Role In Care Research Articles

Theoretically informed codesign of a tailored intervention to support pressure ulcer prevention behaviours by older people living in their own homes in the UK and their lay carers: an intervention codesign study (C-PrUP)

ObjectiveTo codesign a theoretically underpinned, healthcare practitioner-mediated, tailored intervention to support housebound older patients and their lay carers to adopt pressure ulcer prevention behaviours.DesignTheoretical domains framework informed codesign.SettingOne geographical area...

Best Fit for Nurse Advancement: Breaking Down Barriers to Career Progression.

The retention of experienced nurses is a challenge for healthcare organizations in the current employment landscape. One retention tactic is to aid in their professional development. This article describes a program "Best Fit for Nurse Advancement" that provides dedicated time, resources, and support to explore career advancement pathways by breaking organizational progressional barriers. Results have shown retention within the organization, career role advancement, and positive program feedback.

Virtual Hospitals and Patient Experience: Protocol for a Mixed Methods Observational Study.

Virtual care is increasingly incorporated within routine health care settings to improve patient experience and access to care. A patient's experience encompasses all the interactions an individual has with the health care system. This includes a greater emphasis on actively involving carers in the decisions and activities surrounding a patient's health care. This study aimed to investigate the variety of health care delivery challenges encountered in a virtual hospital and explore potential ways to improve the patient experience. Focusing on acute respiratory, this protocol outlines a mixed methods study exploring the patient experience of a virtual hospital in Australia, Royal Prince Alfred Virtual Hospital (rpavirtual). We will use an exploratory mixed methods approach comprising of secondary data analysis, observations, interviews, and co-design focus groups. Participants will include patients, their carers, and health care workers who are involved in the acute respiratory virtual hospital model of care. Together, the data will be triangulated to explore views and experiences of using this model of care, as well as co-designing recommendations for further improvement. Findings from this study will identify current barriers and facilitators to implementing virtual care, such as work-as-done versus work-as-imagined, equity of care, the role of carers, and patient safety during virtual care. As of August 2024, a total of 25 participants have been interviewed. This protocol outlines a mixed methods case study on the acute respiratory model of care from Australia's first virtual hospital, rpavirtual. This study will collect the experiences of patients, carers, and health care workers to co-design a series of recommendations to improve the patient experience. DERR1-10.2196/58683.

Leveraging feminist approaches to care

The work of thinking about, with, and through care is not the prerogative of any single discipline or positionality, as this Special Issue vividly illustrates. Rather, its wide-ranging and enduring force as empirical reality, conceptual approach and political disposition are best grappled with through a multidisciplinary lens, bringing into meaningful conversation and careful comparison different subjects, sites and scales of care. In the process, care emerges as a contested terrain, an object of debate and difference, as well as an ongoing central dimension to life as lived across the realms of the individual to the collective and the institutional. It is thus our hope that the offerings in this Special Issue invite further attention to care's role in shaping social and political life, in Australia and beyond, and for humans and non-humans. We intend for this Issue to stimulate the kinds of coalitional thinking and acting that care demands of scholars across fields and also across differently situated communities of ‘we’.

Queering the role of hostel carers within the sexuality education of visually impaired learners

Background: Literature suggests that the comprehensive sexuality education (CSE) of children with disabilities (CwDs) remains located within parental and educators’ ecologies. However, very little focus has been given to the role of hostel carers, especially given that most special schools are mainly residential schools. As such, there is no policy, guidance, or training consideration for support staff such as hostel carers who equally play a care and support role for the CSE needs of CwDs.Objectives: The aim of this article was to explore how hostel carers in South African residential schools for the blind (SFB) perceived and responded to their role in providing CSE to visually impaired learners.Methods: Thirty-six hostel carers from three SFB were conveniently sampled and interviewed in separate focus group discussions. Queer theory underpinned this study, while the data generated was analysed thematically.Results: Given that visually impaired learners spend 9 months of the year in hostels to be given holistic institutional support, hostel carers reported assuming a major role in their CSE. But because they saw themselves as unqualified, outnumbered by learners, and inundated by other responsibilities (e.g. cooking and cleaning), they reported being powerless and incapable to sufficiently cater for the CSE needs of visually impaired learners.Conclusion: The study suggests that hostel carers have been neglected as care and support agents, despite playing a crucial role in the growing psychosexual needs of visually impaired learners.Contribution: A holistic approach to providing CSE to visually impaired learners incorporating carers is provided.

