Social Care Professionals Research Articles

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.

176 The AVERT DOSE international trial: an update on the Irish experience

Abstract Background Mobility training is a complex intervention and recovery post-stroke is multidimensional. AVERT DOSE aims to define optimal early intervention regimens for people with mild to moderate ischaemic stroke. Methods AVERT DOSE (ACTRN:12619000557134) is an international randomised trial that will recruit >2,500 patients. Randomisation is to two groups according to stroke severity. Patients are then randomised to one of four mobility training regimens in each strata and the intervention is delivered for up to 14-days. Primary Outcome: Identification of the intervention regimen that results in higher proportion of favourable outcome at 3-months post-stroke. Results In Ireland, 4 sites are actively recruiting (1,2,3 and 7), one completing training (4) and two finalising ethical approval and contracts (5,6). Eighteen patients have been recruited to date in Ireland, and over 400 internationally. Trial set-up has proven complex with processes and requirements differing significantly across Irish sites. Time to ethics approval has ranged from 10-months to over 3-years. The novel status of this trial as a non-drug/medical device trial, but rather rehabilitation trial, had led to discussion in relation to the need for a trial EU representative. Staff recruitment and retention challenges have proven to be a significant barrier to recruitment in recent months. The development of an Irish Avert Dose group to collaboratively address challenges and provide peer support has proven very successful in both supporting sites to reach recruitment stage and throughout the stages of screening, recruitment, intervention and blind assessment. Conclusion Undertaking rehabilitation research against the backdrop of a global pandemic and increasing staffing challenges requires a determined, problem-solving approach. Irish sites have embraced this opportunity to answer an important stroke research question. Health and social care professionals have displayed innovation and competence in steering clinical research and this should improve future rehabilitation trial readiness. Trial recruitment is expected to gain pace as more Irish and international sites are approved.

17 The case for more specialist geriatric wards: redesigning health systems to meet the needs of older persons

Abstract Background The National Clinical Programme for Older Persons outlines that each hospital should have a dedicated Specialist Geriatric Ward (SGW) with appropriate staffing and access to Health and Social Care Professionals. As part of a quality improvement initiative to drive the development of a new SGW, we examined what proportion of older medical admissions had care needs that would be best served in a Specialist Geriatric Ward. Methods We completed a retrospective cohort study of unselected medical admissions over a two week period in a level four hospital. We established criteria that would deem a patient suitable for admission to a specialist geriatric ward and examined the journey of patients who were or were not admitted under the care of Geriatric Medicine. Results In total over the two week period there were 307 admissions, with 144 over the age of 75 years (47%). Over half of patients had more than one bed moves during their inpatient stay. 78% were frail. 109 (75%) of patients would have been eligible for care on a specialist geriatric ward. 20% of the over 75 year olds were admitted under the care of Geriatrics. 72% of the remaining patients admitted under general medical teams would have met the criteria for care on a specialist geriatric ward. 20% of this cohort had a review by the frailty at the front door team with 23% having an inpatient geriatric medicine consult. Conclusion A significant proportion of older adults being admitted have care needs that would benefit from coordinated care on a specialist geriatric ward. Patients receive input from geriatric medicine through a variety of avenues but there is a need for increased access to specialist geriatric inpatient wards. This would improve patient access to the Right Care, in the Right Place at the Right Time.

6 Exploring professional-robot interactions in care settings: a case of adopting an Irish air-disinfection device in a nursing home in Japan

