Dr Judith Sleney
Judith Sleney is a Research Fellow and PhD student in the Department of Sociology. She has worked as a researcher for 20 years. She has a particular interest in researching 'difficult to tell' stories. More recently, her work has been located within the sociology of health and illness and more specifically recovery from injury and illness. She is also interested in qualitative research methodologies. Judith completed her BSc Sociology and MSc Social Research Methodology at the University of Surrey and has worked on more than fifteen different research projects at the University since 2001.
Judith is currently working with Professor Hilary Thomas and Elaine McNeilly (University of Hertfordshire) and Dr Sarah Earthy (University of Surrey) on the Economic and Social Research Council (ESRC). http://www.esrc.ac.uk/my-esrc/grants/ES.K006037.1/read funded research project “Getting back to normal?; Patients' perceptions and experiences of recovery”. (http://www.gettingbacktonormal.org.uk/project-background/ . The project runs from 1st May 2013 - 30th April 2015 and involves secondary analysis, using thematic and narrative approaches, of 165 qualitative interviews conducted with patients recovering from heart attack, leukaemia, serious injury or a critical state of health requiring admission to intensive care).
Recent research projects include:
- The Impact of Injuries study, a multi-centre NIHR funded CLAHRC project involving the University of Nottingham (lead), University of Surrey, University of the West of England and Loughborough University. Both qualitative and quantitative methods were used. Researchers recruited 668 participants in total. Each participant completed a baseline questionnaire and SCID (research version of the DSM 4). A questionnaire was completed at 4 further time points over the course of 12 months. 45 of the patients took part in qualitative interviews; 18 carers and 40 service providers were also interviewed. The aims of the project were to explore the psychological, social, economic and functional impacts of unintended injury and experiences of service provision (2009 - 2013).
- Exploring Patient Perceptions of Barriers and Facilitators of Recovery Following Trauma - collaborative research with Monash University, Australia. (Completed 2012).
- UK Burden of Injury (BOI) study - a multi centre study funded by the Department of Health and conducted by the University of Swansea, University of Surrey, University of Nottingham, University of the West of England and the Child Accident Prevention Trust. (2005 - 2008)
- Qualitative evaluation with the Child Accident Prevention Trust of a national programme of work to help improve partnership working amongst local agencies and groups (2009 - 2011)
Judith is also working part time on her PhD. Her research, “Negotiating post injury life: Patients' experiences of recovering from injury”, uses patient interview data from the Impact of Injuries study to explore how patients negotiate their lives after an unintended injury, what recovering means for them and how patients view their body post- injury.
PhD supervisors: Dr Sarah Earthy (Surrey), Dr Nicola Christie (UCL) and Professor Sara Arber (Surrey)
BACKGROUND - It has long been recognised that patients have many concerns during illness (Tuckett et al 1985). Macmillan Cancer Support (2013) has drawn attention to the financial impact of cancer whilst research on injury (Kendrick et al 2012) has shown that self-employed patients may return to work sooner and less successfully than the employed. Notwithstanding these examples, there is comparatively little research examining financial, occupational or relational aspects of recovery. AIMS - This paper explores patients’ concerns about money, work and personal relationships during recovery from serious physical illness or injury. The analysis is drawn from an ESRC funded project (http://www.gettingbacktonormal.org.uk/). METHODS - Secondary analysis was carried out on 165 qualitative interviews collected by the Health Experiences Research Group, University of Oxford, and the UK Burden of Injury Study between 2003 and 2012. The maximum variation samples comprised 44 heart attack patients, 39 leukaemia patients, 37 patients admitted to intensive care and 45 patients hospitalised following unintended injury. Participants were interviewed between one and 23 years after the event. RESULTS - The financial impact of serious illness and injury was significant for most interviewees. Whilst some reported excellent support from employers, many found this to be short-lived and a third changed job, reduced working hours or took early retirement as a consequence of illness. Some younger patients received financial support from parents but older patients were reluctant to ask others for money and awareness of entitlement to benefits varied by health event. Serious illness or injury placed a strain on relationships and patients proactively managed reliance on others. DISCUSSION - The financial, occupational and relational impacts of serious illness and injury are significant and continue throughout recovery. Effects vary by socio-economic background, occupation and life stage. CONCLUSIONS - Patients’ concerns during recovery are rooted in the roles, responsibilities and resources that frame their everyday lives. References Kendrick, D., Vinogradova, Y., Coupland, C., Christie, N., Lyons, R.A., Towner, E.L. and on behalf of the UK Burden of Injuries Study Group (2012) Making a successful return to work: the UK burden of injury multicentre longitudinal study, British Journal of General Practice. vol 62, pp.76-77 Macmillan Cancer Support (2013) Cancer’s hidden price tag; revealing the cost behind the illness, London: Macmillan Cancer Support. Tuckett, D., Boulton, M., Olson, C. and Williams, A. (1985) Meetings Between Experts: An Approach to Sharing Ideas in Medical Consultations, London, Tavistock.
