Practitioner Perspectives Research Articles

Seeking to fulfil the human rights promise: practitioner perspectives and an assessment tool for realizing human rights based social work education and practice

ABSTRACT International social work organizations emphasize human rights (HR) as a main social work principle. However, a focus on HR is often lacking in social work education. This often results in an inspirational, rather than deep and meaningful application of HR commitments in social work practice, with kindness and respect being conflated with a realization of HR. Nevertheless, without a critical HR awareness, social workers may inadvertently neglect or hinder service users’ rights. This article presents the findings of an exploratory study which examined, through in-depth interviews with six practitioners working in HR sensitive contexts in Spain, how the experience (or lack thereof) of HR education influences practitioners’ engagement with HR. Findings indicate that, for social workers to overcome inspirational approaches and achieve an HR based social work practice, training and support mechanisms need to be developed at different contexts: 1. In social work education, importantly including social work placements and a practice orientation of teaching 2. At social work services’ organizations and 3. At the broader social work professional organizations and political-institutional contexts. Drawing on the findings, the researchers developed a Human Rights Practice Assessment Tool to support lecturers, students and practitioners in applying HR principles meaningfully in social work.

Adverse drug reactions in older people following hospitalisation: a qualitative exploration of general practitioners' perspectives.

Older people have greater comorbidity and medication burden. Adverse drug reactions occur in up to 30% of older people within one month of hospital discharge. General practitioners are key stakeholders in transitions of care from hospital to the community. The study aimed to explore general practitioner perspectives of adverse drug reactions in older people after hospitalisation, investigating the medication-related issues encountered and possible approaches to reduce the risk. An invitation to participate in the study was sent to general practitioners in Southern Tasmania, Australia. A semi-structured interview occurred in person at their practice or online. The questions covered experiences with managing medication in older people after hospital discharge, challenges and risks involving adverse drug reactions and suggestions to prevent adverse drug reactions. The interviews were transcribed and analysed through thematic analysis. Twelve general practitioners were interviewed, revealing four themes describing challenges, including (i) complex patients and acceptance of risk, (ii) patient confusion and decline in hospital, (iii) time taken to manage older patients and (iv) communication challenges. Three themes describing recommendations were identified, including (i) clear communication on discharge, (ii) patient involvement and (iii) roles for pharmacists. Prevention of adverse drug reactions after hospital discharge may require clear and timely communication to general practitioners, patients and families to be educated and empowered to help manage their own health and risk, and pharmacists to support both patients and general practitioners in managing the risks.

Evaluation capacity building in theory and practice: Revisiting models from practitioner perspectives

AbstractThis article seeks to bring practitioner experience to bear on existing models of ECB with a particular focus on the models through the lens of our own ECB practice. We reflect on how our ECB practices align with or challenge these models, and how the insights that come from those reflections can inform future ECB research and frameworks for evaluating ECB initiatives. As is often the case when theory collides with practice, current models may not always reflect and serve the work at hand, and the value and usefulness, as well as accuracy and relevance, of existing models is worth investigating. With this in mind, we offer input to inform future models of ECB that are more inclusive of and relevant for the broad spectrum of current ECB practice and, subsequently, its evaluation.

From Novelty to Clinical Practice: Exploring VR Exergames with Physical Therapists

The COVID-19 pandemic, the rise of telehealth and virtual medicine, and the increased accessibility of commercial VR headsets have created opportunities to revitalize the physical therapy field and introduce more innovative tools to complement traditional practice. Researchers are actively exploring the intersection of VR, exergames, and gamified exercise to create new products that can improve both provider efficiency and patient care. This study builds on that momentum by delving into the perspectives of practitioners. We interviewed eight physical therapists after letting them experience a state-of-the-art VR exercise product (i.e., Supernatural VR ). Participants loved the game and were most optimistic about the mental benefits of using VR exergames alongside traditional PT, but cautioned the lack of feedback and expert guidance that could lead to misuse and further injury. Regarding the future integration of VR and PT, participants were cautiously optimistic and offered design feedback and recommendations, with warnings regarding the potential barriers to innovating clinical practice.

