Development Of Support Services Research Articles

A historical overview of policy perspectives towards informal care in Taiwan (1996-2023).

This paper examines the evolution of policy perspectives towards informal care in Taiwan, focusing on the development of carer support services. It traces the transition from self-funded services by the Taiwan Association of Family Caregivers (a nonprofit organisation), to services funded by the government. Taiwan's approach highlights the considerable changes brought about by the implementation of the Long-Term Care Services Act which elevated the legal status of carers. Other reforms include the establishment of community-based carer support centres, the introduction of a carer referral mechanisms, and the decentralisation of services to local governments. Carer policies in Taiwan have increasingly embraced the perspective of carers as co-clients, not only recognising their crucial role in the care ecosystem but also raising the profile of informal care in public policy. However, ensuring sustainable funding from the central government, which is vital for the continuation and expansion of carer support, presents a considerable challenge for future policy considerations. The Taiwanese experiences of integrating carers into the long-term care policy context and of decentralisation of carer support services to local governments, serve as a reference for other countries developing carer policies.

Psychosocial Support Needs and Preferences Among Family Caregivers of ICU Patients with Severe Acute Brain Injury: A Qualitative Thematic Analysis.

Family caregivers of patients with severe acute brain injury (SABI) are at risk for clinically significant chronic emotional distress, including depression, anxiety, and posttraumatic stress. Existing psychosocial interventions for caregivers of intensive care unit (ICU) patients are not tailored to the unique needs of caregivers of patients with SABI, do not demonstrate long-term efficacy, and may increase caregiver burden. In this study, we explored the needs and preferences for psychosocial services among SABI caregivers to inform the development and adaptation of interventions to reduce their emotional distress during and after their relative's ICU admission. In this multicenter longitudinal qualitative study, we conducted semistructed interviews with SABI caregivers at two time points: during their relative's ICU admission (n = 30) and 2months later (n = 20). We analyzed qualitative data using a hybrid of inductive and deductive analytic techniques. We recruited family caregivers of patients with SABI from 14 US neuroscience ICUs. We conducted interviews over live video. Our convenience sample of SABI caregivers (n = 30) was recruited through referral by medical teams and nursing staffs across participating neuroscience ICUs. Caregivers included spouses, children, parents, and siblings to patients with SABI. We identified themes and subthemes related to participants' preferences for (1) the content of psychosocial support services and (2) the delivery and implementation of psychosocial support services. Findings revealed an unmet need for psychosocial support around the time of ICU discharge and 2months later, including information to understand their loved one's condition and guide difficult decision-making, education regarding how best to communicate with the patient's care team and other family members, and emotional and behavioral coping skills. Our findings provide specific recommendations to justify and inform the development and adaptation of psychosocial support services for SABI caregivers for delivery in the ICU and after discharge.

Understanding the Needs of Young and Middle-Aged Chinese People Who Have Experienced a Stroke Who Have Not Successfully Returned to Work: A Qualitative Study.

The study aims to understand the return to work (RTW) needs of young and middle-aged people who have experienced a stroke and to contribute to the development of supportive RTW services. A qualitative study employing the phenomenological method. Eleven young and middle-aged people who have experienced a stroke participated in the study. Semi-structured in-depth interviews were conducted and analysed using Colaizzi's 7-step method to identify and categorize the RTW needs of participants. The analysis delineated four overarching thematic categories of RTW needs among the participants: self-management needs, emphasizing the regulation of symptoms, health maintenance and recovery planning; social support needs, highlighting the significance of workplace accommodations, professional medical guidance, and emotional encouragement from companions and family; the need for information related to returning to work, which includes accessing resources on rehabilitation opportunities, labour rights and professional consultation services; and personal development needs, focusing on fostering self-worth, identifying growth opportunities and acquiring new skills to adapt to changing professional demands. The diverse and comprehensive needs of young and middle-aged people who have experienced a stroke underscore the importance of multifaceted support from healthcare professionals. This support should encompass medical, psychological, informational and skill-development aspects and should involve enhanced communication and collaboration with relevant stakeholders to facilitate a successful RTW. This study was designed without direct involvement from patients or the public in the development of the research question, the design of the study, or the conduct of the research. This decision was informed by the specific focus on qualitative experiences and perceptions of stroke survivors regarding their RTW journey, which relied heavily on personal narratives and subjective accounts collected through individual interviews. However, the insights gained from these narratives have been crucial in shaping the research outcomes, emphasizing the patient-centred approach to understanding RTW barriers and facilitators. This study followed the SRQR checklist for qualitative studies as its reporting method.