A growing body of literature acknowledges the wide ranging impact of serious injury (Lyons et al 2011, Wiseman et al 2012, Polinder and Haagsma 2010). Early psychological intervention following injury is considered beneficial (O’Donnell 2010). Patients and carers interviewed as part of the Impact of Injuries Study described a physical, emotional and psychological aftermath that included continuing pain, anxiety about symptoms, frustration at physical limitations and enforced dependence, flashbacks, depression and loss of confidence. The period between discharge from hospital and the first out-patient appointment was particularly stressful. This paper compares patient and carer accounts of the support received from primary care with views from GPs and hospital-based professionals on the division of responsibility between primary and secondary care. We undertook a qualitative study, nested within a multicentre longitudinal quantitative study assessing the longer term impact of injuries on physical, psychological, occupational and social functioning in working age adults. A total of 668 adults admitted to acute NHS Trusts following an unintentional injury in four study centres (Nottingham, Bristol, Leicester/Loughborough and Surrey) took part in the quantitative part of the study. The qualitative study involved interviews with 45 patients from the main study, 18 carers and 40 service providers. 25.3% of patients in the main study visited their GP during the first month post injury and this rose to 38.9% at T3 (4 months). Most of the patients interviewed believed that although they could contact their GP with a specific issue, primary care was not generally responsible for their injury care. Many patients interviewed would have welcomed more support during the initial period at home and those who had been contacted by their GP following discharge were very appreciative. A few reported their GP dismissing psychological issues connected to their injury. GPs interviewed were aware of insufficiency of information given to patients on discharge and that patients found the early weeks particularly difficult. There was a perception that primary care had neither the capacity nor specialist orthopaedic knowledge to answer patient concerns regarding speed of recovery or likely prognosis. Hospital doctors and other hospital-based staff were aware of patients’ psychological and emotional needs post-injury but felt ill-equipped to respond. GPs considered themselves well positioned to deal with anxiety, depression and other psychological consequences of injury in a similar way to those resulting from other life events.
There has been comparatively little research about experiences of recovery from heart attack from the patient perspective (Wiles 1998; Hird et al 2004). This paper addresses patients’ experiences following heart attack. It forms part of a larger ESRC-funded project (ES/K006037/1) that compares patients’ experiences of recovery from four types of health event. Patients’ perceptions of their physical body after heart attack may have implications for how they respond to physical exercise and exertion, with consequent relevance for physiotherapy practice. Interviews were conducted with 44 participants. The time elapsed between heart attack and interview date ranged from several months to 23 years. Data were collected by senior researchers at HERG, University of Oxford employing a maximum variation sample. Secondary analysis of the interviews was undertaken by the authors of this paper. Having a heart attack came as a shock to most participants irrespective of their health status. Participants tried to make sense of the reasons why the heart attack occurred in the context of age, fitness and lifestyle. Those who attended cardiac rehabilitation valued the supportive presence of physiotherapists, cardiac nurses and other patients. Conversely, this support reinforced their perception that physical activity might be dangerous. Participants reported that family members and others treated them as more vulnerable.
