Client-centered Research Articles

Codesigning training for health providers to improve detection and response to elder abuse.

Screening for elder abuse can improve detection, but many health providers lack the necessary skills and confidence. To address this, training for health providers on elder abuse screening was co-designed as part of a trial aimed at improving elder abuse detection and response. Between March and April 2023, 7 health providers and 10 older people and family carers participated in two national Australian online codesign workshops. Using the World Café method, discussions focused on what knowledge and skills health providers needed for screening; clinical and social issues affecting screening and referral; and support older people needed throughout the process. Data were thematically analyzed. Participants said health providers should take a trauma-informed, person-centered approach to screening, and explain the limits of confidentiality to older people. Clinical, social, and systemic issues such as dementia, ethnic diversity, and housing availability complicated screening and referrals. To facilitate disclosure, participants said health providers needed to reflect on whether they held ageist views. There were differing opinions on the length of the training and if all health providers or only social workers should screen for abuse. Participants' feedback on trauma-informed care, consent, and cognitive impairment concorded with evidence on best practice responses to elder abuse and were integrated in the training. Given operational constraints in health services, feedback from health providers about the training length and the inclusion of all health providers in screening were prioritized. The training is being evaluated in a national trial.

Client characteristics and early working alliance development: A person-centered research approach

Objective Certain client characteristics are associated with early working alliance difficulties in psychotherapy. However, there is limited quantitative evidence on whether combinations of these characteristics (e.g., intersectional identities, prior treatment experiences) are related to alliance development. The present study leveraged a person-centered research approach to examine profiles of early alliance development and differences in the latent class structure of client characteristics among alliance development profiles. Method Individual psychotherapy clients (N = 2,579) rated the working alliance for their first four sessions and self-reported demographics, treatment history, and psychological distress. Therapists provided their assessment of clients’ primary presenting concerns at baseline. Results Latent profile analysis revealed three profiles of working alliance development: high and stable, moderate and increasing, and low and stable. Follow-up person-centered analyses (multigroup confirmatory latent class analysis) indicated that clients in the alliance profiles differed in their combinations of clinical and demographic characteristics. For example, women of color with high baseline distress and a history of prior psychotherapy were over-represented in the low and stable alliance profile. Conclusion These results are consistent with recommendations to holistically consider how clients’ characteristics and experiences shape psychotherapy processes. Results also highlight the utility of person-centered quantitative methods in psychotherapy research.

A Lifeline to Fill the Silence of Homelessness: Person-Centered Analysis of Digital Coping and Links to Mental and Physical Health.

Individuals experiencing homelessness are among the most vulnerable population for mental and physical health disparities. Despite navigating numerous stressors on a day-to-day basis, they are vastly underrepresented within coping research. Using a person-centered approach, this study addresses ways in which technology is leveraged to manage ongoing stressors associated with the experience of homelessness. We employed a two-step and k-means cluster analysis within a sample of unhoused individuals (n = 66). Two distinct clusters emerged, revealing unique patterning of digital coping, stress, self-efficacy, and technology use. Resulting clusters were validated across numerous health outcomes, including mental and physical health problems, as well as digital service use and experience of homelessness. High digital engagement/low self-efficacy individuals (65% of sample) reported high levels of digital self-efficacy, yet lower levels of general self-efficacy. In contrast, low digital engagement/high self-efficacy individuals (35% of sample) engaged in relatively lower digital coping and technology use, with lower stress and higher general self-efficacy. High digital engagement/low self-efficacy individuals, in turn, reported more mental and physical health problems; whereas low digital engagement/high self-efficacy reported somewhat decreased digital access. Relatively few differences emerged between the clusters on experiences of homelessness. Due to the transient nature of unhoused people, reaching such vulnerable populations via technology to support their digital coping and subsequently enhance well-being outcomes represents a critical next step for digital equity. This population is poised to benefit from digital equity efforts, with critical implications for reduced health disparities.

