Staff Focus Research Articles

Evaluation process use in the University Capacity Development Programme at Walter Sisulu University, South Africa

Background: The higher education (HE) policy framework identifies funding inter alia as one of the steering mechanisms, for the transformation of HE in South Africa. However, the role of monitoring and evaluation (ME) in facilitating this transformation is still emerging. While the instrumental use of evaluation findings is common, research on how process use can also play a critical role in facilitating sector change is missing.Objectives: The study investigated the use of process evaluations in enhancing the performance of the University Capacity Development Grant in a previously disadvantaged institution in the Eastern Cape province.Method: Purposive sampling was used as a method to select the participants. The case study design, interpretive paradigm and qualitative methods approach were adopted, and data were collected through individual semi-structured interviews, focus groups and document review. The study sampled 17 participants, including the Department of Higher Education and Training officials, the University Capacity Development Programme (UCDP) management and two staff focus groups.Results: If process use is to be strengthened, the evaluation process must be highly adaptable to specific programmatic circumstances and organisational contexts.Conclusion: Evaluation process use, in its practical form, must go beyond issues of participation from an individual perspective and include organisational and stakeholder management for effective implementation.Contribution: The study’s results are pivotal as they would assist different organisations worldwide that are running similar projects as the UCDP but have not yet understood the benefits that would be obtained by key stakeholders involved in an evaluation process.

Are Cooked Nutritious School Lunches Associated with Improved Attendance? Findings from the 2022-2023 Tasmanian School Lunch Project.

Background/Objectives: During 2022-2023, the School Lunch Project (SLP) provided free nutritious cooked lunches 1-4 days per week to Kinder to Grade 10 students attending 30 schools in areas of high disadvantage in Tasmania, Australia. This analysis examined if the SLP was associated with student attendance. Methods: Staff (teachers, support staff, and principals) from 12 schools completed an online survey and/or participated in focus groups/interviews. Government-held, objectively measured, grade-level attendance data were provided for 17 SLP and 11 matched comparison schools for 2018-2023. Linear mixed models compared attendance on school lunch and non-school lunch days in SLP schools. Difference-in-difference regression compared attendance between SLP and comparison schools. Qualitative data were analysed thematically. Results: Sixty-five staff completed surveys, where 22% reported that increased attendance was a benefit of the SLP. Similar findings were observed in the staff focus groups/interviews (N = 51). Mean attendance was similar on school lunch and non-school lunch days among the SLP schools during 2022 (difference: 0.04, 95% CI: -0.5, 0.6) and 2023 (difference 0.1, 95% CI: -0.2, 0.4) and similar between SLP and comparison schools (average treatment effect in the treated: 1.2, 95% CI: -0.7, 3.0). Conclusions: The SLP was perceived by some staff to improve attendance but was not associated with objectively measured attendance examined at the grade level.

Improving the assessment of cultural, religious and spiritual needs for patients at the end-of-life within an acute hospital trust

BackgroundCultural, religious and spiritual (CRS) needs become increasingly important to individuals as they approach the end of life. CRS needs often remain unmet for patients dying in an acute hospital...

A framework for decolonising and diversifying biomedical sciences curricula: rediscovery, representation and readiness.

To date, most efforts to decolonise curricula have focussed on the arts and humanities, with many believing that science subjects are objective, unbiased, and unaffected by colonial legacies. However, science is shaped by both contemporary and historical culture. Science has been used to support imperialism, to extract and exploit knowledge and natural resources, and to justify racist and ableist ideologies. Colonial legacies continue to affect scientific knowledge generation and shape contemporary research priorities. In the biomedical sciences, research biases can feed into wider health inequalities. Reflection of these biases in our taught curricula risks perpetuating long-standing inequities to future generations of scientists. We examined attitudes and understanding towards decolonising and diversifying the curriculum among students and teaching staff in the biomedical sciences at the University of Bristol, UK, to discover whether our current teaching practice is perceived as inclusive. We used a mixed methods study including surveys of staff (N = 71) and students (N = 121) and focus groups. Quantitative data showed that staff and students think decolonising the curriculum is important, but this is more important to female respondents (P < 0.001). Students are less aware than staff of current efforts to decolonise the curriculum, while students from minority ethnic groups feel less represented by the curriculum than white students. Thematic analysis of qualitative data revealed three themes that are important for a decolonised curriculum in our context: rediscovery, representation and readiness. We propose that this '3Rs framework' could guide future efforts to decolonise and diversify the curriculum in the biomedical sciences and beyond.