Navigating the holistic conceptualizations of mental health issue in social work: a cross-cultural study of practitioner perspectives

ABSTRACT Holistic approaches, such as the Biopsychosocial model, have become mainstream frameworks for organizing mental health services in recent decades. However, little research has explored how frontline social workers embrace and synthesize the different dimensions within this holistic approach. This paper uses semi-structured interviews to investigate diverse conceptualizations of mental health issues among frontline social workers. Fourteen social workers from Hong Kong and twelve from Sydney were interviewed. Three prevalent positions were identified: prioritizing chemical imbalance, questioning the concept of illness, and refusing a fixed understanding of mental health issues. The analysis also reveals how these understandings influence frontline social work practice, uncovers broader socio-cultural influences through s cross-cultural lens, and highlights implications for social work education for navigating the inclusivity of holistic approaches.

Mental Health Risk Assessment and Safety Planning During UK Covid-19 Pandemic Lockdown: Mixed Methods Survey and Interview Study

Risk assessment and safety planning are central to mental health nursing practice but were seriously affected by the Covid-19 pandemic and associated lockdowns. In this study, we aimed to explore how the UK pandemic lockdowns affected risk assessment and safety planning from the perspective of mental health practitioners. A sequential, mixed methods study design was used. A link to an online survey questionnaire was distributed and semi-structured interviews with a subset of respondents were conducted. Survey data were analysed to describe perceived changes in the frequency and nature of risk assessment and safety planning during the pandemic lockdowns. This was supplemented by thematic analysis of qualitative interview data. In total, 106 practitioners were surveyed and 10 participated in semi-structured interviews. More respondents increased than decreased risk assessment frequency but there was no significant overall change. Remote contact was more common in community settings and largely involved telephone appointments. Participants did not wish to continue with remote working following the pandemic. Risk assessment practice changed in UK mental health services as a result of COVID-19 lockdowns.

Developing coaching cultures: an exploration of the enacting practitioner perspective

PurposeDespite the popularity of facilitating coaching cultures, very little is known about this phenomenon, especially from the perspective of different organisational stakeholders. We aim to add the enacting practitioner perspective in developing coaching cultures that has not yet been explored through empirical research.Design/methodology/approachWe interviewed 20 organisational development and coaching practitioners who work in or with organisations to develop coaching cultures.FindingsWe apply Braun and Clarke’s reflexive thematic analysis (TA) and unpack four intersecting themes: (1) “It flows through the veins of the organisation”; (2) “More powerful than anything else is having that one-to-one time”; (3) “The roadmap emerges”; and (4) “Means to an end and an end in itself”. We construct a coaching culture as an ever-evolving, psychologically safe, and empowering dialogic “container” or subculture that is developed and sustained by change agents with first-hand experience of coaching.Originality/valueThe findings add to our understanding of coaching cultures by offering a conceptualisation of coaching culture based on practitioners’ perspectives and constructing a framework of assumptions, values and behaviours that underpin them. We conclude by setting an agenda for further research in the advancement of coaching culture theory and practice in coaching psychology.

Abortion Law Changes and Occupational Therapy Practice in the United States.

