Professor Catherine Pope on “radical change oriented health research.”

This blog post is co-written by the QHRN committee and also appears on the QHRN website.

On June 25^th, the UCL Qualitative Health Research Network hosted a workshop on qualitative approaches to studying change in health, illness and care, supported by the Wellcome Trust.  Our workshop—Responding to Change: Perspectives from Qualitative Health Research—also aimed to “take the pulse” of the qualitative health research community as it engages in the theme of change.  Reflection on this theme comes as we look towards our 4^th biennial symposium—Crafting the Future of Qualitative Health Research in a Changing World—planned for 21^st-22^nd March, 2019.

Change is happening constantly—it is nothing new.  But it has what seems an intrinsic and inexhaustible capacity to present and assert itself as such.  We are witnessing major change in healthcare environments across the globe and across multiple dimensions.  Rapid technological advances, personalised medicine, and on-going demands for more patient involvement, to name just several fundamental shifts underway now.  These advances are happening against a backdrop of major geopolitical and demographic change, with ageing communities, global austerity and the biggest wave of mass migration since the second world war.  These bring significant social consequences for patients, practitioners, policymakers and society at large and they are seriously challenging established forms of care, the allocation of resources and the inscription of new roles, responsibilities and relationships.  At a different scale, change is a fundamental feature of care—we aim to make people better or prevent them becoming ill—and we design ways of intervening in people’s lives in complex ways.  These changes also require nuanced analysis.

As a network—and as independent researchers engaged in qualitative work—we have become increasingly interested in the contributions researchers engaged with qualitative approaches can make to the study of change and how we can help healthcare communities to anticipate and navigate the many and complex social consequences entangled with it—as commentators, theorists and as agents of change.  And we are also interested in the tensions it produces for researchers—as we too have to navigate its many flows.  In short, our goal was to reflect on these questions: How can we study change qualitatively?  How does change, by virtue of its fleeting nature and unintended effects, complicate normative approaches in qualitative health research?  How can we respond to change in meaningful and timely ways?

Our call for papers drew a healthy number of varied and fantastically thoughtful submissions from around the globe.  From these, we selected 24 participants and asked them to submit brief papers for circulation before the workshop.  This greased the wheels for discussion and got participants acquainted with each other’s work.  Researchers came from a variety of academic homes (including anthropology, sociology, science and technology studies, psychology, and medicine), countries (including the UK, Canada, Australia, Spain and Hong Kong), and experience (from PhD students to Professors, and people with direct experience of illness and care).

Catherine Pope, Professor of Medical Sociology at the University of Southampton, started off the day with a rousing keynote lecture, setting the tone as one of deep reflection and progressive action.  Reflecting on what will soon be 30-years of work that has done much to place qualitative approaches on a more solid footing in the academy of health and social care sciences, Cathy provoked us to think about what a community of researchers engaged in “radical change oriented health research” might look like.  What followed certainly rose to her provocation.

In a packed and experimental day of discussion, each participant summarised their paper in a 4-minute speech, without PowerPoint and with an alarm to call time.  Intervention … alarm … intervention … alarm—like a four-minute pulse sending forward the conversation.  What might have been sacrificed in terms of longer more detailed accounts was gained in the generative effect of keeping things open and at a point of imminence—itself a key feature of change.

We ordered papers into three sessions—Tensions and opportunities in evaluating and creating change; Methodological reflections on studying and responding to change; Theorising change and its processes—after which we drew breath and engaged in longer group discussions.

Tensions and opportunities in evaluating and creating change­—The papers in our first session discussed the features and complexities of studying change when the boundaries between researcher and researched are blurred.  Offering examples from approaches broadly characterised as participatory, engaged, and co-produced, these papers suggested productive possibilities and tensions in researcher standpoint and positionality—how researchers are located in the research field.  The opportunities discussed included the possibility of integrated accounts of change between researchers and community; while tensions and challenges included the will to balance impartiality in research with engaged practice when researchers of change are also agents of change.  Collectively, these papers called into question what we mean by the categories of expertise, experience and engagement and their relationships to how communities imagine and try to enact alternative futures for health and care.

