people and their parents can experience diverse and changing experiences associated with ongoing condition management as well as surgery. Biographical continuity, enrichment and disruption are all relevant concepts for such patients living with a long-term continence condition. These can be influenced by their previous experiences of their condition, their expectations, and dynamics with parents, including changes associated with development and the increasing independence of young people.
Journal of Paramedic Practice, 2015
Abstract: The number of children with complex health care needs continues to rise and they often ... more Abstract: The number of children with complex health care needs continues to rise and they often have prolonged hospital stays with their discharge home being delayed by a range of factors, despite the fact that, except in extraordinary circumstances, a child's home is the most appropriate place for them to receive long-term care. The aim of this appreciative, qualitative interview-based study was to explore the work of nurses whose main role is supporting children and families move from an institutional place of care to long-term care within the family home. Analysis of interview transcripts was collaborative, interpretive and thematic. Forty-six participants (9 nurses and 37 local stakeholders) engaged in the study. Findings reflect the ways in which the nurses facilitated transition of children with complex needs from hospital to home and the journeys the nurses took to develop the skills, knowledge and networks needed to support this transition. 'Knowing the places of care' was fundamental to success of the nurses' work. As the nurses' knowledge of the places (and processes) of care deepened, they were better able to act as informed guides to families and other professionals and to improve care. The nurses' practice was driven by the belief that the place where care occurs matters. Home was seen as a transformative and sustaining place where caring practices could become incorporated into an environment in which the family could exist and be nurtured together.
Nurse Education in Practice, May 1, 2011
Background: This study aimed to explore the factors which influence student nurses' ability to ur... more Background: This study aimed to explore the factors which influence student nurses' ability to urethrally catheterise children in their care. This aimed to inform current pre-registration clinical skill training and education. Methodology: A mixed method study using focus groups and written questionnaires. Results: The students identified that being able to competently carry out urethral catheterisation was influenced by a lack of exposure to the clinical skill and a need for specific paediatric focused training. Evaluation of current catheterisation training highlighted that, even after training, only a small proportion of the student nurses (24%, n ¼ 12) felt confident to catheterise children in practice. Conclusion: Student nurses infrequently witnessed paediatric urethral catheterisation in clinical placements which impacted on their ability to consolidate their learning and build competency in this clinical skill. Limited exposure to some clinical skills in practice, may mean that student nurses' education should focus on skills they are more likely to witness in order to optimise their learning opportunities.
Sociology of Health and Illness 2014 36 823 839, Apr 1, 2014
British Journal of School Nursing, Sep 27, 2013
ABSTRACT Faecal incontinence can have a serious impact on the emotional wellbeing of children and... more ABSTRACT Faecal incontinence can have a serious impact on the emotional wellbeing of children and young people. The school nurse is ideally placed to help support them and their families to manage and cope with the complex issues related to soiling.
Research in nursing & health, Jan 17, 2015
Children in acute care often need procedures and interventions, and they are frequently held, oft... more Children in acute care often need procedures and interventions, and they are frequently held, often against their wishes, to enable these procedures to be completed. This report is from a qualitative investigation in which we sought to explore what happens when children undergo clinical procedures within an acute hospital, with a focus on the use of holding for procedures. Qualitative data were generated through non-participant observation of clinical procedures (n = 31) and semi-structured interviews with health professionals (n = 22), parents (n = 21), and children (n = 4) to explore the event from the participants' perspective. Data were analyzed using constant comparison. Through the central theoretical concept of perseverance, we examined the actions, inactions and interactions of health professionals, parents and children during a clinical procedure. Two broad trajectories were noted: "perseverance in spite of," when the procedure was completed despite a child...