Understanding Perceptions to Improve Intervention: HIV Risk Behavior, Testing and Prep Uptake Among Male African American and Latinx Justice-Involved Young Adults

Abstract: Justice-involved young adult (JIYA) men are at high risk for HIV, yet frequently do not access HIV services. A better understanding of testing behaviors and motivation, as well as facilitators and barriers to testing is necessary for treatment-as-prevention approaches to be implemented among JIYA. Seventeen JIYA men and nine staff were recruited from three alternative sentencing programs (ASPs). In-depth interviews and a staff focus group explored HIV risk and testing uptake behaviors. Narratives from JIYA demonstrated a lack of connection among HIV risk and behavior, views on testing, and knowledge of PreP. Youth and staff also disclosed various youth and environmental/structural barriers to HIV testing. The justice system may be a crucial point of intervention to reduce HIV risk and promote HIV testing with interventions targeted to the needs of JIYA.

Challenges With School Meal Provisions in K-12 Public Schools: Findings From the National School COVID-19 Prevention Study.

School meals play a vital role in supporting student health. Access to school meals was disrupted during COVID-19-related school closures, impacting student nutritional intake and household food insecurity. Data from the National School COVID-19 Prevention Study Survey and school staff focus groups were used to examine challenges to school meal provision in K-12 public schools. Data were analyzed using R and MAXQDA. Survey data indicated that most schools served breakfast and lunch in the cafeteria or classroom during the 2021-2022 school year. City schools were less likely to experience challenges with receiving the foods and supplies needed for school meal programs. Qualitative data revealed that school meal participation increased during the COVID-19 pandemic, however schools encountered challenges when implementing the program including staff shortages and supply chain issues. Findings from this study can help strengthen the K-12 school meal system to equitably serve students in future public health emergencies.

Parent and staff focus groups to address NICU racial inequities: "There's radical optimism in that we're in a different time and we're not doing it alone".

To understand local mechanisms of racial inequities and generate recommendations from community members regarding how to promote racial equity in the Neonatal Intensive Care Unit (NICU). In an urban tertiary care NICU, 4 semi-structured in-person focus groups with follow-up audio diaries were conducted with NICU parents and staff from 2022-2023 with support from interpreters, a psychologist, and a family advocate. Researchers coded transcripts independently and thematic analysis was utilized to generate and refine themes. 16 racially diverse and multidisciplinary staff and parents participated, and six themes emerged from the data. Mechanisms of racial inequities included power dynamics, interpersonal and institutional dehumanization, and societal inequities. Recommendations included redistributing power, transforming space and staff to promote humanism, and mitigating harm through peer support and resource allocation. Focus groups are a promising strategy to identify interventions to address racial inequities. Future research should focus on intervention implementation and evaluation.

"It's a fight - the whole personality of the patient to win." The development of concepts of psychosis in the Jewish Hospital in Warsaw, 1898-1943.

This study investigates the development of concepts of psychosis in the Jewish Hospital in Warsaw, within the context of social and historical processes to which the hospital was the subject and a broader scope of European concepts of psychosis. In the years 1898-1909, the first chief physician of the psychiatric ward, Adam Wizel, focused mainly on hysteria. The interest in psychoses was initiated by Maurycy Bornsztajn, who started to promote psychoanalytic ideas. The second decade of the functioning of the Jewish Hospital's psychiatric ward was marked by issues concerning the classification of psychoses. In the third decade, after Poland regained independence, psychosis became the main focus of the hospital's staff. Newly appointed psychiatrists, Gustaw Bychowski and Władysław Matecki, contributed substantially to the psychoanalytic understanding of psychosis. Bornsztajn continued to develop his psychoanalytically based concept of psychosis. Wizel changed his attitude toward psychoanalysis and acknowledged the importance of Freud's discoveries. Władysław Sterling contributed to the biological understanding of schizophrenia. In the last period, 1931-1943, the Jewish Hospital in Warsaw struggled with the consequences of the economic crisis in Poland, Wizel's death, and Bychowski's departure, which resulted in the reduced number of publications in the field of psychosis. Nevertheless, Bornsztajn managed to further develop his concept of somatopsychic schizophrenia and Matecki introduced the category of pseudo-neurotic schizophrenia. The psychoanalytic approach developed by Wizel, Bornsztajn, Bychowski, and Matecki was supplemented with other influences, especially phenomenology. Wizel, Bychowski, and Matecki were advocates of the psychoanalytic psychotherapy of psychotic patients.

