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Palmer J, Sokiri S, Char JNB, Vivian A, Ferris D, Venner G, Dak JJ. From humanitarian crisis to employment crisis: The lives and livelihoods of South Sudanese refugee health workers in Uganda. Int J Health Plann Manage 2024; 39:671-688. [PMID: 38326292 DOI: 10.1002/hpm.3777] [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] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 02/09/2024] Open
Abstract
Despite the many benefits of refugee health workers for health systems, they commonly face challenges integrating into host country workforces. The Global Code of Practice on International Recruitment of Health Personnel, which should monitor and protect migrant health workers, offers little guidance for refugees and research is needed to inform strategy. Based on interviews with 34 refugee health workers and 10 leaders across two settlements supporting populations fleeing the humanitarian crisis in South Sudan since 2013, we describe the governance and social dynamics affecting South Sudanese refugee health worker employment in Uganda. Refugees in Uganda legally have the right to work but face an employment crisis. Refugee health workers report that systemic discrimination, competition from underemployed domestic workers, unclear work permit rules and expensive credentialling processes exclude them from meaningful work in public health facilities and good jobs in the humanitarian response. This pushes them into unchallenging roles in private clinics, poorly remunerated positions on village health teams or out of the health sector altogether. Health system strengthening initiatives in Uganda to integrate humanitarian and government services and to deter the domestic workforce from emigration have overlooked the potential contributions of refugee health workers and the employment crisis they face. More effort is needed to increase fairness in public sector recruitment practices for refugee health workers, support credentialling, training opportunities for professional and non-professional cadres, job placements, and to draw attention to the public benefits of refugee health worker employment alongside higher spending on human resources for health.
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Affiliation(s)
- Jennifer Palmer
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Stephen Sokiri
- South Sudanese Women Building Association, Kampala, Uganda
| | | | | | | | - Georgia Venner
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Wallace TD, Knollman-Porter K, Brown J, Schwartz A, Hodge A, Brown G, Beardslee J, Gore RK. mTBI evaluation, management, and referral to allied healthcare: practices of first-line healthcare professionals. Brain Inj 2024; 38:32-44. [PMID: 38333958 DOI: 10.1080/02699052.2024.2309245] [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: 05/27/2022] [Accepted: 01/19/2024] [Indexed: 02/10/2024]
Abstract
PRIMARY OBJECTIVE To gain an understanding of current evaluation practices, post-injury recommendations, and referrals to allied healthcare professions (AHP) by first-line healthcare professionals (FHPs) providing care for people with mild traumatic brain injury (mTBI). RESEARCH DESIGN Survey study. METHODS AND PROCEDURES Physicians, physician assistants, nurse practitioners, nurses, and athletic trainers (n = 126) completed an online survey, including Likert scale and free response question relating to mTBI evaluation, management, and referral practices. MAIN OUTCOMES AND RESULTS FHPs surveyed reported being confident in their ability to evaluate patients with suspected mTBI, relying most heavily on patient-reported symptoms and physical signs as methods of evaluation. Most FHPs reported making recommendations to compensate for the symptoms experienced following mTBI diagnosis. In contrast, FHPs expressed challenges in the evaluation and management of symptoms associated with mTBI along with limited knowledge of and referrals to AHPs. CONCLUSIONS Overall, FHPs feel confident in the diagnosis of mTBI but experience assessment and management challenges. AHPs are underutilized on mTBI management teams calling for a need for multidisciplinary collaboration on research, education, and rehabilitation efforts to optimally care for people experiencing mTBI symptoms.
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Affiliation(s)
- Tracey D Wallace
- Complex Concussion Clinic, Shepherd Center, Atlanta, Georgia, USA
- SHARE Military Initiative, Shepherd Center, Atlanta, Georgia, USA
| | | | | | - Amber Schwartz
- Complex Concussion Clinic, Shepherd Center, Atlanta, Georgia, USA
- SHARE Military Initiative, Shepherd Center, Atlanta, Georgia, USA
| | - April Hodge
- Complex Concussion Clinic, Shepherd Center, Atlanta, Georgia, USA
| | - Gregory Brown
- Complex Concussion Clinic, Shepherd Center, Atlanta, Georgia, USA
- SHARE Military Initiative, Shepherd Center, Atlanta, Georgia, USA
| | | | - Russell K Gore
- Complex Concussion Clinic, Shepherd Center, Atlanta, Georgia, USA
- SHARE Military Initiative, Shepherd Center, Atlanta, Georgia, USA
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Hare N, Grieve S, Valentine J, Menzies J. Research delivery secondments: A scoping review. Nurs Open 2024; 11:e2089. [PMID: 38268290 PMCID: PMC10790058 DOI: 10.1002/nop2.2089] [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: 01/04/2023] [Revised: 11/01/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
AIM To explore and summarise published literature with regards to secondments to clinical research and to identify the gaps in research to inform further work. DESIGN Systematic scoping review. METHOD A scoping review was undertaken in accordance with the Patterns, Advances, Gaps, Evidence and Research framework. Databases searched included CINAHL, PubMed, Medline and Embase. Inclusion/exclusion criteria were applied by two independent reviewers. Two reviewers independently retrieved full-text studies for inclusion and applied the framework as a tool for synthesising Patterns, Advances, Gaps, Evidence and Research recommendations. RESULTS Six papers and one abstract published between 2003 and 2018 were included. All secondees (n = 34) were released from NHS posts, with secondments (where specified) ranging in duration from 0.25 to 2 years and for 40%-100% of their working hours. All seven papers reported benefits for personal and professional development, predominantly in the form of personal reflections. Few described involvement with research delivery teams. CONCLUSION Published initiatives vary in nature and lack standardised reporting and measurement of impact. Further research is required to identify benefits at a departmental or organisational level, the facilitators for setting up secondments and the application of knowledge gained from secondment opportunities. IMPLICATIONS FOR THE PROFESSION Undertaking a research secondment is reported to offer professional and personal benefit for clinical staff. Research secondments are one way in which a research culture can practically be embedded within clinical settings. IMPACT This scoping review identified a lack of published empirical research seeking to understand research secondments as a tool to enhance research and evidence engagement. Although there is a suggestion that secondments could positively impact staff retention, there is limited evidence about the benefit for the organisation or for patient care. These findings have implications for staff, managers and their organisations. REPORTING METHOD The PRISMA-ScR guidelines were used to guide reporting. NO PATIENT OR PUBLIC CONTRIBUTION This was not relevant to the research design.
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Affiliation(s)
- Naomi Hare
- Guy's and St Thomas' NHS Foundation Trust, St Thomas' HospitalLondonUK
| | - Sharon Grieve
- Royal United Hospitals Bath NHS Foundation TrustBathUK
- University of the West of EnglandBristolUK
| | - Janine Valentine
- Yeovil Hospital NHS Foundation TrustYeovilUK
- University of BournemouthPooleUK
| | - Julie Menzies
- Birmingham Women's and Children's NHS Foundation Trust; Institute of Clinical SciencesUniversity of BirminghamBirminghamUK
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Hannides M, Tariq R, Holland M, Nomikos PA, McKelvin R, Powell M. An Exploration of Student Perception Toward Interprofessional High-Fidelity Clinical Simulation. J Med Educ Curric Dev 2024; 11:23821205241249594. [PMID: 38665623 PMCID: PMC11044798 DOI: 10.1177/23821205241249594] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES Interprofessional education is recognized for its potential for collaboration and teamwork, reflecting clinical practice; however, existing literature for simulation-based interprofessional education does not include Physician Associate (PA) students. This initiative aimed to explore the students' perception of interprofessional clinical simulation for PA students and allied health professional (AHP) students as part of our program development. METHODS A high-fidelity simulation session was designed and conducted for volunteering students from the PA, paramedic science, and physiotherapy courses. We used a mixed-method electronic questionnaire consisting of 15 statements rated on a numerical rating scale (0-5) and four open-ended questions with unlimited free-text responses to explore student perceptions. Inductive thematic analysis was used for qualitative analysis. The session design was underpinned by Allport's (intergroup) contact hypothesis with an emphasis on mutual intergroup differentiation. RESULTS Forty-six students participated in the simulation teaching, with 48% (n = 22) providing feedback. Overall student perception was mainly positive toward the interprofessional simulation; however, some barriers to learning were recognized. Based on the evaluation of our initiative and existing literature, we propose 5 top tips to promote an effective learning experience for students. (1) Understand the importance of interprofessional collaboration. (2) Establish clear roles. (3) Plan the scenarios in advance. (4) Maintain equal status between groups. (5) Provide clear instructions and expectations. CONCLUSION To our knowledge, this is the first study of high-fidelity interprofessional simulation involving PA and AHP students. We successfully explored student perception which highlighted aspects that can impact learning. This pilot study demonstrated that interprofessional simulation is a feasible and acceptable form of learning for our students and highlighted how to improve future interprofessional simulation teaching sessions.
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Affiliation(s)
- Michael Hannides
- School of Clinical and Biomedical Sciences, University of Bolton, Bolton, UK
| | - Rameez Tariq
- School of Clinical and Biomedical Sciences, University of Bolton, Bolton, UK
| | - Mark Holland
- School of Clinical and Biomedical Sciences, University of Bolton, Bolton, UK
| | | | - Rory McKelvin
- School of Clinical and Biomedical Sciences, University of Bolton, Bolton, UK
| | - Michelle Powell
- School of Clinical and Biomedical Sciences, University of Bolton, Bolton, UK
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Hepburn J. Diagnostic uncertainty and axial spondyloarthropathy: A case for cognitive debiasing through practice-based learning and improvement activity. Musculoskeletal Care 2023; 21:1463-1469. [PMID: 37776078 DOI: 10.1002/msc.1818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 08/29/2023] [Accepted: 09/03/2023] [Indexed: 10/01/2023]
Affiliation(s)
- Jordan Hepburn
- Musculoskeletal (MSK) GP Advanced Practice Physiotherapy Service, Edinburgh Health & Social Care Partnership, NHS Lothian, Edinburgh, UK
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Gavin JP, Burgess LC, Immins T, Wainwright TW. Understanding the Patient Perspective When Designing Future Rehabilitation Interventions after Hip or Knee Replacement Surgery-A Patient and Public Involvement Exercise. Medicina (Kaunas) 2023; 59:1653. [PMID: 37763772 PMCID: PMC10534474 DOI: 10.3390/medicina59091653] [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: 08/10/2023] [Revised: 08/31/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Following discharge from hospital, there can be variability in the rehabilitation of patients who have undergone total hip or knee replacement surgery. We invited patients who had had hip or knee replacement surgery to take part in patient and public involvement sessions to help us understand their recovery needs and how rehabilitation services could potentially be improved to meet these needs better. Materials: Patients (n = 14) were invited to one of two patient advisory group sessions which took place in a university setting. Results: Feedback from patients highlighted the need for an inclusive, evidence-based intervention that would benefit patients experiencing all levels of pain, with differing motivations for recovery. Patients desired social support with others who have had similar surgery to reduce the burden of isolation during rehabilitation. Furthermore, patients valued the involvement of their partners and carers in their rehabilitation, to provide social support and guidance on recovery. Patients also expressed a need for consistent information and expert guidance on all aspects of their recovery. Conclusions: These findings can be used to guide the design of rehabilitation interventions following hip and knee replacement and ensure that patient perspectives inform future practice.
