Care Service Staff Research Articles

Study on Long-Term Care Service Awareness, Needs, and Usage Intention of Older Adult Male Homosexuals in Taiwan and Their Ideal Long-Term Care Service Model.

As the significance of long-term care services for older adults becomes more pronounced in Taiwan, especially considering the intensifying trend of an aging population, there remains a lack of comprehensive attention to the long-term care needs and experiences of older adult individuals within the LGBTQ+ community. The present study examines the long-term care service awareness, needs, and usage intention of older adult male homosexuals in Taiwan and assesses their ideal long-term care service model. This study of five older adult male homosexual subjects aged 66 to 73 years is intended as a preliminary exploration. Interviews were used to collect data. The study determined that the five subjects displayed high awareness of long-term care services, as they possessed actual experience of these services or had even participated in care service staff training to obtain certificates. Some even had experience in applying for home care services and reported problems during use. The subjects perceived that they were very likely to require long-term care services in the future and tended to opt for home care services if they required long-term support. Due to their personal experiences, the subjects displayed negative awareness of long-term care services and expressed worry that long-term care service staff harbored poor attitudes toward homosexuals. The subjects considered the most important aspects of long-term care to be basic medical care and lifestyle care. However, they worried that long-term care staff would delay or refuse to provide such services due to the subjects' sexual orientation or stereotypes related to it, and they were concerned above all about the "friendly attitude" of long-term care staff. They hoped that long-term care staff were friendly toward homosexuals and did not discriminate against them, feeling that it would be more appropriate for homosexual long-term care staff to provide assistance. In terms of vision, while preferring organizations with homosexual employees, the subjects worried that they would be stigmatized and discriminated against. Regarding ideal long-term care services, while considering institutions with homosexual staff to be ideal, the subjects also worried that these would be labeled as institutions that were dedicated to homosexuals, potentially resulting in discrimination. Therefore, they hoped that the sexuality sensitivity of long-term care staff could be improved and that they would undergo professional continuing education to learn about homosexuals, their situations, and care needs.

Assessment of employee engagement in pharmaceutical care service at King Abdulaziz Medical City – Central region (KAMC): A cross-sectional study

BackgroundJob engagement and satisfaction are crucial for any successful institution, in recent years, organizations around the globe have begun measuring the engagement level of employees in order to improve productivity and profitability. Employee engagement has the potential to significantly affect employee retention and loyalty. This study was conducted by the pharmacy-Quality Improvement Section to assess pharmacy staff engagement in KAMC-CR in 2019 and to develop a tool to be used as employee engagement key performance indicator (KPI). Aim(1) Assessing employee engagement and satisfaction in the pharmacy Care services- central region. And (2) to develop a tool to be used as employee engagement Key Performance Indicator (KPI). MethodsThis study was conducted at the Pharmaceutical Care Service at King Abdulaziz Medical City (KAMC) and King Abdullah Specialized Children Hospital (KASCH) in Riyadh, Saudi Arabia. A validated survey was selected for the study and was then distributed via e-mail to the pharmacy staff by the quality pharmacy section in October-November 2019. The included participants were comprised of administrators, administrative assistants, clinical pharmacists, pharmacists, technicians, pharmacy aides, and pharmacy residents. There are 20 questions in the survey, and the answers were reported using a five-point Likert scale (1 = strongly disagree; 5 = strongly agree). The survey was composed of sections including demographic data, and section for staff engagement and rating of facility. ResultsParticipants in this study included 228 (54 %) employees out of a total of 420 employees. The mean health facility rating was 6.51 + 1.94 out of 10. As for the employee engagement, the mean score was 65.53 ± 13.84, and the engagement level was 24 (10.5%) had low level of engagement, 122 (53.5%) had moderate level of engagement, and 82 (36%) had high level of engagement. High level of engagement was reported among the studied sample. Employee engagement was significantly associated with occupation, work experience (p = 0.001), as well as rating of the facility (satisfaction) (p < 0.05). ConclusionPharmaceutical care services participants overall average rate of the facility by pharmaceutical care services staff as a workplace is 6.5 out of 10. The Employees engagement improves employee performance and efficiency, which contribute to an organization’s overall success.

