Context Of Social Care Research Articles

‘We are changed yet the same…we can make a difference’: using a critical, creative, collaborative inquiry process to understand and develop professional artistry in nursing

ABSTRACT Professional practice in health and social care is embodied by the practitioners concerned, embedded in practice contexts and creative in nature. It is therefore complex to investigate, understand and develop. Current health and social care contexts can present practitioners with increasingly constraining circumstances and spaces that can feel closed instead of open to exploration and development of practice. The collaborative, critical and creative inquiry methodology presented here was developed among nurses practising in such challenging circumstances. It enables nurses and other health and social care practitioners to reveal, explore and develop their embodied practices, systematically and collaboratively, amid busy daily practice situations. However ‘small’ the space they are in, the process described here can help practitioners to enlarge their space for becoming. The iterative cycle and the use of participatory arts help illuminate otherwise hidden and difficult to articulate aspects of practice, enable the involvement of stakeholders in coming to new understandings and lead to an expanded view of professional practice and its potential for transformation. The purpose of this paper is threefold. First, to present the methodology, methods and lessons learned during the doctoral study in which this approach was developed. Second, to reveal the professional artistry of facilitating this space for becoming and of supporting professionals to reveal their own and others’ professional artistry. Lastly, to offer inspiration and a guide for others considering similar participative inquiry work and to encourage debate and critique of the approach taken.

Assessing the maturity of integration of health and social care in Finland – findings from a pilot study

PurposeIntegrated care is the leading approach to developing health and social care services in Finland. After the national health and social care reform, the importance of assessing integration has been emphasized. The aim of this study was to pilot the SCIROCCO tool, which assesses integration maturity, in Finland. The SCIROCCO tool was translated and adapted to the Finnish health and social care context. The feasibility and utility of this tool for assessing the maturity for integration across health and social care in Finland were evaluated using empirical pilot data collected among employees of selected well-being service counties. The study also provided baseline information on the maturity of integration after the national health and social care reform.Design/methodology/approachEmployees (n = 111) of different personnel groups in health and social care services in four well-being service counties assessed the maturity of integration using a web-based survey. A pilot study design was used.FindingsThe SCIROCCO tool was found to be useful for assessing the maturity of integration in health and social care within the well-being service counties. However, the tool requires further development to be fully adapted to the Finnish health and social care system and to assess integration across sectors. The results emphasize the need to understand the perspectives of different personnel groups on integration and to consider them in the development work.Originality/valueThis was the first study conducted in Finland that provided valuable insights into the assessment of integration across the health and social care sectors. This study establishes the foundation for future research and development in the field of integration assessment.

From passive subjects to active agents: enabling child-centred recordkeeping in social care contexts

ABSTRACT This paper describes the findings and implications of interdisciplinary exploratory research conducted by social work and recordkeeping informatics researchers in Australia and the UK. It sought to identify the practices, systems, education and technologies that can foster rights-based, child-centred recordkeeping practices in child protection contexts, exploring the transformation and advocacy work that could be achieved in child protection case note recording and recordkeeping practices and systems through interdisciplinary collaborations. Drawing from qualitative interviews, focus groups and surveys with Social Work students, Social Work educators and practice educators, and with practitioners working in children’s social care (in England) and the child protection services system (in Australia), we identify how practitioners are prepared for keeping records that reflect children’s voices and experiences, and identify emerging best practices and persistent challenges. Focusing on the intersection of child rights, archival ethics, and participatory approaches, this paper adds to the discourse on critical archival studies concerning children and calls for an interdisciplinary approach to reimagine future possibilities for participatory and child-centred practice in which children are not just passive subjects but active collaborators in the recordkeeping process.

Applying models of co-production in the context of health and well-being. A narrative review to guide future practice.

Recent years have seen a dramatic growth in interest in the nature and extent of co-production in the health and social care sectors. Due to the proliferation of work on co-production, there is variation in practice in how co-production is defined, understood, and used in practice. We conducted a narrative review to explore, and provide an overview of, which models of health and social care co-production have been developed, applied, and critiqued over recent decades. Seventy-three peer-reviewed articles met our inclusion criteria. In this set of articles, we identified three broad types of models: conceptual/theoretical, practice-oriented, and presenting a typology. We found that practice-oriented models, predominantly from the Health Services Research and Quality Improvement literature, had largely not drawn on conceptual/theoretical models from the disciplinary fields of Public Administration & Management and Sociology. In particular, they have largely neglected theoretical perspectives on relationships and power and agency in co-production work. The concepts of Service-Dominant Logic and Public Service-Dominant Logic as ways to think about the joint, collaborative process of producing new value, particularly in the context of the use of a service, have also been neglected. Our review has identified distinct literatures which have contributed a variety of models of health and social care co-production. Our findings highlight under-explored dimensions of co-production that merit greater attention in the health and social care contexts. The overview of models of co-production we provide aims to offer a useful platform for the integration of different perspectives on co-production in future research and practice in health and social care.

