Graduate Research Projects

Ph.D. Candidate: Adam Umar Chukwu

Project funding source: University College Dublin School of Nursing, Midwifery and Health Systems.

Primary supervisor: Dr Timothy Frawley

Co-supervisor: Prof Fiona Timmins

Project Description:

The last two decades or so has witnessed academic debates on the subject of spirituality and religion in mental healthcare settings. Modern mental healthcare systems are premised on the biomedical model that solely rely on scientific methods to ameliorate symptoms however, research evidence suggest religion and spirituality can result in both negative and positive outcomes for individuals living with a mental illness. 

Sub-Saharan Africa is home to the majority of the worlds most religious societies with countries like Nigeria described as having 97% of her citizens who identify as “religious”. There is increasing use and acceptance of religious and spiritually themed complementary mental health service providers in the region. Consequently this project assumes importance in the design of a more culturally, spiritually and religiously aware mental health service that caters for the needs of the growing Black migrant communities in Europe and elsewhere.

This project will explore the use and preference for spiritual and religiously themed mental health care provision by complimentary providers in low and middle income countries such as Nigeria using semi-structured interviews. A narrative story telling approach will serve to illuminate participant experience.  Study outcomes may assist in addressing potential non-inclusive practices within existing mental health care.

Ph.D. Candidate: Brid McCarthy

Project funding source: Judith Chavasse Scholarship (2022), UCD School of Nursing, Midwifery and Health Systems

Primary supervisor: Professor Fiona Timmins

Co-supervisor: Professor Michael Connolly

External collaborators: Professor Alex Molassiotis

Project Description:

• Aim: To gain an understanding of how family caregivers experience transition as they provide end-of-life care. 
• Background: Family caregivers contribute significantly to the care of those who are in the terminal phase of illness and choose to remain at home.  This role of caregiving as a family member can be wide, varied, and oftentimes very challenging.  During this time, family caregivers respond and react to the changing health status of the person for whom they are caring. Such responses or reactions are known as transitions.  Once a terminal diagnosis is made to death itself, family caregivers experience at least one and usually multiple transitions. Understanding this process should give guidance as to how this vulnerable cohort of caregivers can be supported in the future.
• Methodology: Hermeneutic phenomenological approach using semi structured interviews with approximately ten .family caregivers who are actively providing end-of-life care. 
• Progress to Date: A concept analysis has been undertaken and published on the research topic.  A scoping review has also been carried out to chart the research activity on the topic.  This has been submitted to a peer reviewed journal for publication.  Ethics approval has been obtained to carry out this research and data collection is expected to commence in January 2023.

Project Outputs (to date):

McCarthy B., Timmins F. and Connaire K. (2021) Transitions during end-of-life care from the perspective of informal caregivers - A concept analysis using Rodgers' (2000) evolutionary approach. European Journal of Oncology Nursing. Apr;51:101899. doi: 10.1016/j.ejon.2021.101899. Epub 2021 Jan 20. PMID: 33545654.

Ph.D. Candidate: Yuan Chu

Project funding source: UCD-CSC scholarship scheme

Primary supervisor: Professor Fiona Timmins 

Co-supervisor: Professor David R Thompson

Project Description:

A growing number of intensive care unit (ICU) patients successfully survive an ICU stay, and many of these patients encounter physical, psychological, cognitive, and/or social impairments surrounding their survival into years later. It is believed that these impairments across the four domains characteristically emerge in combination, which is why a syndrome classification might be more appropriate and be advised (Needham et al., 2012). Consequently, post-intensive care syndrome (PICS) is used to describe these impairments that may arise after critical illnesses and persist months and years after being discharged from ICU. Previous research has documented ICU survivors presented persistent PICS in different domains, with a prevalence of more than 60% from two months to nine years post-hospital discharge (Hanifa et al., 2018, Kang & Jeong, 2018, Marra et al., 2018, Heydon et al., 2020). However, research on PICS in China is in its infancy, and its prevalence among ICU adults remains under-recognized. Considering the ever-growing cohort of ICU survivors in China, measuring prevalence and associated risk factors is crucially meaningful, which leads to proper health service planning and predicts the potential health burden on the social care system.

Project Outputs (to date):

Shortlisted for two Irish HealthCare Awards under the category of Student Project of the Year & Research Paper of the Year.

Ph.D. Candidate: Anne Dempsey

Project funding source: University College Dublin

Primary supervisor: Dr. Carmel Davies

Co-supervisor: Dr. Deirdre O’Donnell

Project Description:

How do nursing students perceive the connection between their clinical practice placement education and training and their commitment to the nursing profession?

The aim of this research is to explore the connection between practice placement education, training, and the commitment of nursing students to the nursing profession. Registered nurse (RN) retention is an international concern in healthcare (Collard et al., 2020). Nursing shortages (Tuckwood, 2022), nursing student retention, and success (graduation and registration) are a priority (Everett, 2020 and Jeffreys, 2007). Collard et al., (2020) highlight that newly qualified nurse’s leave the profession at a higher rate than any other year of experience. Undergraduate pre-registration nurse education and clinical placement influences retention following qualification albeit the factors leading to this are unclear (Collard et al., 2020). There is a need to better understand effective nursing student retention approaches (Bumby, 2020). It is evident that there is a relative under-exploration of nursing students’ commitment to the nursing profession and this study aims to explore this.