IRAMP: Investigation of Risk Assessment and Management Processes Using Staff Focus Groups

IRAMP: Investigation of Risk Assessment and Management Processes Using Staff Focus Groups

A pilot exploration of staff and service-user perceptions of a novel digital health technology (Virtual Engagement Rehabilitation Assistant) in complex inpatient rehabilitation

Purpose Digital health technologies have the potential to advance rehabilitation. The Virtual Engagement Rehabilitation Assistant (VERA) is a digital technology, co-designed to increase service-user engagement and promote self-management. This qualitative study explored staff and service-user perceptions of implementing VERA on a UK complex inpatient rehabilitation ward. Methods Purposively sampled service-users were allocated to VERA for up to six weeks. The Non-adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework underpinned service-user post-intervention interviews and staff focus groups, and structured analysis of the data. Seven service-users were interviewed. Nine staff contributed to focus groups. Results A framework analysis identified themes (and subthemes) structured by the NASSS framework domains: 1. Nature of Clinical Condition, 2. Technology (Ease of Use, Holding Information/Resources in a single Digital Location, Appointments), 3. Value Proposition (Structuring Time, Feedback, Unexpected Benefits) 4. Adopters (Confidence in using Technology, Usefulness), 5. Wider Organisation. Ease of use and storage of key information in a single location were beneficial. Reliability, and provision of accurate and timely feedback to staff and service-users, were identified as essential. Conclusions A blended approach is required to meet staff and service-user needs. The potential for VERA in a community setting was identified and requires further investigation. Learning from VERA will support development of other digital technologies and their implementation.

By design

This paper takes a design research approach to the challenge of transforming learning and teaching in higher education (HE) as it is experienced at the level of an interdisciplinary team composed of content matter experts and specialists in education. It is based on the reflections of members of the team working collaboratively to transform an undergraduate biology unit, delivered in intensive mode in parallel with a standard teaching semester to improve both student engagement and teaching staff satisfaction. The unit learning design tests 21st century active learning pedagogies in the context preparing students for their professional lives. Using semi-structured interviews and reflective inquiry the authors attempt to uncover the salient features of the process of implementing technology enhanced learning, and generate constructive design solutions. The work is situated in the scholarship of learning and teaching as it encourages "reflection-in-action" and a commitment to sharing what works in STEM teaching and learning in contemporary environments. The teaching team focus on the complex problems of preparation, attendance, and engagement in a series of intensive labs, whilst the professional staff focus on the complex problems of innovation and student engagement in higher education. A number of known and hypothetical learning design principles are integrated with the affordances of the chosen learning environment (OneNote) and used to propose plausible solutions. These solutions are used to iteratively refine the learning environment and reveal new design principles. The data shows improved staff engagement with the unit and the students through an enhanced role in the application and development of modern pedagogies. The paper emphasises the benefits of providing for and supporting the emergence of microcultures, and suggest strategies for those that wish to emulate the approach taken.

