Practitioners In Health Care Settings Research Articles

Becoming the right musician for the job: Versatility, connectedness, and professional identities during personalized, online music-making in hospital maternity wards

The beneficial potential for music in hospital contexts is well established, with research showing that music can promote patient well-being and support recovery. However, less attention has been paid to the ways in which musicians’ practices and professional identities are informed by working in hospital settings. As arts-and-health approaches continue to proliferate, it is essential to recognize the values, emotional labor, and skills associated with these approaches through understanding the experiences of practitioners. As part of an international collaboration led by Hanze University in the Netherlands, the ProMiMiC project explores the professional development of musicians and nurses through person-centered music-making in hospital settings. The current study focused on five conservatoire-trained musicians’ delivery of personalized music-making via Zoom in a hospital maternity setting in London during the COVID-19 pandemic. Their experiences of adapting to the new context, and the impacts on their personal and professional development, were explored using reflective journals, group discussions, and semi-structured interviews. The data were interpreted using the theoretical lens of vocational habitus to examine the skills and dispositions required to be the right musician for this job. Qualitative synthesis revealed the musicians’ developing musical values as they adapted to the online maternity setting, highlighting the centrality of communicative and musical versatility as well as the ability to connect and empathize through music. The findings offer insights into possible ways of supporting emerging music practitioners in healthcare settings and emphasize the imperative for higher music education to prepare and train musicians for this type of work.

Gamifying Sexual Education for Adolescents in a Low-Tech Setting: Quasi-Experimental Design Study.

BackgroundSexual education has become increasingly important as unhealthy sexual practices and subsequent health risks become more prevalent during adolescence. Traditional sex education teaching methodologies are limiting for digital natives exposed to various digital technologies. Harnessing the power of technology applications attractive to the younger generation may be a useful approach for teaching sex education.ObjectiveThe aim of this study was to improve sexual health knowledge and understanding of the problems associated with unhealthy sexual practices and address sexual and reproductive health challenges experienced in a low-tech setting.MethodsA participatory design approach was used to develop the digital gamified methodology. A sample of 120 secondary school students aged 11-15 were randomly assigned to either experimental or control group for each of the 3 teaching approaches: (1) gamified instruction (actual serious games [SG] in teaching); (2) gamification (GM; making nongames, such as game-like learning); and (3) traditional teaching (TT) methods.ResultsThe SG and GM approaches were more effective than TT methods in teaching sexual health education. Specifically, the average scores across groups demonstrated an increase of mean scores from the pre- to posttest (25.10 [SD 5.50] versus 75.86 [SD 13.16]; t119=41.252; P<.001 [2 tailed]). Analysis of variance indicated no significant differences across groups for pretest scores (F2,117=1.048, P=.35). Significant differences across groups were evident in the posttest scores. Students in the SG and GM groups had higher average scores than the TT group (F2,117=83.98; P<.001). Students reported increased learning motivation, attitude, know-how, and participation in learning (P<.001) when using SG and GM approaches.ConclusionsDigital health technologies (particularly teaching and learning through gamified instruction and other novel approaches) may improve sexual health education. These findings may also be applied by practitioners in health care settings and by researchers wishing to further the development of sex education.

Workplace Aggression: Exploring Experiences of Occupational Therapy Practitioners in Healthcare Settings

Workplace aggression (WPA) among healthcare workers is a pervasive and serious problem in the healthcare industry, yet there is a poor understanding of WPA in the profession of occupational therapy (OT). The authors employed a mixed method design using a Likert scale survey and focus groups from two different settings and locations to explore WPA experiences of OT practitioners working in healthcare settings. Participants for the focus groups totaled 14 and 109 surveys were returned. The findings revealed that 100% of the focus group participants and 67% of the survey respondents report exposure to specific types of WPA. Key underlying causes relate to the challenges occupational therapy practitioner’s face in advocating their professional role and values in a predominant biomedical setting. These findings are important not only to increase awareness among practitioners, leaders, and educators but to further examine how occupational therapy’s unique role in healthcare can be fully recognized.