Motivational profiles in instrumental music learning: Perspectives on self-determination theory

This study examined the motivation of child and adolescent music students to learn instruments in five Austrian music schools using a person-centered approach. Drawing on self-determination theory, two autonomous and controlled forms of motivational regulation were surveyed. The results of a cluster analysis ( N = 616) were used to construct four motivational profiles: one autonomously motivated type (high quality), one overall highly motivated type (high quantity), one moderately autonomously motivated type (low quality), and one type with poor quantity motivation. The clusters showed differences in the support required to meet music students’ basic psychological needs in music lessons, which are essential determinants in the development of autonomous motivation, in the individual activity preferences associated with playing an instrument, and in the tendency to stop playing an instrument. No differences were found between the instrument groups and gender. This study provides theoretical and practical implications of a person-centered approach to music-related motivation research.

Development of the iManage SCD mobile health application for transition

ObjectiveThis paper outlines the design and implementation of iManage SCD, a self-management mobile health application for adolescents and young adults (AYA) with sickle cell disease (SCD) during transition from pediatric to adult health care. MethodsThe Integrate, Design, Assess, Share (IDEAS) framework, emphasizing user insights, iterative design, rigorous assessment, and knowledge sharing, guided the development process. The design team consisted of researchers, psychologists, physicians, social workers, AYA with SCD, and parents of AYA with SCD (n = 16) across three states. Qualitative focus groups and interviews were conducted and analyzed using thematic analysis across the integrate and design phases. Point of use feedback from AYA with SCD was used to assess feasibility and acceptability. ResultsThe development process was centered around tenants of the Social-ecological Model of Adolescent and Young Adult Readiness to Transition. Development integrated multidisciplinary perspectives, fostering a person-centered approach. The iterative design process involved collaboration with a digital health firm, Agency39A. Health equity and implementation considerations were addressed at individual, community, and healthcare system levels. Themes that emerged from focus groups with AYA, clinicians, and researchers in the integrate and design phases of development included recommendations for content and user experience features. ConclusionsiManage SCD emerges as a comprehensive, user-friendly mobile health application, incorporating theoretical principles and direct user input. The development process demonstrated feasibility and acceptability, and the paper discusses dissemination strategies for the Community Health Workers and Mobile Health Programs to Help Young Adults with SCD Transition to Using Adult Healthcare Services (COMETS) study.

Health coaching: the node of health literacy & health promotion

Abstract Introduction To achieve sustainable health behaviors and outcomes to move from a precarious health situation to good health, people need to be supported in health literacy in behavior change that ensure interventions’ success. As a non-clinical approach, health coaching aims to increase a person’s levels of self-efficacy, confidence and resilience, by promoting the sense of coherence. This communication aims to identify the benefits that health coaching as a salutogenic approach can trigger. Methods The work is structured in a narrative review of literature and the lived experience of the authors in health coaching. Results The published research on health coaching and the systematic professional experience of the authors highlight: (1) the anchoring of health coaching in the salutogenic model and in the person-centered approach focused on individual characteristics and needs in driving healthy behaviors; (2) health coaching as a collaborative relationship with chronically ill people and people at risk of developing illness; (3) the role of health coaching as a sense of coherence (SOC) promoter; (4) health coaching as a new profession in the healthcare ecosystem (e.g. NHS, UK), cooperating with multidisciplinary teams. Discussion From A.Antonovsky’s model approach to health, the SOC stands out and constitutes one of the basic theories in health coaching interventions, by strengthening the person’s capabilities of comprehensibility, manageability, and meaningfulness. As an emerging profession, with ethical and a growing research foundation, it is facilitated by trained professionals in managing and monitoring health behavior change. Conclusions Health coaching aims to bring relevance, meaning and strategy to a person’s behavioral change. Health coaching demonstrates positive effects on several health parameters by supporting the implementation of health literacy development and empowering people to trigger sustainable changes that lead to healthier lifestyles.