Heart & Lung: The Journal of Acute and Critical Care, 2015
The purpose of the study was to investigate children's perspectives of li... more The purpose of the study was to investigate children's perspectives of living with chronic lung disease (CLD) and their parents' long-term experiences of caring for them. CLD caused by prematurity of birth is associated with continuing respiratory, neuro-developmental and psychosocial issues. 10 children (6-15 years old) with CLD and 12 parents were involved in semi-structured qualitative interviews. Data were analyzed using thematic analysis. CLD was described as 'getting easier over time' and that you 'learnt to live with it.' Expertise was acquired in controlling symptoms and recognizing the onset of illness, despite expressed uncertainty of the nature of the condition. Children experienced difficulties engaging in peer activities and encountered cases of teasing and isolation at school. CLD was reported as becoming easier over time to live with. Despite this, children experienced challenges engaging in peer activities and families described difficulties interacting with health and education services.
British journal of nursing (Mark Allen Publishing), Jan 10, 2015
The importance of providing compassionate care to patients is well established. While compassiona... more The importance of providing compassionate care to patients is well established. While compassionate care can be understood as an individual response to others' vulnerability, it is acknowledged that healthcare environments can impact significantly on this aspect of practice. This study sought to explore how health professionals and pre-qualifying healthcare students (HCS) understand compassionate care and factors that hinder or enable them to practice compassionately. The perceptions of health professionals (n=146) and HCS (n=166) registered at a university in Northwest England were explored using mixed methods. This article reports on the data gained from the qualitative interviews and responses to open-text questions from the mainly quantitative questionnaire. The findings are discussed under the following themes: individual and relationship factors that impact on compassionate care practice; organisational factors that impact on the clinical environment and team; and leadersh...
Emergency medicine journal : EMJ, 2015
- Accepted for publication in Journal of Paramedic Practice.
International Journal of Urological Nursing, 2015
The objective of this study is to review published literature on bladder augmentation in children... more The objective of this study is to review published literature on bladder augmentation in children and young adults (C&YA) with a neuropathic bladder following a neural tube defect or spinal cord injury to inform nursing practice and patient education. Medline, Embase, CINAHL, PsycINFO and the British Nursing Index were systematically searched to identify studies. The papers reviewed were case studies and medical note review in single centres regarding outcome and post-operative complications. This limits the generalisability of the findings surrounding outcome and risk of bladder augmentation surgery in C&YA. Evidence suggests irrigation has a role in ongoing bladder management to reduce complications such as bladder calculi. However, data are sparse regarding both appropriate irrigation solutions and the frequency of irrigation necessary to minimise calculi formation. A statistically significant increase is noted in the risk of perforation following bladder augmentation when associated with bladder neck surgery at the time of primary surgery. Limited evidence exists regarding longer term systemic implications of bladder augmentation, such as malignancy or impact on bone mineral density. None of the studies demonstrated an overall improvement in health-related quality of life (HRQoL) following bladder augmentation. Discrepancies exist between parental and children's HRQoL scores. Bladder augmentation is clinically the standard surgical treatment used to manage refractory neuropathic bladder. However, current evidence demonstrates no improvements to HRQoL following surgery and also describes various complications. Future research in this area is necessary to explore standards of care and most importantly long-term outcome measures from the patient and professional perspective.
Nurse education in practice, 2008
This paper reports on a multi-professional research study, which aimed to explore mentee and ment... more This paper reports on a multi-professional research study, which aimed to explore mentee and mentor perceptions of the mentorship role within nursing, midwifery and medicine. The specific focus of the study was on the conceptualisation of mentoring within the health setting, the factors that influence the mentor-mentee relationship in a positive/negative way, what the professional and personal needs of the mentees are and what are the training and development needs of mentors. This paper will focus on the nursing responses from both questionnaire and interview data highlighted by the responses from the other healthcare professions. The changing nature of the role may be preventing mentors from providing adequate support to students, this is especially relevant in view of the recent concentration on failing students and ensuring trainees are fit for practice at the point of registration. Additionally data suggests that nurse mentors are struggling to fulfil the role with minimal form...