Opportunity, ideal or distraction? Exploring stakeholder perceptions of tackling energy poverty and vulnerability among older Australians

Energy vulnerability intersects with housing, social and health issues, yet current siloed approaches and piece-meal energy assistance initiatives are often leaving ‘hard to reach’ older householders behind. Cross-disciplinary strategies promise better identification of vulnerable people, sustained relief and scalable solutions, yet such innovative approaches are still rare. Using the Australian in-home aged care services as a case study, this research explored how stakeholders perceived the idea of integrating energy assistance with health services for people aged 65 and over. Understanding the views of potential advocates and adopters may guide the development, design and implementation of such an innovation.This study engaged front-line workers, executives and policy makers across organisations aiming at carbon emission reduction, equity and health. Climate action stakeholders and in-home aged care services staff recognised synergies across their programmes and welcomed the idea as an opportunity to address hidden energy poverty. Equity stakeholders perceived it as an ideal and doubted that its aspirations were likely to be fully realised given the priorities of vulnerable, older people. An aged care services industry representative, however, saw this proposition as a distraction from dealing with the broader challenges of an ageing population. These insights highlight the need to co-design such an initiative. The engagement of health policy makers is critical but challenging. Further research is needed to align energy assistance with the needs and circumstances of in-home aged care services clients and to develop solutions for older renters.

Aggressive incidents in home care services and organizational support: A cross-sectional survey in Switzerland.

To explore the available organizational structures addressing aggressive incidents towards home care services staff. Organizational structures how professional caregivers deal with care recipients' aggressive incidents. An explorative cross-sectional survey using the Violence Experienced by Staff (German version revised) and the Impact of Patient Aggression on Carers Scale was conducted. Data from 852 health care professionals in the German-speaking part of Switzerland were collected between July and October 2019. Multiple logistic regression models were used to investigate associations. The STROBE-Checklist was used as the reporting guideline. Organizational support and management support in home care services were generally rated high and found to cause a significant decrease in negative feelings. Some self-rated skills regarding aggression management were linked to a decrease in perceived burden after aggressive incidents, whereas others increased the perceived burden. Organizational structures including official procedures for affected professional caregivers should be established in home care services. This should contain efficient reporting systems and aggression management training for the specific setting. The study highlights the importance of organizational support regarding aggressive incidents in the home care setting as well as of aggression management training.

Healthcare professionals\u2019 perspectives of patient and family preferences of patient place of death: a qualitative study

BackgroundHome death is one of the key performance indicators of the quality of palliative care service delivery. Such a measure has direct implications on everyone involved at the end of life of a dying patient, including a patient’s carers and healthcare professionals. There are no studies that focus on the views of the team of integrated inpatient and community palliative care service staff on the issue of preference of place of death of their patients. This study addresses that gap.MethodsThirty-eight participants from five disciplines in two South Australian (SA) public hospitals working within a multidisciplinary inpatient and community integrated specialist palliative care service, participated in audio-recorded focus groups and one-on-one interviews. Data were transcribed and thematically analysed.ResultsTwo major and five minor themes were identified. The first theme focused on the role of healthcare professionals in decisions regarding place of death, and consisted of two minor themes, that healthcare professionals act to: a) mediate conversations between patient and carer; and b) adjust expectations and facilitate informed choice. The second theme, healthcare professionals’ perspectives on the preference of place of death, comprised three minor themes, identifying: a) the characteristics of the preferred place of death; b) home as a romanticised place of death; and c) the implications of idealising home death.ConclusionHealthcare professionals support and actively influence the decision-making of patients and family regarding preference of place of death whilst acting to protect the relationship between the patient and their family/carer. Further, according to healthcare professionals, home is neither always the most preferred nor the ideal place for death. Therefore, branding home death as the ideal and hospital death as a failure sets up families/carers to feel guilty if a home death is not achieved and undermines the need for and appropriateness of death in institutionalised settings.