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Affiliation(s)
- James P. Gavin
- School of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - Louise C. Burgess
- Department of Rehabilitation and Sport Sciences, Bournemouth University, Bournemouth BH12 5BB, UK
| | - Tikki Immins
- Orthopaedic Research Institute, Bournemouth University, Bournemouth BH8 8EB, UK
| | - Thomas W. Wainwright
- Orthopaedic Research Institute, Bournemouth University, Bournemouth BH8 8EB, UK
- Physiotherapy Department, University Hospitals Dorset, Bournemouth BH7 7DW, UK
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Chalmers S, Hill J, Connell L, Ackerley SJ, Kulkarni AA, Roddam H. Allied health professional research engagement and impact on healthcare performance: A systematic review protocol. Int J Lang Commun Disord 2023; 58:959-967. [PMID: 36354267 DOI: 10.1111/1460-6984.12812] [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: 12/08/2021] [Accepted: 09/23/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Existing evidence suggests that clinician and organization engagement in research can improve healthcare processes of care and outcomes. However, current evidence has considered the relationship across all healthcare professions collectively. With the increase in allied health clinical academic and research activity, it is imperative for healthcare organizations, leaders and managers to understand engagement in research within these specific clinical fields. This systematic review aims to identify the effect of engagement in research by allied health professionals (AHPs) and organizations on healthcare performance. METHODS This systematic review has a two-stage search strategy. The first stage will be to screen a previous systematic review examining the effectiveness of engagement in research in health and social care to identify relevant papers published pre-2012. The search strategy used in the previous review will then be rerun, but with a specific focus on allied health. This multi-database search will identify publications from 2012 to date. Only studies that assessed the effectiveness of allied health engagement in research will be included. All stages of the review will be conducted by two reviewers independently, plus documented discussions with the wider research team when discrepancies occur. This systematic review protocol follows the EQUATOR reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols (PRISMA-P). DISCUSSION The findings of this review will make a significant contribution to the evidence base around the effect of allied health engagement in research on healthcare performance. It will provide insights for clinicians and managers looking to understand the consequences of developing AHP research capability and capacity. The findings of this review will also aim to make recommendations for future evaluation approaches for engagement in research interventions. TRIAL REGISTRATION This systematic review protocol has been registered with PROSPERO, registration number CRD42021253461. WHAT THIS PAPER ADDS What is already known on the subject This study will provide valuable evidence for professionals and policymakers seeking to understand engagement in research in the allied health disciplines. Where supported by the data, there may be recommendations for future research regarding specific variables to be considered when planning and evaluating engagement in research in allied health practice. What this paper adds to existing knowledge A previous systematic review identified a positive association between clinician and organization engagement in research and improved processes of care and health outcomes. The reviews' findings have been used as a justification for clinicians and organizations to increase research capacity. That review evaluated literature published before 2012 and the studies that were identified predominantly reported on engagement in research by medics and nurses. An updated review is now required to include research published since 2012. This review will specifically focus on the effect of engagement in research within allied health disciplines. What are the potential or actual clinical implications of this work? Research activity among AHPs is gaining momentum. Given this growth in AHP research activity and the rise in dedicated clinical academic roles, a contemporary review to identify the specific effect of AHP engagement in research on healthcare performance is prudent. The findings will inform clinicians, clinical managers and leaders of the potential impact of research activities by AHP clinicians and organizations. This will support the planning and development of initiatives focused on research capacity, capability and culture within allied health.
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Affiliation(s)
- Sophie Chalmers
- Allied Health Research Unit, School of Health Sciences, University of Central Lancashire, Preston, UK
- Integrated Community Services Division, Bolton NHS Foundation Trust, Bolton, UK
| | - James Hill
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| | - Louise Connell
- Allied Health Research Unit, School of Health Sciences, University of Central Lancashire, Preston, UK
| | - Suzanne J Ackerley
- Allied Health Research Unit, School of Health Sciences, University of Central Lancashire, Preston, UK
| | - Amit Arun Kulkarni
- Research and Outcomes, Royal College of Speech & Language Therapists, London, UK
| | - Hazel Roddam
- Education and Quality Directorate, Health Education England, Manchester, UK
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Jack-Waugh A. Learning lessons from dementia workforce education to develop general hospital dementia change agents for the future: A constructivist grounded theory study. Dementia (London) 2023; 22:646-663. [PMID: 36752102 PMCID: PMC10009491 DOI: 10.1177/14713012231156004] [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] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
In recognition of the often poor experience of people living with dementia in general hospitals and the lack of dementia curricular content for health and social care professionals, the Scottish Government commissioned a dementia workforce development programme (Dementia Champions) for qualified health and social care professionals in 2011. This constructivist grounded theory study aimed to construct a theory of the learning experienced by the dementia champions before, during and after the programme. The reported experience of change in the champions' professional and personal perspectives about people with dementia was the focus of this study. The findings contribute to a deeper understanding of the long-term negative impact of knowledge and skills gaps in dementia education and on people living with dementia and health and social care professionals. This negative impact has implications for individual professionals, service leaders and health and social care systems internationally. Data was co-produced through intensive interviewing, a focus group and email interviewing with nineteen Dementia Champions. Construction of the theory emerged from direct engagement with the data using the constructivist grounded theory approach. The findings illuminate how, before the programme, professionals were educated, socialised and defined to fail people with dementia. On the programme, multiple learning interventions in which interacting with the lived experience of people living with dementia, their families and colleagues became the stimulators of change. These learning interventions stimulated a disrupted self-definition and actions to resolve this disruption. Once the self-definition was restored, the participants faced the complexity of working with people living with dementia with passion, pride and new thinking. These findings further illuminate the importance of expert facilitation and the inclusion of people with dementia and their families as peer educators in health and social care dementia education. Further research on the negative outcomes of gaps in initial professional education is important.
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Affiliation(s)
- Anna Jack-Waugh
- Alzheimer Scotland Centre for Policy and Practice, 6413University of the West of Scotland, Glasgow, Scotland
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Sampson A, Block R, Lake PW, Gagliardi J, Augusto B, Santiago-Datil W, Sutter M, Schabath MB, Vadaparampil S, Quinn GP. "No one size fits all" A Multi-Method Survey of Oncology Allied Health Professionals Experiences with Lesbian, Gay, Bisexual, Transgender/Queer Questioning Adolescent, and Young Adult Patients with Cancer and Reproductive and Sexual Health". J Adolesc Young Adult Oncol 2023; 12:250-258. [PMID: 35731000 PMCID: PMC10124174 DOI: 10.1089/jayao.2021.0208] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: To assess training needs for providers who care for adolescent and young adult (AYA) lesbian, gay, bisexual, transgender/queer questioning (LGBTQ) cancer patients, we conducted a mixed-method survey. During their cancer care experience, AYA cancer patients experience physical, psychosocial, and reproductive health challenges. In addition to these challenges, AYA LGBTQ individuals are a diverse and medically underserved population who experience unique challenges and disparities in medical care. Methods: Health care providers (n = 351) who participated in our reproductive health in cancer training program completed a survey with 28 quantitative items and 4 open-ended items assessing knowledge, confidence discussing reproductive health, and confidence in knowledge specific to reproductive needs and general health needs among AYA LGBTQ patients. Results: Confidence discussing and confidence in knowledge of reproductive and general health needs are lower regarding transgender and nonbinary patients. Nearly half of providers (45%) demonstrated low knowledge, while 38% and 17% demonstrated moderate and high knowledge, respectively. Open comments indicated providers desired more training around the needs of Trans and nonbinary patients, and creating welcoming environments. Conclusions: The majority of our participants demonstrate low or moderate knowledge regarding factors that can influence AYA LGBTQ patient care, suggesting that this is a key area for improvement. Furthermore, improving provider knowledge may subsequently improve confidence in general and reproductive needs of LGBTQ patients, resulting in improved patient-centered care. Improving provider knowledge and confidence may then ultimately help reduce disparities in cancer care among this patient population.
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Affiliation(s)
- Amani Sampson
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
| | | | - Paige W. Lake
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Community Outreach Engagement, & Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Julia Gagliardi
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
| | - Bianca Augusto
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Community Outreach Engagement, & Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Waleska Santiago-Datil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Community Outreach Engagement, & Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Megan Sutter
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
| | - Matthew B. Schabath
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Community Outreach Engagement, & Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Susan Vadaparampil
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
- Community Outreach Engagement, & Equity, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Gwendolyn P. Quinn
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
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Barrett F, Sutter ME, Campo-Engelstein L, Sampson A, Caplan A, Lawrence M, Vadaparampil ST, Quinn GP. Perspectives surrounding fertility preservation and posthumous reproduction for adolescent and young adults with terminal cancer: Survey of allied health professionals. Cancer Med 2023; 12:6129-6138. [PMID: 36226382 PMCID: PMC10028037 DOI: 10.1002/cam4.5345] [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: 02/13/2022] [Revised: 09/29/2022] [Accepted: 10/02/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND While all reproductive-aged individuals with cancer should be offered fertility preservation (FP) counseling, there is little guidance over offers to adolescent and young adults (AYA) with terminal diagnoses, especially when considering posthumous assisted reproduction (PAR). The Enriching Communication skills for Health professionals in Oncofertility (ECHO/ENRICH) trains Allied Health Professionals (AHPs) to improve communication with AYAs with cancer. Little is known about AHPs' role in assisting in FP and PAR decisions. METHODS This is a cross-sectional survey of ECHO/ENRICH trainees' attitudes and experience with FP and PAR in AYA with terminal cancer. RESULTS The response rate was 61% (365/601). While 69% felt comfortable discussing FP with terminal AYA after ECHO/ENRICH training, 85% desired further education. The majority (88%) agreed FP should be an option for AYA with cancer, though some agreed offering FP provided false hope (16%) or was a waste of resources (7%). Most shared that avoidance of FP discussions was common practice, especially in the medically fragile, late-stage disease, or among minors. Many attributed lack of conversations to oncology team goals. Only 9% had prior experience with PAR. Many were conflicted about how PAR reproductive material should be gifted and who should be permitted to use PAR. Several raised moral concerns for PAR, or discomfort advising family. Many voiced desire for additional PAR-specific education. CONCLUSION ECHO/ENRICH trainees had varied levels of exposure to FP in terminal AYA and limited experiences with PAR. Many expressed uncertainties with PAR, which may be alleviated with further training and transparent institutional policies.
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Affiliation(s)
- Francesca Barrett
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, New York, USA
| | - Megan E Sutter
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, New York, USA
| | - Lisa Campo-Engelstein
- University of Texas Medical Branch, Institute for Bioethics & Health Humanities, Galveston, Texas, USA
| | - Amani Sampson
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, New York, USA
| | - Arthur Caplan
- Division of Medical Ethics, Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Morgan Lawrence
- Barnard College, Columbia University, New York, New York, USA
| | - Susan T Vadaparampil
- Division of Population Science, Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Gwendolyn P Quinn
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, New York, USA
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Feo R, Urry K, Conroy T, Kitson AL. Why reducing avoidable hospital readmissions is a 'wicked' problem for leaders: A qualitative exploration of nursing and allied health perceptions. J Adv Nurs 2023; 79:1031-1043. [PMID: 35332579 DOI: 10.1111/jan.15220] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/18/2022] [Accepted: 02/15/2022] [Indexed: 11/30/2022]
Abstract
AIMS To investigate nursing and allied health professional perceptions of the interrelationship between avoidable hospital readmissions and fundamental care delivery. DESIGN A qualitative, exploratory study using a critical realist approach. METHOD One-to-one semi-structured interviews with 14 nursing and allied health professionals conducted between May and September 2019. RESULTS Several tensions and contradictions were identified in the data, which demonstrated clinicians' perceptions about the priority of both fundamental care and two avoidable readmission conditions (aspiration pneumonia and constipation). These tensions are illustrated in two major themes: Avoidable versus inevitable; and everyone versus no one. The first theme demonstrates clinicians' perceptions that readmissions for aspiration pneumonia and constipation are not common, despite acknowledging that they generally lacked knowledge on readmission rates; and that these conditions may not be preventable in acute settings. The second theme demonstrates clinicians' perception that preventing readmissions is everyone's responsibility, however, this was coupled with a lack of articulation around how this multidisciplinary approach could be achieved, leading to a distinct lack of agency for care delivery. CONCLUSION Articulating the tensions described in the results provides vital knowledge for understanding how clinicians may respond to initiatives designed to reduce avoidable readmissions. Avoidable hospital readmissions may be usefully understood as a wicked problem: one that is complex and requires adaptive, not linear, solutions. Wicked problems pose a challenge for leaders and managers in healthcare because top-down, hierarchical strategies are unlikely to be successful. Effective prevention of avoidable readmissions requires leaders to enable facilitator-led change through relational leadership strategies. IMPACT Avoidable hospital readmissions are a global problem increasingly addressed via funding changes and the introduction of penalties to hospitals. This study provides insights on clinicians' perspectives of avoidable hospital readmissions and their prevention, demonstrating the complexity of this challenge and the need for healthcare leaders to enable individual and organizational readiness for change.
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Affiliation(s)
- Rebecca Feo
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Kristi Urry
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Tiffany Conroy
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Alison L Kitson
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.,Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
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Bernhardt L, Baillon S, Corr SM, de Vries K. Developing a clinical academic career pathway in a Community and Mental Health NHS Trust. J Res Nurs 2023; 28:72-84. [PMID: 36923666 PMCID: PMC10009083 DOI: 10.1177/17449871231152070] [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] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Background Despite growing evidence of the impact that clinical academic (CA) staff have on patient care and clinical practice, there are disproportionately low numbers of nurses, allied health professionals (AHPs) and other healthcare professionals in CA joint roles, compared to their medical colleagues. Aim To describe the initial development of a CA career pathway for nurses, AHPs and other healthcare professionals in a Community and Mental Health NHS Trust. Methods Kotter's 8-Step Change Model was used to expand opportunities and research culture across an NHS Trust. Results A variety of capacity and capability initiatives at different academic levels were created to support CA development and to complement those available externally. These opportunities were underpinned by a research and development strategy, senior leadership buy-in, manager and clinical staff support, and targeted organisation-wide communication. Conclusion The ongoing development of innovative CA opportunities in the Trust, alongside greater support for staff interested in pursuing CA careers, has resulted in a growing number of individuals successful in developing as CAs. This has led to a growth in research culture in the organisation and a greater understanding of what CA staff can bring to patient care, the clinical service and the wider organisation.
