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Leenen JPL, Scherrenberg M, Bruins W, Boyne J, Vranken J, Brunner la Rocca HP, Dendale P, van der Velde AE. Usability of a digital health platform to support home hospitalization in heart failure patients: a multicentre feasibility study among healthcare professionals. Eur J Cardiovasc Nurs 2024; 23:188-196. [PMID: 37294588 DOI: 10.1093/eurjcn/zvad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 06/10/2023]
Abstract
AIMS Heart failure (HF) is a common cause of mortality and (re)hospitalizations. The NWE-Chance project explored the feasibility of providing hospitalizations at home (HH) supported by a newly developed digital health platform. The aim of this study was to explore the perceived usability by healthcare professionals (HCPs) of a digital platform in addition to HH for HF patients. METHODS AND RESULTS A prospective, international, multicentre, single-arm interventional study was conducted. Sixty-three patients and 22 HCPs participated. The HH consisted of daily home visits by the nurse and use of the platform, consisting of a portable blood pressure device, weight scale, pulse oximeter, a wearable chest patch to measure vital signs (heart rate, respiratory rate, activity level, and posture), and an eCoach for the patient. Primary outcome was usability of the platform measured by the System Usability Scale halfway and at the end of the study. Overall usability was rated as sufficient (mean score 72.1 ± 8.9) and did not differ between the measurements moments (P = 0.690). The HCPs reported positive experiences (n = 7), negative experiences (n = 13), and recommendations (n = 6) for the future. Actual use of the platform was 79% of the HH days. CONCLUSION A digital health platform to support HH was considered usable by HCPs, although actual use of the platform was limited. Therefore, several improvements in the integration of the digital platform into clinical workflows and in defining the precise role of the digital platform and its use are needed to add value before full implementation. REGISTRATION clinicaltrials.gov NCT04084964.
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Affiliation(s)
- Jobbe P L Leenen
- Connected Care Centre, Isala Hospital, Dr. van Heesweg 2, Zwolle, AB 8025, The Netherlands
- Isala Academy, Isala Hospital, Dr. van Heesweg 2, Zwolle, AB 8025, The Netherlands
| | - Martijn Scherrenberg
- Heart Centre Hasselt, Jessa Hospital, Salvatorstraat 20, Hasselt 3500, Belgium
- Faculty of Medicine and Life Sciences, UHasselt, Martelarenlaan 42, Hasselt 3500, Belgium
- Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, Hasselt 3500, Belgium
| | - Wendy Bruins
- Isala Heart Centre, Isala Hospital, Dr. van Heesweg 2, Zwolle, AB 8025, The Netherlands
| | - Josiane Boyne
- Cardiology Department, Maastricht University Medical Centre, Minderbroedersberg 4-6, Maastricht, 6211 LK, The Netherlands
| | - Julie Vranken
- Faculty of Medicine and Life Sciences, UHasselt, Martelarenlaan 42, Hasselt 3500, Belgium
- Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, Hasselt 3500, Belgium
| | - Hans-Peter Brunner la Rocca
- Cardiology Department, Maastricht University Medical Centre, Minderbroedersberg 4-6, Maastricht, 6211 LK, The Netherlands
| | - Paul Dendale
- Heart Centre Hasselt, Jessa Hospital, Salvatorstraat 20, Hasselt 3500, Belgium
- Faculty of Medicine and Life Sciences, UHasselt, Martelarenlaan 42, Hasselt 3500, Belgium
- Mobile Health Unit, Faculty of Medicine and Life Sciences, Hasselt University, Martelarenlaan 42, Hasselt 3500, Belgium
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Llimós M, Segura-Benedicto A, Benavides FG. [The public health profession in Spain: an urgent challenge to strengthen its practice]. Gac Sanit 2024; 38:102364. [PMID: 38422945 DOI: 10.1016/j.gaceta.2024.102364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 03/02/2024]
Abstract
The recent health crises have highlighted the weakness of public health structures in Spain. The causes are, among others, the scarcity of economic resources and the delay in their institutional modernization. In addition, there is the weakness of the training processes and the employability. The Spanish Society of Public Health and Health Administration (SESPAS) has developed a White paper of the public health profession with the aim of contributing to strengthening professional practice. The sociodemographic characteristics of the associations federated to SESPAS have been described and the discourse of professionals has been analyzed through six focus groups and 19 interviews (72 people). To agree on the conclusions and recommendations, a meeting was organized with the participation of 29 participants. The demographic and employment data of the 3467 people belonging to seven SESPAS societies show that, overall, about 60% are women and 40% were under 50 years of age. Undergraduate degrees were medicine (35.9%), nursing (17.4%) and pharmacy and veterinary medicine (10.4%). Key aspects of the meaning of public health, training, employability and career and institutionalization of public health were collected through interviews and focus groups. The final meeting agreed on 25 conclusions and 24 recommendations that aim to contribute to strengthening professionals and the public health profession in Spain. Some of them, related to training, employability and professional career, have been shared in a workshop at the School of Public Health of Menorca with public health officials from the Ministry of Health and some autonomous communities.
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Affiliation(s)
- Mireia Llimós
- Departamento de Medicina y Ciencias de la Vida, Universidad Pompeu Fabra, Barcelona, España.
| | | | - Fernando G Benavides
- Departamento de Medicina y Ciencias de la Vida, Universidad Pompeu Fabra, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Hospital del Mar Research Institute, Barcelona, España; Centro de Investigación en Salud Laboral (CiSAL), Universidad Pompeu Fabra, Barcelona, España
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Reid HE, Edge D, Pratt D, Wittkowski A. Working with suicidal mothers during the perinatal period: a reflexive thematic analysis study with mental health professionals. BMC Psychiatry 2024; 24:106. [PMID: 38326817 PMCID: PMC10848420 DOI: 10.1186/s12888-024-05537-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Suicide is the leading cause of death in mothers postpartum and one of the most common causes of death during pregnancy. Mental health professionals who work in perinatal services can offer insights into the factors they perceive as being linked to mothers' suicidal ideation and behaviour, support offered to mothers and improvements to current practices. We aimed to explore the experiences and perceptions of perinatal mental health professionals who have worked with suicidal mothers during the perinatal period. METHOD Semi-structured interviews were conducted face-to-face or via telephone with mental health professionals working in perinatal mental health inpatient or community services across England. Data were analysed using reflexive thematic analysis. RESULTS From the professionals' (n = 15) accounts three main themes were developed from their interview data. The first, factors linked to suicidal ideation and behaviour, overarched two sub-themes: (1.1) the mother's context and (1.2) what the baby represents and what this means for the mother. These sub-themes described factors that professionals assessed or deemed contributory in relation to suicidal ideation and behaviour when a mother was under their care. The second main theme, communicating about and identifying suicidal ideation and behaviour, which outlined how professionals enquired about, and perceived, different suicidal experiences, encapsulated two sub-themes: (2.1) how to talk about suicide and (2.2) types of suicidal ideation and attempts. The third main theme, reducing suicidal ideation through changing how a mother views her baby and herself, focused on how professionals supported mothers to reframe the ways in which they viewed their babies and in turn themselves to reduce suicidal ideation. CONCLUSION Professionals highlighted many factors that should be considered when responding to a mother's risk of suicide during the perinatal period, such as the support around her, whether the pregnancy was planned and what the baby represented for the mother. Professionals' narratives stressed the importance of adopting a tailored approach to discussing suicidal experiences with mothers to encourage disclosure. Our findings also identified psychological factors that professionals perceived as being linked to suicidal outcomes for mothers, such as self-efficacy; these factors should be investigated further.
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Affiliation(s)
- Holly E Reid
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Zochonis Building, Brunswick Street, M13 9PL, Manchester, UK
- Manchester Academic Health Sciences Centre, Manchester, UK
| | - Dawn Edge
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Zochonis Building, Brunswick Street, M13 9PL, Manchester, UK
- Manchester Academic Health Sciences Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Zochonis Building, Brunswick Street, M13 9PL, Manchester, UK
- Manchester Academic Health Sciences Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Zochonis Building, Brunswick Street, M13 9PL, Manchester, UK.
- Manchester Academic Health Sciences Centre, Manchester, UK.
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
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Jumbo AE, Kaufman DR, Faysel MA, Afable A, Levine SR. Survey of Potential Disparity Issues Among Minority Stroke Survivors in Central Brooklyn. Stud Health Technol Inform 2024; 310:1307-1311. [PMID: 38270026 DOI: 10.3233/shti231176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Medical data and information are ubiquitous due to internet availability. However, most people persist in using and trusting their healthcare professionals for health information. They are increasingly flooded with health information from diverse sources such as the internet, community-based organizations, and family or friends. It is crucial to understand where stroke patients vary in the use and trust of health information to improve their conditions. This pilot study aimed to better understand the nature of the problems confronted by stroke patients, such as the source of reliable health information, trust in the healthcare system, and technology trend awareness. African American and Afro-Caribbean stroke patients (n=64) residing in Central Brooklyn, New York, participated in a survey. The results showed that physicians remained the most highly trusted information sources for stroke patients, particularly among patients with higher education, irrespective of the available communication sources.
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Affiliation(s)
| | - David R Kaufman
- SUNY Downstate Health Sciences University, Brooklyn, New York
| | | | - Aimee Afable
- SUNY Downstate Health Sciences University, Brooklyn, New York
| | - Steven R Levine
- SUNY Downstate Health Sciences University, Brooklyn, New York
- Jaffe Stroke Center, Maimonides Medical Center, Brooklyn, New York
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Shuyi AT, Zikki LYT, Mei Qi A, Koh Siew Lin S. Effectiveness of interprofessional education for medical and nursing professionals and students on interprofessional educational outcomes: A systematic review. Nurse Educ Pract 2024; 74:103864. [PMID: 38101092 DOI: 10.1016/j.nepr.2023.103864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/08/2023] [Accepted: 11/25/2023] [Indexed: 12/17/2023]
Abstract
AIM AND BACKGROUND Patient safety is a global health priority as unsafe care is a principal cause of death and disability. Ineffective interprofessional communication and collaboration among nursing and medical professionals and students contribute to unsafe practices. Interprofessional education provides opportunities to strengthen nurse-physician collaboration and enhance patient care. However, there is inconclusive evidence regarding interprofessional education effectiveness. This review aims to systematically evaluate interprofessional education effectiveness for nursing and medical professionals and students on interprofessional educational outcomes (interprofessional attitudes, perceptions, skills, knowledge, behaviours, and organisational and patient outcomes). DESIGN AND METHODS PubMed, Cochrane Library, Embase, Scopus, CINAHL, ERIC, PsycInfo, Web of Science were last searched on 13 January 2022. This review included published and unpublished randomised controlled trials, quasi-experimental and mixed-method studies in English examining interprofessional education outcomes among nursing and medical professionals and students. Two reviewers independently appraised studies using the Joanna Briggs Institute Critical Appraisal Tools and extracted data using a modified Joanna Briggs Institute data extraction form. Narrative synthesis was conducted instead of meta-analysis since majority of the included studies had quasi-experimental design, and various interventions and outcomes. Certainty of evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluations tool. RESULTS This review included 15 studies involving 1185 participants. Improvements were reported in each interprofessional educational outcome after interprofessional education. High-fidelity simulation with multiple scenarios, standardised communication tools, didactic and active learning methods, theoretical frameworks, debriefing sessions and provider training enhanced interprofessional education effectiveness. CONCLUSIONS Effectiveness of interprofessional education for nursing and medical professionals and students was demonstrated since improvements were observed for each interprofessional educational outcome. This systematic review addressed literature gaps, demonstrated effectiveness of interprofessional education in clinical practice and academic curricula and provided evidence-based insights that future research can consider to enhance global patient safety standards for optimal patient outcomes and quality of healthcare. Caution is advised in interpreting findings due to 'very low' evidence certainty and limited studies. More high-quality randomised controlled trials with longitudinal designs are needed.
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Affiliation(s)
- Amelia Tan Shuyi
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Nursing, KK Women's and Children's Hospital, Singapore.
| | - Lew Yi Ting Zikki
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Nursing, KK Women's and Children's Hospital, Singapore
| | - Ang Mei Qi
- Division of Nursing, KK Women's and Children's Hospital, Singapore
| | - Serena Koh Siew Lin
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Menchik DA, Giaquinta M. The words we die by. Soc Sci Med 2024; 340:116470. [PMID: 38091852 DOI: 10.1016/j.socscimed.2023.116470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 11/21/2023] [Accepted: 11/25/2023] [Indexed: 01/23/2024]
Abstract
Hospice is a venue organized to provide a "good death" for patients and family. Since many hospice patients are bedridden and often incoherent or unconscious, many of this venue's interactions take place between hospice professionals and patients' families. The families of patients desire definitive prognoses because knowing what to expect can help them decide how to act, but for professionals such knowledge is characterized by doubt. In light of their needs, how then do hospice professionals use language to achieve and maintain the family's buy-in? Drawing on eight months of observation in Hospice House Interdisciplinary Team (IDT) meetings, we analyze the verbal interactions between hospice professionals and patients' families, focusing in particular on registers of prognosis, to better understand how hospice professionals use language to manage family expectations. In order to accomplish this goal central to their occupational project, hospice professionals use future grammars, primarily comprising predictive and subjunctive verbs. Imperative verbs are rarely used. We refine the enactive perspective on authoritativeness by identifying some linguistic components that mediate authority's efficacy in a venue where emotion management is central to professional work. Paying attention to the uses of these linguistic registers helps us further understand some everyday ways that death is organized, and in general, may offer a richer understanding of death itself.
