Dr Obrey Alexis
Reader in Adult Nursing
Oxford School of Nursing and Midwifery
Role
Dr. Obrey Alexis has worked in the NHS for a number of years. He subsequently became a senior lecturer within the Faculty of Health and Life Sciences where he teaches on undergraduate and post-graduate modules. Obrey's PhD focused on the experiences of overseas nurses in the NHS and he obtained this from the University of Surrey.
Areas of expertise
A qualitative researcher with expertise in culture, diversity and minority ethnic health and experiences. Moreover prostate cancer and internationally recruited nurses are other expert areas.
Teaching and supervision
Courses
Modules taught
- Adult health and welbeing
- Dissertation
- Research methods
Supervision
Dr Obrey Alexis do supervise PhD and Professional Doctorate students.
Research Students
Name | Thesis title | Completed |
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Sandra Rushwaya | What are the barriers and facilitators to the uptake of HIV Pre-exposure Prophylaxis among Black African Heterosexual Women in England? | Active |
Claire Coughlan | Optimising follow up for patients treated for bowel cancer from seldom heard groups | 2024 |
Research
Dr Obrey Alexis research focuses on black and minority ethnic populations and migrant health using qualitative and quantitative approaches. He particular focuses on health disparities, understanding of health and illnesses, the impact of social exclusion on minority populations, cultural congruence of health care services, access and utilisation as well as the provision of health care services for black and minority populations.
Obrey belongs to an advisory group to the Chief Nursing Officer for England. In 2011, Obrey was a visiting scholar at New York University and his focus was to develop a better understanding of internationalisation of the healthcare curriculum. In 2013 Obrey was awarded a Santander scholarship to explore global health at the University of Pennsylvania, Columbia University and the Johns Hopkins University.
Groups
Projects as Co-investigator
- Older Adults’ Perception and Experience of Vulnerability and Inequality in Recovering from the Pandemic (led by University of Regina)(01/07/2022 - 31/12/2023), funded by: University of Regina, funding amount received by Brookes: £589, funded by: University of Regina
Publications
Journal articles
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Kaur HK, Bisht B, Kaur M, Alexis O, Worsley A, John D, 'Effectiveness of interpersonal psychotherapy in comparison to other psychological and pharmacological interventions for reducing depressive symptoms in women diagnosed with postpartum depression in low- and middle-income countries: A systematic review'
Campbell Systematic Reviews 20 (2) (2024)
ISSN: 1891-1803 eISSN: 1891-1803AbstractPublished here Open Access on RADARBackground.
Postpartum depression (PPD) is a condition that can affect any woman regardless of ethnicity, age, party, marital status, income, and type of delivery. This condition is highly prevalent worldwide. PPD, if not treated timely, can affect the maternal-child bond and can have a detrimental impact on the future cognitive, emotional, and behavioral development of the child. Interpersonal psychotherapy (IPT) has been reported as an effective treatment of PPD in previous studies as this focuses on relationship and social support issues. Previous reviews conducted in developed nations have reported the superior efficacy of IPT in comparison to other treatment options. There is no systematic review conducted in low to middle-income countries on the efficacy of IPT on PPD. Therefore it was necessary to undertake a systematic review to assess the effectiveness of IPT in reducing the depression among postpartum women in low and middle-income countries (LMICs).Objectives.
The main aim of this systematic review was to assess the effectiveness of IPT alone or in conjunction with pharmacological therapy and/or other psychological and psychosocial interventions, in reducing depressive symptoms among women diagnosed with PPD residing in LMICs.Search Methods.
The systematic search encompassed several prominent databases and grey literature. Furthermore, experts specializing in the field of IPT were consulted to identify any relevant studies conducted in LMICs that fulfilled the predetermined eligibility criteria. The most recent search update was performed in July 2022.Selection Criteria.
The PICOS criteria were meticulously defined for this review as described. Participants: Postpartum women diagnosed with PPD in LMICs were included. Intervention: IPT either as a standalone treatment or in conjunction with pharmacological therapy was included. Comparison: any form of psychological therapy or pharmacological therapy, whether administered individually or in combination, was considered for comparison. Study designs: experimental and quasi-experimental, factorial designs, and quantitative components (experimental, quasi-experimental, factorial designs) of mixed methods designs were eligible to be included. Studies with single-group study designs and qualitative studies were excluded from the review.Data Collection and Analysis.
Two reviewers from our team conducted a rigorous screening process to determine the eligibility of articles for inclusion. This involved an initial evaluation of titles and abstracts, followed by a comprehensive assessment of the full text of selected articles. In instances where discrepancies arose between the two reviewers, resolution was achieved through discussion or consultation with a third author to establish a consensus. Following the screening process, two team members independently extracted pertinent information and data from the studies that met the inclusion criteria. The treatment effect of the intervention, in comparison to the control group, was subsequently analyzed utilizing the fixed effects model taking into account the small number of studies.Main Results.
A total of 17,588 studies were identified from various databases, and 6493 duplicate studies were removed. Subsequently, 9380 studies underwent independent title and abstract screening resulting in the exclusion of 9040 studies. 345 full texts were thoroughly assessed leading to the exclusion of 341 studies, finally including 4 studies for review. The four included trials were randomized trials and comprised a total sample size of 188 women diagnosed with PPD residing in LMICs. Among these studies, three compared IPT with usual treatment, while one study compared IPT with antidepressant medications (ADMs). In terms of the providers of IPT, in one study, IPT was administered by nurses, while psychologists delivered IPT in another study. In one study, community health workers were responsible for providing IPT. However, in one study, information regarding the specific providers of IPT was not available or reported. The primary outcome measure reported in all four studies was depression, assessed using the Edinburgh Postnatal Depression Scale (EPDS). The geographical distribution of the studies included; one conducted in Zambia, one in Kenya, one in Pakistan, and one in Iran. Out of the four studies, three were included in the meta-analysis, as missing data from one study could not be obtained. Based on the overall treatment effect, it was found that depression scores decreased significantly more in the IPT group compared to other interventions (usual treatment or ADMs) (standardized mean difference [SMD] −0.62, 95% confidence interval [CI] (−1.01, −0.23), Z = 3.13 (p = 0.002), χ2 = 49.49; df = 2; pAuthors' Conclusions.
Our comprehensive search yielded a limited number of four studies conducted in such settings. Despite the scarcity of available evidence, the findings collectively suggest that IPT is indeed an effective treatment for reducing PPD when compared to usual treatment and pharmacological therapy. However given the low certainty of evidence, there is a need for further research in the form of well-designed randomized controlled trials with larger sample sizes and a reduced risk of bias. Such studies would greatly contribute to enhancing the strength and reliability of the evidence base regarding the effectiveness of IPT in the context of PPD in LMICs. The knowledge generated from future research endeavors would be highly valuable in guiding the development of more affordable and cost-effective treatment approaches for PPD in resource-limited settings. -
Alexis O, Mansbridge S, Garbrah W, 'Raising awareness of prostate cancer amongst black communities in the south of England'
Ethnicity and Health 29 (3) (2024) pp.328-342
ISSN: 1355-7858 eISSN: 1465-3419AbstractPublished here Open Access on RADARBlack men are more likely to be diagnosed with prostate cancer than white men and may present with prostate cancer at a much later stage during the cancer journey. This could be due to a lower awareness of the signs and symptoms of prostate cancer, an unwillingness to report symptoms or a lack of trust in the healthcare system or a combination of these. Therefore, the aims of this study were to raise awareness of prostate cancer in black communities in South of England and to evaluate the engagement and raising awareness campaigns.