HCA PIECESTM Care Coach Program: Peer to peer approach to promote person-centred care in long-term care

In Long-Term Care (LTC) settings, the potentially inappropriate use of antipsychotics for behavioural and psychological symptoms of dementia is a persistent issue, with high rates despite limited benefit and serious risk. Best practice is a non-pharmacological, person-centred approach to care, though this can be challenging in LTC settings. To help address this gap, we developed the PIECESTM HCA Care Coach Program and described its implementation and outcomes observed at 13 LTC homes. This program empowers Health Care aides with training, tools, and processes to practice the principles of person-centred care and provide peer mentorship to the care team. After 1 year, we found declining antipsychotics use (by 4.4%) and positive indicators of improved staff experience and improved resident quality of life. The Care Coach Program can be adapted and spread to a variety of LTC settings to help reduce potentially inappropriate antipsychotic use and better support people living with dementia.

Integrated Care in Parkinson’s disease: e-training for multidisciplinary team members

Abstract Background Parkinson’s is a high prevalence disease worldwide and training in Integrated Care (IC) for professionals in this field is an obvious need. The SUPER training course is focused on integrated care applied to Parkinson’s disease (PD) and aimed at social and health professionals. Both the content and the training methodology have been co-designed with people living with PD, relatives/caregivers and professionals from Spain and Italy. The course comprises3 training modules (10 units), alongside self-assessment questions, as well as case studies. Accessible open access via an e-learning platform. It is available in English, Spanish, Italian and French enhancing its applicability and transferability. Objectives The SUPER e-training course aims to equip members of multidisciplinary teams with knowledge, skills and competencies in IC applied to PD. Results The course was validated with 89 socio-health professionals in Spain and Italy (M age = 37.28; 75.28% women), who completed a questionnaire assessing the usefulness and quality of the training modules and the platform, as well as an overall evaluation of the training in terms of quality and impact. According to the them: the training could improve the quality of care offered to people living with PD; it is expected to heighten interest in IC, while also introducing novel and invaluable elements. Conclusions This course is useful to train professionals of different profiles (and European contexts) on IC in PC, increasing their knowledge and skills and improving the provision of care to people living with PD. The SUPER multilingual course is an innovative tool because it has been designed from a bottom-up approach and makes available to any professional a free training that can be taken online at any time. Key messages • SUPER training course equips professionals from a holistic, multidisciplinary and person-centred approach to PD. • This multilingual tool aids diverse professionals in social & health care.

Cancer Prevention in People Experiencing Mental Ill-Health: A co-designed Patient Navigation Concept

Abstract Introduction People experiencing mental ill-health have greater disparities in cancer specific morbidity and mortality. Factors influencing cancer prevention include increased risk behaviours and frequent encounters with barriers to health care utilization. The Patient Navigation Model (PNM) has been proven to reduce barriers in accessing cancer preventive care in vulnerable populations. To facilitate successful implementation, the conceptual features of the PNM were co-designed with patients and other relevant stakeholders. Methods Twelve focus groups were conducted in January 2024 at four pilot sites in Austria, Greece, Poland, and Spain. Iterative focus group discussions were carried out following key considerations for the PNM as outlined by DeGroff et al., audio recorded and transcribed verbatim. Transcripts were analysed deductively using a directed content analysis while allowing for potential inductive emergence of codes and topics. A total of 50 participants attended, representing five groups (individuals with mental ill-health, care givers, care team members, representatives of mental health organizations, and representatives of service managers). Results The co-design focus groups allowed for the PNM to be contextually adapted to each pilot site, but similarities in the approach emerged within the following four themes: 1) the requirement for a person-centred approach, 2) consideration of both person-specific and context-specific needs, 3) flexibility and competencies of navigators and 4) variation of navigation services (e.g., improving health literacy, promoting a healthy lifestyle, and providing practical support). Conclusions Participatory approaches in co-designing interventions allow for context specific development of interventions to meet the requirements of people with complex needs. Co-designing the PNM is part of activities of the CO-CAPTAIN project funded by the European Union’s Horizon Europe Programme (GA 101104784). Key messages • The Patient Navigation Model for Primary Cancer Prevention is a tailored intervention aiming to meet the needs of individuals experiencing mental ill-health. • The conceptual features of the Patient Navigation Model for Primary Cancer Prevention were co-designed with patients and other relevant stakeholders.

A systematic review and meta-ethnography exploring personal perspectives of recovery among those with lived experience of non-suicidal self-injury.