Ph.D. Candidate: Qiaohong Ke

Project funding source: UCD-CSC Scholarship Scheme

Primary supervisor: Professor Fiona Timmins

Co-supervisor: Associate Professor Eileen Furlong

External collaborators: Professor Alexandros Molasiotis

Project Description:

• Background: Breast cancer is the most commonly diagnosed cancer among women worldwide. Women receiving surgery for breast cancer may experience a wide range of care needs, some of which remain unmet for various reasons. To provide better support for women with breast cancer, their experience of unmet care needs should be understood. However, limited evidence is available on the experience of unmet care needs among women receiving surgery for breast cancer in China. 

• Objectives: To identify the scope of unmet care needs among women receiving surgery for breast cancer, and to explore the expressions and experiences of unmet care needs among women receiving surgery for breast cancer in mainland China.

• Design: A multi-site, two-phase sequential mixed-methods study. The quantitative study will collect data via an online platform “Questionnaire Star”. The Chinese version of the short-form Supportive Care Needs Survey and the Functional Assessment of Cancer Therapy Breast Cancer (FACT-B) will be used to assess women’s unmet care needs and quality of life after surgery. Semi-structured interviews will be conducted based on purpose sampling to explore women’s unmet care needs in detail. 

• Setting: This project will collect data from the breast cancer department in three different hospitals in mainland China. Inclusion criteria are 1) women with a breast cancer diagnosis, 2) receiving a mastectomy or breast-conserving surgery, 3) older than 18 years, and 4) indicating their willingness to participate in this study. 

• Potential impact: This study will add knowledge to the scope of unmet care needs among women receiving surgery for breast cancer. In addition, this study will gain new insights into women’s expressions and experiences of unmet care needs after breast cancer surgery. Furthermore, this study will help healthcare workers better understand what kind of needs that women with breast cancer are most required. And finally, contribute to developing appropriate interventions to address the unmet care needs among women with breast cancer. 

Project Outputs (to date): 

1. Unmet care needs among women receiving surgery for breast cancer: A scoping review. (include a protocol).
2. Unmet care needs among women receiving surgery for breast cancer in China: a mixed-methods study.

Ph.D. Candidate: Breda Moloney

Project funding source: Health Research Board [EIA-2017-039; Emerging Investigator Awards (EIA) 2017] to Dr Attracta Lafferty -  Principal Investigator for the CAREWELL Project to ‘Develop a workplace-based programme to promote health and self-care behaviours among working family carers’.

Primary supervisor: Dr. Attracta Lafferty

Co-supervisor(s): Professor Thilo Kroll, Dr. Doreen Mucheru

External collaborators: Family Carers Ireland

Project Description: 

The term ‘young carer’ is a term often used to describe work which involves a young person helping to look after a relative with a condition such as illness, disability, autism requiring substantial support, frailty, a mental health issue or addiction. It can involve the young person having a greater level of responsibility in the family that is normally expected of their age. This can include caring for other (healthy) members of the family when the parent/guardian is unable due to the impact of their dependent condition.

The care at home can include a range of activities and supports i.e. daily cooking, shopping, housework, intimate care provision (bathing, dressing, assistance with toileting), psychological and social support. Young people can be involved in all these activities or some more than others and for considerable lengths of time.

Compared with their peers, young carers are at a higher risk of being ‘NEET’ – not in education, employment or training due to the demands of caring (Chevrier et al, 2022). There is a lack of in-depth exploration into why these vulnerable young adults may end up in this position.

The aim is to explore what the experience is like for young people involved in a caring role and how they manage this whilst attending secondary school. This research also aims to reveal young carers’ perceptions regarding their future career and whether the young carer role has/had any impact on those perceptions.

Project Outputs (to date):

Moloney, B., Kroll, T., and Lafferty, A., (2020) ‘An exploration of young carers’ experiences in school and their perceptions regarding their future career - a scoping review protocol’, [version 3; peer review: 3 approved], Health Research Board Open Research, 3 (41), 1-10. Available at: (https://doi.org/10.12688/hrbopenres.13074.3)

Ph.D. Candidate: Shideh Kiafar

Project funding source: School of Nursing, Midwifery and Health Systems

Primary supervisor: Dr. Denise O’Brien

Co-supervisor: Dr. Susan Knowles

External collaborators: Prof Fionnuala McAuliffe

Project Description:

During childbirth, women may have changes in their vital signs, including temperature which might be due to a multitude of factors including infection. Research provides evidence that pyrexia occurring after labour onset is predominantly of non-infectious origin. However, it is difficult to determine the precise cause of peripartum pyrexia in real-time. As a result, these women have a septic workup and commence on empiric intravenous antibiotic therapy irrespective of aetiology. Antibiotic therapy continues until the results of the septic workup eliminate infection. Excessive use of antimicrobials contributes to the rapid increase of multi-drug resistant organisms which means that we could be close to reaching a point where we may not be able to treat everyday infections. 

If maternity care professionals could more quickly assess clinically which women are at highest risk for infection and limit medical interventions to those patients who are at high risk for infection, the length of hospital stay, antibiotic use and cost will reduce for many patients. Fewer patients may experience adverse effects associated with antibiotic use such as allergic reactions, gastrointestinal disturbances and clostridium difficile infection. The aim of this research is to evaluate the optimal risk stratification using different combinations of risk factors to develop a ‘Pyrexia in Labour Infection Calculator’.