Self-care among healthcare social workers: The impact of COVID-19

ABSTRACT For social work practitioners in healthcare settings, self-care can be an integral tool to assuaging stressors associated with COVID-19. However, research that examines the impact of public health crises, such as COVID-19, is nominal, at best. This exploratory study investigated the impact of COVID-19 on the self-care practices of self-identified healthcare social workers (N = 2,460) in one southeastern state. Primary data were collected via an electronic survey and assessed via a retrospective pre/post design. Analyses compared practices before and after COVID-19 was declared a pandemic. Overall, data suggest that participants experienced significant pre/post decreases in self-care practices across multiple domains. As well, findings indicate that participants who identified as married, financially stable, and working non-remotely, and in good physical/mental health engaged in significantly more self-care practices than other participants, at post. This study underscores the need to foster supportive professional cultures that include developing self-care practice skills, particularly during large-scale crisis, such as COVID-19.

Social Justice and Advanced Cancer Patients: an Analysis of Key Policies

This policy analysis examines key aspects of two policies fundamental to work with terminal cancer patients: the Medicare Hospice Benefit and Medicare policy in palliative care. End-of-life care, affected by these policies, should address physical, emotional, and spiritual suffering for all vulnerable groups. Using Gilbert and Terrell’s framework, social allocations, social provisions, service delivery, and financing are examined to better understand each policy’s effects on equality, equity, and adequacy for terminally ill cancer patients. In practice, each has substantially socially unjust effects for cancer patients. Disproportionate advantages result for those who are white, have family caregiving support systems, those with higher socioeconomic status, and individuals with stable insurance coverage. The Medicare Hospice Benefit and Medicare coverage for palliative care need to be better understood by policy practitioners and all practitioners in health care settings. Advocacy can contribute to improved equity in end-of-life cancer care.

Factors influencing the implementation of advanced midwife practitioners in healthcare settings: A qualitative study

ObjectiveTo explore factors influencing the implementation of advanced midwife practitioner roles. DesignSemi-structured individual face-to-face and focus group interviews were conducted. Data analysis was performed using the Framework Method. Setting and participantsA purposive sample (n = 32) included chief nursing officers, middle managers, head midwives/nurses, primary care team leaders, midwives with and without advanced midwife practitioner roles, heads of midwifery educations, and obstetricians. FindingsBudgetary constraints on a governmental and healthcare organizational level were mentioned as main barriers for role implementation. The current fee-for-service financing model of healthcare professionals was also seen as an impediment. Obstetricians considered the implementation of advanced midwife practitioner roles as a possible financial and professional threat. Documenting the added value of advanced midwife practitioner roles was regarded a prerequisite for gaining support to implement such roles. Healthcare managers’ and midwives’ attitudes towards these roles were considered essential. Participants warned against automatically transferring the concept of advanced practice nursing to midwifery. Although participants seldom discussed population healthcare needs as a driver for implementation, healthcare organizations’ heightened focus on quality improvement and client safety was seen as an opportunity for implementation. University hospitals were perceived as pioneers regarding advanced midwife practitioner roles. Key conclusions and implications for practiceMultiple factors influencing role implementation on a governmental, healthcare organizational, and workforce level illustrate the complexity of the implementation process, and highlight the need for a well-thought-out implementation plan involving all relevant stakeholders. Pilot projects for the implementation of advanced midwife practitioners in university hospitals might be useful.

Leadership in Allied Health: A Review of the Literature

Background: It is well established that effective clinical leadership improves the quality of healthcare service provision and promotes leadership outcomes. [1,2] Leadership capacity and capability of allied health professionals is needed for successful clinical service provision, [3] but less is known about allied health leadership than about other clinical groups.&#x0D; Aims: The literature review aimed to identify research about leadership and leadership development of allied health practitioners in healthcare settings.&#x0D; Methods: A database review was undertaken using SCOPUS, CINAHL, Medline and Business Elite databases from December 2014-September 2015. Three leadership journals were also hand searched. A total of 1665 articles were identified. These were scanned and 129 articles were retrieved with 70 articles shortlisted for indepth review.&#x0D; Results: After application of inclusion and exclusion criteria, seven journal articles were included in the literature review. Review of the studies identified two areas of primary focus: leadership styles and outcomesand leadership development programs.&#x0D; Conclusions: Findings showed that there are currently a limited number of robust published reports in relation to leadership and allied health practitioners. Implications for Practice: Well-designed research studies to further evaluate leadership skills of allied health practitioners as well as to determine the effectiveness of leadership programs in developing transformational leaders are required.&#x0D; Abbreviations: CASP – Clinical Appraisal Skills Program; NHMRC – National Health and Medical Research Council.

