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Randell E, Nollett C, Henley J, Smallman K, Johnson S, Meister L, McNamara R, Wilkins D, Segrott J, Casbard A, Wakelyn J, McKay K, Bordea E, Totsika V, Kennedy E. Watch Me Play!: protocol for a feasibility study of a remotely delivered intervention to promote mental health resilience for children (ages 0-8) across UK early years and children's services. Pilot Feasibility Stud 2024; 10:55. [PMID: 38576026 PMCID: PMC10993464 DOI: 10.1186/s40814-024-01491-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/26/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Half of mental health problems are established by the age of 14 years and 75% by 24 years. Early intervention and prevention of mental ill health are therefore vitally important. However, increased demand over recent years has meant that access to child mental health services is often restricted to those in severest need. Watch Me Play! (WMP) is an early intervention designed to support caregiver attunement and attention to the child to promote social-emotional well-being and thereby mental health resilience. Originally developed in the context of a local authority mental health service for children in care, it is now also delivered online as a low intensity, scalable, preventative intervention. Although WMP shows promise and is already used in some services, we do not yet know whether it is effective. METHODS A non-randomised single group feasibility study with embedded process evaluation. We propose to recruit up to 40 parents/carers of children aged 0-8 years who have been referred to early years and children's services in the UK. WMP involves a parent watching the child play and talking to their child about their play (or for babies, observing and following signals) for up to 20 min per session. Some sessions are facilitated by a trained practitioner who provides prompts where necessary, gives feedback, and discusses the child's play with the caregiver. Services will offer five facilitated sessions, and parents will be asked to do at least 10 additional sessions on their own with their child in a 5-week period. Feasibility outcomes examined are as follows: (i) recruitment, (ii) retention, (iii) adherence, (iv) fidelity of delivery, (v) barriers and facilitators of participation, (vi) intervention acceptability, (vii) description of usual care, and (viii) data collection procedures. Intervention mechanisms will be examined through qualitative interview data. Economic evaluation will be conducted estimating cost of the intervention and cost of service use for child and parents/carers quality-adjusted life years. DISCUSSION This study will address feasibility questions associated with progression to a future randomised trial of WMP. TRIAL REGISTRATION ISRCTN13644899 . Registered on 14th April 2023.
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Affiliation(s)
| | - Claire Nollett
- Centre for Trials Research, Cardiff University, Cardiff, Wales
| | - Josie Henley
- School of Social Sciences, Cardiff University, Cardiff, Wales
| | - Kim Smallman
- Centre for Trials Research, Cardiff University, Cardiff, Wales
| | - Sean Johnson
- Centre for Trials Research, Cardiff University, Cardiff, Wales
| | - Lena Meister
- Centre for Trials Research, Cardiff University, Cardiff, Wales
| | - Rachel McNamara
- Centre for Trials Research, Cardiff University, Cardiff, Wales
| | - David Wilkins
- School of Social Sciences, Cardiff University, Cardiff, Wales
| | - Jeremy Segrott
- Centre for Trials Research, DECIPHer Centre, Cardiff University, Cardiff, Wales
| | - Angela Casbard
- Centre for Trials Research, Cardiff University, Cardiff, Wales
| | | | - Kathy McKay
- Tavistock and Portman NHS Foundation Trust, London, England
| | | | | | - Eilis Kennedy
- Tavistock and Portman NHS Foundation Trust, London, England
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Aladegboye MK, Olowokere AE. Healthcare Service Needs of Orphans and Vulnerable Children in Orphanages and Barriers Caregivers face in meeting their Healthcare Service Needs: A Mixed Method Research. PSYCHOL HEALTH MED 2024; 29:670-681. [PMID: 37450470 DOI: 10.1080/13548506.2023.2236024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
Poor health and well-being among orphans and vulnerable children (OVC) in orphanages has been documented in literature, and evidence has shown an association between access to healthcare and well-being among this population. This study assessed the healthcare service needs of OVC and explored the barriers their caregivers face in meeting their healthcare service needs using a mixed method research approach. The study utilized a multi-stage sampling technique in selecting 384 OVC and 14 caregivers that participated in the study. Data were collected using pre-tested questionnaire and interview guide. The quantitative data were analyzed using Statistical Product and Service Solutions (SPSS) version 23, while the qualitative data were analyzed using thematic and content analysis. The result of the study shows that regular health assessment while in the orphanage tops the list of health services needed by OVC; this was followed by health assessment before or during admission into orphanages and facility visits for management of common illness by health professionals while health education for the children and caregivers ranked third. Mental healthcare was the least need reported by the children. From the caregivers' perspectives, financial, structural and psychological barriers emerged as major themes for barriers faced in meeting the healthcare service needs of OVC. The study concluded that OVC are mainly in need of regular health assessment and treatment of common ailments during facility visits by health professionals. The study further shows that caregivers face significant barriers in meeting the healthcare service needs of OVC.
