Responsibility For Care Research Articles

Living, doing and learning in sport, civic and political activities: possible paths for positive youth development

ABSTRACT This study investigated the relationship between patterns of youth participation in sports, civic and political activities, and positive youth development outcomes, including social and personal responsibility. It used cluster analysis complemented by a MANOVA and MANCOVA. A sample of 1,174 secondary vocational students (57.1% female) aged 14–19 completed an online questionnaire. Results show that different participation patterns promote different developmental outcomes; combining sports and citizenship activities enhances character, caring, and social and personal responsibility. Gender and age are significant moderating factors in the relationship between youth participation patterns and developmental outcomes, with girls scoring higher in character, caring and personal responsibility, while boys showed higher levels of competence and confidence. Older students revealed weaker competence and personal responsibility. This study emphasizes the benefits of combining different activities to promote youth development and the role of schools in promoting active, socially responsible youth. The study appeals to adapted interventions and for more research into contextual variables and long-term effects.

Caring to write, writing to care: a feminist care approach to doctoral supervision in the intimate encounters of co-writing

ABSTRACT My autoethnography examines intimate encounters of co-writing with four former doctoral students and how I juggled the ethical dilemma of performative ways of being in the neoliberal university juxtaposed with care for students and myself as women scholars. I do this from a feminist care perspective, barely considered in doctoral supervision. I critique the neoliberal university, concepts of care and doctoral supervision, coalescing on intimate encounters in co-writing. I draw on email conversations, supervisory notes and personal reflections to explore care in our co-writing relationships. I propose a pragmatic care agenda, identifying four practical CARE components, as a contribution to help us ‘do’ feminist care within doctoral supervisory co-writing, not to reinforce a normative version of individual responsibility for care and healing but to acknowledge and find ways of managing the competing and competitive demands of the neoliberal university and tensions between students and supervisors who experience this differently.

Characteristics of relatives with high expressed emotion and related factors: a study of relatives of people with dementia in China

BackgroundChina has the highest number of people with dementia globally, and the responsibility of caring for people with dementia primarily falls on relatives, who bear heavy caregiving burdens and pressure. Providing care for an individual with dementia is emotionally and physically demanding, particularly due to the frequent manifestation of behavioral and psychological symptoms associated with dementia (BPSD). This underscores the crucial need to comprehend and address caregivers’ emotional expression (EE).AimTo explore the characteristics of relatives with high expressed emotion of people with dementia and related factors in mainland China.MethodsA survey using cross-sectional questionnaires conducted with 165 relatives of individuals with dementia in China.ResultsA significant number of relatives had high EE (n = 61, 39%). The variation in EE, about 37.8%, is explained by seven independent variables. The proportion of psychological distress among relatives in EE variation is 14.5%. (b = 0.387, p < 0.001). Length of care-taking, active coping, and chronic diseases accounted for 6.5% (b = 0.264, p < 0.001), 5.1% (b=-0.239, p = 0.001) and 4.1% (b = 0.211, p = 0.002) of the variance in EE, respectively.ConclusionsChinese health care providers can identify high-risk groups for assistance based on the severity of dementia, age, health status and duration of care. Enhancing coping styles and alleviating emotional distress among relatives could be advantageous in decreasing EE.Clinical evidenceUnderstanding the risk factors for high EE in different cultures can help guide practice on a global scale to improve the quality of life of people with dementia.

Empresas e direitos humanos: a revogação do Dec. 9.571/2018 e os caminhos para um compliance governamental

This article intends to examine the relationship between business and human rights, with the central problem being understanding the main criticisms made of Decree No. 9,571 of 2018, as well as understanding the reasons for its repeal. Furthermore, it brings to light the understanding of the current legislation on corporate responsibility, taking care mainly of what establishes Bill No. 572/2022, currently being processed in the National Congress. Through a deductive and exploratory approach, iIt is concluded that the revocation of Decree No. 9,571/2018 was mainly due to its ineffectiveness, in addition to there being other regulations that take care of corporate social responsibility, but that Bill No. 572/2022 strengthens the necessary framework for the protection of human rights towards companies.

Negotiations of responsibility for community and personal care: Emotional coping, leisure, and restoration for public safety personnel

ABSTRACT Uniformed public safety personnels (PSPs) are the first line of care on scenes of distress, where they are put into positions to negotiate the responsibilities of community and personal care. This work helps expose the oppressive nature that systems governing community safety have on bodies that are uniformed. Using critical, narrative approaches, 11 public safety personnel participants were recruited to participate in focus groups and interviews. Conversations with PSPs centred on how they navigate relations of power and adhere to militant cultural norms to perform the expectations of the ‘uniform.’ We interpretively analyzed the data to describe three threads that make up the uniform and to create reflections on the potentials of leisure as a means of resistance and healing under capitalism. The intent of this paper is to create a stronger rationale for more work in the study of community safety and care, addressing a gap in services for PSPs.