This project involved two phases. The first phase focused on raising awareness of prostate cancer in black men and their families. The awareness was delivered using public facing activities such as stands and talks with participants. Additionally, online awareness activities were undertaken with either black men alone or black men and their families. The second phase of the project involved an evaluation of the raising awareness campaigns through interviews. A total of 320 black men and their families were involved in the awareness sessions and of these, 12 black men were interviewed. The interview transcripts were analysed using thematic analysis.
Analysis of the data generated three main themes including: increased knowledge and mindset change regarding prostate cancer, empowered to take community and personal action, as well as strategies and tools to raise awareness of prostate cancer among black communities.
The raising awareness campaigns had a positive effect in terms of increasing black men’s awareness of the risk factors associated with prostate cancer. Moreover, the campaigns enabled them to make lifestyle adjustments that could help them to reduce their likelihood of developing prostate cancer. Additionally, the participant’s knowledge had improved, and they were empowered and motivated to make a difference to their lives and that of their communities.
Black men are more likely to be diagnosed with prostate cancer than white men and may present with prostate cancer at a much later stage during the cancer journey. This could be due to a lower awareness of the signs and symptoms of prostate cancer, an unwillingness to report symptoms or a lack of trust in the healthcare system or a combination of these. Therefore, the aims of this study were to raise awareness of prostate cancer in black communities in South of England and to evaluate the engagement and raising awareness campaigns.
This project involved two phases. The first phase focused on raising awareness of prostate cancer in black men and their families. The awareness was delivered using public facing activities such as stands and talks with participants. Additionally, online awareness activities were undertaken with either black men alone or black men and their families. The second phase of the project involved an evaluation of the raising awareness campaigns through interviews. A total of 320 black men and their families were involved in the awareness sessions and of these, 12 black men were interviewed. The interview transcripts were analysed using thematic analysis.
Analysis of the data generated three main themes including: increased knowledge and mindset change regarding prostate cancer, empowered to take community and personal action, as well as strategies and tools to raise awareness of prostate cancer among black communities.
The raising awareness campaigns had a positive effect in terms of increasing black men’s awareness of the risk factors associated with prostate cancer. Moreover, the campaigns enabled them to make lifestyle adjustments that could help them to reduce their likelihood of developing prostate cancer. Additionally, the participant’s knowledge had improved, and they were empowered and motivated to make a difference to their lives and that of their communities.
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Coughlan C, Watson E, Matheson L, Alexis O, 'A systematic review of the follow-up priorities of colorectal cancer survivors'
Gastrointestinal Nursing 22 (9) (2024) pp.2-12
ISSN: 1479-5248 eISSN: 2052-2835AbstractPublished here Open Access on RADARBackground: Colorectal cancer (CRC) is the third most common cancer worldwide. Survival has improved over recent years and CRC survivors are a growing group of patients living with and beyond a diagnosis of cancer. Aims: This study aims to explore the follow-up priorities of CRC survivors and to determine if all those affected by CRC have been given a voice through current literature.
Method: A systematic integrative literature review was performed across three databases— CINAHL, Medline and PsycINFO—from 2014 to 2024. This yielded 12 papers for inclusion. Thematic analysis was undertaken with themes from each paper identified and coded. Common themes grouped and renamed.
Results: Six themes emerged: understanding and managing long-term effects of treatment; the importance of good information; delivery of followup care; ease of access to care and investigations; fear of recurrence; and the changing impact of cancer treatment. Ethnic minority groups and non-native language speakers appeared underrepresented in the included studies; only 50% of included studies made ethnicity data available. It was not possible to determine whether other groups had been included, such as members of the LGBTQ+ community, those with learning disabilities or those with mental health conditions.
Conclusions: Survivors of CRC require access to information and support to manage the effects of treatment in the short, medium and long term to optimise quality of life post treatment. The approach to this should be shaped to the preference and need of the individual. Colorectal cancer Clinical Nurse Specialists need to tailor practice and use their expertise to meet the needs of CRC survivors during follow-up care processes. More evidence is needed on the follow-up priorities of CRC survivors from underrepresented groups to ensure that the voice of all groups is heard and their needs addressed.
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Alexis O, Cooke J, Jennings S, Worsley AJ, Basupang NB, 'Empowering Nursing Students'
Mediterranean Nursing and Midwifery [in press] (2024)
eISSN: 2791-7940AbstractPublished here Open Access on RADARIn nursing, empowerment can enable nurses to raise concerns about patient safety and to do so within a safe and supportive environment. Furthermore, empowering patients to gain more ownership of their health can positively influence both nurses and patients. This narrative review focused on the importance of empowering nursing students. The literature determined that nursing students must feel valued and be treated equally, and to work in an environment that is open and transparent, in order to feel empowered. Fear of retaliation may prevent nursing students from speaking out about poor care and poor practice. Moreover, co-developing care and support regimens with service users benefited both nursing students and patients, as well as local communities, reduced stress and burnout, and allowed the patient to self-care, and act in their own best interests.
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Alexis O, Worsley AJ, 'Black men’s experiences of support following treatment for prostate cancer in England: A qualitative study'
European Journal of Oncology Nursing 62 (2022)
ISSN: 1462-3889 eISSN: 1532-2122AbstractPublished here Open Access on RADARPurpose Prostate cancer is a leading cause of death in black men in the United Kingdom (UK). Evidence suggests that unmet supportive care needs are prevalent in contemporary healthcare, particularly for men with advanced prostate cancer, whilst less has been written specifically about the supportive care needs of black men. Therefore this study will examine black men’s experiences of support following prostate cancer treatment in England.
Method A qualitative research design was employed. Twenty black African and black Caribbean men were interviewed on a face-to-face basis to obtain insightful information about their experiences of prostate cancer. Interviews were recorded and transcribed. Data were analysed using thematic analysis which allowed for emergent themes.
Results In this study there were six emergent themes. These were: dealing with the treatment effect, support from loved ones, individuals and organisations, healthcare support, spirituality, and positivity. Black men used different coping strategies to deal with the side effects of treatment.
Conclusion Black men experienced a range of supportive care needs. Some men felt that their individual needs as black men were not met by healthcare professionals, although no specific reasons were forthcoming as to why they felt this way. Healthcare professionals should be aware of the support mechanisms that black men have used throughout the prostate cancer journey and to consider these approaches when treating and caring for black men.
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Alexis O, Cooke J, Shimumbi L, Worsley A, 'The Role of the Nurse Advocate in Health and Social Care'
Mediterranean Nursing and Midwifery 2 (3) (2022) pp.140-146
eISSN: 2791-7940AbstractPublished hereThis article documents the different forms of advocacy and highlights the importance of advocacy in the UK health- and social-care settings. It draws on a number of elements related to advocacy to demonstrate the challenges that nurses may encounter. Moreover, it identifies the skills and knowledge that nurses may use as being advocates for patients/clients and their families. The article makes a strong argument by highlighting that nurses are essential advocates and are duty-bound to adhere to their professional code of conduct. The Nursing and Midwifery Council (NMC) Code clearly states that nurses must ensure that patients/clients and their families are protected, respected, treated with dignity, and are given the highest standard of person-centered care. This article has considered these in relation to nurse advocacy.
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Tola YO, Akingbade O, Akinwaare MO, Adesuji EO, Arowosegbe TM, Ndikom CM, Adejumo PO, Alexis O, 'Psychoeducation for psychological issues and birth preparedness in LMICs: A systematic review'
AJOG Global Reports 2 (3) (2022)
ISSN: 2666-5778 eISSN: 2666-5778AbstractPublished here Open Access on RADARBackground: Psychological issues usually accompany the pregnancy of first-time mothers and psychoeducational interventions might be effective in addressing these concerns and preparing first-time mothers for childbirth and the postnatal period. This study aimed to identify, analyse and synthesise the components as well as determine the effectiveness of psychoeducational interventions that are used for managing psychological issues and enhancing birth preparedness among primigravid women or couples in LMICs.
