Social Care Personnel Research Articles

Governance intricacies in implementing regional shared care records: A qualitative study in the national health service, England.

This study explores the governance intricacies in establishing a large-scale information infrastructure for integrated care within the National Health Service of England. By focusing on the initial 5years of a regional interoperability program, we examine the challenges and dynamics of creating a unified system across organizational boundaries. A longitudinal multi-methods approach was utilized, collecting data through interviews with health and social care personnel involved in project governance, meeting observations, and document analysis. This provided an in-depth understanding of the processes and challenges of developing the regional interoperability program. This study reveals a dynamic negotiation process and evolving governance structures that must continuously adapt to integrate diverse systems. Key findings include challenges in reconciling multiplicity and heterogeneity, the importance of social learning and stakeholder adaptation, and the role of ongoing negotiation and collaborative group construction in implementing interorganizational infrastructures. This study underscores the necessity of continuous adaptation and negotiation among stakeholders in establishing effective governance of integrated care infrastructures. Social learning and active participation play pivotal roles in overcoming the challenges associated with system integration. Strategic insights from this research can guide stakeholders in developing sociotechnical solutions for digital interorganizational infrastructures in integrated care.

O.4.1-4 Integrated geriatric care - a community approach to preventing falls and frailty of elderly Slovenian

Abstract Purpose The need for geriatric treatment is increasing with the aging of the population. Multimorbid patients with social care problems and increased need for rehabilitation and paliative care are more common. Mortality of the elderly, due to falls is 2.5 times higher in Slovenia than in the other EU countries. Until the national regulation of integrated geriatric care in Slovenian health system and in other relevant environments (community, long-term care, social care) and the establishment of appropriate, licensed postgraduate training for health professionals, it is necessary to start educating wider range of health and social care personnel, for most common geriatric syndromes such as frailty, falls and NCDs. Establishing a community approach to health is one effective way to address vulnerability of elderly population. Project description Project Integration of geriatric care for the elderly is implementing the existing commitment from WHO Decade of healthy ageing and the Slovenian Health Care Plan until 2025. With planned activities, it will ensure equal access to quality and safe health services, integrated and comprehensive treatment and will contribute to the deinstitutionalization of the Slovenian eldest population. It will develop a unified set of tools, for the systematic identification of elderly needs, new digital tools for optimization and better communication between different levels of providers and training a wider range of new and already employed health and social care personnel, for optimal health care. Evaluation of new competency models for health care personnel, training methods and proposed clinical pathways will be carried out at the end of the project. Based on final proposals, we will establish a new approach to the system level of integrated geriatric care and bring the treatment closer to the patient's home. Conclusions Project will also contribute to upgrading competences of physiotherapists, kinesiologists, standard health teams in Health Promotion Centers, community nurses, family medicine and internal medicine doctors and social care workers for the integrated geriatric care for the elderly. It will address especially treatment of the physical component in geriatric syndrome, such as decreased muscle strength, balance, impaired walking and frailty, at different levels of health care and communities.

TRANSITIONAL CARE FOR OLDER ADULTS WITH CHRONIC ILLNESS - AN INTEGRATED REVIEW

The increasing trend in the older adult population is proportionate to the burden of chronic illness among them, necessitating the need to move between varied care settings to relieve their pronounced discomforts. Literature reports a high incidence of potentially inappropriate medication, preventable complications, and caregiver burden during this phase. Transitional care plays a vital role in ensuring health care continuity, avoiding preventable poor outcomes among at-risk populations, and promoting the safe and timely transfer of patients from one level of care to another or from one type of setting to another. This review explores and crystallizes empirical literature on transitional care for older adults with an aim to comprehensively articulate its significance, components, interventions, and outcomes. The importance of coordinated and empowered transition between varied care settings is illuminated in this review. The components of transitional care from global evidence string together the staffing and competency requirements. The vastness of interventions employed within transitional care models provides the scope for practitioners to select feasible and affordable interventions within their practice settings. A glimpse into the outcomes of transitional care directs health and social care personnel to weigh outcomes greater than establishment investments.

The implications of COVID-19 on health and social care personnel in long-term care facilities for older people: An international scoping review.