Understanding older Māori informal caregivers’ experiences during the COVID-19 pandemic through Te Whare Tapa Whā

ABSTRACT Drawing upon Tā Mason Durie’s Te Whare Tapa Whā model, this research explores the impact of the COVID-19 pandemic on the health and wellbeing of older Māori informal caregivers in Aotearoa New Zealand. Utilising information from 35 in-depth interviews conducted with Māori informal/whānau caregivers, this study identifies that the pandemic impacted the physical and mental health of Māori informal caregivers, facing challenges due to lockdown measures, limited access to support services and increased care responsibilities. However, the study predominantly highlights a range of positive aspects of informal caregiving during the pandemic, such as a sense of purpose and fulfilment in their role, enhanced appreciation for loved ones, and increased hononga and whanaungatanga. The study underscores the importance of cultural values and practices in maintaining the wellbeing of Māori informal caregivers and suggests the need for larger social changes to address structural injustices as well as inequalities. Overall, the study provides insights into the experiences of Māori informal caregivers and highlights the significance of recognising and addressing their health and wellbeing during times of crisis.

Operating room radiation safety measures: Awareness, compliance, and perceived risks among nurses and other healthcare workers.

This study evaluates and compares nurses' and other healthcare workers' awareness of and compliance with radiation protection measures in operating rooms and their perceived susceptibility to occupational illness due to radiation exposure. Compliance with radiation safety measures minimises occupational radiation exposure risks. Understanding the role of perceived susceptibility to occupational illness in motivating compliance and awareness can enhance safety interventions. Using a questionnaire-based cross-sectional observational design, this study targeted nurses, physicians, and radiologic technologists working in Saudi Arabian operating rooms. The survey measured awareness of and compliance with radiation protection measures and perceived susceptibility to occupational illness. The STROBE checklist was followed to ensure methodological rigour. Nurses demonstrated the lowest awareness and compliance, and the highest perceived susceptibility to occupational illnesses compared to other healthcare professionals. There was a moderate positive correlation between increased awareness of safety measures and compliance, but a weaker correlation between adherence and perceived risk. Nurses' compliance and awareness did not align with their risk perceptions, suggesting a cognitive-behavioural gap in which stronger risk perceptions among nurses do not lead to proactive protective behaviours. This discrepancy may be attributed to the demanding nature of nursing duties, which often overshadow strict adherence to safety protocols. The study identified significant disparities in radiation safety practices, with nurses demonstrating less awareness and compliance but higher risk perceptions than other healthcare professionals. Interventions are needed to bridge the gap between perceived risk and actual safety behaviours. Role-specific training programmes and continuous education are needed to enhance radiation safety practices among nurses. Policies must support these educational efforts, ensuring that nurses can balance patient care responsibilities with radiation protection measures.

Drowning in Paperwork: The Burden of Administrative Responsibilities in Primary Care

Drowning in Paperwork: The Burden of Administrative Responsibilities in Primary Care

‘Little islands’: challenges and opportunities for student carers in higher education

ABSTRACT Student carers face multiple challenges when it comes to participation and success in Higher Education (HE). However, by listening to and acting on the voices of those directly affected, it is possible to identify opportunities to enhance their experience. This article explores the HE experience of student carers, defined here as carers of ill relatives, student parents, as well as sibling carers, via 10 semi-structured one-to-one interviews. Currently, the institution hosting this research holds limited quantitative and qualitative information about student carers – this project filled a qualitative gap. The project explored challenges to participation and success and opportunities presented by balancing unpaid caring responsibilities, work, and social life with study. Crucially, it reports on what student carers say in their own words about what would enhance their experience. The findings demonstrate the paramount importance of first identifying student caregivers and the need to establish positive staff-student relationships based on trust and empathy. Furthermore, how tailored support such as a Carers’ Passport and reasonable adjustments, the sensitive sharing of stories which heighten awareness of student carers, staff training and guidance, as well as the co-creation of resources and initiatives with student carers can aid trust building and enhance the HE experience.