Method: A systematic search of 12 databases (APA PsycINFO, Emcare, Embase, MEDLINE(R), Ovid Nursing, British Nursing Index, Health and Medical Collection, ProQuest, CINAHL, Cochrane, Hinari and PubMed) was conducted to identify relevant studies published between 1946 and October 2021. Quality of the included studies was appraised by the JBI critical appraisal tool and a narrative synthesis was conducted to analyse data extracted from included articles. The systematic review protocol is registered with PROSPERO (CRD42021237896).
Findings: The initial search yielded 8,658 articles. Sixteen articles including seven randomised controlled trials and nine non-randomised trials met the inclusion criteria and were selected and reviewed for quality. Thirty-nine outcomes were measured in the studies including psychological outcomes, birth preparedness outcomes and other outcomes. The design of the interventions included antenatal education that was delivered through lectures, role plays, trainings, and antenatal counselling. All the psychoeducational interventions had a significant effect (p d or Hedge’ g = 0.2 to 1.9) on certain psychological outcomes including childbirth attitude, fear of childbirth, depression, fear, and anxiety and birth preparedness outcomes.
Interpretation: Although first-time mothers experience a range of psychological issues during pregnancy, psychoeducational interventions were beneficial in addressing their psychological concerns. It would appear that these interventions are less expensive and could be easily implemented in LMICs. However, rigorous research like RCTs are hereby warranted to standardise the interventions and outcome assessment tools.
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Bamidele OO, Alexis O, Ogunsanya M, Greenley S, Worsley AJ, Mitchell ED , 'Barriers and facilitators to accessing and utilising post-treatment psychosocial support by Black men treated for prostate cancer - a systematic review and qualitative synthesis'
Supportive Care in Cancer 30 (2022) pp.3665-3690
ISSN: 0941-4355 eISSN: 1433-7339AbstractPublished here Open Access on RADARPurpose: To synthesise findings from published studies on barriers and facilitators to Black men accessing and utilising post-treatment psychosocial support after prostate cancer (CaP) treatment.
Methods: Searches of Medline, Embase, PsycInfo, Cochrane Database of Systematic Reviews and Central, CINAHL plus and Scopus were undertaken from inception to May 2021. English language studies involving Black men aged ³18 and reporting experiences of, or suggestions for, psychosocial support after CaP treatment were included. Low or moderate quality studies were excluded. Searches identified 4,453 articles and following deduplication, 2,325 were screened for eligibility. Two independent reviewers carried out screening, quality appraisal and data extraction. Data were analysed using thematic synthesis.
Results: Ten qualitative studies involving 139 Black men were included. Data analysis identified four analytical constructs. Experience of psychosocial support for dealing with treatment side-effects (including impact on self-esteem, fear of recurrence); barriers to use of psychosocial support (such as perceptions of masculinity, stigma around sexual dysfunction); facilitators to use of psychosocial support (including the influence of others and self-motivation); and practical solutions for designing and delivering post-treatment psychosocial support (the need for trusted healthcare and cultural channels).
Conclusions: Few intervention studies have focused on behaviours among Black CaP survivors, with existing research predominantly involving Caucasian men. There is a need for a collaborative approach to CaP care that recognises not only medical expertise, but also the autonomy of Black men as experts of their illness experience, and the influence of cultural and social networks.
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Woodhead C, Stoll N, Harwood H, Alexis O, Hatch SL, '“They created a team of almost entirely the people who work and are like them”: A qualitative study of organisational culture and racialised inequalities among healthcare staff'
Sociology of Health & Illness 44 (2) (2021) pp.267-289
ISSN: 0141-9889 eISSN: 1467-9566AbstractPublished here Open Access on RADARRacially and ethnically minoritised healthcare staff groups disproportionately experience and witness workplace discrimination from patients, colleagues and managers. This is visible in their under-representation at senior levels and over-representation in disciplinary proceedings, and is associated with adversities such as greater depression, anxiety, somatic symptoms, low job satisfaction, and sickness absence. In the UK, little progress has been made despite the implementation of measures to tackle racialised inequities in the health services. So, what is it about the health service organisational context which shapes and maintains such inequities, and what role does discrimination, bullying and harassment play? Drawing on qualitative interviews with 48 healthcare staff in London (UK), we identify how micro-level bullying, prejudice, discrimination and harassment behaviours, independently and in combination, exploit and maintain meso-level racialised hierarchies. Within teams, the high diversity-low inclusion dynamic shaped and was perpetuated by in- and out-group inclusion and exclusion processes (including ‘insidious dismissal’) often employing bullying or microaggressions. These were linked to intersecting factors such as race, ethnicity, migration, language and religion, and could increase segregation. For racially and ethnically minoritised groups, ingroup maintenance, moving teams or leaving were also ways of coping with organisational inequities. We discuss implications for tackling racialised workplace inequities.
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Collaço N, Wagland R, Alexis O, Gavin A, Glaser, Watson EK, 'Using the Framework Method for the Analysis of Qualitative Dyadic Data in Health Research'
Qualitative Health Research 31 (8) (2021) pp.1555-1564
ISSN: 1049-7323 eISSN: 1552-7557AbstractThere are an increasing number of qualitative studies which focus on the dyad (couples, families, caregivers–patients, health care professionals–patients). However, there is limited literature regarding qualitative methodology for dyadic analysis when members of the couple have been interviewed separately. The aim of this article is to share the knowledge we gained from undertaking a novel approach to dyadic analysis. We used an adapted version of the Framework method on data gathered in a study exploring the impact of prostate cancer on younger men and their partners. In this article, we examine and reflect on the challenges of this type of analysis and describe how we analyzed the interview data from a dyadic point of view, to share what we learned in the process.Published here Open Access on RADAR -
Kang HK, John D, Bisht B, Kaur M, Alexis O, Worsley A, 'PROTOCOL: Effectiveness of interpersonal psychotherapy in comparison to other psychological and pharmacological interventions for reducing depressive symptoms in women diagnosed with postpartum depression in low and middle‐income countries: A systematic review'
Campbell Systematic Reviews 16 (1) (2021)
ISSN: 1891-1803AbstractPublished here Open Access on RADARPostpartum Depression (PPD) is highly prevalent among women in low and middle income countries (LMICs). World Heath Organization has recognised interpersonal Psychotherapy (IPT) as the first line treatment for the postpartum depression. The primary aim of this review is to evaluate the effectiveness of IPT alone or in combination with pharmacotherapy or other psychosocial therapies for treating depressive symptoms in women with postpartum depression. The generated evidence from this review will help to inform policies in relation to the treatment of postpartum depression in LMICs.
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Alexis O, 'Black African and black Caribbean men’s understanding and experiences of prostate cancer post-treatment in England. A qualitative study. '
Cancer Nursing Practice 19 (6) (2020)
ISSN: 1475-4266AbstractPublished here Open Access on RADARAim. Black African and black Caribbean men are two to three times more likely to be diagnosed with prostate cancer compared with white men, and some appear to have little knowledge of the disease. The aim of this study was to examine black African and black Caribbean men’s understanding and experience of prostate cancer post-treatment and to create a video to raise awareness in the African and Caribbean communities of the importance of testing.
Method. In total 20 black African and black Caribbean men were interviewed using a qualitative approach and the data were analysed thematically.
Findings. There was a lack of knowledge and understanding of prostate cancer among the study sample, who were also sometimes exposed to misinformation within the black community, including herbal remedies. Some participants believed their racial features were a barrier to the way in which limited information was shared with them by healthcare professionals.
