1
|
van der Veen R, van der Burgt S, Königs M, Oosterlaan J, Peerdeman S. Team functioning in Neurorehabilitation: a mixed methods study. J Interprof Care 2024; 38:621-631. [PMID: 38470835 DOI: 10.1080/13561820.2024.2325694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
The objective of this study was to enhance understanding of team functioning in a neurorehabilitation team by identifying the factors that impede and facilitate effective interprofessional team collaboration. We focused on team identification, psychological safety, and team learning, and conducted the research at a neurorehabilitation center treating young patients with severe acquired brain injury in the Netherlands. A mixed-methods approach was employed, integrating quantitative data from questionnaires (N = 40) with qualitative insights from a focus group (n = 6) and in-depth interviews (n = 5) to provide a comprehensive perspective on team dynamics. Findings revealed strong team identification among participants, denoting a shared sense of belonging and commitment. However, limited psychological safety was observed, which negatively affected constructive conflict and team learning. Qualitative analysis further identified deficiencies in shared mental models, especially in shared decision-making and integrated care. These results highlight the crucial role of psychological safety in team learning and the development of shared mental models in neurorehabilitation settings. Although specific to neurorehabilitation, the insights gained may be applicable to enhancing team collaboration in various healthcare environments. The study forms a basis for future research to investigate the impact of improvements in team functioning on patient outcomes in similar settings.
Collapse
Affiliation(s)
- Ruud van der Veen
- Department of Pediatrics, Emma Children's Hospital, Follow-Me Program & Emma Neuroscience Group, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Daan Theeuwes Center for Intensive Neurorehabilitation, Woerden, The Netherlands
| | - Stéphanie van der Burgt
- Teaching and Learning Center (TLC), Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Quality of Care Group, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Marsh Königs
- Department of Pediatrics, Emma Children's Hospital, Follow-Me Program & Emma Neuroscience Group, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Daan Theeuwes Center for Intensive Neurorehabilitation, Woerden, The Netherlands
| | - Jaap Oosterlaan
- Department of Pediatrics, Emma Children's Hospital, Follow-Me Program & Emma Neuroscience Group, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
| | - Saskia Peerdeman
- Teaching and Learning Center (TLC), Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Quality of Care Group, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Department of Neurosurgery, De Boelelaan, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
2
|
Battle K, Lockeman KS, Dow AW, Donohoe KL, Hanley L, Slattum PW. Unpacking interactions among student teams in a practice-based IPE setting: a qualitative evaluation study. J Interprof Care 2024; 38:713-721. [PMID: 38717845 DOI: 10.1080/13561820.2024.2345829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 04/16/2024] [Indexed: 05/31/2024]
Abstract
In many healthcare settings, teams change composition regularly, so healthcare students must be trained to function effectively in dynamic teams before entering the workforce. Interprofessional clinical rotations provide an ideal venue for learners to practice these skills, but little is known about how student teams interact in such settings. In this qualitative observational evaluation, learners from multiple health professions at a single institution participated in scheduled clinics in low-income housing communities for older adults. Interprofessional student teams met with program participants for care coordination, health and wellness assessments, and assistance in setting and achieving health goals; team composition changed from week-to-week. A purposive sample was selected from video-recorded encounters between student teams and their program participants. The aim of this study was to explore team interactions and document learner behaviors. Two researchers independently reviewed discrete segments of each video, recorded their observations and reflections, and then the team discussed, categorized, and identified relevant examples of both effective and ineffective behaviors. Four major themes were observed: inclusiveness, leadership, joy of practice, and sharing of clinical knowledge. Students demonstrated both positive and negative examples of behaviors that aligned with each theme. Understanding how students behave on teams in dynamic settings where patient care is taking place can help educators establish practice-based interprofessional education models that better prepare learners to function effectively and strategies that may improve team interactions.
Collapse
Affiliation(s)
- Kimberly Battle
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Kelly S Lockeman
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Alan W Dow
- School of Medicine, Asst. Vice President of Health Sciences for Interprofessional Education and Collaborative Care, Virginia Commonwealth University, Richmond, VA, USA
| | - Krista L Donohoe
- School of Pharmacy, Virginia Commonwealth University, Richmond, VA, USA
| | - Lauren Hanley
- Medical Student, Virginia Commonwealth University, Richmond, VA, USA
| | - Patricia W Slattum
- School of Pharmacy, Virginia Center on Aging, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
3
|
Khemai C, Leão DLL, Janssen DJA, Schols JMGA, Meijers JMM. Interprofessional collaboration in palliative dementia care. J Interprof Care 2024; 38:675-694. [PMID: 38757957 DOI: 10.1080/13561820.2024.2345828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 04/16/2024] [Indexed: 05/18/2024]
Abstract
Interprofessional collaboration (IPC) is essential for high-quality palliative care (PC) for persons with dementia. The aim of this scoping review was to identify IPC approaches in palliative dementia care and explore the elements constituting these approaches. We performed a search in PubMed, CINAHL, and PsychINFO using the Joanna Briggs Institute Reviewers' manual and PRISMA guidelines, and conducted content analysis of the included articles. In total, 28 articles were included, which described 16 IPC approaches in palliative dementia care. The content analysis revealed three overall elements of these approaches: 1) collaborative themes, 2) collaborative processes, and 3) resources facilitating collaboration. Frequently reported collaborative themes embraced pain management and providing care in the dying phase. These themes were addressed through intertwined collaborative processes including communication, coordination, assessing and monitoring, and reflecting and evaluating. To ensure optimal IPC in palliative dementia care, various resources were required, such as PC knowledge, skills to manage symptoms, skills to communicate with collaborators, and a facilitating environment. In conclusion, the identified IPC approaches in palliative dementia care involve diverse collaborating professionals who mainly manage symptoms, prepare for the dying phase and require material and immaterial resources to enable optimal IPC in palliative dementia care.
Collapse
Affiliation(s)
- C Khemai
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - D L L Leão
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - D J A Janssen
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
- Department of Research and Development, Ciro, Horn, the Netherlands
| | - J M G A Schols
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - J M M Meijers
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
- Zuyderland Care, Zuyderland Medical Centre, Sittard-Geleen, the Netherlands
| |
Collapse
|
4
|
Zhao J, Wang BL, Qin X, Liu Y, Liu T. Core elements of excellent hospital leadership: lessons from the five top-performing hospitals in China. Int J Qual Health Care 2024; 36:mzae046. [PMID: 38804900 PMCID: PMC11168336 DOI: 10.1093/intqhc/mzae046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 04/22/2024] [Accepted: 05/27/2024] [Indexed: 05/29/2024] Open
Abstract
Substantial evidence indicates that leadership plays a critical role in an organization's success. Our study aims to conduct case studies on leadership attributes among China's five top-performing hospitals, examining their common practices. A semi-structured interview was conducted with 8 leaders, 39 managers, 19 doctors, and 16 nurses from the five sample hospitals in China. We collected information from these hospitals on the role of senior leadership, organizational governance, and social responsibility, aligning with the leadership assessment guidelines in the Baldrige Excellence Framework. Qualitative data underwent interpretation through content analysis, thematic analysis, and comparative analysis. This study adhered to the consolidated criteria for reporting qualitative research guidelines for reporting qualitative research. Our study revealed that the leaders of the five top-performing hospitals in China consistently established "Patient Needs First" as the core element of the hospital culture. Striving to build world-renowned hospitals with Chinese characteristics, the interviewees all believed strongly in scientific vigor, professionalism, and cooperative culture. The leaders adhered to a staff-centered approach, placing special emphasis on talent recruitment and development, creating a compensation system, and fostering a supportive environment conducive to enhancing medical knowledge, skills, and professional ethics. In terms of organizational governance, they continuously enhanced the communication between various departments and levels of staff, improved the quality and safety of medical care, and focused on innovative medical and scientific research, thereby establishing evidence-based, standardized hospital management with a feedback loop. Meanwhile, regarding social responsibility, they prioritized improvements in the quality of healthcare by providing international and domestic medical assistance, community outreach, and other programs. To a large extent, the excellent leadership of China's top-performing hospitals can be attributed to their commitment to a "Two-Pillared Hospital Culture," which prioritizes putting patient needs first and adopting a staff-centered approach. Furthermore, the leaders of these hospitals emphasize hospital performance, operations management, and social responsibility.
Collapse
Affiliation(s)
- Jinhong Zhao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 9, Dongdansantiao Street, Dongcheng District, Beijing 100730, China
| | - Bing-Long Wang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 9, Dongdansantiao Street, Dongcheng District, Beijing 100730, China
| | - Xiaoping Qin
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 9, Dongdansantiao Street, Dongcheng District, Beijing 100730, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 9, Dongdansantiao Street, Dongcheng District, Beijing 100730, China
| | - Tingfang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 9, Dongdansantiao Street, Dongcheng District, Beijing 100730, China
| |
Collapse
|
5
|
Thys T, Bogaert L, Dankaerts W, Depreitere B, Van Wambeke P, Brumangne S, Bultheel M, Vanden Abeele V, Moke L, Spriet A, Schelfaut S, Janssens L, Swinnen TW. Qualitative study exploring the views of patients and healthcare providers on current rehabilitation practices after lumbar fusion surgery. BMJ Open 2024; 14:e077786. [PMID: 38816040 PMCID: PMC11141188 DOI: 10.1136/bmjopen-2023-077786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 05/12/2024] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVES To explore the views of patients and healthcare providers on current rehabilitation after lumbar fusion surgery (LFS) to fuel the development of a novel rehabilitation care pathway. DESIGN A cross-sectional, qualitative study with an interpretive descriptive design. SETTING Academic and non-academic hospital setting in Belgium. PARTICIPANTS 31 caregivers from (non)-academic settings and 5 patients with LFS were purposefully sampled and in-depth interviewed. RESULTS Out of the data of all interviews, participants reported opinions on 23 thematic clusters that were expressed in a time-contingent manner from the preoperative, perioperative to postoperative phase. Afterwards, themes were mapped to the Consolidated Framework for Implementation Research, with a larger role for concepts related to the innovation, inner and individual domain. As an overarching theme, the importance of an 'individualised, patient-centred rehabilitation built on a strong therapeutic alliance with an accessible interprofessional team' was stressed for patients undergoing LFS. Specifically, participants stated that a biopsychosocial approach to rehabilitation should start in the preoperative phase and immediately be continued postoperatively. No consensus was observed for movement restrictions postoperatively. Uniform communication between the involved caregivers was considered essential for optimal therapeutic alliance and clinical outcome. The precise role and competence of each member of the interprofessional team needs, therefore, to be clearly defined, respected and discussed. An accessible case manager to guide the patient trajectory and tackle problems could further support this. Interestingly, only patients, psychologists and physiotherapists addressed return to work as an important outcome after LFS. CONCLUSIONS This qualitative study identified key experiences and points to consider in the current and future rehabilitation pathway for LFS. Future research should incorporate these findings to build a novel rehabilitation pathway for LFS and evaluate its feasibility and cost-effectiveness. TRIAL REGISTRATION NUMBER This study was registered at clinicaltrials.gov (NCT03427294).
Collapse
Affiliation(s)
- Tinne Thys
- Division of Physical Medicine and Rehabilitation, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Liedewij Bogaert
- Division of Physical Medicine and Rehabilitation, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Wim Dankaerts
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Bart Depreitere
- Division of Neurosurgery, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Peter Van Wambeke
- Division of Physical Medicine and Rehabilitation, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Simon Brumangne
- Division of Physical Medicine and Rehabilitation, KU Leuven University Hospitals Leuven, Leuven, Belgium
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Michael Bultheel
- Division of Physical Medicine and Rehabilitation, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Vero Vanden Abeele
- Department of Computer Science, E-media Research Lab, KU Leuven, Leuven, Belgium
| | - Lieven Moke
- Division of Orthopaedic Surgery, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Ann Spriet
- Division of Physical Medicine and Rehabilitation, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Sebastiaan Schelfaut
- Division of Orthopaedic Surgery, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Lotte Janssens
- Faculty of Rehabilitation Sciences, University Hasselt, Hasselt, Belgium
| | - Thijs Willem Swinnen
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- Division of Rheumatology, KU Leuven University Hospitals Leuven, Leuven, Belgium
| |
Collapse
|
6
|
de Melo GA, Peixoto MGM, Mendonça MCA, Musetti MA, Serrano ALM, Ferreira LOG. Performance measurement of Brazilian federal university hospitals: an overview of the public health care services through principal component analysis. J Health Organ Manag 2024; ahead-of-print. [PMID: 38773727 DOI: 10.1108/jhom-05-2023-0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
PURPOSE This paper aimed to contextualize the process of public hospital providing services, based on the measurement of the performance of Federal University Hospitals (HUFs) of Brazil, using the technique of multivariate statistics of principal component analysis. DESIGN/METHODOLOGY/APPROACH This research presented a descriptive and quantitative character, as well as exploratory purpose and followed the inductive logic, being empirically structured in two stages, that is, the application of principal component analysis (PCA) in four healthcare performance dimensions; subsequently, the full reapplication of principal component analysis in the most highly correlated variables, in module, with the first three main components (PC1, PC2 and PC3). FINDINGS From the principal component analysis, considering mainly component I, with twice the explanatory power of the second (PC2) and third components (PC3), it was possible to evidence the efficient or inefficient behavior of the HUFs evaluated through the production of medical residency, by specialty area. Finally, it was observed that the formation of two groups composed of seven and eight hospitals, that is, Groups II and IV shows that these groups reflect similarities with respect to the scores and importance of the variables for both hospitals' groups. RESEARCH LIMITATIONS/IMPLICATIONS Among the main limitations it was observed that there was incomplete data for some HUFs, which made it impossible to search for information to explain and better contextualize certain aspects. More specifically, a limited number of hospitals with complete information were dealt with for 60% of SIMEC/REHUF performance indicators. PRACTICAL IMPLICATIONS The use of PCA multivariate technique was of great contribution to the contextualization of the performance and productivity of homogeneous and autonomous units represented by the hospitals. It was possible to generate a large quantity of information in order to contribute with assumptions to complement the decision-making processes in these organizations. SOCIAL IMPLICATIONS Development of public policies with emphasis on hospitals linked to teaching centers represented by university hospitals. This also involved the projection of improvements in the reach of the efficiency of the services of assistance to the public health, from the qualified formation of professionals, both to academy, as to clinical practice. ORIGINALITY/VALUE The originality of this paper for the scenarios of the Brazilian public health sector and academic area involved the application of a consolidated performance analysis technique, that is, PCA, obtaining a rich work in relation to the extensive exploitation of techniques to support decision-making processes. In addition, the sequence and the way in which the content, formed by object of study and techniques, has been organized, generates a particular scenario for the measurement of performance in hospital organizations.