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Affiliation(s)
- Daniel A Menchik
- School of Sociology, 1145 E. South Campus Drive, University of Arizona, Tucson, AZ, 85721, USA.
| | - Maya Giaquinta
- Medical College of Wisconsin, Department of Pediatrics, Children's Corporate Center, 999 N. 92nd St., Milwaukee, WI, 53226, USA
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Poveda-López S, Lillo-Navarro C, Sánchez-Pérez A, Gacto-Sánchez M, Montilla-Herrador J. Older persons' expressed perceptions on exercise programs in long-term care institutions: Influence of professionals and institutions. Patient Educ Couns 2023; 117:107985. [PMID: 37734250 DOI: 10.1016/j.pec.2023.107985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/30/2023] [Accepted: 09/16/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE To explore the perceptions of institutionalised older people about the professionals and institutions regarding exercise programs in long-term care institutions DESIGN, SETTING, AND PARTICIPANTS: A qualitative study was carried out using focus group discussions. Forty-seven institutionalised participants (≥ 65 years old) with a score of > 23 in the Mini-Mental State Examination (MMSE) were recruited. RESULTS Most participants believed that the frequency of the exercise sessions could be increased by enhancing the number of staff assisting them and by adapting the facilities to their needs. They also suggested using outdoor spaces and avoiding childish activities and treatment. Participants' beliefs were grouped into three major themes (i) Perceptions about the health professionals delivering the exercise programs (ii) Perceptions about the institution or centre regarding exercise programs; (iii) Perceptions about the exercise programs. CONCLUSION Participants proposed certain changes that could take place in the institutions to promote engagement with exercise programs: tailored exercise programs, avoiding puerile treatment, increasing the number of staff members, and the creation of well-equipped spaces to perform the exercise. PRACTICAL IMPLICATIONS Professionals should spend time designing tailored exercise programs and avoid puerile treatment. Institutions must review the need for spaces and the personnel assigned.
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Affiliation(s)
- Salud Poveda-López
- Faculty of Health Sciences, UCAM Catholic University of Murcia, Murcia, Spain
| | - Carmen Lillo-Navarro
- Center for Translational Research in Physiotherapy (CEIT). Department of Pathology and Surgery. Miguel Hernández University, Alicante, Spain.
| | - Alicia Sánchez-Pérez
- Department of Pathology and Surgery, Miguel Hernández University, Alicante, Spain. Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Mariano Gacto-Sánchez
- CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain
| | - Joaquina Montilla-Herrador
- CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain
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Apers H, Nöstlinger C, Van Praag L. Explanatory Models of (Mental) Health Among Sub-Saharan African Migrants in Belgium: A Qualitative Study of Healthcare Professionals' Perceptions and Practices. Cult Med Psychiatry 2023; 47:878-897. [PMID: 36939966 PMCID: PMC10026223 DOI: 10.1007/s11013-023-09816-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 03/21/2023]
Abstract
Culturally differing approaches to the distinction between physical and mental health contribute to cultural differences in explanatory models of what we call "mental" health in a Western context. For this reason, we use "(mental) health" in this study when referring to these models or differences in understanding. This interpretative, interview-based qualitative study focuses on Belgian mental health professionals' perceptions of the (mental) health explanatory models held by their patients of sub-Saharan African (SSA) descent. The study goals were threefold: first, to assess professionals' perceptions of the explanatory models of their patients of SSA descent; second, to examine how these perceptions influence treatment practices; and third, to investigate the role of the professionals' cultural backgrounds, comparing the results between professionals with and without an SSA background. Twenty-two in-depth interviews with mental health professionals were thematically analyzed, with ten of the participants of SSA descent. Results show that all professionals perceived differences between Western and SSA explanatory models of (mental) health. Causal beliefs were mentioned as the most important difference, including their influence on coping strategies and health-seeking behavior among patients of SSA descent. Professionals' perceptions and familiarity with SSA explanatory models of (mental) health affected their treatment practices. Language and conceptual interpretation difficulties were encountered less frequently by professionals of SSA descent. Those with a Western background applied "culturally sensitive" practices, while professionals of SSA descent implemented an integrated approach. These results contribute to ongoing discussions about what is considered "cultural competency."
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Affiliation(s)
- Hanne Apers
- Centre for Migration and Intercultural Studies/Centre for Population, Family and Health, University of Antwerp, Kipdorp 61, 2000 Antwerp, Belgium
| | - Christiana Nöstlinger
- Department of Public Health, Institute for Tropical Medicine Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium
| | - Lore Van Praag
- Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Mandeville Building, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands
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Mas-Dalmau G, Pequeño-Saco S, de la Poza-Abad M, Borrell-Thió E, Besa-Castellà M, Alsina-Casalduero M, Cuixart-Costa L, Liroz-Navarro M, Calderón-Gómez C, Martí J, Cruz-Gómez I, Alonso-Coello P. Perceptions and attitudes regarding delayed antibiotic prescription for respiratory tract infections: a qualitative study. BMC Prim Care 2023; 24:204. [PMID: 37794330 PMCID: PMC10548630 DOI: 10.1186/s12875-023-02123-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/09/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Antibiotics are overprescribed for respiratory tract infections (RTIs). However, the decision to prescribe is often complex. Delayed antibiotic prescription (DAP), a strategy designed to promote more rational antibiotic use, is still not widely used. The aim of this study was to explore perceptions and attitudes in primary care professionals, regarding antibiotic use and different DAP strategies for uncomplicated RTIs. METHODS We conducted a qualitative study, using an inductive thematic approach to generate themes, based on focus group discussions and semi-structured interviews with professionals, recruited from 6 primary care centres (Barcelona metropolitan area, Spain). RESULTS 26 professionals (25 family physicians and one nurse) were included in four focus group discussions and three semi-structured interviews. Participants commented that RTIs were a main reason for consultation, motivated often by patient anxiety and fear of possible complications, and this was associated with the patients' poor health-related education. Acknowledging inappropriate antibiotic use in the health system, participants attributed this, mainly to defensive medicine strategies. DAP was used when in doubt about the aetiology, and considering factors related to patient-physician interactions. The main perceived advantage of DAP was that it could reduce the need for additional visits, while the main disadvantage was uncertainty regarding proper use by the patient. CONCLUSIONS DAP was used by participants in cases of doubt, in specific situations, and for specific patient profiles. Weak points were detected in our primary care system and its users that affect the proper use of both antibiotics and DAP, namely, time pressure on professionals, poor patient health-related education, and the lack of a patient-physician relationship in some scenarios.
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Affiliation(s)
- Gemma Mas-Dalmau
- Epidemiology and Public Health Department - Iberoamerican Cochrane Centre, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
- Nursing Care Research Group, IIB Sant Pau, Barcelona, Spain.
| | - Sandra Pequeño-Saco
- Epidemiology and Public Health Department - Iberoamerican Cochrane Centre, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Sub- Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | | | | | | | - Maria Alsina-Casalduero
- Llefià Primary Care Centre, Badalona, Spain
- PADES (Domestic Care Program, Support Teams) Mutuam Group, Barcelona, Spain
| | | | | | | | - Joel Martí
- Centre d'Estudis Sociològics sobre la Vida Quotidiana i el Treball (QUIT), Institut d'Estudis del Treball (IET), Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Irene Cruz-Gómez
- Centre d'Estudis Sociològics sobre la Vida Quotidiana i el Treball (QUIT), Institut d'Estudis del Treball (IET), Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Pablo Alonso-Coello
- Epidemiology and Public Health Department - Iberoamerican Cochrane Centre, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- CIBER Epidemiology and Public Health, Instituto de Salud Carlos III (CIBERESP), Madrid, Spain
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Viklund EWE, Forsman AK, Nordmyr J. Timely support for promoting mental wellbeing among families with young children -an interview study exploring the experiences of multi-professional practitioners in Finland. BMC Prim Care 2023; 24:196. [PMID: 37741972 PMCID: PMC10517518 DOI: 10.1186/s12875-023-02156-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/12/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Childhood is a critical period for promoting mental wellbeing and previous research suggests that various family-focused mental health promotion and early prevention initiatives are effective. The aim of the study was to explore Finnish health and social care practitioners' views and experiences of mental health promotion practice targeting families with young children. METHODS Individual semi-structured interviews with 14 practitioners representing various municipal services, faith-based and third sector organizations were conducted in 2021 and analysed using thematic analysis. RESULTS Various challenges and opportunities for supporting mental health related to both structural features of the health and social care landscape and the varying needs of families were identified. The lack of resources as well as the social stigma associated with mental health problems and with public welfare services, hindered proactive work approaches and timely support. However, low-threshold initiatives and adapted information to families as well as further training about mental health for practitioners together with multi-professional collaboration and teamwork were suggested as potential enablers for mental health promotion. CONCLUSIONS The study highlights the importance of reaching families in a timely manner in order to promote mental wellbeing and prevent mental health problems. The findings, bringing to the fore the practitioners' own experiences and views, suggest how current practice could be developed in order to safeguard mental health and wellbeing for all families with young children. The practitioners' views and experiences are key components when building future sustainable and proactive health and social care services.
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Affiliation(s)
- Emilia W E Viklund
- Faculty of Education and Welfare Studies, Health Sciences, Åbo Akademi University, Strandgatan 2, 65100, Vaasa, Finland.
| | - Anna K Forsman
- Faculty of Education and Welfare Studies, Health Sciences, Åbo Akademi University, Strandgatan 2, 65100, Vaasa, Finland
| | - Johanna Nordmyr
- Faculty of Education and Welfare Studies, Health Sciences, Åbo Akademi University, Strandgatan 2, 65100, Vaasa, Finland
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Reid R, Madhu A, Gonzalez S, Crosby H, Stjuste M, Dale SK. Burnout Among Service Providers for People Living with HIV: Factors Related to Coping and Resilience. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01784-2. [PMID: 37704906 DOI: 10.1007/s40615-023-01784-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/15/2023]
Abstract
Individuals who provide services for people living with HIV (PLWH) face numerous work-related challenges, including psychosocial and structural factors affecting the quality of care that they provide. Little is known about the factors that relate to burnout among service providers for PLWH. The current study seeks to examine the factors associated with burnout and the role of resilience and coping in the context of burnout. Via convenience sampling, data was collected from 28 professionals (e.g., peer counselors, HIV testers, case managers/case workers, group facilitators, or social workers) serving PLWH in the USA. Participants completed quantitative measures on sociodemographics, organizational factors, discrimination, trauma, depression, and burnout. A sub-sample of 19 participants provided in-depth qualitative data via semi-structured interviews on burnout, coping, and resilience as a buffer against the effects of burnout. Thematic content analysis revealed themes on the factors related to burnout (e.g., discrimination, limited financial and housing resources, and COVID-19), rejuvenating factors, coping with burnout, and intervention strategies. Additionally, Pearson's product moment correlations revealed significant associations between mental health variables such as depressive and posttraumatic stress disorder symptomology with (a) discrimination and microaggressions and (b) burnout. The current study highlights challenges to providing HIV care, including structural barriers and discrimination that are doubly impactful to the professionals in this sample who share identities with the PLWH whom they serve. These findings may inform the development of an intervention targeting burnout among individuals providing services to PLWH and motivate change to remove structural barriers and improve quality of care for PLWH.
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Affiliation(s)
- Rachelle Reid
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Aarti Madhu
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Stephanie Gonzalez
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Hannah Crosby
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Michelle Stjuste
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Sannisha K Dale
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA.
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Advinha AM, Santos MC, Duarte-Ramos F, Perdigão M, Santos P, Oliveira-Martins S. Experience and Learning from the COVID-19 Pandemic in Portugal: Perceptions of Community Pharmacy Professionals. Port J Public Health 2023; 41:122-131. [PMID: 38021255 PMCID: PMC10664277 DOI: 10.1159/000531446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 05/29/2023] [Indexed: 12/01/2023] Open
Abstract
Background During the COVID-19 pandemic, community pharmacy (CP) professionals were among those who experienced the greatest risk of contracting SARS-CoV-2, which forced major adaptations. Objectives The objectives of the study were to describe the changes implemented in CP professionals during the pandemic, understand the perception of professionals about their experience, and explore changes to remain. Methods An observational and cross-sectional study was conducted via an online questionnaire (June-September 2020). The target population was CP professionals working in Portugal for >2 years and serving the public during the pandemic. Results Of a total of 353 participants, 84% were female (mean age of 37.6 years), and 81% were pharmacists (mean professional experience of 12.9 years). In the management and organizational dimensions, the most mentioned changes were adaptation to legislative changes (90%), fluctuations in the treasury (82%), and reduction of working hours (46%). Only 2% resorted to simplified layoff. In the back office, there was a need to adapt stock management (93%) and purchase personal protective equipment (99%). In the front office, there was a change in service policies - wicket or conditional opening (92%), routes of the arrival of user requests (91%), and home delivery (82%). Physical changes occurred in 100% of pharmacies. The most frequently implemented procedures were the use of protection systems and PPE, articulation with hospital pharmacies for dispensing in proximity (75%), and training in this area (55%). Regarding interpersonal climate, improvements in the connection between team members are evident: increase in mutual help (57%), solidarity (54%), and group cohesion (50%); in the relationship with clients, the majority indicated the replacement of the usual user by third parties (71%), and changes in communication channels (increase in use of technological means 68%). Conclusions Results illustrate the profound impact of the pandemic on CP professionals, both professionally and personally. It also highlights the importance of their roles in proximity and community support.