Abstract Background Digital welfare technologies are increasingly expected to perform a broader set of functions and roles. The worldwide COVID-19 pandemic further underscored use of technology, as it heightened the need for security and safety in care settings, with cleanliness and infection control becoming an even more important aspect of care delivery. While there are great expectations for digitalization and automation of care work, bringing new technologies such as robots into a workplace remains a challenge in terms of acceptance and usability, as well as a reflection of user preferences and needs. Methods An original air-disinfection ‘robot’ was developed for a cross-cultural research project, and was introduced to a residential nursing home in Japan. Prior to its instalment, seven main users (physiotherapists, nurses and social care professionals) were trained by the developer. Semi-structured interviews and focus groups were conducted before, during and after the trial in order to understand care professionals’ needs regarding and impressions of the device. The System Usability Scale (SUS) was also used to test professionals’ experience with the device. Results Overall, the users had a positive experience of using the robot (SUS score of 74.3/100). During the trial, the team of users changed the inorganic appearance of the robot by adding a face, hair, hands and music to it. The qualitative data reveal how additional efforts were made to transform a piece of air-disinfection equipment into an interactive and accessible robot for older adults. The appropriate size and the level of automation were also raised as essential points for design consideration. Conclusion There is great potential for a variety of care robots to be deployed and evaluated beyond cultural boundaries, but local knowledge and professional expertise are crucial to smooth implementation. The study ‘Harmonisation towards the establishment of Person-centred, Robotics-aided Care System’ was supported by the Toyota Foundation (D18-ST-0005, 2019–2022).

112 Barriers and facilitators to data collection for the Irish National Audit of Stroke

Abstract Background Stroke is an important cause of morbidity and mortality in Ireland and worldwide, with over 7,000 new cases in Ireland each year. The audit of stroke facilitates service evaluation and quality improvement initiatives and is becoming increasingly important as acute stroke treatment is rapidly changing. In Ireland, the National Office of Clinical Audit has managed the Irish National Audit of Stroke (INAS) since 2019. This study is part of a wider project titled ‘Maximising the Quality of Stroke Care in Ireland—Development of a National Stroke Audit’ which aims to further develop INAS. Methods As part of the overarching project, semi-structured interviews were conducted with Irish health professionals involved in stroke care and data collection for INAS, including nurses, health and social care professionals and administrators. Qualitative data relating to data collection for INAS were extracted and analysed for recurring themes using NVIVO software. Results The most frequently identified barriers to data collection were: 1. Lack of time and resources; 2. Infrastructural challenges (access to computers, desk space and IT systems); and 3. Perceived uselessness of the audit. Identified facilitators were: (1) Systems of organisation (electronic and paper-based solutions) that allow shared responsibility of data input and (2) Leadership from managers and the influence of team members that perceive the data collection for INAS as important and beneficial for the local service. Professionals who valued the audit as an important clinical tool were more likely to have a positive view of the work required to input data for INAS. Conclusion INAS is a crucial instrument for understanding the demographic characteristics and care received by stroke patients in Ireland. Streamlining the data collection procedures is an important part in developing INAS. There are significant resource and time limitations affecting data collection that need to be taken into consideration for any future audit development.

238 An age related acute medical unit: creating an age-attuned model of acute care

Abstract Background Multi-morbidity increases with age and older adults are more likely to present to acute hospital services with complex health states/Geriatric syndromes. For people with underlying physical or cognitive illnesses, these issues can be compounded by the built environment of acute hospitals. Meeting the needs of a frail older population is a key challenge for acute hospital services. The main aims of this development quality improvement project were to create a dedicated Age-related acute medical unit using the concept of universal design, with dedicated, Gerontological staffing including a Registered Advanced Nurse Practitioner (RANP) in Gerontology. Methods A project team was convened with representation from Geriatric nursing, Geriatric Medicine, Health and Social Care Professionals (HSCP), Estates, Technical services and the executive management team. An appropriate area was identified on the acute floor which was co-located with a newly developed Acute Medical Unit. Using a universal design approach, a 4-cubicle Age Related Assessment Unit (ARAU) including a dedicated multidisciplinary assessment room was created. The role of the RANP in ARAU was developed to provide comprehensive geriatric assessment to older medical patients presenting to unscheduled care. Results Following the implementation of the ARAU there has been a 40% increase in the number of unscheduled older patients (>65’s) assessed in the Acute Medical Unit (Q1 2019 to Q1 2023). Conclusion Operating within a defined scope of practice, the RANP in ARAU/AMU provides advanced specialist geriatric nursing skills and knowledge allowing for the identification of medical, psychosocial and functional needs of older adults for older adults who present to unscheduled care with common geriatric syndromes.