Education and Literacy Impact of Excellence Quality Management on Innovative Organizations in Basic Schools under Nonthaburi Provincial Administrative Organization, Thailand

The objectives of this study were to study (i) the excellence in quality management of basic schools in the Nonthaburi Provincial Administrative Organization, (ii) the innovative organization of basic schools at the Nonthaburi Provincial Administrative Organization, and (iii) the excellence in quality management affecting the innovative organization of primary schools under the Nonthaburi Provincial Administrative Organization. The study involved 240 participants, encompassing administrators, heads of learning groups, and teachers. The research instrument utilized was a questionnaire, and statistical analyses such as frequency, percentage, mean, standard deviation, and stepwise multiple regression analysis were employed to analyze the collected data. Findings reveal significant insights: The study highlights a high level of practice in excellent quality management in basic schools, ranking in descending order as follows: student and stakeholder focus, performance results, strategic planning, faculty, and staff focus, measurement, analysis and knowledge management, process management, and leadership. The innovative organization of basic schools encourages high-level ranking in descending order: key individual, appropriate organizational structure, creative raising climate, effective teamwork, long-term stability, boundary spanning and learning exchange, high-involvement innovation, shared vision, and intention to create innovation. The study excellence quality management five variables: performance results, leadership strategic planning, process management staff focus that affected the innovation organization of primary schools under the Nonthaburi Provincial Administrative Organization, totaling 84.70 percent, written as a regression analysis equation as follows Ytot= 0.080 + 0.269X7 +0.091X1 + 0.231X6 + 0.164X2 + 0.133X5.

Mixed Method Evaluation of ACTS: Advancing Connection Through Storytelling-A Novel Approach to Improve Older Adult Engagement and Staff Interactions in Korean Nursing Homes.

A culture centered on relationships and communication is necessary to improve the quality of life of older adults living in nursing homes. To examine the effects of a storytelling program by examining the cognitive, emotional, and psychosocial changes in older adults in facilities and explore staff experience of changes in care. This mixed method study delivered a 6-week storytelling program based on relationship-centered care for residents of nursing homes (aged >65 years). Changes in emotional expression, depression, communication skills, social support, interpersonal relationships, nurse-patient interaction, and the person-centered environment as perceived by older adults were quantitatively analyzed using pre-intervention and post-intervention surveys. Qualitative data were collected through weekly stories created by residents, followed by focus group interviews with nursing home staff, analyzed using reflexive thematic analysis to enhance understanding of the program's outcomes. The 42 residents reported significant changes in their emotional expression, depression, communication skills, social support, interpersonal relationships, nurse-patient interaction, and person-centered environment scores after the 6-week intervention. Analysis of the residents' stories identified 5 themes. The staff focus group interviews identified 2 themes and 7 subthemes. Intervention group residents were more likely to initiate conversations, express themselves, carefully observe themselves and others, and actively participate in social activities. The storytelling program was useful in reducing older adults' negative emotions by allowing them to express their thoughts and feelings and improve their relationships, creating opportunities for social interaction. These effects could help foster relationship- and communication-centered facility cultures.

The Right to Equal Health: Best Practice Priorities for Māori with Bipolar Disorder from Staff Focus Groups.

Bipolar disorder (BD) is a serious mental health condition that is clinically complex to monitor and manage. While best practice guidelines exist, they vary internationally lacking consensus. Indigenous peoples, including Māori in New Zealand, experience higher community rates of BD. While New Zealand practice guidelines recommend providing culturally responsive care to Māori, studies show that Māori do not receive best practice. This qualitative study aimed to share the evidence about patterns of health service use and Māori patient experiences with focus group participants involved in the design and delivery of BD services, to discuss and develop guidelines for best practice for Māori with BD and address areas of unmet need. Three focus groups were conducted with 22 participants involved in the delivery of services to Māori with BD across three sites. Willing participants were sent background information and three focus group questions framed to elicit priority solutions to improve clinical, structural and organisational features of mental health service delivery for Māori patients with BD and their whānau (family). The nominal group technique was used to synthesise responses, and then develop a prioritised list of proposed solutions. Results identified system-level changes required at the clinical, structural and organisational levels of healthcare. Findings further evidence the need for healthcare reform in New Zealand, to be responsive to Māori with BD.