Nurse education in practice, 2014
Evidence suggests that nurses can struggle to care for patients with sexually transmitted infecti... more Evidence suggests that nurses can struggle to care for patients with sexually transmitted infections in a non-judgemental way. It is unknown how targeted education can influence the knowledge and attitudes of student nurses towards caring for patients with sexually transmitted infections. This study aimed to investigate how a change in curriculum influenced the reported sexual health knowledge and attitudes of pre-registration adult student nurses in a University in the UK. A two phase mixed methods study, using a sequential explanatory strategy, collected quantitative questionnaire data (n = 117) followed by qualitative group data (n = 12). Data were collected from one cohort of students before a curriculum change and then from a subsequent cohort of students. Those students who had increased educational input in relation to sexual health reported higher degrees of knowledge and demonstrated a more positive attitude towards patients with a sexually transmitted infection. Both cohor...
International journal of pediatric otorhinolaryngology, 2013
To review the published/reported experiences and views of parents' whose child has had a trac... more To review the published/reported experiences and views of parents' whose child has had a tracheostomy. To date, no review has focused specifically on parents' experiences and views of having a child with a tracheostomy. MEDLINE, CINAHL, PsycINFO and Embase were systematically searched from 1990 to 2012 and a review of reference lists was conducted. The review draws on articles where parents' views of caring for their child's tracheostomy were either the sole focus of the research or where parental views of caring for their child's tracheostomy have been sought as a subsidiary aim. Studies relating to the aims of the review were examined using quality appraisal tools and in line with criteria for inclusion of studies. Studies were excluded if findings were about adults, studies that only focused on children's or sibling's views were not based on empirical work (e.g. literature reviews or expert commentary) or were not published in the English language. Fin...
Paediatric nursing, 2007
An audit was undertaken in one children's hospital to evaluate practice relating to indwellin... more An audit was undertaken in one children's hospital to evaluate practice relating to indwelling urethral catheterisation of children. The records of 47 patients admitted over an eight-month period were reviewed to obtain information regarding catheter use. A questionnaire was sent to 384 qualified nursing staff and 174 medical staff to identify what training they had received and their level of knowledge about catheterisation practice. In the absence of national guidelines for urethral catheter care, locally developed standards were used for comparison in the audit. Timing and location of catheter insertion were noted. Duration of catheterisation ranged from one to 38 days but in 13 per cent of cases it was not possible to identify duration because of lack of documentation. Both nursing and medical staff reported low levels of training and areas of limited understanding of practice. A majority of nursing staff had never catheterised a child or did so less than once a year. Novel ...
Urologic nursing, 2007
The need to catheterize through the urethra can begin at any age and stage of development in a ch... more The need to catheterize through the urethra can begin at any age and stage of development in a child's life and may involve different strategies for teaching. Intermittent self-catheterization, as a self-management technique, can be of benefit both physically and psychologically to children and young people. Educational strategies are available to aid health care providers in teaching children and young people self-intermittent catheterization. Use of innovative techniques and resources may assist the practitioner in teaching self-catheterization successfully to this challenging population.
British Journal of School Nursing, 2009
ABSTRACT Rectal irrigation is increasingly being used as an early intervention for children with ... more ABSTRACT Rectal irrigation is increasingly being used as an early intervention for children with faecal incontinence resulting from injury or disease. Caroline Sanders and Lucy Bray discuss how it works and the impact it can have on young people and their families.
British Journal of School Nursing, 2009
ABSTRACT Faecal incontinence can have a serious impact on the emotional wellbeing of children and... more ABSTRACT Faecal incontinence can have a serious impact on the emotional wellbeing of children and young people. The school nurse is ideally placed to help support them and their families to manage and cope with the complex issues related to soiling.
Nursing Standard, 2006
This article outlines evidence-based approaches to paediatric catheterisation in acute care setti... more This article outlines evidence-based approaches to paediatric catheterisation in acute care settings. The reasons for catheterisation, anatomy and physiology of the urinary system and the procedure and potential complications are discussed.