This is a quantitative prospective observational cohort study. Analysis will be carried out using SPSS statistics software for multiple logistic regression analysis with a minimum of 546 participants. Information will be obtained on potential risk factors including age, parity, duration of labour, induction (method and duration), epidural analgesia and its duration, duration of labour, duration of prelabour rupture of membranes, maternal laboratory findings for exploratory factors (IL6, Procalcitonin, CRP and Supar). Three combinations of calculators will be formed and tested to evaluate their predictive accuracy in the diagnosis of infectious and non-infectious pyrexia.

Ph.D. Candidate: Sara Dada

Project funding source: Ad Astra PhD Studentship

Primary supervisor: Dr. Brynne Gilmore

Co-supervisor: Dr. Aoife De Brún

External collaborators: Professor Bellington Vwalika (University of Zambia)

Project Description:

Community engagement (CE) has become an increasingly important component in the implementation of global health and health systems interventions and programmes, including for maternal and newborn health (MNH). A range of different activities have been implemented and associated with CE to varying degrees. Low and middle-income countries (LMICs) have become a setting of particular focus for these MNH CE activities largely due to the fact that this is where the majority of global maternal and neonatal deaths occur. Despite the agreement on the value add of CE for MNH, the evidence and literature relating to how to incorporate effective CE across settings is limited. In particular, the communication component of CE is often not described in detail. Since CE and its communications components are a complex process and there is no ‘one-size-fits-all’ approach, programmes and experiences vary across settings. The range of communications used in CE activities for MNH and therefore what makes them “work” is likely to vary greatly. The aim of this PhD is to inform future CE approaches by elucidating patterns of generative causation on how, why, to what extent, and for whom communications in CE for MNH programming in LMICs work. This will be done by using realist methodologies to develop and refine programme theories on communications for CE in MNH through reviewing the literature, engage an expert advisory committee for input and feedback, and test theories in a case study focusing on increasing antenatal care (ANC) care-seeking and support for ANC care-seeking behaviour in Zambia.

Project Outputs (to date):

Dada, S.*, Tuncalp, O., Portela, A., et al. (2021). (opens in a new window)Community mobilization to strengthen community support for appropriate and timely use of antenatal and postnatal care: A review of reviews. Journal of Global Health, 11:04076.

Dada, S.*, De Brún, A., Banda, E. et al. (2022). (opens in a new window)A Realist Review Protocol on Communications for Community Engagement in Maternal and Newborn Health Programs in Low- and Middle-Income Countries. BMC Systematic Reviews, 11:201.

Ph.D. Candidate: Tope Omisore

Project funding source: UCD School of Nursing, Midwifery and Health Systems. 

Primary supervisor: Dr Timmy Frawley 

Co-supervisor: Dr Séan Paul Teeling 

Project Description:

The prevalence of depression among older adults in Nursing homes is very high globally, higher than the prevalence among community-dwelling older adults. Concurrently, there is an expected increase in the number of older adults who may require long-term care in nursing homes, partly due to the aging population. Therefore, there is a need to develop strategies and policies that can lower this high prevalence. 

Person-centred cultures are recommended for the delivery of person-centred in the care of older adults in Nursing homes, but research has indicated mixed outcomes in relation to how person-centred cultures are understood and person-centred care is applied in nursing home settings. This research study, therefore, intends to evaluate the contributions of person-centred cultures to the aetiology and management of depression in nursing home settings using a critical realist approach.

Ph.D. Candidate: Hou Yongchao (Christine)

Project funding source: UCD China Scholarship Scheme (China Scholarship Council [CSC]) from simply China Scholarship Council, Grant/Award Number: CSCNO.202008140086

Primary supervisor: Professor Fiona Timmins 

Co-supervisor: Professor Melissa Corbally

Project Description: 

Violence against nurses by patients and visitors in the emergency department (ED) is on the increase globally. Many associations call for zero-tolerance policies on violence in the healthcare setting, however, this ambitious goal on its own is not enough. Because of increased violence from patients and visitors, ED nurses have to accept violence as a part of their job. Sadly, it will affect ED nurses’ professional commitment to caring for patients. Therefore, effective prevention tactics for violence needed to be developed based on a greater understanding of this phenomenon.

Depending on the hospital policies, health systems in the surrounding community, and societal and cultural factors, the nature and contributing factors of violence against ED nurses from patients and visitors will vary. In China, due to inadequate primary and secondary health resources, people rush to high-level hospitals to see specialists with unrealistic expectations even for minor, self-limiting illnesses. EDs as the first entrance to these tertiary hospitals are often congested. Moreover, basic health insurance in China does not cover the expenditure for emergency services unless the ED patients transfer to the inpatient ward. The patient who should be discharged from the ED has to wait until a bed in the hospital ward become available to be reimbursed, causing frustration for patients and visitors, as well as exacerbating a shortage of resources and congestion in the ED. Further, a characteristic violence "YiNao" in China refers to healthcare disturbances to enforce hospital costs or obtain compensation. 