Innovative Behaviour and Opportunity Recognition in Food and Beverages Firms, Port Harcourt

The study examined innovative behaviour and opportunity recognition of food and beverages firms in Port Harcourt. The study used a correlational research methodology, and the population consisted of 25 food and beverage businesses in Rivers State. The study used a census survey with a managerial staff focus in addition to its population of 25 food and beverage companies. One hundred twenty-five (125) copies of the questionnaire were made available in total. The data collected for this study were analyzed through descriptive and inferential statistics. The Spearman Rank-Order Correlation Technique was employed to test the various hypotheses formulated with the aid of the Statistical Package for Social Sciences (SPSS). From the data generated and analysed, it was empirically discovered that a positive and significant relationship exists between Innovative Behaviour and Opportunity Recognition of food and beverages firms in Port Harcourt. Problem solving and creativity showed a strong positive relationship with s opportunity recognition of food and beverages firms in Port Harcourt. The study concluded that engaging in innovative behaviour will achieve bumper success in many food and beverages firms. Following the conclusion above, the study therefore recommends that; Food and beverages firms in Port Harcourt should adopt problem solving approach to take advantage of market opportunities and improve sales and also food and beverages firms should be creative and innovative, especially through new product development, being first to market with new products.

Side Effects and Solutions of CAR-T Treatment

Cancer poses a significant threat to human health. It is a kind of complex and severe diseases characterized by the expanding of abnormal cells in the whole body due to uncontrolled growth. If left untreated, cancer with metastasis can invade nearby tissues, spread to other parts of the body, and impair the normal functioning of organs and systems. There are some treatment methods for it, such as surgery, chemical therapy and radiation. The field of immunology has made tremendous strides in understanding how the immune system works and how it can be harnessed to fight disease. Immunotherapy has become a rising solution in recent years. CAR-T therapy belongs to immunotherapy using genetically modified T cells with receptors of tumor antigens to specifically eliminate cancer cells, which is a promising approach for cancer patients. However, there are still some issues that remain to be resolved to make it wider using in treatment of cancer patients. For example, CAR-T therapy occurs severe side effects sometimes, even induced patients die, although it has been approved application in clinic since 2017, however, limited studies investigated its adverse reactions. Therefore, in the present, the author provides a comprehensive overview of the side effects of CAR-T therapy from reduction of therapeutic effects of antigen escape, to induction patients die of severe cytokine storms, then discusses corresponding treatment measures, which purpose is to help guide treatment for patients, make clinical staff focus on its side effects and provide some ideas for research and development in the future.

Nursing staff adherence to guidelines on nutritional management for critically ill patients with cancer: A service evaluation.

Critically ill patients with cancer are at high risk of developing malnutrition, negatively affecting their outcome. To critically analyse nursing staff's adherence to nutrition management guidelines for critically unwell patients with cancer and identify barriers which prevent this. Two areas of nutrition management were evaluated: early initiation (<48 h from admission) of enteral nutrition (EN) and continuation of EN without interruption. A retrospective data analysis was performed on mechanically ventilated adult patients admitted to a single cancer centre. Data from electronic patient records (EPR) were collected. Health care professionals' (HCP) documentation was analysed, and a nursing staff focus group (n = 5) was undertaken. Sixty-four patient records were included. Early EN was not administered in 67% (n = 43) of cases. The reasons for the three longest interruptions to EN feed were as follows: delays in EN tube insertion, gastric residual volumes (GRVs) less than the recommended feed discontinuation threshold and endotracheal intubation. Four main themes relating to barriers to practice were identified from the focus group data analysis: HCPs' approach towards nutrition management, the patient's physiological condition and stability, multi-disciplinary team (MDT) communication and guidance on nutrition management, and practical issues with patient care. Multi-disciplinary communication difficulties, lack of clear guidelines and inadequate awareness of the importance of nutrition for critically ill patients with cancer were barriers identified preventing optimal nutrition management. Nursing education is fundamental to help break down the barriers to practice which prevent critically ill patients from receiving optimal nutrition management.