Collapse
Affiliation(s)
| | | | | | | | | | - Lucas Oliveira Gomes Ferreira
- Department of Accounting and Actuarial Sciences, Faculty of Economics, Administration, Accounting and Public Policy Management, University of Brasília, Brasilia, Brazil
| |
Collapse
|
7
|
Fraticelli L, Verot E, Späth HM, Genton MC, Kempf C, Clement C, Darlington-Bernard A, Roy S, Dussart C, Mick G, Carrouel F. Glossary of healthcare pathways: a methodological approach involving a transdisciplinary team in public health. Front Public Health 2024; 12:1347774. [PMID: 38645449 PMCID: PMC11026848 DOI: 10.3389/fpubh.2024.1347774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/20/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction The healthcare pathway is at the heart of public health organization concerns, but communication between the various players can be an obstacle. This work, produced by a French transdisciplinary team, offers a methodological approach based on formalized consensus to elaborate a glossary of healthcare pathways. A two-steps procedure was elaborated, including a double rounded Delphi method to formalize expert consensus, and two groups of experts: a workgroup and a review group. Methods The workgroup provided a list of words or expressions that, in their opinion, described, evaluated or compared the healthcare pathways for patients, caregivers or regulators. The review group checked this list and added or deleted words or expressions. Then, definitions were added by the workgroup based into account three dimensions: official, academic and from the field. The review group validated the definitions and provided complementary proposals if needed. Results After pooling the list of words proposed by each of the six members of the working group, 417 words/expressions were ranked. After the two rounds of evaluation, 294 words/expressions were rated "appropriate" and were analyzed by the review group. This group, after two rounds of evaluation, agreed on 263 words/expressions that were transmitted to the working group who defined them. These definitions were rated by the review group. The first round of evaluation established 195 definitions as being appropriated whereas 68 definitions were amended by the review group. Conclusion This glossary supports transdisciplinary communication, reduces the extent of variations in practice and optimizes decision-making. International debate on all aspects might be strengthened by an improved understanding of the concept of health pathway.
Collapse
Affiliation(s)
- Laurie Fraticelli
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Elise Verot
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
- Presage Institute, University Jean Monnet, Saint-Etienne, France
- CIC 1408 Inserm, CHU of Saint-Etienne, Saint-Etienne, France
| | - Hans-Martin Späth
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Marine C. Genton
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Cédric Kempf
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Celine Clement
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
- Laboratory Interpsy, UR4432, University of Lorraine, Nancy, France
| | - Adeline Darlington-Bernard
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Sylvain Roy
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| | - Claude Dussart
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
- Hospices Civils of Lyon, Lyon, France
| | - Gérard Mick
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
- CHU Grenoble-Alpes-Voiron, Voiron, France
| | - Florence Carrouel
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, Lyon, France
| |
Collapse
|
8
|
Takagishi SC, Grinberg AS, Lindsey H, Goldman RE, Baird SA, Burrone L, Sico JJ, Damush TM. Headache Specialists' Perceptions of the Role of Health Psychologists in Headache Management: A Qualitative Study. Cureus 2024; 16:e56175. [PMID: 38618328 PMCID: PMC11015910 DOI: 10.7759/cureus.56175] [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] [Accepted: 03/14/2024] [Indexed: 04/16/2024] Open
Abstract
Background Since headache specialists cannot treat all the patients with headache disorders, multidisciplinary teams that include health psychologists are becoming more prevalent. Health psychologists mainly use a form of cognitive-behavioral therapy (CBT), along with biofeedback on occasion, to effectively address patients' pain and headache disorders. The Veterans Health Administration (VHA) is one setting that routinely includes a health psychologist with advanced training in pain disorders in their pain care to its veterans. The VHA has established Headache Centers of Excellence (HCoE) around the country to provide multidisciplinary treatment for patients with headache disorders, which enables headache specialists to regularly interact with health psychologists. Objective The study's objective is to evaluate headache specialists' views of health psychologists in the treatment of patients with headache disorders. Method Semi-structured interviews were conducted with headache specialists in academic-based healthcare settings, the community, and VHA HCoE sites. The interviews were audio-recorded and de-identified so they could be transcribed and analyzed using content matrix analysis. Results Four themes emerged: headache specialists desired to work with health psychologists and included them as members of multidisciplinary teams; valued health psychologists because they provided non-pharmacological treatments, such as CBT and biofeedback; preferred in-person communication with health psychologists; and used multiple titles when referring to health psychologists. Conclusion Headache specialists valued health psychologists as providers of behavioral and non-pharmacological treatments and considered them essential members of multidisciplinary teams. Headache specialists should strive to work with a headache psychologist, not just a general health psychologist. By committing to this, headache specialists can foster changes in the quality of care, resource allocation, and training experiences related to health psychologists.
Collapse
Affiliation(s)
- Stanley Curtis Takagishi
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Psychology, James A. Haley Veterans' Hospital, Tampa, USA
| | - Amy S Grinberg
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Neurology, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
- Pain Research, Informatics, Multi-morbidities, and Education (PRIME) Center, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
| | - Hayley Lindsey
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Neurology, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
| | - Roberta E Goldman
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Anthropology & Family Medicine, Warren Alpert Medical School of Brown University, Providence, USA
- Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Sean A Baird
- Health Research & Development Service, Richard L. Roudebush VA (Veterans Affairs) Medical Center, Indianapolis, USA
| | - Laura Burrone
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Neurology, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
- Pain Research, Informatics, Multi-morbidities, and Education (PRIME) Center, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
| | - Jason J Sico
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Neurology, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
- Pain Research, Informatics, Multi-morbidities, and Education (PRIME) Center, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
- Neurology, Yale School of Medicine, New Haven, USA
| | - Teresa M Damush
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Health Research & Development Service, Richard L. Roudebush VA (Veterans Affairs) Medical Center, Indianapolis, USA
- Center for Health Services and Outcomes Research, Indiana University School of Medicine, Indianapolis, USA
- Center for Health Services and Outcomes Research, Regenstrief Institute, Inc., Indianapolis, USA
| |
Collapse
|
9
|
Weismantel I, Zhang N, Burston A. Exploring intensive care nurses' perception of simulation-based learning: A systematic review and meta-synthesis. J Clin Nurs 2024; 33:1195-1208. [PMID: 38258507 DOI: 10.1111/jocn.17016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/13/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024]
Abstract
AIM(S) To explore intensive care nurses' (ICN) perceptions of simulation-based learning (SBL). DESIGN A systematic review and meta-synthesis. METHODS The review followed the PRISMA guidelines for reporting a systematic review. A systematic search strategy was developed using a modified PICo framework. A comprehensive search was conducted in July 2023 in CINAHL, OVID Embase, Medline complete, Web of Science, ERIC and Scopus databases for articles published in English between 2013 and 2023. Data were extracted using the Joanna Briggs Institute QARI Data Extraction, with data synthesis guided by Braun and Clark's thematic analysis approach. Quality appraisal was assessed using the CASP tool. RESULTS Eleven studies providing qualitative data were included for analysis. Analysis and meta-synthesis led to the construction of two themes: The learning experience and professional growth through collaboration. CONCLUSION The review highlights the balance needed in finding the appropriate simulation approach, with the right level of fidelity, conducted at appropriately regular intervals, incorporating the correct makeup of professional team members, conducted in the right environment and facilitated by a skilled facilitator, to ensure best outcomes and return on investment for ICN's education. IMPLICATIONS FOR PRACTICE These findings are a valuable resource for educators and organisations considering simulation-based learning initiatives in the intensive care setting. NO PATIENT OR PUBLIC CONTRIBUTION This review involved analysis of existing literature and as such no unique patient or public involvement occurred. REPORTING METHOD The systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) reporting guidelines.
Collapse
Affiliation(s)
- Isabella Weismantel
- School of Nursing, Midwifery and Paramedicine (Melbourne), Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Nancy Zhang
- School of Nursing, Midwifery and Paramedicine (Melbourne), Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Adam Burston
- Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia
- School of Nursing, Midwifery and Paramedicine (Brisbane), Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
| |
Collapse
|
10
|
Gomes Souza L, Bouba DA, Corôa RDC, Dofara SG, Robitaille V, Blanchette V, Kastner K, Bergeron F, Guay-Bélanger S, Izumi SS, Totten AM, Archambault P, Légaré F. The Impact of Advance Care Planning on Healthcare Professionals' Well-being: A Systematic Review. J Pain Symptom Manage 2024; 67:173-187. [PMID: 37827454 DOI: 10.1016/j.jpainsymman.2023.09.026] [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: 06/12/2023] [Revised: 09/08/2023] [Accepted: 09/16/2023] [Indexed: 10/14/2023]
Abstract
CONTEXT Advance care planning (ACP) improves care for patients with chronic illnesses and reduces family stress. However, the impact of ACP interventions on healthcare professionals' well-being remains unknown. OBJECTIVE To systematically review the literature evaluating the impact of ACP interventions on healthcare professionals' well-being. METHODS We followed the Joanna Briggs Institute methodology for systematic reviews and registered the protocol in PROSPERO (CRD42022346354). We included primary studies in all languages that assessed the well-being of healthcare professionals in ACP interventions. We excluded any studies on ACP in psychiatric care and in palliative care that did not address goals of care. Searches were conducted on April 4, 2022, and March 6, 2023 in Embase, CINAHL, Web of Science, and PubMed. We used the Mixed Methods Appraisal Tool for quality analysis. We present results as a narrative synthesis because of their heterogeneity. RESULTS We included 21 articles published in English between 1997 and 2021 with 17 published after 2019. All were conducted in high-income countries, and they involved a total of 1278 participants. Three reported an interprofessional intervention and two included patient partners. Studies had significant methodological flaws but most reported that ACP had a possible positive impact on healthcare professionals' well-being. CONCLUSION This review is the first to explore the impact of ACP interventions on healthcare professionals' well-being. ACP interventions appear to have a positive impact, but high-quality studies are scarce. Further research is needed, particularly using more rigorous and systematic methods to implement interventions and report results.