There are numerous studies investigating the prevalence of violence in EDs in China. However, more studies relate violence against all ED staff or include other types of violence against nurses from colleagues, rather than specifically focusing on violence against ED nurses by patients or visitors. In addition, it is necessary to fill the gap that violence against nurses in the ED remains under-researched in the central provinces due to the regional differences in medical and health resources and policies in China. Therefore, this project is to explore the nature, contributing factors, and consequences of violence against nurses by patients and visitors in the emergency department of the Shanxi provincial capital city in northern China.

Project Outputs (to date):

Hou, Y., Corbally, M., & Timmins, F. (2022). Violence against nurses by patients and visitors in the emergency department: A concept analysis. Journal of Nursing Management, 30( 6), 1688– 1699. (opens in a new window)https://doi.org/10.1111/jonm.13721

Ph.D. Candidate: Yvonne McCague

Project funding source: UCD SNMHS Ph.D. Scholarship

Primary supervisor: Dr. Eileen Furlong

Co-supervisor: Dr. Suja Somanadhan

External collaborators: (Doctoral Studies Panel) Dr. Mary Ryder (Chair), Dr. Rita Smith, Professor Shannon Scott, Dr. Ikechuckwu Okafor

Project Description:

Functional constipation (FC) is a significant health problem in childhood (Walter et al, 2019); however, its prevalence in Ireland remains undetermined. Constipation is defined as FC if there is no underlying organic cause, and it can be seen in healthy children one year and older (Tabbers et al, 2014). This condition negatively affects health-related quality of life of the child and their family, and also incurs considerable healthcare costs.

Studies have demonstrated a high prevalence of children presenting to the ED globally with functional constipation. In Canada, Nutter et al (2017) found that 2.1% of all paediatric patients who presented to a paediatric ED were diagnosed with constipation with 3.4% presenting multiple times. In Pennsylvania, Caperell et al’s (2013) study found that 20% of children who attended ED with abdominal pain were diagnosed with constipation. This is supported by Magnusdottir et al’s (2019) study in Iceland, which found that abdominal pain represented 12% of all presentations to a paediatric ED, where the most common cause was constipation (22%). Choung et al’s (2011) study in Minnesota also demonstrated that children suffering from constipation were three times more likely to present to an Emergency Department than children who do not have constipation.

Despite being a prevalent childhood condition, FC is often under-recognised and undertreated, and often without adequate treatment, most children develop chronic FC with symptoms continuing through their adult years (Borowitz et al, 2005). There is evidence reporting the impact of FC on children and families’ psychological, emotional, social consequences and health-related quality of life. 

This study will address the research question, “What are the most effective strategies to improve paediatric patient care pathways and communication across paediatric emergency settings and the community for children with FC?”

Ph.D. Candidate: Michael Hevey

Project funding source: UCD SNMHS Ph.D. Scholarship

Primary supervisor: Associate Professor Mary Ryder

Co-supervisor: Dr Eileen Sweeney, Consultant Psychiatrist, St. James’s Hospital/ Dublin South Central Mental Health Service

External collaborators: Dr Clíona Ní Cheallaigh, Associate Professor Consultant, St. James’s Hospital

Project Description:

Inclusion health is a term used to identify people who have traditionally been socially excluded from mainstream healthcare and have experienced factors that have contributed to poor health, such as poverty, violence, and complex trauma (Luchenski et al., 2018). Most often, those excluded are homeless people, individuals with drug and alcohol addiction, members of Traveller, Roma and Gypsy communities, sex workers, migrant populations, people who have been trafficked for slavery, people who have had contact with the criminal justice system, and members of the LGBTQ+ community.

The need to develop specialist inclusion health services that primarily focus on healthcare provision for these population groups has been identified (Ní Cheallaigh et al., 2017; Luchenski et al., 2018). A recent Irish study showed that in one year, close to 3000 homeless people attended an Emergency Department (Ní Cheallaigh et al., 2017).  A sample attendance from the same Emergency Department showed that a quarter of all attendances required a psychiatric consultation (McLoughlin et al., 2021).

Inclusion psychiatry is an emerging health service that focuses on providing care to the homeless population with complex social needs exacerbated by mental health illness. A new inclusion psychiatry team for the south city has been established.  The team is led by a consultant psychiatrist and supported by a Registered Advanced Nurse Practitioner (RANP), a social worker and an administrative assistant. This RANP post is the first of its kind in inclusion psychiatry in Ireland. As this RANP role is being established and the inclusion psychiatry services is developing ongoing evaluation is required, to ensure that the service is meeting client needs by being person-centred and recovery-focused.  The aim of this research is to evaluate the RANP role in an Inclusion Psychiatry Service using critical realism.