Research on the Dynamic Relationships among Taiwan’s Early Childhood Education and Its Stakeholders: The Systematic Dynamic Perspective

In Taiwan, the low birth rate has become one of the most critical problems faced by the government and educational institutions at all levels. The enrolling student number of kindergartens perhaps is the most directly affected by such trend. The purpose of this study aims at constructing a system dynamics model to depict the relationships between the preschool children and their stakeholders for deducing the evolutionary trends of, and the interactions of, government-related policies and the operations of the early childhood education institutions. Through the interpretation of policies and simulation analysis of the twenty-year growth trend related to the child population in Taiwan, this study found that governmental policies and the promotion of education and care services have a positive effect on the growth of all levels of kindergarten classes. Besides, the relationship between the education and care service staff and the kindergarten play a causal balancing role in our proposed model. We suggest that the system dynamics model proposed by this study can help to observe the dynamic relationships formed by the stakeholders in preschool education and care system based on the "joint responsibility" of Taiwan's early childhood education.

The emotional labour of quality improvement work in end of life care: a qualitative study of Patient and Family Centred Care (PFCC) in England

BackgroundThere is a growing emphasis on understanding patient experience in order to inform efforts to support improvement. This paper reports findings from an implementation study of an evidence-based intervention called Patient and Family Centred Care (PFCC) designed to tap into patient experiences as a basis for improvement. In this study the PFCC intervention was spread to a new service area (end of life care) and delivered at scale in England. The findings presented here focus specifically on one key aspect of the intervention: staff shadowing of patients, and the experiences of staff carrying out shadowing for the purposes of service improvements.MethodsThe study methods were ethnographic observations of key events, semi-structured interviews with members of participating teams and the programme implementation support team and managers, and a review of the documents used in the set up and running of the programme.ResultsOne of the key strengths of the PFCC approach is to encourage staff through shadowing to engage with patient experience of services. Many staff described the process of shadowing as a transformative experience that alerted them to immediate areas where their services could be improved. However, engaging with patient experience of end of life care services also had unintended consequences for some staff in the form of emotional labour. Furthermore, we observed difficulties encountered by staff that are not accounted for in the existing PFCC literature relating to how care service structures may unevenly distribute the amount of ‘emotional labour’ that staff members need to invest in implementing the programme.ConclusionsConnecting with patient experience is a crucial aspect of a number of quality improvement interventions that aim to help staff to engage with the lived experience of their services and reconnect their motivations for working in the health care system. However, there may be unintended consequences for health care service staff, particularly in sensitive areas of service delivery such as end of life care. The ‘emotional labour’ for staff of engaging in quality improvement work informed by patient experience should be considered in planning and supporting patient experience led quality improvement.

Lessons Learned From a Program Evaluation of a Statewide Continuing Education Program for Staff Members Working in Assisted Living and Adult Day Care Centers in Virginia.

The number of older adults residing in assisted living facilities (ALF) and utilizing adult day care services is expanding with the increasing population of older adults. Currently, there are no standardized requirements for continuing education for assisted living and adult day care service staff at a national level. Given that 62% of states within the United States require continuing education for ALF staff and/or administrators, a more formalized system is needed that provides evidence-based gerontological training to enhance the quality of care and services provided to older adults. This article describes the challenges and lessons learned from conducting a program evaluation of a Statewide Training and Continuing Education Program for Assisted Living Facility and Adult Day Care Service staff in Virginia. Survey evaluation data from a 6-year period was examined and a formative program evaluation was conducted. The findings from the survey evaluation and formative evaluation are discussed as are the lessons learned.

Developing a good practice model to evaluate the effectiveness of comprehensive primary health care in local communities.

