Responsibility For Care Research Articles

Academic Performance, Health and Support Needs: Comparing Foster Care Alumni and Peers in Higher Education in Norway

The completion rates of higher education are low among young adults with a history of foster care. Understanding how students from foster care alumni fare is imperative for facilitating attainment and preventing drop-out. The aim of this study was to compare students from foster care alumni and the general student population by examining (1) sociodemographic characteristics, academic functioning and need for special assistance; (2) contextual factors important for student life; and (3) mental and somatic health, loneliness, life satisfaction and use of cannabis and alcohol. Data comprised self-reports from the Norwegian national survey Students’ Health and Well-being Study 2022. Reports from foster care alumni students (n = 508) were compared to those of the general student sample (n = 59,036). Compared to the general sample, twice as many foster care alumni students reported receiving or needing special assistance in their studies. Moreover, they reported substantially higher economic burden than their student peers, by higher frequency of work income, more financial worries, and less parental financial support. Foster care alumni students also reported a higher load of informal care responsibilities, poorer mental and somatic health, more loneliness and lower life satisfaction. Foster care alumni students fare comparably well in terms of grades and study progression despite the reported economic burden and impaired health and well-being. As these are factors shown to impact study completion, policies need to be put in place to ensure that care-experienced students receive adequate support through their young adulthood and specifically in higher education.

What does flexible work for men really mean?: a qualitative content analysis of key stakeholder accounts

ABSTRACT This article explores definitions and practice of flexible work and is part of a larger project about men’s flexible work. Flexible work is prevalent in workplace research, but evidence is lacking regarding how flexible work for men is interpreted and applied in practice. Gendered patterns of work and care more often position men in paid employment and less often in care and domestic responsibilities. Men’s use of flexible work could assist in balancing paid employment with unpaid domestic and care tasks. Qualitative content analysis (QCA) was undertaken to summarise participants’ descriptions of two key aspects of flexible work – forms of flexible work, and the reasons for flexible work. QCA was applied to 30 interviews about men’s flexible work with organisational leaders (n = 12, 3 women and 9 men) and men who use flexible work arrangements (n = 18). Participants typically discussed flexible work in their white-collar employment situations, most often in the form of part-time work and for the reason of caring for children. Participants’ descriptions of flexible work differed from how flexible work is commonly defined in policy and legislation, demonstrating that men use flexible work in ways not described in policy or legislation.

Health behaviours and affective states of partners of fly‐in fly‐out workers: A daily diary study

AbstractPartners of fly‐in fly‐out (FIFO) workers face increases in demands, for instance in care and family responsibilities, particularly in the absence of workers; however, little is known about how their daily life experiences influence their health across the FIFO work cycle. This study examined the within‐person effects of workload, job control and social support on affective states and health behaviours of partners of FIFO workers. Forty‐four (N = 44) partners of FIFO workers completed online diary surveys on affective states and health behaviours once a day for 28 consecutive days during on‐and off‐shift periods of the FIFO worker. Multilevel models were used to analyse day‐level data. The results of the study demonstrated significant differences in partners' depressed affect and alcohol consumption during both on‐ and off‐shift periods of FIFO workers. Daily increases in workload were associated with anxious affect, whereas daily increases in job control and social support were associated with low depressed affect and positive affect in partners of FIFO workers. Daily increase in social support was also found to be associated with an increase in daily alcohol intake. Interventions could support partners in managing the daily workload and encouraging the creation of social support networks in partners of FIFO workers.

Exploring Belief Systems in Kinship Fostering Practice in Igbo Indigenous Communities of Southeast Nigeria

ABSTRACTKinship fostering in Igbo indigenous communities is an enduring alternative child care practice that promotes collective responsibility for child care in a family environment. The practice is believed to be fundamental for family and community continuity. Weakening extended family ties and a lack of social work support services in this care arrangement have cast doubt on the continual viability of this alternative child care practice This is an exploratory study using grounded theory. In‐depth interviews with six community leaders and six senior public social welfare officers provided insight on belief systems promoting kinship fostering in Igbo indigenous communities. Findings were thematically analysed to show continuity of lineage, preservation of family name and challenges associated with kinship fostering. Belief systems on kinship fostering provides insights on how children are viewed in Igbo culture, which can help policymakers design intervention programme that are culturally relevant in child‐care formation in Nigeria given challenges in kinship fostering. The study promotes indigenous knowledge that is vital for social work education and practice in Nigeria. Further study suggests exploring the belief of foster children and their experiences in kinship fostering.