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Affiliation(s)
- Lizelle Bernhardt
- Clinical Academic Careers Pathway Lead, Leicestershire Partnership NHS Trust, Leicester, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Sarah Baillon
- Senior Research Associate, Leicestershire Partnership NHS Trust, Leicester, UK
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Susan M Corr
- Independent Coach/Consultant specialising in Clinical Academic Careers; Former Head of Research and Development, Leicestershire Partnership NHS Trust (formerly), Leicester, UK
| | - Kay de Vries
- Professor of Older Peoples Health, De Montfort University, Leicester, UK
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Lee G, Caton E, Knight A. Evaluating digital competencies for allied health professionals in the United Kingdom. Digit Health 2023; 9:20552076231176658. [PMID: 37214660 PMCID: PMC10196533 DOI: 10.1177/20552076231176658] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/02/2023] [Indexed: 05/24/2023] Open
Abstract
The Covid-19 pandemic accelerated the move to virtual and remote consultations in clinical practice with digital technologies widely implemented. eHealth interventions and use of applications in a variety of conditions means that patients and their families, as well as healthcare professionals, can access and interpret data in real-time, as well as providing trends in various clinical parameters including blood pressure for instance. Despite the aim of digital transformation in the National Health Service in the United Kingdom, this has not been fully realised and there is no consensus on the skills and competencies required for allied health professionals (AHPs). This qualitative study undertook two focus groups with twelve AHPs to evaluate the AHP Digital Competency Framework in the UK. The participants recognised the importance of a digital technology in their clinical practice and perceived digital literacy as essential for AHPs. In relation to the AHP framework, participants agreed that competencies in digital technology were clinically relevant, and assessment of these competencies should be performed regularly in practice. However, the majority were unaware of the AHP digital competency framework and suggested improvements to optimise its use in practice and identified areas for improvement. Overall, the AHP Digital Competency Framework has the potential, with better dissemination and further refinement of the wording, to become a useful tool to support the enhancement of digital competency in AHPs and improve the delivery of patient care.
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Affiliation(s)
- Geraldine Lee
- Florence Nightingale Faculty of
Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Emma Caton
- Florence Nightingale Faculty of
Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Annemarie Knight
- Department of Nutritional Sciences,
King's College London, London, UK
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14
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Postavaru GI, McDermott H, Biswas S, Munir F. Receiving and breaking bad news: A qualitative study of family carers managing a cancer diagnosis and interactions with healthcare services. J Adv Nurs 2022; 79:2211-2223. [PMID: 36565239 DOI: 10.1111/jan.15554] [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] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 11/27/2022] [Accepted: 12/11/2022] [Indexed: 12/25/2022]
Abstract
AIMS To explore family carer experiences of managing the process of receiving and breaking bad news about cancer. BACKGROUND Family carers' experiences of bad news are underrepresented in the literature. This study involved oncology staff with personal experience of caregiving and carers to develop broader insights into the range of needs and difficulties experienced by family members in the process of managing a cancer diagnosis. This can help facilitate subsequent interactions with healthcare professionals and improve continuity of care. DESIGN This is a descriptive qualitative study informed by the theory of social constructionism. Data were analysed using template analysis. METHODS Data were collected using semi-structured interviews and focus groups with 4 healthcare professionals and 17 family carers between January and July 2018. A purposive sampling strategy was used. Interviews were transcribed verbatim to explore participant experiences and perspectives on family carers managing a cancer diagnosis. FINDINGS Three key themes were identified: (1) receiving the bad news; (2) management of bad news and (3) interaction with healthcare and support services. These and associated subthemes are discussed, with recommendations for future research and practice. CONCLUSIONS There was variability in the experiences and needs of carers involved in receiving and breaking the bad news. IMPACT Although family members experienced a multitude of difficult emotions when the bad news was shared, they were not often able to discern help from healthcare professionals with sharing the diagnosis with the patient and others. This impacted on access to and use of healthcare and support services. Individualized approaches to communication are needed to enable carers to seek support and provide perspectives on the patient home environment and family structure. This can help tailor breaking the bad news and care plans. PUBLIC CONTRIBUTION Anonymised results were shared with family carers to validate the congruency of the codes with their experiences.
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Affiliation(s)
| | | | - Sanchia Biswas
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
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15
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Block RG, Sampson A, Gagliardi J, Augusto B, Santiago-Datil W, Schabath MB, Vadaparampil ST, Quinn GP. The LOvE ECHO Training: Developing a Web-Based LGBTQ Cultural Competency Training Module for Oncology Allied Health Professionals. J Adolesc Young Adult Oncol 2022; 11:556-563. [PMID: 35475655 PMCID: PMC9784593 DOI: 10.1089/jayao.2021.0159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/30/2022] Open
Abstract
Purpose: This article describes the development of the LGBTQ Oncofertility Education (LOvE-ECHO). The Enriching Communication skills for Health professionals in Oncofertility (ECHO) team created this new education module in response to the needs of oncology allied health professionals to provide inclusive and affirming care to lesbian, gay, bisexual, transgender, and queer (LGBTQ) AYA patients with cancer. The new module is part of the ECHO, a web-based educational training program for oncology allied health professionals to improve communication with AYA about reproductive health. Methods: The development of LOvE-ECHO includes five phases-learner needs assessment, content development and revision, piloting, and finalizing. Results from a survey of past ECHO learners and a comprehensive literature review provided the basis of need for this module and identified the most prominent gaps in knowledge and training. Content development and revision were iterative, including input, feedback, and voices from LQBTA youth and survivors, researchers, reproductive health experts, oncology clinicians, and web developer. Results: The complete LOvE-ECHO module consists of both didactic and interactive lessons. A glossary of terms and narrated PowerPoint establishes a knowledge base and shared vocabulary. Three interactive cases and a plan for action provide learners opportunities to test their new knowledge and transfer it to their practice. Conclusion: The module has received positive feedback to date. It is currently being piloted with new learners who complete a pre-test and post-test, as well as a feedback survey. Analysis of these results will inform revisions to the module.
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Affiliation(s)
| | - Amani Sampson
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
| | - Julia Gagliardi
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
| | - Bianca Augusto
- Department of Health Outcomes and Behavior, and Equity, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Waleska Santiago-Datil
- Department of Health Outcomes and Behavior, and Equity, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Matthew B. Schabath
- Department of Cancer Epidemiology, and and Equity, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Susan T. Vadaparampil
- Department of Health Outcomes and Behavior, and Equity, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
- Community Outreach Engagement, and Equity, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Gwendolyn P. Quinn
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York, New York, USA
- Departments of Population Health and Perlmutter Cancer Center, New York, New York, USA
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16
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Patel Y, Vassilev I, du Toit SHJ. Implementing a digital tool to support meaningful engagement with socially isolated or lonely older adults. Health Soc Care Community 2022; 30:e6456-e6466. [PMID: 36308765 PMCID: PMC10092141 DOI: 10.1111/hsc.14090] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/18/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Social isolation and loneliness are significant concerns in community dwelling older adults due to associated poorer health outcomes, inadequate crises responsiveness and increased societal burdens of care and cost. Generating Engagement in Networks Involvement (GENIE) is an online evidence-based, client-centred social network tool piloted by community-aged care services in Sydney, Australia. GENIE facilitates access to community resources, activities and people to extend or re-establish a client's social connections. This study aimed to identify GENIE's potential to maintain and promote social connections in older adults from the perspective of allied health professionals who could deliver GENIE. This qualitative exploratory study involved 33 participants on an emerging placement across two organisations who piloted GENIE. Data included consensus and priority statements produced from six nominal group technique-facilitated discussions, and an inductive thematic analysis of student documentation and all consensus statements. The main findings indicated that participants prioritised GENIE's clinical advantages, implementation barriers and recommendations for future implementation. The inductive thematic analysis revealed the two themes of practice applications, and client and professional experiences when using GENIE. As a time-efficient and personalised intervention, the research team concluded that GENIE could empower service providers to address the overarching needs of clients through rapidly connecting older adults to resources of their interests within the overburdened Australian-aged care system.
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Affiliation(s)
- Yasheeka Patel
- Discipline of Occupational Therapy, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
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17
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King OA, Wong Shee A, Howlett O, Clapham R, Versace VL. Research training incorporating education and mentoring for rural and regional allied health professionals: An evaluation study. Aust J Rural Health 2022; 30:654-665. [PMID: 35596656 PMCID: PMC9790691 DOI: 10.1111/ajr.12879] [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] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/17/2022] [Accepted: 04/28/2022] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION AND OBJECTIVE Building rural health workforce research capacity is critical to addressing rural health inequalities. Research training is a mainstay research capacity building strategy. This paper describes the delivery and evaluation of a research training program for rural and regional allied health professions (AHPs). DESIGN A mentored research training program was delivered to AHPs employed public health services in rural and regional Victoria, Australia. The program was evaluated using the Evidence-Based Practice Knowledge Attitudes and Practice (EBP-KAP) tool at baseline and 3 months post-training. Semi-structured interviews undertaken at 3 and 16 months post-training explored participants' perspectives of the training, their development and application of EBP and research skills. Survey data were analysed descriptively, and interview data were analysed using a framework approach. FINDINGS Thirty-four individuals from 14 organisations attended the first workshop and 31 attended the second. Thirty-one participants completed the survey at baseline and nine at 3 months post-training. Sixteen interviews were undertaken with 11 participants, five participating at both time points. Participants had positive EBP attitudes at both time points. Overall, participants' knowledge and incorporation of EBP into their practice, and retrieval of evidence was unchanged 3 months post-training. Themes identified in the interview data were as follows: (1) individual research capacity enhanced through supported practice, (2) organisational factors influence individuals' progression of research and (3) individual contributions towards research capacity within the organisation. CONCLUSION A mentored rural research training program promoted the application of EBP skills at the individual level and contributed to organisational research capacity.
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Affiliation(s)
- Olivia A. King
- Barwon HealthGeelongVictoriaAustralia,South West HealthcareWarrnamboolVictoriaAustralia,Monash Centre for Scholarship in Health EducationClaytonVictoriaAustralia
| | - Anna Wong Shee
- Ballarat Health ServicesBallaratVictoriaAustralia,Deakin UniversityWarrnamboolVictoriaAustralia
| | - Owen Howlett
- Bendigo HealthBendigoVictoriaAustralia,La Trobe University Rural Health SchoolFlora HillVictoriaAustralia
| | - Renee Clapham
- Ballarat Health ServicesBallaratVictoriaAustralia,Deakin UniversityWarrnamboolVictoriaAustralia
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18
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Scheffler B, Schimböck F, Schöler A, Rösner K, Spallek J, Kopkow C. Tailored GuideLine Implementation in STrokE Rehabilitation (GLISTER) in Germany. Protocol of a Mixed Methods Study Using the Behavior Change Wheel and the Theoretical Domains Framework. Front Neurol 2022; 13:828521. [PMID: 35968277 PMCID: PMC9363877 DOI: 10.3389/fneur.2022.828521] [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: 12/03/2021] [Accepted: 06/17/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Evidence-based guidelines are important for informing clinical decision-making and improving patient outcomes. There is inconsistent usage of guidelines among physical therapists involved in stroke rehabilitation, suggesting the existence of a gap between theory and practice. Addressing the German guideline "evidence-based rehabilitation of mobility after stroke (ReMoS)," the aims of this project are (1) to describe the current physical therapy practice within the context of stroke rehabilitation in Germany, (2) to evaluate barriers and facilitators of guideline usage, (3) to develop, and (4) to pilot test a theory-based, tailored implementation intervention for the benefit of guideline recommendations. Materials and Methods This study uses a stepwise mixed methods approach for implementing a local guideline. A self-reported online questionnaire will be used to survey the current physical therapy practice in stroke rehabilitation. The same survey and systematic-mixed methods review will be used to evaluate the barriers and facilitators of guideline usage quantitatively. Semi-structured interviews will add a qualitative perspective on factors that influence ReMoS guideline implementation. The Behavior Change Wheel and Theoretical Domains Framework will be used to support the development of a tailored implementation intervention which will be pilot tested in a controlled study. Patient and physical therapy-related outcomes, as well as the appropriateness, such as acceptance and feasibility of the tailored implementation intervention, will be analyzed. Conclusion This will be the first endeavor to implement a guideline in German stroke rehabilitation with a focus on changing care provider behavior based on the knowledge of current practice and determining factors using a tailored and theory-based intervention.