Non-suicidal self-injury (NSSI) is a significant public health concern. Research and treatment interventions largely focus on stopping self-injury. People who self-injure do not necessarily equate recovery to cessation. Qualitative accounts allow greater understanding of personal recovery narratives. This study aimed to synthesise personal conceptualisations of NSSI recovery. Participants had lived experience of NSSI and discussed their recovery. Papers not written in English or had a quantitative design were excluded. Four databases (PsycInfo, CINAHL, Medline and Web of Science) were systematically searched. The quality of each paper was assessed using the CASP quality assessment tool. Data were synthesised using a meta-ethnographic approach. Thirteen studies comprising 159 participants were included. Three overarching themes were developed. While ceasing NSSI was an important aspect of recovery for some, recovery was typically viewed more holistically, encompassing developments within the self and relationships. Recovery was regarded an ongoing non-linear journey. The personal and multifaceted nature of the recovery process emerged through a line of argument synthesis. This was the first qualitative synthesis of personal conceptualisations of NSSI recovery. The findings highlighted the personal and multifaceted nature of NSSI recovery and supported person-centred models of self-injury recovery. Clinical implications include the importance of expanding self-injury recovery beyond cessation within research and clinical practice, and for collaborative and person-centred approaches to be embraced when supporting those who self-injure.

How stop smoking outreach works: a co-inquiry informed, complex intervention model

Abstract Background Across Europe, smoking prevalence is concentrating in underserved communities with high levels of deprivation. And yet, there is little research on how stop smoking services (SSS) can engage these communities. This study presents the findings of a 12-month collaboration involving an external public health research team and staff of an English SSS. Staff worked with community partners (e.g., schools) to raise awareness of the service, which included a newly introduced e-cigarette offer. Methods A complex intervention model was developed and refined through 6 facilitated co-inquiry sessions involving 13 SSS staff. Staff also completed 32 reflection forms on outreach events and rapid ethnography was conducted, by the research team, to evaluate staff’s working assumptions. This included 8 observations of outreach events and interviews with 10 SSS staff and 8 community members, from the service target groups. Data were organised into themes. Findings The model presents a picture of stop smoking outreach as challenging, unpredictable and resource intensive yet often having great impact. The themes enrich this to highlight 1) the appreciation for yet unpredictability of outreach referrals for people disconnected from health services; 2) the importance of staff adopting a person-centred approach; 3) the challenges and opportunities presented by e-cigarettes; and 4) the role of strategic community partnerships in optimising staff time on outreach. Conclusions Stop smoking outreach can generate considerable interest in SSS, particularly when delivered in combination with an e-cigarette offer. Future research should explore the economic and social return on investment in community outreach: while time consuming, referrals generated proactively may become more important for SSS as smoking concentrates in underserved communities. Key messages • Stop smoking outreach is an effective way to raise awareness and generate referrals but must be done non-judgementally and via effective community partnerships. • Staff’s careful discussion of an e-cigarette offer can change the perception of SSS without contributing to recreational normalization.

Process evaluation of a randomised controlled trial - prevention of sickness absence through early identification and rehabilitation of at-risk patients with musculoskeletal disorders (PREVSAM)