The Weight of Caregiving, The Wait For Formal Support: Acknowledging Caregiver Responsibility in the Black Community

Identifying what cultural factors motivate family members to become caregivers can augment existing knowledge regarding family caregiving. This includes development of supportive services that are more culturally sensitive to family caregivers from distinct (Black) communities providing care for someone with Alzheimer’s disease or a related dementia. This paper reports on a study that found a reluctance among family caregivers in the Black community to utilize formal services. Twelve Black caregivers caring for family members with Alzheimer’s were interviewed. Seven received formal services and five were waitlisted for services. Questions included: (1) How does the experience of caregiving impact your sense of identity? (2) How does the experience of caregiving impact your motivation to continue providing care? (3) What types of supportive services do you believe would better meet your needs as a caregiver? Using a Heideggerian phenomenological approach, information garnered was interpreted, reviewed, and coded. Notable distinctions between caregivers waitlisted for supportive services versus those in receipt of services were identified. Recognizing how these distinctions related to the ability to adjust to changing care recipient needs while transitioning from having primarily a familial identity to a caregiver identity is crucial in applying services in line with the caregiver’s lived experiences.

Barriers and supports for Indigenous youth and young adults with childhood- onset chronic health conditions transitioning from pediatric to adult healthcare: a qualitative study

BackgroundThis study examined the experiences of Indigenous youth and young adults with pediatric onset chronic health conditions who had or were about to transition from pediatric to adult healthcare services. Transition is the process by which youth develop the knowledge and self-management skills needed to manage their health condition, ideally beginning around age 12–13 and continuing until the mid-20s. There is a growing body of literature on healthcare transition, but there is an absence of literature on Indigenous youth, who face additional barriers to accessing healthcare relative to non-Indigenous Canadians. The primary objective of this study was to identify the supports and barriers for Indigenous youth with childhood-onset chronic health conditions transitioning from pediatric to adult healthcare services.MethodsThe research was done in the province of Alberta, Canada, in collaboration with a Community Advisory Committee comprised of Indigenous healthcare providers, Elders and Knowledge Keepers and guided by a community-based participatory research approach. Semi-structured qualitative interviews (n = 46) were conducted with Indigenous youth, caregivers, and healthcare providers. There were three Talking Circles, two for youth (9 participants) and one for caregivers (6 participants). Three research assistants coded the transcripts thematically using NVivo. The key findings were presented to the Community Advisory Committee for feedback to validate the interpretation of the qualitative data.ResultsThe thematic findings include: (1) systemic inequalities exacerbate gaps in healthcare; (2) intergenerational trauma created unique barriers for Indigenous youth; (3) long-term relationships with care providers as a protective factor; (4) the incorporation of Indigenous worldviews into healthcare services to aid transition; and (5) assuming new responsibilities as an adult. The participants provided recommendations to improve healthcare service delivery including the need for Indigenous transition supports in community and improving education for healthcare practitioners about transition and Indigenous worldviews.ConclusionThis study demonstrates the complexity of the transition experience for Indigenous youth with pediatric onset chronic health conditions. The identified barriers to successful transition could be addressed through systems level changes and the development of Indigenous specific transition support services. Such approaches need to be Indigenous-led and incorporate Indigenous culture, language, and teachings.

Spiritual Meaning Making and Trauma Recovery: Evaluation of a Psycho-social Intervention for Earthquake Survivors in Turkey.

