Susceptibilidad de S nonagrioides a toxinas Cry

An invitation to participate in this study was sent to all qualified practicing mental health nurses in a particular Trust.

Although my sample of seventeen volunteers covered a range of ages, experience and gender, analysis of the data indicated that all of the participants were white and there was a high number (11 out of 17) who voluntarily identified themselves in the study as having a Catholic or Christian background.

Public information readily available from the Trust’s website shows in the region of 4,700 people are employed (of which a percentage are nurses but this is not specified in the available information). On enquiry, they kindly provided me with additional information on staff ethnicity which indicated that 91.42% of the whole Trust currently identified as white but their religious or spiritual affiliations were not included. Nevertheless, given that less than 10% of the population of this group are non-white, it is fair to assume that diverse mix of religious and spiritual beliefs may also be somewhat limited. The Trust’s figures show a higher percentage of white workers compared with national statistics where only 86% of the population identified as white. The ONS (2011) figures showed only 59% of the UK population identified as Christian, with Muslims as the second largest religious group at less than 5%. There is also an

176

increase in the proportion of people who report to have no religion whilst Christianity is decreasing.

Whilst my study provided rich, in depth data from my participants, the findings are limited to the population of nurses working as members of the Trust at that time and though they may have been representative of some other NHS Trusts’ (Priest et al, 2015) they were not fully representative of the wider population in the area it serves (ONS, 2011). Webster (2015) talked about the national disparity of white to BME groups and described an ‘uncomfortable truth’ regarding discrimination especially in leadership roles in the NHS which this particular Trust is anxious to address.

Priest et al (2015) looked at promoting equality for ethnic minority staff and proposed ways on how to address discrimination and promote ethnic diversity in the NHS. They recommended that mandatory policies are the most effective strategies in achieving diversity. In recognition of this, one of the Trust’s ‘core values’ was to show a commitment to promote equality and diversity in the way it provides its services and as an employer. The Trust’s Equality, diversity and inclusion report (2016), recommended a targeted recruitment strategy to improve the representation of Asian people within the workforce to reflect the communities it serves. There are also quality and policy documents supporting proactive strategies to ensure services respect and value differences readily available (SWPFT, 2017). These are aimed at meeting diverse needs of people for example gender, religion, disability, language and sexuality (SWYPFT, 2016).

The disparity in the diverse mix of the workforce in the Trust at that time may not be the only reason for the lack of diversity in this sample. Rugkasa and Canvin (2011) reported difficulties in recruiting people from ethnic minority backgrounds to participate in health research and said a comprehensive understanding cannot be achieved unless all sections of society are included as it might impact on the potential development of effective services. They go on to say that there is little published literature on practical ways to ensure qualitative research is accessible and meaningful to people from minority groups. Weatherhead and Daiches (2010) said some minority groups are

177

reluctant to access projects like mine because of the reputation of institutionalised racism evidenced by the lack of health professionals from minority backgrounds and the likely discrimination. Priest et al (2015) said that the experience of discrimination, bullying and harassment are higher amongst BME staff and this is harmful, not only the individual but to the wider organisation.

Whilst official figures from this Trust show minority groups may be underrepresented, as a former employee of the Trust my own experience was that there are in fact more non-white, non-Christian individuals working as nurses than these figures suggest. However, many of them are bank or agency workers because of the higher wages often afforded to agency staff and the opportunity to work extended or unsocial hours. Many of the agency nurses have families in other countries who are reliant on their income, hence their choice of employment but as a result would not have had the opportunity to participate in my study and would not be included in the Trust diversity data indicating a skewed perception of reality.

Another possible explanation for the high number of white Catholic participants may be understood from the interview invitation itself. Although the intention was to be inclusive of all mental health nurses regardless of religious, cultural or spiritual backgrounds, it is possible there were subtle indications within the message which may have affected the nurses in different ways. For example, I identified myself ‘Ruth Elliott’ and from this it is not unreasonable to assume I may be a female white Christian. Because of this, the participants may have identified with their perception of me at some level which could have affected their responses resulting in a large proportion of white Catholic participants. Conversely this may have also acted as a barrier to nurses from different cultures who may have been put off by this perception and might have responded more positively had my name reflected their own identity. This type of perception is not unusual in this type of study as Rugkasa and Canvin (2011) indicated in their reflection on recruitment of participants for mental health research in minority ethnic communities. They identified one of the main problems which affected recruitment was in relation to the gatekeeper of the study and whether the participant could identify with them. They reported that a barrier to including people from ethnic minority groups is a failure to take into consideration the ethnic composition of matching the interviewer to the

178

interviewees. They suggested qualitative research relies on the success of the researcher in using their own identities to connect with a particular group, such as age, religion, ethnicity and gender which could enable or constrain the research and data collection. The possibility of using certain identities or qualities may be a useful strategy in larger scale studies who have a team of people gathering data.

My study was an exploration of mental health nurses’ understanding of the spiritual needs of service users and there was a good response to my small scale study. However, it may be argued that the responses to my invitation was taken up by people who had strong feelings on the subject and felt a need to contribute. Literature and policy guidance (e.g. Swinton, 2001; Narayanasamy and Owen, 2001; RCN, 2011; McSherry and Jamieson, 2010) strongly advocated the benefits and importance of spirituality in health care but studies like mine rely on interested parties and the nature of ‘volunteering’ means that only interested parties will come forward to participate. Other potential participants fitting my inclusion criteria with less strong feelings or opinions about the value of spirituality may well not have participated because they did not have any particular interest in the subject matter. Spirituality and addressing spiritual need may not perceived as pertinent or indeed valuable to at least some mental health nurses and that emphasis on this aspect of care might be less important to those who did not volunteer. Therefore, the findings of research like this and indeed large-scale studies, like the RCN Spirituality Survey (2011), are limited to interested parties which suggests the true value of spirituality for the general population may be harder to assess. Nevertheless, the results and key findings of this study clearly show the richness of the data collected from the participants. However, the strong Christian influence within the responses must be acknowledged and may not reflect the understanding of spirituality from non-Christian religious and non-religious backgrounds. A research suggestion that could flow from this would be a repetition of the study but specifically recruit people from a broader variety of backgrounds including, purposive sampling of participants to include those identifying as members of other religious groups, atheist or non-religious.

179