A Century of Surgical Quality: Origins, Evolution, and Future Directions.

Over a century has passed since Ernst A. Codman's pioneering call for surgeons to take open responsibility for patient care, a concept integral to the emergence and leadership of the American College of Surgeons (ACS). Codman's End Result Idea, originating in the early 20th century, laid the groundwork for professional responsibility and accountability in surgical practice, catalyzing the formation of the ACS. His innovative use of the "end result" technique at Massachusetts General Hospital highlighted significant variability in surgical outcomes, spurring debates on specialization and accountability. The ACS, under John Bowman's leadership, aimed to ensure optimal care through defined standards and verification mechanisms. Codman's Bone Sarcoma Registry, initiated in 1920, marked an early attempt at quality assessment and improvement through data collection. Despite facing resistance, Codman's vision laid the foundation for modern quality initiatives in surgical care. ACS programs, spanning trauma care to cancer treatment and beyond, have significantly enhanced patient outcomes while reducing costs. Looking forward, advancing surgical quality requires measuring quality, leveraging trusted data, embracing change management, fostering collaboration, and empowering specialists. The future of surgical care depends on collective efforts to uphold standards that ensure optimal care for all.

Early Childhood Education and Care Services, and Parents’ Work–Life Balance

Parents’ work–life balance represents a major challenge, especially for those who have young children. The present article aims to identify the perceptions of parents relating to the purpose of early childhood education and care (ECEC) services, care responsibilities, and factors that affect the balance between caring responsibilities for children and the professional career of parents. Using a database with 825 parents, who have children aged between 0 and 6 years enrolled in the ECEC system (nurseries, kindergartens), we performed a descriptive statistical analysis and a logistic regression to identify factors that affect the balance between caring responsibilities and career. The results indicate an appreciation of the usefulness of ECEC services (nurseries/kindergartens) by parents and underline the importance of parents’ involvement in the activities of ECEC services. Results also show that three factors affect the balance between caring responsibilities for children and professional career as follows: the residence area, the educational level, and the proximity to ECEC services. The need to develop ECEC services in Romania is correlated with the work–family balance field. Policymakers should focus more on structural changes and the development of early childhood education and care services, as well as the expansion of such services in both rural and urban areas.

New House, New Furniture, New Room: Children’s Pandemic Landscapes of Care in Chile

Standing at the intersection between geographies of care and children’s geographies, we present three ethnographic stories (emerging from three ethnographic studies) through which we argue that, as a result of pandemic confinement in Chile, children’s places within their landscapes of care shifted in a twofold sense: First, given the de-mobilisation and spatial concentration of spaces of care at home, children’s place became closer to adults,’ suspending the usual spatial segregation that separates them. And second, in tandem with this new proximity that we refer to as in-person family relationships, new possibilities for the involvement of children in family care practices emerged. This rearrangement of children’s places within landscapes of care brings to the fore two interrelated aspects of family care from children’s perspective. First, the kind and amount of in-person family time spent in a shared space in “normal” times was not enough from the perspective of children’s needs and interests. And second, even though children are usually seen as subjects of care, they are people who care for others and who are able to take on more caring responsibilities than the ones that they usually are expected to.

Exploring the relationship between energy poverty and mental wellbeing: a qualitative study