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Affiliation(s)
- Bettina Scheffler
- Department of Therapy Sciences I, Brandenburg University of Technology Cottbus—Senftenberg, Senftenberg, Germany
| | - Florian Schimböck
- Department of Nursing Sciences and Clinical Nursing, Brandenburg University of Technology Cottbus—Senftenberg, Senftenberg, Germany
| | - Almut Schöler
- Department of Therapy Sciences I, Brandenburg University of Technology Cottbus—Senftenberg, Senftenberg, Germany
| | - Katrin Rösner
- Department of Health Sciences, University of Lübeck, Lübeck, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus—Senftenberg, Senftenberg, Germany
| | - Christian Kopkow
- Department of Therapy Sciences I, Brandenburg University of Technology Cottbus—Senftenberg, Senftenberg, Germany
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19
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Marroney N, Beattie J, Hildebrand N, Flint T, Smith RM. Does training therapists to manage benign paroxysmal positional vertigo in patients with acute traumatic brain injury reduce vestibular neurology referrals? Brain Inj 2022; 36:822-826. [PMID: 35133230 DOI: 10.1080/02699052.2022.2034955] [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] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Dizziness is common in patients with acute traumatic brain injury (aTBI). However, patients are not always managed by the ward team but instead are referred to a visiting vestibular neurology team or referred for outpatient follow-up. We aimed to ascertain whether training trauma ward therapists to manage a common form of post-traumatic dizziness (Benign paroxysmal positional vertigo [BPPV]) reduced referrals to a visiting vestibular neurology team. DESIGN Referrals of patients with aTBI with complaints of dizziness to the visiting vestibular neurology team were audited from the Major Trauma Centre at Imperial College Healthcare NHS Foundation Trust, London, UK. Ward therapists subsequently received training on management of BPPV. Referrals to the vestibular neurology service were re-audited. Therapist confidence in assessing and treating BPPV was also assessed pre and post-training. RESULTS Pre-training, referral rate to the visiting vestibular neurology service was eight patients per month. Following training, referrals to the vestibular neurology service reduced by 35%. Therapist confidence improved significantly following training. CONCLUSIONS Training trauma ward therapists to manage BPPV reduced referrals to a visiting vestibular neurology service. Further research is necessary to assess implications for service and patient level parameters, such as length of stay and time to discharge.
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Affiliation(s)
- Natalie Marroney
- Physiotherapy Department, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Jenna Beattie
- Occupational Therapy Department, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Natalie Hildebrand
- Physiotherapy Department, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Thomas Flint
- Physiotherapy Department, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Rebecca M Smith
- Brain and Vestibular Group, Neuro-otology Unit, Department of Brain Sciences, Imperial College London, London, UK
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20
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Ford-Jones PC, Daly T. Filling the gap: Mental health and psychosocial paramedicine programming in Ontario, Canada. Health Soc Care Community 2022; 30:744-752. [PMID: 33034116 DOI: 10.1111/hsc.13189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 03/26/2020] [Revised: 09/07/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
Paramedics respond to acute medical and trauma emergencies in the community and transport patients to emergency departments (ED). In some cases, paramedics are not only attending calls for mental health and psychosocial care but are also connecting individuals with more appropriate services to address their needs. This study qualitatively explores to what extent there are promising practices to be learned from paramedic services that are connecting patients to mental health and psychosocial programming. The study is organised as follows. In terms of the methods, we conducted a critical ethnographic case study of mental health and psychosocial care within paramedic services in Ontario, Canada. Interviews were conducted with frontline paramedics (n = 31), paramedic services management (n = 5), educators at paramedic college programmes (n = 5) and Base Hospital physicians/directors (n = 5). Work observations were also performed in three paramedic services, with multiple crews across different shifts (n ~90 hr). The study findings outline three promising practices: diversion programmes that transfer patients to a destination other than the ED; crisis response teams that attend calls identified as involving mental health and community paramedicine programmes including referral programmes. We outline the social, political and economic conditions in which these programmes were established and are provided. We also describe the conditions required to enable connecting patients to non-ED supports. The benefits of implementing specific programming for mental health-related calls within paramedic services are discussed, as well as the importance of reaching beyond the prehospital and mental healthcare system to comprehensively and preventatively address mental health needs. Tensions are explored related to running programmatic interventions for mental health by paramedic services. We conclude by noting some public policy-level challenges including the need to focus more broadly on prevention and address the social determinants of health to aid the de-escalation of distress.
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Affiliation(s)
- Polly Christine Ford-Jones
- Faculty of Health Science and Wellness, Humber Institute of Technology & Advanced Learning, Toronto, Canada
| | - Tamara Daly
- School of Health Policy and Management, York University Centre for Aging Research and Education, York University, Toronto, ON, Canada
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21
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Johnsson G, Bulkeley K. Practitioner and Service User Perspectives on the Rapid Shift to Teletherapy for Individuals on the Autism Spectrum as a Result of COVID-19. Int J Environ Res Public Health 2021; 18:11812. [PMID: 34831567 PMCID: PMC8620428 DOI: 10.3390/ijerph182211812] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 11/26/2022]
Abstract
Prior to COVID-19, research into teletherapy models for individuals on the autism spectrum was slowly progressing. Following the onset of COVID-19, teletherapy became a necessity for continuity of services, however, research was still emerging for how to translate best practice autism support to the online environment. The aim of this research was to gain insight into the rapid shift to teletherapy for practitioner and service users and the implications for the broader disability sector. Survey responses were collected from 141 allied health practitioners (speech pathologists, occupational therapists, psychologists, educators, and social workers) from four Australian states and territories. A total of 806 responses were collected from service users following an individual teletherapy session. Five themes were identified during the qualitative analysis; (1) technology-love it or hate it; (2) teletherapy as a "new normal"; (3) short term pain, for long term gain; (4) the shape of service delivery has changed; (5) is teletherapy always an option? Data from the quantitative analysis provided further insights into the first two themes. While COVID-19 has brought forward significant advances in telehealth models of practice, what is needed now is to delve further into what works, for who, and in which context, and explore the potentiality, efficiencies, and scalability of a post-pandemic hybrid approach. This will inform practice guidelines and training, as well as information for service users on what to expect.
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Affiliation(s)
- Genevieve Johnsson
- Individual and Community Services, Autism Spectrum Australia, Sydney 2153, Australia
- Centre for Disability Research and Policy, University of Sydney, Sydney 2153, Australia;
| | - Kim Bulkeley
- Centre for Disability Research and Policy, University of Sydney, Sydney 2153, Australia;
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22
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Yisma E, Gillam M, Versace VL, Jones S, Walsh S, May E, Jones M. Geographical distribution of 3 allied health professions in South Australia: A summary of access and disadvantage. Aust J Rural Health 2021; 29:721-728. [PMID: 34636104 DOI: 10.1111/ajr.12816] [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] [Received: 08/29/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe the distribution of 3 allied health professionals-occupational therapists, physiotherapists and podiatrists-in South Australia stratified by the Modified Monash Model and the Index of Relative Socio-Economic Disadvantage. DESIGN A descriptive data linkage cross-sectional study. SETTING The state of South Australia, Australia. PARTICIPANTS AND MAIN OUTCOME MEASURES Distribution of the 3 registered allied health professional groups stratified by Modified Monash Model and Index of Relative Socio-Economic Disadvantage. RESULTS The largest proportion of the 3 allied health professional groups (occupational therapists, physiotherapists and podiatrists) were found in areas classified as Modified Monash 1 and Modified Monash 2 (86.5%). The lowest proportion of allied health professionals were found in Modified Monash 7. The largest number of allied health professionals per 10 000 population was found in areas classified as Modified Monash 1 and Modified Monash 2. The lowest number of allied health professionals per 10 000 population was found in Modified Monash 7 areas. The largest number of allied health professionals per 10 000 population was found in areas with Index of Relative Socio-Economic Disadvantage quintile 2, while the lowest number of allied health professionals per 10 000 population was found in areas with Index of Relative Socio-Economic Disadvantage quintile 1. CONCLUSIONS The distribution of allied health professionals according to geographical remoteness, socio-economic disadvantage and per 10 000 population varies widely in South Australia. The number of allied health professionals per 10 000 population was lowest in rural and remote/very remote areas, explaining the typically poor access to allied health services for communities in these areas. The number of allied health professionals per 10 000 population according to Index of Relative Socio-Economic Disadvantage was variable within the context of both urban and rural areas.
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Affiliation(s)
- Engida Yisma
- Department of Rural Health, Allied Health & Human Performance, University South Australia, Whyalla and Mount Barker, SA, Australia
| | - Marianne Gillam
- Department of Rural Health, Allied Health & Human Performance, University South Australia, Whyalla and Mount Barker, SA, Australia
| | - Vincent L Versace
- Deakin Rural Health, Faculty of Health, Deakin University, Warrnambool, Vic., Australia
| | - Sara Jones
- Department of Rural Health, Allied Health & Human Performance, University South Australia, Whyalla and Mount Barker, SA, Australia
| | - Sandra Walsh
- Department of Rural Health, Allied Health & Human Performance, University South Australia, Whyalla and Mount Barker, SA, Australia
| | - Esther May
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Martin Jones
- Department of Rural Health, Allied Health & Human Performance, University South Australia, Whyalla and Mount Barker, SA, Australia
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23
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VanSpronsen AD, Zychla L, Villatoro V, Yuan Y, Turley E, Ohinmaa A. Engaging Laboratory Staff in Stewardship: Barriers Experienced by Medical Laboratory Technologists in Canada. J Appl Lab Med 2021; 7:480-494. [PMID: 34599588 DOI: 10.1093/jalm/jfab103] [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] [Received: 06/01/2021] [Accepted: 07/08/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Laboratory stewardship programs aim to improve the use of laboratory resources, including reducing inappropriate testing. These programs should engage all healthcare stakeholder groups, including all levels of laboratory staff. Medical laboratory technologists (MLTs) are highly skilled professionals and are well positioned to play a supportive role in stewardship but may be overlooked. The aim of this study is to identify the barriers to MLT participation in stewardship activities. METHODS We developed and disseminated a self-administered survey to MLTs in Canada to assess their knowledge and attitudes toward inappropriate laboratory utilizatioz and explore perceived barriers to taking on an active role in stewardship initiatives. Themes were identified in open-ended responses and mapped to the Theoretical Domains Framework (TDF). RESULTS MLTs feel accountable for helping ensure appropriate resource use and recognize that it is an important issue to address. However, they experience significant barriers and have low intention to act. The self-reported barrier most frequently described was lack of time arising from excessive workloads, but other constraints exist. Themes mapped to the TDF most strongly in the domain of environmental context and resources, supporting evidence that workplace structure and culture play key roles in impacting this group. CONCLUSIONS To meaningfully engage MLTs in stewardship activities, these barriers should be addressed. Highlighting MLT expertise and creating communication structures and opportunities for their unique contributions may be fruitful.
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Affiliation(s)
- Amanda D VanSpronsen
- Department of Laboratory Medicine & Pathology, Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada
| | - Laura Zychla
- Department of Research, Canadian Society for Medical Laboratory Science, Hamilton, ON, Canada
| | - Valentin Villatoro
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB, Canada
| | - Yan Yuan
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Elona Turley
- Department of Coagulation Medicine, Alberta Precision Laboratories, Edmonton, AB, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Porter-Armstrong A, Daly-Lynn J, Turtle B, Abercrombie W, McLean A, Martin S, Stinson M. Joining the workforce during the COVID-19 pandemic: views of Allied Health Profession students. J Interprof Care 2021; 36:651-659. [PMID: 34582727 DOI: 10.1080/13561820.2021.1976122] [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] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In the United Kingdom, the onset of the COVID-19 pandemic placed great pressures on universities to ensure final year health care students completed their studies earlier than planned in order to join the National Health Service workforce. This study aimed to explore the anticipations and support needs of final year allied health profession students transitioning to practice during a pandemic. Final year university students across seven healthcare professions were asked to complete an online survey. Demographic data were analyzed by descriptive statistics and responses to open questions were explored using content analysis. Sixty participants completed the survey. Content analysis regarding students' anticipations, fears, and support needs identified the following themes: professional identity and growth; opportunities for improvement; preparedness for transition from university to the workplace, the workplace environment; COVID-19; support from lecturers; daily support within the workplace and innovative methods of support. Although the transition from student to practitioner continues to be a stressful period, only a minority of participants reported COVID-19 as an explicit stressor. However, as the effects of COVID-19 continue to evolve in the United Kingdom, universities and healthcare trusts must ensure adequate supports are in place for recent graduates navigating this transition during a healthcare crisis.