Conclusion. There is a need to raise awareness about prostate cancer in black communities to educate men about the disease and its effects. Additionally, evidence-based information about the disease is required to educate black men and to reduce the effects of misinformation and herbal remedies on their well-being. In the health sector, unconscious bias should be recognised, addressed and avoided to ensure inclusive and person-centred care regardless of ethnicity.
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Sonoiki T, Young J, Alexis O, 'Challenges faced by nurses in complying with aseptic non-touch technique principles during wound care: a review'
British Journal of Nursing 29 (5) (2020) pp.S28-S35
ISSN: 0966-0461 eISSN: 2052-2819AbstractPublished here Open Access on RADARBackground:
Surgical and wound site infections (SWSIs) are the second most frequent type of healthcare-associated Infection. One way of preventing SWSIs is by adhering to the principles of asepsis. However, many nurses struggle to apply the principles of aseptic non-touch technique (ANTT) during wound management.Aim:
To identify the barriers and enablers that influence nurses' adherence to the principles of ANTT during wound care.Method:
A literature search using a systematic approach was carried out. Four databases were searched to identify relevant studies published between January 1993 and December 2018. Titles and abstracts were reviewed. Studies that met the inclusion criteria were reviewed for quality. The extracted data were then synthesised.Findings:
A total of seven studies fulfilled the requirements for inclusion. Three themes emerged and were found to be the most dominant factors influencing adherence to the principles of ANTT: material and resources, nurse education, and nurses' behaviour.Conclusion:
Nurses' compliance with aseptic practice is directly influenced by environmental and psychological factors. Ensuring compliance to ANTT may require an integrated approach involving local, national and worldwide organisations, in collaboration with higher education institutions that teach nurses and similar healthcare professionals. -
Sonoiki T, Young J, Alexis O , 'Challenges faced by nurses in complying with aseptic non-touch technique principles during wound care: a review'
British Journal of Nursing 29 (5) (2020) pp.S28-S35
ISSN: 0966-0461AbstractPublished hereBackground: Surgical and wound site infections (SWSIs) are the second most frequent type of healthcare-associated Infection. One way of preventing SWSIs is by adhering to the principles of asepsis. However,
many nurses struggle to apply the principles of aseptic non-touch technique (ANTT) during wound management. Aim: To identify the barriers and enablers that influence nurses’ adherence to the principles of ANTT during wound care. Method: A literature search using a systematic approach was carried out. Four databases were searched to identify relevant studies published between January 1993 and December 2018. Titles and abstracts were reviewed. Studies that met the inclusion criteria were reviewed for quality. The extracted data were then synthesised. Findings: A total of seven studies fulfilled the requirements for inclusion. Three themes emerged and were found to be the most dominant factors influencing adherence to the principles of ANTT: material and resources, nurse education, and nurses’ behaviour. Conclusion: Nurses’ compliance with aseptic practice is directly influenced by environmental and psychological factors. Ensuring compliance to ANTT may require an integrated approach involving local, national and worldwide organisations, in collaboration with higher education institutions that teach nurses and similar healthcare professionals. -
Alexis O, Adeleye AO, Worsley AJ, 'Men’s Experiences of Surviving Testicular Cancer: an Integrated Literature Review'
Journal of Cancer Survivorship 14 (3) (2020) pp.284-293
ISSN: 1932-2259 eISSN: 1932-2267AbstractPublished here Open Access on RADARPurpose. To synthesize literature in order to elucidate the experiences of men who have survived testicular cancer and determine their quality of life following treatment. Methods. An integrated review sought appropriate literature by utilising a keyword search across seven databases. Retrieved studies were appraised for quality, with two qualitative, twelve quantitative, and two mixed method studies deemed appropriate for this review. The data were extracted and aggregated into categories by way of a thematic analysis. The themes were: personal challenges and impact on health, psychological and emotive challenges, perception of reproduction and sexual changes, and outlook and support. Results. Men experienced physical, emotional, and sexual difficulties. Some men believed they were infertile, despite evidence that fertility is not compromised in the long term. Psychological conditions can be exacerbated by cultural pressures to conceive and cultural expressions about male identity. Men who had undergone orchidectomy reported minimal impact on their mental health than the men who had chemotherapy or radiotherapy as part of their treatment modality. Sexual dysfunction caused by chemotherapy-associated side effects was detrimental to men’s quality of life. In addition, men who had a partner, who were employed, and who had children were able to adjust better after treatment than those who did not. Provision of clear and honest information post-treatment helped testicular cancer survivors return to their normal lives. Conclusions.
The evidence from the review suggests that the burden of disease for testicular cancer survivors is overall low. Men who had surgical intervention and were treated for testicular cancer experienced minimal impact on their mental health status than the men who had chemotherapy or radiotherapy as part of their treatment modality. Implications for Cancer Survivors. There is a need to provide appropriate referrals to the relevant services, including psychosocial support, and the development of more adequate communication resources for men following treatment for testicular cancer. -
Wagland R, Nayoan J, Matheson L, Rivas C, Brett J, Collaco N, Alexis O, Gavin A, Glaser AW, Watson E., 'Adjustment strategies amongst black African and black Caribbean men following treatment for prostate cancer: findings from the Life After Prostate Cancer Diagnosis (LAPCD) study'
European Journal of Cancer Care 29 (1) (2019)
ISSN: 0961-5423 eISSN: 1365-2354AbstractPublished here Open Access on RADARObjective: To explore adjustment strategies adopted by Black African (BA) and Black Caribbean (BC) men in the UK as a response to the impact of PCa diagnosis and treatment effects.
Methods: Men were recruited through the UK-wide ‘Life After Prostate Cancer Diagnosis’ (LAPCD) survey. Telephone interviews were conducted with men (n=14) with BA and BC backgrounds between 18-42 months post-diagnosis. Data were analysed using a Framework approach.
Results: Most men (n=12) were born outside the UK, were married (n=9) and employed (n=9). Median age was 66 years (range: 55-85). Six overarching themes emerged: a strong reliance upon faith beliefs; maintaining a ‘positive’ front; work as distraction; non-disclosure of diagnosis even amongst family members, influenced by stigma and masculinity concerns; active awareness-raising amongst a minority, and; support-seeking from close community. A few men emphasised a need to ‘pitch’ awareness-raising messages appropriately. Potential links existed between faith beliefs, presenting a positive front, community support-seeking and local awareness-raising.
Conclusion: The provision of patient-centred care requires cultural sensitivity. Interventions that challenge stigma and mens’ reluctance to disclose problems associated with PCa and treatment may encourage help-seeking for symptom support. Research is needed to determine how best awareness-raising messages should be conveyed to black men. -
Waskiewicz A, Alexis O, Cross D, 'Supporting patients with long term catheterisation to reduce risk of catheter-associated urinary tract infection'
British Journal of Nursing 28 (9) (2019) pp.S4-S17
ISSN: 0966-0461AbstractPublished here Open Access on RADARMore than 90 000 of the UK adult population are estimated to have a urinary catheter, with 24% likely to develop symptoms of catheter-associated urinary tract infection (CAUTI). The consequences of having a CAUTI are reduced quality of life, risk of hospitalisation and increased mortality. The authors undertook a literature review of primary research studies to identify how nurses could support patients to maintain effective catheter care to reduce the risk of CAUTI. Four themes emerged: education, knowledge, empowerment and communication. The authors therefore conclude that consistent knowledge, clear communication and treating patients as partners in the decision-making process can help build trust and allow empower patients. This will enable patients to make safe and healthy decisions about their catheter, particularly with regard to personal hygiene and optimal fluid intake, to reducing the risk of CAUTI.