Proposed title: Co-designing a resource to increase awareness of cervical screening among women of low socio-economic position in urban areas in Ireland

Ph.D. Candidate: Sophie Mulcahy Symmons

Project funding source: Irish Cancer Society (ref: CRS21SYM)

Primary supervisor: Dr. Aoife De Brún

Co-supervisor: Dr Amanda Drury (DCU)

Project Description:

In Ireland, approximately 292 women and people with a cervix are diagnosed with cervical cancer each year (National Cancer Registry Ireland, 2022). Incidence of cervical cancer is not evenly distributed across the population and women in areas of high deprivation and urban areas have higher incidence of cervical cancer (National Cancer Registry Ireland, 2016). Cancer screening plays a key role in early identification of cancer, reducing morbidity and mortality (Raffle et al., 2019). In Ireland, people with a cervix aged 25-65 are eligible for screening. The 2015-20 five-year average uptake of cervical screening in Ireland is relatively high at 78.7% but varies by demographics (National Screening Service, 2022). Understanding the distribution of participation and awareness of cervical screening in Ireland would enhance targeted supports for women and people with a cervix to make informed decisions about participating in cervical screening. Co-design in healthcare research involves meaningful engagement and equal partnerships with individuals who have lived experience of a system or service to work together to redesign that service (Williams and Caley, 2020, Trischler et al., 2018). Co-design harnesses stakeholders’ knowledge to achieve improved outcomes that are more sustainable and result in higher quality research as this participatory approach allows the patient voice to be heard (Jagosh et al., 2012).

This research will employ co-design methods to promote awareness of cervical screening among populations with lower rates of participation. After literature review and interviews with stakeholders (objectives 1 and 2) to determine what populations in Ireland have lower participation in cervical screening, the target population is women with no higher than secondary level education who are not working or in low waged employment (i.e. low socio-economic position) and live in urban areas.

The objectives are:

1. Identify demographic groups who have higher incidence of cervical cancer and lower participation with cervical screening in Ireland. (Complete)
2. Explore expert stakeholder views on the accessibility and attendance of cervical screening in Ireland. (Complete)
3. Explore perceptions of cervical screening among people of low socio-economic position in urban areas to identify their barriers and facilitators to attendance and information needs.
4. Co-design a resource with people of low socio-economic position to improve knowledge of cervical screening in their community.
5. Assess the perceptions of the co-designed resource in the community.

Project Outputs (to date):

Publications

• Mulcahy Symmons, S., Heavey, L., Mason Mohan, C., Drury, A., & De Brun, A. “How is equity captured for colorectal, breast and cervical cancer incidence and screening in the Republic of Ireland: A review”. 2023. Preventive Medicine Reports.  (opens in a new window)https://doi.org/10.1016/j.pmedr.2023.102405

Oral presentations

• Mulcahy Symmons, S., Drury, A., & De Brun, A. “Stakeholder views on identifying who is less engaged with cervical cancer screening in Ireland.” Cancer Screening Networking Event, University of Galway. Feb 2023 [oral presentation]
• Mulcahy Symmons, S., Drury, A., & De Brun, A. “Promoting health among disadvantaged and underserved groups”. European Oncology Nursing Society Conference, Madrid, Spain. Oct 2023 [oral presentation]

Poster presentations

• Mulcahy Symmons, S., Heavey, L., Mason Mohan, C., Drury, A., & De Brun, A. “How is equity captured for colorectal, breast and cervical cancer incidence and screening in the Republic of Ireland: A review”. Irish Association for Cancer Research Conference. Feb 2023. [poster presentation]
• Mulcahy Symmons, S., Heavey, L., Mason Mohan, C., Drury, A., & De Brun, A. “How is equity captured for colorectal, breast and cervical cancer incidence and screening in the Republic of Ireland: A review”. CHAS Graduate Research Symposium, University College Dublin. May 2023. [poster presentation]
• Mulcahy Symmons, S., Heavey, L., Mason Mohan, C., Drury, A., & De Brun, A. “Understanding who does or does not attend cervical screening in Ireland”. International Cancer Screening Network Conference, Turin, Italy. Jun 2023 [poster presentation]
• Mulcahy Symmons, S., Drury, A., & De Brun, A. “What makes cervical screening accessible and to whom in Ireland: a stakeholder interview study”. European Oncology Nursing Society Conference, Madrid, Spain. Oct 2023 [poster presentation]

Awards

• SPHeRE Shani Rushin award for academic excellence 2022
• IACR Best Survivorship poster 2023

Ph.D. Candidate: Maxine Radcliffe

Project funding source: HSE sponsorship

Supervisors: Associate Professor Kate Frazer and Professor Thilo Kroll

Project Description:

Aim: To gain an understanding of women’s experiences of homelessness

The common statutory approach of recognising homelessness as ‘rooflessness’ lends itself to gender bias as men are identified as the primary ‘sample’ requiring a policy response (Maycock 2015). Women experiencing homelessness have an increased likelihood of experiencing both physical and mental health issues, engaging in substance misuse voluntarily or otherwise and exposure to violence and abuse from others repeatedly ‘cycling in and out ‘of homelessness throughout their life course. (Bretherton and Pleace 2018, Maycock 2015, Williams 2016). Furthermore, these experiences are identified as key drivers in women remaining homeless and their voices are poorly captured in the literature.  This study seeks to understand women’s experiences throughout their life course.

Progress to Date: A systematic review is ongoing.

Project Outputs (to date):

Maxine Radcliffe, Anne Cronin, Thilo Kroll, Diarmuid Stokes, Kate Frazer, Matthew Douma. A systematic review examining women’s experiences of homelessness in high income countries. PROSPERO 2022 CRD42022359937 Available from: (opens in a new window)https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022359937

Ph.D. Candidate: Matthew J Douma

Project funding source: Alberta Registered Nurse Education Trust $16000; Canadian Association of Critical Care Nurses $5000, Edmonton Emergency Physicians Association $5000

Supervisors: Professor Thilo Kroll and Associate Professor Kate Frazer

Project Description:

Aim: This project aims to answer the question, “What are the care needs of families experiencing cardiac arrest, and how can those care needs best be met?”