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Affiliation(s)
- Ana Margarida Advinha
- CHRC – Comprehensive Health Research Centre, University of Évora, Evora, Portugal
- Department of Health and Medical Sciences, School of Health and Human Development, University of Évora, Evora, Portugal
- Pharmacovigilance Regional Unit of Central and North Alentejo, University of Évora, Evora, Portugal
| | - Margarida C. Santos
- Lisbon School of Health Technology, Polytechnic Institute of Lisbon, Lisboa, Portugal
- Research Center for Psychological Science, University of Lisbon, Alameda da Universidade, Lisboa, Portugal
| | - Filipa Duarte-Ramos
- Research Institute for Medicines (iMed.ULisboa), Lisboa, Portugal
- Faculty of Pharmacy, Universidade de Lisboa, Lisboa, Portugal
- EPIUnit – Public Health Institute, University of Porto, Porto, Portugal
| | - Margarida Perdigão
- Pharmacovigilance Regional Unit of Central and North Alentejo, University of Évora, Evora, Portugal
| | | | - Sofia Oliveira-Martins
- CHRC – Comprehensive Health Research Centre, University of Évora, Evora, Portugal
- Faculty of Pharmacy, Universidade de Lisboa, Lisboa, Portugal
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Pértega E, Holmberg C. A systematic mapping review identifying key features of restraint research in inpatient pediatric psychiatry: A human rights perspective. Int J Law Psychiatry 2023; 88:101894. [PMID: 37244128 DOI: 10.1016/j.ijlp.2023.101894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/30/2023] [Accepted: 05/02/2023] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Restraints, a highly regulated and contentious measure in pediatric psychiatry, have significant negative impacts on children. The application of international human rights standards, such as the Convention of the Rights of the Child (CRC) and the Convention of the Rights of Persons with Disabilities (CRPD), has spurred global efforts to reduce or eliminate the use of restraints. However, a lack of consensus on definitions and terminology, as well as quality indicators in this field, hinders the ability to compare studies and evaluate interventions consistently. AIM To systematically map existing literature on restraints imposed upon children in inpatient pediatric psychiatry against a human rights perspective. Specifically, to identify and clarify gaps in literature in terms of publication trends, research approaches, study contexts, study participants, definitions and concepts being used, and legal aspects. These aspects are central to assess whether published research is contributing to achieve the CRPD and the CRC in terms of interpersonal, contextual, operational, and legal requirements of restraints. METHODS A systematic mapping review based on PRISMA guidelines was conducted, adopting a descriptive-configurative approach to map the distribution of available research and gaps in the literature about restraints in inpatient pediatric psychiatry. Six databases were searched for literature reviews and empirical studies of all study designs published between each database's inception and March 24, 2021, manually updated on November 25, 2022. RESULTS The search yielded 114 English-language publications, with a majority (76%) comprising quantitative studies that relied primarily on institutional records. Contextual information about the research setting was provided in less than half of the studies, and there was an unequal representation of the three main stakeholder groups: patients, family, and professionals. The studies also exhibited inconsistencies in the terms, definitions, and measurements used to examine restraints, with a general lack of attention given to human rights considerations. Additionally, all studies were conducted in high-income countries and mainly focused on intrinsic factors such as age and psychiatric diagnosis of the children, while contextual factors and the impact of restraints were not adequately explored. Legal and ethical aspects were largely absent, with only one study (0.9%) explicitly referencing human rights values. CONCLUSIONS Research on restraints of children in psychiatric units is increasing; however, inconsistent reporting practices hinder the understanding of the meaning and frequency of restraints. The exclusion of crucial features, such as the physical and social environment, facility type, and family involvement, indicates inadequate incorporation of the CRPD. Additionally, the lack of references to parents suggests insufficient consideration of the CRC. The shortage of quantitative studies focusing on factors beyond patient-related aspects, and the general absence of qualitative studies exploring the perspectives of children and adolescents regarding restraints, suggest that the social model of disability proposed by the CRPD has not yet fully penetrated the scientific research on this topic.
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Affiliation(s)
- Elvira Pértega
- Faculty of Law, University of Technology Sydney, Sydney, Australia; Child and Adolescens Mental Health Department, Hospital Lucus augusti, Lugo, Spain.
| | - Christopher Holmberg
- Department of Psychotic Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Health and Care Science, University of Gothenburg, Gothenburg, Sweden
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Malam Moussa Ahmet H, Bika Lele EC, Guessogo WR, Bian WM, Guyot J, Ahmadou, Assomo-Ndemba PB, Ayina CN, Kojom Foko LP, Dupré C, Barth N, Bongue B, Ba A, Samb A, Mandengue SH, Mekoulou Ndongo J. Musculoskeletal pains among amateur and professional athletes of five disciplines in Senegal: a preliminary study. BMC Musculoskelet Disord 2023; 24:210. [PMID: 36949497 PMCID: PMC10031927 DOI: 10.1186/s12891-023-06275-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 02/27/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Musculoskeletal pains (MSPs) in sport are cause of poor performances and loss of competition in athletes. The present study aimed at determining the prevalence of MSPs with regard to sport disciplines and athletic status. METHODS A cross-sectional study was conducted among 320 Senegalese professional and amateur athletes practicing football, basketball, rugby, tennis, athletics, and wrestling. Rates of MSPs in the past year (MSPs-12) and week (MSPs-7d) were assessed using standard questionnaires. RESULTS Overall proportions of MSPs-12 and MSPs-7d were 70 and 74.2%, respectively. MSPs-12 were more frequently reported on shoulders (40.6%), neck (37.1%) and hips/thigh (34.4%), while MSPs-7d were predominant on hips/thigh (29.5%), shoulders (25.7%), and upper back (17.2%). Proportions of MSPs-12 and MSPs-7d varied significantly by sport disciplines, with highest values among basketball players. Again, highest MSPs-12 proportions on shoulders (29.7%, P = 0.02), wrists/hands (34.6%, P = 0.001), (40.2%, P = 0.0002), and knees (38.8%, P = 0.002) were seen among basketball players. High proportions of MSPs-7d were seen on shoulders (29.6%, P = 0.04) for tennis players, wrists/hands (29.4%, P = 0.03) for basketball and football players, and hips/thigh (38.8%, P < 0.00001) for basketball players. Football players had reduced risk of MSPs-12 by 75% on lower back (OR = 0.25; 95% CI. 0.10-0.63; P = 0.003) and by 72% on knees (OR = 0.28; 95% CI. 0.08-0. 95; P = 0.04). In contrast, tennis players were more at risk of MSPs-12 on shoulders (OR = 3.14; 95% CI. 1.14-8.68; P = 0.02), wrists/hands (OR = 5.18; 95% CI.1.40-11.13; P = 0.01), and hips/thigh (OR = 2.90; 95% CI. 1.1-8.38; P = 0.04). Professionals were protected from MSPs-12 on neck pain with a significant reduction of risk by 61% (OR = 0.39, 95% CI. 0.21-0.75, P = 0.03). CONCLUSION MSPs are a reality among athletes and their risk is modulated by sport disciplines, athletic status and gender.
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Affiliation(s)
| | - Elysée Claude Bika Lele
- Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | | | - Wiliam Mbang Bian
- National Institute for Youth and Sports Yaounde, University of Yaounde I, Yaounde, Cameroon
| | - Jessica Guyot
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, University Jean Monnet, Saint-Etienne, 42023, France
| | - Ahmadou
- Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Peguy Brice Assomo-Ndemba
- Department of Physiology, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Clarisse Noel Ayina
- Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Loick Pradel Kojom Foko
- Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon
| | - Caroline Dupré
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, University Jean Monnet, Saint-Etienne, 42023, France
| | - Nathalie Barth
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, University Jean Monnet, Saint-Etienne, 42023, France
| | - Bienvenu Bongue
- Mines Saint-Etienne, INSERM, U1059 Sainbiose, University Jean Monnet, Saint-Etienne, 42023, France
| | - Abdoulaye Ba
- Laboratory of Physiology and Functional Explorations, Faculty of Medicine, Pharmacy and Dentistry, University of Cheikh Anta Diop Dakar, Dakar, Senegal
| | - Abdoulaye Samb
- Laboratory of Physiology and Functional Explorations, Faculty of Medicine, Pharmacy and Dentistry, University of Cheikh Anta Diop Dakar, Dakar, Senegal
| | - Samuel Honoré Mandengue
- Laboratory of Physiology and Functional Explorations, Faculty of Medicine, Pharmacy and Dentistry, University of Cheikh Anta Diop Dakar, Dakar, Senegal
| | - Jerson Mekoulou Ndongo
- Physical Activities and Sport Physiology and Medicine Unit, Faculty of Science, University of Douala, Douala, Cameroon.
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Attrash-Najjar A, Katz C. The social response to child sexual abuse: Examining parents, perpetrators, professionals and media responses as described in survivors' testimonies to the Israeli Independent Public Inquiry. Child Abuse Negl 2023; 135:105955. [PMID: 36413887 DOI: 10.1016/j.chiabu.2022.105955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 07/10/2022] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND CSA is an extremely adverse experience, and its prompt and early disclosure is vital. Whether the effects of disclosure are positive or negative depends largely on the recipients' reactions to the disclosure. Early disclosure of abuse could help end the abuse, prevent repeated victimization, protect other children, enable psychological interventions, and make it possible to hold the perpetrator(s) accountable. OBJECTIVE Spotlighting the societal responsibility regarding CSA, the current study was designed to examine how adult survivors of CSA perceived and experienced various actors' responses to the CSA, as well as the impact of these responses on their lives. METHODS Qualitative inductive thematic analysis was carried out on 35 written narratives of adult survivors of CSA submitted to the Israeli Independent Public Inquiry into CSA. RESULTS The results pointed to several actors responding to CSA, and delved into the perceived responses of the parents, preparators, professionals and media. CONCLUSION The discussion emphasizes the crucial role of social responses to CSA, while addressing the various actors and their dynamics. The journey to justice through the inquiry process is being challenged throughout the social discourse highlighted in the current study. There is an urgent need to provide public platforms for survivors to share their testimonies to mitigate the stigmatization of CSA, which will hopefully promote more just societies.
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Affiliation(s)
| | - Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Israel.
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Abstract
Purpose of Review Sleep is an essential human behavior that plays a key role in proper biopsychosocial development as well as short- and long-term biological, physical, psychological, and cognitive health. Sleep plays a key role in athletic performance, influencing an athlete's ability to train, recover, and perform, as well as their overall wellness. Over the recent decade, the awareness of sleep's import has penetrated just about every professional sport domain. The purpose of the review was to identify and synthesize the literature published within the past 5 years (2018-2022) that relates to sleep and performance in professional athletes. Literature related to nonprofessional, high-level athletes (e.g., collegiate; Olympic) was omitted as well as those associated with non-traditional professional sports (e.g., eSports). Recent Findings Results from 38 articles were incorporated into this review, which covered (1) the sleep's role in the training, physical injury prevention and recovery, competitive performance, and mental health of professional athletes, (2) common sleep problems and disorders in professional athletes, and (3) the impact of unique challenges from training, travel, competition, and other factors on sleep health. Additionally, we provide an orientation to utilized strategies and interventions to assist with sleep health in professional athletes, as well as conclude with a commentary on critical steps forward. Summary Sleep plays a critically important role in the training, recovery, performance, and overall wellness of professional athletes. Professional athletes are vulnerable to a variety of sleep-related problems and disorders, due to unique factors related to training, travel, and competition, among other factors. Improved, standardized research methodology and partnerships between professional athletes, coaches, teams, and organizations and researchers are necessary to advance the knowledge of sleep and performance in professional athletes, including identifying sport-specific differences and variation across individual characteristics, as well as developing individualizable, dynamic, and appropriate interventions for improving sleep health among professional athletes.
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Affiliation(s)
- Jesse D. Cook
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI USA
- Department of Psychology, University of Wisconsin-Madison, Madison, WI USA
| | - Jonathan Charest
- Faculty of Kinesiology, University of Calgary, Calgary, AB Canada
- Centre for Sleep & Human Performance, 106, 51 Sunpark Drive SE, Calgary, AB T2X 3V4 Canada
- École de Psychologie, Université Laval, Québec, QC Canada
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Klop HT, de Veer AJE, Gootjes JRG, Groot M, Rietjens JAC, Onwuteaka-Philipsen BD. Implementation of a threefold intervention to improve palliative care for persons experiencing homelessness: a process evaluation using the RE-AIM framework. BMC Palliat Care 2022; 21:192. [PMID: 36329461 PMCID: PMC9635139 DOI: 10.1186/s12904-022-01083-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
Background Palliative care provision for persons experiencing homelessness is often poor. A threefold consultation service intervention was expected to increase knowledge of palliative care and multidisciplinary collaboration, and improve palliative care for this population. This intervention comprised: 1) consultation of social service professionals by palliative care specialists and vice versa; 2) multidisciplinary meetings with these professionals; and 3) training and education of these professionals. We aimed to evaluate the implementation process and its barriers and facilitators of this service implemented within social services and healthcare organizations in three Dutch regions. Methods A process evaluation using structured questionnaires among consultants, semi-structured individual and group interviews among professionals involved, and (research) diaries. Qualitative data were analysed using thematic analysis. The process evaluation was structured using the Reach, Adoption, Implementation and Maintenance dimensions of the RE-AIM framework. Results All three regions adopted all three activities of the intervention, with differences between the three regions in the start, timing and frequency. During the 21-month implementation period there were 34 consultations, 22 multidisciplinary meetings and 9 training sessions. The professionals reached were mainly social service professionals. Facilitators for adoption of the service were a perceived need for improving palliative care provision and previous acquaintance with other professionals involved, while professionals’ limited skills in recognizing, discussing and prioritizing palliative care hindered adoption. Implementation was facilitated by a consultant’s expertise in advising professionals and working with persons experiencing homelessness, and hindered by COVID-19 circumstances, staff shortages and lack of knowledge of palliative care in social service facilities. Embedding the service in regular, properly funded meetings was expected to facilitate maintenance, while the limited number of persons involved in this small-scale service was expected to be an obstacle. Conclusions A threefold intervention aimed at improving palliative care for persons experiencing homelessness is evaluated as being most usable when tailored to specific regions, with bedside and telephone consultations and a combination of palliative care consultants and teams of social service professionals. It is recommended to further implement this region-tailored intervention with palliative care consultants in the lead, and to raise awareness and to remove fear of palliative care provision. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-01083-3.