This scoping review mapped out the existing literature pertaining to health and social care personnel experiences during the coronavirus disease‐2019 (COVID‐19) pandemic and their work in a long‐term care setting for older people. This review identified the gaps in the implications of health and social care personnel's own health and well‐being during the pandemic as well as the ethical dilemmas inherent in providing care during the COVID‐19 pandemic. The authors utilised the PRISMA checklist for undertaking scoping reviews. The Databases Medline, PsychINFO, CINAHL, SCOPUS, Web of Science and Google Scholar were searched for relevant articles in English that were published between March 28, 2020 and June 1, 2022. This time period was selected to focus specifically on the COVID‐19 pandemic. In the context of this review, long‐term care facilities were defined to include institutions such as nursing homes, skilled nursing facilities, retirement homes and residential care homes. The gaps identified were a paucity of research on the experiences of health and social care personnel in long‐term care facilities, the impact on their mental health, and the wider challenges experienced during the COVID‐19 pandemic is discussed. The findings of this scoping review indicate a need for adequate preparedness during a pandemic within the health and social care sector to protect health and social care personnel and the individuals they care for.

Pandemic impact on patients with advanced non-COVID-19 illness and their family carers receiving specialised palliative home care: a qualitative study

ObjectivesTo investigate the experiential impact of the COVID-19 pandemic on patients with non-COVID, life-threatening disease and their family carers.DesignAn interpretative qualitative design informed by phenomenological hermeneutics and based on data...

Workplace Factors, Burnout Signs, and Clinical Mental Health Symptoms among Mental Health Workers in Lombardy and Quebec during the First Wave of COVID-19.

Several research contributions have depicted the impact of the pandemic environment on healthcare and social care personnel. Even though the high prevalence of burnout depression and anxiety in healthcare settings before COVID-19 has been well documented in the research, the recent increase in psychological distress and mental health issues in healthcare and mental health workers should be attributed to the effect of the COVID-19 pandemic. The aim of the present study is to develop, evaluate, and compare a model of COVID-19 workplace stressors between two different territories, the Italian region of Lombardy and the Canadian province of Quebec. Within this model, burnout is depicted as the strongest determinant of mental health symptoms for mental health workers. In turn, the main workplace determinants of burnout are the perception of a lack of support from the organization and the fear of contracting COVID-19 at work. Findings also provide insights for designing interventions to promote and protect mental health workers in the context of the pandemic. In conclusion, it is necessary to monitor burnout and carefully analyze elements of organizational culture, in addition to offering clinical and psychological care for those in need.

Relevance and paucity of evidence: a dental perspective on personal protective equipment during the COVID-19 pandemic.

The global COVID-19 pandemic, caused by the SARS-CoV-2 virus, has highlighted the importance of personal protective equipment (PPE) for health and social care personnel. This is a really important issue for dentistry, where we place great emphasis on infection control and universal precautions, given the nature of care provided. Cochrane have recently updated their review of PPE for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff. It examined evidence on which type of full body PPE and which method of donning (putting on) or doffing (removing) are most effective, while having the least risk of contamination or infection for healthcare workers, as well as which training methods increase compliance with PPE protocols. The objective of this paper is to raise awareness of the above review of PPE, its findings and their relevance to dentistry as outlined in the Cochrane Oral Health website.The available evidence comes from healthcare generally, mostly involving simulation exercises, and is of low or very low certainty. None of the evidence specifically comes from dentistry.The findings in relation to the nature of PPE, methods of donning and doffing, and the importance of training are all of practical relevance to dentistry. Research is critically important to provide evidence for future decision making in support of patients and staff.

The Relationship Between Spiritual Life and Quality of Life in People with Intellectual Disability and/or Low-Functioning Autism Spectrum Disorders.

Spirituality seems to represent a relevant domain in the person-centred care planning and outcome assessment for persons with intellectual disability and low-functioning autism spectrum disorder. Despite this, the impact of spirituality on subjective well-being and quality of life (QoL) has been scarcely investigated. The aim of the present study was to map the international scientific literature in order to identify the reasons of such misconsideration and the key points for future research and practice implementation. The relationship between spirituality and QoL depends on a complexity of factors, ranging from QoL theoretical models to services' organisation. Personal attitude, family members, health and social-care personnel, training, faith and life communities, and even different religions seem to deserve an in-depth analysis.