Enhancing Nursing Care through Cultural Competence: Focus on the Inupiat Community.

This article explores the historical and cultural background of the Inupiat community, highlighting health disparities and emphasizing culturally competent care's role in addressing them. Inupiat health beliefs, communication styles, family dynamics, and dietary habits are examined in relation to Western medical practices within tribal health systems. Strategies for cultural education include curriculum development, simulations, clinical assignments, and partnerships with Inupiat healthcare professionals. Challenges in providing culturally competent care to the Inupiat community are identified, including barriers in nursing education and legal implications for nursing practice. Strategies for enhancing nursing cultural competency are outlined. This paper advocates integrating cultural competency into nursing practices to improve care for the Inupiat community, focusing on training, education, and policy recommendations. It emphasizes the importance of respecting and integrating Inupiat cultural practices to enhance health outcomes and healthcare experiences.

The Impact of Medical Education Quality on Career Adaptability for International Students in China: The Mediating Role of Proactive Career Planning Behavior

Background: The quality of medical education plays a significant role in shaping the career outcomes of international students. As they navigate the challenges of their studies and career paths in a foreign country, understanding the elements that influence their career adaptability is essential. Objective: This study aims to examine the impact of medical education quality on career adaptability among international students in China and to emphasize the mediating role of proactive career planning behavior. It also investigates challenges related to cultural adjustment. Methodology: A quantitative technique is employed in a cross-sectional survey of international medical students in China. Information was collected from 575 valid responses through structured questionnaires. The research utilizes regression analysis and Structural Equation Modeling (SEM) to assess the relationships between medical education quality, career adaptability, proactive career planning behavior, and cultural adjustment challenges. Result: The evaluation revealed that medical education quality positively influences career adaptability (p < 0.001, β = 0.45). Proactive career planning behavior was found to positively influence career adaptability (p < 0.001, β = 0.38). Medical education quality positively influences proactive career planning behavior (p < 0.001, β = 0.50), and proactive career planning behavior mediated the connection between medical education quality and career adaptability (p = 0.013, β = 0.20). Cultural adjustment challenges moderated the relationship between medical education quality and career adaptability, with a significant interaction effect (p = 0.032, β = -0.15). Conclusion: The research emphasizes the significance of high-quality medical education in promoting career adaptability among international students, highlighting proactive career planning and examining cultural adjustment challenges for optimal career outcomes. These insights can inform educational practices and support services for international medical students, aiming to enhance their career readiness and adaptability in a global context.

A Patient and Public Engagement Project to Inform Dementia Care in a UK Hospital Trust.

The increasing prevalence of dementia in the United Kingdom presents significant challenges for healthcare, with projections estimating over a million affected individuals by 2025, costing the NHS £6.3 billion annually. Hospital admissions among dementia patients are common, occupying about 25% of UK hospital beds and leading to prolonged stays and diminished health outcomes. This paper presents the opening stages, part of a larger project where Patient and Public Involvement and Engagement (PPIE) was employed to understand and navigate what it means for hospital care for a person living with dementia. To understand hospital care for dementia patients, focus groups were conducted through dementia cafés in Essex and Suffolk from February to July 2023 engaging patients, carers and family members. Recognised processes for reporting PPIE and thematic analysis were used and identified six themes and 21 subthemes regarding hospital care: individualised care, role of carers, basic care, interpersonal communication, information sharing and staffing. The results from the PPIE will be used to inform and work with stakeholders through the next phases of the project, which involves examining care processes in the hospital, identifying touchpoints and evaluating these areas. The project continues to be informed by stakeholders including people living with dementia, carers and staff. Additionally, the results may inform other service providers for care enhancements, processes and delivery. Moving forward, the study emphasises the importance of building collaborative relationships with stakeholders involved in dementia care. Additionally, it provides insights to focus areas that are fundamental for acute care organisations when delivering care to people living with dementia. By incorporating insights from PPIE, this project seeks to identify inequalities in dementia care services, improve hospital care for people living with dementia, fostering a more inclusive and supportive healthcare environment. The purpose of the study was to explore the most important issues around hospital care for people with dementia, their carers and families. Persons living with dementia, carers and family members were involved in the study through community dementia cafés and recruited to take part in focus groups to discuss hospital care for patients with dementia. The design of questions and materials for the discussions was developed through consultation with the university department's service user lead and dementia specialist and reviewed by a service user member living with dementia. A pilot focus group was conducted with a group of carers. We worked with the dementia café managers to coordinate recruitment and a suitable environment to run the focus groups. Not applicable.