Qualified nurses' perceptions of nursing graduates' abilities vary according to specific demographic and clinical characteristics. A descriptive quantitative study

BackgroundEvidence from the literature and anecdotally from clinical settings suggests that newly graduated nurses are not fully prepared to be independent practitioners in healthcare settings. Aims and ObjectivesThe aim of this study was to explore perceptions of qualified nurses in relation to the practice readiness of newly registered nursing graduates and determine whether these views differ according to specific demographic characteristics, clinical settings, and geographical locations. DesignA descriptive quantitative design was used. MethodsAn online survey tool was used to assess how qualified nurses (n=201) in Victoria, Australia, rated newly graduated nurses' abilities on 51 individual clinical skills/competencies in eight key skill areas. A composite score was calculated for each skill area and a comparative analysis was undertaken on the various cohorts of participants according to their demographic and clinical characteristics using one-way ANOVA and post hoc tests. ResultsNewly graduated nurses were found to be lacking competence in two key skill areas and were rated as performing adequately in the remaining six skill areas assessed. Significant differences (p≤0.05) in performance were found according to the age of the nurse, number of years registered, the educational setting in which they undertook their nurse education, their role, and the clinical area in which they worked. There were no significant differences according to whether the nurse worked in the private or public healthcare sector. Few differences were found between nurses working in a metropolitan vs. regional/rural healthcare setting. ConclusionThis is the first study to quantify the scale of this problem. Our findings serve as a reference for both nurse education providers and healthcare settings in better preparing nursing graduates to be competent, safe practitioners in all clinical areas.

Intimate Partner Violence, Depression, PTSD, and Use of Mental Health Resources Among Ethnically Diverse Black Women

This study examined exposure to violence and risk for lethality in intimate partner relationships as factors related to co-occurring MH problems and use of mental health (MH) resources among women of African descent. Black women with intimate partner violence (IPV) experiences (n = 431) were recruited from primary care, prenatal or family planning clinics in the United States and the U.S. Virgin Islands. Severity of IPV was significantly associated with co-occurring MH problems, but was not associated with the use of MH resources among African-American women. Risk for lethality and co-occurring problems were also not significantly related to the use of resources. African Caribbean women with severe physical abuse experiences were significantly less likely to use resources. In contrast, severity of physical abuse was positively associated with the use of resources among Black women with mixed ethnicity. Severe IPV experiences are risk factors for co-occurring MH problems, which in turn, increases the need for MH services. However, Black women may not seek help for MH problems. Thus, social work practitioners in health care settings must thoroughly assess women for their IPV experiences and develop tailored treatment plans that address their abuse histories and MH needs.

Strangers among strangers: clients and health practitioners in health care settings

This paper describes a course assignment designed to sensitise nursing students to the meaning of the experience of being a stranger in a cultural setting where the norms and rules for behaviour are unclear or essentially unknown. This experience alerts the student to be aware of the possibility that people's usual responses to strangers in unfamiliar settings, may be an inhibitory factor in the development of a therapeutic relationship between the nurse, and other health practitioners, and their clients. Discussion is centred on the student learning which occurs, both personally and professionally, in the conduct of this assignment.

Social work influence on interdisciplinary ethical decision making in health care settings.

Because of structural and philosophical changes in health care, social work practitioners are having to interact more with other practitioners in health care settings. Many of those interactions are interdisciplinary and often involve an understanding of the application of professional values and ethics. The authors have suggested that social workers' influence on ethical decision making is correlated directly to their ability to contribute to those decisions. In their study, the authors tested five independent variables and one dependent variable to show the factors that are related significantly to social workers' influence on ethical decision-making processes in multidisciplinary health care settings.