The U.S. Supreme Court overturned Roe v. Wade in 2022, changing access to abortion in many states. The impact of these changes on occupational therapy practice has not yet been explored through empirical research. To explore the perspectives of occupational therapy practitioners on how restrictions to abortion in the United States may have influenced their clients' needs and thus their practice. This was a qualitative research study. We used an interpretivist epistemological approach and an inductive, thematic content analysis. Participants were recruited through state occupational therapy associations and social media. Two independent researchers coded data and had an initial agreement percentage of 88%. Data trustworthiness was enhanced through documentation of decisions, reflexive thinking about our positionality and the data, and team-based discussions. Occupational therapy practitioners (N = 15) working in states with new abortion law changes at the time of interviews. The four key themes of this study were as follows: (1) abortion restriction laws are affecting some occupational therapy clients' mental health, (2) clients are discussing reproductive health with occupational therapy practitioners across a variety of settings, (3) occupational therapy practitioners are using clinical judgment and their personal beliefs to support clients affected by abortion restrictions, and (4) occupational therapy practitioners are seeking guidance and evidence-based resources to best support clients in the wake of abortion-related legislation changes. Our findings underscore the relevance of reproductive health to occupational therapy practice and highlight the importance of preparing occupational therapy practitioners to respond to client needs related to abortion care. Plain-Language Summary: We sought to determine whether occupational therapy practitioners perceive that the 2022 abortion-related restrictions are affecting occupational therapy practice; specifically, we wanted to know whether and how practice is being affected and what resources occupational therapy practitioners might need to address clients' needs. Fifteen occupational therapy practitioners were interviewed and revealed that many of their clients were experiencing stress and anxiety (i.e., mental health challenges) specifically related to abortion access. We also found that occupational therapy practitioners who routinely discuss reproductive health with clients were commonly hearing from clients about abortion-related needs. Overall, this research uncovers a need for resources and guidance from state or national occupational therapy organizations so that occupational therapy practitioners can better support their clients given these new changes in abortion access. Positionality Statement: We are a team of three researchers who identify as cisgender women, and we reside in an urban area in the northeastern United States. Two of us identify as White, and one identifies as a person of color. We have all participated in reproductive health access advocacy and critically examined our own lenses as we engaged in this analysis.

Exploring perceived relationships between weather, climate and mental health: biometeorological perspectives of healthcare practitioners.

Over the last decade, there has been an increase in research examining the influence of weather and climate in mental health caseloads. Variations in temperature, sunshine hours, cloud cover, precipitation and extreme weather events have been statistically linked to diagnoses and increases in hospital admissions for several mental health conditions. This study aimed to explore whether mental health practitioners perceive there to be a link between mental health and daily, seasonal, or inter-annual shifts in various climate variables in South Africa, and the timing and causal mechanisms thereof. Semi-structured interviews were conducted with 50 practicing healthcare practitioners, and the data was analysed using thematic analysis. The findings of this research show that all 50 participants were aware of the link between weather, climate and mental health, primarily through their awareness of seasonal affective disorder. Of the 50 participants, 38 participants could explain the aetiology of seasonal affective disorder. Participants perceived sunlight and temperature to exert an influence on mental health. All 50 participants perceived exposure to sunlight to exert a positive influence on several mental health conditions. Of the 50 participants, 36 participants perceived increases in temperature to exert an adverse effect on mental health symptomology. A minority of 11 participants perceived precipitation to influence mental health conditions such as seasonal affective disorder, bipolar disorder, and substance abuse disorder. Participants' perceptions of the influence of precipitation on mental health provided a unique potential explanation of this relationship, which, at the time of writing, has not been discussed in formal research.

Financing diversified water strategies for megacities: the case of Mexico City and rainwater harvesting

Abstract Megacities are increasingly confronted with water supply challenges, requiring innovative and diversified management strategies to ensure sustainability. This study examines Mexico City’s Cosecha de Lluvia program, a government initiative promoting residential rainwater harvesting (RWH). This case study offers valuable lessons for other megacities facing similar water security issues. The study particularly explores result-based financing (RBF) as a promising strategy to strengthen Mexico City’s RWH sector. Despite its potential, research on RBF for water supply diversification remains limited, especially from the perspective of practitioners. To address this gap, the study employs a systems thinking approach supported by qualitative methods, including a literature review and interviews. Thematic networks analysis revealed that RBF could enhance Cosecha de Lluvia by improving monitoring and results measurement, facilitating information exchange, and increasing transparency—key factors for successful water supply diversification. While these identified benefits do not address all of Cosecha de Lluvia’s challenges and RBF could have implementation challenges, there is a clear opportunity for this financial mechanism to enhance programs like the one studied and have a positive impact on several of its elements. As part of the RBF suitability assessment, three different funding sources were evaluated—public, private, and philanthropic—to determine their effectiveness in overcoming Cosecha de Lluvia’s challenges. The findings suggest that no single source of finance markedly influences the program’s effectiveness alone. Instead, a blended financing approach that integrates all three sources is recommended as a strategy to explore further for implementing RBF in water supply diversification efforts. Overall, the study highlights the necessity of diversifying water supply to build climate resilience in megacities. While programs like Cosecha de Lluvia are crucial, significant room for improvement exists. RBF offers a promising mechanism to enhance such initiatives, and its potential merits further exploration.