BackgroundMusculoskeletal disorders are commonly treated in primary healthcare and may, if not treated adequately, entail a risk for long-term disability and sickness absence. A team-based rehabilitation intervention (PREVention of Sickness Absence for Musculoskeletal disorders, PREVSAM) was evaluated in a randomised controlled trial. The purpose of this study was to evaluate the process of implementing the PREVSAM model in primary care rehabilitation.MethodsThis process evaluation was conducted alongside the trial, collecting quantitative and qualitative data to evaluate how the PREVSAM model was implemented, mechanisms of impact, and contextual factors. Acceptability, feasibility, appropriateness, adaptations, training and support, resources, recruitment, reach, retention, dose, fidelity, and readiness for change were investigated. Qualitative data were collected from healthcare professionals and patients.ResultsEight of 22 invited rehabilitation clinics (36%) and 28 of 54 healthcare professionals (52%) were included in the PREVSAM trial and this process evaluation. Of 507 eligible patients, 261 (51%) were included. Of those, 134 were randomised to the intervention and 129 (96%) were retained. Twelve healthcare professionals and 15 patients participated in the qualitative evaluations. The model’s essential components; individual assessments and structured, team-based rehabilitation with clear division of responsibilities agreed in a joint health plan; were generally delivered according to protocol. The optional components early access to psychological treatment and workplace contact were delivered to a lesser extent. Perceived acceptability, feasibility, and appropriateness of the PREVSAM model were moderate to high. Several contextual barriers, in the form of missing prerequisites, affected the implementation. Qualitative data showed that the model, with its holistic view, was appreciated by both healthcare professionals and patients.ConclusionsThis process evaluation suggests that PREVSAM is acceptable, feasible and appropriate for patients with MSDs reporting psychological risk factors associated with increased risk for sickness absence. While essential components were implemented with fidelity for most patients, optional components were not. This variability reflects the complexity of the model, its mandatory and optional components, contextual barriers, and the person-centred approach meeting individual patient needs. As all model components were not delivered to all patients, the intervention may have been too similar to treatment as usual to detect differences on a group level. A limitation of the study is that half of the participating rehabilitation clinics withdrew prematurely.

Reflections beyond the thesis—exploring wellbeing, emotional work and research identity following a PhD

This paper reflects on the experience of my PhD in Interactive Textiles for wellbeing and intends to provide ways for other PhDs to reflect and understand their PhD beyond the data. I provide context for my research, methodology and approach; Research through Design and a Person Centred Approach. Reflecting using the Gibbs Cycle I explore the emotional work required to conduct my studies, particularly within Dementia Friendly Communities. Alongside this I explain how my background and previous experience contributed to my overall approach and identity as a researcher. My key learnings from my experience form an action plan, offering ways for future researchers to; Reflect on and manage wellbeing; Reflect as a researcher working on challenging and emotional topics; Reflect on how researcher identity can influence research approaches. In addition, this paper provides training and networking suggestions.

Exploring Implementation of Reasonable Adjustments in Hospitals for People With Intellectual Disability: Using a Realist Lens.

To explore the factors influencing the implementation of reasonable adjustments in hospitals for people with intellectual disability: using a realist lens. A qualitative study using a realist lens. Data collection involved one focus group interview and three semi-structured interviews with healthcare professionals working in hospital or community settings in September 2023. Data were analysed using qualitative content analysis and findings were mapped to the Context and Implementation of Complex Interventions (CICI) framework across the dimension's context, implementation and setting. Healthcare professionals support the provision of reasonable adjustments in acute hospitals as a person-centred approach to caring for people with intellectual disability. While reasonable adjustments are evident in practice, they are mostly individual-level cases with little evidence of strategic system-level implementation. The factors influencing the implementation of reasonable adjustments in practice were conceptualised using the CICI framework. Context factors spanned the domains of epidemiological (e.g., ageing population), socio-cultural (e.g., historical healthcare), political (e.g., lack of integrated care pathways) and ethical (e.g., provision of person-centred care). Implementation factors spanned the domains of strategies (e.g., leadership strategies), agents (e.g., liaison and advocacy roles) and outcomes (e.g., individual-level reasonable adjustments). The setting for the complex intervention was the acute hospital. System-level indicators for successful implementation include intellectual disability specific policies/procedures for integrated care pathways, education and awareness training for hospital staff, and leadership strategies such as the development of liaison nursing roles and the appropriate allocation of physical and human resources. A radical change is needed where implementation of reasonable adjustments in acute hospitals are broadened beyond isolated individual-level cases to system-level healthcare. This research highlights the importance of exploring the integrated dimensions of context, implementation and setting in complex interventions such as reasonable adjustments and sets foundation for further implementation research in this area. Reasonable adjustments at the system-level within acute hospitals would promote person-centred care and help address the inequities and health disparities experienced by people with intellectual disability. This research uses a realist lens to explore the factors influencing the implementation of reasonable adjustments in acute hospitals for people with intellectual disability. The factors influencing the implementation of reasonable adjustments in practice were conceptualised using the CICI framework across the dimensions of context (domains epidemiological, socio-cultural, political and ethical), implementation (domains strategies, agents and outcomes) and setting. System-level indicators for successful implementation include intellectual disability specific policies/procedures for integrated care pathways, education and awareness training for hospital staff, and leadership strategies such as the development of liaison nursing roles and the appropriate allocation of physical and human resources. This research highlights the importance of exploring the integrated dimensions of context, implementation and setting of complex interventions such as reasonable adjustments and sets a foundation for further implementation research in this area. This research adhered to the Equator research reporting guideline: standards for reporting qualitative research. A parent of a child with intellectual disability was involved in the conduct of this research, specifically in the design, data collection and preparation of the manuscript.

