BU Research Blog

Authors: Sarah Hean (School of Health and Social Care) on behalf of the Older Person, Children and Diverse Groups Programme (OPCD) of the Centre of Wellbeing and Quality of Life (CeWQoL)

Alternative name suggestion: Wellbeing and Quality of Life of Older People OR Wellbeing and Quality of Life across the Life Span

Brief theme summary: The theme focuses on intergroup communication as a means of enhancing older people’s quality of life.  Two dimensions are highlighted specifically: social and mental wellbeing.

Social wellbeing:  The theme focuses on reducing social isolation by enhancing older people’s communication with peers, community, health/social care professionals and other service providers (we view service providers as all professionals that may enhance the QOL of Older People and do not confine this to health and social care professionals alone), in order that their voice is heard in social policy. Professionals, working in multiprofessional, interagency environments, and who offer client-centred services, need to effectively communicate with each other and the client to ensure the quality of life of the older person. This theme explores how these processes can be better streamlined, understood and developed.

Mental well being: The mental/cognitive well being of older people is also a theme focus, considering particularly the experiences of older people living with dementia and the associated concepts of vulnerability.

We promote a humanistic approach that puts an emphasis on the lived experience of the older person, embodying their life goals and values.  Hereby, older people, form part of interprofessional, interdisciplinary or interagency teams rather than the passive recipient of their actions.  The theme therefore also focuses on developing these interprofessional teams through exploring and developing Interprofessional training that promotes an understanding of the value maps of both other professionals/agencies and the older person themselves.

Scope of theme: what is included? Research is often related to applied social science type research and service evaluations.

Developing rigorous theoretical models to guide research and practice in the theme is central.

Quantitative research: secondary data analysis of service records and cross sectional and longitudinal surveys. 

Qualitative research:  a range of perspectives (phenomenology, grounded theory etc) through focus groups, interviews and practice observations.  Practice development/service enhancement methodologies are also relevant.

Members of our OPCD programme apply their expertise in user involvement, social capital, social isolation, social networks, working with vulnerable groups, mental health, Dementia, Complementary Therapies, Interprofessional working and Education to this theme.  We focussing these skills on improving:

• the outcome of Wellbeing and Quality of life
• the population group of Older People.

To give a flavour of the types of project that fit under this theme, see below:

Previously funded Projects in Programme

• Evaluation of the Mid Essex Memory Assessment and Support Service Care (Programme themes: Dementia, Older people) (Funder: NHS)
• Evaluation of a Women worker in Criminal Justice System ((Programme themes: mental health, intergroup communication) (CoFunders: NHS/Criminal Justice System)
• Evaluation of the South West Mental Health Assessment, Advice and Reports in Court Proceedings Pilot ((Programme themes: mental health/ intergroup communication)(CoFunders: NHS/CJS) 
• Evolving theory in interprofessional education seminar series CROSS INSTITUTIONAL (Programme themes: Intergroup communication; Funder: ESRC)   

Current Funded Projects in Programme

• Exploring the impact of friendship clubs on social isolation for the older age group”  – commissioned by. 2008-2011;  (Programme themes: Older People, social wellbeing) (Funder: Brendon care)
• Knowledge Transfer Partnership: Building a business/social enterprise model to support older people self funding their own care (CROSS SCHOOL: HSC-BS))(Programme themes: Older people, intergroup communication) (Funder: ESRC/ HTB)
• Exploring older people’s experiences of wellbeing and financial literacy during an Economic Down Turn (CROSS SCHOOL: HSC-BS) (Programme theme: Older people, quality of life, intergroup communication) (Joint Funders Institute of chartered accountants Scotland, Bournemouth Foundation)

Bids submitted

• Interagency working London: evaluation of Focus teams liaising between Medium Secure Unit and CMHTs: (Short listed tender interview completed, Awaiting outcome: Programme theme: (Mental health, intergroup communication) (Funder: NHS)
• Economic impact of social organisations: SW form: shortlisted for interview: Sarah Hean, John Fletcher, Charlie Monkcom (CAB) Presentation July 2011 CROSS SCHOOL (HSC-Tourism)(Programme theme: Older people, quality of life, Mental health, intergroup communication)(Funder: Big Lotttery. SW Forum)(Awaiting outcome)

Bids planned for term ahead:

• Dementia bid: mapping the care pathway from the perspective of the patient: CROSS INSTITUIONAL (Programme theme: Older people, dementia) (Funder ESRC)

Scope of theme: what is excluded? Drug control trials or laboratory trials are out of our remit.