260 Using participatory action research to examine attitudes and awareness of adult safeguarding practices in the acute hospital context

Abstract Background The investigation of, and interventions on, the alleged abuse of vulnerable adults has become an important feature of social work and other professional practices in Ireland. This implies important organisational challenges in ensuring that adult safeguarding responsibilities are delivered in ways that ensure positive outcomes for all stakeholders. Many factors can influence staff responses to concerns in acute care contexts. This can relate to awareness of the many forms of abuse and reporting obligations, attitudes to adult safeguarding and understanding the impact of abuse. Acute hospitals offer unique opportunities to intervene in abusive situations and to offer support to those at risk. This study set out to explore the awareness, understanding and attitudes towards safeguarding practices of staff in a large Dublin teaching hospital using a Participatory Action Research Approach (PAR). Methods A PAR methodology was utilised involving a social work academic and six members of the Medical Social Work team as co-researchers in the study design, data collection and data analysis. A quantitative, descriptive study design was adopted, which utilised a cross-sectional online survey of hospital staff which generated 100 responses from a variety of hospital staff including nurses, doctors and health and social care professionals. Results Findings indicate that acute care staff have varying levels of awareness of different categories of abuse. 59% of respondents reported being ‘somewhat confident’ in recognising and reporting suspected harm, neglect or abuse of a patient they were treating. 66% of respondents reported being aware of their mandated reporting requirements under the Criminal Justice (Withholding of Information on Offences against Children and Vulnerable Persons) Act 2012. Conclusion Many staff in acute care contexts lack confidence and knowledge in detecting and reporting the abuse of adults at risk, including their mandated reporting obligations with 90% of respondents stating that they need further training in this area.

74 Making mobility falls prevention and management everyone’s business

Abstract Background Falls in hospital are detrimental to patient safety and the highest reported patient safety incident. The falls committee undertook a review. It identified a need for improved processes around the identification of falls risk. There was a need for a succinct multi-disciplinary approach to falls prevention following the identification of falls risk. Staying mobile and having clear visible mobility goals while in hospital was targeted as a strategy. This was appropriate as reduced mobility is a modifiable risk factor for in-patient falls. Methods PDSA quality improvement methodology was used. A mobility and falls policy was developed. The policy provides a framework of three algorithms for falls risk identification, prevention and management. Additionally, referrals to health and social care professionals were streamlined to reduce time from risk assessment to referral. Falls prevention information leaflets were developed to help make patients partners in the process. Whiteboards were used behind patients beds with magnets to clearly show falls risk. Mobility status and goals were written on the whiteboard. This ensured a succinct joint approach to patient mobility. Education and staff engagement enabled implementation. Excellence was awarded with a certificate for display on the wards quality boards. Clinical audit was used to measure results. Results Review of audit data between October 2022 and January 2023 recognised improved processes in the identification and management of falls. Outcome measurement showed up to 100% increase in communication between healthcare professionals in relation to patient mobility status and goals. Conclusion In conclusion, we learnt that identifying and communicating falls risk was not enough. A clear succinct multi-disciplinary plan of action was required. Patients must be partners in that plan.

A realist process evaluation of an intervention to promote competencies in interprofessional collaboration among interdisciplinary integrated care teams for older people: Study protocol.

Background: International policy is increasingly committed to placing interdisciplinary team-working at the centre of health and social care integration across the lifespan. The National Clinical Programme for Older People in Ireland has a critical role in the design and implementation of the National Older Person's Service Model, which aims to shift the delivery of care away from acute hospitals towards community-based care. Interdisciplinary Community Specialist Teams for older persons (CST-OPs) play an important role in this service model. To support the development of competencies for interprofessional collaboration and an interdisciplinary team-based approach to care integration, a culture shift will be required within care delivery. Design:This study builds upon a collaborative partnership project which co-designed a framework describing core competencies for interprofessional collaboration in CST-OPs. A realist-informed process evaluation of the framework will be undertaken as the competencies described in the framework are being fostered in newly developed CST-OPs under the national scale-up of the service model. Realist evaluation approaches reveal what worked, why it worked (or did not), for whom and under what circumstances. Three iterative and integrated work packages are proposed which combine multiple methods of data collection, analysis and synthesis. Prospective data collection will be undertaken within four CST-OPs, including qualitative exploration of the care experiences of older people and family carers. Discussion: The realist explanatory theory will provide an understanding of how interprofessional collaboration can be fostered and sustained in various contexts of care integration for older people. It will underpin curriculum development for team-based education and training of health and social care professionals, a key priority area in the national Irish health strategy. It will provide healthcare leaders with knowledge of the resources and supports required to harness the benefits of interprofessional collaboration and to realise the goals of integrated care for older people.