Collapse
Affiliation(s)
- Lucas Gomes Souza
- Department of Social and Preventive Medicine (L.G.S., D.A.B.), Faculty of Medicine, Université Laval, Québec, Canada, and VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | - Dalil Asmaou Bouba
- Department of Social and Preventive Medicine (L.G.S., D.A.B.), Faculty of Medicine, Université Laval, Québec, Canada, and VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | - Roberta de Carvalho Corôa
- Department of Family Medicine and Emergency Medicine (R.C.C.), VITAM, Centre de recherche en santé durable, Unité de soutien au système de santé apprenant, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Suélène Georgina Dofara
- VITAM, Centre de recherche en santé durable (S.G.B., S.G.D.), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | - Vincent Robitaille
- Faculty of Medicine, Université Laval (V.R.), VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
| | - Virginie Blanchette
- Department of Human Kinetics and Podiatric Medicine (V.B.), Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | | | | | - Sabrina Guay-Bélanger
- VITAM, Centre de recherche en santé durable (S.G.B., S.G.D.), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | | | - Annette M Totten
- Department of Medical Informatics and Clinical Epidemiology (A.M.T.), School of Medicine, Oregon Health & Science University, Portland, OR
| | - Patrick Archambault
- Department of Family Medicine and Emergency Medicine (P.A.), Faculty of Medicine, Université Laval, VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-Appalaches, Québec, QC, Canada
| | - France Légaré
- Department of Family Medicine and Emergency Medicine (F.L.), Faculty of Medicine, Université Laval, VITAM, Centre de recherche en santé durable, Researcher, Centre de recherche du CHU de Québec, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada.
| |
Collapse
|
11
|
Mathew N, Farai P, Ekpenyong MS. COVID-19 and Challenging Working Environments: Experiences of Black Sub-Saharan African (BSSA) Front-Line Health Care Professionals Amid of COVID-19 Pandemic in the English Midlands Region. J Racial Ethn Health Disparities 2024:10.1007/s40615-023-01906-w. [PMID: 38231386 DOI: 10.1007/s40615-023-01906-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/18/2024]
Abstract
PURPOSE The impact of COVID-19 is challenging for many health and social care workers. The impact has been more felt by all ethnic groups, but during the course of its tenure, it has become more apparent that the black community has been affected more than others. They have been reported to suffer more fatalities from the pandemic compared to their white counterparts. Blacks are reported to make a significant percentage of health care workers. They are sometimes undervalued, lowly paid, with many on insecure contracts and experiencing professional inequality. This study sought to explore the challenges experienced by Black Sub-Saharan African (BSSA) front-line workers in health care during COVID-19 pandemic. METHODOLOGY The study utilised an explorative qualitative approach (EQA). Forty research participants were recruited for the study. Semi-structured interviews were used to collect data through online platforms which included Zoom, WhatsApp and Teams. A thematic approach was used to analyse data. RESULTS Following data analysis, the research found that the research participants experienced undermining of expertise, lack of appreciation and unfair allocation of tasks and were overlooked for promotion and perceived as carriers of COVID-19. CONCLUSION This group was over-represented in agency and self-employed roles. There is need for a strong government commitment to prevent discrimination through enacting a comprehensive legislation to support tackling the problem. Race equality training awareness needs to be rolled out into healthcare organisations and empower managers to deal with equality issues at work.
Collapse
Affiliation(s)
- Nyashanu Mathew
- Department of Nursing & Allied Professions, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK.
| | - Pfende Farai
- Department of Nursing & Allied Professions, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | - Mandu Stephen Ekpenyong
- Department of Public Health and Nursing, Manchester Metropolitan University, All Saints Campus, M1 5GF, Manchester, UK
| |
Collapse
|
12
|
Nøst TH, Dahl-Michelsen T, Aandahl H, Steinsbekk A. Healthcare professionals' experiences of interdisciplinary collaboration in pain centres - A qualitative study. Scand J Pain 2024; 24:sjpain-2023-0132. [PMID: 38469660 DOI: 10.1515/sjpain-2023-0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVES The complexity of chronic pain requires interdisciplinary collaboration. Although this is recognisable in the framework for pain centres, few studies have investigated how interdisciplinary collaboration in pain centres is experienced by healthcare professionals, including the facilitators and barriers to interdisciplinary collaboration. The aim of the current study was therefore to investigate experiences of interdisciplinary collaboration in the treatment of patients with chronic pain among healthcare professionals in tertiary care pain centres. METHODS Eleven healthcare professionals, representing different healthcare disciplines from the four regional pain centres in Norway, participated in semi-structured individual interviews. The data were analysed thematically. RESULTS The results were categorised into three themes 'The best approach for chronic pain treatment', 'Collegial collaboration', and 'Challenges with interdisciplinary teamwork'. The informants valued the interdisciplinary work at the pain centre. They perceived it as the best approach for their patients and appreciated the support the collegial collaboration gave them as professionals. Although working together was rewarding and provided new insights, the informants also experienced the interdisciplinary teamwork as challenging, e.g., when the different professions disagreed on recommendations for further treatment or did not manage to work together as a team. CONCLUSION The informants found the interdisciplinary collaboration at the pain centre to provide the best treatment approach for their patients. It should be acknowledged that interdisciplinary teamwork can be challenging, and efforts should be put into establishing a good climate for collaboration and gaining knowledge about each profession's unique character and how they contribute to pain centre treatments.
Collapse
Affiliation(s)
- Torunn Hatlen Nøst
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7491 Trondheim, Norway
- Norwegian Advisory Unit on Complex Symptom Disorders, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Tone Dahl-Michelsen
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Faculty of Health, VID Specialized University, Oslo, Norway
| | - Hanne Aandahl
- Department for Pain and Complex Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Aslak Steinsbekk
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Digital Health Care Unit, Norwegian Centre for E-Health Research, Tromsø, Norway
| |
Collapse
|
13
|
Allaire JF, Morin P, Doré C, Hyppolite SR, Suzanne Badji M, Zomahou HTV. Integrated Community Care Delivered by Public Health-Care and Social-Care Systems: Results from a Realist Synthesis. Int J Integr Care 2024; 24:11. [PMID: 38370568 PMCID: PMC10870956 DOI: 10.5334/ijic.7042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 09/09/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction Integrated community care (ICC) is defined as an interweaving of health-care and social-care interventions deployed in spatial and relational proximity using an interdisciplinary and cross-sectoral approach. Consideration of territory scale and time scale are at the center of ICC practices. Its deployment in public health and social care networks (HSCN) can be complex due to their broad mandate, the complexity of their management, and accountability. Therefore, we aimed to describe ICC delivered by public HSCN to determine how, why, for whom, and in what circumstances ICC works and produces outcomes. Methods A realist synthesis was conducted consisting of five steps consistent with realist synthesis standards (RAMESES projects) to produce configurations of Context - Mechanism - Outcomes (CMOc) and development of a middle-range explanatory theory of why and how the identified outcomes may have occurred. Results In total, 26 studies were selected and used, as evidence, to support-either partially or fully-the production of CMOc based on the initial program theory. Nine unique CMO configurations were identified based on the data analyses and team discussion. ICC middle-range theory is informed by the CMO configurations identified. Discussion This realist synthesis allowed us to identify the central mechanisms of ICC delivered by public HSCN and to produce a middle range theory. ICC is based on a specific philosophy and deployed by a professional agency oriented toward a community agency within a local system of interdisciplinary and cross-sectoral action. Conclusion Our middle-range theory will provide a solid analytical framework as a foundation for ICC implementation and future research.
Collapse
Affiliation(s)
- Jean-François Allaire
- Institut universitaire de première ligne en santé et services sociaux (IUPLSSS) du Centre intégré universitaire de santé et de services sociaux de l’Estrie –Centre hospitalier universitaire de Sherbrooke (CIUSSSE-CHUS), Hopital et centre d’hébergement D’Youville, Sherbrooke, QC, Canada
| | - Paul Morin
- Institut universitaire de première ligne en santé et services sociaux (IUPLSSS) du Centre intégré universitaire de santé et de services sociaux de l’Estrie –Centre hospitalier universitaire de Sherbrooke (CIUSSSE-CHUS), Hopital et centre d’hébergement D’Youville, Sherbrooke, QC, Canada
- Université de Sherbrooke, Canada
| | - Chantal Doré
- Institut universitaire de première ligne en santé et services sociaux (IUPLSSS) du Centre intégré universitaire de santé et de services sociaux de l’Estrie –Centre hospitalier universitaire de Sherbrooke (CIUSSSE-CHUS), Hopital et centre d’hébergement D’Youville, Sherbrooke, QC, Canada
- School of Nursing and Researcher, Université de Sherbrooke, Canada
| | - Shelley-Rose Hyppolite
- Centre intégré universitaire de santé et de services sociaux de la Capitale Nationale, Canada
- Faculté de médecine, Université Laval, Canada
| | - Marie Suzanne Badji
- Institut universitaire de première ligne en santé et services sociaux (IUPLSSS) du Centre intégré universitaire de santé et de services sociaux de l’Estrie –Centre hospitalier universitaire de Sherbrooke (CIUSSSE-CHUS), Hopital et centre d’hébergement D’Youville, Sherbrooke, QC, Canada
| | - Hervé Tchala Vignon Zomahou
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
- Institut national d’excellence en santé et services sociaux, Quebec, Québec, Canada
| |
Collapse
|
14
|
Pryce R, Langan E, Tector K, Raggett L, Flynn R, Smart KM. Patients' experiences following total knee arthroplasty: a qualitative evidence synthesis. Disabil Rehabil 2024; 46:214-231. [PMID: 36617965 DOI: 10.1080/09638288.2022.2159548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/12/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE Total knee arthroplasty (TKA) is a common surgical intervention for patients with advanced arthritis. The aim of this qualitative evidence synthesis was to systematically review the qualitative literature on patients' experiences following primary TKA. MATERIALS AND METHODS Four electronic databases (PubMed, CINAHL, Cochrane and Embase) were searched from inception until October 2021. Pairs of reviewers independently screened search results for eligibility, analysed the quality of included studies and extracted data. We undertook a thematic synthesis and used an interpretive approach to identify recurring themes and draw a conclusion. Data were synthesised using thematic analysis and an interpretive approach was used to identify themes. RESULTS Twenty-three studies exploring patients' experiences following TKA were included. Five main themes emerged: (i) Experience of healthcare staff, (ii) Pain/Medications, (iii) Was it worth it? (iv) Social Support (v) Follow up. CONCLUSIONS This review highlights the variability in patients' experiences following TKA. Whether this experience detailed their pain, function, or encounter with healthcare staff or systems, patients reported a variety of both positive and negative sentiments. Each theme invites attention to an area in which healthcare can improve to enhance patients' experiences. The importance of patient support, individualised rehabilitation and appropriate follow-up are highlighted.
Collapse
Affiliation(s)
- Robert Pryce
- Department of Physiotherapy and Sports Science, UCD School of Public Health, Health Science Centre, University College Dublin, Belfield, Ireland
| | - Emma Langan
- Department of Physiotherapy and Sports Science, UCD School of Public Health, Health Science Centre, University College Dublin, Belfield, Ireland
| | - Katie Tector
- Department of Physiotherapy and Sports Science, UCD School of Public Health, Health Science Centre, University College Dublin, Belfield, Ireland
| | - Leah Raggett
- Department of Physiotherapy and Sports Science, UCD School of Public Health, Health Science Centre, University College Dublin, Belfield, Ireland
| | - Roisin Flynn
- Department of Physiotherapy and Sports Science, UCD School of Public Health, Health Science Centre, University College Dublin, Belfield, Ireland
| | - Keith M Smart
- Department of Physiotherapy and Sports Science, UCD School of Public Health, Health Science Centre, University College Dublin, Belfield, Ireland
| |
Collapse
|
15
|
Criter RE, Sheperd M, Northrup D, Shuster L. Perceptions of the Scope of Practice of Audiology. Am J Audiol 2023; 32:930-940. [PMID: 37783210 DOI: 10.1044/2023_aja-23-00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023] Open
Abstract
PURPOSE The primary purpose of this study was to determine which scope of practice roles and responsibilities are attributed to the profession of audiology (AUD) relative to other health care disciplines by a group of health and human services faculty and students. METHOD An online survey inquiring about participant knowledge of different health professions' scopes of practice, and experience with and attitude toward the profession of AUD, was sent to faculty and students in the Western Michigan University College of Health and Human Services. Students also completed two subscales of the Interprofessional Attitudes Scale. Descriptive statistics and chi-square and Kruskal-Wallis analyses evaluating response differences between groups are presented. RESULTS Thirty-six faculty and 118 students (48 graduate and 70 undergraduate) completed the survey. AUD was the profession most often associated with all hearing-related scope of practice activities. Speech-language pathology was often associated with hearing-related scope of practice activities. Audiologists were less commonly associated with vestibular, balance, and mobility scope of practice activities. Group was significant for four scope of practice activities. About half of respondents indicated they knew nothing or a little about AUD, and a majority had no or rare interactions with audiologists in class or clinic. Only about half of participants responded they were likely or very likely to refer patients to an audiologist. CONCLUSION Increased knowledge of the scope of practice and exposure to the profession of AUD may benefit other health care professionals and patients, possibly leading to increased interprofessional practice and an increased number of appropriate referrals.
Collapse
Affiliation(s)
- Robin E Criter
- Department of Speech, Language and Hearing Sciences, Western Michigan University, Kalamazoo
| | - Melanie Sheperd
- Department of Speech, Language and Hearing Sciences, Western Michigan University, Kalamazoo
| | | | - Linda Shuster
- Department of Speech, Language and Hearing Sciences, Western Michigan University, Kalamazoo
| |
Collapse
|
16
|
Smeets RGM, Hertroijs DFL, Ruwaard D, Spoorenberg SLW, Elissen AMJ. Supporting professionals to implement integrated, person-centered care for people with chronic conditions: the TARGET pilot study. Scand J Prim Health Care 2023; 41:377-391. [PMID: 37665602 PMCID: PMC11001371 DOI: 10.1080/02813432.2023.2250392] [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: 10/07/2022] [Accepted: 08/16/2023] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVE The TARGET program for integrated, person-centered care for people with chronic conditions offers primary care (PC) professionals a set of tools and trainings to actively engage in population segmentation and person-centered needs assessments (PCNAs). A pilot study was conducted to gain insight into the program's feasibility and acceptability, and identify preconditions for successful implementation. DESIGN AND SETTING Seven Dutch PC practices participated in a half-year pilot study starting in August 2020. We performed a review of the population segmentation tool, observed four training sessions and 15 PCNAs, and interviewed 15 professionals and 12 patients. RESULTS Regarding feasibility and acceptability, we found that the tools and trainings provided professionals with skills to use the segmentation tool and take a more coaching role in the well-appreciated PCNAs. Concerning implementation preconditions, we found that team commitment and network connections need improvement, although work pleasure increased and professionals generally wanted the program to continue. CONCLUSIONS While the content of the TARGET program is supported by its users, the implementation process, for instance team commitment to the program, needs more attention in future upscaling efforts.