Exploring Public, Practitioner and Policymaker Perspectives of Unhealthy Lifestyle Factors in the Context of Socioeconomic Deprivation: A Qualitative Study.

Unhealthy lifestyle factors, such as smoking, high alcohol intake, poor diet and physical inactivity, are key risk factors for premature mortality. How unhealthy lifestyle factors are viewed in the wider context of socioeconomic deprivation is rarely considered. Understanding key stakeholder views on lifestyle factors in the context of deprivation is critical to intervention development and reducing harm in more deprived populations. The aim of this study was to explore public, healthcare professional and policymaker views around unhealthy lifestyle factors in the context of deprivation. The aim was broad to facilitate iterative development of ideas, as the views of this wide range of stakeholders are rarely captured. Twenty-five adult members of the public in Scotland took part in four focus groups between August 2022 and June 2023. Eighteen semi-structured interviews were conducted with professionals: 12 primary-care practitioners and 6 public-health practitioners and policymakers. Reflexive thematic analysis was undertaken. Four main themes were developed: (1) Evolving complexity of lifestyle factors - the number of lifestyle factors that adversely impact health has grown, with increasingly complex interactions, (2) Social determinants of lifestyle - numerous links were made between socioeconomic conditions and unhealthy lifestyle factors by all participants, (3) Poverty as a fundamental social determinant - poverty was identified as a core factor for unhealthy lifestyle factors, and (4) Agency versus structure in relation to lifestyle - individual agency to address lifestyle factors was limited by structural constraints. Among professionals, understanding the challenging social determinants of unhealthy lifestyle factors was countered by a desire to support healthy change in those affected by deprivation. Public and professional views around lifestyle highlight an evolving understanding of the new and growing number of lifestyle factors as well as the increasingly complex interplay between lifestyle factors. Views of the social determinants of lifestyle and structural limits to agency strengthen arguments for reduced emphasis on individual-level responsibility for unhealthy lifestyle factors and for deeper integration of social determinants into lifestyle interventions. In addition to addressing poverty and socioeconomic inequalities directly, innovative policy, planning and legislation that incorporate wider approaches could tackle upstream determinants of numerous unhealthy lifestyle factors simultaneously. Members of the public who participated in this study have made contributions by sharing their views and perspectives. The National Health Service Research Scotland Primary Care Patient and Public Involvement (NRS PPI) Group contributed to the development of this work. The NRS PPI Group was consulted as part of the preparatory work for H. M. E. F.'s doctoral thesis funding application. The findings of the qualitative work were presented to them, and they informed the interpretation of those findings and related work presented at conferences and public engagement events.

Practitioners’ Experiences of School Readiness in Rural Early Childhood Centres in QwaQwa Free State, South Africa

The analysis of the school preparation experiences of rural early childhood practitioners. Multiple complex issues exist regarding school preparedness in South Africa. Research has found that many South African children are unprepared for formal schooling. Some of the challenges experienced by these young learners were low reading strength, learning setbacks and complications, and sluggish general development. As a result of these issues, young children face long-term repercussions. These include the inability to escape the cycle of poverty, lack of educational support, and poor socioeconomic conditions within their environment. Therefore, it can be argued that teaching within the South African public schooling context is marred with difficulties and unforeseen challenges. It is difficult to imagine how to modify South African infrastructure so all children can reach their full potential. Given that our ancient past is still rife with historical and power changes, the government must consider several factors while developing ways to aid transformation. This study investigated the perspectives of practitioners on school preparedness. At the same time, it investigates the significant learning at the grass-roots level that emerged from participation in a critical paradigm-based participatory action research project. The study is anchored in a philosophical methodology that leverages Practitioners’ idea that early childhood learners are ready for formal school. They do not emphasize play as a pedagogy for learning in preparation for school readiness. This paper is grounded in constructivism, which helps comprehend how school readiness knowledge improves formal education for young students. The author used the qualitative research approach with an interpretive paradigm to explore practitioners’ school readiness experiences. The author developed a semi-structured interview schedule to collect data from six practitioners in the Thabo-Mofutsanyana district in the Free State Province. The findings revealed practitioners lacked appropriate training and support in preparing young learners in ECD centres. Furthermore, practitioners lacked appropriate pedagogical skills to strengthen teaching and learning. The study recommended that practitioners receive ongoing professional teacher development in school readiness and use various teaching and learning strategies such as play pedagogy.