BackgroundThis paper describes the development of a model of Comprehensive Primary Health Care (CPHC) applicable to the Australian context. CPHC holds promise as an effective model of health system organization able to improve population health and increase health equity. However, there is little literature that describes and evaluates CPHC as a whole, with most evaluation focusing on specific programs. The lack of a consensus on what constitutes CPHC, and the complex and context-sensitive nature of CPHC are all barriers to evaluation.MethodsThe research was undertaken in partnership with six Australian primary health care services: four state government funded and managed services, one sexual health non-government organization, and one Aboriginal community controlled health service. A draft model was crafted combining program logic and theory-based approaches, drawing on relevant literature, 68 interviews with primary health care service staff, and researcher experience. The model was then refined through an iterative process involving two to three workshops at each of the six participating primary health care services, engaging health service staff, regional health executives and central health department staff.ResultsThe resultant Southgate Model of CPHC in Australia model articulates the theory of change of how and why CPHC service components and activities, based on the theory, evidence and values which underpin a CPHC approach, are likely to lead to individual and population health outcomes and increased health equity. The model captures the importance of context, the mechanisms of CPHC, and the space for action services have to work within. The process of development engendered and supported collaborative relationships between researchers and stakeholders and the product provided a description of CPHC as a whole and a framework for evaluation. The model was endorsed at a research symposium involving investigators, service staff, and key stakeholders.ConclusionsThe development of a theory-based program logic model provided a framework for evaluation that allows the tracking of progress towards desired outcomes and exploration of the particular aspects of context and mechanisms that produce outcomes. This is important because there are no existing models which enable the evaluation of CPHC services in their entirety.

Care Service Staff's Awareness of the Management of Undernutrition in Japan

Care Service Staff's Awareness of the Management of Undernutrition in Japan

CAN CONTINUOUS, INTER-GENERATIONAL COOPERATION POSITIVELY IMPACT THE QUALITY OF LIFE OF ELDERLY ALZHEIMER’S SUFFERERS?: AN INTERIM REPORT

This article summarizes the impact of inter-generational cooperation on the quality of life of elderly Alzheimer’s sufferers. The study is a continuing, two-year intervention and reports the results of the first year. It consists of an intervention and a control group of eight and six sufferers, respectively, who have been diagnosed with Alzheimer's disease. Both groups attend day care services. The intervention group participates in the inter-generational program with children, while the control group does not. On the Philadelphia Geriatric Center Affect Rating Scale, three items have been proved statistically significant. Pleasure, Interest, and Contentment have increased with inter-generational cooperation. The magnitude of the change was not so remarkable as to influence QOL-AD at home. However, the present results may imply a reduction on the burden of the day care service staff and family carers. Another advantage may be in the educating of the children’s parents, whose understanding of dementia was poor.

Perceptions of health and risk management among home care workers in Sweden

Background: Municipal home care workers provide high-quality services to an increasing proportion of elderly people living in private homes. The work environments and working conditions of these workers vary to a great extent, implying rapid priority-making among both employers and employees to ensure that the work can be performed in a safe way.Objectives: This study aims to examine home care workers’ perceptions of health, risks, working conditions, and risk management within their organization.Method: The study was based on cross-sectional data collected from home care service staff in a municipality in the north of Sweden. Nursing assistants and care aides (n = 133) replied to a self-administered questionnaire. Descriptive statistics and between-group differences were analysed.Results: Home care work was perceived to require high levels of professional skill and ingenuity, a good psychosocial work situation, but required a high physical workload. The general health, the capacity and self-efficacy of the staff in relation to work were good. Difficulty in performing risk assessments and following safety regulations due to lack of time, equipment, and information were identified.Conclusion: There is a need to increase participation in risk assessments among the staff, improve management support, structures, and cooperation with other divisions of the social services and the medical care organizations.

The evaluation of A Triage Tool for A Community Palliative Care Service Provider

Triage, widely used by the military and emergency departments, has not been reported in community palliative care services. Policy designed to improve equitable provision of this care has led to the development of a triage tool. Retrospective data were collected (50 percent of referrals, n = 204) and analyzed using the Wilcoxon signed-rank test to determine the accuracy of the tool in predicting patient status at the first visit. Semi-structured interviews (n = 7) with palliative care service staff added qualitative data. Although significant differences between triage scores compared to outcomes at first visit were observed, issues such as upgrading of triage category compared to priority score occurred in more than 30 percent of cases. When correction for this was made, the tool was found to be an accurate guide to patient needs. This tool, when used as intended, was effective in assessing the urgency of need, and it is potentially useful on a wider scale, subject to further evaluation.