Collapse
Affiliation(s)
- Rowan G. M. Smeets
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Dorijn F. L. Hertroijs
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Dirk Ruwaard
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Sophie L. W. Spoorenberg
- Primary Care Group ‘Dokter Drenthe’ (formerly known as Huisartsenzorg Drenthe; HZD), Assen, The Netherlands
| | - Arianne M. J. Elissen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
17
|
Fukami T. Patient engagement with psychological safety. DIALOGUES IN HEALTH 2023; 3:100153. [PMID: 38515810 PMCID: PMC10953965 DOI: 10.1016/j.dialog.2023.100153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 03/23/2024]
Abstract
Psychological safety is a multidimensional, dynamic phenomenon that concerns team members' perception of whether it is safe to take interpersonal risks at work. It is particularly important within health care teams who need to work interdependently to coordinate safe patient care within a highly complex, variable and high-stakes work environment. High levels of psychological safety have clear benefits for patient safety by improving the delivery of clinical care and promoting health care providers' job satisfaction and well-being. Feeling psychologically safe can enable team members to engage in speaking up behavior, such as asking questions, pointing out mistakes, or reporting errors. Several studies have explored psychological safety in health care teams and its impact on patient safety. These studies have highlighted the importance of psychological safety in health care organizations and provided strategies for promoting psychological safety. Psychological safety in health care involvement with patients can improve patient engagement.
Collapse
Affiliation(s)
- Tatsuya Fukami
- Patient Safety Division, Shimane University Hospital, 693-8501 Izumo, Japan
| |
Collapse
|
18
|
Costa JB, de Mazzi NR, Peduzzi M, Germani ACCG, Silva JAM, Agreli HLF, Nascimento AG, Belber GS, Leonello VM. Characterization of interprofessional education experiences in health education at the University of São Paulo. Rev Esc Enferm USP 2023; 57:e20230118. [PMID: 38051222 PMCID: PMC10697139 DOI: 10.1590/1980-220x-reeusp-2023-0118en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 09/11/2023] [Indexed: 12/07/2023] Open
Abstract
OBJECTIVE To map the experiences of Interprofessional Education (IPE) in Health at the São Paulo campus of the University of São Paulo. METHOD This is a descriptive, exploratory study with a quantitative approach and data collection through an online questionnaire addressed to teachers from eight teaching units and 14 health courses. The data was analyzed using absolute and percentage frequencies. RESULTS The majority of teachers do not take part in IPE experiences (70.4%). Most of the experiences are between six and ten years old, involving up to four teachers and small groups of students, mostly extracurricular or extension activities. The teaching and assessment strategies are diverse and open to students of all years. CONCLUSION IPE experiences involve a small number of students and teachers and, although consolidated in terms of the time they have been offered, are limited to extracurricular spaces. Factors such as improvements in institutional support and teacher development are pointed out as important for making progress in strengthening IPE in the analyzed context.
Collapse
|
19
|
Ingersen A, Soendenbroe C, Ahmed HI, Borch J, Moseholm KF, Dal MH, Kusta O, Bergien SO, Gillberg L. Should young researchers engage with interdisciplinary research?: A reflective proposal from early career researchers at the Center for Healthy Aging. Acta Physiol (Oxf) 2023; 239:e14053. [PMID: 37840373 DOI: 10.1111/apha.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023]
Affiliation(s)
- Arthur Ingersen
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Casper Soendenbroe
- Institute of Sports Medicine Copenhagen, Center for Healthy Aging, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Haboon Ismail Ahmed
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Borch
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kristine Frøsig Moseholm
- NNF CHALLENGE ("Harnessing the Power of Big Data to Address the Societal Challenge of Aging"), Center for Healthy Aging, Section for Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mette Hyldig Dal
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Olsi Kusta
- Department of Public Health, Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
- Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Melbourne, Victoria, Australia
| | - Sofie Olsgaard Bergien
- Department of Public Health, Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
- The Danish Multiple Sclerosis Society, Valby, Denmark
| | - Linn Gillberg
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
20
|
Dufour E, Bolduc J, Leclerc-Loiselle J, Charette M, Dufour I, Roy D, Poirier AA, Duhoux A. Examining nursing processes in primary care settings using the Chronic Care Model: an umbrella review. BMC PRIMARY CARE 2023; 24:176. [PMID: 37661248 PMCID: PMC10476383 DOI: 10.1186/s12875-023-02089-3] [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: 07/31/2022] [Accepted: 06/22/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND While there is clear evidence that nurses can play a significant role in responding to the needs of populations with chronic conditions, there is a lack of consistency between and within primary care settings in the implementation of nursing processes for chronic disease management. Previous reviews have focused either on a specific model of care, populations with a single health condition, or a specific type of nurses. Since primary care nurses are involved in a wide range of services, a comprehensive perspective of effective nursing processes across primary care settings and chronic health conditions could allow for a better understanding of how to support them in a broader way across the primary care continuum. This systematic overview aims to provide a picture of the nursing processes and their characteristics in chronic disease management as reported in empirical studies, using the Chronic Care Model (CCM) conceptual approach. METHODS We conducted an umbrella review of systematic reviews published between 2005 and 2021 based on the recommendations of the Joanna Briggs Institute. The methodological quality was assessed independently by two reviewers using the AMSTAR 2 tool. RESULTS Twenty-six systematic reviews and meta-analyses were included, covering 394 primary studies. The methodological quality of most reviews was moderate. Self-care support processes show the most consistent positive outcomes across different conditions and primary care settings. Case management and nurse-led care show inconsistent outcomes. Most reviews report on the clinical components of the Chronic Care Model, with little mention of the decision support and clinical information systems components. CONCLUSIONS Placing greater emphasis on decision support and clinical information systems could improve the implementation of nursing processes. While the need for an interdisciplinary approach to primary care is widely promoted, it is important that this approach not be viewed solely from a clinical perspective. The organization of care and resources need to be designed to support contributions from all providers to optimize the full range of services available to patients with chronic conditions. PROSPERO REGISTRATION CRD42021220004.
Collapse
Affiliation(s)
- Emilie Dufour
- Faculty of Nursing, Université de Montréal, Montréal, Canada.
| | - Jolianne Bolduc
- École de santé publique, Université de Montréal, Montréal, Canada
| | | | - Martin Charette
- School of Nursing, Université de Sherbrooke, Sherbrooke, Canada
| | - Isabelle Dufour
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Canada
| | - Denis Roy
- Commissaire à la santé et au bien-être, Gouvernement du Québec, Montréal, Canada
| | | | - Arnaud Duhoux
- Faculty of Nursing, Université de Montréal, Montréal, Canada
| |
Collapse
|
21
|
Burns A, Collins D. Interdisciplinary practice in performance sport: A scoping review of evidence of collaboration. Eur J Sport Sci 2023; 23:1877-1891. [PMID: 37042174 DOI: 10.1080/17461391.2023.2201812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Performance support teams are increasingly comprised of sub-disciplines, bringing varied expertise to support an athlete or team in achieving the desired result. With more voices in the room, however, there is a need to investigate how these individuals can effectively work together collaboratively. Accordingly, the present study reviewed empirical articles that have examined interdisciplinary practice in performance sport. In total, 22 articles met the full inclusion criteria. We discuss the four key themes that emerged from the literature linked to these contexts: namely, Theoretical frameworks, Facilitative leadership and culture, Organisational and logistical structure and processes, and Personal and interpersonal qualities. To deepen the understanding in this intricate field, conducting future research such as longitudinal studies that follow team working practices over time and delve into the lived experiences of teams, as well as the perspectives of various stakeholders, would be beneficial.
Collapse
Affiliation(s)
- Andrew Burns
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Dave Collins
- Grey Matters Performance Ltd, Stratford-Upon-Avon, UK
| |
Collapse
|
22
|
Janosy NR, DeBoer EM, Prager JD, Vogeli J, Wine T, Beacham AO. Social support moderates the relationship between burnout and job satisfaction in aerodigestive team members. Int J Pediatr Otorhinolaryngol 2023; 170:111602. [PMID: 37224738 DOI: 10.1016/j.ijporl.2023.111602] [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: 01/25/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Burnout among healthcare workers is a public health crisis. Burnout is associated with elevated cynicism, emotional exhaustion, and low job satisfaction. Methods to combat burnout have been challenging to identify. Based on positive experiences of pediatric aerodigestive team members, we hypothesized that social support in multidisciplinary aerodigestive teams moderates the effects of burnout on job satisfaction. METHODS Using a survey of the Aerodigestive Society, members of Aerodigestive teams (N = 119) completed demographics, the Maslach Burnout Inventory, and measures of job satisfaction, emotional, and instrumental social support. In addition to assessing relationships between components of burnout and job satisfaction, six tests were conducted using PROCESS to ascertain the degree to which social support moderated these relationships. RESULTS Similar to US healthcare base rates, burnout scores in this sample suggest that a third-to-half felt Emotionally Exhausted and Burned Out from work "A few times a month"-to-"Every Day." Simultaneously, however, the majority in sample (60.6%) noted feeling that they "positively impact others' lives" with 33.3% endorsing "Every Day." Job satisfaction was strikingly high at 89%, with most reporting Aerodigestive team affiliation related to higher job satisfaction. Both Emotional and Instrumental social support moderated the effect of Cynicism and Emotional Exhaustion on Job Satisfaction, with higher Job Satisfaction scores in conditions of high support. CONCLUSIONS These results support the hypothesis that social support from a multidisciplinary aerodigestive team moderates the effect of burnout in its team members. Further work is needed to understand if membership in other interprofessional healthcare teams can help combat the negative effects of burnout.
Collapse
Affiliation(s)
- Norah R Janosy
- University of Colorado Department of Anesthesia, Aurora, CO, USA; Children's Hospital Colorado Aerodigestive Program, Aurora, CO, USA.
| | - Emily M DeBoer
- Children's Hospital Colorado Aerodigestive Program, Aurora, CO, USA; University of Colorado Department of Pediatrics, Aurora, CO, USA.
| | - Jeremy D Prager
- Children's Hospital Colorado Aerodigestive Program, Aurora, CO, USA; University of Colorado Department of Otolaryngology, Aurora, CO, USA.
| | - Jo Vogeli
- University of Colorado Department of Anesthesia, Aurora, CO, USA.
| | - Todd Wine
- Children's Hospital Colorado Aerodigestive Program, Aurora, CO, USA; University of Colorado Department of Otolaryngology, Aurora, CO, USA.
| | - Abbie O Beacham
- University of Louisville School of Dentistry, Louisville, KY, USA.
| |
Collapse
|
23
|
Chan GH, Lo TW, Fung JSC. Use of theatresports to promote positive education among youth participants. BMC Public Health 2023; 23:913. [PMID: 37208646 DOI: 10.1186/s12889-023-15825-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 05/05/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Due to the scarcity of research on the benefits of theatresports for youth, this study examined the outcomes of theatresports as a means to implement positive education in youth work settings. METHODS To this end, qualitative research was conducted with 92 participants in a theatresports program. Thematic analysis was applied to analyze the participants' experiences of the program, using the framework of positive education. RESULTS Results showed that the processes and practices of the theatresports program helped the participants achieved well-being in terms of various domains namely positive emotions, positive health, positive relationships, positive engagement, positive accomplishment, and positive meaning. These capabilities and qualities acquired helped them achieve well-being, and the learning acquired from the program could even be applied to daily life situations and deal with the challenges. CONCLUSIONS This shows that the theatresports program manifests the benefits of positive education. Corresponding implications were discussed.