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Affiliation(s)
- Hanna T. Klop
- grid.12380.380000 0004 1754 9227Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute (APH), De Boelelaan 1117, Amsterdam, Netherlands
| | - Anke J. E. de Veer
- grid.416005.60000 0001 0681 4687Netherlands Institute for Health Services Research (Nivel), Otterstraat 18, Utrecht, Netherlands
| | - Jaap R. G. Gootjes
- Hospice Kuria, Valeriusplein 6, Amsterdam, Netherlands ,grid.16872.3a0000 0004 0435 165XExpertise Centre for Palliative Care, Amsterdam UMC location VUmc, De Boelelaan 1117, Amsterdam, Netherlands
| | - Marieke Groot
- Research Centre Innovations in Care, University of Applied Sciences Rotterdam, Rotterdam, Netherlands
| | - Judith A. C. Rietjens
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Bregje D. Onwuteaka-Philipsen
- grid.12380.380000 0004 1754 9227Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute (APH), De Boelelaan 1117, Amsterdam, Netherlands ,grid.16872.3a0000 0004 0435 165XExpertise Centre for Palliative Care, Amsterdam UMC location VUmc, De Boelelaan 1117, Amsterdam, Netherlands
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Wolker Manta S, Fabrício Sandreschi P, Christofoletti Dos Santos M, Maria Konrad L, Miranda Tassitano R, Rosane Bertoldo Benedetti T. Barriers and facilitators on the implementation of physical activity in Primary Health Care: A systematic review. Prev Med Rep 2022; 28:101875. [PMID: 35813399 PMCID: PMC9260606 DOI: 10.1016/j.pmedr.2022.101875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 05/05/2022] [Accepted: 06/24/2022] [Indexed: 11/26/2022] Open
Abstract
Barriers and facilitators influence the implementation of physical activity (PA) in Primary Health Care (PHC). This study aimed to analyze the scientific evidence on barriers and facilitators perceived by stakeholders on the implementation of PA in PHC.The search databases consisted of Web of Science, Medline, Scopus, and Lilacs. Two independent researchers reviewed the eligibility criteria and extracted and coded the information according to the Theoretical Domains Framework (TDF). The Consolidated Criteria for Reporting Qualitative Research was used to report the quality of the included studies. We analyzed 8.471 studies but included only 16. The studies identified 54 different reports on barriers and 48 on facilitators. Reports were often identified in the "environmental context and resources" domain, with 27 reports on barriers and 27 on facilitators. We found 25 reports of barriers and 16 of facilitators in the TDF domains that demonstrate professional profile characteristics. The low expectations in the professional profile for the implementation can influence the context and the organizational climate to identify more barriers than facilitators.
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Elliott M, Reuter JC. The Benefits and Challenges of Employment for Working Professionals Diagnosed with Mental Illness. Community Ment Health J 2022; 58:645-656. [PMID: 34244866 DOI: 10.1007/s10597-021-00866-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/27/2021] [Indexed: 11/29/2022]
Abstract
The purpose of this study is to explore how professional employment impacts mental health among people with mental illness, and how having a mental illness impacts job performance, both positively and negatively. The research is based on in-depth interview data from 56 professionals diagnosed with mental illness, and the interview transcripts are analyzed in accordance with the flexible coding model of qualitative data analysis. We find that working conditions of professional jobs pose challenges to managing symptoms of mental illness, including the pressures of responsibility and exposure to secondary trauma. However, professional employment also provides benefits such as social connections and feeling accountable. Similarly, symptoms cause problems at work like having angry outbursts, yet experience with mental illness informs job performance such as by increasing empathy with others. We use these findings to recommend new directions for research and argue for inclusion of people with mental illness in the workplace.
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Affiliation(s)
- Marta Elliott
- University of Nevada, Reno, 1664 N. Virginia St., Mail Stop 300, Reno, NV, 89557, USA.
| | - Jordan C Reuter
- University of Nevada, Reno, 1664 N. Virginia St., Mail Stop 300, Reno, NV, 89557, USA
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20
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Radu M, Moldovan R, Băban A. Families with complex needs: an inside perspective from young people, their carers, and healthcare providers. J Community Genet 2022. [PMID: 35301684 DOI: 10.1007/s12687-022-00586-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/03/2022] [Indexed: 11/01/2022] Open
Abstract
Complex health needs are demanding and often require additional medical, psychological and social support. All those involved (e.g., patients, carers, professionals) face a unique set of challenges and needs, especially in families where the patient is a child or a young person with a lifelong condition. The aim of the study was to explore carers' and young people's needs when living with long term conditions, as well as the views of the healthcare professionals supporting them. Semi-structured interviews with 30 participants (11 professionals, 10 parents, and 9 young people) were conducted. Interviews focused on 3 main areas-(1) medical needs, (2) psychological needs, and (3) communication needs-and were analyzed using thematic analysis. Four main themes emerged: (1) Acceptance takes time refers to the often long and challenging process of adapting to the diagnosis and living with the condition; (2) Close guidance captures the importance of specialised and long term guidance in accessing and managing the complexities of the medical system; (3) Open communication shows the families' need to be collaboratively connected to healthcare providers and other families facing similar difficulties; and (4) Long-term support underlines the importance of long term formal and informal support strategies. The participants' experiences and views have provided us with insight and guidance for developing and implementing personalized and integrated services. This inside perspective is key for future research aimed at better understanding the impact of complex conditions and meaningful ways to support families throughout their journeys.
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21
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Degen Jermann E, Liebig B. [Vulnerable persons, partners or warriors? How relatives perceive their roles in palliative care]. Z Evid Fortbild Qual Gesundhwes 2022; 168:33-39. [PMID: 35148969 DOI: 10.1016/j.zefq.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/01/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
Relatives play a very important role in palliative care. Whilst previous research has investigated this role from the perspective of health professionals, this article focuses on the perspectives of the relatives of palliative patients. The present paper aims to identify relatives' perceptions of their role with respect to their relationship to professionals and to describe their significance for satisfaction with palliative care. Content analysis of 23 guideline-based interviews with relatives in Switzerland identified three main role perceptions of relatives, namely as: "vulnerable persons", as "partners" or "warriors". The results indicate that relatives' satisfaction with palliative care depends on the role assigned to them by specialists in the care process. This article demonstrates that well-trained health personnel in the field of palliative care and a common understanding of the roles within the palliative care team are central to supporting relatives. These findings can help inform good collaboration between relatives and professionals in palliative care (e.g., general practitioners, nurses, specialized doctors, such as oncologists, and specialized nurses) and to encourage families to feel comfortable with the care their loved ones receive.
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Affiliation(s)
- Eveline Degen Jermann
- Hochschule für Angewandte Psychologie der Fachhochschule Nordwestschweiz, Olten, Schweiz.
| | - Brigitte Liebig
- Hochschule für Angewandte Psychologie der Fachhochschule Nordwestschweiz, Olten, Schweiz
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22
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Carvalho HM, Mota CP, Santos B, Costa M, Matos PM. From Chaos to Normalization and Deconfinement: What did the Pandemic Unveil in Youth Residential Care. Child Adolesc Social Work J 2022; 40:1-13. [PMID: 35095182 PMCID: PMC8782691 DOI: 10.1007/s10560-021-00808-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2021] [Indexed: 05/23/2023]
Abstract
The conditions imposed by the Covid-19 outbreaks forced residential care (RC) facilities to experience new challenges and to adopt new practices. The aim of the current study is to analyze how RC facilities have experienced and managed confinement during the 1st wave of the pandemic. A thematic analysis of 20 semi-structured interviews were conducted with professionals responsible for managing crisis in RC facilities. The main implications of the confinement measures on RC dynamics and relations were organized in three major themes: Chaos, novelty and organization; reinventing normalization and deconfinement. The pandemic exposes the structural weaknesses of RC, namely mobility of human resources, scarcity of supportive networks, and fragilities in providing comprehensive and integrative care. These factors need to be considered when addressing risk/vulnerability and discussing best practices and policies on child/youth welfare domain. Future studies should explore representations of important key actors as youth, families and other professionals from youth care.
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Affiliation(s)
- Helena M. Carvalho
- Centre for Psychology, University of Porto, Porto, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, Alfredo Allen Street, 4200-135 Porto, Portugal
| | - Catarina P. Mota
- Centre for Psychology, University of Porto, Porto, Portugal
- University of Tras-os-Montes and Alto Douro, Vila Real, Portugal
| | - Beatriz Santos
- Faculty of Psychology and Education Sciences, University of Porto, Alfredo Allen Street, 4200-135 Porto, Portugal
| | - Mónica Costa
- Centre for Psychology, University of Porto, Porto, Portugal
| | - Paula M. Matos
- Centre for Psychology, University of Porto, Porto, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, Alfredo Allen Street, 4200-135 Porto, Portugal
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23
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Awada M, Becerik-Gerber B, White E, Hoque S, O'Neill Z, Pedrielli G, Wen J, Wu T. Occupant health in buildings: Impact of the COVID-19 pandemic on the opinions of building professionals and implications on research. Build Environ 2022; 207:108440. [PMID: 34697517 PMCID: PMC8520175 DOI: 10.1016/j.buildenv.2021.108440] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/17/2021] [Accepted: 10/10/2021] [Indexed: 05/19/2023]
Abstract
The objectives of this study are to investigate building professionals' experience, awareness, and interest in occupant health in buildings, and to assess the impact of the COVID-19 pandemic on their opinions, as well as to compare the research on occupant health in buildings to professionals' opinions. To address these objectives, a mixed research methodology, including a thorough review of the literature (NL = 190) and an online survey (NS = 274), was utilized. In general, there is an increasing research interest in occupant health and a heightened interest in health-related projects, among professionals, following the COVID-19 pandemic. Specifically, among the nine different building attributes examined, indoor air quality was the most researched building attribute with a focus on occupant health and was also presumed to be the most important by the professionals. Professionals considered fatigue and musculoskeletal pain to be the most important physical well-being issues, and stress, anxiety, and depression to be the most important mental well-being issues that need to be the focus of design, construction, and operation of buildings to support and promote occupant health, while eye-related symptoms and loss of concentration were the most researched physical and mental well-being symptoms in the literature, respectively. Finally, professionals indicated that COVID-19 pandemic had significant effect on their perspectives regarding buildings' impact on occupant health and they believed future building design, construction and operation will focus more on occupant health because of the pandemic experience.
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Affiliation(s)
- Mohamad Awada
- Department of Civil and Environmental Engineering, University of Southern California, United States
| | - Burçin Becerik-Gerber
- Department of Civil and Environmental Engineering, University of Southern California, United States
| | - Elizabeth White
- School of Computing Informatics and Decision Systems Engineering, Arizona State University, United States
| | - Simi Hoque
- Department of Civil, Environmental, and Architectural Engineering, Drexel University, United States
| | - Zheng O'Neill
- Department of Mechanical Engineering, Texas A&M University, United States
| | - Giulia Pedrielli
- School of Computing Informatics and Decision Systems Engineering, Arizona State University, United States
| | - Jin Wen
- Department of Civil, Environmental, and Architectural Engineering, Drexel University, United States
| | - Teresa Wu
- School of Computing Informatics and Decision Systems Engineering, Arizona State University, United States
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24
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Echeverría-Esparza P, Lasanta-Sáez MJ, Elizalde-Soto L, Antoñanzas-Baztán E. [Professional and family perception on care and compliance with the end of life regulations. A qualitative study.]. Rev Esp Salud Publica 2021; 95:e202112201. [PMID: 34931625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 08/31/2021] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVE The scope and types of health interventions in the dying process are the subject of a social and professional debate that has been increasing in recent years. The objective of the study was focused on analyzing the perceptions of professionals and relatives of patients who have recently died and assessing the degree of compliance with the rights established in the current legislation on this subject. METHODS Qualitative research with a hermeneutical phenomenological approach carried out in 2019 by conducting and analyzing two discussion groups with health professionals from hospital and primary care, and four groups with relatives of recently deceased patients, divided by age ranges: 18- 30 years old, 31-45, 46-60 and over 60. RESULTS The total number of people included in the study was 28 participants. Family members and professionals find it difficult to communicate with each other in the context of health care at the end of life. Family members and professionals agree on their preference to die at home. There are specific deficiencies in knowledge about the terminology used at the end of life. The term "euthanasia" is the one best known by family members. CONCLUSIONS Deficiencies in knowledge of the rights established in the regulations related to the death process have been detected, both in relatives of patients and in professionals. These deficiencies contribute to breaches of legal regulations. Communication difficulties related to death between the professionals-patient-family trinomial are the most relevant related factor.
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Affiliation(s)
- Pablo Echeverría-Esparza
- Institute for Advanced Social Research (I-COMMUNITAS). Departamento de Sociología y Trabajo Social. Universidad Pública de Navarra (UPNA). Pamplona. España
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25
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Agnoli L, Charters S. The alcohol consumption of wine drinkers with the onset of Covid-19. Food Qual Prefer 2021; 98:104489. [PMID: 34924696 PMCID: PMC8669912 DOI: 10.1016/j.foodqual.2021.104489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/14/2021] [Accepted: 12/05/2021] [Indexed: 11/27/2022]
Abstract
The onset of Covid-19 has been the most evident global crisis of the current decade so far. This study explores the difference between professionals in the drinks industry and non-professional wine lovers and the impact on their consumption behaviour of wine and other alcoholic beverages in the early stages of the pandemic, particularly in the context of anxiety. A survey by questionnaire was administered worldwide from the end of March to the end of June 2020 to test four research hypotheses. Results are relevant for the alcoholic beverage industry and public policy. They highlight a higher incidence of unchanged alcohol consumption among non-professionals. They also reveal similarities and differences in changes in consumption behaviour and trends among the two cohorts. Anxiety has an impact on the wine consumption of professionals, and on beer consumption of non-professionals, where the gender and age of respondents are also relevant. The findings of a short qualitative data-collection process enrich our understanding of the results.