Work Experiences During and After Treatment Among Self-Employed People with Cancer.

Purpose The proportion of self-employed people in the workforce is growing. However, most research on work participation among cancer survivors has focused on salaried workers. We aimed to explore how self-employed people experience work during and after cancer treatment. Methods In this qualitative study, we conducted semi-structured interviews with seven self-employed people who had been treated for cancer. To provide a variety of perspectives on work-related aspects of self-employed cancer survivors we also interviewed seven counselors in the Norwegian Labour and Welfare Administration (NAV) who had long experience in supporting self-employed people and cancer patients around work participation. The interviews were transcribed verbatim and thematic analysis was undertaken. Results Five themes related to owning a business during and after cancer treatment emerged: entrepreneurship and engagement; cancer treatment and late-effects; business-related worries; shame; and support. Because of high job engagement and high autonomy the self-employed survivors often worked during treatment. While working could provide a sense of normalcy and a distraction from cancer, it was also essential to keep the business running. Survivors struggled with several work-related issues (e.g. high work demands, low work ability), but financial issues related to running their business caused particular worry. Getting cancer and, consequently, struggling with financial problems elicited a sense of shame that was closely connected to their strong identity as (successful) self-employed business (wo)men. Conclusion To support self-employed cancer survivors to retain work following a cancer diagnosis it is necessary to focus on the specific challenges faced by this group of workers, particularly related to financial issues and keeping the business afloat. Support measures to secure production and thus prevent loss of customers and bankruptcy are needed. It is important for health and social care personnel to be aware that self-employed cancer survivors may suffer from shame related to the cancer, low work ability and financial struggles, but that they may have difficulties talking about this shame.

Agency in dementia care: systematic review and meta-ethnography.

A systematic search was conducted on IBSS, MedLine, PsychINFO, EMBASE, and CINAHL. Two independent researchers screened the studies and conducted the quality appraisal. We used meta-ethnography for data analysis. As part of the synthesis, we identified behavioral mechanisms underlying the process of decision-making and looked at how the support of carers comes into play in making deliberate choices. The meta-ethnography involved 20 studies. Three levels of third-order constructs were identified, each describing a decision-making pathway and reflecting the degree of autonomy of the person with dementia: autonomous decision-making, shared decision-making, and pseudo decision-making. Findings highlight those inter-relational processes that promote or negatively impact on the agency of people with dementia. Our review will provide health and social care personnel with an understanding of the role of the carer in the decision-making process, and therefore which mechanisms need to be promoted or discouraged through training.

What does Brexit mean for the UK social care workforce? Perspectives from the recruitment and retention frontline.

The UK's departure from the European Union (Brexit) is likely to result in greater immigration and employment restrictions on European Union/European Economic Area (EU/EEA) nationals within the United Kingdom. EU/EEA citizens constitute a significant proportion of the current social care workforce. Research evaluating the impact of Brexit on social care has highlighted potentially severe future workforce shortfalls, but has not engaged in detail with the experiences of social care personnel involved in day‐to‐day recruitment and retention activities. This article explores how social care managers evaluate Brexit's prospects for future workforce sustainability, through the prism of their organisation's workforce requirements. This qualitative study incorporated in‐depth semi‐structured interviews and questionnaire surveys with domiciliary and residential care managers. Data collection focused on an urban conurbation in south‐west England, with demographic characteristics likely to make post‐Brexit recruitment and retention in social care particularly challenging. A key finding is that, irrespective of whether they employ EU/EEA workers or not, research participants have deep concerns about Brexit's potential impact on the social care labour market. These include apprehensions about future restrictions on hiring EU/EEA nurses, as well as fears about increased competition for care staff and their organisation's future financial viability. This article amplifies the voices of managers as an under‐researched group, bringing their perspectives on Brexit to bear on wider debates on social care workforce sustainability.

The adoption of care robots in home care-A survey on the attitudes of Finnish home care personnel.