Methodological reflections on studying and responding to change—The papers in our second session offered ways of using and enhancing qualitative methods to study change within individuals and populations and across multiple kinds, rates and degrees of change.  They reflected deeply on broader societal change, policy, and individual attitudes, suggesting how flexible and adaptive approaches like oral history, longitudinal interview and ethnography might better enable us to capture change.  Here, stories are traced as they unfold, wresting accounts of subjectivity and society from the static quality of snapshots to the more dynamic character of the moving picture.  The papers in this session also offered reflections on the timely dissemination of research in rapidly changing environments, such as epidemic disease and service reorganisation.  These papers tackled questions of rigour, relevance and timeliness, and how advocates of rapid approaches might address accusations of being “quick and dirty.”

Theorising change and its processes—The papers in our final session broadly cohered around concepts and mechanisms of change.  They offered theoretical perspectives on studying change, its processes and the critical need to account for social context.  Papers suggested ways to theoretically integrate different levels of change (e.g., micro, meso, macro), consider how change occurs across multiple temporalities (kinds and rates of change), and reflect on its broader dynamics and relationships to continuity.  These papers therefore drew attention to structural conditions and contexts—for example, funding, policy, and governance—which bear upon how we can think about and study change.

As we look forward to our 4^th symposium, we report that the pulse of qualitative health research and its investments in studying change is strong, supporting a body of researchers adapted and ready for radical change oriented health research.  This approach is extremely capable of producing the rich and nuanced accounts that are much needed to help patients, health and social care practitioners, policymakers, and society at large, anticipate and navigate the social consequences of change as it unfolds continuously through multiple arenas.  A big thank you to all who participated.  Read more about the workshop in our detailed report … coming soon!

The UCL Qualitative Health Research Network is a cross-faculty collaboration between UCL Department of Applied Health Research, UCL Division of Psychiatry Qualitative Researchers Working Group supported by the Marie Curie Palliative Care Research Department, and UCL Research Department of Behavioural Science and Health, and it is open to anyone interested in qualitative health research in the UK and abroad.  We hold a Wellcome Trust award, which supported the workshop in addition to our quarterly seminars and forthcoming international two-day symposium planned for 21^st-22^nd March, 2019.  Check here for more details.

UCL Psychiatry’s Naaheed Mukadam was interviewed on TRT World for Alzheimer’s Awareness Month earlier this week. Watch it here (Naaheed’s section starts 6 minutes 46 seconds in):

Have you ever missed a lecture, workshop or seminar you really wanted to attend? Perhaps you’ve been wandering around UCL glued to your phone, desperately trying to google the location of an event. If so, a group of UCL students have created Houndly – an events app that could mean you never have to miss another event on campus… including Division of Psychiatry events! Read more here or visit www.houndly.co.

Thursday 26^th November, 12.30pm to 2pm

Chadwick Building, room G07

Professor Anthony Finkelstein, Dean of the Faculty of Engineering Sciences, will be talking about the challenges of caring for ageing parents and balancing work with caring responsibilities.  There will be an opportunity afterwards for Q&A and networking.  Light refreshments will be provided but attendees should also feel free to bring lunch.

More information on this event can be found on the UCL staff webpages (http://tinyurl.com/owos823)

PACT is a social network that aims to support UCL staff members who are balancing ongoing caring responsibilities with work.  More information and contact details can be found on the UCL equalities webpages   http://www.ucl.ac.uk/hr/equalities/gender/pact.php.

Three months ago, five researchers woke up at 4am to walk 26 miles and climb three mountains in just 12 hours. Why? I asked myself the same question clambering up towards the third summit.

As Research Assistants on the MARQUE project, we had decided to try and do more to support dementia research by fundraising for the Alzheimer’s Society.

MARQUE is not funded by the Alzheimer’s Society, it is funded by the NIHR and the ESRC, but we wanted to fundraise for them for a number of reasons. The Alzheimer’s Society is the UK’s leading dementia support and research charity and we have benefitted from their existence in a number of ways. The Alzheimer’s Society support MARQUE by running our community of interest meetings and attending the steering groups and managers groups.