This study sets out to develop a psycho-social model for assessing the effectiveness of spiritually oriented logotherapy for earthquake victims with PTSD following the 6 February 2023, Kahramanmaraş earthquake in Turkey. The findings of this study will undoubtedly contribute to the development of post-disaster spiritual support services. We developed and implemented a six-week "Psycho-Social Training Programme through Spiritually Oriented Meaning" in the cities of Malatya, Elazığ and Kahramanmaraş, which were significantly affected by the earthquake. A randomised controlled trial (RCT) design was used, with participants randomly assigned to either the intervention group or the control group. Pre-test and post-test assessments were conducted to evaluate the programme's impact. The findings were clear: the programme significantly reduced PTSD symptoms (p < .05), proving the effectiveness of a meaning-oriented approach in the survivors' healing process. Additionally, the programme made a positive contribution to spiritual support services and provided a model to meet post-disaster psychological needs. This programme demonstrated its potential as an effective method for addressing PTSD and enhancing spiritual recovery in earthquake survivors.

Psychosocial Complaints and Life Satisfaction Among Greek University Students: A Pre- and Pandemic-Era Comparison

This study aims to identify and compare the prevalence and risk factors associated with psychosocial and psychological complaints, as well as life and study satisfaction, among Greek undergraduate students before and during the COVID-19 pandemic. Data were collected in two phases: initially, from 2018 to 2019 (pre-COVID), through face-to-face surveys, and later, from October 2020 to June 2021 (COVID period), through online surveys. The study, conducted at Democritus University of Thrace (DUTH) in Greece, utilized a repeated descriptive and comparative cross-sectional design. The sample comprised 540 and 641 undergraduate students during the pre-COVID and COVID period, respectively. The following questionnaires were used: I. A socio-demographic characteristics form, II. Psychosocial Complaints List (PCL), and III. Satisfaction with Life and Studies Scale (SLSS). During the COVID period, there was an increase of 63% in psychosocial complaints (p &lt; 0.001), as indicated by the PCL total, and a 25% decrease in satisfaction with life and studies (p = 0.001), according to the SLSS, compared to the pre-COVID period. Incidences of “suicidal thoughts”, “sexual problems”, and “extreme psychological distress” nearly doubled (61%, 67%, and 104%, respectively) during the pandemic. Females exhibited a 33% increase in the PCL total during the COVID period compared to males (p &lt; 0.001). These findings highlight the profound impact of pandemic-induced changes on students’ mental health and quality of life. Female gender and the pandemic period itself emerged as significant factors influencing these outcomes. Universities should prioritize the development of comprehensive support services to mitigate these adverse effects.

An Exploration of the Barriers and Facilitators Shaping Vaping Cessation Among Australian Young Adults

This study of 18–24-year-old young adults (YAs) in Australia who use, or used to use, nicotine vape products (NVPs) sought to explore their experiences when attempting to quit vaping to understand the barriers and identify facilitators of cessation. We analysed data from a survey (n = 532) of 422 YAs who vape and 110 YAs who used to vape, as well as interactive workshops (n = 12) and semi-structured interviews (n = 3), which included 7 YAs using and 8 no longer using NVPs. Social Cognitive Theory informed the data collection, with open-ended questions exploring how personal, environmental and behavioural factors shaped vaping cessation. Qualitative analyses revealed 11 themes shaping vaping cessation, including the normalisation of vaping, easy access and a desire to fit in. Vaping cessation was complicated by using NVPs to manage symptoms of mental ill-health. Additionally, former vapers reported using combustibles to replace vaping, highlighting the risk of health impacts from smoking. Potential support sources included friends and general practitioners, or family doctors. Support service development must consider de-normalising vaping, addressing underlying mental health issues and providing effective campaigns around the health risks of vaping and smoking. The findings highlight the need to invest in vaping cessation, and they can inform the design of vaping cessation programs to better support those trying to quit and ensure the success of their quit attempts.