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Collaco N, Wagland R, Alexis O, Gavin A, Glaser A, Watson KE, 'The challenges on the family unit faced by younger couples affected by prostate cancer: A qualitative study'
Psycho-Oncology 28 (2) (2018) pp.329-335
ISSN: 1057-9249 eISSN: 1099-1611AbstractPublished here Open Access on RADARObjective. The number of younger men being diagnosed with Prostate cancer (PCa), (aged ≤65) is increasing. It is recognised that PCa and treatment side effects can have a significant impact on quality of life. This study explores the challenges faced by younger couples affected by PCa with dependent children (under 18 years) or young adults (18-29 years) in their families. Methods. Twenty-three men with PCa and their partners were interviewed (separately) by telephone. Participants were recruited from respondents to the Life After Prostate Cancer Diagnosis (LAPCD) national survey. Men were three to five years post-diagnosis, and following a range of treatment pathways. Data were analysed using the Framework approach. Results. Younger couples affected by PCa felt challenged by issues relating to their parental role and the dynamics within the family. Five main themes emerged: difficult conversations about PCa diagnosis; parental perceptions of the impact of diagnosis on children; parental responses to the impact of PCa on the family; shielding, coping and normalising strategies; and levels of support. Conclusions. A diagnosis of PCa can cause significant disruption to the family unit and the quality of life of its members. Support programmes offering guidance to children/young adults affected by PCa in their family, and addressing the concerns of parents may help families to better adapt. Encouraging clinical professionals to initiate conversations with younger couples about their children may be a way forward in directing appropriate support. Further research is needed to elucidate appropriate, effective supportive interventions.
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Alexis O, Worsley AJ, 'The experiences of gay and bisexual men post-prostate cancer treatment: a meta-synthesis of qualitative studies'
American Journal of Men's Health 12 (6) (2018) pp.2076-2088
ISSN: 1557-9883 eISSN: 1557-9891AbstractStudies suggest that gay and bisexual men are affected by the psychological aspects of prostate cancer treatment differently than that of heterosexual men, however the data have not yet been synthesized. The focus of this meta-synthesis is to explore gay and bisexual men’s experiences of prostate cancer post-treatment. Empirical research published in peer reviewed journals between January 1990 and January 2018 were identified in six databases: CINAHL, Cochrane, Medline, PsycINFO, PubMed, and Web of Science. Titles and abstracts were checked by two reviewers. The six studies that met the inclusion criteria were selected and reviewed for quality and the extracted data were then synthesized. The main themes that emerged were sexual impact, physical and psychological difficulties, challenges to intimacy, and support mechanisms. Gay and bisexual men can have specific sexual roles and developing prostate cancer and undergoing treatment may compromise their ability to perform their sexual role. The needs of heterosexual men were perceived to be accommodated more often than that of gay and bisexual men because of engrained heteronormativity in the healthcare system. The review suggests that more support groups specifically for gay and bisexual men should be established, whilst urologists should cater to the sexual and masculine implications of treatment, and not frame problems for gay and bisexual men in heterosexual terms. By failing to address the salient needs and concerns of gay and bisexual men, healthcare professionals are reinforcing invisibility and marginalisation of gay and bisexual men with prostate cancer.Published here Open Access on RADAR -
Collaco N, Rivas C, Matheson L, Nayoan J, Wagland R, Alexis O, Gavin A, Glase A, Watson E, 'Prostate cancer and the impact on couples: a qualitative metasynthesis.'
Supportive Care in Cancer 26 (6) (2018) pp.1703-1713
ISSN: 0941-4355 eISSN: 1433-7339AbstractPublished here Open Access on RADARPurpose: To review and interpret existing qualitative literature on the experiences of couples affected by prostate cancer (PCa).
Methods: A metasynthesis was carried out which included a systematic search of seven databases between 2000 and 2016. A modified version of Noblit and Hare’s meta-ethnographic approach was used to synthesise qualitative study findings and inform overarching interpretations.
Results: Thirty-seven studies focusing on the experiences of men with PCa and their partner dyad were included producing seven interconnected constructs. The construct accepting change vs seeking continuity reflects the range of ways individuals within the dyad and couples adjust to the diagnosis. Cultivating connection vs disengaging illustrates how couples seek to manage the impact of PCa and its treatment on their relationship, which may lead to a threatened identity, including sexual insecurities. Shielding me, you and us reflects the ways in which couples strive to protect themselves as individuals and/or each other from the impact of PCa. Being a partner and its challenges highlights the responsibilities partners assume and the impact of their supporting role. Yet, partners sometimes report feeling unsupported and side-lined both by the man they are caring for and by healthcare professionals. Couples often recognise the value of facing PCa together.
Conclusions: PCa affects both members of the dyad as individuals, as well as the couple’s relationship. How best to support couples and how to overcome difficulties in expressing their concerns to one another requires further consideration. Healthcare professionals should endeavour to employ a couple-focused approach where appropriate. -
Alexis O, Worsley AJ, 'An integrative review exploring black men of African and Caribbean backgrounds, their fears of prostate cancer and their attitudes towards screening'
Health Education Research 33 (2) (2018) pp.155-166
ISSN: 0268-1153 eISSN: 1465-3648AbstractEvidence suggests that black men are disproportionately more affected than any other ethnicity by prostate cancer. The aim of this review is to identify studies exploring black men of African and Caribbean descent, their fears of prostate cancer and their attitudes towards screening. Four databases were searched and reference lists of relevant papers were hand searched. The inclusion criteria were studies exploring attitudes towards screening and fear of prostate cancer in black men of African and Caribbean backgrounds, peer reviewed research, qualitative studies, surveys, questionnaires and English language publications. Qualitative findings were synthesised using a thematic framework to which quantitative findings were integrated. Of the sixteen papers, ten were quantitative and six were qualitative, all of which were conducted in the United States of America. Poorer and less educated black men were reluctant to seek help for prostate cancer. They may not visit their doctors for fear of intrusion into their personal lives. Moreover, they were fearful of being emasculated as a result of the digital rectal examination. The review identifies a paucity of UK literature on black men’s fears and perceptions of prostate cancer. Further studies are needed in the UK to address this gap in the literature.Published here Open Access on RADAR -
Ahiagba P, Alexis O, Worsley AJ, 'Factors that may influence black men and their partners’ knowledge and awareness of prostate cancer screening: a literature review'
British Journal of Nursing 26 (18) (2017) pp.S14-S21
ISSN: 0966-0461AbstractPublished here Open Access on RADARProstate cancer is the most commonly diagnosed cancer in men in the UK, with 46 690 new cases in 2014. While there is sufficient research on this topic in the USA, there is no review in the UK regarding both black men and their significant others’ perspective on prostate cancer screening. Aim: To identify and explore factors that may influence black men and their significant others’ knowledge and awareness of prostate cancer screening. Method: A literature search revealed seven relevant articles. Results: Six of the seven articles were conducted in the USA. The results are described using four themes: perception of prostate cancer screening, fear,
anxiety and discomfort, misinformation about prostate cancer screening procedures and communication and decision-making. Conclusion: The evidence suggests that some black men and their significant others had knowledge and awareness of prostate cancer screening. However, their views were influenced by misperceptions, misinformation, fear and anxiety
around screening procedures and mortality. Communication and spousal support were important in decision making.
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Alexis O, Worsley AJ, 'A meta-synthesis of qualitative studies exploring men’s sense of masculinity post prostate cancer treatment'
Cancer Nursing 41 (4) (2017) pp.298-310
ISSN: 0162-220X eISSN: 1538-9804AbstractBackground: There has been little psychosocial research concerning men’s adaption to prostate cancer and treatment-related sexual dysfunction. Qualitative studies have explored men’s sense of self following treatment, but the data has yet to be synthesised.Published here Open Access on RADAR
Objective: To report a meta-synthesis of qualitative studies exploring men’s sense of masculinity following treatment for prostate cancer.