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Affiliation(s)
- Mercy K Aladegboye
- Department of Community Health Nursing, Faculty of Nursing Sciences, University of Medical Science, Ondo, Nigeria
| | - Adekemi E Olowokere
- Department of Nursing Science, Faculty of Basic Medical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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3
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Ferro L, Cariello M, Colombesi A, Adduci C, Centonze E, Baccini G, Cristofanelli S. The Well-Being of Social Health Professionals: Relationship between Coping Strategies, Emotional Regulation, Metacognition and Quality of Professional Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:51. [PMID: 38248516 PMCID: PMC10815882 DOI: 10.3390/ijerph21010051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024]
Abstract
Social health professionals should have the knowledge and skills and use personal resources that promote the helping relationship, access to effective intervention strategies, and well-being at work. This study aims to investigate the relationship between some personal resources (coping strategies, emotional regulation and metacognition) and professional satisfaction in a group of social-health professionals working with minors suffering from psychosocial distress. In this professional group, the risk of burnout is common and the quality of professional life is strongly related to the intensity and frequency of exposure to critical and traumatic events. The sample was assessed using self-report instruments: Professional Quality of Life Scale, Coping Orientation to the Problem Experienced, Difficulties in Emotional Regulation Scale and Metacognition Self-Assessment Scale. The quality of professional life showed significant correlations with the psychological characteristics studied. We then tested different regression models: coping orientation scores were found to be a significant predictor of quality of work life for all three components, while emotional dysregulation scores appeared to predict only the burnout component. The quality of professional life of social health professionals was influenced by individual resources at different levels, regardless of knowledge and skills. They showed greater fatigue and aspects of secondary traumatization when emotional disengagement occurred and it seemed to be difficult for them to accept their emotional reactions.
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Affiliation(s)
- Laura Ferro
- Department of Psychology, Faculty of Psychology, University of Valle d’Aosta, 11100 Aosta, Italy; (A.C.); (S.C.)
| | - Marina Cariello
- TIARE’, Association for Mental Health, 10125 Turin, Italy; (M.C.); (C.A.); (E.C.); (G.B.)
| | - Alessandra Colombesi
- Department of Psychology, Faculty of Psychology, University of Valle d’Aosta, 11100 Aosta, Italy; (A.C.); (S.C.)
- TIARE’, Association for Mental Health, 10125 Turin, Italy; (M.C.); (C.A.); (E.C.); (G.B.)
| | - Chiara Adduci
- TIARE’, Association for Mental Health, 10125 Turin, Italy; (M.C.); (C.A.); (E.C.); (G.B.)
| | - Eleonora Centonze
- TIARE’, Association for Mental Health, 10125 Turin, Italy; (M.C.); (C.A.); (E.C.); (G.B.)
| | - Giorgia Baccini
- TIARE’, Association for Mental Health, 10125 Turin, Italy; (M.C.); (C.A.); (E.C.); (G.B.)
| | - Stefania Cristofanelli
- Department of Psychology, Faculty of Psychology, University of Valle d’Aosta, 11100 Aosta, Italy; (A.C.); (S.C.)
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Williamson V, Larkin M, Reardon T, Ford T, Spence SH, Morgan F, Cathy C. Primary school-based screening for childhood mental health problems and intervention delivery: a qualitative study of parents in challenging circumstances. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2022. [DOI: 10.1080/13632752.2022.2122285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Victoria Williamson
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Michael Larkin
- Institute for Health and Neurodevelopment, Department of Psychology, Aston University, Birmingham, UK
| | - Tessa Reardon
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Susan H. Spence
- School of Applied Psychology and Australian Institute of Suicide Research and Prevention, Griffith University, Panama, Australia
| | | | - Creswell Cathy
- Department of Experimental Psychology, Anna Watts Building, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
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Monson K, Herrman H, Moeller-Saxone K, Humphreys C, Harvey C. How can mental health practitioners collaborate with child welfare practitioners to improve mental health for young people in out of home care? Early Interv Psychiatry 2021; 15:1768-1776. [PMID: 33474788 DOI: 10.1111/eip.13118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 11/07/2020] [Accepted: 01/04/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Young people who grow up in out of home care have higher risk of poor mental health outcomes than peers who grow up with their family-of-origin. Interagency collaboration is an important service-level intervention to improve access to mental healthcare. However, few descriptions of collaboration provide guidance about collaboration between individual practitioners. AIM This substudy aimed to contribute to a larger study-the Ripple project-through exploring the experiences of practitioners working across child welfare and mental health services regarding collaboration in the care of young people; and to identify practices that might enhance collaborative work and improve mental health outcomes. METHODS Practitioners from across child welfare and mental health services were purposively sampled and participated in focus groups. Recordings and transcriptions of focus groups were analysed to identify themes within and between groups. A cross-sector expert advisory group was involved in this work. RESULTS Focus groups were convened with 43 practitioners. We identified four themes during analysis, these were: shared understanding of the history and context of problems; specific skills and practices; self-awareness of workers and carers; and involving and supporting carers. CONCLUSIONS A number of practices were identified that might lead to enhanced collaboration between agencies and across interdisciplinary care teams. Supporting mental health practitioners to adopt these might assist interagency and interdisciplinary working.
