Blog
Meeting in Edinburgh, Seminar in London
Sunday, November 08, 2009
We held the second meeting of our NIHR Peer Learning Set for Normalization Process Theory in Edinburgh last week. It was a great success, and I've discussed it briefly in my blog - along with a link to a seminar that I'm giving in London on 18 November - details at http://socioblog252.blogspot.com/
First grant to combine NPT and MDM, and an NPT masterclass
Thursday, October 15, 2009
Frances Mair, Victor Montori, and I have now secured funding for a study that will explore the interactions between Normalization Process Theory as an analytic toolkit and minimally disruptive medicine as a policy objective. We will be exploring the ways that people with heart failure make sense of the work of being sick and integrate it with the work of patienthood. This is really exciting, and promises to grow an exciting collaboration.
More info at:
http://minimallydisruptivemedicine.org/2009/10/15/great-news-new-grant
And today also saw a great NPT masterclass hosted by Glasgow Caledonian University. There was a crowd of about 40 senior academic staff - and afterwards an interesting conversation convened by Professor Francine Cheater. I got interested in things I hadn't thought about, like the application of NPT to problems in sport....
Analysing illness experiences with Normalization Process Theory
Monday, September 28, 2009
I'm involved in three really interesting and closely interconnected projects at the moment. In all three we’re using normalization process theory to explore the work of being sick. First of all, a group led by Chris Dowrick, is using NPT to examine the work of being depressed. This group has its counterpart in a group led by Victor Montori at the Mayo Clinic, who is leading a programme of work that explores the burden of work in chronic illness and comorbidity, again using NPT, but combining it with our work on Minimally Disruptive Medicine. Finally, Frances Mair and I are working with Katie McGrath – a really interesting early career research in general practice – to develop an NPT based analysis of the interaction between burden of illness and burden of treatment in people with chronic heart failure.
More details are at http://socioblog252.blogspot.com/
Even more Minimally Disruptive Medicine
Saturday, August 29, 2009
Our paper on Minimally Disruptive Medicine is now published in the British Medical Journal off-line. The Mayo Clinic has posted a video of co-author Victor Montori giving a brilliant presentation of MDM at http://vimeo.com/6328967
More minimally disruptive medicine
Wednesday, August 19, 2009
A very thoughtful and interesting post on the PalliMed blog (http://www.pallimed.org/2009/08/minimally-disruptive-medicine.html) discusses the clinical implications of our recent BMJ paper on Minimally Disruptive Medicine. Even though this hasn't appeared in the hard copy of the journal yet, I've been really pleased by the positive responses not to the paper - not least from some of my own colleagues here in Newcastle. For me, one of the key conceptual issues that has arisen out of this is how to understand the complex relationships between the burden of the lived experience of illness and the procedural and practical burden of treatment. It's quite clear, when we make up an NPT matrix for Minimally Disruptive Medicine that professionals and patients end up doing different kinds of work. Understanding how those two kinds of work come together is important if MDM is to be a reality.
Minimally Disruptive Medicine
Wednesday, August 12, 2009
One of the features of my work, first of all around chronic disease management in primary care, and then around telemedicine and related technologies, is the sense that patients are increasingly burdened by the delivery, management and organization of their own treatments. This is especially true as the 'self-care' revolution takes off. With Victor Montori and Fances Mair, I have proposed that we need Minimally Disruptive Medicine. The aim here is to accept that the burden of work transferred from the clinic to the home is growing steadily greater, and that the burden of illness plus the burden of treatment may be too great for some people to bear. This is especially the case as a growing population of older people suffer an increasing number of co-morbidities. This view stems from the ways that we are using Normalization Process Theory to think about the new kinds of healthcare work that are implemented, embedded, and integrated, in everyday life - and which are crossing the boundaries between the clinic and the home.
Our paper is published today in the British Medical Journal, you can download it at:
http://www.bmj.com/cgi/content/full/bmj.b2803?ijkey=GrnqZhD5tbhn2VA&am
At long last.....
Monday, August 10, 2009
Six weeks after it was published, Sage publications have finally released the open access version of our Outline of Normalization Process Theory.