Methods: Using a pragmatic approach, and co-design methods, this study was undertaken in partnership with persons with lived experience as collaborators and co-researchers.

Study outputs include a scoping review, meta-synthesis, an interview study, qualitative document analysis, clinical practice recommendations, and a treatment algorithm. The impact of this research includes updating international life support and resuscitation guidelines with family-centred care practices, invited presentations at meetings and conferences, and establishing an online and physical survivor and family care program at a major Canadian teaching hospital.

Project Outputs (to date):

Loch, T., Drennan, I.R., Buick, J.E. et al. Caring for the invisible and forgotten: a qualitative document analysis and experience-based co-design project to improve the care of families experiencing out-of-hospital cardiac arrest. Can J Emerg Med 25, 233–243 (2023). (opens in a new window)https://doi.org/10.1007/s43678-023-00464-8

Douma, M., Frazer, K., & Kroll, T. (2022). A scoping review, systematic review and meta-synthesis–performed in partnership with persons who have lived experience of cardiac arrest care. INTERNATIONAL COLLABORATION for COMMUNITY HEALTH NURSING RESEARCH in cooperation with Linnaeus University.

Douma, M. J., Graham, T. A., Ali, S., Dainty, K. N., Bone, A., Smith, K. E., ... & Frazer, K. (2021). What are the care needs of families experiencing cardiac arrest?: A survivor and family led scoping review. Resuscitation, 168, 119-141.

Douma, M. J., Graham, T. A. D., Bone, A., Ali, S., Dennett, L., Brindley, P. G., Kroll, T., & Frazer, K. (2021). What are the Care Needs of Families Experiencing Cardiac Arrest Care? A Survivor and Family-Performed Systematic Review and Qualitative Meta-Synthesis Protocol. International Journal of Qualitative Methods, 20. (opens in a new window)https://doi.org/10.1177/16094069211048600

Douma, M. J., Ali, S., Bone, A., Dainty, K. N., Dennett, L., Smith, K. E., ... & Canada, G. (2021). The needs of families during cardiac arrest care: a survivor-and family-led scoping review protocol. Journal of Emergency Nursing, 47(5), 778-788.

Ph.D. Candidate: Saydeh Dableh

Project funding source: Self-funding international student

Supervisors Professor: Thilo Kroll & Associate Professor Kate Frazer

Project Description:

Ensuring access for older people to Primary Health Care (PHC) is vital to achieve universal health coverage and improve health outcomes and health-system performance. However, older people living in Low- and Middle-Income Countries (LMICs) face barriers constraining their timely access to appropriate care. Lebanon is a middle-income country facing a critical financial crisis, with less than 20% of the Lebanese population seeking care from the primary health care centres (PHCCs) and the public sector. With the economic crisis, the capacity of older people and their families to seek care from the private sector will shrink, leading to more fragmented care, high health expenditure and increased morbidity and mortality rates, especially among older people who present health and financial vulnerabilities. A contextual exploration of the topic is needed now more than ever to meet a potentially growing reliance on the public sector that should be strengthened to deliver adapted care, especially for older people.

Aim

To explore the experiences of Lebanese older people accessing primary health care and identify barriers and enablers to accessing the PHCCs. Co-designing with older people, their family members, and PHC providers solutions to maximise older people's access to services delivered by PHCCs.

Progress to date:

Completion of a scoping review summarising the available literature on older people's access to PHC in LMICs [under review].

Project outcomes (to date):

Dableh S, Frazer K, Kroll T., (2021) 'Access of older people to primary healthcare services in low- and middle-income countries: a systematic scoping review protocol' HRB Open Research, 4(57). Available at: https://hrbopenresearch.org/articles/4-57/v1.

PhD Candidate Name: Rachel Howe

Project Funding Source: None currently

Primary Supervisor: Thilo Kroll

 Co-supervisor: N/A

Project Description:

The overall aim of my PhD research is to explore the barriers and enablers of implementing animal assisted interventions (AAI); more commonly known as pet therapy; for children and young people who have had spinal surgery for scoliosis, a curvature of their spine.

My scoping review demonstrated many benefits of pet therapy in other specialities, such as patients recovering from heart transplant surgery, mental health conditions and elderly care settings, but none specifically in my area of interest. Benefits of pet therapy include improved mood, lowered blood pressure, heart and respiratory rates. Exposure to the animal, more commonly a dog, for just a few minutes can promote calmness and wellbeing. The therapy dog has been found to ease anxiety, distract from pain and motivate people to get-up and get out of bed to exercise.

Young people diagnosed with scoliosis face many challenges. The journey to recovery from spinal surgery can be long, typically 9-12 months and therefore AAI may be a worthwhile initiative to support the child’s recovery journey.

Currently, I am recruiting young people aged 12-16 years, who have had surgery for scoliosis, to come to a co-design workshop to explore and design an AAI prototype for eventual pilot on a Children’s Ward. I am delighted to be at this exciting data collection phase of my PhD and I look forward to share results with you all.