Abstract Background Rising rates of energy poverty in Europe, affecting 11% of households, are a serious public health concern. The inability to meet energy needs impacts mental wellbeing, preventing people from productively engaging in society. Our objective was to explore this relationship within the context of three European cities, each characterized by distinct climatic conditions, cultural and societal characteristics and governance arrangements. This work is part of the European funded research project WELLBASED, grant no. 945097. Methods Semi-structured interviews (n = 34) were conducted with people experiencing energy poverty in the United Kingdom, the Netherlands and Spain. Purposive sampling ensured the representation of a diverse range of family and household types, gender and experiences with energy poverty. Thematic analysis was conducted using MaxQDA software. Preliminary results The analysis resulted in six themes: (1) worries and fear (2) stress (3) value of the home and neighborhood, (4) caring for others, (5) engaging with daily life and (6) autonomy in managing the situation and seeking for and receiving support. Participants were worried and stressed about the rising energy bills, the thermal discomfort, and health impacts of their poor housing conditions. In relation to caring responsibilities, participants were especially concerned about the impact on their children and prioritized children’s needs. Participants also expressed a strong will for independence and having control over their lives, but at the same time valued being seen and supported. Conclusions The persistent worries, fear and stress highlight implications of failure to meet energy needs for mental wellbeing. Caring responsibilities, engaging with daily life and autonomy proved important for mental wellbeing among people living in energy poverty. Our findings call for addressing energy poverty challenges in public health programs to improve mental wellbeing of vulnerable citizens. Key messages • People experiencing energy poverty in the United Kingdom, Spain and the Netherlands recognize the impact of their energy poverty situation on their mental wellbeing. • The public health community needs to be informed and engaged about the impact of energy poverty on mental wellbeing in order to take action.

UPDATE KNOWLEDGE: PERAN GENDER DAN MASA KERJA TERHADAP MOTIVASI KERJA PERAWAT DI RAWAT INAP RUMAH SAKIT

<p><em>Quantitative workload can be expressed as the amount of work required to fulfil a patient's medical needs. High-quality workload represents a high level of responsibility in patient care. Nurses' workload is the most important predictor of mental health, stress, job dissatisfaction, fatigue, and the presence of burnout. This service activity aims to provide and increase student knowledge about the Effect of Gender and Years of Service on Work Motivation of Nurses in Hospital Inpatients to Students of the Hospital Administration Study Program, Undergraduate Program, Faculty of Health Sciences, Kusuma Husada University, Surakarta by using a pre-experiment design with a research design of one group pretest and post-test design with a total of 35 students and the activity time in May 2024. This service uses quantitative research with multiple linear regression. There is an increase in the knowledge of participants before and after the provision of material marked by the pre-test and post test which shows that the level of knowledge before being given the material is 69% but after being given the material has increased to 89%. There is a significant difference between students' knowledge about gender roles and tenure on nurses' work motivation in hospital inpatient care.</em></p><p><strong><em>Keywords: Workload, Gender, Work motivation, Nurses, Hospitalisation</em></strong><em></em></p>

On Being a Good Worker, a Good Mother, a Good Carer: Women Journalists, Motherhood, and Caregiving

ABSTRACT This paper examines the relationship between journalism, caregiving, and family-building, focusing on women journalists in Portugal. Drawing on a critical thematic analysis of thirty interviews, it explores an analytic framework that includes cultural, structural, and agentic dimensions of career limitations, organised in three overarching themes. The first examines how women journalists experience work constraints stemming from traditional cultural ideals where women are still the main caregivers and work cultures that perpetuate a male perspective on professional routines. The second theme explores the mismatch between work and care responsibilities that arises from prevailing family structures and work processes. The third theme centres on how women journalists respond to constraints by making choices and developing strategies. Journalists’ reflexive deliberations about career decisions, employment conditions, family life and cultural assumptions underpinning parenthood demonstrate the complex interrelationship between cultural and working structures, organisational materiality, and agency. Together, these dimensions replicate patterns that make journalism more inhospitable for women. A central point in this research is that while a systemic gender bias exists beyond the sector, workplace inequalities are particularly consequential for journalism and democracy.

Navigating the COVID-19 crisis: exploring care arrangements and gendered inequalities for migrant women in transnational families in Berlin

ABSTRACT The COVID-19 pandemic has precipitated a notable shift in care responsibilities, transferring them from institutions to families, with a pronounced impact on migrant women in transnational families who navigate both local and transnational care arrangements. This study explored how the pandemic affected women's care arrangements and exacerbated existing inequalities at the intersection of labour, migration, and welfare regimes. Following a qualitative methodology based on grounded theory and ethnography, this study analysed interviews with migrant women, their family members, and experts to understand their experiences with caregiving and transnational family dynamics during the pandemic, the costs and coping strategies related to gendered aspects of care, and the changing landscape of migration and care policies during the pandemic. This study scrutinised the intricate web of local and transnational caregiving structures, emphasising women's agency in negotiating care needs amid pandemic restrictions and constraints on access to formal social protection.