Which big societal questions are addressed by this theme? The Big Society promotes a move away from state support for social action to an increased reliance on community involvement and support of these activities.  This places particular pressure on third/voluntary sector organisations to fill the gap left by the with drawl of state funding and services.  These organisations are finding it increasingly important to be accountable for the social and financial impact of any state funding they do still receive and they need to develop their organisations financially to be increasingly independent of state funding.  In an increasingly ageing population, those third sector organisations supporting older people are particularly vulnerable.

This theme explores both the social impact (specifically on the quality of life of older people) and financial implications of these services.  We anticipate that novel interagency partnerships between the private, public and third sector will be key to the way the Big Society is managed and that the theme will contribute to this by developing an understanding of these opportunities and how they work.

How do these link to the priorities of the major funding bodies? The theme is congruent with the RCUK, cross council theme of Ageing: Lifelong Health and Wellbeing: realising economic, social and health gains of healthy ageing while reducing dependency, costs and inequities later in life.

By way of example, the funded project exploring the quality of life during and economic downturn and financial literacy in older people highlights the economic gains of health and wellbeing in older populations.

The currently funded KTP is developing a business model for older people self funding their own care.  This is particularly relevant to reducing dependency and costs in the older population

The evaluations/tenders that fall under this theme are increasingly being asked to address the links between cost effectiveness and social impact.  Our tenders on the a) economic impact of social organisations b) interagency working: London respond to this trend through a focus on cost effectiveness of wellbeing interventions, the financial impact of social interventions and the social impact of financial investment.

The research councils, the ESRC, specifically emphasises the importance of interdisciplinary working.  Thematically and operationally our bids to date are interdisciplinary: crossing school, professional, academic discipline, academic institution and public/private/third sector boundaries.

How does this theme interlink with the other BU themes currently under consideration? Links with the Health and Wellbeing theme.

Authors: Heather Hartwell and Ann Hemingway (School of Tourism and School of Health and Social Care)

Alternative name suggestion: Wellbeing and Quality of Life

Brief theme summary: Wellbeing as described by the World Health Organisation (WHO) in its constitution (2006) denotes ‘health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’. However, the concept is not new for example Aristotle described wellbeing in terms of ‘ataraxia’ (inner peace) and ‘eudaimonia’ (a feeling of wellbeing, happiness, contentment, pleasure, satisfaction and living the best life possible).Within the field of happiness economics, where the concept of subjective wellbeing is defined as life satisfaction, it can be both uni- or multi-dimensional. In other words from an economic standpoint, subjective wellbeing can be defined and measured as both satisfaction with life in general (uni-dimensional) and satisfaction with different aspects, or domains, of life (multi-dimensional). Happiness, although challenging to assess, as people will derive differing amounts of pleasure from the same experience, resonates with the ‘set-point’ theory of wellbeing where each individual is thought to have a set-point of happiness given by genetics and personality. Life events may deflect above and below but in time hedonic adaptation will return an individual to this initial point. The theoretical framework for interpretation is the theory of ‘Subjective Wellbeing Homeostasis’ (Australian Unity, 2010), which proposes that everyone has a genetically determined ‘set-point’ for well-being that is internally maintained and defended, similarly to how body temperature is managed. Currently, the wellbeing debate anchors on two general perspectives: the hedonic approach, which defines wellbeing in terms of pleasure attainment; and the eudaimonic approach, which focuses on meaning and self-realization. The latter resonates with an emerging conceptualisation of public health which is to reject the model of ourselves as mechanics that diagnose and fix what is wrong to organic metaphors where we understand ourselves as ‘gardeners’, enabling the growth of what nourishes human life and spirit.

Scope of theme: what is included?

The cross university wellbeing theme currently with 113 staff registered has identified the following foci of activity:

• Quality of life, wellness, wellbeing
• Public Health
• Health behaviours, physical activity, nutrition
• Economic wellbeing
• Health systems
• Assistive and enabling technologies
• Wellbeing in the workplace, learning environment, caring environment
• Social inclusion and cohesion
• Use of Media to influence Public Wellbeing
• Emotions
• Human right and ethics

Scope of theme: what is excluded? Infectious diseases.