“Starting to think that way from the start”: approaching deprescribing decision-making for people accessing palliative care - a qualitative exploration of healthcare professionals views

BackgroundDeprescribing has been defined as the planned process of reducing or stopping medications that may no longer be beneficial or are causing harm, with the goal of reducing medication burden while improving patient quality of life. At present, little is known about the specific challenges of decision-making to support deprescribing for patients who are accessing palliative care. By exploring the perspectives of healthcare professionals, this qualitative study aimed to address this gap, and explore the challenges of, and potential solutions to, making decisions about deprescribing in a palliative care context.MethodsSemi-structured interviews were conducted with healthcare professionals in-person or via video call, between August 2022 – January 2023. Perspectives on approaches to deprescribing in palliative care; when and how they might deprescribe; and the role of carers and family members within this process were discussed. Interviews were audio-recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes. QSR NVivo (Version 12) facilitated data management. Ethical approval was obtained from the NHS Health Research Authority (ref 305394).ResultsTwenty healthcare professionals were interviewed, including: medical consultants, nurses, specialist pharmacists, and general practitioners (GPs). Participants described the importance of deprescribing decision-making, and that it should be a considered, proactive, and planned process. Three themes were developed from the data, which centred on: (1) professional attitudes, competency and responsibility towards deprescribing; (2) changing the culture of deprescribing; and (3) involving the patient and family/caregivers in deprescribing decision-making.ConclusionsThis study sought to explore the perspectives of healthcare professionals with responsibility for making deprescribing decisions with people accessing palliative care services. A range of healthcare professionals identified the importance of supporting decision-making in deprescribing, so it becomes a proactive process within a patient’s care journey, rather than a reactive consequence. Future work should explore how healthcare professionals, patients and their family can be supported in the shared decision-making processes of deprescribing.Trial registrationEthical approval was obtained from the NHS Health Research Authority (ref 305394).

Applying Bronfenbrenner’s Ecological Systems Model in Family Court

he work of Urie Bronfenbrenner is a key framework in Family Science, yet there are many areas where it has seldom been applied, including in the processes experienced by divorcing families in Family Court. Acknowledging the paucity of scholarship applying ecological systems theory to these topics, the paper offers instructive interpretations of personal practice experience in these roles. Described are two of several career roles in Family Court available to professionals trained in family science and how Bronfenbrenner’s ecological systems model of development is applicable in that work. Careers described are providing training and consultation for attorneys and judges and conducting custody evaluations. Bronfenbrenner’s model affords consistent and useful principles for both roles. The processes of separation and divorce are described as a series of ecological transitions that affect not only family structure, but the relationships that make up the family system, as well as family members’ participation in other ecosystems. Changes in relationships and ecosystems affect development by requiring individuals to adapt. Family Court itself is an ecosystem with roles, activities and macrosystem beliefs that are often stressful for family members and that may increase risks to family relationships and development. Discussion considers areas where Family Scientists can use Bronfenbrenner’s model to contribute to improved research and practice for divorcing families.

Identifying patterns and profiles of vaccination hesitancy among nurses for tailoring healthcare policies in the UK: A cross-sectional study.

To profile the characteristics of nurses with varying levels of vaccine hesitancy toward the COVID-19 and influenza vaccines. In many countries across the world, healthcare workers, and nurses in particular, display significant reluctance toward COVID-19 and influenza vaccines due to concerns about safety, distrust in healthcare policies, and media influences. To address this, a proposed approach involves profiling nurses to tailor vaccination campaigns and to improve acceptance rates and public health outcomes. This cross-sectional study adopted the Vaccination Attitudes Examination scale to assess hesitancy toward COVID-19 and influenza vaccines among 294 registered nurses in the UK between March and July 2023. A K-means cluster analysis was performed. The Strengthening the Reporting of Observational Studies in Epidemiology guidelines were adopted. Three profiles were identified. Profile A showed low vaccination hesitancy, profile B showed average hesitancy, and profile C showed high hesitancy toward vaccines. The highest concern for all profiles was related to unforeseen future effects of vaccination. Profile C had more nurses in early career roles, whereas nurses in profiles A and B were in more senior roles. Profile A showed higher educational attainment. Nurses in profile C used Snapchat more, whereas nurses in profile A used Twitter more frequently. This study identified specific characteristics associated with higher levels of vaccination hesitancy in nursing. Unforeseen future effects of vaccination are a core aspect to consider in promoting vaccination. Policies and vaccination campaigns should be targeted on early career nurses and should deliver tailored messages to dispel misinformation about unforeseen future effects of vaccination through specific social media platforms. Senior nurses should be involved as role models in promoting vaccination. These results are key for enhancing an evidence-based approach to implementing global health policies in healthcare.