Interventions/Methods: Six databases were searched to identify relevant studies conducted and published between Jan 1990 and Aug 2016. Titles and abstracts were reviewed by two reviewers. Studies that met the inclusion criteria were selected and reviewed for quality. The extracted data was then synthesised.
Results: A total of 14 studies met the inclusion criteria and passed the quality assessment. The meta-synthesis found that men’s sense of masculinity diminished following treatment for prostate cancer. Impotence, incontinence, the loss of control and physical changes caused psychological stress. Underpinning these factors were cultural influences and dominant ideals of what it means to be a man.
Conclusions: Men had entrenched ideas about what manhood entailed. The review found that men’s sense of masculinity was diminished post treatment for prostate cancer. They felt that they could not exercise their manliness because of the side effects associated with prostate cancer treatment.
Implications for Practice: More support and communication throughout the process is required to better inform patients of the outcomes of treatment. Additionally, it would be beneficial to have open forums through which to encourage men to talk frankly about their masculine identities.
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Alexis O, Shillingford A, 'Internationally recruited neonatal nurses experiences in the NHS in London.'
International Journal of Nursing Practice 21 (4) (2015) pp.419-425
ISSN: 1322-7114AbstractThe aim of this study was to explore internationally recruited neonatal nurses' (IRNNs) perceptions of their experiences of working in the National Health Service (NHS) in London. This was an exploratory study. A purposive sample of 13 nurses (all females) from two teaching hospitals in London participated in this study. Semi-structured face-to-face interviews were used to capture IRNNs views of working in the NHS in London. Five themes emerged, namely: motivation to migrate, lack of preparation for neonatal nurses, environmental conditions impacting on care delivery, neonatal nurses deskilling, and role restrictions as well as professional development. The findings of this study provide first-hand insights from the subjective perspectives of IRNN experiences. IRNNs experienced some challenges to their working lives; however, good preparation is important when recruiting them to work in the NHS.Published here -
Alexis O, 'Internationally recruited nurses' experiences in England: A survey approach'
Nursing Outlook 63 (3) (2015) pp.238-244
ISSN: 0029-6554AbstractBackgroundPublished hereOver the past few years, there has been an impetus to recruit internationally registered nurses to work in the National Health Service (NHS) to avert the labor shortage inherent in the United Kingdom.
Purpose
To determine internationally registered nurses' perception of discrimination, support, and their adjustment to a new environment in the NHS in England.
Methods
A descriptive survey was used. Data were collected from 188 internationally recruited nurses using a questionnaire approach from 15 National Health Service hospitals in England. Data were analyzed using chi-square, Fisher exact, or Kruskal-Wallis tests.
Results
The study had a 21% response rate. There were 81.9% females and 18.1% males who participated in the survey. A mean score of 7.55 and standard deviation of 6.82 were calculated for the number of years of experience of working in the NHS. The findings revealed many statistical differences between the different ethnic groups used in the study. Generally, internationally recruited nurses from Africa, in particular, perceived discrimination to be evident in the workplace, the support they received was limited, and their adjustment to a new environment was the weakest in comparison with the other internationally recruited nurses from the different data sets.
Conclusion
Although the needs of all internationally recruited nurses should be considered, it would appear that the needs of African nurses are the greatest because the study found that they experienced challenges in the working environment in the NHS.
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Netherwood M, Skittrall R, Alexis O, 'Regulation of nursing assistants: A critical international issue?'
Contemporary Nurse: Healthcare Across the Lifespan 48 (2) (2014) pp.197-198
ISSN: 1037-6178 eISSN: 1839-3535AbstractPublished hereHealth care or nursing assistants are valuable members of health care teams who undertake a wide range of tasks, contribute to meeting the increasingly complex healthcare needs of patients and have various levels of training. However, they are not subject to regulation in many countries. If training and regulation are pre-requisites for ensuring the standards of care delivered by registered nurses, then this must also apply to nursing assistants. Regulation ensures the need for on-going education and development which is critical to maintaining and refreshing the values underpinning compassionate care for both nursing assistants and registered nurses.
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Alexis O, Shillingford A, 'Exploring the perceptions and work experiences of internationally recruited neonatal nurses: a qualitative study'
Journal of Clinical Nursing (2011)
ISSN: 0962-1067 eISSN: 1365-2702AbstractPublished hereAim: To explore the perceptions and work experiences of internationally recruited neonatal nurses. Background: Neonatal nursing and health care are global issues facing developing and developed countries. In the UK, the recruitment of international nurses to address the labour shortage is not a new phenomenon. Methods: A purposeful sample was drawn from internationally recruited neonatal nurses, working at two teaching hospitals in London. Husserl" s phenomenological approach underpins this study. Thirteen nurses, (all female) participated in the study and semi-structured face-to-face interviews were conducted to capture the unique perceptions and experiences of neonatal nurses at two hospital sites. A qualitative approach was adopted and this study used Colaizzi" s analytical framework to analyse the data. Results: The analysis of the data resulted in four themes namely the support mechanisms, unfamiliarity with family centred care, feelings of being treated like a child and coping strategies. Conclusion: It can be concluded that in recruiting internationally recruited neonatal nurses to work in the NHS, there is a need to support them, encourage them to become familiar with family centred care and they should be treated as qualified nurses. Therefore, there is a need to consider these findings in any recruitment process involving neonatal nurses. Relevance to clinical practice: Internationally recruited neonatal nurses play an important role in caring for neonates in the NHS in the UK however meeting their needs have not always been addressed in the health care setting.
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Alexis O, 'A guide to understanding and measuring a patient's pulse'
British Journal of Healthcare Assistants 4 (5) (2010) pp.241-245
ISSN: 1753-1586AbstractThis article outlines the knowledge and skills that healthcare assistants (HCAs) require to check a patient" s pulse accurately, thus providing safe care. It defines pulse rate and provides an overview of the purpose of pulse measurement. The choice of puIse sites that can be used is given, as well as factors that can affect the pulse, such as age, gender, medication, stress, pyrexia and hormones. Guidelines for measuring pulse rate and the equipment used are described alongside the rationale for each action. The article concludes by emphasizing the importance that of HCAs acquiring the knowledge and skill of pulse measurement. -
Alexis O, 'Manual blood pressure knowledge'
British Journal of Healthcare Assistants 4 (2) (2010) pp.75-79
ISSN: 1753-1586AbstractThis article explores manual blood pressure and the importance of healthcare assistants developing their knowledge base in this area. The author looks at a number of pertinent areas, such as the meaning of blood pressure, systolic and diastolic, some factors that may influence the accuracy of measuring a patient's blood pressure, and guidelines of how a blood pressure should be taken. -
Alexis O, 'Providing best practice in manual pulse measurement'
British Journal of Nursing 19 (4) (2010) pp.228-234
ISSN: 0966-0461AbstractThis article focuses on the knowledge and pulse measurement skills that healthcare professionals require in order to safely care for patients. This paper will define pulse rate and explain why measuring pulse rate is important. In addition, it provides an overview of the different pulse sites, factors affecting the pulse, the equipment and guidelines used and information on significant groups. It will conclude by highlighting the importance of healthcare professionals acquiring the knowledge and skill of pulse monitoring. -
Alexis O, Vydelingum V, 'Experiences in the Uk National Health Service: the Overseas Nurses Workforce'
Health Policy - The best evidence for better policies 90 (2-3) (2009) pp.320-328
ISSN: 0168-8510AbstractBackgroundPublished hereThis paper presents an analysis based on the recently recruited overseas nurses in the NHS in the United Kingdom [UK].
Objectives
The aims of the study were to determine how overseas nurses perceive equal opportunity as well as the opportunities for skill development and training to be in the National Health Service [NHS] in the UK.