Collapse
Affiliation(s)
- Gloria Hongyee Chan
- Department of Social and Behavioral Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong.
| | - T Wing Lo
- Research and Technology, Caritas Institute of Higher Education, Tsueng Kwan O, Hong Kong
| | - Johnny S C Fung
- Department of Social and Behavioral Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong
| |
Collapse
|
24
|
Babu D, Rowett D, Lim R, Marotti S, Wisdom A, Ellett LK. Clinical pharmacists' participation in ward rounds in hospitals: responses from a national survey. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2023:7161614. [PMID: 37178018 DOI: 10.1093/ijpp/riad028] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 04/18/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVES The inclusion of clinical pharmacists in ward rounds (WRs) can reduce adverse drug events, improve communication and enable collaborative decision-making. The aim of this study is to investigate the level of and factors that influence WR participation by clinical pharmacists in Australia. METHODS An online administered, anonymous survey of clinical pharmacists in Australia was conducted. The survey was open to pharmacists aged ≥18 years, who had worked in an Australian hospital in a clinical role in the previous two weeks. It was distributed via The Society of Hospital Pharmacists of Australia and on pharmacist-specific social media threads. Survey questions related to the extent of WR participation and factors that influence WR participation. Cross-tabulation analysis was conducted to determine whether there was an association between WR participation and factors that influence WR participation. KEY FINDINGS Ninety-nine responses were included. The level of WR participation by clinical pharmacists in Australian hospitals was low, with only 26/67 (39%) pharmacists who had a WR in their clinical unit actually attending the WR in the previous 2 weeks. Factors that influenced WR participation included having recognition of the role of the clinical pharmacist within the WR team, support from pharmacy management and the broader interprofessional team, and having adequate time and expectation from pharmacy management and colleagues to participate in WRs. CONCLUSIONS This study highlights the need for ongoing interventions such as restructuring workflows and increasing the awareness of the role of a clinical pharmacist in WR to increase participation of pharmacists in this interprofessional activity.
Collapse
Affiliation(s)
- Dona Babu
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, Australia
- SA Pharmacy, SA Health, Adelaide, SA, Australia
| | - Debra Rowett
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, Australia
- SA Pharmacy, SA Health, Adelaide, SA, Australia
| | - Renly Lim
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Sally Marotti
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, Australia
- SA Pharmacy, SA Health, Adelaide, SA, Australia
| | | | - Lisa Kalisch Ellett
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| |
Collapse
|
25
|
Resnick B, Vellega A, Levy C. The Interdisciplinary Care Team Approach in Long-Term Care: Where are We and Where do We Need to Go? J Am Med Dir Assoc 2023; 24:407-409. [PMID: 37005056 DOI: 10.1016/j.jamda.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 04/03/2023]
Affiliation(s)
| | | | - Cari Levy
- University of Colorado, Denver School of Medicine, Denver, CO, USA
| |
Collapse
|
26
|
Brassel S, Brunner M, Power E, Campbell A, Togher L. Speech-Language Pathologists' Views of Using Virtual Reality for Managing Cognitive-Communication Disorders Following Traumatic Brain Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:907-923. [PMID: 36580534 DOI: 10.1044/2022_ajslp-22-00077] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Using virtual reality (VR) to support rehabilitation is an emerging area of research that may offer people with communication disorders a stable and safe communication environment to practice their communication skills. There are currently no VR applications that have been designed to assess or treat cognitive-communication disorders (CCDs) following traumatic brain injury (TBI). Therefore, this study aimed to explore the views of speech-language pathologists (SLPs) who work with people who have a TBI to generate ideas and considerations for using VR in rehabilitation for CCDs. VR researchers were included to provide expert advice about VR technology. METHOD A total of 14 SLPs and three VR specialists participated in an online interview or focus group. Semistructured discussions explored participants' perspectives related to potential ideas for VR use and any perceived barriers and facilitators to VR implementation for managing CCDs following TBI. Data were video- and audio-recorded, transcribed, and analyzed qualitatively using thematic analysis. RESULTS Three main themes were generated from thematic analysis: VR is a tool that could enhance clinical practice, the need to consider and navigate potential red flags, and solutions to pave the way forward. Suggestions to overcome perceived barriers to VR use were also provided. DISCUSSION Participants expressed interest in using VR for rehabilitation of CCDs following TBI. However, potential barriers and risks to use should be considered prior to implementation. The findings offer guidance to support future research and development of VR in this field. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21669647.
Collapse
Affiliation(s)
- Sophie Brassel
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Melissa Brunner
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Emma Power
- Speech Pathology, Graduate School of Health, University of Technology Sydney, New South Wales, Australia
| | - Andrew Campbell
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Leanne Togher
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| |
Collapse
|
27
|
Pozzi C, Tatzer VC, Strasser-Gugerell C, Cavalli S, Morandi A, Bellelli G. Innovative Non-Pharmacological Management of Delirium in Persons with Dementia: New Frontiers for Physiotherapy and Occupational Therapy? Geriatrics (Basel) 2023; 8:geriatrics8020028. [PMID: 36960983 PMCID: PMC10037565 DOI: 10.3390/geriatrics8020028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 02/02/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Delirium and dementia are two of the most common geriatric syndromes, which requires innovative rehabilitation approaches. AIM We aimed at determining which occupational therapy and physiotherapy interventions are applied with older people with delirium and dementia in different care settings. We also identified the assessment tools that were used. MATERIALS AND METHODS We conducted a literature search for scientific articles published from 2012 to 2022 (PubMed, MEDLINE, AMED and CINAHL) with adults aged >65 years including experimental study designs with randomized or non-randomized intervention, exploratory studies, pilot studies, quasi-experimental studies, case series and/or clinical cases. Studies that did not use interventions that could be classified as occupational therapy or physiotherapy were excluded. RESULTS After applying the exclusion criteria, 9 articles were selected. The most widely used assessment to define dementia was the MMSE (N = 5; 55.5%), whereas the CAM (N = 2; 22.2%), CAM-ICU (N = 2; 22.2%) and RASS (N = 3; 33.3%) were the most widely used to define delirium. The rehabilitation interventions that were most frequently performed were early mobilization, inclusion of the caregiver during treatment, modification of the environment to encourage orientation and autonomy, the interprofessional systemic approach and engaging persons in meaningful activities. CONCLUSIONS Despite the growing evidence on its effectiveness, the role of physiotherapy and occupational therapy interventions in the prevention and treatment of people with dementia and delirium is still emerging. More research is needed to investigate if effective occupational therapy programs known to reduce the behavioral and psychological symptoms in people with dementia are also useful for treating delirium and specifically delirium superimposed on dementia. Regarding physiotherapy, it is crucial to know about the amount and timing of intervention required. Further studies are needed including older adults with delirium superimposed on dementia to define the role of the interprofessional geriatric rehabilitation team.
Collapse
Affiliation(s)
- Christian Pozzi
- Centre of Competence on Ageing, University of Applied Sciences and Arts of Southern Switzerland SUPSI, 6928 Manno, Switzerland
- Public Health, University of Milano-Bicocca, 20126 Milano, Italy
| | - Verena C Tatzer
- Department of Occupational Therapy, University of Applied Sciences Wiener Neustadt, 2700 Wiener Neustadt, Austria
| | - Cornelia Strasser-Gugerell
- Department of Occupational Therapy, University of Applied Sciences Wiener Neustadt, 2700 Wiener Neustadt, Austria
| | - Stefano Cavalli
- Centre of Competence on Ageing, University of Applied Sciences and Arts of Southern Switzerland SUPSI, 6928 Manno, Switzerland
| | - Alessandro Morandi
- Azienda Speciale "Cremona Solidale", 26100 Cremona, Italy
- Parc Sanitari Pere Virgili, Vall d'Hebrón Institute of Research, 08016 Barcelona, Spain
| | - Giuseppe Bellelli
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milano, Italy
- Acute Geriatric Unit, San Gerardo Hospital, ASST-Monza, 20900 Monza, Italy
| |
Collapse
|
28
|
Doig E, Prescott S, Pick V, Turner B, Suleman S, Douglas D, Foster M. Normalising interdisciplinary role-based goal setting in inpatient brain injury rehabilitation: reflections and recommendations of clinicians. Disabil Rehabil 2023; 45:673-683. [PMID: 35282717 DOI: 10.1080/09638288.2022.2040612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE Person-centred goal setting with people with brain injury, by interdisciplinary teams has benefits including improved communication between patients, families and clinicians, person-centred care, and improved engagement in rehabilitation. Exploring the experiences of team members who have adopted interdisciplinary, person-centred goal setting may assist in understanding what is needed to implement this complex, core component of rehabilitation practice. This study explored experiences of clinicians working in an extended inpatient brain injury rehabilitation unit about implementing a role-based goal planning approach within an interdisciplinary team. MATERIALS AND METHODS Semi-structured interviews with 13 clinicians working at the rehabilitation unit explored their experiences about the cognitive participation and collective actions required to carry out the practice, with data analysed using inductive content analysis guided by Normalisation Process Theory. RESULTS Three primary themes were identified: putting the person at the centre, accepting the mind-shift to participation focused goals and working collaboratively. CONCLUSIONS This study has elucidated some key processes that occurred and were necessary to carry out goal setting. A mind-shift towards holistic, participation-focussed goal setting was described as "unlearning" discipline-specific goal setting. Development and ownership by the team, acceptance of team members and willingness to share, and structured processes and resources were necessary.IMPLICATIONS FOR REHABILITATIONNormalising interdisciplinary role-based goal setting in multi-professional teams requires a mind-shift away from traditional, discipline-specific goal setting.Implementation of interdisciplinary, collaborative team goal setting within health service settings requires collective actions including collaborative working by team members, structured processes including organised time for collaborative team and family meetings, practical resources and training to support processes.Clinicians perceived the goal setting approach to put the person at the centre resulting in a deep understanding of the person, shared understanding, and motivation for rehabilitation.
Collapse
Affiliation(s)
- Emmah Doig
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Hospital Service, Brisbane, Australia
| | - Sarah Prescott
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Valerie Pick
- Brain Injury Rehabilitation Service, Metro South Health, Brisbane, Australia
| | - Ben Turner
- Acquired Brain Injury Outreach Service, Metro South Health, Brisbane, Australia
| | - Sameera Suleman
- Brain Injury Rehabilitation Service, Metro South Health, Brisbane, Australia
| | - David Douglas
- Brain Injury Rehabilitation Service, Metro South Health, Brisbane, Australia.,School of Medicine, University of Queensland, Brisbane, Australia
| | - Michele Foster
- The Hopkins Centre, Griffith University, Brisbane, Australia
| |
Collapse
|
29
|
Lindsay RK, Smith L, Allen PM. Delphi Study: Designing Training to Enable Visual Impairment Services to Promote Physical Activity. Vision (Basel) 2023; 7:vision7010008. [PMID: 36810312 PMCID: PMC9944588 DOI: 10.3390/vision7010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/12/2023] [Accepted: 01/20/2023] [Indexed: 01/25/2023] Open
Abstract
Research suggests adults with visual impairment would increase their physical activity (PA) if they were advised to by a professional working in visual impairment services. However, there are no training programs which are targeted at enabling these professionals to promote PA. Therefore, this study aims to inform a UK-based training program which facilitates PA promotion within visual impairment services. A modified Delphi technique was used, consisting of a focus group and two rounds of surveys. The panel included 17 experts in round one, and 12 experts in round two. Consensus was defined as equal to or greater than 70% agreement. The panel agreed training should: educate professionals on PA benefits, injury prevention, and wellbeing, address myths associated with PA, address health and safety concerns, help professionals to find local PA opportunities, and include a networking session for professionals in visual impairment services and local PA providers. The panel agreed training should also target PA providers and volunteers for visual impairment services, and that training should be delivered online and in-person. In conclusion, training should provide professionals with the capability to promote PA and to establish stakeholder partnerships. The present findings can inform future research which tests the panel's recommendations.
Collapse
Affiliation(s)
- Rosie K. Lindsay
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge CB1 1PT, UK
- Correspondence:
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Peter M. Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge CB1 1PT, UK
| |
Collapse
|
30
|
Bendowska A, Baum E. The Significance of Cooperation in Interdisciplinary Health Care Teams as Perceived by Polish Medical Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:954. [PMID: 36673710 PMCID: PMC9859360 DOI: 10.3390/ijerph20020954] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
Teamwork, as the preferred method of cooperation in healthcare, became prevalent in the 1960s, and since then has been universally recognized as a measure to improve the quality of healthcare. Research indicates that medical care based on interdisciplinary cooperation is associated with increased patient safety, lower hospitalization rates, and reduced rates of complications and medical errors. Furthermore, it enhances the coordination of care and improves patient access to medical services. This model of providing medical care also results in considerable benefits for medical professionals. These include greater job satisfaction and a reduced risk of professional burnout syndrome. AIM The aim of the study was to explore the opinions of medical students with regard to cooperation in the interdisciplinary team, as well as the factors affecting the formation of opinions. MATERIAL AND METHODS The study was conducted using the Polish version of the questionnaire Attitudes Towards Interprofessional Health Care Teams. The study involved 1266 participants, including students of medicine (n = 308), midwifery (n = 348), nursing (n = 316) and physiotherapy (n = 294). RESULTS According to the opinions of the students participating in the study, the therapeutic process based on the interdisciplinary model improves the quality of medical care provided, increases patient safety, and improves communication between members of the therapeutic team. The factors affecting the assessment of cooperation in interdisciplinary medical care teams included the faculty and the year of studies, gender, as well as participation in the multidisciplinary courses. CONCLUSIONS Students recognize the need for interdisciplinary medical teams. The training of future medical professionals should incorporate the elements of interprofessional education. This form of education allows students to develop both a professional identity and identification with their own profession, as well as encourages teamwork skills and shapes the attitude of openness towards representatives of other medical professions. However, in order to provide the students with the relevant knowledge, skills and competencies, it is essential to respect their diversity in terms of the faculty, as well as to account for the impact of gender and the year of studies which may affect their readiness to engage in teamwork.