This article examines the attitudes of Finnish home care registered nurses, licensed vocational nurses and other health and social care personnel towards the introduction and use of care robots in home care. The significance of care robotics has been highlighted in recent years. However, personnel-related social psychological barriers to the introduction of care robots have been given very little study. Cross-sectional study conducted by questionnaire. The theoretical framework of the study is based on Ajzen's theory of planned behaviour and the research discussion about attitudes towards robots. The research data were collected in five municipalities in different parts of Finland in 2016, and the questionnaire was answered by a total of 200 home care workers. The research data were analysed using exploratory factor analysis, Pearson product-moment correlation, one-way analysis of variance and linear regression analysis. The results are consistent with Ajzen's theory and previous studies on the acceptance of information systems in health care. Personnel behavioural intentions related to the introduction of robot applications in home care are influenced by their personal appreciation of the usefulness of robots, the expectations of their colleagues and supervisors, as well as by their own perceptions of their capacity to learn to use care robots. In particular, personnel emphasised the value of care robots in providing reminders and guidance, as well as promoting the safety of the older people. The study shows that an intimate human-robot relationship can pose a challenge from the perspective of the acceptance of care robots. From the perspective of the introduction of care robots in home care, personnel training and the construction of a positive working atmosphere play a key role. In addition, the introduction of robots requires further consideration of a number of ethical issues.

English

Home Based Wireless Health Monitoring System give a detailed insight into design and implementation of the system. Biomedical engineering is the application of engineering principles and techniques to the medical field. The development of biomedical engineering is responsible for improving healthcare diagnosis ,monitoring and therapy. The novel idea behind Health line is to provide quality health service to one and all.The idea is driven by the vision of a cable free biomedical monitoring system. On body sensors monitor the vital parameters (blood pressure, ECG, temperature and heart beat rate) and transmits the data to doctors end via wireless communication network. Periodic health monitoring (or preventative care) allows people to discover and treat health problems early, before they have consequences. Especially for risk patients and long term applications, such a technology offers more freedom, comfort, and opportunities in clinical monitoring.The very idea of the health line is to provide service to community. Chronic diseases have a significant influence on healthcare costs and are common among people. Changes in demographic structure and lack of health and social care personnel force us to study new innovations, which could o er a relief to these challenges. Seniors have to make frequent visits to their doctor to get their vital signs measured. The vital signs include Pulse rate ,Blood pressure,Body temperature ,ECG,etc.

Evidence-based modelling of a generic integrated home care and discharge practice

Introduction: The focus is to describe the process of evidence-based modelling, and the evaluation of the suitability and the effects of a model. The development and evaluation of a generic integrated home care and discharge practice is used as an example. Aims: The aims are (1) to develop a generic practice based on scientific and practical knowledge, its evaluation criteria and an embedding method and (2) to evaluate its impacts on clients/patients, relatives (informal caregivers) as well as health and social care personnel. Methods: Several types of evidence were used in the modelling of a generic good practice. A register-based analysis (the administrative registers on stroke and hip-fracture patients) was used to find out the variance in care and discharge practices between municipalities. Surveys to the directors of social and health services (n=302), personnel of home nursing (n=302), home help (n=302) and hospital wards (n=302) were used to find out service structure, need for development of a new practice and ongoing improvements. Also effective home care and discharge practices were searched by reviewing literature. Earlier mentioned evidence was integrated with practical expertise of home care (home nursing and home help) and hospital personnel in an action research based modelling. Results: The generic model was embedded in the home care services in other municipalities. The impacts of the generic model on clients/ patients, relatives, health and social care personnel, and cost effectiveness were evaluated in the design of a cluster randomised controlled trial. That involved 22 municipality-hospital pairs (number of inhabitants, services structure) randomly assigned between trial and nontrial group. The data was gathered using interviews of patients, questionnaires sent to informal caregivers and staff, and other documents. The patients were selected using inclusion and exclusion criteria. Both the trial and the non-trial group aimed to have 385 patients before and after implementation. The modelling produced a generic integrated practice with evaluation criteria and an embedding method for integration in another context (which enable also unit-led implementation). The model improved vertical and horizontal integration: change of information, multidisciplinary teamwork on interfaces of organizations, patient’s discharges, especially, discharge practices between hospital and home nursing, hospital and home help, home care and support services improved. Collaboration practices improved in both municipality groups but more improvements were found in the municipalities of the trial group. Continuity of care improved in both municipality groups, but in the trial-group the change was greater and in greater number of activities. Information exchange improved especially between home care and informal care givers, health centres, service houses and support services. Conclusion: In conclusion, the embedding of the model improved collaboration between parties in home care and discharging. Also developed methods (model and guidelines) were useful tools in embedding and—the effects on clients are presented in other presentation.