Advances in breathlessness support services for people with serious illness.

Breathlessness remains a common and distressing symptom among people with serious illness, particularly in advanced disease. This review synthesises recent advances in the development, characteristics, and outcomes of breathlessness support services. The expanding body of evidence regarding breathlessness support services has broadened and strengthened our understanding of clinical and cost-effectiveness. The expansion of these services, into diverse settings and including digital delivery, has augmented their reach and accessibility to a wider population. Additionally, there is increasing attention to the psychological aspects of breathlessness and its management, including the challenges of optimising breathlessness support services for long-term benefit. Recent studies have made substantial progress in enhancing our knowledge of breathlessness support services and their impact on people with serious illness. Innovations extending services into new countries and settings, including use of digital platforms for intervention delivery, plus increased recognition of psychological mechanisms, have the potential to support more people with serious illness to live as best as possible with breathlessness.

Fluctuating emotional states before and during child sexual abuse and rape: a file review analysis of males in mandated care in The Netherlands

Purpose The purpose of this study is to examine emotional states preceding and during sexual crimes in a Dutch sample of adult male patients who were admitted to mandated clinical care. Design/methodology/approach Emotional states preceding child sexual abuse (CSA) (n = 63) and rape against adults (n = 60) were compared using the Mode Observation Scale. Findings CSA and rape were equally preceded by feelings of vulnerability, undifferentiated anger and loneliness and characterised by callous unemotionality. Emotional manipulation was more dominant in the events leading up to CSA, whereas an exaggerated sense of self-worth was more dominant in the event preceding rape. Substance-related detachment was more common preceding rape but was equally common during both types of crimes. Controlled anger was more common in rape. Practical implications CSA and rape crimes are predominantly characterised by similar emotional states of persons who were admitted to mandated clinical care. This informs the development of more effective therapeutic interventions and support services tailored to the emotional profiles of patients, potentially improving rehabilitation or treatment outcomes. Scientifically, the results of this study provide a compelling foundation for further research into the psychological mechanisms underpinning sexual violence. Originality/value While previous research has often focused on these crimes in isolation, this study bridges a critical gap by examining the emotional commonalities between them. This study challenges the conventional understanding that treats these forms of sexual violence as entirely distinct, proposing instead that they may share underlying emotional dynamics.

Balancing Athletic and Academic Excellence: A Quantitative Study of Student-Athletes' Time Management Strategies

This study focuses on the unique challenges faced by student-athletes and explores how they find a balance between competitive sports and academic pursuits. Through a one-year longitudinal study of 360 college athletes from a variety of sports and academic backgrounds, we deeply analyzed the relationship between time management strategies and academic achievement, athletic performance, and psychological health. The study used quantitative research methods to analyze the data and revealed several key time management strategies that were associated with significant improvements in academic and athletic performance. In particular, we discovered a novel "flexible focus" strategy that enabled students to quickly switch their attention between learning and training while maintaining high efficiency. In addition, the study found the moderating effects of social media use, sleep patterns, and nutritional intake on time management effects. Based on these findings, we proposed a comprehensive "dual-track development model" to provide a practical guidance framework for student-athletes, coaches, and educators. This model is not only applicable to traditional college sports programs, but also considers the emerging field of e-sports, providing a new perspective for understanding and supporting the comprehensive development of student-athletes in the 21st century. The results of this study have important implications for higher education policy, athletic training program design, and the development of student support services, providing an empirical basis for promoting the comprehensive development of student-athletes.