Leadership self-assessment tool.

A leadership self-assessment tool, featured in last month's Webscan, has been further developed, so that it can be used by all health and care service staff who want a quick review of their leadership skills.

Making health choices; Part 1. Advance Care planning in aged care project. Setting the scene

IntroductionThe (2009) Australian National Health & Hospital Reform Commission Report highlighted the need for advance care planning (ACP) for older persons in residential aged care facilities (RACFs). Using knowledge gained...

Reaching those with the greatest need: how Australian primary health care service managers, practitioners and funders understand and respond to health inequity

Equity of access to services and in health outcomes are key goals of primary health care. This study considers understandings of equity and perceptions of current performance in relation to equity among primary health care service staff, health service executives and funders. Semi-structured interviews were conducted with managers, practitioners and administration staff at five primary health care services in Adelaide and one in Alice Springs, as well as with South Australian funders and regional health service executives (n = 68). Services were responding to health inequity by taking actions to improve equitable access to their service, facilitating equitable access to health care more generally, and advocating and taking action on the social determinants of health inequities. As well as availability, affordability and acceptability, our analysis indicated a fourth dimension of equity of access we named 'engagement'. Our respondents were less able to point to examples of advocacy or action on the social determinants of health inequities than they were to examples of actions to improve equity of access. These findings indicate current strengths and also scope to encourage a broader and more comprehensive role for primary health care in addressing health inequities.

Situación de la atención primaria de salud mental en servicios públicos de El Alto, La Paz, Bolivia

To determine the mental health and behavioral disorders (MHBD) treated by a Bolivian health network; and to gauge the perspective of the health professionals, community members, and care-providers in order to identify ways to better handle the issues. A descriptive cross-sectional study was conducted from January to December 2005 in 15 public health centers in districts 2 and 3 of the Corea Network, one of four urban networks in the municipality of El Alto, province of Murillo, department of La Paz, Bolivia. The research and active participation methodology was employed through interviews, focus group sessions, review of external consultation logs and clinical histories, and active observation. Only 0.05% of primary care visits were for MHBD. Among the barriers identified by doctors were: lack of a specialized reference center (60.0%), not enough time (40.0%), a shortage of specialized personnel (33.3%), the drug supply (20.0%), and undertrained staff (16.6%). The departmental and federal programs have limited human resources training, standards of care are nonexistent, and the information system does not collect data on MHBD. Community members amply identified the mental health problems and care needs that, to date, have not been met by the social services. Conclusiones: Training and development of primary care services staff must be expanded so as to provide the proper care for mental health disorders. Improvements must be made in the management of health care services and the reporting of behavioral and mental health disorders. Another recommendation is to incorporate community participation in the model approach to mental health within the framework of primary health care.

The reliability and validity of the Care Planning Assessment Tool

The development of a simple, comprehensive, valid and reliable tool to assist aged care services staff develops and monitors care plans. An assessment with proven utility in a psychogeriatric setting was modified to improve its relevance to aged care services. Reliability was assessed from the scores obtained from two independent raters assessing 48 randomly selected residents in a large aged care facility. Validity was assessed by comparison with well-validated measures of cognition and function. The Care Planning Assessment Tool has very high interrater reliability and good internal consistency. The validity of the subscales compared with well-validated assessments was very high. The psychometric properties of the Care Planning Assessment Tool are sufficiently good to allow it to be used with confidence in the care planning process. This is supported by a similar evaluation carried out on the Japanese version.

Beyond training: implementing a new educational programme

This article considers an initiative which was adopted by BUPA Care Services. It was designed for staff within the residential care sector to enable them to access an educational programme. This article describes the organization, planning, delivery and outcomes of the first cohort of BUPA Care Services staff who took the Joseph Rowntree Certificate in Care, accredited by the University of Lincolnshire and Humberside.