Effects of Income on Family Care Organization in Mexico: An Analysis Based on Data from the Encuesta Nacional de Ingreso y Gasto de los Hogares (ENIGH) from 2010 to 2020

This article examines the impact of income level on family care organizations in Mexico to elucidate how families apportion care responsibilities according to their economic standing. The study design employed a quantitative approach, utilizing two distinct methodologies to construct two indices: one representing the time devoted to care and the other representing care transferred to the market. Factor analysis converts minutes and hours into a time index and transforms the number of domestic workers and health and hospital expenses into a market index. A regression model estimates the effect of income on these indices, aiming to analyze the relationship between income and spending on health and services and between income and time spent on home care. The results are based on data from the National Household Income and Expenditure Survey (ENIGH) 2010–2020, using a nationally representative sample of 81 thousand dwellings. The data analysis concluded that households with higher incomes spend a more significant proportion of their expenditure on domestic care-paid services and have greater access to professional care. In contrast, lower-income households face significant challenges due to their limited financial resources and the higher demands for unpaid care.

Financial strain and resilience: a qualitative exploration of parental perspectives on caring for children with sickle cell disease in Ghana

BackgroundIn Ghana, nearly one in four (25%) of the population are sickle cell disease carriers. Furthermore, 2% of all babies born (20 for every 1000 live births) has sickle cell disease. However, little is known about how parents negotiate the financial challenges facing parents of a child with sickle cell disease. This study explores the financial difficulties of parents and children living with sickle cell disease.MethodsThe study adopted a qualitative approach. Twenty-seven parents were purposively selected from a sickle cell clinic in Accra, Ghana. Data collection was through an in-depth, face-to-face interview, using an interview guide based on the research objectives, and analyzed using thematic analysis.ResultThe findings showed that parents faced multiple financial difficulties (both direct and indirect) as they met the direct cost of medications, routine laboratory investigations, and hospital admissions. The National Health Insurance scheme does not wholly cover these costs. Families also describe more indirect costs, such as those associated with maintaining their child’s well-being alongside those connected to their caring responsibilities, including the impact of giving up work and reducing working hours. Findings highlight the most pressing challenge, including the lack of access to financial support and a more general lack of understanding of the difficulties they faced on the part of policymakers.ConclusionSupporting sickle cell parents’ financial needs would improve their emotional and social well-being, enabling them to be more effective family carers.

Abstract Su601: Missed Hypoxia in the Prehospital Care of Major Traumatic Brain Injury: Discrepancies Between Continuous Monitor Data and Clinical Documentation

Background: It is well established that prehospital hypoxia dramatically increases mortality in Traumatic Brain Injury (TBI). Thus, in EMS TBI research, case ascertainment and risk adjustment are highly dependent upon documentation of in-field O 2 saturation (SpO 2 ). Objective: To compare the rate of hypoxia identified by EMS personnel and documented in EMS patient care records (PCR) versus the actual rate of hypoxia recorded by continuous, non-invasive monitoring in TBI. Methods: A subset of major TBI cases (moderate/severe) from 5 EMS agencies reporting monitor data (Philips MRx™) in the EPIC EMS TBI Study (NIH 1R01NS071049) were evaluated (02/13-02/18). All monitor data available for post-hoc review were displayed and accessible to the providers during EMS care. We compared PCR documentation of hypoxia (SpO 2 &lt;90%) to continuous monitor data in TBI patients (nasal canula O 2 , mask, basic or advanced airway). Statistic: exact McNemar’s test, α=0.05. Results: 120 cases were included [med. age 50; IQR (23.8, 68); 65% male. Monitors recorded 44 hypoxic cases (36.7%; 95%CI 28.1, 45.9%). Only 8 (6.7%; 2.9, 12.7%) were documented in the PCR (p&lt;0.0001; Figure). Three machine-detected hypoxia cases had no PCR-documented SpO 2 at all. Conclusions: The difference in PCR-documented and monitor-identified hypoxia was dramatic. The monitor data revealed a five-fold greater incidence of hypoxia than that documented by EMS providers. This may be partially explained by the continuous nature of pulse oximetry in the face of ongoing care responsibilities and scene distractions. The field environment may cause providers to miss low readings as they fluctuate moment-by-moment. These findings have major clinical implications. While some of the discrepancy between PCR reporting and monitor data might simply be failure to document hypoxia, the much more concerning implication is that many cases might be unrecognized and untreated. Furthermore, these findings have important implications for case ascertainment, confounding, and risk-adjustment in EMS TBI research. Whenever possible, quality improvement and research projects should utilize continuous non-invasive monitor data to identify and evaluate hypoxic patients in the setting of TBI. These findings may also have implications for identifying hypoxia in EMS patients with other critical conditions.