S9-2 Dutch national falls prevention program- implementation challenges

Abstract Purpose In the Netherlands, a very ambitious falls prevention program is being implemented in 2023 and 2024. Falls among older adults lead to a high burden on healthcare and high societal costs. This program is therefore part of the current government coalition agreement. Each year one in seven persons over 65 should be screened on fall risk and should be stimulated to reduce fall risk. The whole program includes specific falls prevention programs (FPPs) as well as Physical activity (PA) programs outside these FPPs to keep fall risk restricted. Large responsibility is given to municipalities for implementation at the local level, and to regional public health services at a higher level. Project description At present there is no good organisation of falls prevention. A whole infrastructure has to be set up to be able to carry out the prevention program. This is coordinated by VeiligheidNL. It involves a considerable number of stakeholders and different working packages on FFPs, implementation, and communication. Starting in 2022, a number of sessions have been held to inform municipalities, regional health services, and professionals. Funding frameworks are set up including refunding of FPP participation and support of coordination by municipalities. As part of the process, we evaluated among scientists, PA professionals and municipalities what is needed to organise PA for maintenance after FPPs and for people without increased risk. This includes more available organised PA, increase in frequency and intensity of current group PA, and involving regular sports clubs to increase overall capacity. Most municipalities need to take a much stronger coordinating role, including also a professional with ‘broker’ role, generally the so-called neighbourhood sports coach (NSC). This professional guides older people to suitable PA and is a connector between health, social care and PA professionals. Conclusions The ambitious falls prevention program, supported by considerable financial resources, has the potential to give a large boost to PA in older adults. There are still a lot of challenges at the national as well as local level before implementation is successful, but several locations have already managed to develop a good infrastructure.

S6-4 How to engage community-dwelling older adults in fall prevention programs? – a qualitative study into potential strategies

Abstract Aim Fall rates and fall-related injuries among community-dwelling older adults (≥65 years) will likely increase due to the rapidly aging population worldwide. Therefore, fall prevention has become an international priority. Fall prevention programs (FPPs), consisting of strength and balance exercises, have been proven effective in reducing the number of falls among older adults. However, in practice, professionals find it difficult to enroll participants for FPPs. Therefore, this study aims to identify effective strategies that promote engagement in FPPs among older adults. Methods Based on previously identified barriers and facilitators for participation in FPPs by older adults, six strategies were designed using Intervention Mapping: 1) reframing; 2) informing about benefits; 3) raising awareness of risks; 4) involving social environment; 5) offering tailored intervention; 6) arranging practicalities. Strategies were presented and validated during semi-structured interviews with older adults (n = 12) at risk of falling. Interviews were recorded, transcribed and analyzed following a hybrid qualitative thematic method. Results Analysis showed that reframing 'aging’ and 'fall prevention' is important. Within this strategy, themes emerged related to respondents’ preference to be approached differently, taking a ‘life course’ perspective about falls, and avoiding confronting terms. Furthermore, the strategy 'informing about benefits' (e.g. ‘living independently for longer') could contribute to understanding the relevance of participating in FPPs. Other strategies were considered important to take into account too, but were less emphasized. Conclusion This study provides insight into possible strategies to stimulate older adults to participate in FPPs. Reframing ‘aging’ and 'fall prevention' may facilitate the conversation about fall prevention, which can be achieved by communicating differently about the topic, for example ‘staying fit and healthy’, while focusing on the benefits of participating in an FPP. Developing practical recommendations about how to apply the strategies, is an area for future research, as this could help health and social care professionals to enhance older adults’ participation in FPPs. Currently, the strategies are further developed to be applied and evaluated for effectiveness in multiple field labs in a central Dutch region (Utrecht). Funding source This research was co-funded by Regieorgaan SIA, part of the Netherlands Organization for Scientific Research (NWO).