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Affiliation(s)
- Alison Porter-Armstrong
- Senior Lecturer in Rehabilitation Sciences, School of Health Sciences, Institute of Nursing and Health Research. Ulster University, Newtownabbey
| | - Jean Daly-Lynn
- Lecturer in Psychology, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - Beverley Turtle
- Research Associate, Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - Warren Abercrombie
- Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - Aislinn McLean
- Occupational Therapist, Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - Suzanne Martin
- Professor of Occupational Therapy, Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - May Stinson
- Lecturer in Occupational Therapy, Institute of Nursing and Health Research, School of Health Sciences, Ulster University, Newtownabbey, UK
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Ricci L, Beguinet M, Guillemin F, Klein S. French nurses' and allied health professionals' perception of research in their fields: A descriptive qualitative study. Int Nurs Rev 2021; 69:58-68. [PMID: 34514588 DOI: 10.1111/inr.12709] [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: 12/10/2020] [Revised: 07/13/2021] [Accepted: 07/19/2021] [Indexed: 01/12/2023]
Abstract
AIM To gather information from nurses and allied health professionals in the French context of the emergence of research in the field so as to inform the development of a new tool: The research in nursing and allied health sciences' Ideas Generator (GénI) capable of sustaining the identification of research ideas from professionals in the field. BACKGROUND In many countries, research in nursing and allied health sciences remains underdeveloped. INTRODUCTION Before developing the Ideas Generator tool, it was essential to explore professionals' basis of reference in providing care, then investigate (1) their representation of research in this field of science and (2) their perception of needs for and obstacles to starting a research process. METHODS The qualitative research design used focus groups. The study population included 24 participants naive to research in four hospitals in eastern France (13 nurses and 11 allied health professionals). Thematic analysis was used to analyze the data. The study was reported in compliance with the consolidated criteria for reporting qualitative research criteria. FINDINGS Professionals used tacit knowledge and their experiences to address care, but the culture of scientific evidence was clearly missing (lack of knowledge of the origin of care guidelines, few bibliographic skills). Participation in a research process could hardly be envisaged without a supervised collaboration with a physician. Research was perceived not to be part of professionals' culture. They self-censured for lack of methodological competencies. DISCUSSION Findings underlined some leverage, obstacles, and need to consider to generate a stimulation in the field, especially in countries where such research is still in its infancy. IMPLICATION FOR NURSING, HEALTH, AND EDUCATION POLICY Strengthening the field of nursing and allied health research is essential to extend the skills of nurses and allied health workers and to improve the quality of patient care by taking into account results from the literature. The Ideas Generator tool will be implemented to sustain learning the skills of research through education and training.
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Affiliation(s)
- Laetitia Ricci
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
| | - Mélanie Beguinet
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
| | - Francis Guillemin
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France.,Université de Lorraine, APEMAC, Nancy, France
| | - Sylvie Klein
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
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Abstract
Over the past decade, the role of nurses, midwives and allied health professionals (NMAHPs) have been transformed within the UK research community. Assisted by new funding opportunities and a recognition of their role in interdisciplinary working, NMAHPs are driving innovative patient care. Challenges still remain to maximise the potential of NHAMPs in clinical research; signposting opportunities to become involved in research, promoting clear career pathways and developing innovative roles with the NHS to attract and retain this community are critical.
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Affiliation(s)
- David Jones
- University of Newcastle upon Tyne, Newcastle upon Tyne, UK
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Bird M, Cerutti S, Jiang Y, Srugo SA, de Groh M. Implementation of the CANRISK Tool: A Qualitative Exploration Among Allied Health Professionals in Canada. Can J Diabetes 2021; 46:118-125. [PMID: 34334307 DOI: 10.1016/j.jcjd.2021.06.006] [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: 01/22/2021] [Revised: 05/28/2021] [Accepted: 06/22/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Launched in 2011 by the Public Health Agency of Canada, the Canadian Diabetes Risk Questionnaire (CANRISK) is a self-assessment tool validated in a Canadian sample, but its uptake has never been assessed. We sought to determine the level of current use of the CANRISK tool, identify common facilitators and barriers to its use and recommend future improvements. METHODS Ten professional allied health organizations across Canada were contacted for in-depth interviews. Contextual content and thematic analysis were used to analyze the qualitative data set. RESULTS According to allied health professionals, the tool is widely used, appealing and needed, and is being used for risk screening and health promotion. Respondents also identified the need to provide support and next steps for users identified as high risk. Still, several barriers to implementation were found, including readability, offensive or confusing language and difficulty ascertaining body measurements. CONCLUSIONS The CANRISK is a valuable diabetes risk assessment tool in Canada, particularly for allied health organizations.
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Affiliation(s)
- Madeleine Bird
- Social Determinants of Health Division, Public Health Agency of Canada, Montréal, Québec, Canada; Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal, Montréal, Québec, Canada
| | - Stephanie Cerutti
- Ontario Regional Office, Public Health Agency of Canada, Toronto, Ontario, Canada
| | - Ying Jiang
- Applied Research Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Sebastian A Srugo
- Applied Research Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Margaret de Groh
- Applied Research Division, Public Health Agency of Canada, Ottawa, Ontario, Canada.
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Oulton K, Wray J, Kelly P, Khair K, Sell D, Gibson F. Culture, cognisance, capacity and capability: The interrelationship of individual and organisational factors in developing a research hospital. J Clin Nurs 2021; 31:362-377. [PMID: 34046965 DOI: 10.1111/jocn.15867] [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] [Received: 10/29/2020] [Revised: 03/31/2021] [Accepted: 04/26/2021] [Indexed: 11/30/2022]
Abstract
AIM To share our experience of implementing a programme of interventions aimed at building research capacity and capability of nurses and allied health professionals in a specialist children's hospital. BACKGROUND Clinicians at the forefront of care are well positioned to lead on research to improve outcomes and experiences of patients but some professional groups continue to be underrepresented. Inequities persist alongside robust national infrastructures to support Clinical Academic Careers for non-medical health professionals, further highlighting the need to address local infrastructure and leadership to successfully build research capacity. DESIGN An evolving programme of inquiry and analysis was established in one organisation, this included targeted interventions to mitigate barriers and enable research capacity and capability. METHODS An all-staff survey was conducted in 2015 to understand the existing research culture. Interventions were put in place, evaluated through a second survey (2018), and focus group interviews with staff who had accessed interventions. RESULTS Respondents demonstrated high levels of interest and commitment to research at the individual level which were not always harnessed at the organisational level. Inequities between professional groups existed in terms of training, time to undertake research and opportunities and outputs. Follow-up revealed continuing structural barriers at an organisational level, however at an individual level, interventions were reflected in >30 fellowship awards; major concerns were reported about sustaining these research ambitions. CONCLUSIONS Success in building a research-active clinical workforce is multifactorial and all professional groups report increasing challenges to undertake research alongside clinical responsibilities. Individuals report concerns about the depth and pace of cultural change to sustain Clinical Academic Careers and build a truly organisation-wide research hospital ethos to benefit patients. RELEVANCE TO CLINICAL PRACTICE The achievements of individual nurses and allied health professionals indicate that with supportive infrastructure, capacity, cognisance and capability are not insurmountable barriers for determined clinicians. We use the standards for reporting organisational case studies to report our findings (Rodgers et al., 2016 Health Services and Delivery Research, 4 and 1).
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Affiliation(s)
- Kate Oulton
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Paula Kelly
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Kate Khair
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,Haemnet, London, UK
| | - Debbie Sell
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Faith Gibson
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,School of Health Sciences, University of Surrey, Guildford, Surrey, UK
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29
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Ewen C, Jenkins H, Jackson C, Jutley-Neilson J, Galvin J. Well-being, job satisfaction, stress and burnout in speech-language pathologists: A review. Int J Speech Lang Pathol 2021; 23:180-190. [PMID: 32408775 DOI: 10.1080/17549507.2020.1758210] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE The purpose of this review was to evaluate the factors that influence well-being, job satisfaction, stress, and burnout in speech-language pathologists (SLPs), and to identify the impact of these variables on worker recruitment and retention. METHOD A systematic literature search was conducted. Four electronic databases (PsycARTICLES & PsycINFO, PubMed/Medline, CINHAL and ABI/INFORM) were searched. The search was limited to articles published in English between 1998 and June 2018. To be eligible for inclusion, studies needed to investigate or report well-being, job satisfaction, stress or burnout in SLPs. The methodological quality of each paper was assessed using the "Strengthening the Reporting of Observational Studies in Epidemiology" (for quantitative data) and "Consolidated criteria for Reporting Qualitative research" (for qualitative data) checklists. A data-driven thematic analysis of the literature was used to identify key themes. RESULT Seventeen of 2050 studies met the inclusion criteria, of which 15 were cross-sectional surveys yielding quantitative data. Two were qualitative studies. There was consistent evidence for SLPs in the USA and Canada experiencing average to high satisfaction in their jobs. However, SLP job satisfaction in the UK was low, and studies in other countries did not address satisfaction. Facet analysis revealed six contributory themes, three of which were clearly associated with well-being: workload/caseload size, professional support, and salary. The contribution of job control (autonomy), length of time in practice and work setting was inconclusive. Evidence for stress and dissatisfaction leading to workforce attrition was found. CONCLUSION Job satisfaction, stress, and burnout were found to be associated with various occupational features, including elements of demand, support and reward. No previous studies have investigated the interaction between different elements of a job, which might boost satisfaction or ameliorate stress in SLPs. This is the first review using a systematic approach to focus on well-being, satisfaction, stress and burnout in SLPs and suggests more work needs to be done to help identify and improve the well-being of the workforce.
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Affiliation(s)
- Claire Ewen
- Department of Psychology, Birmingham City University, Birmingham, UK
| | - Helen Jenkins
- Department of Speech and Language Therapy, Dietetics and Rehabilitation Work (Visual Impairment), Birmingham City University, Birmingham, UK, and
| | - Craig Jackson
- Department of Psychology, Birmingham City University, Birmingham, UK
| | | | - John Galvin
- Department of Psychology, Birmingham City University, Birmingham, UK
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30
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Campbell N, Farthing A, Witt S, Anderson J, Lenthall S, Moore L, Rissel C. Health Professional Student Placements and Workforce Location Outcomes: Protocol of an Observational Cohort Study. JMIR Res Protoc 2021; 10:e21832. [PMID: 33443482 PMCID: PMC7843200 DOI: 10.2196/21832] [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] [Received: 06/26/2020] [Revised: 11/08/2020] [Accepted: 11/17/2020] [Indexed: 11/17/2022] Open
Abstract
Background The successful recruitment and retention of health professionals to rural and remote areas of Australia is a health policy priority. Nursing or allied health professional students’ learning placements in the Northern Territory (NT) of Australia, most of which is considered remote, may influence rural or remote work location decisions. Objective The aim of this study is to determine where allied health professionals and nurses who have had a student placement in the NT of Australia end up practicing. Methods This research is an observational cohort study, with data collection occurring at baseline and then repeated annually over 10 years (ie, 2017-2018 to 2029). The baseline data collection includes a demographic profile of allied health and nursing students and their evaluations of their NT placements using a nationally consistent questionnaire (ie, the Student Satisfaction Survey). The Work Location Survey, which will be administered annually, will track work location and the influences on work location decisions. Results This study will generate unique data on the remote and rural work locations of nursing and allied health professional students who had a placement in the NT of Australia. It will be able to determine what are the most important characteristics of those who take up remote and rural employment, even if outside of the NT, and to identify barriers to remote employment. Conclusions This study will add knowledge to the literature regarding rates of allied health and nursing professionals working in remote or rural settings following remote or rural learning placements. The results will be of interest to government and remote health workforce planners. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000797976; https://www.anzctr.org.au/ACTRN12620000797976.aspx International Registered Report Identifier (IRRID) PRR1-10.2196/21832
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Affiliation(s)
| | - Annie Farthing
- Flinders University, Northern Territory, Alice Springs, Australia
| | - Susan Witt
- Flinders University, Northern Territory, Adelaide, Australia
| | - Jessie Anderson
- Flinders University, Northern Territory, Adelaide, Australia
| | - Sue Lenthall
- Flinders University, Northern Territory, Katherine, Australia
| | - Leigh Moore
- Flinders University, Northern Territory, Darwin, Australia
| | - Chris Rissel
- Flinders University, Northern Territory, Darwin, Australia
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31
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Stewart-Lord A, Beanlands C, Khine R, Shamah S, Sinclair N, Woods S, Woznitza N, Baillie L. The Role and Development of Advanced Clinical Practice Within Allied Health Professions: A Mixed Method Study. J Multidiscip Healthc 2020; 13:1705-1715. [PMID: 33268992 PMCID: PMC7701658 DOI: 10.2147/jmdh.s267083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/03/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To investigate the profiles of advanced clinical practitioners (ACPs) in the allied health professions (AHPs) and their skills, attributes, experiences and involvement in new models of care. METHODS A 2 phase, cross sectional, mixed method survey of AHP ACPs across London was conducted in 2018-2019. Online questionnaires were completed by 127 AHP ACPs and then semi-structured interviews were conducted with 15 AHP ACPs. RESULTS The survey results gave a comprehensive overview of the attributes of AHPs in ACP roles across London. There was considerable variability between role titles, types and levels of qualification, and evolution of the roles. The respondents predominately worked in clinical practice, and less frequently in other ACP domains (research, leadership and management, education). The interview findings provided in-depth insights into the AHP ACP roles within four themes: being advanced, career pathways, outcomes of the advanced practitioner role and influencing and transforming. The "Being advanced" theme highlighted that expert practice comprised confident and autonomous practice, leadership, and applying specialist and expert decision-making skills. "Career pathways" highlighted the diversity within the participants' roles, titles, career opportunities and development. In the "Outcomes of the advanced clinical practitioner role" theme, the ACPs described their services as prompter, more accessible and providing an improved patient journey. The "Influencing and transforming" theme highlighted networking and dissemination and ideas for innovation, influencing and transforming services. CONCLUSION This is the first comprehensive profile of ACP roles across AHPs and indicates that these roles are already having a positive impact on healthcare services and supporting new models of care. However, establishing the necessary infrastructure, standardization and governance for ACP roles across sectors, along with the career pathways, funding, sustainability and education, could increase impact in the future.