Impact of the COVID-19 pandemic on medical office assistants (MOAs) Working in Primary Care: A Qualitative Study.

Medical Office Assistants (MOAs), also known as receptionists and clerks, are front line workers and the most accessible member of the primary care team. Historically, their contributions to primary care have been unrecognised and undervalued. The COVID-19 pandemic put pressure on existing roles and systems in primary care: how MOAs adapted is unknown. To explore the experiences of MOAs working in primary care during the COVID-19 pandemic from the perspectives of MOAs and family physicians (FPs) who worked with MOAs during this period. A qualitative study using Constructivist Grounded Theory, conducted in Ontario, Canada METHOD: Seventeen participants were recruited through professional contacts of the research team. Individual semi-structured interviews were conducted with MOAs and FPs across the province. MOAs' many responsibilities in primary care intensified during the pandemic. MOAs leveraged their healthcare system knowledge and therapeutic relationships with patients to reduce patient distress. Unfortunately, MOAs experienced more frustration, and in some cases, abuse from patients. MOAs' ability to adapt to new systems and respond to high patient needs seemed to be positively influenced by their relationships with patients and FPs. FPs expressed concern for MOA welfare and recognised their critical role on primary care teams. MOAs made significant contributions to primary care during the COVID-19 pandemic. This study suggests MOAs have greater capacity than previously recognised which has important implications for planning in an era of under-resourced healthcare.

Managing families, managing time. Parents’ work-family difficulties and work-family strategies over time

ABSTRACT This article contributes expanded knowledge about parents’ difficulties in reconciling work and family and their work-family strategies by studying how these difficulties and strategies change over time, e.g. from the early childhood years to the school-age/preteen years. Drawing on qualitative, longitudinal interviews with Swedish parents of school-age children who were interviewed when their first child was about 1.5 years of age, and then later when that child was 11 years of age, the article addresses the following research questions: What are the main difficulties in the parents’ reconciliation of paid work and caring responsibilities, and how have these difficulties changed over time? What are the parents’ most important work-family strategies for reconciling paid work and caring responsibilities and how have these strategies changed over time? The article draws on theories of work-family conflict, gender and time, and the results indicate change and continuity concerning the work-family difficulties and work-family strategies. Time famine appears to be a central difficulty that is consistent throughout the years. The findings also indicate gendered aspects of some of the strategies.

Academic Performance, Health and Support Needs: Comparing Foster Care Alumni and Peers in Higher Education in Norway.

The completion rates of higher education are low among young adults with a history of foster care. Understanding how students from foster care alumni fare is imperative for facilitating attainment and preventing drop-out. The aim of this study was to compare students from foster care alumni and the general student population by examining (1) sociodemographic characteristics, academic functioning and need for special assistance; (2) contextual factors important for student life; and (3) mental and somatic health, loneliness, life satisfaction and use of cannabis and alcohol. Data comprised self-reports from the Norwegian national survey Students' Health and Well-being Study 2022. Reports from foster care alumni students (n = 508) were compared to those of the general student sample (n = 59,036). Compared to the general sample, twice as many foster care alumni students reported receiving or needing special assistance in their studies. Moreover, they reported substantially higher economic burden than their student peers, by higher frequency of work income, more financial worries, and less parental financial support. Foster care alumni students also reported a higher load of informal care responsibilities, poorer mental and somatic health, more loneliness and lower life satisfaction. Foster care alumni students fare comparably well in terms of grades and study progression despite the reported economic burden and impaired health and well-being. As these are factors shown to impact study completion, policies need to be put in place to ensure that care-experienced students receive adequate support through their young adulthood and specifically in higher education.

What does flexible work for men really mean?: a qualitative content analysis of key stakeholder accounts

ABSTRACT This article explores definitions and practice of flexible work and is part of a larger project about men’s flexible work. Flexible work is prevalent in workplace research, but evidence is lacking regarding how flexible work for men is interpreted and applied in practice. Gendered patterns of work and care more often position men in paid employment and less often in care and domestic responsibilities. Men’s use of flexible work could assist in balancing paid employment with unpaid domestic and care tasks. Qualitative content analysis (QCA) was undertaken to summarise participants’ descriptions of two key aspects of flexible work – forms of flexible work, and the reasons for flexible work. QCA was applied to 30 interviews about men’s flexible work with organisational leaders (n = 12, 3 women and 9 men) and men who use flexible work arrangements (n = 18). Participants typically discussed flexible work in their white-collar employment situations, most often in the form of part-time work and for the reason of caring for children. Participants’ descriptions of flexible work differed from how flexible work is commonly defined in policy and legislation, demonstrating that men use flexible work in ways not described in policy or legislation.