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Affiliation(s)
- Lara Agnoli
- School of Wine & Spirits Business, Burgundy School of Business CEREN EA 7477, Université Bourgogne Franche-Comté, Dijon, France
| | - Steve Charters
- School of Wine & Spirits Business, Burgundy School of Business CEREN EA 7477, Université Bourgogne Franche-Comté, Dijon, France.,Adelaide Business School, The University of Adelaide, Adelaide, South Australia, Australia
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Hansen TEA, Præstegaard J, Tjørnhøj-Thomsen T, Andresen M, Nørgaard B. Dementia-friendliness - A matter of knowledge, responsibility, dignity, and illusion. J Aging Stud 2021; 59:100970. [PMID: 34794715 DOI: 10.1016/j.jaging.2021.100970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/24/2022]
Abstract
Worldwide, dementia-friendly initiatives are being developed primarily based on and driven by political strategies. Health professionals, local government officials, and initiators alike are working to create dementia-friendly communities, but little is known about how professionals discursively construct dementia-friendliness and how their various interpretations affect current practices in the field. This study aimed to explore how those involved in establishing dementia-friendly initiatives, nursing homes, and dementia villages ascribe meaning to and construct dementia-friendliness. Three focus groups were conducted, including two with five health professionals each from two nursing homes for people with dementia and one with seven initiators involved in the development and establishment of nursing homes and dementia villages. We further conducted a small-group interview with a consultant and a project worker representing a local authority. Seeing dementia-friendliness as a discursive construction, we conducted a critical discourse analysis, taking inspiration from the work of Norman Fairclough. The surveyed professionals reported relying on knowledge, responsibility, dignity, and illusion discourses to construct dementia-friendliness. Our results also indicated that the construct of dementia-friendliness fosters discursive battles indicated by dilemmas concerning the adequate and dignified treatment of people with dementia and health professionals' critical stances toward the construct of dementia-friendliness.
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Ingrand I, Dupraz C, Meunier AS, Devaux C, Dujoncquoy S, Thebaud E, Blouin P, Gandemer V, Menkes O, Pellier I, Carausu L, Millot F. [Consequences of childhood cancer in the quest for first job in the Grand Ouest inter-region: A mixed-method study designed from the Grand Ouest Cancer de l'Enfant (GOCE) organization in childhood cancer survivors and professionals]. Bull Cancer 2021:S0007-4551(21)00361-1. [PMID: 34656299 DOI: 10.1016/j.bulcan.2021.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/24/2021] [Accepted: 06/27/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The professional situation of patients treated for childhood cancer differs from country to country. The aim of the study is to study, with the French sociocultural specificities, the first professional integration of these young people. METHODS A sequential quantitative-qualitative mixed approach associates 16 individual interviews and responses to a self-questionnaire of 254 young cancer survivors (sex-ratio=1, median age 23.5 years diagnosed between 2000 and 2010; 68% leukemia) to 30 individual and collective interviews of professionals. Results They seem to have had fewer difficulties than the general population to find their first job (33% vs. 44%). Young women had more difficulties, young people thought they had stopped studying too early and those who mentioned their sequelae (mainly psychological and neurocognitive). The qualitative phase shows that, in this context, the information provided during the job interview plays an important role in access to the first job. DISCUSSION The study showed a need for information, communication and training for all actors whose main axes could be: i) for young people: learn to introduce themselves and adapt speeches and postures, be aware of their non-obligation to reveal a situation relating to health and to the handicap; ii) for the medical profession: to promote communication and to find spaces for exchanges between specialists, generalists, occupational physicians; iii) for employers: better know the disease and the laws to adapt their eyes and practices.
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28
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Slagboom MN, Bröer C, Berg J. Negotiating ADHD: Pragmatic medicalization and creolization in urban India. Soc Sci Med 2021; 289:114400. [PMID: 34563868 DOI: 10.1016/j.socscimed.2021.114400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 09/05/2021] [Accepted: 09/13/2021] [Indexed: 11/30/2022]
Abstract
Although a growing number of studies have demonstrated differences in responses to ADHD-like behaviours, very few studies have focused on theorizing diversity in the way ADHD is framed and approached globally. To contribute to the study of medicalization in a global context, this study examines the discursive field in which care professionals explain and treat ADHD among children in metropolitan India and addresses the need for an analytic framework to grasp the variations in the way ADHD is understood and approached. Building on the concepts of pragmatic medicalization and creolization, we study ADHD discourses in India asking 'What is at stake' and 'What matters most'? In this mixed methods study, 64 care professionals regularly involved in assessing ADHD-like behaviour completed an online Q-sort, and 21 professionals participated in face-to-face interviews. The Q-data were subjected to factor analysis. The interviews were analyzed using qualitative content analyses. Our study identified six distinct ADHD discourses, which showed that care professionals combine explanatory and treatment models. Professionals adapt their explanations and treatments of ADHD to parents' worries regarding academic performance, family prestige, stigma and side effects of allopathic medicine. Our findings indicate that an awareness of local concerns and adjustments to structural opportunities can diversify how ADHD-like behaviour is framed and responded to. This study demonstrates that medicalization operates between the emerging institutions of care and the everyday concerns of families and care professionals and reveals the need to examine conflicting stakes as drivers of diverse responses to ADHD diagnosis and treatment in India and the rest of the world.
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Affiliation(s)
- M Nienke Slagboom
- Public Health and Primary Care, Leiden University Medical Centre, the Netherlands.
| | - Christian Bröer
- Political Sociology, University of Amsterdam, the Netherlands
| | - Jonathan Berg
- Health Policy & Management, Erasmus University Rotterdam, the Netherlands
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29
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Hamilton-Giachritsis C, Hanson E, Whittle H, Alves-Costa F, Pintos A, Metcalf T, Beech A. Technology assisted child sexual abuse: Professionals' perceptions of risk and impact on children and young people. Child Abuse Negl 2021; 119:104651. [PMID: 32854947 DOI: 10.1016/j.chiabu.2020.104651] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 07/13/2020] [Accepted: 07/25/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Despite the rise in 'online'/technology-assisted child sexual abuse (TA-CSA), little research has been conducted on professionals' perceptions beyond reporting on young people's experiences. OBJECTIVES This novel study aimed to understand how professionals who work with victims perceive online CSA (i.e., dynamics and impact), and organizational responses to it. PARTICIPANTS AND SETTINGS Seven child protection professionals completed a paper-based pilot questionnaire; another 45 professionals (from child protection, policing, education and therapy) completed a shorter, online survey. METHODS Recruitment occurred via a child protection conference, relevant law enforcement/child protection organizations, and advertised via BASPCAN (a national organization for child protection professionals). RESULTS Professionals often demonstrated a limited understanding of the wide range of 'online' CSA. Online CSA was often seen by organizations and some professionals as less serious than offline CSA, with offline victims' prioritized as higher risk, even though respondents noted the impact may be the same. Organizations rarely had clearly outlined assessment/intervention pathways, and some professionals noted that organizations are more likely to perceive victims as 'active' participants or to blame for their abuse. CONCLUSIONS There is often a limited understanding of the risks and severity of TA-CSA, and this can lead to victims remaining at risk, a systemic failure to protect, and a decreased chance of accessing appropriate interventions. Drawing on our findings, we make a number of recommendations, including adoption of the term 'technology-assisted abuse', adapted assessment tools and interventions, and widespread training. Policies should be reviewed to ensure they are not implicitly minimizing this serious form of abuse.
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Affiliation(s)
| | - Elly Hanson
- School of Psychology, University of Birmingham, UK
| | | | | | | | - Theo Metcalf
- Department of Psychology, University of Bath, UK
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30
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Williams SJ, Radnor Z, Aitken J, Esain A, Matthias O. Transferring, translating and transforming knowledge: the role of brokering in healthcare networks. J Health Organ Manag 2021; ahead-of-print. [PMID: 34448388 DOI: 10.1108/jhom-02-2021-0063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This research examines how knowledge and information are managed within two care networks. We develop a conceptual framework drawing on the notion of brokering and the 3T framework, which is used to describe the relative complexity of boundaries (referred to in the framework as syntactic, semantic and pragmatic) as well as capabilities and processes required to exchange information within the network. Previous research on brokering has focused on healthcare managers and professionals, but this research extends to patients and caregivers. Understanding knowledge exchange and brokering practices in healthcare is critical to the delivery of effective services. DESIGN/METHODOLOGY/APPROACH For this case research, non-participant observation and experienced-based interviews were undertaken with healthcare professionals, patients and caregivers within two care networks. FINDINGS The findings reveal brokering roles occupied by healthcare professionals, patients and caregivers support the transfer, translation and transformation of knowledge and information across functional and organisational boundaries. Enablers and disablers to brokering and the exchange of knowledge and information are also identified. RESEARCH LIMITATIONS/IMPLICATIONS The study is limited to two care networks for long-term conditions within the UK. Further research opportunities exist to examine similar care networks that extend across professional and organisational boundaries. PRACTICAL IMPLICATIONS This research informs healthcare professionals of the brokering capabilities that occur within networks and the enabling and disabling factors to managing knowledge across boundaries. ORIGINALITY/VALUE This paper provides a conceptual framework that categorises how increased levels of knowledge and information exchange and brokering practices are managed within care networks.
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Affiliation(s)
- Sharon J Williams
- College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Zoe Radnor
- Bayes Business School, City, University of London, London, UK
| | - James Aitken
- Faculty of Management and Law, University of Surrey, Guildford, UK
| | - Ann Esain
- Buckingham Lean Enterprise Unit, The University of Buckingham, Buckingham, UK
| | - Olga Matthias
- Leeds Business School, Leeds Beckett University, Leeds, UK
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von Thiele Schwarz U, Lyon AR, Pettersson K, Giannotta F, Liedgren P, Hasson H. Understanding the value of adhering to or adapting evidence-based interventions: a study protocol of a discrete choice experiment. Implement Sci Commun 2021; 2:88. [PMID: 34380575 PMCID: PMC8356451 DOI: 10.1186/s43058-021-00187-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 07/11/2021] [Indexed: 12/20/2022] Open
Abstract
Background Whereas the value of an evidence-based intervention (EBI) is often determined by its effect on clinical outcomes, the value of implementing and using EBIs in practice is broader, reflecting qualities such as appropriateness, equity, costs, and impact. Reconciling these value conflicts involves a complicated decision process that has received very limited scholarly attention. Inspired by studies on decision-making, the objective of this project is to explore how practitioners appraise the values of different outcomes and to test how this appraisal influences their decisions surrounding the so-called fidelity–adaptation dilemma. This dilemma is related to the balance between using an EBI as it was designed (to ensure its effectiveness) and making appropriate adaptations (to ensure alignment with constraints and possibilities in the local context). Methods This project consists of three sub-studies. The participants will be professionals leading evidence-based parental programs in Sweden and, in Sub-study 1, parents and decision-makers. Sub-study 1 will use sequential focus groups and individual interviews to explore parameters that influence fidelity and adaptation decisions—the dilemmas encountered, available options, how outcomes are valued by practitioners as well as other stakeholders, and value trade-offs. Sub-study 2 is a discrete choice experiment that will test how value appraisals influence decision-making using data from Sub-study 1 as input. Sub-study 3 uses a mixed-method design, with findings from the two preceding sub-studies as input in focus group interviews to investigate how practitioners make sense of findings from optimal decision situations (experiment) and constrained, real-world decision situations. Discussion The project will offer unique insights into decision-making processes that influence how EBIs are used in practice. Such knowledge is needed for a more granular understanding of how practitioners manage the fidelity–adaptation dilemma and thus, ultimately, how the value of EBI implementation can be optimized. This study contributes to our knowledge of what happens once EBIs are adopted—that is, the gap between the way in which EBIs are intended to be used and the way in which they are used in practice.