The bidirectional association between psychiatric disorders and sheltered homelessness.

Psychiatric disorders and homelessness are related, but temporal associations are unclear. We aimed to explore the overlap between hospital-based psychiatric disorders and sheltered homelessness. This population-based cohort study was conducted using the Danish registers e.g., the Danish Homeless Register and the Danish National Patient Register. The study cohort included all individuals aged 15 years or older, living in Denmark at least one day during 2002-2021 (born 1984-2006). First psychiatric diagnosis was used to define psychiatric disorder and first homeless shelter contact to define homelessness. Adjusted incidence rate ratios (IRRs) and cumulative incidences were estimated. Among 1 530 325 individuals accounting for 16 787 562 person-years at risk aged 15-38 years, 11 433 (0.8%) had at least one homeless shelter contact. Among 1 406 410 individuals accounting for 14 131 060 person-years at risk, 210 730 had at least one psychiatric disorder. People with any psychiatric disorder had increased risk of sheltered homelessness relative to individuals with no psychiatric disorder [IRR 9.2, 95% confidence interval (CI) 8.8-9.6]. Ten years after first psychiatric disorder, 3.0% (95% CI 2.9-3.1) had at least one homeless shelter contact. Individuals experiencing homelessness had increased risk of any psychiatric disorder compared to individuals with no homeless shelter contact (IRR 7.0, 95% CI 6.7-7.4). Ten years after first homeless shelter contact, 47.1% (45.3-48.0) had received a hospital-based psychiatric diagnosis. Strong bidirectional associations between psychiatric disorders and homelessness were identified. Health and social care professionals should be aware of and address these high risks of accumulated psychiatric and social problems.

The positive and negative effects of working with child sexual abuse for health and social care professionals: A systematic review

AbstractThe aim of this systematic review was to determine the positive and negative outcomes of working with children who had experienced sexual abuse for health and social care professionals. The following four databases were searched using predetermined terms: PsycINFO, PubMed, CINAHL and Web of Science. Inclusion criteria included peer‐reviewed qualitative, quantitative, multi‐method or mixed method studies written in the English language. Study identification, quality assessment and data extraction were independently completed by two researchers, with a high degree of inter‐rater reliability. Eight studies (six qualitative, one quantitative and one multi‐method) met the inclusion criteria. Reviewed studies were conducted in the United States, Israel, Ireland and South Africa. Both positive and negative outcomes for healthcare professionals working with childhood sexual abuse (CSA) were identified. Additionally, a range of personal and contextual mitigating and risk factors were identified that may affect professionals' vulnerability to negative outcomes from CSA work, which have implications for practice. Due to the limited evidence base, clinical implications are tentative. Future research should adopt longitudinal methodologies and focus on participants from a range of disciplines and work contexts, particularly outside the United States.

What Do Students' Questionnaire Responses Tell Us about Their Language around Person-Centred Care? An Exploratory Sentiment Analysis.

There is a global movement for health and social care to be person-centred: supporting people's active participation when making health decisions and considering their opinions, beliefs, and needs. The World Health Organization recommend the inclusion of person-centred care in health and social care provision. This research aimed to explore Australian health and social care profession students' language around person-centred care. Final-year health and social care professions students, attending one of two Australian universities, participated in an online questionnaire. Responses were analysed and themed to an existing person-centred care framework, then a sentiment analysis was applied to each response. Of the responses collected from 90 students, 235 statements were linked to the four core values of the person-centred care framework: cultivating communication (44%); respectful and compassionate care (35%); engaging patients in managing their care (20%); and integration of care (<1%). Within these, 24 statements were positively aligned (10%); 100 statements were neutral (43%); and 111 statements contained negative sentiments (47%). Almost half of the responses were not aligned with the core values of person-centred care. This suggests that many of the final-year students are not yet conceptualizing care using a person-centred approach.