Identification of research gaps to improve care for healthy ageing: a scoping review

ObjectiveSeveral research gaps affect the improvement of care for healthy ageing. Their identification is crucial to developing a specific research prioritisation agenda supporting progress at the micro (clinical), meso (service...

Profiles of refugee-related trauma exposure and depression among North Korean refugees in South Korea: A latent class analysis.

North Korean refugees (NKRs) exhibit alarmingly high levels of depression prior to or immediately after entering South Korean society, which is likely attributable to their pre-migration traumatic experiences. However, prior research on NKRs has simply examined the cumulative effect of trauma on depression. Despite calls for research identifying trauma exposure patterns that co-occur among refugees, to date, no study has investigated distinct profiles of NKRs' pre-migration trauma exposure and their associations with depression in this high-risk population. To better understand the unique mental health needs of NKRs and provide them with tailored care, it is imperative to identify meaningful subgroups of NKRs with distinct profiles of trauma exposure. Using latent class analysis (LCA), which is a person-centered approach, this study aimed to identify subgroups of NKRs based on trauma exposure and their associations with sociodemographic characteristics and depression levels. A sample of NKRs (N = 405) in South Korea were assessed for depression, pre-migration trauma, and sociodemographic covariates through a self-administered survey. LCA was conducted to identify trauma exposure classes and multivariate ordinary least squares regression analysis was performed to examine associations between trauma exposure classes and depression. The prevalence of clinically significant depression was 47.2% for our study sample. Three classes of trauma were identified: deprivation trauma and witnessing death (59.3%), complex and pervasive trauma (23.7%), and low exposure (17.0%). Members in the complex and pervasive trauma class demonstrated very high probabilities of exposure to all traumatic events and had the strongest association with elevated depression. Our findings underscore the importance of identifying subgroups of NKRs to unravel heterogeneity in trauma exposure and provide more nuanced explanations for different risk profiles regarding depression. These findings also provide evidence for a framework for clinicians to provide individualized resources and trauma-informed services to NKRs.

Muggle, Juggle, Snuggle, and Struggle: profiles of parenting experiences of mothers and fathers in South Korea during the COVID-19 pandemic

ABSTRACT The current study expands the literature on parenting during the COVID-19 pandemic by considering how much time spent on childcare increased and how the time was perceived by mothers and fathers in South Korea. Using the perspective of family systems theory and taking a person-centered approach, this study examined how parental experiences differ according to parental gender and investigated subgroups of mothers and fathers in terms of parental experiences during the pandemic. This study also examined how those groups differ in terms of the factors of family subsystems, adaptive self-organization, and sociodemographic variables. With a sample of 372 mothers and 366 fathers in South Korea, this study employed latent profile analysis and identified four distinct subgroups of mothers and fathers: Muggle, Juggle, Snuggle, and Struggle. Some parents feel like muggles, managing short childcare times without much joy or challenge, whereas others juggle long hours with their children, finding both joy and difficulty. Some snuggle, enjoying their extended childcare time with delight, whereas others struggle, facing the hardships of prolonged childcare without much enjoyment. The overall profile patterns and the ratios of these profiles were similar for both mothers and fathers. Suggestions for future researchers, practitioners, and policy-makers are discussed.