Collapse
Affiliation(s)
- Aleksandra Bendowska
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| | - Ewa Baum
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 60-806 Poznan, Poland
- Division of Philosophy of Medicine and Bioethics, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| |
Collapse
|
31
|
Hizam-Hanafiah M, Abdul Ghani MF, Mat Isa R, Abd Hamid H. Critical Success Factors of Franchising Firms: A Study on Franchisors and Franchisees. ADMINISTRATIVE SCIENCES 2022; 13:8. [DOI: 10.3390/admsci13010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
The franchising sector demands a high level of assurance and commitment. This is because creating entrepreneurial value is at the core of any franchising strategy. However, little is understood about what causes franchised businesses’ critical success factors, particularly in developing nations like Malaysia. Hence, this study aims to identify the critical success factors in franchising business firms. The characteristics of franchisors and franchisees that can contribute to the franchise system’s success in Malaysia were discovered using a focus group method by inviting franchisors and franchisees who are already running their businesses. In addition, Perbadanan Nasional Berhad (PERNAS) and the Malaysian Franchise Association (MFA), together with academicians, were also invited as a part of the focus group discussion. The findings show that three critical success factors emerged from this study, the franchisor’s capability, interconnection with franchisees, and constant innovation. These three elements demonstrated that there is still room for a more significant expansion. Therefore, anyone considering joining a franchise should know it is an option. Additionally, this research helps produce a valuable model of the franchising business process that regulators, franchisors, and franchisees can use as a guide. Finally, this study also offers directions for further research.
Collapse
|
32
|
Van Slingerland KJ, DesClouds P, Durand-Bush N, Boudreault V, Abraham A. How collaborative mental health care for competitive and high-performance athletes is implemented: A novel interdisciplinary case study. Front Psychol 2022; 13:994430. [PMID: 36817380 PMCID: PMC9936891 DOI: 10.3389/fpsyg.2022.994430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Collaborative care is considered a best practice in mental health care delivery and has recently been applied in high-performance sport to address athletes' mental health needs. However, how the collaborative process unfolds in practice in the sport setting has not yet been well documented. The purpose of this illustrative case study was to investigate a novel interdisciplinary approach used within the Canadian Centre for Mental Health and Sport (CCMHS) to provide mental health care to clients. Focusing on 'how' the approach was implemented, the aim of the study was to provide insight into the collaboration that occurred between mental performance and mental health practitioners to provide care to a high-performance athlete over an 11-month period, as well as factors facilitating and impeding the team's collaboration. The case involved three practitioners and a 16-year-old female athlete experiencing chronic pain, low mood, and elevated anxiety. Methods In the first phase of the data collection process, each practitioner engaged in guided reflective journaling to describe the case and reflect on their practice and outcomes. During the second phase, practitioners co-created a case timeline to describe the collaborative process using clinical documents. Lastly, practitioners participated in collaborative reflection to collectively reflect more broadly on collaboration practice occurring within the CCMHS and Canadian sport system. Results The data depict a complex care process in which the necessity and intensity of collaboration was primarily driven by the client's symptoms and needs. A content analysis showed that collaboration was facilitated by the CCMHS' secure online platform and tools, as well as individual practitioner and team characteristics. Collaboration was, however, hindered by logistical challenges, overlapping scopes of practice, and client characteristics. Discussion Overall, there were more perceived benefits than drawbacks to providing collaborative care. While flexibility was required during the process, deliberate and systematic planning helped to ensure success. Factors such as interdependence of collaborative practice, complementarity of practice within care teams, compensation for collaboration, in-person versus virtual delivery, and intricacies of care coordination should be further examined in the future to optimize collaborative mental health care in sport.
Collapse
Affiliation(s)
- Krista J. Van Slingerland
- SEWP Lab, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Poppy DesClouds
- SEWP Lab, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Natalie Durand-Bush
- SEWP Lab, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada,*Correspondence: Natalie Durand-Bush,
| | | | - Anna Abraham
- Department of Sports Services, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
33
|
Interprofessional Collaboration in the Context of Pain Management in Neonatal Intensive Care: A Cross-Sectional Survey. Pain Manag Nurs 2022; 23:759-766. [PMID: 36104262 DOI: 10.1016/j.pmn.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 08/10/2022] [Accepted: 08/13/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Describe interprofessional collaboration (IPC) in the context of pain management in neonatal intensive care based on healthcare team members' perceptions of partnership, cooperation and coordination. DESIGN A descriptive cross-sectional study design was used. BACKGROUND IPC improves the quality of pain management for neonates. IPC is teamwork involving both professionals and the neonates' parents. Parents play an important role in the holistic care of their infant, which includes pain management. METHODS Data was collected with Assessment of Interprofessional Collaboration Scale (AITCS-II) from the healthcare teams featuring representatives (n = 132) of multiple professional groups who were working in neonatal intensive care units (n = 4) in Finland. Descriptive statistical methods and the Mann-Whitney or Kruskal-Wallis nonparametric tests were used to analyze the data. RESULTS The results were examined in three subscales of IPC (partnership, cooperation and coordination) on three different levels: "need to focus on developing collaborative practice", "moving towards collaboration" and "good collaboration". Participants perceived all the subscales as well as the overall level of IPC for pain management in neonatal intensive care to be at level "moving towards collaboration". CONCLUSION Participants appreciated each other as professionals and were willing to cooperate, but they had different perceptions of parental involvement in IPC. Attention should be paid to IPC in specific contexts such as pain management.
Collapse
|
34
|
Richmond JP, Johnston A, Kelly MG, Roche K, Murphy PJ, Murphy AW. Stakeholders' perceptions of a community-based advanced nurse practitioner-led integrated oncology care model for adults receiving oral anti-cancer medication-A qualitative study. Eur J Cancer Care (Engl) 2022; 31:e13733. [PMID: 36259243 DOI: 10.1111/ecc.13733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/13/2022] [Accepted: 09/26/2022] [Indexed: 12/31/2022]
Abstract
Oral anti-cancer medications (OAMs) are increasingly prescribed in oncology, and although administered at home, ongoing monitoring generally requires the patient to attend an acute hospital. With the requirement to provide safe yet convenient care and to increase hospital capacity, the potential exists to transition this cohort of patients to the community to be assessed by oncology health care professionals (HCPs). The onset of COVID-19 facilitated this planned transition. OBJECTIVE The primary objective was to understand stakeholders' perceptions of a community-based advanced nurse practitioner (ANP)-led integrated OAM care model for adults. METHODS Qualitative data from interviews and focus groups were obtained from 33 individuals; either service users who attended ANP-led OAM clinics or stakeholders involved in OAM care. Data were subsequently analysed using thematic analysis. RESULTS Four themes were identified and included reflection on pre-COVID-19 system, role of ANP in current OAM care, importance of robust communication and infrastructural requirements for transition to an integrated OAM care model. CONCLUSION This study demonstrated that patients and HCPs perceived the proposal positively. They identified the ANP as the appropriate HCP to care for this cohort and the importance of communication and strategic planning for transitioning this model of care to the community setting. CLINICAL TRIAL REGISTRATION ISRCTN10401455.
Collapse
Affiliation(s)
| | | | | | - Kevin Roche
- HRB Primary Care Clinical Trials Network, Discipline of General Practice, NUI Galway, Galway, Ireland
| | - Patrick J Murphy
- HRB Primary Care Clinical Trials Network, Discipline of General Practice, NUI Galway, Galway, Ireland
| | - Andrew W Murphy
- HRB Primary Care Clinical Trials Network, Discipline of General Practice, NUI Galway, Galway, Ireland
| |
Collapse
|
35
|
Eide T, Gullslett MK, Eide H, Dugstad JH, McCormack B, Nilsen ER. Trust-based service innovation of municipal home care: a longitudinal mixed methods study. BMC Health Serv Res 2022; 22:1250. [PMID: 36243699 PMCID: PMC9569082 DOI: 10.1186/s12913-022-08651-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Scandinavia, various public reforms are initiated to enhance trust in the healthcare services and the public sector in general. This study explores experiences from a two-step service innovation project in municipal home care in Norway, coined as the Trust Model (TM), aiming at developing an alternative to the purchaser-provider split (PPS) and enhancing employee motivation, user satisfaction, and citizen trust. The PPS has been the prevalent model in Norway since the 1990s. There is little empirical research on trust-based alternatives to the PPS in healthcare. The overall objectives of this study were to explore facilitators and barriers to trust-based service innovation of municipal homecare and to develop a framework for how to support the implementation of the TM. METHODS The TM elements were developed through a comprehensive participatory process, resulting in the decision to organize the home care service in small, self-managed and multidisciplinary teams, and trusting the teams with full responsibility for care decisions and delivery within a limited area. Through a longitudinal mixed methods case study design a) patients' expressed values and b) factors facilitating or preventing the service innovation process were explored through two iterations. The first included three city districts, three teams and 80 patients. The second included four districts, eight teams and 160 patients. RESULTS The patient survey showed patients valued and trusted the service. The team member survey showed increased motivation for work aligned with TM principles. Both quantitative and qualitative methods revealed a series of facilitators and barriers to the innovation process on different organizational levels (teams, team leaders, system). The key message arising from the two iterations is to keep patients' values in the centre and recognize the multilevelled organizational complexity of successful trust-based innovation in homecare. Synthesizing the results, a framework for how to support trust-based service innovation was constructed. CONCLUSIONS Trust-based innovation of municipal homecare is feasible. The proposed framework may serve as a tool when planning trust-based innovation, and as a checklist for implementation and improvement strategies. Further research is needed to explore the validity of the framework and its replicability in other areas of healthcare.
Collapse
Affiliation(s)
- Tom Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.
| | - Monika K Gullslett
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Hilde Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Janne H Dugstad
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Brendan McCormack
- Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.,Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Etty R Nilsen
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| |
Collapse
|
36
|
Morris KA, Glover S, Neff S. Interprofessional Collaboration to Optimize Trauma-Informed Care in Pediatric Forensics. JOURNAL OF FORENSIC NURSING 2022; 18:247-253. [PMID: 35437298 DOI: 10.1097/jfn.0000000000000395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
There are many challenges in providing trauma-informed healthcare to pediatric victims of sexual abuse and their families. We address this through collaborative interprofessional efforts within our hospital facility, located in a Midwestern adult Level 1 and pediatric trauma center. Our sexual assault nurse examiner team is composed of eight nurses and provides 24/7 coverage. The child abuse team located in our hospital includes one board-certified child abuse pediatrician, one certified pediatric nurse practitioner, and a licensed clinical social worker. The application of trauma-informed care using case scenarios involving both teams is described in this article.
Collapse
Affiliation(s)
| | - Stephanie Glover
- Center of Hope Forensics, Peyton Manning Children's Hospital at Ascension St. Vincent Hospital
| | - Samantha Neff
- Center of Hope Forensics, Peyton Manning Children's Hospital at Ascension St. Vincent Hospital
| |
Collapse
|
37
|
Public health nurses’ views on quality measures: A cross-sectional study. Collegian 2022. [DOI: 10.1016/j.colegn.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
38
|
Fujimori T, Kijima T, Honda S, Yamagata S, Makiishi T. A Case of Acute Cerebral Infarction With Chief Complaints of Abdominal Pain and Bloody Diarrhoea: The Power of a Patient-Centered Inclusive Diagnostic Team. Cureus 2022; 14:e27386. [PMID: 36046325 PMCID: PMC9418667 DOI: 10.7759/cureus.27386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 11/05/2022] Open
|
39
|
Bertolaccini L, Mohamed S, Bardoni C, Lo Iacono G, Mazzella A, Guarize J, Spaggiari L. The Interdisciplinary Management of Lung Cancer in the European Community. J Clin Med 2022; 11:jcm11154326. [PMID: 35893419 PMCID: PMC9332145 DOI: 10.3390/jcm11154326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/16/2022] [Accepted: 07/20/2022] [Indexed: 02/01/2023] Open
Abstract
Lung cancer continues to be the largest cause of cancer-related mortality among men and women globally, accounting for around 27% of all cancer-related deaths. Recent advances in lung cancer medicines, particularly for non-small-cell lung cancer (NSCLC), have increased the need for multidisciplinary disease care, thereby enhancing patient outcomes and quality of life. Different studies in the European community have evaluated the impact of multidisciplinary care on outcomes for lung cancer patients, including its impact on survival, adherence to guideline treatment, utilization of all treatment modalities, timeliness of treatment, patient satisfaction, quality of life, and referral to palliative care. This publication will examine the roles and duties of all multidisciplinary members and the influence of multidisciplinary care on lung cancer outcomes in Europe. Multidisciplinary treatment is the foundation of lung cancer treatment. The optimal setting for interdisciplinary collaboration between specialists with complementary functions is multidisciplinary meetings. Multidisciplinary care in lung cancer facilitates the delivery of a high-quality service, which may improve lung cancer patients’ survival, utilization of all treatment modalities, adherence to guideline management, and quality of life, despite the fact that only limited observational data have demonstrated these results. To confirm the relationship between multidisciplinary treatment and improved lung cancer patient outcomes, however, further research is required.