Project Publications:

Howe R, Nicholson S, Lafferty A et al. (2021) Animal assisted interventions in the children's hospital: protocol for a scoping review [version 2; peer review: 2 approved]. HRB Open Res 2021, 3:74 Available at: (opens in a new window)https://doi.org/10.12688/hrbopenres.13143.2

Howell, T.J.; Nieforth, L.; Thomas-Pino, C., Howe, R. et al. (2022) Defining Terms Used for Animals Working in Support Roles for People with Support Needs. Animals 2022, 12, 1975. Available at: (opens in a new window)https://doi.org/10.3390/ ani12151975

Howe, R. (2023) ‘Pet therapy for scoliosis surgery patients’ blog available at: (opens in a new window)https://mcgowanphysio.com/pet-therapy-for-scoliosis-surgical-patients/

Atkinson, T., Howe, R. (2022) ‘Pet Therapy Research in Ireland’ Podcast: Available at: (opens in a new window)https://open.spotify.com/episode/7cifODWz8jiYHINcfKwkC8?si=wmKF-C-WQPig0K9_sOkEbg

Howe, R. (2021) ‘Blog ‘Pawsitive’ influence - Do animals boost morale and help children recover in hospital?’ Available at: (opens in a new window)https://blog.hrbopenresearch.org/2021/07/27/do-animals-boost-morale-and-help-children-recover-in-hospital/

Ph.D. Candidate Name: Ms. Yewande Ogunnaike

Project Funding Source: Sr. Antoinette Kelleher scholarship 

Primary Supervisor: Associate Professor Dr. Suja Somanadhan 

Co-supervisor: Professor Abbey Hyde

Project Description:

Background and Problem

Ireland has become an increasingly diverse nation, and home to many nationalities and dialects (MacFarlaneet al.,2020). Immigration into Ireland has encouraged an increase in multilingualism in Ireland today (Modrescu and Carson, 2017).Some migrants may speak little to none of their migrating countries’ native language.Limited English Proficiency (LEP) presents a challenge for immigrant children and families accessing healthcare in Ireland. Hence, Healthcare professionals (HCPs) are actively seeking ways to address this challenge and facilitate effective communication with these families.Presently, the use of medical interpreters is commonly implemented in paediatric healthcare settings, however little to no research exists on their efficacy or the experiences of its end-users, the healthcare professionals.

Aim

The objective of this thesis is to explore paediatric healthcare professionals’ experiences and their motivations for the use of medical interpreters in their practice.

Methods

Using an established scoping review framework, phase one of this thesis divulges a scoping review of current research on this topic on a global scale (Peters et al., 2020).

With phase two, a quantitative post-positivist lens permitted exploration of paediatric HCP’s experiences in Ireland through a web-based questionnaire. Permission was obtained for use of theCommunication over Language Barriers questionnaire (CoLB-q), which was modified to suit the Irish context.Limited English Proficiency (LEP) presents a challenge for immigrant children and families accessing healthcare in Ireland. Hence, Healthcare professionals (HCPs) are actively seeking ways to address this challenge and facilitate effective communication with these families.Presently, the use of medical interpreters is commonly implemented in paediatric healthcare settings, however little to no research exists on their efficacy or the experiences of its end-users, the healthcare professionals.

Publications (to date):

Prevalent practices amongst healthcare professionals in paediatric settings in using medical interpreters for families with limited national language proficiency: A narrative scoping review https://www.sciencedirect.com/science/article/pii/S2666142X22000480

PhD scholar name: Olalekan Agunbiade

Project funding source: UCD School of Nursing, Midwifery and Health Systems Scholarship

Primary supervisor: Prof. Martin McNamara

Co-supervisor: Dr. Wayne Thompson

Project Description:

Given the emphasis on adopting a collaborative, multidisciplinary approach to clinical practice in healthcare (Rogers et al., 2020; Anjara et al., 2021), it is timely and essential to analyse power relationships and dynamics in health systems and how nurses among other healthcare professionals make sense of and experience them. The term power relates to perceptions and meanings determined by values, beliefs, culture, individuals’ experiences and especially the context in which the term is used (Seenandan-Sookdeo, 2012). Health systems globally often operate within a hierarchical model in which power is exerted by those at the top of the pile - superordinates, on the individuals and professionals at the base - subordinates (Griscti et al., 2017; Rogers et al., 2020; Morrow, Gustavson and Jones, 2016). While structures and hierarchies come with organisational benefits, the model, among other concerns, has been described as fostering oppression (Maner and Mead, 2010; Morrow et al., 2016).

This study describes and analyses how power relations in nurses’ practice contexts enable or constrain their capacity to practice to the full extent of their education, training, and experience (Cohen Konrad et al., 2019). The hermeneutic phenomenological approach will be employed to conduct a conceptual and empirical inquiry into how nurses in Irish acute hospitals construe and experience power in health systems. It is anticipated that this inquiry will make power relations and dynamics in health systems more explicit and enable an exploration of their impacts on nursing practice. The improved understanding of health systems’ power dynamics will help to identify strategies to strengthen enabling power conditions and address disabling conditions so that nurses can better realise their potential to contribute to collaborative care and treatment to improve patient and health system outcomes (McNamara and Teeling, 2021). Being the most populous and ever-present members of the healthcare teams, enabling nurses to optimise their contribution should be a priority pursuit for every health system. 

