ORCID Profile
0000-0002-6989-5848
Current Organisation
University of Lincoln
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Publisher: Informa UK Limited
Date: 24-05-2023
Publisher: Elsevier BV
Date: 10-2021
Publisher: Public Library of Science (PLoS)
Date: 24-08-2017
Publisher: Springer Science and Business Media LLC
Date: 06-08-2022
DOI: 10.1186/S12906-022-03688-W
Abstract: Complementary Medicine (CM) is widely used internationally but there is limited understanding of the forms of knowledge CM practitioners use in their clinical practice and how they use this knowledge in interactions with patients . This review aims to synthesise the existing evidence on the forms of knowledge that are mobilised, and the role of this knowledge in the interactions between practitioners and patients during CM consultations. It considered a erse range of CM practice areas to develop a classification of CM practitioners’ knowledge use in consultations. Systematic searches of health and sociology databases were conducted using core concepts, including complementary and alternative medicine, practitioners, and knowledge. Articles were included where they reported on data from recorded CM practitioner and patient consultations and offered insights into the types and applications of knowledge used in these consultations. 16 unique studies were included in the review. Data were extracted, coded and analysed thematically. Results demonstrate that erse sources of knowledge were mobilised by practitioners, predominantly derived from the patients themselves –their bodies and their narratives. This reflected principles of patient-centredness. The use of discipline specific forms of knowledge and references to biomedical sources illustrated ongoing efforts towards legitimacy for CM practice. CM practitioners are navigating tensions between what some might see as competing, others as complementary, forms of knowledge. The classification system provides a useful tool for promoting critically reflective practice by CM practitioners, particularly in relation to self-assessment of knowledge translation and patient interactions.
Publisher: Wiley
Date: 24-11-2017
DOI: 10.1002/HPM.2473
Publisher: Elsevier BV
Date: 02-2023
Publisher: Springer Science and Business Media LLC
Date: 15-09-2017
Publisher: BMJ
Date: 23-08-2022
DOI: 10.1136/EMERMED-2022-999.21
Abstract: Community first responders (CFRs) are volunteers delivering emergency medical assistance and maintaining a patient’s condition until an ambulance arrives. Previous research has highlighted the CFR role and relationships, motivations, practice and perceptions, and need for mental health support. However, factors influencing CFR practise in the field are a relatively underexplored area. We aimed to explore the factors embedded in CFR implementation processes that either facilitated or hindered CFRs’ activities and practice in the UK. In a qualitative study, we conducted interviews with CFRs and CFR leads, paramedics and ambulance clinicians, commissioners, patients and relatives across six English ambulance service regions. Thematic analysis, supported by NVivo, enabled the identification codes and themes. Overall, 47 participants were interviewed including CFR leads (15), CFRs (21), ambulance staff (4), and commissioners (2) from six ambulance services with patients and relatives (5) from the same regions. The findings revealed multi-layered factors influencing effective CFR functioning at three levels, namely in idual, institutional, and societal. CFRs’ local expertise helped them to navigate operational challenges. Use of a personal vehicle and navigation software aided CFRs’ ability to respond promptly. Continuing training improved CFRs’ skills. CFR functioning was facilitated by positive relationships with ambulance crews. Identification and recognition by patients were important and aided by wearing uniforms. Community support was a facilitator for CFR activities in rural areas. In contrast, limited communication in remote regions, long waits for an ambulance, and reliance on community donations impeded CFRs’ care function. Volunteer shortages and lack of access to a blue light while using trusts’ car hindered CFRs’ ability to respond quickly. Negative relationships with ambulance crews also h ered CFRs’ involvement. This study highlights factors associated with effective CFR functioning and the requirement for supportive institutional and societal contexts for CFRs to assist patients in medical emergencies.
Publisher: Springer Science and Business Media LLC
Date: 13-02-2023
DOI: 10.1186/S13049-023-01071-3
Abstract: Community First Responder (CFR) schemes are a long-established service supplementing ambulance trusts in their local community in the United Kingdom. CFRs are community members who volunteer to respond to people with life-threatening conditions. Previous studies highlighted the motivations for becoming CFRs, their training, community (un)awareness and implications of their work on themselves and others. The practices of CFRs in prehospital care remain underexplored. Therefore, we aimed to explore real-world practice of Community First Responders and their contribution to prehospital emergency care. We conducted 47 interviews with CFRs (21), CFR leads (15), ambulance clinicians (4), commissioners (2) and patients and relatives (5) from six ambulance services and regions of England, United Kingdom. Thematic analysis enabled identification of themes and subthemes, with subsequent interpretation built on the theory of practice wisdom. Our analysis revealed the embeddedness of the concept of doing the right thing at the right time in CFR practice. CFRs’ work consisted of a series of sequential and interconnected activities which included: identifying patients’ signs, symptoms and problems information sharing with the ambulance control room on the patient’s condition providing a rapid emergency response including assessment and care and engaging with ambulance clinicians for patient transfer. The patient care sequence began with recognising patients’ signs and symptoms, and validation of patient information provided by the ambulance control room. The CFRs shared patient information with ambulance control who in turn notified the ambulance crew en-route. The practices of CFRs also included delivery of emergency care before ambulance clinicians arrived. Following the delivery of a rapid emergency response, CFRs engaged with the ambulance crew to facilitate patient transfer to the nearest medical facility. The sequential CFR practices supported ambulance services in delivering prehospital and emergency care in rural areas. CFR practices were founded on the principle of practice wisdom where CFRs constructed their practice decisions based on the patient’s condition, their training, availability of equipment and medications and their scope of practice.
Publisher: Springer Science and Business Media LLC
Date: 16-01-2023
DOI: 10.1186/S12913-022-08960-W
Abstract: A key focus is placed on engaging communities to become involved in making decisions to support health and care services in healthcare policies in England, UK. An ex le is the deployment of volunteers such as community first responders (CFRs), who are members of the public with basic life support skills, trained to intervene in emergency situations prior to the arrival of ambulance services. CFR policies have been devised by National Health Service (NHS) Trusts as a way of governing these and related activities. This paper critically examines the discourse around CFR policies to understand how CFR roles are organised and monitoring governance mechanisms are delineated in ensuring quality care delivery. We collected ten CFR policies from six ambulance services. Inductive analysis, guided by Foucault’s theory, enabled the identification of themes and subthemes. We found that Trusts have a common goal to make care quality assurances to regulatory bodies on CFR roles, and this is depicted in common hierarchies of in idual responsibilities across Trusts. However, policies that govern approaches to CFRs activity vary. Firstly, the paper highlights institutional approaches to ensuring public safety through the application of organised surveillance systems to monitor CFR activities, and draws parallels between such surveillance and Foucault’s docile bodies. Secondly, the paper discusses how varying rules in the surveillance system compromises safety by decentralising knowledge to regulatory bodies to whom NHS Trusts must make safety assurances. We suggest that stronger interrelationships between Trusts in considering the CFR role has potential to increase public safety and outline a clearer direction for CFRs.
Publisher: Springer Science and Business Media LLC
Date: 15-11-2017
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Gupteswar Patel.