Opportunity lost: addressing DEI in academic conference design practices

PurposeAttending academic conferences is important for career progression. However, conferences can be experienced as exclusionary by historically marginalised groups. Non-attendance through exclusionary event design thus has far-reaching consequences, which is a social and structural justice issue. This research therefore aims to shine a light on event design in academic conferences, and its relationship to diversity, equity and inclusion (DEI).Design/methodology/approachThrough empirical study, we address the question “Are academic conferences communicating a commitment to DEI for delegates from historically marginalised groups, and if so, how?”. Using a content protocol (Loh et al., 2022) and signalling theory (Bradley et al., 2023), we analyse the publicly available conference materials of 70 tourism, leisure, events and hospitality academic conferences planned or convened between 2023 and 2025 to assess DEI discourses and practices for evidence of conference design that fosters inclusivity, belongingness and therefore addresses justice.FindingsReferences to one or more elements of DEI were found in the discourses of around one quarter of the conferences. However, for BIPOC [1], precarious academics, those from the LGBTQIA+ or disability communities, those with caring responsibilities, those on low or no incomes or with visa requirements, and to a large degree still for women, there were few signs within conference design practices that could be construed as conveying a welcoming culture. We therefore argue that academic conferences within the fields of tourism, leisure, events and hospitality are perpetuating inequity, exclusion and injustice through failing to give full consideration to whom their event design practices are inviting to participate. This is an opportunity lost, and we provide a checklist for conference organisers to help them communicate that historically marginalised academics are welcome and belong at their event.Originality/valueWe believe this is the first study to take a DEI lens to an examination of academic conferences, and apply a content protocol and signalling theory as analytic tools in the process.

Evaluation and redesign of an internal medicine pharmacy practice model at a tertiary care hospital.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Clinical pharmacists are embedded into the care for patients admitted to internal medicine floors at Cleveland Clinic. The existing practice model utilized by the internal medicine pharmacy team had an uneven distribution of clinical activities among the various pharmacist roles. A study was completed to evaluate a potential adjustment to the pharmacy practice model. The objective of this study was to assess the type and quantity of clinical activities performed by each pharmacist role. These data were then utilized to evaluate the need for redistribution of care activities among the pharmacist roles and to determine the need for additional pharmacist full-time equivalents. From January to February 2023, data pertaining to the amount and type of clinical activities completed by the 9 internal medicine pharmacist roles was either manually collected or extracted from the electronic medical record. The data were then utilized to calculate a responsibility score for each role. Descriptive statistics were also calculated to assess the results. Each pharmacist role cared for an average of 34.4 patients (minimum, 24.4; maximum, 57.7) during the study period. The average responsibility score for each pharmacist role was 309.8 (minimum, 237.5; maximum, 447.8). On the basis of the data collected during the 4-week study period, a new pharmacy practice model was developed that incorporated 2 additional full-time equivalents. This model balanced patient care responsibilities among the pharmacist roles and moved the practice model from a location-based to a team-based coverage model.

Patients’ Perception of using Robotics and Artificial Intelligence in Dentistry: A Cross-sectional Study

Introduction Robotics and Artificial Intelligence (R&AI) are now playing a significant role in influencing the future of dentistry, owing to the fast advancements in technology. The use of AI in dentistry has already begun to enhance patient care and streamline operational efficiency. However, there has been limited research exploring how dental patients perceive the adoption of R&AI. Objective To assess and evaluate the knowledge, concerns, and perceptions of patients agreeing to undergo treatment in its variable forms and procedures under R&AI in order to gain insight into the public understanding of such advanced technologies. Methods This cross-sectional study was conducted at the dental teaching hospital of King Abdul Aziz University in Saudi Arabia from July 2023 to December 2023. The subjects were dental patients from an open network and the public community in different segments, with an alternate group of ages. A digital questionnaire from Google Surveys was used. Data was analyzed using IBM SPSS version 23 (IBM Corp., Armonk, N.Y., USA). Results This study evaluated the perceptions of 807 participants about R&AI dental treatment. The majority, 78.3%, n = 632, reported having already encountered the term AI in dentistry; however, they had never encountered any AI-based treatment (91.9%, n = 742) and remained uninterested in seizing the opportunity (52.8%, n = 381). Around one-third of them also perceived strong disagreement with the dental performance of robotics alone (39.2%, n = 316), even if it was offered at a reduced cost compared to normal treatment (30.7%, n = 248). Conclusion The study's findings reveal that patients' perceptions of R&AI-assisted dental procedures remain inconsistent. While the participants show a greater willingness to embrace the use of R&AI in dental operations, their overall level of trust in R&AI is only mediocre. Patients believe it is critical for a dentist to have control over the R&AI application and take full responsibility for dental care.