Collapse
Affiliation(s)
- Luca Bertolaccini
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (S.M.); (C.B.); (G.L.I.); (A.M.); (L.S.)
- Correspondence: ; Tel.: +39-02-57489665; Fax: +39-02-56562994
| | - Shehab Mohamed
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (S.M.); (C.B.); (G.L.I.); (A.M.); (L.S.)
| | - Claudia Bardoni
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (S.M.); (C.B.); (G.L.I.); (A.M.); (L.S.)
| | - Giorgio Lo Iacono
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (S.M.); (C.B.); (G.L.I.); (A.M.); (L.S.)
| | - Antonio Mazzella
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (S.M.); (C.B.); (G.L.I.); (A.M.); (L.S.)
| | - Juliana Guarize
- Unit of Interventional Pulmonology, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy;
| | - Lorenzo Spaggiari
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy; (S.M.); (C.B.); (G.L.I.); (A.M.); (L.S.)
- Department of Oncology and Hemato-Oncology, University of Milan, 20141 Milan, Italy
| |
Collapse
|
40
|
Brito S, White J, Hill B, Thomacos N. Effective long-term management of brachial plexus injury following surgery: What is needed from hand therapists' perspectives. J Hand Ther 2022; 35:267-274. [PMID: 35246366 DOI: 10.1016/j.jht.2022.01.006] [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: 10/24/2020] [Revised: 01/16/2022] [Accepted: 01/24/2022] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Traumatic, brachial plexus injuries (BPI) result represent a significant cost to the individual and society. Recovery involves multiple surgeries, takes years, and often results in permanent physical dysfunction. While the last couple of decades have seen advancements in surgical management, the BPI rehabilitation literature has not kept pace with these developments. PURPOSE We aim to explore the experience of public and privately employed hand therapists' in delivering effective long-term rehabilitation services to inviduals with BPI in Australia. METHODS An interpretative qualitative study. Two focus groups were conducted with Australian hand therapists' (n = 10). Data were analyzed using an inductive thematic approach. RESULTS Three key themes were generated from the data. The first theme 'Falling through the gaps: overlooked components of therapy for BPI' captures participants' thoughts on postinjury health care and rehabilitation services. The second 'Developing a therapeutic alliance: underpinned by time and trust' relates to the relationship building challenges and opportunities following trauma that will withstand the long-term recovery of individuals following BPI. The last theme, 'Factors required for professional development: knowledge and support,' considers the variation seen with these clients in relation to therapy needs and outcomes. CONCLUSIONS The findings of this study highlight the need to better equip hand therapists' skills and knowledge in responding to pain and psychological management post BPI. Our results reinforce the benefit of interdisciplinary models of care in the management of individuals with BPI.
Collapse
Affiliation(s)
- Sara Brito
- Occupational Therapy Department, Federation University, Churchill, Victoria, Australia; Department of Occupational Therapy, Monash University, Frankston, Victoria, Australia.
| | - Jennifer White
- Department of Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Bridget Hill
- Epworth Monash Rehabilitation Medicine Unit, Epworth Hospital, Richmond, Victoria Australia
| | - Nikos Thomacos
- Department of Occupational Therapy, Monash University, Frankston, Victoria, Australia
| |
Collapse
|
41
|
Douglas N, Mays N, Al-Haboubi M, Manacorda T, Thana L, Wistow G, Durand MA. Observations of community-based multidisciplinary team meetings in health and social care for older people with long term conditions in England. BMC Health Serv Res 2022; 22:758. [PMID: 35676685 PMCID: PMC9175164 DOI: 10.1186/s12913-022-07971-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 04/05/2022] [Indexed: 11/20/2022] Open
Abstract
Background Community-based multi-disciplinary teams (MDTs) are the most common means to encourage health and social care service integration in England yet are rarely studied or directly observed. This paper reports on two rounds of non-participant observations of community-based multi-disciplinary team (MDT) meetings in two localities, as part of an evaluation of the Integrated Care and Support Pioneers Programme. We sought to understand how MDT meetings coordinate care and identify their ‘added value’ over bilateral discussions. Methods Two rounds of structured non-participant observations of 11 MDTs (28 meetings) in an inner city and mixed urban–rural area in England (June 2019-February 2020), using a group analysis approach. Results Despite diverse settings, attendance and caseloads, MDTs adopted similar processes of case management: presentation; information seeking/sharing; narrative construction; solution seeking; decision-making and task allocation. Patient-centredness was evident but scope to strengthen ‘patient-voice’ exists. MDTs were hampered by information governance rules and lack of interoperability between patient databases. Meetings were characterised by mutual respect and collegiality with little challenge. Decision-making appeared non-hierarchical, often involving dyads or triads of professionals. ‘Added value’ lay in: rapid patient information sharing; better understanding of contributing agencies’ services; planning strategies for patients that providers had struggled to find the right way to engage satisfactorily; and managing risk and providing mutual support in stressful cases. Conclusions More attention needs to be given to removing barriers to information sharing, creating scope for constructive challenge between staff and deciding when to remove cases from the caseload.
Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07971-x.
Collapse
Affiliation(s)
- Nick Douglas
- Policy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK. .,Now School of Psychology, University of Sussex, Brighton, East Sussex, UK.
| | - Nicholas Mays
- Policy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Mustafa Al-Haboubi
- Policy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Tommaso Manacorda
- Policy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.,Now Public Health, Advocacy and Welfare, Italian Multiple Sclerosis Society, Genoa, Italy
| | - Lavanya Thana
- Policy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Gerald Wistow
- Policy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.,Care Policy & Evaluation Centre, London School of Economics & Political Science, London, UK
| | - Mary Alison Durand
- Policy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
42
|
Alvarez-Cuesta E, Madrigal-Burgaleta R, Broyles AD, Cuesta-Herranz J, Guzman-Melendez MA, Maciag MC, Phillips EJ, Trubiano JA, Wong JT, Ansotegui I. Standards for practical intravenous rapid drug desensitization & delabeling: A WAO committee statement. World Allergy Organ J 2022; 15:100640. [PMID: 35694005 PMCID: PMC9163606 DOI: 10.1016/j.waojou.2022.100640] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/27/2022] [Accepted: 03/03/2022] [Indexed: 12/16/2022] Open
Abstract
Drug hypersensitivity reactions (DHRs) to intravenous drugs can be severe and might leave patients and doctors in a difficult position where an essential treatment or intervention has to be suspended. Even if virtually any intravenous medication can potentially trigger a life-threatening DHR, chemotherapeutics, biologics, and antibiotics are amongst the intravenous drugs most frequently involved in these reactions. Admittedly, suspending such treatments may negatively impact the survival outcomes or the quality of life of affected patients. Delabeling pathways and rapid drug desensitization (RDD) can help reactive patients stay on first-choice therapies instead of turning to less efficacious, less cost-effective, or more toxic alternatives. However, these are high-complexity and high-risk techniques, which usually need expert teams and allergy-specific techniques (skin testing, in vitro testing, drug provocation testing) to ensure safety, an accurate diagnosis, and personalized management. Unfortunately, there are significant inequalities within and among countries in access to allergy departments with the necessary expertise and resources to offer these techniques and tackle these DHRs optimally. The main objective of this consensus document is to create a great benefit for patients worldwide by aiding allergists to expand the scope of their practice and support them with evidence, data, and experience from leading groups from around the globe. This statement of the Drug Hypersensitivity Committee of the World Allergy Organization (WAO) aims to be a comprehensive practical guide on the technical aspects of implementing acute-onset intravenous hypersensitivity delabeling and RDD for a wide range of drugs. Thus, the manuscript does not only focus on clinical pathways. Instead, it also provides guidance on topics usually left unaddressed, namely, internal validation, continuous quality improvement, creating a healthy multidisciplinary environment, and redesigning care (including a specific supplemental section on a real-life example of how to design a dedicated space that can combine basic and complex diagnostic and therapeutic techniques in allergy).
Collapse
Affiliation(s)
| | - Ricardo Madrigal-Burgaleta
- Allergy & Severe Asthma Service, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
- Drug Desensitisation Centre, Catalan Institute of Oncology (ICO), Barcelona, Spain
- Corresponding author. Allergy & Severe Asthma Service, Respiratory Department, 4th Floor, King George V Building, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
| | - Ana D. Broyles
- Division of Allergy & Immunology, Boston Children's Hospital, Boston, MA, USA
| | - Javier Cuesta-Herranz
- Department of Allergy and Immunology, FIIS-Fundación Jiménez Díaz, UAM, Madrid, Spain
- RETIC ARADyAL, Instituto de Salud Carlos III, Spain
| | | | - Michelle C. Maciag
- Division of Allergy & Immunology, Boston Children's Hospital, Boston, MA, USA
| | - Elizabeth J. Phillips
- Department of Medicine & Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jason A. Trubiano
- Department of Infectious Diseases and Centre for Antibiotic Allergy and Research, Austin Health, Heidelberg, Australia
| | - Johnson T. Wong
- Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Steering Committee AuthorsAliF. RunaMBBS, PhD, FRCPaxAngel-PereiraDenisseMDlBanerjiAleenaMDayBerges-GimenoMaria PilarMD, PhDmBernal-RubioLorenaMDmBrockowKnutMDnCardona VillaRicardoMDoCastellsMariana C.MD, PhDpCaubetJean-ChristophMDqChangYoon-SeokMD, PhDrEnsinaLuis FelipeMD, MSc, PhDsChikhladzeMananaPhDtChiriacAnca MirelaMD, PhDuChungWeng-HungMD, PhDvEbisawaMotohiroMD, PhDwFernandesBryanMBBS, MRCPaxGarveyLene HeiseMD, PhDxawGomezMaximilianoMD, PhDyGomez VeraJavierMDzGonzalez DiazSandraMD, PhDaaHongDavid I.MDpIvancevichJuan CarlosMDabKangHye-RyunMD, PhDacKhanDavid A.MDadKuruvillaMerinMDaeLarco SousaJose IgnacioMDafLatour-StaffeldPatriciaMDagLiuAnne Y.MDahMacyEricMDaiMallingHans JorgenMDajMasperoJorgeMDakMaySara M.MDalMayorgaCristobalinaPhDamParkMiguel A.MDanPeterJonathanMBChB, PhDaoPicardMatthieuMD, FRCPCapRodriguez-BouzaTitoMD, PhDaq2RomanoAntoninoMDarSanchez-BorgesMarioMDazbaTannoLuciana KaseMD, PhDuTorresMaria JoseMD, PhDamUreña-TaveraAliciaMDasValluzziRocco L.MDatVolcheckGerald W.MDauYamaguchiMasaoMD, PhDavHospital Universitario de Canarias, Tenerife, SpainAllergy Division, Ramon y Cajal University Hospital, Madrid, SpainDepartment of Dermatology and Allergy Biederstein, School of Medicine, Technical University of Munich, Munich, GermanyUniversidad de Antioquia, Medellín, ColombiaDivision of Allergy and Clinical Immunology, Department of Medicine, Brigham & Women's Hospital, Boston, MA, USAPediatric Allergy Unit, Geneva University Hospitals, Geneva, SwitzerlandDivision of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of KoreaDivision of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of Sao Paulo, BrazilMedical Faculty at Akaki Tsereteli State University, KuTaisi, Tskaltubo, GeorgiaDivision of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, FranceDepartment of Dermatology, Chang Gung Memorial Hospital, Taipei, Linko and Keelung, TaiwanClinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Kanagawa, JapanAllergy Clinic, Copenhagen University Hospital Gentofte, Copenhagen, DenmarkSchool of Health Sciences, Catholic University of Salta, ArgentinaInstitute of Security and Social Services of State Workers, López Mateos Regional Hospital, Mexico City, MexicoRegional Center of Allergy and Clinical Immunology, University Hospital “Dr. José Eleuterio González”, Gonzalitos y Madero s/n Colonia Mitras Centro, Monterrey, MexicoServicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, ArgentinaInstitute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of KoreaDepartment of Internal Medicine, Division of Allergy & Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USADivision of Pulmonary, Allergy, Critical Care & Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USAAllergy Department, Clinica San Felipe, Lima, PeruCentro Avanzado de Alergia y Asma de Santo Domingo, Santo Domingo, Dominican RepublicStanford University School of Medicine, Palo Alto, CA, USASouthern California Permanente Medical Group, Kaiser Permanente Southern California, San Diego Medical Center, San Diego, CA, USADanish Allergy Centre, University of Copenhagen, Copenhagen, DenmarkAllergy and Respiratory Research Unit, Fundación CIDEA, Buenos Aires, ArgentinaDivision of Pulmonary, Critical Care, Sleep & Allergy, University of Nebraska Medical Center, Omaha, NE, USAAllergy Unit and Research Group, Hospital Regional Universitario de Málaga, UMA-IBIMA-BIONAND, ARADyAL, Málaga, SpainDivision of Allergic Diseases, Mayo Clinic, Rochester, MN, USADivision of Allergology and Clinical Immunology, Department of Medicine, University of Cape Town, Cape Town, South AfricaDepartment of Medicine, Division of Allergy and Immunology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, Québec, CanadaCentro de Patología Alérgica, Hospital Quirón Palmaplanas, Palma, SpainOasi Research Institute – IRCCS, Troina, ItalyClinica Union Medica del Norte, Santiago, Dominican RepublicMultifactorial and Systemic Diseases Research Area, Predictive and Preventive Medicine Research Unit, Division of Allergy, Bambino Gesù Children's Hospital IRCCS, Rome, ItalyDivision of Allergic Diseases, Mayo Clinic, Rochester, MN, USADivision of Respiratory Medicine, Third Department of Medicine, Teikyo University Chiba Medical Center, Anesaki, Ichihara, Chiba, JapanDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkAllergy & Severe Asthma Service, St Bartholomew's Hospital, Barts Health NHS Trust, London, UKDivision of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, MA, USAAllergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, VenezuelaAllergy and Clinical Immunology Department, Clínica El Avila, Caracas, Venezuela
| | | |
Collapse
|
43
|
Leland NE, Lekovitch C, Martínez J, Rouch S, Harding P, Wong C. Optimizing Post-Acute Care Patient Safety: A Scoping Review of Multifactorial Fall Prevention Interventions for Older Adults. J Appl Gerontol 2022; 41:2187-2196. [PMID: 35618304 DOI: 10.1177/07334648221104375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Accidental falls are preventable adverse events for older post-acute care (PAC) patients. Yet, due to the functional and medical care needs of this population, there is little guidance to inform multidisciplinary prevention efforts. This scoping review aims to characterize the evidence for multifactorial PAC fall prevention interventions. Of the 33 included studies, common PAC intervention domains included implementing facility-based strategies (e.g., staff education), evaluating patient-specific fall risk factors (e.g., function), and developing an individualized risk profile and treatment plan that targets the patient's constellation of fall risk factors. However, there was variability across studies in how and to what extent the domains were addressed. While further research is warranted, health system efforts to prevent accidental falls in PAC should consider a patient-centered multifactorial approach that fosters a culture of safety, addresses individuals' fall risk, and champions a multidisciplinary team.