Persisting gaps in dementia carer wellbeing and education: A qualitative exploration of dementia carer experiences.

To explore the emotional wellbeing of dementia carers in the lead up to and during transition of a person living with dementia to a residential aged care facility. An interpretative qualitative study. Semi-structured interviews were conducted with informal carers of person living with dementia between February and June 2023. Data were analysed using an inductive thematic approach and resulted in three themes. The majority of carers were adult children (n = 19) and six were wives. Carers lived across metropolitan (n = 20) and regional settings (n = 5) in the most populous state of Australia. Three themes were identified which were attributed to different aspects of the carer role: (1) Carer emotional journey as dementia progresses - impacted by knowledge and lack of support; (2) Questioning decision making-underpinned by knowledge and confidence; and (3) Challenges in re-establishing identity - impacted by ongoing concerns. As dementia progresses carers of person living with dementia consistently reported gaps in knowledge including how to access support. Specifically, this study identified the need for more to be done to help carers to develop the skills needed for their role, including participation in care planning and identifying care preferences for the future. Nurses can play a key role in promoting referral to services that support carers. Findings offer practical solutions to ameliorate carer stress and promote shared decision making. This research was guided by the Consolidated Criteria for Reporting Qualitative Research.

The role of career and technology dual enrollment programs in facilitating student postsecondary transition

The role of career and technology dual enrollment programs in facilitating student postsecondary transition

Dr Catherine Chisholm, 'children's physician': Her work for child welfare and feminist networking in Manchester.

Catherine Chisholm BA MB ChB MD FRCP CBE (1879-1952) is celebrated as the first woman to qualify in medicine from Manchester University in 1904 and is remembered for founding the Manchester Babies Hospital in 1914 (later renamed in 1935 as the Duchess of York Hospital for Babies). She was indefatigable in her pursuit to improve the education and status of women doctors; the first woman member and president of the British Paediatric Society; first woman president of the Manchester Medical Society and was mainly responsible for establishing the Medical Women's Federation in 1917. Her career was a complex mixture of medical and social networks that linked her work as a children's physician to the Manchester Public Health Committee, Liberal politics and feminist groups. These networks played an important role in Dr Chisholm's successful career and are at the centre of this paper.

Understanding Dementia Carer Experiences Before Admission to a Residential Aged Care Facility: Implications for Integrated Care.

In-depth understanding of dementia carer experience can assist clinicians by providing insight into dementia onset, symptoms and management, and help conceptualize and understand the pattern of dementia progress over time and what help is needed. We undertook a qualitative study to understand dementia carers experiences of providing care and reasons for admission to a residential aged care facility (RACF). Three themes were identified: (1) Challenges in the path to diagnosis and care, leading to delays accessing support; (2) Carer role impacted by living circumstances; and (3) Variation in decision support prior to admission to a RACF. Identifying dementia carer experiences, reinforces the need for more timely diagnosis, referral for support and interventions to promote better quality of life for a people living with dementia and their carer and to delay premature RACF placement.

Middle school students’ career parental support and adolescent–parent career congruence: the mediating role of self-efficacy

AbstractSocial cognitive career theory accepts that an individual’s career journey occurs through the interaction of multiple factors. The career development process includes internal or external factors’ positive or negative effects. This study aims to examine the mediating role of career and talent development self-efficacy, which expresses the belief about a person’s ability, in the relationship between two variables related to parents (adolescent–parent career adaptation—career-related parental support), which is an important factor in the career development of secondary school students. The model was tested with data collected from 652 secondary school students. The results showed that career and ability self-efficacy had a partial mediating role between career-related parental support and adolescent–parent career adjustment. Suggestions are presented to increase adolescent–parent harmony.