Methods
A survey approach was adopted to investigate the aims of the study. There were 900 questionnaires distributed of which 188 were suitable for the study, thus giving rise to 21% success rate.
Results
The findings revealed many statistical differences between the different ethnic groups used in the study. Overall, overseas nurses from Africa perceived equal opportunity and their prospect for skills development and training to be different to that of their overseas counterparts. In addition the results showed that African nurses were less likely to view their experiences positively particularly if they were not working in any of the NHS trust hospitals in London.
Conclusion
It is important to say that equal opportunity as well as opportunities for skills development and training should be universal within the NHS as this could improve the inequitable treatment that is apparent throughout the UK. There is a need for NHS trust hospitals in the UK to review their equal opportunity and skills development and training policies in the light of these findings.
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Alexis O, 'Overseas trained nurses' perception of UK nurses' caring attitudes: a qualitative study'
International Journal of Nursing Practice 15 (4) (2009) pp.265-270
ISSN: 1322-7114 eISSN: 1440-172XAbstractThe aim of this study was to explore overseas nurses' perception of their nursing colleagues' caring attitudes in the National Health Service (NHS) in the UK. A qualitative phenomenological approach using semi-structured interviews was used to obtain data from 12 overseas nurses. The interview transcripts were transcribed verbatim and analysed using van Manen thematic approach. Although many themes emerged following thematic analysis, this study will report the findings of three themes such as empathy, understanding and caring perspectives, emotional impact and lack of teamwork. In conclusion, this study provides an insight and it increases our understanding of overseas nurses' perceptions of their nursing colleagues' caring attitudes in the NHS in the UK. This paper concludes by indicating that teamwork, being empathetic, understanding and reducing emotional labour for overseas nurses could lead to a more satisfied working environment for overseas nurses in the NHS in the UK.Published here -
Alexis O, 'Providing best practice in manual blood pressure measurement'
British Journal of Nursing 18 (7) (2009) pp.410-415
ISSN: 0966-0461AbstractThis article discusses the practical skills and underpinning knowledge needed when manually taking a patient's blood pressure. The author defines blood pressure and the terms systolic and diastolic and explores the purpose of manual measurement. The article also goes on to examine what is meant by 'normal' blood pressure, hypertension and hypotension, as well as factors that may influence blood pressure measurement. There is a brief outline of the equipment used for manually measuring blood pressure, followed by some factors that may affect the accuracy of the final reading. The author also highlights the different positions used for taking blood pressure and the arguments surrounding their respective merits. Finally, the article includes a practical step-by-step guide to manual blood pressure measurement. -
Alexis O, Vydelingum V, Robbins I, 'Engaging with a new reality: experiences of overseas minority ethnic nurses in the NHS'
Journal of Clinical Nursing 16 (12) (2007) pp.2221-2228
ISSN: 0962-1067 eISSN: 1365-2702AbstractAIM AND OBJECTIVE: The purpose of this study was to explore, describe and develop a greater understanding of the experiences of overseas black and minority ethnic nurses in the National Health Service (NHS) in the south of England. BACKGROUND: For the past five decades, the NHS has been recruiting overseas black and minority ethnic nurses from several former British colonies to alleviate the manpower shortages. More recently there has been a shortage of nurses in the labour force and as a result the NHS has once again recruited overseas nurses. Despite this recruitment drive there are limited studies outlining how overseas black and minority nurses have fared in the NHS. METHODS: This qualitative phenomenological study used four purposeful focus groups and all participants involved were interviewed at a place convenient for them. These all non-white participants originated from Asia, Africa and the Caribbean. Each focus group contained six participants with an overall total of 24 participants involved in the study. RESULTS: Following thematic analysis, the findings revealed six themes such as, the devaluation process, concept of self-blame, discrimination/lack of equal opportunity, concept of invisibility, experiencing fear and benefits of being here. Several overseas nurses felt devalued and indicated that white UK nurses appeared to have placed little trust in them. They stated that both discrimination and lack of equal opportunity were present in the workplace and they also revealed that some white UK nurses were sometimes abusive. As a result they tolerated such behaviour for fear of being thrown out with their families. Despite such negative experiences participants indicated that the experiences gained whilst working in the NHS were useful. CONCLUSIONS: There is a need for overseas nurses to be treated fairly and with respect particularly in the light of an acute labour shortage of nurses in the NHS. The findings suggest that overseas minority ethnic nurses' experiences have been mixed, with some positive as well as negative experiences, within a process that devalues them as workers. RELEVANCE TO CLINICAL PRACTICE: This paper highlights a need for a re-evaluation of equal opportunity policies and proposes more diversity training so as to prepare nurses to cope with an increasingly complex and diverse workforce.Published here -
Alexis O, Vydelingum V, 'Migrating registered nurses in the United Kingdom: Black and minority ethnic overseas nurses' perspectives'
International Journal of Health Care Quality Assurance: Addressing the issues of management and quality 20 (5) (2007) pp.441-452
ISSN: 0952-6862AbstractPurpose - The purpose of the study is to explore, describe and develop a greater understanding of overseas Black and minority ethnic nurses' experiences of, as well as the impact of, their experiences on the quality and service delivery in the UK's NHS. Design/methodology/approach - Phenomenology was adopted to explore overseas nurses' experiences. Twelve face-to-face interviews were completed and all participants involved were interviewed in their homes. Participants originated from Asia, Africa and the Caribbean. Findings - Findings revealed five themes such as building ties, reflecting on experience, moving on, reduced confidence and lack of support. Practical implications - Despite negative experiences, participants indicated that time working in the NHS was useful and contributed towards their development. In recruiting and retaining overseas nurses in the UK NHS, it is important to address their needs - demonstrating NHS commitment to a diverse workforce with ultimate effects on patients' care. Originality/value - This article shows that some overseas nurses are unhappy in the clinical environment and as a consequence they decide to seek alternative workplaces where they feel that they may be valued.Published here -
Alexis O, Vydelingum V, Robbins I, 'Overseas nurses' experiences of equal opportunity in the NHS in England'
Journal of Health Organization and Management 20 (2) (2006) pp.130-139
ISSN: 1477-7266AbstractPURPOSE: To explore the experiences of overseas black and minority ethnic nurses in the National Health Service (NHS) in the south of England. METHODS: Semi-structured in-depth interviews were conducted with 12 overseas black and minority ethnic nurses. All interviews were taped, transcribed verbatim and analysed using thematic analysis. All transcripts were read and re-read to elicit general themes. FINDINGS: Qualitative data analysis was undertaken using Van Manen framework and this enabled a number of themes to be identified that were part of overseas black and minority ethnic nurses' experience, however, two main themes would be discussed in this study. Firstly, unequal opportunities in career advancement and secondly, unequal opportunities for skill development and training. Both themes affected overseas nurses chances of promotion in the NHS. RESEARCH LIMITATION/IMPLICATIONS: The study has identified a notably gap in the implementation of equal opportunity policies and suggests that a more transparent implementation of such policies is needed in the NHS in the UK where this study was conducted. Additionally, more research is needed to determine whether overseas nurses in other areas experience similar problems. PRACTICAL IMPLICATIONS: The findings of this study could encourage managers to re-examine their equal opportunity policies in the light of these findings. Although this study has explored overseas nurses experiences, the findings cannot be generalised to the wider population. ORIGINALITY VALUE: The differences experienced by overseas nurses in relation to career opportunities and skill development and training.Published here -
Alexis O, Vydelingum V, 'Overseas black and minority ethnic nurses: a systematic review'
Nurse Researcher 12 (4) (2005) pp.42-56
