Context Of Social Care Research Articles

Understanding experiences of neglected tropical diseases of the skin: a mixed-methods study to inform intervention development in Ethiopia

BackgroundThe WHO and Ethiopia’s Ministry of Health have developed strategies to expand and integrate services for co-endemic neglected tropical diseases (NTDs) which manifest in the skin. To inform these strategies, we aimed to understand the social, economic and health system context of skin NTD care in Kalu woreda, Amhara region, Ethiopia, where cutaneous leishmaniasis (CL) and leprosy are endemic.MethodsBetween October 2020 and May 2022, we surveyed and reviewed records of 41 primary healthcare facilities and explored common disease experiences in focus group discussions (n=40) and interviews with people affected by leprosy (n=37) and CL (n=33), health workers (n=23), kebele authorities and opinion leaders (n=33) and traditional healers (n=7). Opportunities for integrated skin NTD service provision were explored through policy document review, interviews with health officials (n=25), and stakeholder meetings.ResultsAvailability of diagnostic supplies and health worker competence to provide skin care was very limited across primary healthcare facilities, particularly for CL. People with leprosy commonly sought care from healthcare facilities, while people with CL administered self-care or sought help from traditional healers. Travel and costs of care at specialised facilities outside the district inhibited timely care-seeking for both diseases. Transmission discourses shaped different understandings of who was affected by leprosy and CL and expectations of behaviour during and after treatment. Many policy actors felt that existing supply chain interventions, decentralised treatment approaches and community engagement initiatives for leprosy could also benefit CL, but others also warned against increasing care-seeking unless CL treatment could be provided on a scale commensurate with the large burden they perceived.ConclusionOur findings demonstrate significant gaps in the provision of care for skin NTDs within primary healthcare, very different health-seeking patterns for leprosy and CL, and a need to develop new models of care, especially for CL.

A Systematic Review of Trust Assessments in Human–Robot Interaction

The integration of robots into daily life has increased significantly, spanning applications from social-care to industrial settings with collaborative robots. Ensuring a safe, secure environment and equitable workload distribution in human-robot collaborations is crucial. Trust is a key factor in these environments, essential for enhancing collaboration and achieving tasks while maintaining safety. Under-trusting robots can hinder productivity, while over-trusting them can lead to accidents. A comprehensive literature review of 100 publications from 2003 to 2023 analyzes trust and its influencing factors in industrial and social-care contexts. Findings reveal that in industrial settings, robot-related factors are more influential, whereas in social-care, human and environmental factors play a significant role. Furthermore, the review delves into gauging trust through observable behavior, while also exploring various trust evaluation methodologies. Results show that trust can be gauged through human behaviors, physical cues, and physiological measurements. Concerning trust evaluation methodologies, traditional questionnaires have limitations, opening new opportunities for machine learning and sensor-based approaches to real-time trust evaluation, as trust is a dynamic cognitive value that evolves over time. Notably, 97% of the reviewed articles were published in the last decade, underscoring a growing interest in human–robot interaction and trust within the scientific community.

Primary care functional features and their health impact on patients enrolled in the Shanghai family doctor service: a mixed-methods study.

While research in multiple countries confirms that primary care functional features significantly improve patient health, China's primary care system differs markedly due to unique structural and contextual factors. This study aims to measure and explore the functional features experienced by patients received family doctor contract service in the past year, evaluating the impacts and pathways of these primary care features on health outcomes. We employed a mixed-methods explanatory sequential design. In the quantitative phase, we randomly selected 2118 residents from 12 primary care institutions. The intensity of functional features was assessed using the Person-Centered Primary Care Measure (PCPCM), and their association with levels of EuroQol Visual Analogue Scale (EQ VAS) was evaluated through multilevel modelling. In the qualitative phase, a qualitative description approach was used, conducting 24 focus groups with a total of 85 patients to gather in-depth information about their experiences with functional features and perceived health impacts. Finally, the quantitative and qualitative data were integrated using meta-synthesis and joint display methods to validate, interpret, and expand the results. The average PCPCM score was 3.65, with subdomain scores ranging from 3.39 to 3.83. Qualitative findings confirmed the quantitative results regarding the intensity and manifestation of features like accessibility, coordination, and relationship-building. However, discrepancies were noted in features such as comprehensiveness, integration, and family and community context. Additionally, two new functional features, 'being appreciated' and 'being cared for,' were identified. The quantitative results also showed that higher PCPCM scores were positively associated with EQ VAS levels (odds ratio (OR) = 1.18; 95% confidence interval (CI) = 1.03-1.35, P < 0.001). Furthermore, qualitative results revealed six key pathways supporting the beneficial effects of local primary care functional features on health maintenance and improvement. This study demonstrates high functional scores for Shanghai's family doctor services and highlights a positive association between primary care functionality and population health. These features and their health benefits are deeply shaped by the local social and health care context. This confirms the progress of Shanghai's primary care development and underscores the need for further exploration of primary care functional features across China, along with the development of tools tailored to local conditions to better measure and improve primary care quality and health outcomes. primary healthcare; primary care; quality measurement; population health; mixed method research; China.