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Affiliation(s)
- Katherine Monson
- Orygen, Melbourne, Australia.,NorthWestern Mental Health, Melbourne, Australia
| | - Helen Herrman
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | | | - Cathy Humphreys
- Department of Social Work, The University of Melbourne, Melbourne, Australia
| | - Carol Harvey
- NorthWestern Mental Health, Melbourne, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Australia
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A Systematic Review on Foster Parents' Psychological Adjustment and Parenting Style-An Evaluation of Foster Parents and Foster Children Variables. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010916. [PMID: 34682659 PMCID: PMC8535523 DOI: 10.3390/ijerph182010916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 10/04/2021] [Accepted: 10/14/2021] [Indexed: 01/04/2023]
Abstract
The current systematic review aimed to evaluate the variables influencing foster parents’ parenting stress, distress and parenting style, thereby supporting their adjustment and well-being as well as that of foster children. A PRISMA-guided search was conducted in three databases. Observational studies examining parenting stress, parenting distress (subsuming anxiety, depression and stress symptoms) and parenting style—all assessed through validated tools—were considered. A total of 16 studies were included, comprising N = 1794 non-relative foster parents (age range = 30–67 years). Results showed heightened parenting stress over time, both overall and compared to parents at large. Neither foster parents’ nor foster children’s socio-demographic characteristics significantly contributed to the increase in parenting stress; yet child-related stress and children’s externalizing problems were its main predictors. Foster parents’ couple cooperation was associated with reduced parenting stress. Moreover, the authoritative parenting style was associated with parental warmth, while the authoritarian style was associated with foster parents’ greater perceived burden, greater criticism and rejection toward the foster child. Evidence supports the mutual influence between foster parents and children. Foster care services should support foster parents’ needs within a concentric modular system, to ultimately provide better care for both foster parents and children.
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McLean K, Hiscock H, Scott D, Goldfeld S. Foster and kinship carer survey: Accessing health services for children in out-of-home care. J Paediatr Child Health 2021; 57:132-139. [PMID: 32949433 DOI: 10.1111/jpc.15157] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 07/14/2020] [Accepted: 08/14/2020] [Indexed: 10/23/2022]
Abstract
AIM To explore the experiences of Victorian foster and kinship carers in accessing health services for children in their care and to quantify the frequency of potential barriers to health care. METHODS On-line survey co-designed with the Foster Care Association of Victoria measuring carer-reported health service engagement by a child/young person in their care, ease of service access, time to receiving Medicare number and out-of-pocket health-related costs. A total of 239 foster and 51 kinship carers were recruited through email and social media by carer support agencies. RESULTS In total, 90% of children/young people had engaged with a general practitioner. Most had engaged with dental (75%), paediatric (72%), optometry (61%) and audiology (54%) services. Mental health services were most likely to be needed but not yet received. Neither carer education nor socio-economic status was associated with likelihood of service engagement. Carers reported that it was hardest to get appointments with mental health and paediatric services. Twenty-seven percent had waited to see a health service because of delays in carers receiving their Medicare number. Sixty percent of carers had paid out-of-pocket for health services; 78% of these had not been reimbursed. CONCLUSION Victorian foster and kinship carers report high health service use for children and young people in their care. Mental health services were the hardest to access with the largest gap between identified need and service use. Timely access to Medicare numbers and financial support are barriers to access that could be addressed. The development of integrated paediatric health care and clinicians co-located with child protection could also assist.