Loneliness and Social Isolation in Older Adults in Latvia and Iceland During COVID-19

Abstract Background The COVID-19 pandemic has significantly impacted the mental health and wellbeing of older populations across Europe, exacerbating feelings of loneliness and social isolation, known risk factors for poor physical and mental health outcomes. This study aims to understand the extent and implications of these changes in Latvia and Iceland, providing essential insights for targeted public health interventions. Methods This comparative study utilized data from two key sources: the Survey of Health, Ageing, and Retirement in Europe (SHARE) for Latvia and the HL20 study for Iceland, focusing on individuals aged 67 and above. Both quantitative surveys were conducted during the pandemic, offering data on health status, loneliness, and social isolation. A novel approach was applied in analyzing older populations to standardize comparisons between the two distinct datasets. This methodological innovation is part of a bilateral EEA initiative FM2021/23 aimed at strengthening research collaboration between Latvia and Iceland. Descriptive statistics and the Pearson Chi-square test were used to compare outcomes between the two countries and within demographic subgroups. Results The study revealed stark differences between the two countries: 80% of Latvian older adults reported social isolation compared to 42.7% in Iceland. Similarly, 45% of Latvians experienced loneliness versus 30% of Icelanders. Significant associations were found between social isolation, loneliness, and deteriorating mental and physical health, with worse outcomes noted in socially isolated individuals. Conclusions Our findings demonstrate a clear link between social isolation and adverse health outcomes among the older adults, exacerbated by the COVID-19 pandemic. The study supports the need for proactive public health measures in Latvia and Iceland, including the development of community engagement programs and mental health support services tailored to the needs of older adults. Key messages • Study shows significant health impact of social isolation among older adults in Latvia and Iceland, highlighting urgent need for targeted public health interventions. • Effective public health strategies and innovative digital outreach can mitigate adverse effects of loneliness and isolation observed in older populations.

Challenges for Family Caregivers of Persons With Mild Cognitive Impairment: A Qualitative Longitudinal Study.

Family caregivers of persons with mild cognitive impairment attempt to understand the behavioural and functional changes exhibited by their relative. However, how caregivers respond to initial changes and changes over time has not been explored. The purpose of this qualitative study was to explore the experience of family caregivers responding to changes in their relative's memory, behaviours, and physical functions over 2 years. Eleven family caregivers of a relative with mild cognitive impairment were purposively recruited from neurological clinics in Taiwan. Face-to-face semi-structured interviews were conducted within 6-months of referral; three follow-ups were conducted at 6-month intervals. Content analysis of 41 transcribed audio-recorded interviews revealed the longitudinal changes in their relative with cognitive impairment was made caregiving challenging. Three themes described the challenges: (1) Changes related to their relative's cognitive impairment, which included increases in mood fluctuations, erratic behaviours, and reductions in physical abilities; (2) changes in their relative's comorbidities, which included adapting to new symptoms and treatments for a chronic disease, monitoring medication adherence and drug interactions; and (3) changes in caregiver burden, which increased levels of stress, uncertainty, and anxiety resulting in greater role strain. Caregiving became more challenging with time, especially caregivers whose relative developed dementia during the study period. These findings offer insight into the trajectory of the experience of family caregivers attempting to understand changes in cognition, behaviours, and physical functions for their relative with mild cognitive impairment over 2 years, which could help mental healthcare providers develop support services to reduce caregiver role strain.

A systematic analysis of neurologic manifestations of Long COVID in Nigeria.

Long COVID, also called post-acute sequelae of SARS-CoV-2 infection (PASC) affects millions of people in the world. The neurologic manifestations of PASC (Neuro-PASC) are among the most debilitating but they are largely unreported in Africa. We sought to compare the demographics, symptoms and cognitive profile of post-hospitalization Neuro-PASC (PNP) and non-hospitalized Neuro-PASC (NNP) patients in Nigeria. In this cross-sectional study performed at the Lagos University Teaching Hospital, 106/2319 (4.6%) SARS-CoV-2 positive individuals contacted via telephone reported Neuro-PASC symptoms with a higher frequency in PNP than in NNP individuals ((23/200 (11.5%) vs. 83/2119 (3.9%), p = < 0.0001). The predominant neurologic symptoms at any time during the disease course were difficulty remembering / brain fog (63/106; 59.4%), fatigue (59/106; 55.7%), sleep problems (34/106; 32%), headache (33/106; 31%), paresthesia (12/106; 11.3%), and myalgia (10/106; 9.4%). Of 66 participants with Neuro-PASC who underwent in-person neurological evaluation and cognitive screening, all had normal scores on the Intervention for Dementia in Elderly Africans cognition screen, while 11/65 (16.9%) that completed the Montreal Cognitive Assessment had results consistent with mild cognitive impairment (3/16 PNP (18.8%) and 8/49 NNP (16.3%); p = 1.0). Finally, 47/66 (71.2%) had digit span test scores consistent with mild cognitive dysfunction (12/16 PNP (75%) and 35/50 (70%) NNP; p = 1.0). Our findings reveal the previously unrecognized occurrence of Neuro-PASC among COVID-19 survivors in Nigeria and highlight the need for improved screening and diagnosis of Neuro-PASC in our population. Development of cognitive support services for persons suffering from Neuro-PASC in Nigeria is warranted.