Satisfaction with Life Among Elderly Participants in Active Maturity Groups: A Comparative Study with Institutionalized and Community Elderly Individuals

Objective: To compare levels of life satisfaction among three distinct groups of elderly individuals: those residing within the community, those in institutional care, and those engaged in an active aging program. Additionally, to explore the factors associated with this measure of well-being within each group. Methods: This cross-sectional study was conducted from September 2022 to May 2023. Participants aged 60 years or older were recruited from three groups: community-dwelling individuals, those in institutional settings, and participants in an active aging program. Data collection included sociodemographic variables, self-rated general health status, duration of sedentary behavior, levels of intrinsic religiosity, feelings of hope, and degrees of social isolation. The primary outcome assessed was life satisfaction. Results: The study included 305 elderly individuals: 115 (37.7%) from the active aging program, 119 (39.0%) from the community, and 71 (23.3%) institutionalized individuals. Institutionalized participants were older, engaged in longer durations of sedentary behavior, had lower educational attainment, and reported poorer health perceptions. Multiple linear regression analysis revealed that hope, social isolation, and self-rated health were significantly associated with life satisfaction. Conclusion: The findings highlighted the importance of hope, social support, and self-rated health as primary determinants of life satisfaction among the elderly. Contrary to the initial hypothesis, group affiliation (community, active aging program, or institutionalized) did not emerge as a significant factor, suggesting the need for personalized, person-centered approaches to optimize elderly well-being.

Social connection in long-term care homes: a qualitative study of barriers and facilitators

BackgroundSocial connection is a basic human need and is essential to quality of life. It is associated with better mental and physical health outcomes for long-term care (LTC) home residents and is a key aspect of quality of care and person-centred care. There are considerations for LTC homes that may present obstacles to and opportunities for social connection. It is therefore important to understand what restricts or enables good social connection in LTC homes, to guide better quality care and future interventions in this population. This qualitative study aims to identify barriers and facilitators to social connection for LTC residents.MethodsWe used thematic analysis to describe themes derived from individual and group qualitative interviews from 67 participants (18 residents, 17 staff members and clinicians, 32 family members and friends) recruited from LTC homes in the United Kingdom and Canada.ResultsThemes were grouped into four categories: (1) becoming familiar with life in the LTC home to support social connection; (2) physical and virtual access beyond the LTC home as strategies to maintain contact; (3) getting to know residents to deepen relationships; (4) person-centred approaches to build social connection. ‘Becoming familiar with life in the LTC home to support social connection’ described the benefits of counteracting the institutionalized feel of LTC homes, enabling LTC residents to spend time in meaningful ways, and increasing freedom of mobility around the home. ‘Physical and virtual access beyond the LTC home as strategies to maintain contact’ related to the benefits of outings, providing support with technology, and involving family and friends in LTC home life. ‘Getting to know residents to deepen relationships’ related to the benefits of using routine care and interactions as opportunities for social contact, using family and friend knowledge as a resource, and fostering resident relationships. ‘Person-centred approaches to build social connection’ included considering physical, mental, cognitive, and sensory impairments, accounting for adjustment and sociability, using communal spaces well, and prioritizing psychosocial needs.ConclusionsThis study identifies barriers and facilitators to social connection for LTC residents which can be addressed in care policies, staff selection and training, and can inform policies and interventions to build and maintain social connection in LTC homes.Clinical trial numberclinicaltrials.gov ID NCT05315960.

Person-centered and qualitative approaches to network analysis in physics education research

Network analysis has become a well-recognized methodology in physics education research (PER), with study topics including student performance and persistence, faculty change, and the structure of conceptual networks. The social network analysis side of this work has focused on quantitative analysis of whole-network cases, such as the structure of networks in single classrooms. Egocentric or personal network approaches are largely unexplored, and qualitative methods are underdeveloped. In this paper, we outline theoretical and practical differences between two major network paradigms—whole-network and egocentric—and introduce theoretical frameworks and methodological considerations for egocentric studies. We also describe qualitative and mixed-methods approaches that are currently missing from the PER literature. We identify areas where these additional network methods may be of particular interest to physics education researchers and end by discussing example cases and implications for new PER studies. Published by the American Physical Society 2024