Eliciting and prioritising determinants of improved care in multimorbidity: A modified online Delphi study.

Multimorbidity is a major challenge to health and social care systems around the world. There is limited research exploring the wider contextual determinants that are important to improving care for this cohort. In this study, we aimed to elicit and prioritise determinants of improved care in people with multiple conditions. A three-round online Delphi study was conducted in England with health and social care professionals, data scientists, researchers, people living with multimorbidity and their carers. Our findings suggest a care system which is still predominantly single condition focused. 'Person-centred and holistic care' and 'coordinated and joined up care', were highly rated determinants in relation to improved care for multimorbidity. We further identified a range of non-medical determinants that are important to providing holistic care for this cohort. Further progress towards a holistic and patient-centred model is needed to ensure that care more effectively addresses the complex range of medical and non-medical needs of people living with multimorbidity. This requires a move from a single condition focused biomedical model to a person-based biopsychosocial approach, which has yet to be achieved.

The selfie project: A successful approach to lifestyle monitoring and health promotion in adolescents.

Adolescence is a critical period for the physical and cognitive development. To promote adolescents' health and well-being, prevention and health education interventions are to be implemented at all levels of society, with schools and families playing a fundamental role. In 2015, the "Semi di Melo" Center for Education and Research on Childhood and Adolescence was established in Milan, northern Italy to help parents and teachers to better explicate their supportive role toward their children/students during adolescence. Through a survey called 'Selfie', conducted via an internet-based, self-administered, and fully anonymous questionnaire, Semi di Melo collects qualitative and quantitative information on the demographic characteristics, lifestyle, leisure time, risk behavior, social relationships and mental wellbeing of middle and high school students in Italy. Data are then analyzed, interpreted, and shared with teachers, parents, and students during guided workshops and focus groups aimed at raising awareness of risky behaviours during adolescence and facilitating intergenerational exchange. To date, the Selfie questionnaire has been distributed to more than 400 Italian public schools, reaching more than 90,000 students. In late 2022, Semi di Melo and the University of Pavia started a collaboration to expand research on data acquired from the Selfie questionnaire through an analytical approach, allowing a more comprehensive understanding of Italian adolescents' lifestyle, social, and psychological well-being. The gathered evidence will be made available to help educators, health and social care professionals, as well as local authorities and decision-makers to develop effective support systems and evidence-based interventions that help adolescents realise their full potentia.

The development of a core outcome set for studies of pregnant women with multimorbidity

BackgroundHeterogeneity in reported outcomes can limit the synthesis of research evidence. A core outcome set informs what outcomes are important and should be measured as a minimum in all future studies. We report the development of a core outcome set applicable to observational and interventional studies of pregnant women with multimorbidity.MethodsWe developed the core outcome set in four stages: (i) a systematic literature search, (ii) three focus groups with UK stakeholders, (iii) two rounds of Delphi surveys with international stakeholders and (iv) two international virtual consensus meetings. Stakeholders included women with multimorbidity and experience of pregnancy in the last 5 years, or are planning a pregnancy, their partners, health or social care professionals and researchers. Study adverts were shared through stakeholder charities and organisations.ResultsTwenty-six studies were included in the systematic literature search (2017 to 2021) reporting 185 outcomes. Thematic analysis of the focus groups added a further 28 outcomes. Two hundred and nine stakeholders completed the first Delphi survey. One hundred and sixteen stakeholders completed the second Delphi survey where 45 outcomes reached Consensus In (≥70% of all participants rating an outcome as Critically Important). Thirteen stakeholders reviewed 15 Borderline outcomes in the first consensus meeting and included seven additional outcomes. Seventeen stakeholders reviewed these 52 outcomes in a second consensus meeting, the threshold was ≥80% of all participants voting for inclusion. The final core outcome set included 11 outcomes. The five maternal outcomes were as follows: maternal death, severe maternal morbidity, change in existing long-term conditions (physical and mental), quality and experience of care and development of new mental health conditions. The six child outcomes were as follows: survival of baby, gestational age at birth, neurodevelopmental conditions/impairment, quality of life, birth weight and separation of baby from mother for health care needs.ConclusionsMultimorbidity in pregnancy is a new and complex clinical research area. Following a rigorous process, this complexity was meaningfully reduced to a core outcome set that balances the views of a diverse stakeholder group.