Medical practitioners’ experiences and considerations when managing sleep medication for adolescents and young adults

Introduction The prevalence of sleep disorders and use of sleep medication, particularly melatonin, are rising among adolescents and young adults (13–24 years). In Denmark, melatonin is approved for use in children with autism and ADHD up to 18 years of age, with other prescriptions being off-label in these age groups. The perspectives of medical practitioners on prescribing sleep medications to this age group remain largely unexplored. Aim This study aims to investigate the considerations of general practitioners (GPs) and child and adolescent psychiatrists (psychiatrists) when prescribing and deprescribing sleep medications for 13–24-year-olds. Methods We conducted qualitative semi-structured interviews with 10 GPs and six psychiatrists. Data were analyzed using an inductive approach. Results Psychiatrists typically prescribed melatonin with the expectation that deprescription would occur in general practice. Despite the universal goal of deprescription, it was hindered by various challenges. GPs identified patient motivation and a clear focus on deprescription as facilitative factors and expressed a need for enhanced emphasis on these aspects in general practice. Discussion and implications The findings align with existing prescription trends and literature on factors that promote and inhibit deprescription. The study underscores the complexities of deprescribing sleep medications for adolescents and young adults, suggesting the need for expanded guidelines and enhanced continuing education for GPs. Conclusions The research highlights significant discrepancies among medical practitioners regarding the deprescription process of sleep medications for young individuals, complicated by multiple factors. This underscores the need for better guidelines and further studies.

Supporting primary care practitioners to promote dementia risk reduction in Australian general practice: outcomes of a cross-sectional, non-randomised implementation pilot study.

Background Primary care practitioners worldwide are urged to promote dementia risk reduction as part of preventive care. To facilitate this in Australian primary care, we developed the Umbrella intervention, comprising a waiting room survey and patient information cards for use in consultations. Educational and relational strategies were employed to mitigate implementation barriers. Methods In this cross-sectional, non-randomised implementation study within the South East Melbourne Primary Health Network, we employed mixed-methods outcome evaluation. Antecedent outcomes (acceptability, appropriateness, and feasibility) and actual outcomes (adoption, penetration, and fidelity) were assessed from the perspective of primary care practitioners and patients. Results Five practices piloted the intervention and implementation strategies, including 16 primary care practitioners engaging with 159 patients. The Umbrella intervention was deemed acceptable, appropriate, and feasible, but penetration was limited. Approximately half of eligible primary care practitioners used the intervention, with moderate fidelity. Engagement with implementation strategies was similarly limited. While most strategies were well-received, improvements in online peer discussions and staff readiness were desired. Conclusions The Umbrella intervention is a viable approach to promoting dementia risk reduction in Australian general practice, supported by educational and relational strategies. Stakeholder-informed refinements to enhance uptake are recommended before advancing to a definitive trial.

Fostering collaboration: an exploration of knowledge exchange between Rongoā Māori practitioners and surgical clinicians.

