UCD IRIS Ph.D. Research Projects

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: Olalekan Agunbiade

Project funding source: Self-funded

Primary supervisor: Professor 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 important 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 that are 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 is concerned with describing and analysing how and under what conditions existing 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). Using the interpretive phenomenological approach and the Oshry’s Organic Systems Framework Oshry (2019), the study will explore strategies for strengthening enabling conditions and for addressing 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). A conceptual and empirical inquiry into how nurses in Irish acute hospitals think about and experience power in health systems will make power relations and dynamics explicit; enable exploration of their impact on nursing practice, and help to identify strategies to enable nurses to optimise their contribution to health systems.

Project Outputs (to date):

Cohen Konrad, S. et al. (2019) 'Theories of power in interprofessional research – developing the field', Journal of Interprofessional Care, 33(5), pp. 401-405.

Griscti, O. et al. (2017) 'Power and resistance within the hospital's hierarchical system: the experiences of chronically ill patients', Journal of Clinical Nursing, 26(1-2), pp. 238-247.

Maner, J. K. and Mead, N. L. (2010) 'The essential tension between leadership and power: when leaders sacrifice group goals for the sake of self-interest', Journal of personality and social psychology, 99(3), pp. 482.

McNamara, M. and Teeling, S. P. (2021) 'Introducing health care professionals to systems thinking through an integrated curriculum for leading in health systems', Journal of Nursing Management, 29(8), pp. 2325-2328.

Morrow, K. J., Gustavson, A. M. and Jones, J. (2016) 'Speaking up behaviours (safety voices) of healthcare workers: A metasynthesis of qualitative research studies', International Journal of Nursing Studies, 64, pp. 42-51.

Oshry, B. (2019) The organic systems framework : a new paradigm for understanding and intervening in organizational life. Axminster, England: Triarchy Press.

Seenandan-Sookdeo, K.-A. I. (2012) 'The Influence of Power in the Canadian Healthcare System', Clinical Nurse Specialist, 26(2), pp. 107-112.