Norma Raynes, Lydia Coulthard, Charlotte Glenister and Bogusia Temple
This paper describes a study that explored older people's views and priorities on what made for quality in home care services, ways of accessing these and enabling them to become…
Abstract
This paper describes a study that explored older people's views and priorities on what made for quality in home care services, ways of accessing these and enabling them to become part of mainstream service monitoring. It took place in a city in the north of England, in 2000. The research was funded by the Joseph Rowntree Foundation. Older people's definitions of a quality home care service go outside the service boundaries that are set by social service departments who define the quality specifications for home care services and commission them. Older people had a joined‐up perspective of what contributes to quality in a home care service including, for example, in their definitions of a quality service: access to transport to get out of the house, aids, adaptations and health care. They emphasised the importance of domestic help, which has been reported in other studies. To obtain information on their definitions of a quality service older people were offered the choice of a home‐based interview or participation in a focus group. Following the collection of the data on quality a round table discussion was arranged. The purpose of this was to explore how older people's views on the quality of home care services could become part of routine monitoring, to shape further development and assist in commissioning. Older people who had participated in the first part of the study were invited to attend this, as were local commissioners, service providers and elected members with executive responsibility for older people's services. The recommendations of this round table are discussed.
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Katie Bell, Helen Coulthard, Diane Wildbur and Iain Williamson
Self-disgust appears to be a prominent feature in anorexia nervosa (AN), which might help explain why AN is often such a persistent disorder. Little is known about how this…
Abstract
Purpose
Self-disgust appears to be a prominent feature in anorexia nervosa (AN), which might help explain why AN is often such a persistent disorder. Little is known about how this emotion can impact on recovering from this disorder. This study aims to develop our understanding of how people experience the emotion of self-disgust after physical recovery from AN.
Design/methodology/approach
Twelve female participants who reported previously having had a clinical diagnosis of AN but had physically recovered according to their EDE-Q scores took part in a semi-structured interview to explore their experiences of recovery and the role self-disgust played within this. Interpretative phenomenological analysis was used to explore the data.
Findings
Three themes were identified within the data to explain the experiences of self-disgust in those with AN: continued self-disgust following physical “Recovery”, multiple manifestations of self-disgust in recovery and increasing self-disgust in recovery as a driver for relapse.
Practical implications
Self-disgust was something each participant appeared to experience often, despite being physically recovered from AN. Disgust-based reactions to the self are enduring and highly resistant to change even whilst other aspects of the disorder become less potent. Self-disgust is multi-faceted and may trigger relapse as the signs of improvement and behaviours inherent in recovering were generally viewed as disgusting to the individuals.
Originality/value
Self-disgust is an emotion that continues to affect people with AN despite physical recovery. The recovery process itself is not linear and self-disgust is enduring and may cause those affected to relapse. Considering this emotion within therapeutic intervention may encourage those with AN to accept their recovered self.