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Affiliation(s)
- Adéle Stewart-Lord
- Therapeutic Radiography Allied Health Sciences School of Health and Social Care London South Bank University, London, UK
| | - Clare Beanlands
- Occupational Therapy, Allied Health Sciences, London South Bank University, London, UK
| | - Ricardo Khine
- Therapeutic Radiography, City University of London, London, UK
| | - Shani Shamah
- Service-User; Research (Public Patient Involvement) Consultant, Independent, London, UK
| | - Noreen Sinclair
- Therapeutic Radiography Allied Health Sciences School of Health and Social Care London South Bank University, London, UK
| | - Sandie Woods
- Occupational Therapy, Allied Health Sciences, London South Bank University, London, UK
| | - Nick Woznitza
- Diagnostic Radiography, Homerton University Hospital NHS Foundation Trust, London, UK
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32
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Molassiotis A, Fraser A, Culligan M, Labuc P, Csaba DL, Charalambous A. Nursing and Allied Health Research Priorities in the Care of Patients With Thoracic Malignancies: An International Cross-Sectional Survey. Front Oncol 2020; 10:591799. [PMID: 33194753 PMCID: PMC7649333 DOI: 10.3389/fonc.2020.591799] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/05/2020] [Indexed: 11/13/2022] Open
Abstract
Background There is currently no evidence of research priorities from nurses and allied health professionals working in the field of thoracic malignancies, which could provide strategic directions for funders, policy makers, and researchers. Objective The aim of this study is to identify the priorities for lung cancer and other thoracic malignancies research and practice in nurses and allied health professionals. Methods Descriptive cross-sectional web-based international survey conducted through international societies’ membership lists. Results Participants included 152 nurses and allied health professionals. Key priority categories were related to developing and evaluation interventions; symptom management interventions; health care system issues; treatment-related research (immunotherapy; targeted therapies); persistent/late effects management (fatigue; pulmonary toxicity); risk reduction, and screening research. The specific topic with the highest endorsement (80.9%) was the development of interventions to improve quality of life. Symptom management interventions, particularly for pain, dyspnea, and fatigue, were also highly endorsed. Health care system topics were related to delivery of care and included nurse-/allied health-led care (67.5%), working with the multidisciplinary team (67.5%), continuity of care (69.2%), and access to care (67.5%). Topics around screening/early detection research were highly endorsed too. Conclusion A clear focus (and need) for research in interventions to improve quality of life and symptom management, particularly for pain, dyspnea, and fatigue was also established, alongside healthcare system issues and screening research. Implications for practice International societies and funding bodies could consider these topics in their funding decisions and in shaping their strategic directions in the care of patients with thoracic malignancies.
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Affiliation(s)
- Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Anne Fraser
- Blood and Cancer Service, Auckland City Hospital, Auckland, New Zealand
| | - Melissa Culligan
- School of Medicine, University of Maryland Medical Center, Baltimore, MD, United States
| | - Pippa Labuc
- Department of Occupational Therapy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Degi L Csaba
- Faculty of Sociology and Social Work, Babeş-Bolyai University, Cluj-Napoca, Romania
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Seaton J, Jones A, Johnston C, Francis K. Allied health professionals' perceptions of interprofessional collaboration in primary health care: an integrative review. J Interprof Care 2020; 35:217-228. [PMID: 32297811 DOI: 10.1080/13561820.2020.1732311] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 01/07/2023]
Abstract
This integrative review synthesizes research studies in order to explore the perceptions of allied health professionals regarding interprofessional collaboration in primary health care. A comprehensive literature search was conducted using three electronic databases and a manual search of the Journal of Interprofessional Care. The Crowe Critical Appraisal Tool was used to assess the quality of included papers. Study findings were extracted, critically examined and grouped into themes. Twelve studies conducted in six different countries met the inclusion criteria. Thematic analysis revealed five themes: (1) shared philosophy; (2) communication and clinical interaction; (3) physical environment; (4) power and hierarchy; and (5) financial considerations. This review has identified diverse key elements related to interprofessional collaboration in primary health care, as perceived by allied health professionals. Opportunity for frequent, informal communication appeared essential for interprofessional collaboration to occur. Allied health professionals working in close proximity to health practitioners from other professions had more regular interprofessional interactions than those who were geographically separated. Co-location of multiple primary health care services within the same physical space may offer increased opportunities for interprofessional collaboration. Future research should avoid reporting on allied health professionals in primary health care collectively, and isolate data to the individual professions. Direct observational methods are warranted to investigate whether allied health professionals' perceptions of interprofessional collaboration align with their actual clinical interactions in primary health care settings.
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Affiliation(s)
- Jack Seaton
- Discipline of Physiotherapy, College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Anne Jones
- Discipline of Physiotherapy, College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Catherine Johnston
- Discipline of Physiotherapy, School of Health Sciences, the University of Newcastle, Callaghan, Australia
| | - Karen Francis
- Discipline of Nursing, College of Health and Medicine, The University of Tasmania, Launceston, Australia
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34
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Keeves J, Braaf SC, Ekegren CL, Beck B, Gabbe BJ. Caring for people with serious injuries in urban and regional communities: a qualitative investigation of healthcare providers' perceptions. Disabil Rehabil 2020; 43:3052-3060. [PMID: 32109168 DOI: 10.1080/09638288.2020.1728787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/23/2022]
Abstract
Purpose: To understand the factors that affect the management of people after serious injury in urban and regional settings, beyond hospital discharge from the perspectives of allied health professionals (AHPs).Materials and methods: An exploratory qualitative study of AHPs caring for people with serious injuries post-hospital discharge in urban and regional areas of Victoria, Australia was completed. Twenty-five semi-structured interviews were undertaken with AHPs and thematically analysed.Results: Allied health professionals in urban and regional settings reported the benefits of a multi-disciplinary team to deliver high-quality care. However, a number of barriers to service delivery were identified that impacted on their ability to meet the needs of patients. These included insufficient psychological services, a shortage of available carers and an unmet need for external clinical support in regional areas. Communication between AHPs and other services, and care co-ordination of post-discharge services, was also highlighted as key areas to improve for optimal patient care.Conclusions: Factors that influenced optimal patient management included the availability of psychological and carer services, communication between health professionals and coordination of post-discharge care. The experiences of AHPs can offer practical suggestions to optimise service delivery and post-discharge care for people with serious injuries.Implications for RehabilitationAllied health professionals (AHPs) face a number of challenges in the provision of optimal care to people with serious injuries.Improving the availability of psychological support and attendant carers is needed in regional areas.A designated care coordinator role may assist people with serious injuries transitioning between hospital and home to engage with necessary services and reduce administrative burden for AHPs.Telehealth may provide facilitate improved communication between health professionals and support regional clinicians caring for people with complex injuries.
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Affiliation(s)
- Jemma Keeves
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.,Department of Physiotherapy, Epworth Hospital, Melbourne, Australia
| | - Sandra C Braaf
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Christina L Ekegren
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Ben Beck
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Belinda J Gabbe
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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35
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Hollis R, Ersser SJ, Iles-Smith H, Milnes LJ, Munyombwe T, Sanders C, Swallow V. A Feasibility Study Of Administering The Electronic Research And Development Culture Index To The Multidisciplinary Workforce In A UK Teaching Hospital. J Multidiscip Healthc 2019; 12:935-945. [PMID: 31819468 PMCID: PMC6875253 DOI: 10.2147/jmdh.s218630] [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: 06/06/2019] [Accepted: 10/11/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose The study aims were: (i) to convert the Research and Development Culture Index (a validated rating instrument for assessing the strength of organizational Research and Development culture) into electronic format (eR&DCI), and (ii) to test the format and assess the feasibility of administering it to the multidisciplinary (allied health professionals, doctors and nurses) workforce in a National Health Service Hospital (NHS) in the United Kingdom (UK) by trialing it with the workforce of the tertiary Children’s Hospital within the organization. Population and methods The eR&DCI was emailed to all professional staff (n=907) in the Children’s Hospital. Data were analyzed using IBM SPSS Statistics 22. Results The eR&DCI was completed by 155 respondents (doctors n=38 (24.52%), nurses n=79 (50.96%) and allied health professionals (AHPs) n=38 (24.52%)). The response rate varied by professional group: responses were received from 79 out of 700 nurses (11%); 38 out of 132 doctors (29%) and 38 out of 76 AHPs (50%). Index scores demonstrated a positive research culture within the multidisciplinary workforce. Survey responses demonstrated differences between the professions related to research training and engagement in formal research activities. Conclusion This is the first study to assess the feasibility of assessing the strength of an organization’s multidisciplinary workforce research and development (R&D) culture by surveying that workforce using the eR&DCI. We converted the index to “Online Surveys” and successfully administered it to the entire multidisciplinary workforce in the Children’s Hospital. We met our criteria for feasibility: ability to administer the survey and a response rate comparable with similar studies. Uptake could have been increased by also offering the option of the paper-based index for self-administration. Results of the survey are informing delivery of the research strategy in the Children’s Hospital. This methodology has potential application in other healthcare contexts.
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Affiliation(s)
- Rachel Hollis
- The Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Heather Iles-Smith
- Research and Innovation, Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | | | | | - Cilla Sanders
- School of Healthcare, University of Leeds, Leeds, UK
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Chadwick O, Chia SN, Rotchford A. Establishing an allied health professional delivered selective laser trabeculoplasty service in Scotland. Ophthalmic Physiol Opt 2019; 39:216-223. [PMID: 30994202 DOI: 10.1111/opo.12611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 10/03/2018] [Accepted: 03/11/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To describe the process of establishing a selective laser trabeculoplasty (SLT) service delivered by experienced allied health professionals (AHP) in a Scottish NHS Hospital Eye Service, and assess the safety and efficacy in comparison with SLT performed by ophthalmologists. METHODS A training scheme for AHPs who were experienced in extended roles within the glaucoma service was developed, consisting of supervised training by a consultant ophthalmologist specialising in glaucoma leading to the AHPs independently delivering SLT. A prospective audit of consecutive SLT procedures performed by AHPs between November 2015 and April 2017 was performed. Data were analysed and compared to a previous intradepartmental audit of SLT performed by ophthalmologists (consultants and trainees). RESULTS A total of 325 eyes of 208 patients underwent SLT, of which 117 patients had bilateral SLT in a single session. The overall rate of complications was 3.9%, however these were minor and/or self-limiting (this compared to a 3.8% complication rate in the ophthalmologist delivered SLT series). The rate of intraocular pressure (IOP) spike was 0.3%, compared to 1.4% in the ophthalmologist delivered SLT series. Mean IOP at listing was 20.9 ± 5.1 mmHg, 17.3 ± 4.5 mmHg at 3 months post SLT and 17.6 ± 3.7 mmHg at 12 months-a median reduction of 16.7% at 3 months and 17.4% at 12 months. There was no statistically significant difference between the percentage reduction in IOP in the AHP and ophthalmologist delivered SLT groups at 3 or 12 months. CONCLUSIONS This is the first service of its kind in Scotland and the outcomes of this study demonstrate that the AHP delivered SLT service is at least as safe as the previous ophthalmologist delivered SLT service. The data demonstrate a similar efficacy between AHP and ophthalmologist delivered SLT. In the face of increasing demand and workload, this is a practical model in service commissioning to free up medical clinicians for more complex glaucoma management.
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Affiliation(s)
- Oliver Chadwick
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, NHS Greater Glasgow and Clyde, Glasgow, Scotland
| | - Seen Nee Chia
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, NHS Greater Glasgow and Clyde, Glasgow, Scotland
| | - Alan Rotchford
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, NHS Greater Glasgow and Clyde, Glasgow, Scotland
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Klaic M, McDermott F, Haines T. How soon do allied health professionals lose confidence to perform EBP activities? A cross-sectional study. J Eval Clin Pract 2019; 25:603-612. [PMID: 30178627 DOI: 10.1111/jep.13001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 04/06/2018] [Revised: 06/16/2018] [Accepted: 06/18/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To explore if there is a relationship between allied health professionals' confidence to perform a range of evidence-based practice (EBP) activities and the time since they graduated from their entry-level degree and the presence of postgraduate qualifications. DESIGN Cross-sectional survey. SETTING Allied health professionals from two Australian public metropolitan health services, including acute, subacute, and community settings. PARTICIPANTS Sample of 288 (n = 288) allied health professionals from the disciplines of physiotherapy, occupational therapy, speech pathology, social work, dietetics/nutrition, and other. MAIN OUTCOME MEASURE Cross-sectional survey including 12 questions measuring respondents' confidence to conduct a range of EBP activities. RESULTS Allied health professionals begin to lose confidence related to EBP activities within the first 5 years of clinical practice, particularly for those activities involving critical analysis of published studies. Respondents with postgraduate qualifications were more likely to report greater confidence with EBP activities, suggesting that higher level qualifications protect against the effect of degradation of EBP skills and confidence over time. CONCLUSIONS Allied health professionals' confidence to perform EBP activities degrades over time, particularly for those individuals with no postgraduate qualifications. Registration and accreditation bodies along with allied health professional employers should explore potential strategies to preserve and enhance EBP skills, confidence, and behaviours.