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Affiliation(s)
- Ulrica von Thiele Schwarz
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden. .,Procome, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.
| | - Aaron R Lyon
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Kristoffer Pettersson
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden
| | - Fabrizia Giannotta
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden
| | - Pernilla Liedgren
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden
| | - Henna Hasson
- Procome, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.,Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
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Bastos de Carvalho A, Lee Ware S, Belcher T, Mehmeti F, Higgins EB, Sprang R, Williams C, Studts JL, Studts CR. Evaluation of multi-level barriers and facilitators in a large diabetic retinopathy screening program in federally qualified health centers: a qualitative study. Implement Sci Commun 2021; 2:54. [PMID: 34022946 PMCID: PMC8141191 DOI: 10.1186/s43058-021-00157-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/11/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Recommended annual diabetic retinopathy (DR) screening for people with diabetes has low rates in the USA, especially in underserved populations. Telemedicine DR screening (TDRS) in primary care clinics could expand access and increase adherence. Despite this potential, studies have observed high variability in TDRS rates among clinics and over time, highlighting the need for implementation supports. Previous studies of determinants of TDRS focus on patients' perspectives, with few studies targeting upstream multi-level barriers and facilitators. Addressing this gap, this qualitative study aimed to identify and evaluate multi-level perceived determinants of TDRS in Federally Qualified Health Centers (FQHCs), to inform the development of targeted implementation strategies. METHODS We developed a theory-based semi-structured interview tool based on the Consolidated Framework for Implementation Research (CFIR). We conducted 22 key informant interviews with professionals involved in TDRS (administrators, clinicians, staff). The interviews were audio-recorded and transcribed verbatim. Reported barriers and facilitators were organized into emergent themes and classified according to CFIR constructs. Constructs influencing TDRS implementation were rated for each study site and compared across sites by the investigators. RESULTS Professionals identified 21 main barriers and facilitators under twelve constructs of the five CFIR domains. Several identified themes were novel, whereas others corroborated previous findings in the literature (e.g., lack of time and human resources, presence of a champion). Of the 21 identified themes, 13 were classified under the CFIR's Inner Setting domain, specifically under the constructs Compatibility and Available Resources. Themes under the Outer Setting domain (constructs External Incentives and Cost) were primarily perceived by administrators, whereas themes in other domains were perceived across all professional categories. Two Inner Setting (Leadership Engagement, Goals and Feedback) and two Process (Champion, Engaging) constructs were found to strongly distinguish sites with high versus low TDRS performance. CONCLUSIONS This study classified barriers and facilitators to TDRS as perceived by administrators, clinicians, and staff in FQHCs, then identified CFIR constructs that distinguished high- and low-performance clinics. Implementation strategies such as academic detailing and collection and communication of program data and successes to leadership; engaging of stakeholders through involvement in implementation planning; and appointment of intervention champions may therefore improve TDRS implementation and sustainment in resource-constrained settings.
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Affiliation(s)
- Ana Bastos de Carvalho
- Department of Ophthalmology and Visual Sciences, University of Kentucky, 110 Conn Terrace Ste 550, Lexington, KY, 40508, USA.
| | - S Lee Ware
- Department of Ophthalmology and Visual Sciences, University of Kentucky, 110 Conn Terrace Ste 550, Lexington, KY, 40508, USA
| | - Tamara Belcher
- Department of Ophthalmology and Visual Sciences, University of Kentucky, 110 Conn Terrace Ste 550, Lexington, KY, 40508, USA
| | - Franceska Mehmeti
- Department of Ophthalmology and Visual Sciences, University of Kentucky, 110 Conn Terrace Ste 550, Lexington, KY, 40508, USA
| | - Eric B Higgins
- Department of Ophthalmology and Visual Sciences, University of Kentucky, 110 Conn Terrace Ste 550, Lexington, KY, 40508, USA
| | - Rob Sprang
- Kentucky Telecare, University of Kentucky, Lexington, KY, USA
| | - Cody Williams
- Department of Ophthalmology and Visual Sciences, University of Kentucky, 110 Conn Terrace Ste 550, Lexington, KY, 40508, USA
| | - Jamie L Studts
- Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Cancer Prevention and Control Program, University of Colorado Cancer Center, Aurora, CO, USA
| | - Christina R Studts
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Hamzah NFA, Umat C, Harithasan D, Goh BS. Challenges faced by parents when seeking diagnosis for children with sensorineural hearing loss. Int J Pediatr Otorhinolaryngol 2021; 143:110656. [PMID: 33662710 DOI: 10.1016/j.ijporl.2021.110656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/03/2021] [Accepted: 02/14/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The Joint Committee of Infant Hearing (JCIH) recommended hearing screening by one month of age, diagnosis of hearing loss by three months of age, and intervention initiated by six months of age. In Malaysia however, the age of diagnosis of hearing loss in children is relatively late. This study aimed to identify the challenges faced by parents in seeking a diagnosis of hearing loss for their children. METHOD The study utilized a semi-structured interview with open-ended questions to obtain information about parents' experiences during the diagnosis period and their challenges when going through that process. In this study, a total of 16 parents of children who were diagnosed with moderate to profound sensorineural hearing loss and received intervention within three years at the time of the study participated. Ten of the children were cochlear implant users, and six were hearing aid users. RESULTS Thematic analysis was used to analyse themes generated from the data according to the study objective. Four main themes and 17 subthemes were identified from this study. The four main themes were 1) Parents' emotion; 2) Parental knowledge; 3) Others; 4) Profesional services. Challenges that parents faced often include emotional behaviours such as feeling guilty and devastated during the diagnosis, lack of information-sharing from healthcare givers, lack of knowledge on childhood hearing loss among parents, support from families, seek for a second opinion, worry about others' acceptance, longer time for diagnosis to confirm, late referral to other related profesionals and no priority for the appointment. CONCLUSION Emotion is identified as the biggest challenge faced by parents in the process of diagnosis for their children with hearing loss. Hence, management of parental emotion needs to be emphasized by health profesionals as it influences the acceptance of parents towards their child's diagnosis.
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Affiliation(s)
- Nur Fatihah Ainun Hamzah
- Center for Rehabilitation & Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Cila Umat
- Center for Rehabilitation & Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Deepashini Harithasan
- Center for Rehabilitation & Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Bee See Goh
- Department of Otorhinolaryngology-Head & Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Laustsen CE, Westergren A, Petersson P, Haak M. Conceptualizing researchers' perspectives on involving professionals in research: a group concept mapping study. Health Res Policy Syst 2021; 19:39. [PMID: 33736671 PMCID: PMC7977251 DOI: 10.1186/s12961-021-00685-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 01/26/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Researchers have shown an increased interest in involving professionals from outside academia in research projects. Professionals are often involved in research on ageing and health when the purpose is to address the gap between research and practice. However, there is a need to acquire more knowledge about what the involvement might lead to by exploring researchers' experiences of involving professionals in research on ageing and health and developing conceptual areas. Therefore, the aim of this study was to identify conceptual areas of professionals' involvement in research on ageing and health, from the perspective of researchers themselves. METHODS Group concept mapping, a participatory and mixed method, was used to conceptualize areas. Researchers with experience of involving professionals in research projects on ageing and health participated in qualitative data collection through brainstorming sessions (n = 26), and by sorting statements (n = 27). They then took part in quantitative data collection, where they rated statements according to how much a statement strengthened research (n = 26) and strengthened practice (n = 24). Data were analysed using multidimensional scaling analysis and hierarchical cluster analysis. In addition, a qualitative analysis of the latent meaning of the cluster map was conducted. RESULTS Analysis of the sorting stage generated five clusters illustrating conceptual areas of professionals' involvement in research projects on ageing and health. The five clusters are as follows: complex collaboration throughout the research process; adaptation of research to different stakeholders, mutual learning through partnership; applicable and sustainable knowledge; legitimate research on ageing and health. The qualitative latent meaning of the cluster map showed two themes: the process of involvement and the outcome of involvement. A positive strong correlation (0.87) was found between the rating of strengthened research and practice. CONCLUSIONS This study reveals conceptual areas on a comprehensive and illustrative map which contributes to the understanding of professionals' involvement in research on ageing and health. A conceptual basis for further studies is offered, where the aim is to investigate the processes and outcomes entailed in involving professionals in research on ageing and health. The study also contributes to the development of instruments and theories for optimizing the involvement of professionals in research.
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Affiliation(s)
- Christine E Laustsen
- Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Albert Westergren
- Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Pia Petersson
- Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Maria Haak
- Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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von Thiele Schwarz U, Giannotta F, Neher M, Zetterlund J, Hasson H. Professionals' management of the fidelity-adaptation dilemma in the use of evidence-based interventions-an intervention study. Implement Sci Commun 2021; 2:31. [PMID: 33726864 PMCID: PMC7962232 DOI: 10.1186/s43058-021-00131-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 02/28/2021] [Indexed: 11/20/2022] Open
Abstract
Background Evidence-based interventions (EBIs) can be effective tools for the prevention of disease and health promotion. However, their implementation often requires a delicate balance between the need to adjust the intervention to the context in which it is implemented and the need to keep the core components that make the intervention effective. This so-called dilemma between fidelity and adaptation is often handled by health professionals in the sustainment phase of an implementation (i.e., once the intervention has been adopted and institutionalized in an organization), but not much is known about how and to what extent health professionals are affected by this dilemma. Focusing on the sustainment phase, this project aims to study (1) how fidelity and adaptation are managed by professionals using an EBI, (2) how the fidelity–adaptation dilemma affects professionals’ psychosocial working conditions, and (3) how a structured decision support influences professionals’ management of the dilemma and their psychosocial working conditions. Methods The study is set in Sweden, and the EBI in focus is a parental program (All Children in Focus). A longitudinal within-person intervention design is used, combined with a cross-sectional survey design. Data sources include web-based questionnaires, brief interviews, fidelity ratings, paper-and-pen questionnaires, and written documentation, collected at multiple time points with both group leaders and parents as respondents. Discussion This project approaches fidelity and adaptation from the perspective of the professionals that manage EBIs during the sustainment phase of implementation. Although it is well known that EBIs continue to change over time, it remains to be understood how the fidelity–adaptation dilemma can be managed so that the effectiveness of interventions is retained or improved, not diluted. Moreover, the project adds to the literature by presenting an occupational health perspective on the fidelity–adaptation dilemma. It is acknowledged that fidelity and adaptation may have consequences for not only clients but also the occupational wellbeing of the professionals managing the dilemma, and subsequently, their willingness and ability to deliver EBIs in a sustainable way. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-021-00131-y.
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Affiliation(s)
- Ulrica von Thiele Schwarz
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden. .,Procome, Medical Management Centre, Karolinska Institute, Stockholm, Sweden.
| | - Fabrizia Giannotta
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden
| | - Margit Neher
- Procome, Medical Management Centre, Karolinska Institute, Stockholm, Sweden.,Department of Rehabilitation, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Johanna Zetterlund
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, Västerås, Sweden
| | - Henna Hasson
- Procome, Medical Management Centre, Karolinska Institute, Stockholm, Sweden.,Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine, Region Stockholm, Sweden
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Chang YC, Chang LH, Hsu ST, Huang MW. Professional perspectives on providing recovery-oriented services in Taiwan: a qualitative study. BMC Psychiatry 2021; 21:154. [PMID: 33726694 PMCID: PMC7962288 DOI: 10.1186/s12888-021-03152-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/04/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The experiences of professionals in well-established recovery-oriented programs are valuable for professionals in similar practice settings. This study explored professionals' experiences with providing recovery-oriented services in community psychiatric rehabilitation organizations. METHODS Semi-structured interviews were conducted with 14 professionals from five recovery-oriented psychiatric rehabilitation organizations in Taiwan. The interviews were recorded and transcribed verbatim. Thematic analysis was used for the qualitative data analysis. RESULTS The analyses documented three main themes with 13 subthemes. Recovery-oriented service implementation included seven subthemes: Enabling clients to set their own goals and make decisions, using a strengths-based approach, establishing partnerships with clients, improving individuals' self-acceptance, encouraging community participation, seeking family, peer, and organizational support, and building team collaboration. Problems with implementing recovery-oriented services included limited policy and organizational support, a lack of understanding of recovery among professionals, stigma, clients' lack of motivation or self-confidence in their own ability to achieve recovery, and passive or overprotective family members. Strategies to resolve implementation problems included policy changes and organizational support, improving the recovery competence and confidence of professionals, and family and public education. CONCLUSIONS To date, this is the first known study examining the perspectives of mental health professionals who have experience implementing recovery-oriented services in Asia. The participants identified family collaboration, anti-stigma efforts, and changes in policy and attitudes as critical to successful implementation and delivery of recovery-oriented services.
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Affiliation(s)
- Yen-Ching Chang
- grid.64523.360000 0004 0532 3255Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ling-Hui Chang
- grid.64523.360000 0004 0532 3255Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan ,grid.64523.360000 0004 0532 3255Institute of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Su-Ting Hsu
- grid.414813.b0000 0004 0582 5722Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Meng-Wen Huang
- Department of Rehabilitation Science, Jenteh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
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Hoej M, Johansen KS, Olesen BR, Arnfred S. Negotiating the Practical Meaning of Recovery in a Process of Implementation : An Empirical Investigation of How a Participatory-Inspired Research Approach to Implementation Might Facilitate a More Recovery-Oriented Practice: The Case of RENEW-DK. Adm Policy Ment Health 2021; 47:380-394. [PMID: 31707520 DOI: 10.1007/s10488-019-00993-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
As implementation of recovery-oriented practices has proven difficult, this study investigates whether a participatory-inspired approach to implementing and adjusting a recovery-oriented model, RENEW-DK, might facilitate a more recovery-oriented practice among the professionals in public sector services. Ten narrative interviews with professionals was analyzed from a Science and Technology Studies perspective, and special attention was devoted to the concepts of distortion and stigmatization. Despite a one-year participatory process of model adjustment and implementation, professionals experienced RENEW-DK as a distortion and thus shaped their practice of RENEW-DK according to organizational requirements and professional beliefs instead of making their practice more recovery-oriented. The study calls attention to the need to acknowledge contradictions between intentions in general models and values in specific organizations with local norms and practices.