ISSN: 1351-5578AbstractThis paper is based on a study of overseas black and minority ethnic nurses in the NHS. Following a critical and analytical discussion of the principles of systematic reviewing, Obrey Alexis and Vasso Vydelingum describe the process of reviewing the literature and outlines the techniques of critically appraising all types of literature, including evidence that is opinion-based. -
Alexis O, Vydelingum V, 'Overseas black and minority ethnic registered nurses in an English hospital: a phenomenological study'
Journal of Research in Nursing 10 (4) (2005) pp.459-472
ISSN: 1744-9871AbstractOverseas black and minority ethnic nurses have contributed significantly to the National Health Service (NHS) in the UK. Yet despite this, there was little information on how they had fared. This study was conducted to explore, describe and develop a greater understanding of the experiences of overseas black and minority ethnic nurses who are working in the NHS in the south of England. A phenomenological method was used. A total of 12 overseas black and minority ethnic nurses were interviewed in their own homes. Semi-structured interviews were tape-recorded, transcribed verbatim and analysed. The findings revealed eight themes, namely not feeling appreciated, feeling inadequate, feeling unwelcome, lack of opportunities for skill development and training, unfairness in nursing practice, performance review, support from overseas black and minority ethnic colleagues and proving self. The paper concludes by arguing that overseas black and minority ethnic nurses should be treated with respect as they play a significant role in the delivery of services in the NHS.Published here -
Chamber C, Alexis O, 'Creating an inclusive and diverse environment for black and minority ethnic nurses'
British Journal of Nursing 13 (22) (2004) pp.1355-1358
ISSN: 0966-0461AbstractBlack and minority ethnic nurses are an important part of today" s NHS and acknowledging the part that they play and creating an environment where they feel valued is essential for multiprofessional working. Celebration of the diversity that nurses from different ethnic backgrounds bring to nursing care and to team working is often absent from the cultural environment in which nurses work. In fact, nurses can feel discriminated against and feel that their ethnic background is adversely affecting their career progression (Beishon et al, 1995). Creating a culturally competent environment should be central to the ethos of the NHS and cultural awareness and cultural empowerment are key components of an enhanced level of cultural competence. Educational and career development opportunities are essential in enhancing confidence and self-esteem and in creating career progression equality for nurses from different ethnic backgrounds.Published here -
Alexis O, Vydelingum V, 'The lived experience of overseas black and minority ethic nurses in the national health service in the south of england'
Diversity in Health and Social Care 1 (1) (2004) pp.13-20
ISSN: 1743-1913AbstractThe NHS has always depended heavily on the recruitment of black and minority ethnic nurses from overseas. Recent international recruitment strategies have resulted in attracting a new influx of overseas nurses who, like their predecessors, make a significant contribution to healthcare in England. In the study reported here, a phenomenological approach was used to examine the lived experiences of 12 nurses who originated from the Philippines, South Africa, the Caribbean and sub-Saharan Africa and who had recently been recruited to work in the NHS in the south of England. Semi-structured interviews were tape-recorded, transcribed verbatim and analysed using Van Manen's analytical framework to reveal eight themes: differences in nursing practice, adjustment to a new environment, differences in communication, absence of support, discrimination, lack of equal opportunity, bullying and separateness. Overall the findings showed that the nurses were marginalised and felt excluded. This paper concludes by arguing that overseas black and minority ethnic nurses should be treated with respect but, more importantly, that social justice and equality should be principles that are inherent in the NHS. -
Alexis O, Worsley AJ, 'The impact of ethnicity on decisions and decision making in prostate cancer: an integrative review.'
Ethnicity and Health
ISSN: 1355-7858 eISSN: 1465-3419AbstractOpen Access on RADARObjectives: There are various factors that influence men’s treatment decision-making for prostate cancer. However, the evidence has not been synthesized by ethnicity. The aim of this integrative review is to identify studies exploring men’s decision making treatment choices for prostate cancer by ethnicity.
Design: Literature was sought from British Nursing Database, CINAHL, PsycINFO and PubMed. The inclusion criteria consisted of studies that concerned men from any ethnic background and had received a diagnosis for prostate cancer and treatment decision making was discussed. 12 papers were included in this review.
Results: The results showed that a combination of external and internal influences affected men’s treatment decision making based on ethnicity. Men from certain ethnic backgrounds opted for certain types of treatment over others depending on their personal contexts which was further divided amongst age, education, and language spoken. Generally, White men were more likely to opt for surgery, with Black and Hispanic men less likely to undergo surgery.
Conclusion: In this review, White and Black men stated that their doctors’ recommendation was a factor in their treatment decision making for prostate cancer, however other men reported that their doctors were less helpful with language representing a barrier. Further UK studies are required.
Book chapters
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Worsley A, Alexis O, 'Synthesizing Qualitative Studies Exploring Gay and Bisexual Men’s Experiences of Prostate Cancer' in SAGE Research Methods Cases, Sage (2020)
ISBN: 9781529712957AbstractPublished here Open Access on RADARLiterature reviews are ideal for summarizing and understanding all the available data about a particular topic. Researchers must find and analyze all the current knowledge on a subject if they are to present a succinct review. A meta-synthesis consists of a literature review of qualitative studies only. The extracted data are then synthetized into a narrative where the current knowledge on a topic can then be evaluated. Research of a qualitative nature is useful for obtaining the thoughts and feelings of a particular population and can provide crucial insights into their ontological perspectives. A meta-synthesis process can be a viable approach to deepening our understanding of a distinct body of qualitative research. This case study will provide an overview into how a review of qualitative studies was conducted on a particular health care issue and will explain the process undertaken by the researchers. The study will explain how the search strategy was conceived, how the data were synthesized, and the value a meta-synthesis can add to the body of existing literature.
Other publications
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Bamidele, O. Alexis, O., Ogunsanya, ME., Greenley, S. and Worsley, A., 'A systematic review of barriers and facilitators to access and utilisation of post-treatment psychosocial support by Black men treated for prostate cancer', (2020)
Published here Open Access on RADAR
Professional information
Memberships of professional bodies
Obrey is the chair of:
- The Independent Advisory Group to Hampshire Constabulary for the Northern Area.
- The North Hampshire Caribbean and African Network from 2002 to 2008.
He is also a member of:
- Chair of Independent Advisory Group for the Police Service in Aldershot, Basingstoke and Rushmoor. Sept 2006 – Sept 2015.
- Member of the Black Asian and Minority Ethnic Advisory Group to the Chief Nursing Officer in England.
- Member of the Independent Advisory Group for the Police Service in Aldershot, Basingstoke and Rushmoor. Sept 2015 – January 2020.
- A member of Sigma Theta Tau International
- A member of UK Nursing Oncology Society
- Senior Fellow at the Higher Education Academy [Advance HE]
- A member of the European Public Health Association [EUPHA] and Migrant and Ethnic Minority Health.
- Prostate Cancer Transatlantic Consortium – CaPTC.
- Inclusion, Diversity and Gender Network at Oxford Brookes University.
- BAME staff Network at Oxford Brookes University.
- Invited Editorial Board Member of the Journal of Cancer Nursing Practice.
- Invited Editorial Board Member for the Journal of Multidisciplinary Research in Healthcare.
- Invited member Task and finish group: Mary Seacole Leadership and Development Awards.
- Invited Clinical Advisory Board Member for Prostate Cancer Research.
- Invited member for the African Caribbean Cancer Consortium.
- Invited Clinical Advisory Board Member for Prostate Cancer UK.
- Invited Editorial Board Member of BMC Nursing.
Further details
As a result of funding from the Mary Seacole Award, Obrey developed the following two you tube videos to raise awareness of prostate cancer in Black African and Black Caribbean communities:
- https://www.youtube.com/watch?v=mxgVhDcza6E&t=12s (approximately 3.25 mins)
- https://www.youtube.com/watch?v=PRZWlpywT2k&t=160s (approximately 16.24 mins)