The British Geriatrics Society's position on assisted dying.

In response to increased focus on the issue of Assisted Dying (AD) in the UK due to the presentation of The Terminally Ill Adults (End of Life) Bill 2024-25 [1] and bills before parliaments in the Isle of Man, Guernsey and Scotland, the British Geriatric Society (BGS) recently developed a position statement opposing legalisation of AD in the UK [2]. We set out our key reasoning behind this position, namely the current adverse health and social care context and significant concern about whether effective safeguards can be created to protect older people with complex needs from undue harms. The BGS asks for improved, personalised, multidisciplinary care for older people at the end of their lives, including high-quality palliative and end-of-life care. It urges caution about legalisation and offers its expertise in any potential future shaping and implementation of AD legislation. This should include a conscience clause for professionals objecting to direct involvement. The main outcomes from a survey of member's opinions are also outlined [2]. The majority were against legalisation of AD; however, a significant minority were in favour, with some undecided. This diversity of opinion highlights a need for the Society to maintain balance and nuance on this difficult and emotive issue, warranting future BGS reviews if the relevant legislation changes.

ICT acceptance in social and healthcare context - A scoping review of theories and models.

Although Information and Communication Technology (ICT) acceptance processes have been studied widely in the social and healthcare context, the theoretical background of these studies is widely based on Technology Acceptance Models (TAM, TAM2, UTAUT) and their extensions. These theoretical models have been criticized for being overly simplistic and focusing narrowly on individual adopters' beliefs, perceptions, and usage intentions without considering multidimensional approaches to capture the complexity of certain phenomena. Thus, there is a need for identifying other approaches to study ICT acceptance in the complex and digitalizing social and health care context. The aim of this review is to identify and describe existing theories and models of ICT acceptance studies, other than TAM and UTAUT, in the social and health care context. In addition, the aim is to identify and classify the dimensions of ICT acceptance within these theories and models. JBI methodology for scoping reviews was used as guidance. A literature search was done on four electronic databases (PubMed, Scopus, Web of Science and CINAHL). The reporting was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for the scoping review (PRISMA-ScR). Further, descriptive statistics and inductive content analysis were used to analyse the theories, models and dimensions of ICT acceptance within them. 21 studies were included in this review. Results indicated that ICT acceptance in the social and healthcare context have been studied by using a variety of theories and models from different disciplines. Within these theories and models, organization, technology, human, sociocultural and environment were identified as the main dimensions of ICT acceptance in the social and healthcare context. This review provides an overview of the alternative theories and models of ICT acceptance and dimensions to be considered when assessing ICT acceptance in the social and healthcare context.

Enhancing Impact for Key Leadership Domains

Significant operational and functional action domains require health, aged and social care leaders and managers’ expertise and responsibilities. Contemporary strategic; development and operational activities involving patient/client centred care; strategic vision articulation and alignment; financial performance; workforce management; effective communications; informatics challenges; enabling strong and positive organisational cultures as well as managing conflict and resistance to change are required and need to deeply focused on the context of clinical and social health care.....

Embedding treatment in stronger care systems.

A key lesson from the west Africa (2014-16) Ebola disease epidemic was that outbreak responses fail when they respond to patients through a narrow clinical lens without considering the broader community and social context of care. Here, in the second of two Series papers on the modern landscape of Ebola disease, we review progress made in the last decade to improve patient-centred care. Although the biosafety imperatives of treating Ebola disease remain, recent advances show how to mitigate these so that patients are cared for in a safe and dignified manner that encourages early treatment-seeking behaviour and provides support after the return of patients to their communities. We review advances in diagnostics, including faster Ebola disease detection via real-time RT-PCR, and consider design improvements in Ebola disease treatment units that enhance patient safety and dignity. We also review advances in care provision, such as the integration of palliative care and mobile communication into routine care, and address how greater access to research is possible through harmonised clinical trials. Finally, we discuss how strengthened community engagement and psychosocial programmes are addressing stigma and providing holistic support for survivors.

‘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.

An User-Centered Evaluation of Two Socially Assistive Robots Integrated in a Retirement Home

Socially assistive robots are receiving a growing interest in the health and social care sectors. They are considered a promising technology to add value to the work of caregivers, and relieve them of simple and repetitive tasks. However, these robots currently face significant difficulties when deployed in everyday scenarios due to a number of factors. Most of these factors are related to insufficient consideration of the user perspective and incorrect evaluation procedures. This paper aims to address these issues. Its objective is to analyze the long-term accessibility, usability, social acceptance and user experience for two different socially assistive robots performing the same tasks in a retirement home. The evaluation procedure is based on a framework specifically designed to consider these criteria. Collected results show that both robots received an overall positive feedback. Although the number of users participating in the evaluation was not very high, due to the chosen recruitment criteria and the period of activity of this research project, during the COVID19 pandemic, these results allow to extract relevant insights towards a meaningful use of social robots in shared social care contexts.

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.