Dimensions of clinical leadership among pre-registration nursing students: a cross-sectional study between two countries

To explore a) pre-registration students' self-perceptions of clinical leadership behaviours and b) differences in students' self-perceptions of leadership behaviours between two countries (UK and Israel). Effective leadership has been associated with high-quality and compassionate care provision in health and social care contexts. This has led to a common acceptance that teaching leadership in nursing education is essential if students are to develop competencies in this area. Worldwide, there is limited research on nursing students' perception of clinical leadership behaviours as well as on the development of leadership behaviours during the study years. A cross-sectional survey design was used among two convenience samples of UK and Israeli pre-registration nursing students. Closed questionnaires were uploaded in the format of a commercial internet survey provider (Qualtrics.com) and distributed through the virtual learning platforms in the two participating universities. In total 656 students were invited to participate and the response rates were 28.1 % (Israel) and 17.9 % (England). Overall, 140 students completed the questionnaires. Significant differences were found between the two sites in the leadership dimensions "Emotional Intelligence" and "Impact and Influence" (p < .05), with UK students scoring higher than Israeli students. Among the Israeli sample, significant differences were found in leadership dimensions according to years of study, with higher scores reported in the 3rd and 4th year students compared with the 1st and 2nd Year students in the referred dimensions (p < .05). Differences in students' clinical leadership perception exist between the two cohorts examined. Nurse educators should expand international research on this subject to identify possible antecedents in developing clinical leadership behaviours. At the same time, there is a need to continue efforts to enhance the development of clinical leadership behaviours during all study years through curriculum updating to prepare future nurses better to provide quality, safe and person-centered care.

Reflections on co‐productive research in a youth‐focused climate education project

AbstractThe 1989 UN Convention on the Rights of the Child emphasises the value of listening to young people’s voices. Since its inception, there have been significant moves to involve young people in research that concerns their lives in a time of environmental emergency. Drawing on critical analysis of our work with Youth Action Partnerships (YAPs), this article explores how co‐production with young people can effectively be achieved and offers meaningful ways for young people to share their stories in a time of climate crisis. We draw on rich insights from our experience of working in partnership with young people and explore how they have been supported to shape and influence the research process. Our findings enable us to build on Hickey’s five principles for co‐production with adults in a health and social care context. We show that, in addition to those, there is need to consider three other principles when co‐working with youth. We embed the eight principles for co‐production in a new model for effective co‐production with young people to support researchers to successfully prepare for, and implement, such co‐production processes in other work.

A systematic review of literature examining the application of a social model of health and wellbeing.

Following years of sustained pressure on the UK health service, there is recognition amongst health professionals and stakeholders that current models of healthcare are likely to be inadequate going forward. Therefore, a fundamental review of existing social models of healthcare is needed to ascertain current thinking in this area, and whether there is a need to change perspective on current thinking. Through a systematic research review, this paper seeks to address how previous literature has conceptualized a social model of healthcare and, how implementation of the models has been evaluated. Analysis and data were extracted from 222 publications and explored the country of origin, methodological approach, and the health and social care contexts which they were set. The publications predominantly drawn from the USA, UK, Australia, Canada and Europe identified five themes namely: the lack of a clear and unified definition of a social model of health and wellbeing; the need to understand context; the need for cultural change; improved integration and collaboration towards a holistic and person-centred approach; measuring and evaluating the performance of a social model of health. The review identified a need for a clear definition of a social model of health and wellbeing. Furthermore, consideration is needed on how a model integrates with current models and whether it will act as a descriptive framework or, will be developed into an operational model. The review highlights the importance of engagement with users and partner organizations in the co-creation of a model of healthcare.