Ph.D. Candidate Name: Yuan Chu

Project Funding Source: UCD-CSC Scholarship Scheme, Grant No. 202108300015

Primary Supervisor: Prof Fiona Timmins

Co-supervisor: Prof David R Thompson (Queen’s University Belfast)

Project Description:

A growing number of intensive care unit (ICU) patients successfully survive an ICU stay, and many of these patients encounter physical, psychological, cognitive, and/or social impairments surrounding their survival years later. These impairments across the four domains are believed to characteristically emerge in combination, so a syndrome classification was advised (Needham et al., 2012). Post-intensive care syndrome (PICS) is thus used to describe these impairments that may arise after critical illnesses and persist months and years after being discharged from the ICU. Previous research has documented that ICU survivors presented persistent PICS in different domains, with a prevalence of more than 60% from two months to nine years post-hospital discharge (Marra et al., 2018; Heydon et al., 2020). However, research on PICS in many countries is in its infancy, and its prevalence among ICU adults remains under-recognized, so is in China. Considering the ever-growing cohort of ICU survivors in China, measuring prevalence and associated risk factors is crucially meaningful, which leads to proper health service planning and predicts the potential health burden on the social care system.

The project objectives are to 1) examine the prevalence of PICS in the context of China and 2) identify the associated risk factors contributing to the development of PICS.

Project Publications (to date):  

Yuan C, Timmins F, Thompson DR. Post-intensive care syndrome: A concept analysis. Int J Nurs Stud. 2021 Feb;114:103814. (opens in a new window)http://doi:10.1016/j.ijnurstu.2020.103814.

Yuan, C., Timmins, F. and Thompson, D.R. (2022), Post-intensive care syndrome: Time for a robust outcome measure?. Nursing in Critical Care, 27: 8-9. (opens in a new window)https://doi.org/10.1111/nicc.12700.

Chu Y, Timmins F, Thompson D, Eustace-Cook, J. Instruments to measure postintensive care syndrome: a scoping review protocol. BMJ Open 2022;12: e061048. (opens in a new window)https://doi:10.1136/bmjopen-2022-061048.

Chu, Y, Thompson, DR, Eustace-Cook, J, Timmins, F. Instruments to measure post-intensive care syndrome: A scoping review. Nursing in Critical Care. 2023; 28(4): 484-498. (opens in a new window)https://doi:10.1111/nicc.12885.

Ph.D. Candidate Name: Niamh Buckle

Project Funding Source: UCD SNMHS PhD Scholarship (Full-Time)

Primary Supervisor: Dr Suja Somanadhan (SNMHS)

Co-supervisor: Dr Orla Doyle (UCD School of Economics); Dr Naonori Kodate (School of Social Policy, Social Work and Social Justice)

External Collaborators: Prof AJ McKnight (Queen’s University Belfast); Dr. Emma Nicholson (Dublin City University).

Project Description:

Rare diseases are a group of conditions that are all unique in nature but can be grouped together due to their low incidence rates. These diseases affect a significant percentage of the global population, are often complex and place significant burden on individuals, their families, communities, health systems and society overall, an impact reflected in the increasing recognition of rare diseases as a health priority across contexts.

A high burden of illness, long diagnostic odyssey, lack of treatment options, lack of reliable epidemiological data, poor screening strategies, marginalisation and lack of consideration in health systems and health and social care policies are some of the challenges individuals with rare diseases and their families and carers can face (Chung et al., 2022; Valdez, Ouyang and Bolen, 2016; Groft and de la Paz, 2017). Psychosocial and economic impacts of living with a rare disease can also affect patients, family members and caregivers by negatively impacting their quality of life and their financial situation.

This doctoral project will explore the socio-economic impacts of rare diseases for children and their families using an all-Ireland perspective. It will aim to improve outcomes amongst the rare disease community and expand traditional research on rare disease, which focuses on diagnosis and treatment and uses the biomedical model. The project also will use a participatory approach with families of children with rare diseases, an uncommon technique in rare disease research. By using this approach, the voices of those living with, caring, and advocating for children and their families living with a rare disease will be incorporated directly into the research process, including design, implementation, analysis and interpretation of results.

PhD Candidate Name: Elaine Shelford-Mead

Project Funding Source: Self-funded    

Primary Supervisor: Professor Martin McNamara

Co-supervisor: Dr Séan-Paul Teeling

Project Description:               

Pawson and Tilley (1997), pioneers of realist research, sought to understand what aspects of specified interventions, worked/didn’t work, for whom, in what circumstance, leading to anticipated outcomes. I am using this realist approach to explore the intersection among the use of Lean quality improvement interventions for removing non-value-added activity in complex healthcare environments, the consequences of healthcare delivery on both population and planetary health and any resultant impact on and waste of natural resources.

Whilst there is significant research on the impact of climate change on the population's health, there is less published work on the environmental impact of healthcare delivery despite it being responsible for upwards of 4% of world carbon emissions.  The historical and current pressures on healthcare systems may have resulted in a lack of measurable outcomes relating to environmental protection elements and their inclusion in Lean quality improvement programmes. I will explore the use of Lean as an intervention to support increased awareness and action.