Conceptualizing social support in families of children with special needs

Purpose: Families usually try to organize the family environment and reach out to resources that can meet their child's needs. Successful resource utilization is important for families in dealing with the daily challenges and demands of caring for a child with special needs. In particular, social support influences the successful adaptation of these families. The concept of social support is increasingly being used to understand families and their functioning, and this research contributes to the evolving process of adaptation. Method: This study used systematic literature review design. The article search was carried out from January- March 2022 for the literature on parenting styles for children with special needs. Result: The results mentioned that one or all of the family members experienced adjustments in their work, i.e. shortened working hours, quit their job, or quit their job. The various adjustments that must be made often lead to various disturbances and stress for parents. The stress experienced by parents is also related to the heavy responsibilities of caring for and raising children. Parents' reactions vary. There are parents who cope realistically, resisting, feeling sorry for themselves. When facing significant stressors, families will go through certain processes that allow them to survive and adapt until they can become a harmonious family. Conclusion: This social support can be emotional, assistance, or informational because it can have an effect on children with special needs so that they do not have to worry about their own weaknesses. Children with special needs that they do not feel different from normal children. This shows that one of the family functions is working very well.

Divergent rhythms of motherhood. Patterns of paid and unpaid work and domestic outsourcing among mothers in the United Kingdom and Western Germany

Objective: This article investigates class differences in mothers’ daily organization of paid and unpaid work, and how they are associated with domestic outsourcing in the United Kingdom and Western Germany. Background: Operating hours of schools and daycare facilities often conflict with long working hours in high-skilled jobs and nonstandard working hours in low-skilled jobs. However, little is known on whether advantaged mothers rely on domestic outsourcing to resolve such scheduling conflicts, and how disadvantaged mothers reconcile their daily care responsibilities with paid work, depending on the welfare state context. Method: The study uses sequence and cluster analyses on time-use data to identify typical patterns of paid and unpaid work (N=1,947). Regression models predict how these patterns differ by the mothers’ education and household income, and how they are associated with outsourcing housework and childcare. Results: In both contexts, disadvantaged mothers were more likely to have unpaid workdays rather than nonstandard workdays. However, British advantaged mothers were considerably more likely to outsource childcare to pursue standard workdays. By contrast, the pattern of partial workdays in the morning, combined with more unpaid work allocation, prevailed among Western German mothers. Conclusion: In the United Kingdom, more market-oriented as opposed to conservative family policies, stronger labor market deregulation, and more consistent policy incentives for domestic outsourcing seem more effective than in Western Germany in promoting advantaged mothers’ careers. However, this comes at the expense of greater class differences in how mothers organize their time.

Acute Care Nurses' Partnership With Patients to Recognise and Respond to Changes in Patients' Clinical States: AQualitative Study.

To explore and describe acute care nurses' partnership with patients to recognise and respond to changes in patients' clinical states. Acute care nurses' decisions to partner with patients to recognise deterioration in clinical states and to respond by activating a rapid response system improves patient outcomes. Acutely unwell patients can also experience clinical changes that include improvement and deterioration that does not trigger rapid response system activation over the course of hospitalisation from illness and treatment. How acute care nurses partner with patients in response to improvement and deterioration not triggering a rapid response system is not well-understood. An exploratory, descriptive study underpinned by Tanner's Clinical Judgement Model. Using purposive and quota sampling, 20 nurses with direct patient care responsibilities on one medical and one surgical ward in a large Australian hospital were recruited. Nonparticipant observations followed by semistructured interviews were conducted between January and May of 2021. Nurse-patient interactions were observed for 4 h, and verbally described and recorded. Semistructured interviews were recorded and explored nurses' reasoning behind decisions observed. Reflexive thematic analysis was used to analyse the data. Three themes were identified from the data: nurses checking in for changes; nurses forming judgements; and nurses partnering with patients to respond. Acute care nurses promoted subjective assessment based on patients' safety risks. Patients' participation in response to changes was prioritised based on acute care nurses' judgement of safety. Patients receive significant safety benefits when acute care nurses partner with patients in response to their experience of improvement and deterioration during acute illness. Further research should evaluate the sensitivity of subjective cues in patient assessment. Partnership with patients in assessment and management of improvement and deterioration improves the quality and safety of patient care. Assessment frameworks should equally prioritise the use of objective and subjective cues. Nursing education should promote the safety benefits of patient partnerships in responding to patient changes. Equator checklist COREQ. Data collected included description of patients' interactions with study participants.