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Affiliation(s)
- Karen McLean
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Harriet Hiscock
- Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Health Services Research Unit, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Dorothy Scott
- Department of Social Work, Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Sharon Goldfeld
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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8
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Jennings S, Evans R. Inter-professional practice in the prevention and management of child and adolescent self-harm: foster carers' and residential carers' negotiation of expertise and professional identity. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:1024-1040. [PMID: 32285475 PMCID: PMC7318230 DOI: 10.1111/1467-9566.13071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Inter-professional collaboration remains a significant concern within healthcare and social care. However, there has been scant attention paid to practices at the interface of clinicians and carers, namely foster carers and residential carers. The present study considers child and adolescent self-harm management and prevention practices as a site of empirical interest due to reports that multi-agency teams are not effectively operating. Drawing upon a grounded theory approach, data were generated via semi-structured interviews and focus groups with residential carers (n = 15) and foster carers (n = 15) in Wales. Themes were developed through axial coding. The results present two central themes to explain the nature and perceived causes of inter-professional discord. First, there are clear contestations in expertise, with carers challenging clinicians' propositional knowledge in favour of their own experiential expertise. However, participants simultaneously endorse medical dominance, which contributes to their sense of disempowerment and marginalisation. Second, is the preclusion of carers' professional identity, primarily due to inadequate professionalisation procedures. Meanwhile, the privileging of their parenting role is perceived to support the perpetuation of courtesy stigma. Carers are then compelled to undertake the effortful labour of legitimisation. Together these thematic insights provide direction on mechanisms to improve inter-professional interactions, notably around training and accreditation.
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Affiliation(s)
- Stephen Jennings
- Centre for the Development and Evaluation of Complex Interventions for Public Health ImprovementCardiff UniversityCardiffUK
| | - Rhiannon Evans
- Centre for the Development and Evaluation of Complex Interventions for Public Health ImprovementCardiff UniversityCardiffUK
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Hurley D, Swann C, Allen MS, Ferguson HL, Vella SA. A Systematic Review of Parent and Caregiver Mental Health Literacy. Community Ment Health J 2020; 56:2-21. [PMID: 31541315 DOI: 10.1007/s10597-019-00454-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 09/07/2019] [Indexed: 12/14/2022]
Abstract
This study aimed to systematically review the current body of research on parent and caregiver mental health literacy. Electronic databases were searched in January 2018 with 21 studies meeting inclusion criteria. A narrative synthesis of quantitative and qualitative studies was conducted. Findings across studies suggest that parents and caregivers had limited mental health knowledge. Factors associated with help-seeking included cultural and religious beliefs, financial and knowledge barriers, fear and mistrust of treatment services, and stigma. Notable limitations include non-representative samples, cross-sectional research designs, and use of inconsistent and non-validated study measures. Research would benefit from more diverse samples, an increased focus on prevention, and controlled trials of educational programmes targeting mental health literacy.
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Affiliation(s)
- Diarmuid Hurley
- School of Psychology, University of Wollongong, Wollongong, Australia. .,Global Alliance for Mental Health and Sport, School of Psychology, University of Wollongong, Wollongong, Australia.
| | - Christian Swann
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, NSW, Australia.,Centre for Athlete Development, Experience & Performance, Southern Cross University, Coffs Harbour, Australia
| | - Mark S Allen
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Helen L Ferguson
- School of Psychology, University of Wollongong, Wollongong, Australia.,English Institute of Sport, Manchester, England, UK
| | - Stewart A Vella
- School of Psychology, University of Wollongong, Wollongong, Australia.,Global Alliance for Mental Health and Sport, School of Psychology, University of Wollongong, Wollongong, Australia
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Evans RE. Survival, Signaling, and Security: Foster Carers' and Residential Carers' Accounts of Self-Harming Practices Among Children and Young People in Care. QUALITATIVE HEALTH RESEARCH 2018; 28:939-949. [PMID: 29577848 PMCID: PMC6146315 DOI: 10.1177/1049732318759935] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Research on clinicians' interpretations of self-harming practices has shown that they can often be negative. To date there has been limited consideration of other professionals' narratives, notably those working in social care. This article presents focus group and interview data generated with foster carers ( n = 15) and residential carers ( n = 15) to explore the symbolic meanings ascribed to self-harm among the children and young people they care for. Three repertoires of interpretation are presented: survival, which conceives self-harm as a mechanism for redefining the identity of "looked-after"; signaling, which understands self-harm as a communicative tool for the expression of emotion; and security, which sees self-harming practices as testing the authenticity and safety of the caring relationship. Through their focus on sociocultural narratives, carers position themselves as experts on self-harm due to their intimacy with young people's social worlds. This construction potentially creates distance from health professionals, which is problematic given the current privileging of interprofessional working.
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