Throughout the project, they have always been there to provide us with valuable PPI input. As Research Assistants, we have always been able to reach and gain insights from their ever-helpful research engagement manager. As researchers, we have enjoyed attending their annual research conference as part of a diverse and inclusive audience. Here, we can talk with people affected by dementia as well as other researchers looking into the care, cure and prevention of dementia. In our day to day work, we rely on being able to refer our participants to the dementia helpline following potentially distressing discussions about quality of life.

For these reasons, we travelled to the Yorkshire Dales to climb Pen-y-Ghent (694m), Whernside (736m) and Ingleborough (723m) on, allegedly, the only sunny day in Yorkshire in 2015.

Walking on the left and sliding down on the right (it still counts, i checked).

The journey itself was complete with equal measures of hilarity and misery. We arrived late due to a necessary detour off the motorway to get a cooked breakfast and coffee. This presented two additional challenges. We started roaming behind the main group along grass that we hoped was the “official path” because with a walk that long we couldn’t really afford to take the scenic route. Our late start also meant that we couldn’t afford to really take a break at the top of each peak as we risked not being at the final check point by 4pm and being carted off in the mini bus with those not able to finish…

For the first 10 miles:  we walked, we talked, and we laughed. The view was absolutely breath taking (so was the climb) and we were really enjoying the trip out of the congested city of London. I honestly remember, naively, wondering why I didn’t do this every weekend.

As the journey continued and our mobility decreased we gained a new basis for empathy with some of our participants. We ploughed on, however, with an awareness of the investment that kind people had made into the completion of the task.

MARQUE Researchers on top of the first mountain (and the world)

The final 3 miles were definitely the hardest. We completely lost the ability to talk; which, if you know any of us, you will appreciate is quite out of character. Nevertheless, we continued to drag our heavy, battered limbs through fields lined with pain until we reached the finish line and received our medals. We rewarded our exhaustion with several cups of tea and fish and chips.

The day was a huge success and we managed to raise £1,535 in total for the Alzheimer’s Society! One of the ways we did this was by hosting a bake sale with no fixed prices for cakes. We received amazing support fundraising within our division. We found that people gave generously and we raised £267.55 on just one day within the division. Even Shanlee’s courgette and raisin cakes managed to sell.

The cake sale – where even my contribution looks appealing from a distance

I want to say a big thank you to all those who donated and share our story.

I also wanted to acknowledge another fundraising success within the division this year. On the 19^th October the CORE team raised £750 for the charity Basmeh & Zeitooneh, a charity committed to serving Syrian refugees in Lebanon and Turkey. Liberty and Monica raised the money in creative and exciting ways. They approached local business for donations to add to a raffle. They also organised a silent auction and approached local colleagues to donate their time and offer experiences. This provided a fabulous auction that included everything from: a day out sailing for two; to hot drinks made by Monica for a week. These events were orchestrated around a highly enjoyable and well attended pub quiz!

I really wanted to write this piece so that we could celebrate these successes and say thank you to everybody that donated. I also want to actively encourage other research teams to do the same.

Fundraising events within the department are a great means to multiple good ends. They can bring research teams together and get people talking across the department – all whilst raising money for really good causes!

I would, therefore, encourage everybody to think about how we could do this more within the department: whether that’s up Pen-y-Ghent or down at the pub.

Written by: Sarah Robertson, PhD Student & Research Assistant on the MARQUE Project

Email: sarah.robertson@ucl.ac.uk

Twitter: @1SarahMae

The 2nd British Symposium on The History of Neurology and Psychiatry is on 25th and 26th November

A commemoration of the centenary of the death of Sir William Gowers November 25th. Reviewing Gowers contribution to Neurology. Speakers include: Rebecca and Timothy Gowers, Andrew Lees, Christopher Boes, Michael Hanna, Alastair Compston, Mark Weatherall, John Duncan.