Patient and carer feedback and engagement with ECHOMANTRA, a digital guided intervention for anorexia nervosa.

We developed ECHOMANTRA, a digital guided intervention for patients with anorexia nervosa and their carers to provide support during transition from inpatient care to community settings. This study reports on participants' engagement with, and feedback of, ECHOMANTRA. Patients and carers (N=184 dyads) were given access to ECHOMANTRA for 12months. The intervention included online groups, a workbook and recovery-oriented videoclips. Satisfactory engagement was defined as attendance of a minimum of four online groups by each dyad. Participants received an Intervention Feedback Form to measure frequency of use and provide feedback of the intervention. Those who did not meet the engagement criterion were asked to complete an Obstacles to Engagement Form. 19% of the sample reached the engagement criterion. Seventy-six patients and 60 carers completed the Intervention Feedback Form. Of those, approximately 60% reported using at least a quarter of the workbook and videoclips. Overall, participants found the materials useful and easy to access (median=3 on a scale 1-5). Obstacles to engagement (35 patients and 14 carers) included lack of time due to caring responsibilities, treatment, work/school commitments. A more personalised form of support may be needed to enhance motivation and ability to change following inpatient care.

Intensity of care and the health status of caregivers to elderly rural South Africans.

Informal caregivers play an indispensable role in and are often the sole source of care for older adults in low and middle-income settings worldwide. Intensive informal care predicts mortality and morbidity among caregivers in higher-income settings. However, there is limited evidence from poorer settings, including Africa countries, where caregiving is shared widely, including across generations. We therefore investigated caregivers' health status in rural South Africa. We conducted quantitative interviews with all household members and all non-household caregivers aged ≥12 (n=1012) of 106 older adults in rural Mpumalanga, South Africa. We used multivariable regression with care-recipient random intercepts to assess the relationships between four caregiving characteristics and both self-reported chronic conditions and self-reported health status, considering how caregiver age moderated each association. Over half of all caregivers reported at least one chronic health condition, despite half being aged under 40. Caregivers self-reporting the worst health status provided high hours of care. However, caregivers' health status was not significantly associated with weekly care quantity or history of caring. Those aged ≥40 who reported being a main caregiver had 52% increased odds of reporting poorer health compared to other same-aged carers (95% confidence interval: 0.99, 2.35), while having more chronic conditions was associated with being expected to act as a sole caregiver more often among caregivers aged ≤39. Greater caring responsibilities for older adults were not consistently associated with caregivers' health in a setting where poor health is common, and caregiving is spread widely. Longitudinal data is necessary to unpack possible explanations of these findings, and to determine whether intensive caregiving speeds downward health trajectories for carers.

Participation and influence of welfare associations in early childhood education in legislative procedures in Germany

ABSTRACT In Germany, responsibility for early childhood education and care (ECEC) lies with the 16 federal states, which define the structures, financing and regulations concerning ECEC. Due to a subsidiary system, municipalities are not able to offer ECEC as long as private providers offer enough places. These providers employ a large variety of pedagogical concepts and practices. The article explores the role of welfare associations and interest groups in ECEC policies. What is their position in legislative procedures and their influence on the development of a competent system under the perspective of professionalization? First, we give a theoretical framework about professionalization and the development of a competent system and then describe the structure of the German ECEC system. Then we provide a content analysis of documents on the influence of associations in an exemplary legislative procedure to promote quality in ECEC. The results illustrate how welfare associations can influence ECEC policies.