Artificial intelligence in higher education: exploring faculty use, self-efficacy, distinct profiles, and professional development needs

Faculty perspectives on the use of artificial intelligence (AI) in higher education are crucial for AI’s meaningful integration into teaching and learning, yet research is scarce. This paper presents a study designed to gain insight into faculty members’ (N = 122) AI self-efficacy and distinct latent profiles, perceived benefits, challenges, use, and professional development needs related to AI. The respondents saw greater equity in education as AI’s greatest benefit, while students and faculty members’ lack of AI literacy was among the greatest challenges, with the majority interested in professional development. Latent class analysis revealed four distinct faculty member profiles: optimistic, critical, critically reflected, and neutral. The optimistic profile moderates the relationship between self-efficacy and usage. The development of adequate support services is suggested for successful and sustainable digital transformation.

Lecturers' Perspectives on Disability and Inclusion in Afghan Higher Education Institutions: A Study Toward Achieving the Sustainable Development Goals

Objective: This study investigates lecturers' insights into disability and inclusive practices within Afghan Higher Education Institutions (HEIs), exploring the challenges and accommodations provided to students with disabilities (SwDs) in alignment with Sustainable Development Goal 4 (SDG 4), which promotes inclusive and equitable education. Theoretical Framework: The study is grounded in the concepts of inclusive education and disability studies. The study draws on the medical and social models of disability to analyze how faculty members perceive and implement inclusive practices. The social model aligns with SDG 4’s emphasis on removing societal barriers to provide equal educational opportunities. Method: This qualitative study uses semi-structured interviews with 27 faculty members from six Afghan HEIs. Purposeful sampling was used to select participants with knowledge of inclusive education. Data were collected through face-to-face and virtual interviews, transcribed, translated, and analyzed using thematic analysis. Results and Discussion: Lecturers demonstrate willingness to support SwDs, but barriers such as inadequate infrastructure, limited faculty training, and societal attitudes persist. The findings highlight that current practices are predominantly shaped by the medical model, limiting inclusivity. Targeted faculty development and institutional reforms are needed to align practices with SDG 4. Research Implications: This research offers critical insights for improving inclusive education in Afghanistan and other low-resource settings, informing policymaking and development of disability support services to achieve SDG 4. Originality/Value: This study is among the first to explore faculty perspectives on inclusive education in Afghan HEIs, providing recommendations for developing inclusive frameworks in conflict-affected and resource-limited contexts.

An insurmountable obstacle: Experiences of Chinese women undergoing in vitro fertilization.