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Affiliation(s)
- Michaela Hoej
- Competence Centre for Rehabilitation and Recovery, Mental Health Centre Ballerup, The Mental Health Services of the Capital Region of Denmark, Maglevaenget 2, Building 2, 2750, Ballerup, Denmark.
| | - Katrine Schepelern Johansen
- Competence Centre for Dual Diagnoses, Mental Health Centre Sct. Hans, The Mental Health Services of the Capital Region of Denmark, Boserupvej 2, 4000, Roskilde, Denmark
| | - Birgitte Ravn Olesen
- Department of Communication and Arts, Roskilde University, Universitetsvej 1, 40.2, 4000, Roskilde, Denmark
| | - Sidse Arnfred
- Mental Health Services West, Region Zealand, Faelledvej 6, Building 3, 4th Floor, 4200, Slagelse, Denmark
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Manor-Binyamini I, Schreiber-Divon M. Bedouin mothers of young children with developmental disability - Stigma, quality of life and collaboration with professionals. Res Dev Disabil 2021; 108:103819. [PMID: 33302171 DOI: 10.1016/j.ridd.2020.103819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/22/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although children across the world experience Developmental Disabilities, most research on DD has been conducted using Western cultural perspectives. Similarly, though much has been written on the subject of collaboration between parents and professionals around the world, this subject has hardly been studied among Bedouin mothers in the Middle East, leaving significant gaps in the literature. This study intends to fill some of these gaps by exploring and gaining an understanding of the experiences of Bedouin mothers raising young children with DD. AIMS The aims of the study were to examine: A) Do stigma and the QoL of mothers of young children with DD affect the collaboration between them and professionals? B) Do relationships exist between stigma, QoL, and collaboration among the mothers? METHODS Ninety Bedouin mothers of children with DD completed: a socio-demographic questionnaire, a questionnaire of collaboration between parents and professionals, and a QoL questionnaire. RESULTS A significant negative relationship was found between stigma and the collaboration of the mothers with the professional, and a significant positive relationship between QoL and collaboration. The model for predicting collaboration using stigma and QoL was significant. CONCLUSIONS AND IMPLICATIONS This study emphasizes the need for collaboration between this mothers and professionals, and to develop community programs.
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Monje F, Erume J, Mwiine FN, Kazoora H, Okech SG. Knowledge, attitude and practices about rabies management among human and animal health professionals in Mbale District, Uganda. One Health Outlook 2020; 2:24. [PMID: 33829139 PMCID: PMC7993504 DOI: 10.1186/s42522-020-00031-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/04/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To assess the knowledge, attitude and practices (KAP) of animal and human health professionals towards rabies management and also to establish the level of relationship between KAP. METHODS A cross-sectional study was conducted between December 2012 and March 2013 among 147 randomly selected animal and human health professionals in Mbale District. Of these, only 16 were animal health professionals. Quantitative data was obtained using a semi-structured questionnaire while qualitative data was obtained from 4 Focus Group Discussions (FGDs) and 2 Key Informant (KI) interviews. Quantitative data was entered into EpiInfo version 3.5.1 and proportions computed while qualitative data was summarised into themes and sub-themes resulting from content analysis of interview scripts. FINDINGS Of all the respondents, only 44% (65/147) had sufficient knowledge about rabies while 25% (37/147) had positive attitude towards rabies management. A half of the respondents (50%, 73/147) had limited good practices. Respondents knowledgeable about rabies were more likely to have positive attitude towards rabies management (OR = 3.65; 95% CI: 1.60-8.3) while respondents with positive attitudes, were more likely to have good practices towards rabies management (OR: 2.22; 95% CI: 1.01-4.86). CONCLUSION Respondents had low knowledge, negative attitude and limited good practices of rabies management. Regular refresher trainings about rabies to broaden staff knowledge and improve their attitudes and hence practices of rabies management should be conducted by the District leaders. Harnessing multi-sectoral and multi-disciplinary collaborative efforts ("One Health" approach) for rabies control should be instituted to reduce the incidence of the disease in the District. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1186/s42522-020-00031-6.
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Affiliation(s)
- Fred Monje
- Ministry of Agriculture, Animal Industry and Fisheries, P.O. Box 102, Entebbe, Uganda
| | - Joseph Erume
- College of Veterinary Medicine, Animal Resources and Biosecurity (COVAB), Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Frank N. Mwiine
- College of Veterinary Medicine, Animal Resources and Biosecurity (COVAB), Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Herbert Kazoora
- African Field Epidemiology Network (AFENET), P.O Box 12874, Kampala, Uganda
| | - Samuel George Okech
- College of Veterinary Medicine, Animal Resources and Biosecurity (COVAB), Makerere University, P.O. Box 7062, Kampala, Uganda
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Sharp CA, Bresnen M, Austin L, McCarthy J, Dixon WG, Sanders C. Implementing disruptive technological change in UK healthcare: exploring development of a smart phone app for remote patient monitoring as a boundary object using qualitative methods. J Health Organ Manag 2020; ahead-of-print. [PMID: 33277889 DOI: 10.1108/jhom-07-2020-0295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Developing technological innovations in healthcare is made complex and difficult due to effects upon the practices of professional, managerial and other stakeholders. Drawing upon the concept of boundary object, this paper explores the challenges of achieving effective collaboration in the development and use of a novel healthcare innovation in the English healthcare system. DESIGN/METHODOLOGY/APPROACH A case study is presented of the development and implementation of a smart phone application (app) for use by rheumatoid arthritis patients. Over a two-year period (2015-2017), qualitative data from recorded clinical consultations (n = 17), semi-structured interviews (n = 63) and two focus groups (n = 13) were obtained from participants involved in the app's development and use (clinicians, patients, researchers, practitioners, IT specialists and managers). FINDINGS The case focuses on the use of the app and its outputs as a system of inter-connected boundary objects. The analysis highlights the challenges overcome in the innovation's development and how knowledge sharing between patients and clinicians was enhanced, altering the nature of the clinical consultation. It also shows how conditions surrounding the innovation both enabled its development and inhibited its wider scale-up. ORIGINALITY/VALUE By recognizing that technological artefacts can simultaneously enable and inhibit collaboration, this paper highlights the need to overcome tensions between the transformative capability of such healthcare innovations and the inhibiting effects simultaneously created on change at a wider system level.
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Affiliation(s)
- Charlotte A Sharp
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester, Manchester, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, The University of Manchester, Manchester, UK
- National Institute for Health Research School for Primary Care Research, The University of Manchester, Manchester, UK
- Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Mike Bresnen
- Faculty of Business and Law, Manchester Metropolitan University, Manchester, UK
| | - Lynn Austin
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester, Manchester, UK
- National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
| | - Jillian McCarthy
- Alliance Manchester Business School, The University of Manchester, Manchester, UK
| | - William G Dixon
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, The University of Manchester, Manchester, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, The University of Manchester, Manchester, UK
- Rheumatology Department, Salford Royal NHS Foundation Trust, Manchester, UK
| | - Caroline Sanders
- National Institute for Health Research School for Primary Care Research, The University of Manchester, Manchester, UK
- National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
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Sugiura K, Pertega E, Holmberg C. Experiences of involuntary psychiatric admission decision-making: a systematic review and meta-synthesis of the perspectives of service users, informal carers, and professionals. Int J Law Psychiatry 2020; 73:101645. [PMID: 33246221 DOI: 10.1016/j.ijlp.2020.101645] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/26/2020] [Accepted: 10/31/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND In involuntary psychiatric admission, used globally, professionals or caretakers decide upon hospitalization regardless of what the person with psychosocial disabilities decides. This raises clinical, ethical, legal, and human rights concerns, and it goes against Convention on the Rights of Persons with Disabilities (CRPD). CRPD mandates that member states respect the autonomy of people with disabilities. Through Article 12, it recognizes full enjoyment of legal capacity for persons with disabilities. Implementation of Article 12 is challenging in every country, and exploring all the stakeholders' experiences at admission decision-making will help us to understand the challenges that the current psychiatry system poses for service users to exercise their autonomy and identify the areas where service users need support to have their rights, will, and preferences respected. AIM To describe the experiences of service users, informal carers, and professionals in involuntary psychiatric admission decision-making and throughout the subsequent involuntary admission. We explored the support that the service users need to have their rights, will, and preferences respected. METHOD A search of twelve databases in medicine, sociology, and law in Danish, English, Japanese, Norwegian, Portuguese, Spanish, and Swedish was conducted in 2017 and 2018, limited to the past 10 years, using terms such as "involuntary," "admission," "mental illness," and "experience". The search identified 682 articles. Four researchers independently reviewed the articles to find those that completed original qualitative or mixed method studies exploring experiences of involuntary psychiatric admission among adults. We added seven publications from the articles' references, contacted experts in the field (no publications were added), and excluded two articles that were in German. Three researchers analyzed the articles' results using Thematic Analysis (PROSPERO registration number CRD42019072874). RESULTS Overall, 37 articles were included from 11 countries; they involved 731 service users, 100 informal carers, and 291 mental health professionals. We identified a lack of communication and a power imbalance among the stakeholders, which was exacerbated by the professionals' attitudes. At admission decision-making, the service users wanted to be heard and wanted to understand the situation. The families felt responsibility for the service users, they were careful not to ruin relationships, and they struggled to obtain support from the mental health system. Professionals believed that threats or harming others should lead to admission regardless of what the service users or their families felt. Professionals sometimes felt that it was not necessary to explain the information to the service users because they would not understand. Professionals were concerned and frustrated with difficulties in coordinating among themselves. During admission, service users struggled with the ward environment and relationship with staff; they most objected to coercion, such as forced medication. Families were frustrated that they were not involved in the treatment planning, especially as the service users moved toward discharge. The professionals often rationalized that coercion was necessary, and they believed that they knew what was best for the service users. CONCLUSIONS A lack of communication and a power imbalance among the stakeholders hindered respect for the service users' rights, will, and preferences. This was exacerbated by professionals rationalizing coercion and assuming that service users were incapable of understanding information. Services that encourage communication and overcome power imbalances (e.g. Crisis Plans, Family Group Conferencing) combined with stronger community mental health support will respect service users' rights, will, and preferences and avoid substituted decision-making on issues such as involuntary admission and forced medication.
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Affiliation(s)
- Kanna Sugiura
- Department of Mental Health, The University of Tokyo, Tokyo, Japan.
| | - Elvira Pertega
- Faculty of Law, University of Technology Sydney, Sydney, Australia
| | - Christopher Holmberg
- Department of Psychotic Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Health and Care Science, University of Gothenburg, Gothenburg, Sweden
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Clément MÈ, Dufour S, Gagné MH, Gilbert S. Prediction of health, education, and psychosocial professionals' attitudes in favor of parental use of corporal punishment. Child Abuse Negl 2020; 109:104766. [PMID: 33069092 DOI: 10.1016/j.chiabu.2020.104766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/25/2020] [Accepted: 09/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND To date, there have been few studies pertaining to the knowledge and attitudes regarding the use of corporal punishment (CP) among professionals working with parents and children. Yet, many parents turn to these professionals for advice on child discipline. OBJECTIVE This study aimed to describe professionals' legal knowledge about parental use of CP and their attitudes toward this practice. METHOD A study was conducted among professionals working directly with children or their parents through an online questionnaire. PARTICIPANTS A total of 1,758 respondents from three sectors of training (psychosocial, health, education) completed the questionnaire. RESULTS The results showed that professionals have little knowledge of the legal guidelines surrounding the use of CP in Canada. This poor knowledge as well as the perceived impacts of CP on children acted as predictors of favorable attitudes toward this disciplinary practice. According to the regression analyses, other personal and professional factors also explain a person's approval of CP, including violence in childhood, religious practice, and sources of knowledge. The results also highlighted some findings related to the respondents' professional sectors. CONCLUSIONS The study results emphasize the need to better train professionals by targeting cognitive, personal, as well as professional factors.
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Affiliation(s)
- Marie-Ève Clément
- Département de Psychoeducation et de Psychologie, Université du Québec en Outaouais, 5 Rue Saint-Joseph, Saint-Jérôme, QC, Canada.
| | - Sarah Dufour
- École de Psychoéducation, Université de Montréal, Montréal, QC, Canada
| | | | - Sophie Gilbert
- Département de Psychologie, Université du Québec à Montréal, Montréal, QC, Canada
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Başaran O. "The self-making of the scientific circumciser (fenni sünnetçi):" the medicalization of male circumcision in Turkey. Soc Sci Med 2020; 265:113367. [PMID: 33039731 DOI: 10.1016/j.socscimed.2020.113367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/31/2020] [Accepted: 09/09/2020] [Indexed: 11/15/2022]
Abstract
This article analyzes the medicalization of male circumcision in Turkey. In the 1960s, the Turkish state launched its largest network of healthcare services in its history. As part of the network, health officers began to perform circumcisions and introduced medical expertise into male circumcision. They advertised new surgical techniques via mass media and aimed to persuade families of their benefits and replace itinerant circumcisers stigmatized in the new modern, national imaginary. To do so, this article argues, health officers turned themselves into "fenni sünnetçi (scientific circumciser)." By operationalizing the concept of ambivalence, this article investigates how "fenni sünnetçi" came to epitomize a hybrid identity that enabled health officers to differentiate themselves from itinerant circumcisers and maintain their professional status while resonating with families accustomed to the services of itinerant circumcisers. The article enriches our understanding of medicalization by paying attention to the changing subjectivities of medical professionals who initiate the medicalization process.
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Affiliation(s)
- Oyman Başaran
- Assistant Professor Department of Sociology Bowdoin College, 255 Maine Street Brunswick, Maine, 04011, USA.
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Kallio H, Voutilainen A, Viinamäki L, Kangasniemi M. In-service training to enhance the competence of health and social care professionals: A document analysis of web-based training reports. Nurse Educ Today 2020; 92:104493. [PMID: 32673934 DOI: 10.1016/j.nedt.2020.104493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/27/2020] [Accepted: 06/04/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To identify and describe what professional competencies have been addressed by in-service training for health and social care professionals and what kind of teaching and evaluation methods have been used. DESIGN Cross-sectional descriptive study. METHODS A document analysis design was used to explore 7817 in-service training project documents relating to 203 projects carried out from 2002 to 2020. The project data were obtained from the websites run by the relevant health and social care organizations. RESULTS The most frequent competencies that were addressed were health promotion and clinical skills (17%), preventing social problems (16%) and promoting the wellbeing of children and families (15%) and older adults (14%). The main target groups were general health and social care professionals (19%). A total of 222 training interventions were used by the 203 projects and the most frequently used methods were conventional classroom education (56%), followed by coaching and orientation (12%) and theme days (9%). Only 38% of the projects measured the effects of the training and the main method was collecting feedback from participants. We also found that collaboration between projects was necessary to ensure that training was not duplicated and transparent reporting played a central role in that process. CONCLUSIONS In order to achieve successful in-service training for health and social care professionals, projects needed to recognize topical competence needs and provide the most appropriate training methods. Collaboration and transparent reporting helped to avoid duplication in training.