Health behaviours and affective states of partners of fly‐in fly‐out workers: A daily diary study

AbstractPartners of fly‐in fly‐out (FIFO) workers face increases in demands, for instance in care and family responsibilities, particularly in the absence of workers; however, little is known about how their daily life experiences influence their health across the FIFO work cycle. This study examined the within‐person effects of workload, job control and social support on affective states and health behaviours of partners of FIFO workers. Forty‐four (N = 44) partners of FIFO workers completed online diary surveys on affective states and health behaviours once a day for 28 consecutive days during on‐and off‐shift periods of the FIFO worker. Multilevel models were used to analyse day‐level data. The results of the study demonstrated significant differences in partners' depressed affect and alcohol consumption during both on‐ and off‐shift periods of FIFO workers. Daily increases in workload were associated with anxious affect, whereas daily increases in job control and social support were associated with low depressed affect and positive affect in partners of FIFO workers. Daily increase in social support was also found to be associated with an increase in daily alcohol intake. Interventions could support partners in managing the daily workload and encouraging the creation of social support networks in partners of FIFO workers.

Exploring Belief Systems in Kinship Fostering Practice in Igbo Indigenous Communities of Southeast Nigeria

ABSTRACTKinship fostering in Igbo indigenous communities is an enduring alternative child care practice that promotes collective responsibility for child care in a family environment. The practice is believed to be fundamental for family and community continuity. Weakening extended family ties and a lack of social work support services in this care arrangement have cast doubt on the continual viability of this alternative child care practice This is an exploratory study using grounded theory. In‐depth interviews with six community leaders and six senior public social welfare officers provided insight on belief systems promoting kinship fostering in Igbo indigenous communities. Findings were thematically analysed to show continuity of lineage, preservation of family name and challenges associated with kinship fostering. Belief systems on kinship fostering provides insights on how children are viewed in Igbo culture, which can help policymakers design intervention programme that are culturally relevant in child‐care formation in Nigeria given challenges in kinship fostering. The study promotes indigenous knowledge that is vital for social work education and practice in Nigeria. Further study suggests exploring the belief of foster children and their experiences in kinship fostering.

A Century of Surgical Quality: Origins, Evolution, and Future Directions.

Over a century has passed since Ernst A. Codman's pioneering call for surgeons to take open responsibility for patient care, a concept integral to the emergence and leadership of the American College of Surgeons (ACS). Codman's End Result Idea, originating in the early 20th century, laid the groundwork for professional responsibility and accountability in surgical practice, catalyzing the formation of the ACS. His innovative use of the "end result" technique at Massachusetts General Hospital highlighted significant variability in surgical outcomes, spurring debates on specialization and accountability. The ACS, under John Bowman's leadership, aimed to ensure optimal care through defined standards and verification mechanisms. Codman's Bone Sarcoma Registry, initiated in 1920, marked an early attempt at quality assessment and improvement through data collection. Despite facing resistance, Codman's vision laid the foundation for modern quality initiatives in surgical care. ACS programs, spanning trauma care to cancer treatment and beyond, have significantly enhanced patient outcomes while reducing costs. Looking forward, advancing surgical quality requires measuring quality, leveraging trusted data, embracing change management, fostering collaboration, and empowering specialists. The future of surgical care depends on collective efforts to uphold standards that ensure optimal care for all.

Early Childhood Education and Care Services, and Parents’ Work–Life Balance

Parents’ work–life balance represents a major challenge, especially for those who have young children. The present article aims to identify the perceptions of parents relating to the purpose of early childhood education and care (ECEC) services, care responsibilities, and factors that affect the balance between caring responsibilities for children and the professional career of parents. Using a database with 825 parents, who have children aged between 0 and 6 years enrolled in the ECEC system (nurseries, kindergartens), we performed a descriptive statistical analysis and a logistic regression to identify factors that affect the balance between caring responsibilities and career. The results indicate an appreciation of the usefulness of ECEC services (nurseries/kindergartens) by parents and underline the importance of parents’ involvement in the activities of ECEC services. Results also show that three factors affect the balance between caring responsibilities for children and professional career as follows: the residence area, the educational level, and the proximity to ECEC services. The need to develop ECEC services in Romania is correlated with the work–family balance field. Policymakers should focus more on structural changes and the development of early childhood education and care services, as well as the expansion of such services in both rural and urban areas.