This paper considers patients' views of their uncertain futures in the under-researched area of recovery from physical illness or injury. The data presented come from the ESRC funded project “Getting Back to Normal?” Patients’ experiences and expectations following major illness or injury (ES/K006037/1) conducted by researchers from the University of Hertfordshire (Hilary Thomas and Elaine McNeilly) and the University of Surrey (Sarah Earthy and Jude Sleney) - http://www.gettingbacktonormal.org.uk/. The project involves secondary analysis of 165 qualitative interviews with patients who have experienced heart attack, leukaemia, a critical state of health requiring admission to intensive care or a serious injury. The presentation will focus primarily on the experiences of adults diagnosed with acute and chronic forms of leukaemia (n=39) but will also draw on insights from across the four datasets. Themes to be discussed include differences and similarities between narratives of acute and chronic forms of leukaemia, strands of experience that might be described as ‘recovery from’ and ‘recovery to’, the impact of perceived causation on envisioning of the future and the reconstruction of a life made different by serious physical illness or injury.
This paper considers the health care work required of ICU patients during critical illness and recovery. The longer term consequences of critical illness and time spent in ICU on patients’ health and wellbeing may be considerable.1 Literature on patients’ experiences is more limited but useful contributions include Rier’s2 first person account of critical illness and emergence from this, and the difficulties experienced by critically ill patients following transfer from ICU to the general ward.3 The concept of work offers an alternative way of understanding the tasks, roles and duties undertaken by ICU patients in hospital and following discharge.4, 5 Secondary thematic analysis of 37 qualitative interview transcripts was carried out using a dataset on intensive care from the archive of the Health Experience Research Group (HERG), University of Oxford, UK. The dataset provides a maximum variation sample of the type of illness or health event preceding admission to ICU and variation in socio-economic factors. Of the 37 interviewees: 22 were men and 15 women; age at interview ranged between 23 and 76 (mean 51.9 years). Participants were admitted to ICU due to illness or injury (n=23), were transferred as planned aftercare following surgery (n=5) or were emergency admissions following surgery (n=9). Participants described the changing tasks and variable agency required of them in the diverse settings of ICU, a general or other ward and following discharge to home. Key areas of work included body work, emotional labour and adaptation to interactional styles in different settings. Work varied in its visibility to staff and others, and in its legitimacy in relation to health care expectations.
Objectives: To explore experiences of patients after injury and identify implications for clinical care and support within the hospital setting and primary care. Design: Semi-structured telephone administered qualitative interviews with purposive sampling and thematic qualitative analysis. Participants: Patients who have experienced an unintentional injury and attended hospital. Setting: Bristol, Surrey and Swansea. Results: Key issues that emerged were: most patients reported mixed experiences of hospital care but some described the delivery of care as depersonalising; the need for clinicians to provide adequate, timely and realistic information to patients about their injury and treatment to inform their expectations of recovery; the impact of pain at the time of the injury and for an extended period afterwards; the experience of injury on patients' emotional state with possible implications for longer term mental health issues; the pivotal role of physiotherapy care in providing practical and individualised strategies for recovery; and the importance of social support for recovery. Conclusions: Trauma patients' recovery needs to be supported by information protocols. The social circumstances of patients need to be considered at the point of discharge and during recovery. There is a need to identify people who may be experiencing mental health issues for timely referral to assessment services and appropriate care. Signposting to support groups may also be helpful for those with life changing injuries. Improved pain management would help alleviate discomfort and stress. Physiotherapy has a key role to play in supporting patients in recovery. © 2013 Elsevier Ltd. All rights reserved.