Collapse
Affiliation(s)
- Natalie E Leland
- Department of Occupational Therapy, 6614University of Pittsburgh, Pittsburgh, PA, USA
| | - Cara Lekovitch
- Department of Occupational Therapy, 6614University of Pittsburgh, Pittsburgh, PA, USA
| | - Jenny Martínez
- Department of Occupational Therapy, 6559Jefferson College of Rehabilitation Sciences, Philadelphia, PA, USA
| | - Stephanie Rouch
- Department of Occupational Therapy, 6614University of Pittsburgh, Pittsburgh, PA, USA
| | - Patrick Harding
- Chan Division of Occupational Science and Occupational Therapy, 5116University of Southern California, Los Angeles, CA, USA
| | - Carin Wong
- Department of Sociology, 14669California State University Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
44
|
Cameron N, Fetherstonhaugh D, Rayner JA, McAuliffe L. How do health and allied health practitioners perceive excellence in residential aged care? An exploratory qualitative study. Australas J Ageing 2022; 41:e364-e370. [PMID: 35510528 PMCID: PMC10084196 DOI: 10.1111/ajag.13077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/16/2022] [Accepted: 03/28/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To identify factors that health and allied health practitioners consider central to excellence in residential aged care facilities (RACFs) with the objective of supporting improvements in monitoring, accountability and service delivery within the sector. METHODS In a qualitative, exploratory designed study, interviews were undertaken with seventeen participants from 10 health and allied health disciplines (general practice, dentistry, pharmacy, psychiatry, psychology, neuropsychology, physiotherapy, speech pathology, occupational therapy and palliative care) with experience of working in Victorian RACFs. The interviews focused on how practitioners perceived excellence within RACFs. Data were analysed thematically. RESULTS Thematic analysis yielded five themes, which correspond with different dimensions or ways of understanding excellence, including resident well-being, residences as a true home, good practice models, effective management and skilled staff, and unmet needs. Under each of these themes, participants referred to issues closely related to the concerns of their particular professions as well as those more general in nature. CONCLUSIONS The diversity in issues to which participants drew attention highlights the importance of obtaining the perspectives of a broad range of practitioners providing services to RACF residents to achieving excellence in the sector. Commonalities in their responses indicate the potential for a greater level of collaboration among the health and allied health professions.
Collapse
Affiliation(s)
- Nadine Cameron
- Australian Centre for Evidence Based Aged Care, La Trobe University, Bundoora, Victoria, Australia
| | - Deirdre Fetherstonhaugh
- Australian Centre for Evidence Based Aged Care, La Trobe University, Bundoora, Victoria, Australia
| | - Jo-Anne Rayner
- Australian Centre for Evidence Based Aged Care, La Trobe University, Bundoora, Victoria, Australia
| | - Linda McAuliffe
- Australian Centre for Evidence Based Aged Care, La Trobe University, Bundoora, Victoria, Australia
| |
Collapse
|
45
|
Hotez E, Berghaus M, Verbiest S, Russ S, Halfon N. Proposal for Life Course Intervention Researcher Core Competencies. Pediatrics 2022; 149:186918. [PMID: 35503320 PMCID: PMC9847407 DOI: 10.1542/peds.2021-053509f] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 01/21/2023] Open
Affiliation(s)
- Emily Hotez
- Center for Healthier Children, Families, and Communities, University of California, Los Angeles, Los Angeles, California,Departments of Medicine,Address correspondence to Emily Hotez, PhD, 911 Broxton Ave, 2 Floor, Los Angeles, CA 90024. E-mail:
| | - Mary Berghaus
- Center for Healthier Children, Families, and Communities, University of California, Los Angeles, Los Angeles, California,Pediatrics, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Sarah Verbiest
- School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Shirley Russ
- Center for Healthier Children, Families, and Communities, University of California, Los Angeles, Los Angeles, California,Pediatrics, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | - Neal Halfon
- Center for Healthier Children, Families, and Communities, University of California, Los Angeles, Los Angeles, California,Pediatrics, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California,Department of Health Policy and Management, Fielding School of Public Health,Department of Public Policy, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California
| |
Collapse
|
46
|
McInerney J, Seedhouse D, Pettit M, Roberts S, Druva R, Lewicki S. Interdisciplinary interprofessional education using an online learning environment called values exchange: A qualitative investigation. J Med Radiat Sci 2022; 69:309-317. [PMID: 35475599 PMCID: PMC9442323 DOI: 10.1002/jmrs.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 03/19/2022] [Accepted: 03/30/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Interprofessional education (IPE) is implemented throughout the curricula of student healthcare professions as it is understood to provide positive impact on patient outcomes in the clinical environment. There are different methods to provide IPE such as through online learning or traditional face‐to‐face methods. However, there is a lack of research surrounding the use of Online Learning Environments (OLEs) to teach IPE. Methods In a pilot study, seventy‐one undergraduate radiography students and twenty Master of Pharmacy students engaged in an ethical scenario using the OLE, Values Exchange (Vx). Following the activity, students were invited to complete an open‐ended response question. Fourteen students responded and these data were used for qualitative analysis. Results A thematic analysis of the students' open‐ended responses found the emergence of three major themes, namely; understanding the roles of other healthcare professionals, developing self‐reflection skills and, preparing for the clinical environment. Students suggested that additional time allocated for undertaking the study would benefit their engagement in the activity. Students would benefit from added engagement in the Vx task in both the short and long term for IPE. Conclusion Students are receptive in utilising contemporary approaches such as OLEs in furthering their IPE. Positive interpretations and suggestions by both radiography and pharmacy students in this study demonstrate how Vx as an OLE teaching tool can be used effectively. OLEs can overcome barriers that exist in face‐to‐face education experiences. OLEs should be considered for greater use within academic curricula of healthcare professions, but only if they have been evaluated for effectiveness.
Collapse
Affiliation(s)
- John McInerney
- Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, Australia.,Radiology Department, Royal Melbourne Hospital, Melbourne, Australia
| | - David Seedhouse
- University of Derby, Derby, UK.,University of Western Sydney, Penrith, Australia
| | - Michael Pettit
- Department of Pharmacy, University of Sussex, Sussex, UK
| | - Simone Roberts
- Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, Australia
| | - Ruth Druva
- Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, Australia
| | - Sabrina Lewicki
- Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, Australia
| |
Collapse
|
47
|
Martin AK, Green TL, McCarthy AL, Sowa PM, Laakso EL. Healthcare Teams: Terminology, Confusion, and Ramifications. J Multidiscip Healthc 2022; 15:765-772. [PMID: 35422626 PMCID: PMC9005079 DOI: 10.2147/jmdh.s342197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/11/2022] [Indexed: 11/23/2022] Open
Abstract
One strategy to meet increasing consumer demand for healthcare services in the pandemic era has been to reorganize the healthcare workforce. This can be achieved by reorganizing healthcare teams, which are associated with improved workforce productivity and better patient outcomes. However, healthcare teams are described using numerous terminologies and labels, which has led to conceptual confusion for researchers and research users. In this paper, we explore the disparate nature of healthcare team terminology, ramifications of conceptual confusion, and we propose standardized terminology with synthesized definitions focused on characteristics of clinically based healthcare teams including unidisciplinary, multidisciplinary, interprofessional, and transdisciplinary teams.
Collapse
Affiliation(s)
- Aleysha K Martin
- Faculty of Medicine, Mater Research Institute – The University of Queensland, Brisbane, QLD, Australia
- Correspondence: Aleysha K Martin, Faculty of Medicine, Mater Research Institute – The University of Queensland, Level 2 Aubigny Place, Raymond Terrace, South Brisbane, QLD, 4101, Australia, Tel +61 457 993 248; +61 7 3163 2550, Email
| | - Theresa L Green
- School of Nursing, Midwifery and Social Work, The University of Queensland – MNHHS Surgical Treatment and Rehabilitation Service, Brisbane, QLD, Australia
| | - Alexandra L McCarthy
- School of Nursing, Midwifery and Social Work, Mater Research Institute – The University of Queensland, Brisbane, QLD, Australia
| | - P Marcin Sowa
- Centre for the Business and Economics of Health, The University of Queensland, Brisbane, QLD, Australia
| | - E-Liisa Laakso
- Allied Health, Mater Research Institute – The University of Queensland, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Gold Coast, Australia
| |
Collapse
|
48
|
Clinical Resources for Assessing Mobility of People with Lower-Limb Amputation: Interviews with Rehabilitation Clinicians. JPO JOURNAL OF PROSTHETICS AND ORTHOTICS 2022; 34:69-78. [PMID: 35431518 PMCID: PMC9007274 DOI: 10.1097/jpo.0000000000000345] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction Mobility tests are increasingly used in prosthetic rehabilitation to evaluate patient outcomes. Knowledge of the space, equipment, and time resources available to clinicians who work in different settings can guide recommendations for which tests are most clinically-feasible and promote coordination of mobility testing among members of the rehabilitation team. The primary aim of this study was to characterize the different resources available to clinicians for measuring mobility of people with lower limb amputation. A secondary aim was to identify performance tasks that clinicians use to evaluate prosthetic mobility. Materials and methods Semi-structured interviews were conducted with prosthetists, physical therapists, and physiatrists who treat people with lower limb amputation. Researchers used convenience and snowball sampling to identify participants. Interviews included questions about the resources available for conducting mobility tests, as well as questions about which tasks clinicians deemed valuable to assessing mobility of patients with lower limb amputation. Interviews were audio-recorded and transcribed. Summary and frequency statistics were calculated for quantitative data; explanatory comments were summarized. Results Interviews were conducted with 25 clinicians (8 prosthetists, 9 physical therapists, and 8 physiatrists). Participants had access to multiple spaces and basic measurement equipment. The maximum time participants were willing to spend on performance tests varied. Physiatrists reported less time available (median=10 minutes, range 5-30 minutes) than prosthetists and physical therapists (median=30 minutes, range 5-60 minutes for both professions). Mobility tasks commonly used to evaluate patients with lower limb amputation included sit-to-stand, standing balance, walking, and varying speed. Participant comments suggested that mobility tests need to be quick, simple, and add value; existing mobility tests are beneficial but challenging to incorporate into practice; mobility tests should reflect real-world activities; and technological advancements could improve mobility testing. Conclusions Clinicians generally had small-to-medium spaces, basic measurement equipment, and sufficient training to administer mobility tests in their clinics. A limiting factor was time, which can be addressed through selection of efficient measures and collaboration within the rehabilitation team.
Collapse
|
49
|
Practical Recommendations for Youth Care Professionals to Improve Evaluation and Reflection During Multidisciplinary Team Discussions: An Action Research Project. Int J Integr Care 2022; 22:26. [PMID: 35431704 PMCID: PMC8973782 DOI: 10.5334/ijic.5639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/15/2022] [Indexed: 11/20/2022] Open
|
50
|
Exploring the connection between transdisciplinary co-production and urban sustainability solutions: a case study at an urban stream management symposium. Urban Ecosyst 2022. [DOI: 10.1007/s11252-022-01226-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|