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Affiliation(s)
- Marlena Klaic
- Allied Health, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Fiona McDermott
- Department of Social Work, Monash University, Melbourne, VIC, Australia
| | - Terry Haines
- School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
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Csontos JK, Fitzsimmons D, Jones M, Wilkinson WM, Horton J, Love-Gould L, Tee A, Watts T. Realist evaluation of cancer rehabilitation services in South Wales (REEACaRS): a mixed methods study protocol. BMJ Open 2019; 9:e025953. [PMID: 31015271 PMCID: PMC6500344 DOI: 10.1136/bmjopen-2018-025953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 03/14/2019] [Accepted: 03/18/2019] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Long-term and late effects of cancer treatments can cause functional limitations and reduce quality of life. Cancer rehabilitation services, which can comprise physical exercise, psychological support and educational interventions depending on the individual's needs, have been found to have a positive effect on health-related quality of life worldwide. However, accessibility or the lack of awareness on available help can act as barriers and influence the uptake of services, resulting in people having unmet rehabilitation needs. In Wales, UK, 41% of people, who have had health and social care needs resulting from cancer and its treatments, reported that they did not receive care when needed. The reason for this lack of support has not yet been fully investigated. The aim of this study is to investigate the conditions in which cancer rehabilitation services work and their underpinning mechanisms in South Wales, UK, specifically addressing barriers, facilitators and costs. METHODS AND ANALYSIS Realist evaluation, which explains for whom a service works in what circumstances and how through context-mechanism-outcome pattern conjunctions, will be used in three phases to investigate the conditions in which cancer rehabilitation services work and their underpinning mechanisms. Phase 1 will be secondary analysis of a cancer rehabilitation database from a local Health Board to give context to who are accessing rehabilitation. Phase 2 will be thematic analysis of face-to-face, semistructured rehabilitation participant (n=20) and healthcare professional (n=20) interviews to explore the mechanisms of how cancer rehabilitation works. Phase 3 will be two case studies and cost-consequences analysis of cancer rehabilitation services. ETHICS AND DISSEMINATION This study received favourable ethical opinion from London South-East Research Ethics Committee (17/LO/2123) in December 2017. This project is part of the author's PhD thesis and it is expected that the findings will be disseminated in academic journals and at local and international conferences.
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Affiliation(s)
| | | | | | | | - Joanne Horton
- Abertawe Bro Morgannwg University Health Board, Port Talbot, UK
| | | | - Anna Tee
- Macmillan Cancer Support, Bridgend, UK
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Erwin J, Edwards K, Woolf A, Whitcombe S, Kilty S. Better arthritis care: Patients' expectations and priorities, the competencies that community-based health professionals need to improve their care of people with arthritis? Musculoskeletal Care 2018; 16:60-66. [PMID: 28730727 DOI: 10.1002/msc.1203] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 06/07/2023]
Abstract
OBJECTIVE The aim of the present study was to identify the competencies that patients think non-specialist community-based nurses and allied health professionals (AHPs) need to enable them to assess, care for and manage arthritis appropriately. METHODS Four face-to-face focus groups were held with a total of 16 women and nine men with arthritis, to discuss the care they received from community-based health professionals, the skills and knowledge they expected from community-based health professionals and what they prioritized. RESULTS People with arthritis wanted health providers to have an understanding of the difference between inflammatory arthritis (IA) and osteoarthritis (OA), of how serious OA can be, and of the unpredictability of IA and flares. They emphasized the need for nurses and AHPs to understand the psychosocial impact of arthritis on individuals, family and friends, and the psychological adjustment needed when diagnosed with IA. They wanted community-based health professionals to have some knowledge of the types of drug treatments that people with IA receive and the implications of taking immunosuppressive drugs. They also wanted them to understand the pain associated with arthritis, particularly OA, which participants felt was not taken seriously enough. They wanted nurses and AHPs in the community to be able to give basic advice on pacing and pain management, to make multidisciplinary referrals, to communicate effectively between referral points and to be able to signpost people to sources of help and good, reliable sources of education and information (especially for OA). They also wanted them to understand that patients who have had a diagnosis for a long time are the experts in their own disease. Other areas which were emphasized as being important were good communication skills and taking a holistic approach to caring for people with arthritis. CONCLUSIONS OA and IA differ significantly, both in their nature and their management. However, patients with arthritis want health professionals working in the community to be able to take a holistic approach to arthritis, with an understanding not just of the physical effects, but also their impact on the lives of patients, their family and their wider social circle, and on their ability to participate. People with OA want their condition to be taken seriously and to be offered appropriate management options, while people with IA want professionals to understand the unpredictability of their condition and to have a basic understanding of the drugs used for its treatment.
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Affiliation(s)
- J Erwin
- Bone & Joint Research Group, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - K Edwards
- Bone & Joint Research Group, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - A Woolf
- Bone & Joint Research Group, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - S Whitcombe
- School Healthcare Studies, Cardiff University, Cardiff, UK
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Westwood G, Richardson A, Latter S, Macleod Clark J, Fader M. Building clinical academic leadership capacity: sustainability through partnership. J Res Nurs 2018; 23:346-357. [PMID: 34394442 DOI: 10.1177/1744987117748348] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 11/15/2022] Open
Abstract
Background A national clinical academic training programme has been developed in England for nurses, midwives and allied health professionals but is insufficient to build a critical mass to have a significant impact on improved patient care. Aim We describe a partnership model led by the University of Southampton and its neighbouring National Health Service partners that has the potential to address this capacity gap. In combination with the Health Education England/National Institute of Health Research Integrated Clinical Academic programme, we are currently supporting nurses, midwives and allied health professionals at Master's (n = 28), Doctoral (n = 36), Clinical Lecturer (n = 5) and Senior Clinical Lecturer (n = 2) levels working across seven National Health Service organisations, and three nurses hold jointly funded Clinical Professor posts. Results Key to the success of our partnership model is the strength of the strategic relationship developed at all levels across and within the clinical organisations involved, from board to ward. We are supporting nurses, midwives and allied health professionals to climb, in parallel, both clinical and academic career ladders. We are creating clinical academic leaders who are driving their disciplines forward, impacting on improved health outcomes and patient benefit. Conclusions We have demonstrated that our partnership model is sustainable and could enable doctoral capacity to be built at scale.
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Affiliation(s)
- Greta Westwood
- Formerly Deputy Director of Research, Portsmouth Hospitals NHS Trust, Portsmouth, UK; Director of Clinical Practice, Faculty of Health Sciences, University of Southampton, UK; Director of Training and Engagement, Faculty of Health Sciences, NIHR CLAHRC Wessex, UK; Now Chief Operating Officer Florence Nightingale Foundation, London, UK
| | - Alison Richardson
- Professor of Cancer Nursing and End of Life Care & Director of the Southampton Academy of Research, Faculty of Health Sciences, University of Southampton, UK; University Hospitals Southampton NHS Foundation Trust, UK
| | - Sue Latter
- Professor of Nursing, Faculty of Health Sciences, University of Southampton, UK
| | - Jill Macleod Clark
- Professor of Nursing, Faculty of Health Sciences, University of Southampton, UK
| | - Mandy Fader
- Dean of Health Sciences, Professor of Continence Technology, Faculty of Health Sciences, University of Southampton, UK
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Erwin J, Edwards K, Woolf A, Whitcombe S, Kilty S. Better arthritis care: What training do community-based health professionals need to improve their care of people with arthritis? A Delphi study. Musculoskeletal Care 2017; 16:48-59. [PMID: 28745007 DOI: 10.1002/msc.1202] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 02/02/2023]
Abstract
OBJECTIVE The aim of the present study was to identify the competencies that non-specialist community-based nurses and allied health professionals (AHPs) need to enable them to assess, care for and manage arthritis appropriately. METHODS A Delphi survey with an expert panel of 43 rheumatology specialists and expert patients was used to identify the competencies needed by community-based nurses and AHPs to enable them to improve their care of people with arthritis. The process was informed by feedback from focus groups with arthritis patients, community-based nurses and AHPs. RESULTS The core competencies in arthritis care needed by non-specialist community-based nurses and AHPs were identified. The key goals identified were to increase the understanding of arthritis and its impact on patients' lives, and to increase the ability to help patients to self-manage their condition and access support. Competencies included an understanding of the pathology underlying inflammatory and non-inflammatory arthritis, the ability to distinguish between the two and the ability to recognize early warning signs, with an emphasis on osteoarthritis (OA), rheumatoid arthritis, gout and septic arthritis. Essential competencies included the ability to engage in shared decision making, goal setting and signposting, to provide patients with education and information and to make appropriate referrals. CONCLUSIONS Health professionals working in the community commonly encounter arthritis as a presenting problem or as a co-morbidity. The quality of care provided to people with inflammatory arthritis and OA in the community is currently variable. The present study identified the core competencies that all community-based nurses and AHPs should have in relation to OA and inflammatory arthritis.
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Affiliation(s)
- J Erwin
- Bone & Joint Research Group, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - K Edwards
- Bone & Joint Research Group, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - A Woolf
- Bone & Joint Research Group, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - S Whitcombe
- School Healthcare Studies, Cardiff University, Cardiff, UK
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Abstract
BACKGROUND In Canada, functional capacity evaluations (FCEs) are commonly administered by several health care professions including kinesiologists. Kinesiologists have been recently regulated as health care professionals in Ontario and we know little about their demographics, the frequency of FCE administration, or the types of FCEs used by this group. OBJECTIVE The purposes of this study were to identify: 1) the demographic characteristics and FCE education of kinesiology FCE practitioners; 2) the FCE systems most used by these practitioners and 3) the constructs from assessments used to determine functional capacity. METHODS A survey was distributed to members of the Canadian Kinesiology Alliance. Descriptive statistics and frequency distributions were calculated from the survey responses (n = 77). RESULTS FCE practitioners were represented by kinesiologists (79%) practicing more than 15 years and 1-5 years, who received FCE training from a certification course. ARCON (23%) was the most common FCE system used. Low-level lifting (43%), mid-lift (38%), pulling (38%) and walking (38%) are the most common FCE task components used to assess functional capacity. Although kinesiologists consider multiple factors when making decisions about task component endpoints, biomechanical observations/body mechanics are the primary methods used. CONCLUSIONS Kinesiologists are conducting FCEs for the primary purpose of preparing return-to-work or workplace accommodation recommendations. Although functional capacity is determined using multiple factors, there is an emphasis on biomechanics and body mechanics. Focusing FCE training and research on these constructs may provide opportunities to further strengthen the reliability and validity of FCE outcomes.
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Affiliation(s)
- Kathryn E Sinden
- School of Kinesiology, Lakehead University, Thunder Bay, ON, Canada
| | | | | | - Steven L Fischer
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.,School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
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Warnock C, Buchanan J, Tod AM. The difficulties experienced by nurses and healthcare staff involved in the process of breaking bad news. J Adv Nurs 2017; 73:1632-1645. [PMID: 28072478 DOI: 10.1111/jan.13252] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2016] [Indexed: 11/26/2022]
Abstract
AIMS The aim of this study was to explore the difficulties experienced by nurses and healthcare professionals when engaging in the process of breaking bad news. BACKGROUND The challenges faced by staff when breaking bad news have previously been researched in relation to particular settings or participants. This study involved staff from diverse settings and roles to develop broader insights into the range of difficulties experienced in clinical practice. DESIGN The study used a descriptive survey design involving self-reported written accounts and framework analysis. METHODS Data were collected using a structured questionnaire containing a free text section that asked participants to describe a difficult experience they had encountered when involved in the process of breaking bad news. Data were collected from healthcare staff from hospital, community, hospice and care home settings attending training days on breaking bad news between April 2011 and April 2014. FINDINGS Multiple inter-related factors presented challenges to staff engaging in activities associated with breaking bad news. Traditional subjects such as diagnostic and treatment information were described but additional topics were identified such as the impact of illness and care at the end of life. A descriptive framework was developed that summarizes the factors that contribute to creating difficult experiences for staff when breaking bad news. CONCLUSION The framework provides insights into the scope of the challenges faced by staff when they engage in the process of breaking bad news. This provides the foundation for developing interventions to support staff that more closely matches their experiences in clinical practice.