Topics include: The Bethlem Hospital, Insanity, Child and Old Age Psychiatry, Psychotherapy, Neurasthenia, Shellshock, Hysteria, Epilepsy, Movement Disorders, Brain Imaging, The Institute of Neurology and The London Hospital. Speakers will include: Victoria Northwood, Bonnie Evans, Claire Hilton, Simon Shorvon, Niall Quinn, Adrian Thomas, David Bell, Deji Ayonrinde, Jon Stone, Stefanie Linden, Michael Clark, Alastair Compston and Michael Swash.

See www.hnps.co.uk for full programme and registration details. Click here for Flyer.

Last week UCL held the SSBP annual meeting, co-hosted by Dr Andre Strydom. The meeting was very successful and comprised an education day and two days of research presentations. You can find out more about the conference and the Society here: http://www.ssbpconference.org/index.html

Next year the meeting will be in Siena, Italy – we hope to see some of you there!

The UCL Division of Psychiatry is holding an Open Afternoon on 15th July 2015 from 1pm until 5pm for offer holders on the MSc in Clinical Mental Health Sciences Research and Mental Health Sciences Research. We also welcome people who are still in the application process and would like to hear some detailed presentations about the course content, and people who are thinking seriously about applying. Lunch is from 1pm to 2pm, and there will then be presentations from the course team and module leads on the course content and structure and on student experiences at UCL.

To register to attend, please contact our course administrator Chris Coup – c.coup@ucl.ac.uk

Further information:

The UCL MSc in Mental Health Sciences Research

The UCL MSc in Clinical Mental Health Sciences

Division of Psychiatry at UCL

Midnight, Saturday 20th June. From E1 to SE11
Together we can STAMP OUT homelessness

Starting at midnight, we’ll walk from dawn until dusk on Summer Solstice, mapping the history of homelessness, discovering London’s hidden secrets and watching immersive performances by Cardboard Citizens talented members along the way.

Cardboard Citizens is an award-winning charity that helps homeless and at-risk people change their lives through theatre and the performing arts.

What’s the cost? Entry fee is £39 (£30 for concessions), which includes the guided walk and performances, a tote bag, snacks and drinks, breakfast, and a ticket to an exclusive showing of a Chaplin short film at the Kennington Cinema Museum.
As an exclusive opportunity we are wavering the required fundraising fee (previously at £250) for our Training alumni. As a friend and advocate of Cardboard Citizens, we would love to see you involved in this event, which we know from last year is going to be a magical and unique experience.

Start time & location: 11pm Saturday 20th June at Cardboard Citizens, 77A Greenfield Road, London, E1 1EJ
End time & location: 7am Sunday 21st June at The Cinema Museum, Kennington, SE11 4TH

For more information and to register click here, or contact Molly on 020 7377 8948 or molly@cardboardcitizens.org.uk

Interest in qualitative approaches is growing among research communities concerned with health, illness and care.  This is clearly indicated by the rise of mixed methods studies, the proliferation of qualitative health research journals and conferences, and the marked presence of qualitative researchers in academic centres of health research.

While this reflects the recognition and endorsement of its contribution, the inclusion of qualitative approaches in health research is not straightforward.  Indeed, tensions remain between the conceptual and methodological approaches of qualitative research and those of a quantitative paradigm generally more familiar to health practitioners, policymakers and often other researchers.  These tensions foreground questions to be explored around the applicability, value, contribution, legitimacy and limitations of qualitative inquiry within the prevailing research culture.

The UCL Division of Psychiatry’s Qualitative Researchers Working Group is collaborating with the UCL Department of Applied Health Research and the UCL Health Behaviour Research Centre on a one day symposium to discuss these questions and to generate constructive commentary on the contributions that qualitative inquiry can make to understandings of health, illness and care.

Papers cohere around three key themes: (1) problematising the research landscape, (2) re-approaching familiar frameworks, and (3) enriching the potential for qualitative approaches in research on health, illness and care.

The symposium will include a keynote paper by Dr Sara Shaw, Queen Mary University of London and a panel discussion featuring Professor Paul Higgs, UCL Division of Psychiatry, Professor Naomi Fulop, UCL Department of Applied Health Research, and Professor Richard Watt, UCL Epidemiology and Public Health.

For more information about the symposium and to register please click here.  For the full symposium programme please click here.