Attitude towards the risk-based approach implementation into the russian healthcare system among employees of medical organizations

Aim of the study was to develop recommendations for improving procedures and unifying the content of risk management of the healthcare system to preserve public health based on an analysis of the opinions of doctors, organizers and experts of the healthcare system. Material and methods. As part of a quantitative online survey conducted from September to December, 2022, 104 respondents working in the healthcare system of the Russian Federation were interviewed. Additionally, 6 in-depth interviews were conducted with the organizers and experts of the healthcare sector as part of a qualitative sociological study. Desk research included analysis of scientific literature, and the regulatory framework related to the introduction of a risk-based approach to healthcare. Results and discussion. The article presents an analysis the perception of risks in healthcare by doctors, organizers and experts at the level of a medical organization, of the healthcare system and of public health (macro level), with the identification and classification of the main risk groups, on the basis of which risk-management’ measures can be built. The results of the study testify to the insufficiently deep introduction of risk management into the management system of medical organizations. The half of the respondents noted the low and extremely low level of risk management principles’ usage in their own organizations (50 % of respondents) and in Russian medical organizations in general (58.6 % of respondents). At the same time, from a third to a half of the participants found that it was difficult to answer about risk management implementation in their organizations, due to the lack of a unified methodology, imperfection of standards and quality control system of this set of measures, lack of specialists who could manage risks, lack of educational activities. To introduce a systematic approach to the unification of risk management processes, it is necessary to develop and approve the methodology of best practices, as well as take care of the training of specialists. Conclusions. In order to implement a systematic approach to the unification of risk management processes, it is necessary to develop and approve a methodology of best practices, as well as to take care of the training of specialists. It is imperative that hospital managers and staff focus on improving the organizational culture of patient safety management as the basis for their mission to preserve public health. It is necessary to continue further research in this direction in order to develop a strategy for countering risks at the level of public health as a medical and social resource of society.

Aphasia disrupts usual care: “I’m not mad, I’m not deaf” – the experiences of individuals with aphasia and family members in hospital

Purpose Communication difficulties are highly prevalent in the stroke population, with implications for patient experience, safety and outcomes. This study explores the experiences of people with aphasia and family members regarding healthcare communication in acute and subacute stroke settings. Methods and materials A phenomenological approach was used to understand participants’ experiences. Participants took part in a focus group and data were analysed using an inductive thematic approach. Results For individuals with aphasia (n = 4) and family members (n = 2), five themes were generated: “aphasia makes it hard to communicate,” “hospital staff focus on the patient’s medical status only,” “people with aphasia do not get the help they need to improve,” “staff lack the skills to communicate with people with aphasia,” and “staff are crucial to improving healthcare communication.” Conclusions The stroke team has expertise in the medical management of stroke but struggle to communicate with patients with aphasia. Patients’ experience of healthcare communication is often one-way and limited to following instructions, with missed opportunities to discuss core topics such as prognosis, rehabilitation, and person-specific needs. Patients and families assert that all members of the stroke healthcare team should be able to adapt communication to accommodate patients.

Relationship between fear of progression and quality of life in inflammatory bowel disease: Mediating role of health literacy and self-care.

The increasing prevalence of inflammatory bowel disease is emerging as a significant global healthcare concern due to its recurrent episodes of intestinal inflammation. This study aims to explore the relationship between fear of progression and health-related quality of life in inflammatory bowel disease patients, investigating the sequential mediating roles of health literacy and self-care. A cross-sectional study. Eligible participants diagnosed with inflammatory bowel disease were recruited through convenience sampling method at a tertiary hospital in Shenyang, China, between May 2022 and May 2023. A total of 241 participants completed the questionnaires regarding fear of progression, health literacy, self-care and quality of life. Data analysis was conducted using SPSS 25.0 and PROCESS plug-ins. (1) Fear of progression was found to be negatively associated with quality of life and had a directly predictive effect on quality of life. (2) Health literacy and self-care could independently mediate the relationship between fear of progression and quality of life. (3) There was a significant chain mediating effect of health literacy and self-care in the relationship between fear of progression and quality of life. Fear of progression could not only directly predict the quality of life in inflammatory bowel disease patients but also indirectly affect their quality of life through the chain mediation of health literacy and self-care. This study highlights the importance of nursing staff focusing on the interplay between fear of progression, health literacy, self-care and quality of life in caring for inflammatory bowel disease patients. Understanding the potential correlation mechanism underlying quality of life may help develop targeted care interventions to synergistically enhance health literacy and self-care in these patients. STROBE guidelines. No public or patient contribution.