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Affiliation(s)
- Hanna Kallio
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, PB 1627, 70211 Kuopio, Finland
| | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Leena Viinamäki
- Lapland University of Applied Sciences, Social Services, Health and Sport, Kemi, Finland
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Medicine, University of Turku, Finland.
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Abstract
Despite extensive needs, interventions for parents with psychosis are rarely offered, poorly described, and vary between offering instrumental and emotional support. To improve the design of interventions offered to families with parental psychosis, more knowledge is needed. The aim of this study was to gain knowledge about mental health professionals' perceptions of parenting by patients with psychosis. Eleven mental health professionals educated in family interventions were interviewed using a semi-structured interview guide and the material underwent inductive thematic analysis. Results showed that the professionals described the patients parenting as characterized by difficulties in providing security and predictability, taking part in and organizing family life, and to focus on the child's needs. The difficulties were described as related to specific symptoms such as voice hearing, cognitive impairments, anxiety, and paranoia. As a vast amount of research stresses the psychosocial basis of psychosis and the interpersonal causes of its symptoms, parenting difficulties in people with psychosis could benefit from being addressed from a relational perspective. Accordingly, parents with psychosis should be offered interventions that enable them to create positive parental role models, develop reflective functioning, and identify situations in which their symptoms might hinder positive parenting. Many of these needs are unmet by interventions offered in adult psychosis services today.
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Affiliation(s)
- Jennifer Strand
- Department of Psychology, University of Gothenburg, Box 500, 405 30, Göteborg, Sweden.
| | - Lisa Rudolfsson
- Gothenburg Research Institute, University of Gothenburg, Box 603, 405 30, Göteborg, Sweden
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Valero Alzaga E, Martín Roncero U, Domínguez-Rodríguez A. [Covid-19 and child health: confinement and its impact according to child professionals.]. Rev Esp Salud Publica 2020; 94:e202007064. [PMID: 32713937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/08/2020] [Indexed: 06/11/2023] Open
Abstract
OBJECTIVE The Covid-19 pandemic led to the establishment of the state of alarm in Spanish and the initial lockdown of the entire population. The aim of this study is to analyse the assessment of professionals working with children on the impact of quarantine on the health and health inequalities of the child population, as well as the importance given to the intermediate factors that can modulate the impact of the experience of lockdown on children's health. METHODS A cross-sectional study was made according to an online questionnaire to professionals in health and socio-educational fields working with children (n=214) with questions concerning the potential effects of lockdown and the dimensions that could modulate those effects. For the analysis, descriptive statistics were calculated together with Chi-square tests and comparison of means to analyse differences according to professional field. RESULTS 86% of the experts pointed out the potential negative impact of quarantine on the health of children, especially that of the most vulnerable, highlighting the adverse effects of conflict at home and exposure to tobacco smoke in this experience, which were scored in importance with more than 9 and 8.5 respectively. CONCLUSIONS The results show how, according to child professionals, lockdown can have an impact on the health of the child population that goes beyond the direct effect of Covid-19.
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Affiliation(s)
- Erika Valero Alzaga
- Grupo Opik en Determinantes Sociales de la Salud y Cambio Demográfico. Leioa. España
- Departamento de Sociología II. Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU). Leioa. España
| | - Unai Martín Roncero
- Grupo Opik en Determinantes Sociales de la Salud y Cambio Demográfico. Leioa. España
- Departamento de Sociología II. Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU). Leioa. España
| | - Antía Domínguez-Rodríguez
- Grupo Opik en Determinantes Sociales de la Salud y Cambio Demográfico. Leioa. España
- Departamento de Sociología II. Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU). Leioa. España
- Departamento de Ciencias Políticas y Sociales. Universidad Pompeu Fabra (UPF). Barcelona. España
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Ohene LA, Power KJ, Raghu R. Health Professionals' Perceptions and Practice of Family Centred Care for Children Injured in Road Traffic Accidents: A Qualitative Study in Ghana. J Pediatr Nurs 2020; 53:e49-e56. [PMID: 32113734 DOI: 10.1016/j.pedn.2020.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/09/2020] [Accepted: 02/11/2020] [Indexed: 02/01/2023]
Abstract
UNLABELLED The Family Centered Care (FCC) model is widely recognized as the standard for pediatric care practice in the context of families and hospitalized children. Healthcare professionals' knowledge of the FCC model is therefore central to its successful implementation. Nonetheless, there is paucity of scholarship in the Ghanaian context, regarding professionals' knowledge and practice of FCC. OBJECTIVES This study, being the first in the Ghanaian context aimed to explore the perceptions of family centered care among healthcare professionals who provide the healthcare needs of children hospitalized through road traffic accidents. METHOD Twenty-four (24) healthcare professionals were interviewed as part of a larger study which adopted a Grounded Theory approach. Data collection and analysis occurred concurrently. Here, we employed constant comparative methods to structure emerging categories and sub-categories. FINDINGS Most health professionals in the study perceived family centered care to mean family involvement, although obvious inconsistencies characterized existing practices. Based on contextual perspectives, three categories emerged, namely; parental involvement, communication and setting boundaries. CONCLUSION The concept of FCC is a familiar terminology among health professionals. However, its principles, components and dimensions in the western context are alien to healthcare professionals in Ghana. A context-specific FCC model which reflects social values and cultural norms is therefore required for healthcare services to children and families in Ghana.
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Nooteboom LA, van den Driesschen SI, Kuiper CHZ, Vermeiren RRJM, Mulder EA. An integrated approach to meet the needs of high-vulnerable families: a qualitative study on integrated care from a professional perspective. Child Adolesc Psychiatry Ment Health 2020; 14:18. [PMID: 32411295 PMCID: PMC7211334 DOI: 10.1186/s13034-020-00321-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/15/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND To meet the needs of high-vulnerable families with severe and enduring problems across several life domains, professionals must improve their ability to provide integrated care timely and adequately. The aim of this study was to identify facilitators and barriers professionals encounter when providing integrated care. METHODS Experiences and perspectives of 24 professionals from integrated care teams in the Netherlands were gathered by conducting semi-structured interviews. A theory-driven framework method was applied to systematically code the transcripts both deductively and inductively. RESULTS There was a consensus among professionals regarding facilitators and barriers influencing their daily practice, leading to an in depth, thematic report of what facilitates and hinders integrated care. Themes covering the facilitators and barriers were related to early identification and broad assessment, multidisciplinary expertise, continuous pathways, care provision, autonomy of professionals, and evaluation of care processes. CONCLUSIONS Professionals emphasized the need for flexible support across several life domains to meet the needs of high-vulnerable families. Also, there should be a balance between the use of guidelines and a professional's autonomy to tailor support to families' needs. Other recommendations include the need to improve professionals' ability in timely stepping up to more intensive care and scaling down to less restrictive support, and to further our insight in risk factors and needs of these families.
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Affiliation(s)
- L. A. Nooteboom
- grid.10419.3d0000000089452978Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Centre, Post Box 15, 2300 AA Leiden, The Netherlands
| | - S. I. van den Driesschen
- grid.10419.3d0000000089452978Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Centre, Post Box 15, 2300 AA Leiden, The Netherlands
| | - C. H. Z. Kuiper
- grid.5477.10000000120346234Leiden University of Applied Sciences, Zernikedreef 11, 2311 CK Leiden, The Netherlands ,Horizon Youth Care and Special Education, Mozartlaan 150, 3055 KM Rotterdam, The Netherlands
| | - R. R. J. M. Vermeiren
- grid.10419.3d0000000089452978Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Centre, Post Box 15, 2300 AA Leiden, The Netherlands ,Youz: Parnassia Group, Dr. van Welylaan 2, 2566 ER, The Hague, The Netherlands
| | - E. A. Mulder
- grid.10419.3d0000000089452978Department of Child and Adolescent Psychiatry, Curium-Leiden University Medical Centre, Post Box 15, 2300 AA Leiden, The Netherlands ,Intermetzo-Pluryn, Post Box 53, 6500 AB Nijmegen, The Netherlands ,grid.7177.60000000084992262Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centre - location VUMC, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
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Kremeike K, Frerich G, Romotzky V, Boström K, Dojan T, Galushko M, Shah-Hosseini K, Jünger S, Rodin G, Pfaff H, Perrar KM, Voltz R. The desire to die in palliative care: a sequential mixed methods study to develop a semi-structured clinical approach. BMC Palliat Care 2020; 19:49. [PMID: 32299415 PMCID: PMC7164236 DOI: 10.1186/s12904-020-00548-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 03/17/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although desire to die of varying intensity and permanence is frequent in patients receiving palliative care, uncertainty exists concerning appropriate therapeutic responses to it. To support health professionals in dealing with patients´ potential desire to die, a training program and a semi-structured clinical approach was developed. This study aimed for a revision of and consensus building on the clinical approach to support proactively addressing desire to die and routine exploration of death and dying distress. METHODS Within a sequential mixed methods design, we invited 16 palliative patients to participate in semi-structured interviews and 377 (inter-)national experts to attend a two-round Delphi process. Interviews were analyzed using qualitative content analysis and an agreement consensus for the Delphi was determined according to predefined criteria. RESULTS 11 (69%) patients from different settings participated in face-to-face interviews. As key issues for conversations on desire to die they pointed out the relationship between professionals and patients, the setting and support from external experts, if required. A set of 149 (40%) experts (132/89% from Germany, 17/11% from 9 other countries) evaluated ten domains of the semi-structured clinical approach. There was immediate consensus on nine domains concerning conversation design, suggestions for (self-)reflection, and further recommended action. The one domain in which consensus was not achieved until the second round was "proactively addressing desire to die". CONCLUSIONS We have provided the first semi-structured clinical approach to identify and address desire to die and to respond therapeutically - based on evidence, patients' views and consensus among professional experts. TRIAL REGISTRATION The study is registered in the German Clinical Trials Register (DRKS00012988; registration date: 27.9.2017) and in the Health Services Research Database (VfD_DEDIPOM_17_003889; registration date: 14.9.2017).
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Affiliation(s)
- Kerstin Kremeike
- Department of Palliative Medicine, Medical Faculty, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Gerrit Frerich
- Department of Palliative Medicine, Medical Faculty, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Vanessa Romotzky
- Department of Palliative Medicine, Medical Faculty, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Kathleen Boström
- Department of Palliative Medicine, Medical Faculty, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Thomas Dojan
- Department of Palliative Medicine, Medical Faculty, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Maren Galushko
- Department of Palliative Medicine, Medical Faculty, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Kija Shah-Hosseini
- Institute of Medical Statistics and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany
| | - Saskia Jünger
- Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health (ceres), University of Cologne and University Hospital of Cologne, Cologne, Germany
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Institute of Medical Science, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Holger Pfaff
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Medical Faculty, Cologne, Germany
| | - Klaus Maria Perrar
- Department of Palliative Medicine, Medical Faculty, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Raymond Voltz
- Department of Palliative Medicine, Medical Faculty, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), University of Cologne, Cologne, Germany.,Clinical Trials Centre Cologne (ZKS), University of Cologne, Cologne, Germany
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50
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Moreno-Milan B, Cano-Vindel A, Lopez-Dóriga P, Medrano LA, Breitbart W. Meaning of work and personal protective factors among palliative care professionals. Palliat Support Care 2019; 17:381-7. [PMID: 30841936 DOI: 10.1017/S147895151800113X] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Healthcare professionals who work in palliative care units face stressful life events on a daily basis, most notably death. For this reason, these professionals must be equipped with the necessary protective resources to help them cope with professional and personal burnout. Despite the well-recognized importance of the construct "meaning of work," the role of this construct and its relationship with other variables is not well-understood. Our objective is to develop and evaluate a model that examines the mediating role of the meaning of work in a multidisciplinary group of palliative care professionals. Using this model, we sought to assess the relationships between meaning of work, perceived stress, personal protective factors (optimism, self-esteem, life satisfaction, personal growth, subjective vitality), and sociodemographic variables. METHOD Professionals (n = 189) from a wide range of disciplines (physicians, psychologists, nurses, social workers, nursing assistants, physical therapists, and chaplains) working in palliative care units at hospitals in Madrid and the Balearic Islands were recruited. Sociodemographic variables were collected and recorded. The following questionnaires were administered: Meaning of Work Questionnaire, Perceived Stress Questionnaire, Life Orientation Test-Revised, Satisfaction with Life Scale, Subjective Vitality Scale, Rosenberg Self-Esteem Scale, and the Personal Growth Scale. RESULT The explanatory value of the model was high, explaining 49.5% of the variance of life satisfaction, 43% of subjective vitality, and 36% of personal growth. The main findings of this study were as follow: (1) meaning of work and perceived stress were negatively correlated; (2) optimism and self-esteem mediated the effect of stress on the meaning attached to work among palliative care professionals; (3) the meaning of work mediated the effect of stress on subjective vitality, personal growth, and life satisfaction; and (4) vitality and personal growth directly influenced life satisfaction. SIGNIFICANCE OF RESULTS The proposed model showed a high explanatory value for the meaning professionals give to their work and also for perceived stress, personal protective factors, and sociodemographic variables. Our findings could have highly relevant practical implications for designing programs to promote the psychological well-being of healthcare professionals.
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