Leading the American Academy of Nursing: A historical review of the Presidents’ words and actions on “rationality,” inclusivity, and health policy, 1973 to 2023

BackgroundLittle has been written about the history of the American Academy of Nursing (Academy). An examination of the association’s origins, purpose, early goals, and leaders’ words and accomplishments can illuminate the organization’s role within the profession today. PurposeThis paper begins the process of documenting the Academy’s history. It focuses on the words and accomplishments of the Academy’s Presidents, setting them within the social, political, economic, and health care context of the years between 1973 and 2023. MethodsTraditional historical methods with a social history framework. DiscussionThree themes emerged. These include the importance of “rationality” (later termed “scientific evidence”) as the basis for practice; the critical need for cultural, racial, and ethnic inclusivity in the association; and the necessity of engaging all Academy Fellows and Expert Panels in the work of driving health care policy. ConclusionUnderstanding the association's history, beginning with an analysis of the Presidents' words and accomplishments is a first step in documenting the Academy's history.

Older adults’ experiences of ehealth in health and social care

Using the Unified Theory of Technology Acceptance (UTAUT) model as a framework for this study, the aim was to describe how older adults assess digital services in terms of ease of use and quality in health and social care and how often those services are offered. Further, the aim was to describe how older adults receive support for service use, focusing on people aged 65 and over. A structured web-based questionnaire was used for data collection. The data (N=978) was analysed by quantitative statistical analysis. Most of the respondents found the digital services of health and social care easy to use. The function of the services was considered understandable. Respondents also felt that they could find the necessary information about the services. For the most part, they received service use help from their children or grandchildren. However, the role of health and social services professionals was less important. According to our findings, older adults received minimal support from health and social care professionals or employees in third sector organizations. Although, most respondents (70 %) needed support when using digital services. In the future, health and social care service providers should invest in increased digital services. In conclusion, we found that older citizens know how to use digital services in the health and social care context and they receive adequate help from their relatives in using them.

Of Dog and Dice: Affective-Messy Posthuman Narratives Through Creative Pedagogies and Corresponding in the Classroom

Drawing on our work with children in education and with adults in Health and Social Care contexts, this paper presents two vignettes that demonstrate how the authors became “messy” researchers. This “messy” framework offered them the opportunity to view and understand the nuanced mechanisms of teacherly relationships as shared spaces and places of mutual discovery, well-being, and flourishing. In a time when COVID-19 presents challenges to classrooms in terms of touch and social distance measures, re-claiming the body as discourse has never been more relevant to learning and educational settings.

The “PERSPECS” principles: early action and migrant children with no recourse to public funds

PurposeThis paper aims to make the case for early action approaches with migrant families, introducing a set of principles for practice, mapped against the Professional Capabilities Framework for social work and the Social Work England professional standards.Design/methodology/approachThe paper first explores the context of social work with migrant families, outlining the challenges and gaps in our conceptual understanding of this work. The paper then introduces a conceptual model of work with migrant families which draws on the literature from social work and allied professions, and informed by social work values and ethics.FindingsCurrent social work practice with migrant children has been criticised as defensive, procedural and lacking a coherent conceptual basis, particularly for those who are subject to the no recourse to public funds (NRPF) rule. This field of social work practice would benefit from an evidence-informed model of practice, anchored in human rights approaches and focused on early action. Eight principles, drawn from existing good practice in other social work and social care contexts, are outlined as the basis for a new model of practice in social work with migrant families.Originality/valueThe NRPF rule is a provision in the immigration rules that prevents people who are subject to immigration control from claiming most social security benefits in the UK. In recent years, there has been an increased interest in research about the NRPF rule and its negative impact on children. However, there is currently no evaluated model of social work practice for children and families with NRPF.

Improving primary care based post-diagnostic support for people living with dementia and carers: Developing a complex intervention using the Theory of Change.

The need to improve support following a diagnosis of dementia is widely recognised, but it is unclear how this can best be achieved within UK health and social care systems. A task-shared and task-shifted approach has been recommended, but there is limited guidance on how to achieve this in practice. As part of a programme of research, we developed an intervention to enhance the role of primary care in post-diagnostic care and support for people living with dementia and carers. We used the Theory of Change to develop a complex intervention informed by initial literature reviews and qualitative work. The intervention was developed through an iterative series of workshops, meetings and task groups with a range of stakeholders, including the multidisciplinary project team, people living with dementia and carers, service managers, frontline practitioners, and commissioners. 142 participants contributed to intervention development through face-to-face or virtual meetings. The intervention comprises three complementary strands of work focusing on: developing systems, delivering tailored care and support, and building capacity and capability. Clinical dementia leads, based in primary care networks, will facilitate the intervention providing tailored expertise and support. The Theory of Change proved useful in providing structure and engaging stakeholders. The process was challenging, took longer and was less participative than intended due to restrictions caused by the COVID-19 pandemic. We will next conduct a feasibility and implementation study to explore whether the intervention can be successfully delivered within primary care. If successful, the intervention offers practical strategies for delivering a task-shared and task-shifted approach to post-diagnostic support that could be adapted for similar health and social care contexts internationally.