Acceptability and preliminary effects of the volunteer-supported Meaningful Moments program to engage older adults with advanced dementia on a hospital-based specialized dementia care unit: a mixed methods study

BackgroundNamaste Care offers practical skills for healthcare providers, volunteers, and families to meaningfully engage individuals with dementia in activities (e.g., music, massage, reminiscing, socialization, aromatherapy, snacks). A hospital-based specialized dementia care unit for patients with mid- to late-stage dementia offered an adapted version of the Namaste Care program, which was called Meaningful Moments. The aim of this study was to assess the acceptability and preliminary effects of this novel approach using trained volunteers for older adults with mid- to late-stage dementia.MethodsA mixed methods multiphase design was used. Qualitative description was used to explore acceptability of the Meaningful Moments program delivered over 6 months through focus groups (e.g., charge nurses, therapeutic recreationists, nurses, social workers) and individual interviews with one volunteer and two family members. A prospective pre-post-test study design was used to evaluate the preliminary effects of the program for patients with dementia and family members. Outcomes included quality of life, neuropsychiatric symptoms, and pain for patients with dementia and family carer role stress and the quality of visits for families. Data were collected from June 2018 to April 2019. Descriptive analyses of participants’ characteristics were expressed as a mean (standard deviation [SD]) for continuous variables and count (percent) for categorical variables. Focus group and individual interview data were analyzed using thematic analysis. The generalized estimating equations (GEE) method was used to assess change in the repeated measures outcome data.ResultsA total of 15 patients received the Meaningful Moments interventions. Families, staff, and volunteers perceived that patients experienced benefits from Meaningful Moments. Staff, volunteers, and families felt fulfilled in their role of engaging patients in the Meaningful Moments program. Individualized activities provided by volunteers were perceived as necessary for the patient population. There were no statistically significant improvements in patient outcomes. There was a statistically significant decline in family carer role stress.ConclusionsUsing a one-on-one approach by volunteers, patients experienced perceived benefits such as improved mood and opportunities for social interactions. There is a need for tailored activities for older adults with advanced dementia through practical strategies that can offer benefit to patients.

Bibliometric Analysis of Key Findings in Studies on Gender Disparities in Education and Employment

This study employs bibliometric analysis to explore the evolving landscape of research on gender disparities in education and employment from 1985 to 2024. Utilizing VOSviewer for data visualization, we identified key thematic clusters, analyzed trends over years, and pinpointed less-researched areas that present opportunities for further inquiry. Our findings revealed that while traditional topics like wage disparities and labor market participation continue to dominate the research, newer areas such as the impact of global events (e.g., COVID-19) and intersectional identities on gender inequalities are gaining prominence. Notably, the analysis highlighted significant gaps in research related to poverty, household dynamics, and health care's role in gender disparities. These findings suggest a need for a more nuanced exploration of how gender disparities affect various socioeconomic outcomes and call for targeted research efforts in underexplored areas to develop a more comprehensive understanding of the issues at hand.

Women’s caring responsibilities as they age: assessing the Sandwich Generation’s satisfaction with life and well-being

ABSTRACT While dual-caring responsibilities have increased for some middle-aged adults, due to caring for parents and children, limited research exists on the effects on well-being of this dual care role on working carers, and specifically with respect to women. For this ‘Sandwich Generation’, especially for those who work outside the home, these increased demands may adversely affect their life and job satisfaction, and their well-being, inclusive of their general health. The present research explored the impact of care responsibilities on the overall self-reported quality of life of women dual carers who work. It explored the usefulness of resources for working dual carers, in supporting them in their distinct roles. Employed women (N = 433, aged 23–69, M = 51.27 years) mainly from the United Kingdom and Australia completed an online structured survey. Findings indicated that higher levels of personal and work resources, in particular optimism, self-efficacy, job autonomy, skill discretion, and social support, were able to buffer deleterious outcomes, such as poor well-being (depression, anxiety, stress, negative affect), while supporting well-being (positive affect, general health), increasing job satisfaction and life satisfaction. The dual carer role was not a significant predictor of the participants’ well-being, with only the women’s general health being slightly reduced.

Experiences of middle-aged individuals with lower extremity amputation caused by diabetic foot ulcer after disability in China: A qualitative study.

To understand the experiences of individuals who undergo LEA due to DFU after disability. A descriptive research design in qualitative research. Semi-structured interviews were used in this qualitative descriptive study. Eleven middle-aged patients (45-59 years) who underwent LEA due to DFU were purposively selected and interviewed. Qualitative data were thematically analysed. Three themes and 10 subthemes were identified. The themes were (1) role function confusion, (2) self-concept stress and (3) unreasonable objective support. Subthemes included (1) weakened career role, (2) family role reversal, (3) social role restriction, (4) over-focusing on appearance, (5) immersion in patient experience, (6) living with faith, (7) polarization of independent consciousness, (8) low perceived benefits of peer support, (9) existence of treatment disruption and (10) poor participation in medical decision-making.