This research investigates the potential for collaboration of Rongoā Māori, the Indigenous healing practices of Māori, with New Zealand's contemporary healthcare system. It aims to bridge the gap between Rongoā Māori and Western medicine by exploring the perspectives of practitioners from both fields, identifying barriers to integration, and highlighting potential areas for collaboration. Qualitative interviews were conducted with both Rongoā practitioners and Western surgeons. The data collected were subjected to thematic analysis to extract key themes related to the integration process, challenges faced, and the potential for mutual recognition and respect between the two healing paradigms. The study reveals a deep respect for Rongoā Māori among Western surgeons but identifies significant systemic barriers that impede its integration. These include bureaucratic challenges and the absence of clear referral pathways. Rongoā practitioners express concerns over being overlooked within the healthcare system and highlight a lack of awareness among healthcare professionals about their practices. Despite these challenges, there is a shared interest in collaborative approaches to healthcare that respect and incorporate Rongoā Māori. The findings underscore the need for systemic changes to facilitate the integration of Rongoā Māori into mainstream healthcare, including the development of clear referral pathways and initiatives to raise awareness among healthcare professionals. The study highlights the need for a more collaborative healthcare approach that values the contributions of Rongoā Māori, aiming to improve patient care through holistic practices.

ACE Enquiry in Primary care: A Qualitative Exploration of the Perspective of General Practitioners in Northern Ireland

ACE Enquiry in Primary care: A Qualitative Exploration of the Perspective of General Practitioners in Northern Ireland

'Leaving the Door Open': Perspectives on Decision-Making for Non-Emergency Diabetes-Related Amputation.

Having a lower extremity amputation is a life-changing decision for people living with a diabetes-related foot ulcer. Although previous research has described both positive and negative lifestyle and function outcomes of diabetes-related amputations, limited research has been conducted on the decision-making processes leading up to the amputation. This study aimed to explore the perspectives of persons, healthcare practitioners and experts (including academics and specialists) on decision-making for people with a diabetes-related foot ulcer who may require a non-emergency amputation. A qualitative descriptive study using semi-structured interviews enabled people to share their thought processes when making decisions for amputation. Twenty-six participants were interviewed, including nine people with a diabetes-related foot ulcer or amputation, nine health practitioners and eight experts located across five countries. There were 13 female and 13 male participants. Thematic analysis was used for data analysis. Four themes described the decision-making considerations for amputation: 'Balancing the evidence in decision-making', 'Trust, respect and timing of conversations inform decision-making', 'Tailoring decisions for individual circumstance' and 'Reaching the tipping point in decisions for the future'. Work commitments, functional and lifestyle impacts of amputation, the presence of support networks and clinical wound features formed the evidence for a decision for amputation. Understanding quality of life needs ensured that decisions for amputation addressed expectations and lifestyle needs. Living with a diabetes-related foot ulcer presented daily challenges that pushed people to a tipping point, at which amputation was considered to overcome these hardships and enable them to move on to the next chapter of their life. Further research is required to understand how person-centred factors can be better incorporated alongside objective clinical assessments in decisions for amputation. People with diabetes-related foot ulcers, health practitioners and experts shared their perspectives on the decision-making process for amputation through one-to-one interviews. Consideration of the person in the context of their life, environment and personal needs alongside the pathological factors is warranted.

Practitioner Perspectives on Arctic Marine Mammals in Environmental News Reporting

Practitioner Perspectives on Arctic Marine Mammals in Environmental News Reporting

Navigating and Resisting Educational Systems: The Experiences of Latinx Families in Rural Oregon.

This study explores the experiences of Latinx parents in rural Oregon from the perspectives of Latinx parents, Latinx students, and community practitioners to understand the barriers Latinx families encounter and how they leverage their community cultural wealth to address these barriers within the context of initiatives implemented by the district. This qualitative study is guided by the following questions: What barriers do Latinx families encounter in rural schools, and how do parents leverage their community cultural wealth to address these barriers? Findings indicate that even when families were engaged in initiatives (e.g., dual language immersion programs) implemented by the district to create a welcoming environment, Latinx parents continued to encounter multiple systemic barriers (e.g., immigration laws) and leveraged multiple forms of community cultural wealth (e.g., linguistic capital) to navigate these barriers. Our findings reveal the complex dynamics at play in rural school communities serving Latinx families.

Practitioner perspectives on equitable implementation of evidence-based interventions for cancer prevention and control

Practitioner perspectives on equitable implementation of evidence-based interventions for cancer prevention and control