Exploring the Distinctiveness of Social Enterprises Delivering Adult Social Care in England

Social enterprises, which are businesses with social objectives, have been championed by the UK government as an opportunity to deliver more innovative, socially oriented, and commercially sustainable public services. However, very little is known about them, especially in a social care context. This paper therefore aims to answer the following three questions: (1) What are care social enterprises?, (2) What are their distinctive qualities?, and (3) How can they contribute to the adult social care sector? It presents evidence from a “mapping” of care social enterprises in three English local authorities, and from interviews with 35 stakeholders from across the social care and social enterprise sectors. Drawing on an institutional logics framework, we explore the influence of different norms, goals, and practices on care social enterprises and the extent to which they are aligned with those of the public, private, and not-for-profit sectors. We found that their unique combination of business and social logics, along with an entrepreneurial mindset, may make them more flexible, innovative, and able to diversify their income than public and not-for-profit care organisations. They were also considered more trustworthy than private care services. However, their competing social and business logics can create internal tensions and bring uncertainty about what organisational model they are. These tensions can make it challenging for us to define what a care social enterprise is and in turn for social enterprises to promote themselves and attract funding.

How Accommodative Are Houses in Trinidad? Implications for Older Persons With Disabilities

ABSTRACT This paper examines the accommodation in houses in Trinidad in the context of older persons with disabilities. An exploratory sequential mixed-methods research design was used. In the qualitative phase, a list of accommodation items was identified via interviews. This information was used to develop a questionnaire to measure accommodation items of a large nationally representative sample of houses in Trinidad. Only physical accessibility items were identified, and data from 768 houses indicated that no house had all identified items. There is a need for urgent adoption and implementation of accessibility standards. Findings also indicate modification cost is a challenge and that responses targeted to low-income and rural households are needed. Lastly, the social care context, specifically the family care potential, is an important consideration in housing policy debates, and community homes for the aged and programs involving multiple experts to identify and support housing modification are recommended.

Exploring companion animal caretakers' attitudes, perceptions and behavioural drivers of antimicrobial use within the social context of veterinary care.

To explore companion animal caretakers' attitudes, perceptions and behavioural drivers of antimicrobial use within the social context of veterinary care. Five semi-structured focus groups were conducted with 26 cat and dog owners. Transcripts were subjected to thematic analysis to systematically code and classify themes related to the study objectives. Thematic analysis revealed five themes - trust-building/relationships, shared decision-making/empowerment, clear communication, judicious use and concerns surrounding antimicrobial use. Strong veterinarian-client relationships were the underlying factor influencing acceptance of antimicrobial use stewardship principles. Participants viewed themselves as advocates for their animals and preferred a relationship-centred approach to care facilitated through competent communication. They cited the importance of clear communication related to diagnosis and antimicrobial recommendations including using client-friendly terminology, providing explicit instructions for antimicrobial use, and having a shared plan for next steps and follow-up communication. Participants reported challenges with administering antimicrobial drugs, expressed concerns with potential side effects and development of antimicrobial resistance. Consequently, they reported an interest in alternatives to antimicrobial drugs and a focus on preventive medicine that was counterbalanced with concerns for animal comfort and welfare. Conversations about antimicrobial use can be reframed to include alternatives to antimicrobials as part of the treatment plan, and clients can be empowered to play a more active role in their animals' care. Veterinarians can apply core communication skills to advance antimicrobial stewardship principles and thereby contribute to preserving the effectiveness and availability of antimicrobials while preserving the trusting relationship and shared decision-making between clients and veterinarians.

ENACT study: What has helped health and social care workers maintain their mental well-being during the COVID-19 pandemic?