A framework for practice

Over the years, different professional and government organisations in the UK have developed and promoted frameworks for practice. One of the most well known is Essence of Care (Department of Health (DH), 2001), a toolkit for benchmarking the fundamentals of care. Since its publication, this document has been the foundation for clinical audit within the nursing clinical governance structure. The intention of developing the toolkit was for health and social care personnel to use it to address issues of concern within their areas of work, to improve services already provided and to monitor existing practices.What is of primary concern is that all health care practitioners engaged in benchmarking, including patients and carers, where involved, should agree the indicators that demonstrate best practice within their area of care. The importance of getting these fundamental aspects of care right is essential for patient, client and carer care to improve. This was also reinforced in the NHS Plan (DH, 2000). Since the introduction of these documents, many health care organisations have begun special programmes designed to ensure clinicians possess the necessary skills and knowledge to guarantee high standards of care.

Evaluation of communication, life participation and psychological well‐being in chronic aphasia: The influence of group intervention

Background: The impact of change in communication, life participation, and psychological well‐being in aphasia is recognised but still not fully explored. Further, considerable scope exists to address these factors within the context of intervention. Innovative practices and group intervention are advocated for people with chronic aphasia but detail and evidence remains limited. We are grateful to Leeds Health Authority, the Leeds Speech and Language Therapy Service, Leeds Social Services, Leeds Metropolitan University and the Leeds Modernisation Team ‐ Disability for funding and other resources for the group and the research. Our thanks in particular are conveyed to the group participants. Additionally we thank the reviewers for their guidance. Aims: To explore the experience of aphasia within the context of communication, life participation and psychological well‐being and evaluate the outcomes of these phenomena in people with chronic aphasia following participation in a group intervention involving a social model approach. Methods & Procedures: A group of seven people with chronic moderate aphasia were assessed on communication measures, by means of the Conversational Analysis Profile for People with Aphasia (CAPPA), and aspects of psychological well‐being, by means of The Hospital Anxiety and Depression Scale (HADS) and The Visual Analogue Self‐esteem Scale (VASES) pre, post, and at 3‐month follow‐up of a group intervention. The group involved a social model approach and the use of Total Communication to support conversation. Speech and language therapy and social care personnel, including an equality disability trainer, contributed to the group. Outcomes & Results: Although variation in individual participants was demonstrated, results showed evidence of statistically significant beneficial change in conversation experiences (many of these related to life participation) and, to a lesser degree, beneficial change in conversation abilities. Additionally there were beneficial changes for some participants on psychological well‐being measures. Due to the small sample, participant variation, and (in the case of psychological well‐being measures) the lack of evidence of serious reduction in psychological well‐being at the outset, the results have to be evaluated with caution. Conclusions: Appropriately planned group intervention can produce benefits in conversation, life participation, and psychological well‐being in chronic aphasia.

Home care personnel's perspectives on successful discharge of elderly clients from hospital to home setting

The successful discharge of elderly patients from hospital to home care is a process requiring co-operation between health and social care personnel in addition to their commitment and skills. During the discharge process it is important that health and social care professionals have a shared view of the health and mental status and needs of the patient so that appropriate plans for meeting these needs can be made. The aim of the study was to investigate home care personnel's (health and social care workers) views of which practices between the discharging hospital and home care are associated with the successful discharge of clients. Home care personnel in 22 Finnish municipalities (n = 1890, response rate 63%) received a questionnaire in spring 2001. When the respondents' background factors were standardized, the best predictors of successful discharge from the home care personnel's point of view were adequate information received about the treatment of the patient's illnesses and their functional ability and cognitive potentials, timely information about the discharge, and good co-operation between the discharging hospital, and the home care, social care and health care workers working in home care. There were differences in the opinions of social care workers and health care workers working in home care. From the home care personnel's point of view the most important correlates of an elderly client's discharge from hospital to a home setting were factors associated with how they can best plan their work. Their perspective on the discharge process may diverge from clients and their informal care givers point of view. To ensure the successful discharge process we must take them all into account.