Which big societal questions are addressed by this theme? Behavioural and lifestyle factors are major contributors to ill health and death some are well known such as unhealthy diet and lack of exercise however some are less obvious such as social isolation which is associated with increasing the risk of mental illness and coronary heart disease. A strong evidence base is required that will change the focus of our ‘National Sickness Service’ to one of prevention. In the Public Health White Paper, 2010, the emphasis is on research that can demonstrate new and cost effective ways of encouraging healthy behaviour.

The current fifth wave of public health identifies three main challenges:

• How can the social and commercial changes which have conspired to make overweight/obesity more ‘normal’ be reversed?
• How can the social inequality gap be reduced?
• How can the rise in the levels of depression and anxiety with the associated loss of mental and emotional wellbeing be addressed?

How do these link to the priorities of the major funding bodies?

AHRC – Lifelong Health and Wellbeing (LLHW) is a major cross-council initiative supporting multi-disciplinary research addressing factors across the life course that influence healthy ageing and wellbeing in later life. 

ESRC STRATEGIC PRIORITIES 2011-2015 – There are three refined primary strategic research objectives, which will guide future funding from the ESRC, in light of the comprehensive spending review – health and wellbeing would be incorporated within:

• Influencing Behaviour and Informing Interventions – Create a better understanding of how and why people and organisations make decisions, and how these can be managed or influenced.

EU – FP7 Activity 2.2 Fork to farm: Food (including seafood), health and well being – Understanding consumer behaviour and consumer preferences as a major factor in the competitiveness of the food industry and the impact of food on the health, and well-being of the European citizen.

National Institute of Health Research (NIHR) Funding stream on applied research focusing on dementia prevention, diagnosis and care and specifically on promoting the wellbeing of sufferers.

How does this theme interlink with the other BU themes currently under consideration? This theme will link with recreation and leisure (serious leisure and physical activity), society and social change, green economy (slow travel), and aging.

Currently, there is much interest from local and national colleagues, for example locally, Dr Adrian Dawson (Director of Public Health) and social enterprises such as BH Live and Active Dorset. Nationally, the Department of Health and the Royal Society for Public Health are engaged with the HEIF Wellbeing in the Workforce project. A horizontal wellbeing theme links the relationship between research and policy and hence provides an opportunity to demonstrate impact.

Key dates are:

• May 27^th (cross university meeting with the Director of Public Health)
• July 6^th (Innovation in Wellbeing Conference, HEIF Wellbeing in the Workplace project)
• July 13^th (cross university meeting with BH Live)

In addition, this theme will build on the work of CeWQoL, with its many local, national and international partners, and is a vertical stream within HSC, as it is within the School of Tourism through the Centre for Events and Sport Research.

Just to note: 

• BU has a Memorandum of Understanding with the Royal Society for Public Health, a powerful and strategic leader within this discipline.
• BU is part of the Healthy University network.

Authors: Carol Bond (Health and Social Care)

Alternative name suggestion: None

Brief theme summary: Personal health and wellbeing. Understanding personal concepts of health and wellbeing, especially for people who face additional health challenges. How healthcare systems and healthcare professionals can develop to support health and wellbeing.

Scope of theme: what is included? Concepts of health

Concepts of health in people who have additional health needs

Health care professionals (education, development, ethics, attitudes, culture, power)

Experience of people with additional health needs (i.e. living with long term conditions and disability)

People’s experiences of healthcare (systems, providers, treatments, care) – and using this to improve systems and care

‘New’ technologies  in health, such as use of the internet, web 2.0 etc by people to support their own health needs and self management

Scope of theme: what is excluded? Medicine / Development of clinical procedures (focus should be on better understanding the ‘patient’ experience and using this to improve care)

Which big societal questions are addressed by this theme? How can publicly funded heathcare systems (the NHS) cope with the increase in people living with long term conditions

How can people be supported / encouraged to take more responsibility for managing their own health

How can the NHS achieve its aims of creating a ‘revolution for patients – “putting patients first” – giving people more information and control and greater choice about their care’  

How do these link to the priorities of the major funding bodies? Not stated.

How does this theme interlink with the other BU themes currently under consideration? If the theme is Society & Social Change rather than culture and society I can see a link with this theme in the area of changing public expectations of health services and societies attitudes towards health (e.g. disability,  body image, mental health) and the way that society impacts on personal health and wellbeing. There are also links with Aging, as a lot of people experience new health challenges along with the aging process.