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Affiliation(s)
- Clare Warnock
- Weston Park Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Jean Buchanan
- Weston Park Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Angela Mary Tod
- School of Nursing and Midwifery, The University of Sheffield, UK
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Harron A, Titterington J. Use of outcome measurement by paediatric AHPs in Northern Ireland. Int J Lang Commun Disord 2016; 51:487-492. [PMID: 26997123 DOI: 10.1111/1460-6984.12224] [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: 01/31/2015] [Accepted: 10/29/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Professional standards advocate routine use of outcome measurement (OM) in the practice of allied health professionals (AHPs). Historically, OM has focused on impairment and its immediate constraints on activity, while current policy encourages the development and addition of impact-based OM. There appears to be an assumption at this stage of AHP development that the use of OM is well embedded into practice. However, there is no evidence to support this assumption, which leads to the current investigation into the overall readiness of paediatric AHPs-speech and language therapists (SLTs), occupational therapists (OTs) and physiotherapists (PTs)-to use OM. AIMS To investigate the readiness of paediatric AHPs in the use of OM and to consider what influences this use. METHODS & PROCEDURES A total of 133 paediatric AHPs working in the National Health Service (NHS) in Northern Ireland completed the Clinician Readiness for Measuring Outcomes Scale (CReMOS). CReMOS's 26 statements are rated on a six-point Likert scale identifying readiness to use OM based on the Transtheoretical Model of Change. OUTCOMES & RESULTS While about 75% of clinicians were using OM, 25% require support to roll this out in their practice. This pattern was similar across the professions, and while the majority perceived the value of OM, several factors influenced their use. CONCLUSIONS & IMPLICATIONS Clinicians would benefit from protected time and support from experts/role models to promote and facilitate best practice in the use of OM. Furthermore, funding for AHP services based on measurable outcomes for service users would facilitate their use in practice. Further research teasing out the different types of OM and the supports and barriers to their use would be very valuable.
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Affiliation(s)
- Anita Harron
- CIDS Team, Knockbracken Healthcare Park, Belfast, UK
| | - Jill Titterington
- Speech and Language Therapy Department, School of Health Sciences, Ulster University, Newtownabbey, UK
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Lundon K, Shupak R, Canzian S, Ziesmann E, Schneider R. Don't let up: implementing and sustaining change in a new post-licensure education model for developing extended role practitioners involved in arthritis care. J Multidiscip Healthc 2015; 8:389-95. [PMID: 26347223 PMCID: PMC4556301 DOI: 10.2147/jmdh.s83237] [Citation(s) in RCA: 6] [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] [Indexed: 11/25/2022] Open
Abstract
Key message Across a 9-year period, the Advanced Clinician Practitioner in Arthritis Care program has achieved a set of short-term “wins” giving direction and momentum to the development of new roles for health care practitioners providing arthritis care. Implication This is a viable model for post-licensure training offered to multiple allied health professionals to support the development of competent extended role practitioners (extended scope practice). Challenges at this critical juncture include: retain focus, drive, and commitment; develop academic and financial partnerships transferring short-term success to long-term sustainability; advanced, context-driven, system-level evaluation including fiscal outcome; health care policy adaptation to new human health resource development. Supporting evidence Success includes: completed 2-year health services research evaluating 37 graduates; leadership, innovation, educational excellence, and human health resource benefit awards; influential publications/presentations addressing post-licensure education/outcome, interprofessional collaboration, and improved patient care.
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Affiliation(s)
- Katie Lundon
- Office of Continuing Professional Development, Faculty of Medicine, University of Toronto, Toronto, ON, Canada ; Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Rachel Shupak
- Office of Continuing Professional Development, Faculty of Medicine, University of Toronto, Toronto, ON, Canada ; Division of Rheumatology, St Michael's Hospital, Toronto, ON, Canada ; Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sonya Canzian
- Trauma/Neurosurgery and Mobility Programs, St Michael's Hospital, ON, Canada
| | - Ed Ziesmann
- Programs and Services, The Arthritis Society, ON, Canada
| | - Rayfel Schneider
- Division of Rheumatology, The Hospital for Sick Children, ON, Canada ; Department of Paediatrics, University of Toronto, Toronto, ON, Canada
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Abstract
An evidence-based healthcare system necessitates a new role allocation and new role definitions of the players. By means of professional delegation, physician-nurse substitution and adoption of new professional functions, which so far have not been part of their professional profiles, nurses, midwives and allied health professionals will adopt a broad spectrum of new responsibilities. At present, nurses, midwives and allied health professionals lack basic scientific competencies and opportunities to acquire skills in evidence-based practice. A reliable link between evidence-generating sciences in nursing, midwifery and allied health professions and clinical practice is missing. In the future, an increase of academically qualified health professionals and a new skills mix within each profession might promote active and effective participation in an evidence-based healthcare system. (As supplied by author).
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Affiliation(s)
- Gabriele Meyer
- Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland.
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Young HML, Apps LD, Harrison SL, Johnson-Warrington VL, Hudson N, Singh SJ. Important, misunderstood, and challenging: a qualitative study of nurses' and allied health professionals' perceptions of implementing self-management for patients with COPD. Int J Chron Obstruct Pulmon Dis 2015; 10:1043-52. [PMID: 26082628 PMCID: PMC4461084 DOI: 10.2147/copd.s78670] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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] [Indexed: 11/23/2022] Open
Abstract
Background In light of the growing burden of COPD, there is increasing focus on the role of self-management for this population. Currently, self-management varies widely. Little is known either about nurses’ and allied health professionals’ (AHPs’) understanding and provision of self-management in clinical practice. This study explores nurses’ and AHPs’ understanding and implementation of supported COPD self-management within routine clinical practice. Materials and methods Nurses and AHPs participated in face-to-face semistructured interviews to explore their understanding and provision of COPD self-management, as well as their perceptions of the challenges to providing such care. Purposive sampling was used to select participants from a range of professions working within primary, community, and secondary care settings. Three researchers independently analyzed each transcript using a thematic approach. Results A total of 14 participants were interviewed. Nurses and AHPs viewed self-management as an important aspect of COPD care, but often misunderstood what it involved, leading to variation in practice. A number of challenges to supporting self-management were identified, which related to lack of time, lack of insight regarding training needs, and assumptions regarding patients’ perceived self-management abilities. Conclusion Nurses and AHPs delivering self-management require clear guidance, training in the use of effective self-management skills, and education that challenges their preconceptions regarding patients. The design of health care services also needs to consider the practical barriers to COPD self-management support for the implementation of such interventions to be successful.
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Affiliation(s)
- Hannah M L Young
- National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Lindsay D Apps
- National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Samantha L Harrison
- National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Vicki L Johnson-Warrington
- National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Nicky Hudson
- School of Applied Social Sciences, De Montfort University, Leicester, UK
| | - Sally J Singh
- National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, Leicester, UK ; Applied Research Centre in Health and Lifestyle Interventions, Coventry University, Coventry, UK
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Gallego G, Dew A, Bulkeley K, Veitch C, Lincoln M, Bundy A, Brentnall J. Factors affecting retention of allied health professionals working with people with disability in rural New South Wales, Australia: discrete choice experiment questionnaire development. Hum Resour Health 2015; 13:22. [PMID: 25895685 PMCID: PMC4414418 DOI: 10.1186/s12960-015-0013-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 01/29/2014] [Accepted: 04/09/2015] [Indexed: 05/02/2023]
Abstract
OBJECTIVE This paper describes the development of a discrete choice experiment (DCE) questionnaire to identify the factors (attributes) that allied health professionals (AHPs) working with people with disability identify as important to encouraging them to remain practising in rural areas. METHODS Focus groups and semi-structured interviews were conducted with 97 purposively selected service providers working with people with disability in rural New South Wales, Australia. Focus groups and interviews were digitally recorded, transcribed, and analysed using a modified grounded theory approach involving thematic analysis and constant comparison. RESULTS Six attributes that may influence AHPs working with people with disability in rural areas to continue to do so were inductively identified: travel arrangements, work flexibility, professional support, professional development, remuneration, and autonomy of practice. The qualitative research information was combined with a policy review to define these retention factors and ensure that they are amenable to policy changes. CONCLUSION The use of various qualitative research methods allowed the development of a policy-relevant DCE questionnaire that was grounded in the experience of the target population (AHPs).
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Affiliation(s)
- Gisselle Gallego
- Centre for Health Research, School of Medicine, University of Western Sydney, Building 3, Campbelltown Campus, Locked Bag 1797, Penrith, New South Wales, 2751, Australia.
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, East St, PO Box 175, Lidcombe, New South Wales, 1825, Australia.
| | - Angela Dew
- Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, 2052, Australia.
| | - Kim Bulkeley
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, East St, PO Box 175, Lidcombe, New South Wales, 1825, Australia.
| | - Craig Veitch
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, East St, PO Box 175, Lidcombe, New South Wales, 1825, Australia.
| | - Michelle Lincoln
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, East St, PO Box 175, Lidcombe, New South Wales, 1825, Australia.
| | - Anita Bundy
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, East St, PO Box 175, Lidcombe, New South Wales, 1825, Australia.
| | - Jennie Brentnall
- Faculty of Health Sciences, University of Sydney, Cumberland Campus, East St, PO Box 175, Lidcombe, New South Wales, 1825, Australia.
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Kushida CA, Nichols DA, Holmes TH, Miller R, Griffin K, Cardell CY, Hyde PR, Cohen E, Manber R, Walsh JK. SMART DOCS: a new patient-centered outcomes and coordinated-care management approach for the future practice of sleep medicine. Sleep 2015; 38:315-26. [PMID: 25409112 PMCID: PMC4288613 DOI: 10.5665/sleep.4422] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 01/07/2014] [Accepted: 10/10/2014] [Indexed: 11/03/2022] Open
Abstract
ABSTRACT The practice of medicine is currently undergoing a transformation to become more efficient, cost-effective, and patient centered in its delivery of care. The aim of this article is to stimulate discussion within the sleep medicine community in addressing these needs by our approach as well as other approaches to sleep medicine care. The primary goals of the Sustainable Methods, Algorithms, and Research Tools for Delivering Optimal Care Study (SMART DOCS) are: (1) to introduce a new Patient-Centered Outcomes and Coordinated-Care Management (PCCM) approach for the future practice of sleep medicine, and (2) to test the PCCM approach against a Conventional Diagnostic and Treatment Outpatient Medical Care (CONV) approach in a randomized, two-arm, single-center, long-term, comparative effectiveness trial. The PCCM approach is integrated into a novel outpatient care delivery model for patients with sleep disorders that includes the latest technology, allowing providers to obtain more accurate and rapid diagnoses and to make evidence-based treatment recommendations, while simultaneously enabling patients to have access to personalized medical information and reports regarding their diagnosis and treatment so that they can make more informed health care decisions. Additionally, the PCCM approach facilitates better communication between patients, referring primary care physicians, sleep specialists, and allied health professionals so that providers can better assist patients in achieving their preferred outcomes. A total of 1,506 patients 18 y or older will be randomized to either the PCCM or CONV approach and will be followed for at least 1 y with endpoints of improved health care performance, better health, and cost control. CLINICAL TRIALS NUMBER http://www.clinicaltrials.gov, NCT02037438.
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Affiliation(s)
| | | | | | | | - Kara Griffin
- Sleep Medicine and Research Center, Chesterfield, MO
| | | | | | - Elyse Cohen
- Stanford Sleep Medicine Center, Redwood City, CA
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Abstract
Background Internationally, health care services are under increasing pressure to provide high quality, accessible, timely interventions to an ever increasing aging population, with finite resources. Extended scope roles for allied health professionals is one strategy that could be undertaken by health care services to meet this demand. This review builds upon an earlier paper published in 2006 on the evidence relating to the impact extended scope roles have on health care services. Methods A systematic review of the literature focused on extended scope roles in three allied health professional groups, ie, physiotherapy, occupational therapy, and speech pathology, was conducted. The search strategy mirrored an earlier systematic review methodology and was designed to include articles from 2005 onwards. All peer-reviewed published papers with evidence relating to effects on patients, other professionals, or the health service were included. All papers were critically appraised prior to data extraction. Results A total of 1,000 articles were identified by the search strategy; 254 articles were screened for relevance and 21 progressed to data extraction for inclusion in the systematic review. Conclusion Literature supporting extended scope roles exists; however, despite the earlier review calling for more robust evaluations regarding the impact on patient outcomes, cost-effectiveness, training requirements, niche identification, or sustainability, there appears to be limited research reported on the topic in the last 7 years. The evidence available suggests that extended scope practice allied health practitioners could be a cost-effective and consumer-accepted investment that health services can make to improve patient outcomes.
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Affiliation(s)
- Robyn L Saxon
- School of Health and Sports Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, Australia ; Cluster for Health Improvement, University of the Sunshine Coast, Sippy Downs, QLD, Australia ; Queensland Health, Brisbane, QLD, Australia
| | - Marion A Gray
- School of Health and Sports Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, Australia ; Cluster for Health Improvement, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Florin I Oprescu
- School of Health and Sports Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, Australia ; Cluster for Health Improvement, University of the Sunshine Coast, Sippy Downs, QLD, Australia
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