Care coordination for children with a disability or developmental difficulty: Empowers families and reduces the burden on staff supporting them.

Almost half of all children and young people with a disability or developmental difficulty (DDD) have complex disability and are likely to require multidisciplinary care. Care coordination (CC) aims to provide a single point of contact and a coordinated service, thereby improving care experiences, meeting unmet needs and empowering families. The impact of CC for children with DDD was evaluated. Between May and August 2020, an in-depth evaluation of CC in Gwent, South Wales was conducted. Of 284 families who accessed CC, 38 were approached, as well as 177 health and social care professionals based at Serennu, Nevill Hall and Caerphilly Children's Centres. Nine families and 14 professionals completed semi-structured interviews. Interview transcripts were analysed using thematic analysis. This evaluation found perceived improvements in families' abilities to navigate, organize and understand care and increased parental engagement. Professionals observed fewer missed appointments, and both professionals and families described CC as a source of holistic support, including practical advice regarding housing, finances and emotional support. Professionals commented on CC easing pressure on their service. Potential limitations included restricted staff capacity and the role not being defined clearly for families and professionals. At a time of increased stress for families of children with DDD, and scarce resources to support them, care coordinators play a vital role in assisting families to engage with health services, while feeling supported and empowered. CC reduces the burden on professionals, while enhancing relationships with families.

The association between appreciative management and work engagement among health- and social care professionals: A cross-sectional study.

The importance of work engagement has been emphasised due to the increasing demand for health- and social care and the shortage of skilled labour. Improving organisational and managerial factors is important when enhancing professionals' work engagement. The association between management and work engagement has only been established in previous studies at a general level, but the association between appreciative management and work engagement has not received equivalent research interest. This study aimed to describe the association between appreciative management and work engagement among health- and social care professionals. The study used a cross-sectional survey design. The data were collected in five health and social services centres in one city in Finland from September to October 2022 using the Appreciative Management Scale 2.0 and the Utrecht Work Engagement Scale-9. A total of 182 health- and social care professionals participated. The data were analysed using correlations, linear regression analyses, independent samples t-tests and two-way analyses of variance (ANOVAs). A moderate association was found between appreciative management and work engagement and its dimensions of vigor, dedication and absorption. Systematic management had the strongest association and equality had the weakest association with work engagement. Among the dimensions of work engagement, appreciative management had the strongest association with vigour and the weakest association with absorption. Appreciative management and work type predicted 18% of the variance in work engagement. Full-time employees reported higher levels of work engagement and all its dimensions than did part-time employees. The results indicate that appreciative management and full-time work predict work engagement among health- and social care professionals. Due to this positive association, it is important to promote managers' appreciative management skills by educating them to understand how appreciative management enables and supports professionals' vigour, dedication and absorption in health- and social care.

Effectiveness of multi-professional educational interventions to train Comprehensive Geriatric Assessment (CGA) - a Systematic Review.

As the world population ages, health and social care professionals are increasingly confronted with patients with chronic long-term conditions and multimorbidity, requiring an extensive assessment and integrated care management strategy. The aim of this paper was to systematically collect and assess evidence of interprofessional education and training strategies for Comprehensive Geriatric Assessment (CGA) to build a competent health workforce. A systematic review was conducted according to PRISMA guidelines and the databases Medline, CINAHL, Cochrane and Embase were searched for studies illustrating effectiveness of educational interventions for teaching and training CGA in an interprofessional context. Based on 21 identified studies, a great variability and heterogeneity in duration, setting and design of the interventions was identified. Promising results were found in the domains analysed, ranging from knowledge and skills; practices and behaviour; patient health outcomes; attitudes and perceptions to collaboration and quality of care. Education and training of transversal skills within a continuous learning approach is key to equip the health care workforce for successful CGA performance in an interprofessional environment. Further research in this field is recommended to strengthen the evidence-base towards development of a resilient and integrated health care workforce for an ageing population.