A growing body of research has highlighted the adverse impact of COVID‐19 stressors on health and social care workers' (HSCWs) mental health. Complementing this work, we report on the psychosocial factors that have had both a positive and negative impact on the mental well‐being of HSCWs during the third lockdown period in Scotland. Using a cross‐sectional design, participants (n = 1364) completed an online survey providing quantitative data and free open‐text responses. A multi‐method approach to analysis was used. The majority of HSCWs were found to have low well‐being scores, high levels of COVID‐19 stress, worry, burnout and risk perception scores and almost half of HSCWs met the clinical cut‐off for acute stress (indicative of PTSD). HSCWs with higher scores on adaptive coping strategies and team resilience reported higher scores on mental well‐being. HSCWs were significantly more likely to seek informal support for dealing with personal or emotional problems compared to formal supports. Barriers to formal help‐seeking were identified including stigma and fear of the consequences of disclosure. HSCWs mostly valued peer support, workplace supports, visible leadership and teamwork in maintaining their mental well‐being. Our findings illuminate the complexity of the effects of the COVID‐19 pandemic on HSCWs' well‐being and will inform future intervention development seeking to increase positive adaptation and improve staff well‐being. Addressing barriers to mental health help‐seeking among HSCWs is essential. The implications emphasise the importance of lessons learned across health and social care contexts, planning and preparedness for future pandemics.

Assessing potential brief screening questions for use within different social care-related contexts to identify individuals experiencing gambling-related harms: A scoping review.

Gambling-related harms are increasingly recognised as public health concerns internationally. One response is to improve identification of and support for those affected by gambling-related harms, including individuals who gamble and those close to them, 'affected others'. Adult social care services have been identified as a setting in which screening for gambling-related harms is suitable and desirable. To achieve this, a tool is required which can identify gambling-related harms experienced by individuals and affected others. This scoping review aimed to identify whether any brief (i.e. three questions or less) screening tools are being used and, if so, how brief screening for gambling-related harm is being implemented in health and social care-related contexts. An international English language scoping review of research and grey literature was undertaken between April and July 2021. The search included single-item and brief screening tools which have been developed to identify gambling-related harms for individuals and affected others across a range of health and social care-related contexts. Findings show that screening tools for gambling-related harms have been developed for use in health settings rather than in social care contexts. For example within gambling, mental health or substance misuse support services. We found no evidence of a brief or single-item screening tool for identifying harms to individuals and affected others which is of adequate quality to strongly recommend for use in an adult social care setting. Development of a validated brief or single-item screening tool is recommended to assist adult social care practitioners to effectively screen, identify, support and signpost people affected by gambling-related harms.

Evidence in Norwegian child protection interventions – Analysing cases of familial violence

AbstractHow is expert evidence used in care order proceedings when children are considered for foster care placement because of familial violence? What are important factors and how do the decision‐makers use and evaluate evidence from specialists and experts? In this in‐depth analysis of 104 published care order decisions from the Norwegian County Boards, I investigate how decision‐makers use and evaluate evidence from expert witnesses to determine whether a care order may be granted. The analysis shows that the evidence largely revolves around social functioning, care context and topics about how parents and children relate to each other. Led by the law, the decision‐makers use this evidence to determine whether the child's situation is harmful, whether support services are viable and whether a care order is in the child's best interests. I find that decision‐makers draw unevenly on evidence with regards to these legal requirements, and that the use predominantly defers to expert authority. However, there is also evidence of independent reasoning, where deferral to the epistemic authority of the experts is weakened. This is shown through evaluative and critical assessments and scrutiny of the disciplinary evidence.

Digital interventions for people with dementia and carers: effective, cost-effectiveand equitable?

Digital interventions for people with dementia and carers: effective, cost-effectiveand equitable?

A Scoping Review to Map the Evidence on the Use of Sandplay to Understand the Subjective Experience

An interest in applying creative arts-based research approaches, such as sandplay in the health and social care contexts, is growing worldwide. The aim of our study was to identify the existing studies that use sandplay as a method or intervention and their impact on different target groups in health and social care settings. We conducted this review following the Joanna Briggs Institute’s method for scoping reviews, using Arksey and O’Malley’s five-stage scoping review framework. We conducted a comprehensive search in the CINAHL Complete, MEDLINE Complete and the Psychology and Behavioral Sciences Collection databases. A search strategy with selected inclusion and exclusion criteria was used to reveal a wide range of evidence. This study included quantitative and qualitative studies published in English from 2009 to 2019. Thirty-two studies formed the final data set and, ultimately, we selected seven published papers for our review. Most of the participants in these studies were children aged from 4 to 17 years. The scoping review highlighted the use of sandplay as a method to express and understand a person’s day to day lived experiences, especially with children. A joyful, accepting, individual centered and positive therapeutic environment reportedly characterized the sandplay sessions. And it was a valuable arts-based approach that positively affected the participants’ mental health and well-being, community building, creative self-expression, self-acceptance, problem solving and empowerment.