It can be found here:
http://soc.sagepub.com/cgi/content/abstract/43/3/535
Final versions of Normalization Process Theory papers now published
Monday, June 15, 2009
Two key Normalization Process Theory papers have now been published in final form, and the manuscript versions previously available on my academia.edu page are going to be taken down soon. The published articles can be found at:
May C, Finch T: Implementation, embedding, and integration: an outline of Normalization Process Theory. Sociology 2009, 43(3):535-554. http://soc.sagepub.com/cgi/content/abstract/43/3/535
May C, Mair FS, Finch T, MacFarlane A, Dowrick C, Treweek S, Rapley T, Ballini L, Ong BN, Rogers A et al: Development of a theory of implementation and integration: Normalization Process Theory. Implementation Science 2009, 4(29). http://www.implementationscience.com/content/4/1/29/abstract/
Telecare, ethics, ageing
Tuesday, June 09, 2009
Maggie Mort and Celia Roberts have edited a special edition of ALTER, with papers exploring the socio-technical and ethical problems of telecare. The special edition can be found here.
http://www.em-consulte.com/revue/alter/3/2
This is an important special edition because so few studies of telecare and telemedicine seriously engage with the people who use them. This has been a longstanding problem, one where the 'patient satisfaction survey' has tended to be a substitute for genuine engagement between service providers, designers, and the citizens that use telecare systems.
Developing theory
Friday, May 22, 2009
One problem for students and researchers interested in evaluating theories in the social sciences is understanding the trajectory of their development. Because theory is so important in explaining and understanding social phenomena we need to know how they are put together and operationalized. This helps us adjudicate on the claims of theorists about their work, its validity, and its practical usefulness. After all, there's nothing so practical as a good theory!
The network of researchers that has coalesced around developing Normalization Process Theory has just published a paper that describes the work of defining and developing NPT - it shows how the theory was organized and enacted practically in a series of well defined discrete tasks that ran from the development of a set of empirical generalizations about telemedicine systems to a fully formed middle range theory of implementation and integration
The paper is available here: www.implementationscience.com/content/4/1/29
May C, Mair FS, Finch T, MacFarlane A, Dowrick C, Treweek S, et al. Development of a theory of implementation and integration: Normalization Process Theory. Implementation Science. 2009;4(29).
Developing an on-line resource for Normalization Process Theory
Monday, May 11, 2009
Normalization Process Theory enables clinicians and managers to understand the dynamics of embedding new healthcare techniques and organizational changes in context.
In the UK, the Economic and Social Research Council (ESRC) has now anounced that it will fund the development of an on-line users manual and web-based tools that will assist researchers, clinicians, and managers in employing NPT. This is a major investment by the ESRC, and over the next 12 months it will involve authoring an on-line users' manual for NPT, developing a set of web-enabled tools for users, and will conclude with a major symposium.
Investigators on this project include: Frances Mair, Elizabeth Murray, Carl May, Shaun Treweek, Tim Rapley and Tracy Finch. International collaborators include Anne MacFarlane (NUI Galway), Luciana Ballini (Bologna), Jane Gunn (Melbourne), Mary Ellen Purkis (Victoria), France Legare (Montreal), and Victor Montori (the Mayo Clinic).
The protocol for the project is available at:
http://newcastle.academia.edu/CarlMay/Papers/94657/Protocol--Normalizi
In Sickness and In Health
Saturday, April 25, 2009
In Sickness and In Health 2009 was a great conference. Highlights for me were a plenary by Sioban Nelson (Toronto) on 'imperial residues' in nursing training, and a paper on the ways that professionals account for intuition by Michael Traynor (Middlesex). Traynor's argument was that professionals in his study sought to damp down notions of intuition by appeals to evidence and science - he cited this as evidence of regulatory objectivity.
Tacked on to the conference was a weekend workshop on 'Redesigning Patient Care' convened by Mary Ellen Purkis of Victoria University (British Columbia) and Lynn Stevenson (Vancouver Island Health Authority). There is some great work going on in BC around understanding the contents and dynamics of nursing work.
Finally, an important message about salad.
http://timontheweb.com/Reels/Salad_The_Silent_Killer.html
Normalization Process Theory News
Tuesday, April 14, 2009
The NPT site (www.normalizationprocess.co.uk) has been really successful. Much more successful than any of us expected, in fact, and now gets several hundred views a month. Part of this is a result of Dan Pargeter's NPT Wikipedia entry linking directly to the site. Access stats for the NPT wkipedia page site show a steady increase in interest too.
The next NPT paper will be published in Sociology in June 2009. It will be the first 'Open Access' paper published by that journal - which is also an achievement. It's currently available as a manuscript for download from this page ('Implementing, Embedding and Integrating Practices: An Outline of Normalization Process Theory').