This study aimed to explore the perceptions of women who have undergone unsuccessful in vitro fertilization (IVF) in Hangzhou, Zhejiang Province, China, and to explore how treatment failure has impacted their lives and relationships, thereby enabling the public to understand the unique experiences of these women. A descriptive qualitative approach was employed, with purposive sampling used to recruit participants from the gynecological department of a traditional Chinese medicine clinic at a large tertiary hospital in Zhejiang province. Twelve women undergoing IVF treatment was involved in the study. Data were collected through face-to-face semi-structured interviews, which were transcribed verbatim. Conventional content analysis methods were used to analyze the data. Following analysis, three main categories emerged: 1) The Psychological Experience of Initial Miscarriage from IVF Treatment, 2) The Psychological Experience of Repeated Treatment Failure, and 3) Interpersonal experiences and challenges. Women experiencing initial failure from IVF treatment reported emotions such as surprise, doubt, sadness, disappointment, and embarrassment. They perceived the process as harder than expected, leading to unexpected daily life challenges and difficulties in achieving success. As unsuccessful attempts persisted, they endured psychological suffering and lived in the shadow of repeated treatment failures. Doubts, perplexity, and anxiety grew, making reproduction seem like an insurmountable obstacle in their lives. In their interpersonal experience, women often felt guilt toward family, faced social isolation, and found it challenging to discuss IVF openly everywhere. They encountered a lack of understanding from others but also found mutual sympathy and support among people who shared similar experiences. The study provided an insight into the suffering of Chinese women undergoing IVF treatment, highlighting the challenges of overcoming treatment failures. The findings not only inform Chinese infertile women considering IVF treatment but also contribute to the development of more effective support services by healthcare providers.

Patient experiences in high-grade gliomas: from symptoms to radiotherapy

ObjectivesLittle is known in the literature about felt experience and supportive care needs of patients with new diagnosis of adult-type diffuse gliomas Central Nervous System WHO grades 3 and 4....

Family carers as service producers – insights into psychological contracts

ABSTRACT Family carers and caregiving have a role in the service system but family carers are often invisible and go unnoticed in society. In this article we are interested in family carers as service producers in health and social care. We analyze family care using the concept of a psychological contract. A psychological contract is an unspoken, unconfirmed and unwritten agreement where an exchange is based on perception rather than what is explicitly written and agreed. A psychological contract shapes family carers’ expectations and obligations, while providing a concept for understanding their work. The data were analyzed via theory-driven content analysis. Research question is: what are the features of a psychological contract in a family carer´s work? Data were collected from Finland in 2015. Ten family carers, aged between 64–78 years, who take care of their spouses were interviewed. A psychological contract involves the normative and mental schema of the carers, which direct what kind of care they feel they should provide as a spouse and carer. The psychological contract also guides what kind of support the carers may be willing to accept. The psychological contract clearly shows that family carers are primarily spouses rather than service providers. The concept of the psychological contract provides a workable frame to describe the relationship between family carers and the service system. This study enables the development of family care support services for the needs of family carers.

Oncology Healthcare Professionals’ Awareness and Uptake of the Employee Assistance Programme in Three Public Healthcare Facilities in KwaZulu-Natal, South Africa

Institutional psychosocial support services have gained traction, globally, more so within the context of healthcare facilities. This is mainly due to the recognition that institutional psychosocial support services are beneficial to both employees and employers, alike. However, while these institutional psychosocial support services are important, their uptake remains relatively low. With the focus being on the employee assistance programme (EAP), this study aimed to explore the awareness and uptake of institutional psychosocial support services among oncology healthcare professionals (OHPs) in public healthcare facilities in KwaZulu-Natal (KZN), South Africa. Using the interpretative phenomenological approach, the qualitative study was conducted in three public healthcare facilities that offer oncology services in KZN. Semi-structured in-depth interviews were conducted among 31 participants who were OHPs in the three public healthcare facilities. Thematic data analysis produced two main themes and six respective sub-themes. The main themes were awareness of institutional psychosocial support services and low uptake of institutional psychosocial support services, mainly owing to adequate personal support systems, privacy and confidentiality concerns, and stigma. The study findings point to the need for stronger EAPs that are needs-based, promoted regularly, and evaluated, in public healthcare facilities. To encourage service uptake and address privacy, confidentiality and stigma concerns, innovative and non-stigmatising ways of promoting these services are required, including hybrid approaches to the provision of EAP services. The study findings can provide a valuable contribution to the continued development and strengthening of institutional psychosocial support services in public healthcare facilities.