Social Care Organisations Research Articles

Tensions surrounding (mal)nutrition in indigenous and white populations in Salta, Argentina: an anthropological perspective

This article analyzes the ways in which malnutrition is related to land access, labor conditions, ethnic and gender relations, and the social and cultural organization of child care in rural and peri-urban contexts in Orán, Salta, Argentina. Research was conducted from an ethnographic approach in which qualitative and quantitative techniques were used with ava-guaraní, kolla, wichí and white populations who were patients of Salta's Primary Health Care Program (PROAPS) between 2010 and 2016. Although child malnutrition is cast as an "indigenous problem" by certain health personnel and public officials, cases of malnutrition were observed in white children, while there were no positive diagnoses of malnutrition among children living in communities with territorial recognition. Access to rural land, even without title deeds, enables food self-production and allows access to more stable housing and working conditions. The violation of indigenous populations' territorial rights are a determining factor in understanding nutritional deficits among children.

Adapted guided self-help booklets for supporting the well-being of people with intellectual disabilities during the COVID-19 pandemic: an evaluation of impact

PurposeThe COVID-19 pandemic meant that it became impossible for many individuals with intellectual disability to access specialist mental health support. The purpose of this study was to evaluate a set of guided self-help resources adapted for delivery on an outreach basis.Design/methodology/approachThe use and impact of the resources were evaluated through: data about downloads and requests for printed materials; interviews with individuals who used the resources; webinars with organisations; family members and support workers who had delivered the resources and an online survey with individuals who had delivered the resources.FindingsThe resources had considerable reach, with over 12,555 printed copies requested from across Scotland. The materials were perceived to be relevant and useful, helping individuals to talk about difficulties and to be aware that others were facing similar challenges.Originality/valueThe findings highlight the potential long-term value of guided self-help resources to help promote well-being that can be delivered on an outreach basis by family members and social care organisations.

Assessing workplace civility: Validity and 1-year test-retest reliability of a Japanese version of the CREW Civility Scale.

ObjectivesThis study aimed to examine the reliability and validity of the Japanese version of the eight‐item CREW Civility Scale which measures workplace civility norms and compare the civility scores among various occupations.MethodsA longitudinal study included all employees in a social care organization (N = 658) and a cross‐sectional study included all civil servants in one city (N = 3242) in Japan. Structural validity was tested through confirmatory factor analyses (CFA). Construct validity was assessed through Pearson's correlations of civility with other variables. Internal consistency was assessed by Cronbach's alpha and 1‐year test‐retest reliability was assessed by the Intraclass Correlation Coefficient (ICC).ResultsThe results of CFA showed an acceptable level of model fit (TLI =0.929; CFI =0.949; and SRMR =0.034). CREW Civility Scale scores were significantly positively correlated with supervisor support, co‐worker support, and work engagement, while significantly negatively correlated with incivility, workplace bullying, intention to leave, and psychological distress, which were consistent with our hypotheses. Cronbach's alpha coefficient was 0.93 and ICC was 0.52. Younger, high‐educated, and managerial employees and, childminder/nursery staff reported higher civility. High school graduates and respondents who did not graduate from high school, part‐time employees, nurses, paramedical staff, and care workers reported lower civility.ConclusionsThe Japanese version of the CREW Civility scale is a reliable, valid measure of civility, appropriate for Japanese workplaces as well as for use in multi‐national studies alongside other existing versions of this scale in English, Portuguese and Farsi.

Provider and Manager Perspectives on the Use of an Integrated Clinical Pathway for Community-Dwelling Older Adults: A Qualitative Case Study.

Background:Integrated care pathways (ICPs) could improve the organisation and delivery of care for community dwelling older adults. An ICP was developed and implemented in Québec to support home care processes. This study explores the perspectives of home care staff on the use of an ICP to support the organisation and delivery of health and social care to community-dwelling older adults with complex needs.Theory and Methods:A case study based on eleven semi-structured interviews and analysis of documents was carried out in an urban home care unit. The Normalization Process Theory was used for mixed thematic analysis.Results:While its capacity to store data and enhance interprofessional information exchange was appreciated by home care staff, the broad scope, and automated features of the ICP tool were often problematic. Concerns about increased provider workloads, disruption to provider-client relationships during clinical encounters, and difficulties engaging clients in decision-making were main obstacles in the use of the ICP.Conclusion:Given the importance of ICPs in advancing clinical integration, it is critical to continuously adjust their design to align with providers’ realities in order to optimize their potential in real life contexts.

The Significance of Trust in Washington State's Aging Network COVID Response

In late summer of 2020, we interviewed 45 senior leaders of social services and health care organizations serving older adults throughout Washington State about service demand, new challenges, and organizational adaptations. These organizations work with people made particularly vulnerable in the pandemic. A significant share reported that half or more of their clients live at or below the poverty line (54%), are people of color (29%), or have limited English language proficiency (20%). The state’s aging network leveraged strong partnerships, expertise, and community knowledge to provide trusted essential services to older Washingtonians and their caregivers. The role of trust as an enabler of emergency response and connection in the context of gentrification, the digital divide, employment loss, and language service gaps will be discussed, as will lack of trust as a barrier to service access, particularly for Latinx immigrant and migrant older adults.

Stress, psychological distress and support in a health care organization during Covid-19: A cross-sectional study.

The main aim of this study was to understand what health and wellbeing initiatives are helpful for health care workers' stress and psychological distress during the Covid-19 pandemic. Health care workers are at increased risk of poor mental health during health emergencies; understanding support required for health care workers is of paramount importance. Participants were health care workers at a health and social care organization (N = 159). The study included an online questionnaire including an evaluation of health and wellbeing initiatives and measures of perceived stress and psychological distress. The highest rated resources were counselling, personal protective equipment (PPE) and Covid-19 testing. Those who accessed yoga reported significantly less stress and psychological distress than those who did not access yoga. Health care workers with higher stress and psychological distress felt less supported by their organization, less listened to and less involved in organizational decisions. Practical implications are discussed such as forward planning for health emergencies (e.g., PPE supply), accessible Covid-19 testing as well as budgeting for counselling services and exercise classes. In addition, targeted support for those diagnosed with Covid-19 is recommended, alongside involvement of staff members in organizational decisions.

Availability and Use of Vaccines against COVID-19 in Pregnancy

Pregnant women when infected with SARS-CoV-2 infection are more at risk of having severe outcomes including ICU admission, adverse cardiac and thromboembolic events and preterm delivery. Immunization in pregnancy has certain ethical dilemmas and vaccination seems to be challenging. Preliminary data regarding the use of mRNA based vaccines against this virus in pregnant women is promising. Recently, RCOG and WHO have widened the scope of use of vaccines among pregnant women against COVID-19. Similarly, ACOG has also given the go-ahead to the use of two mRNA based and one viral vector based vaccine in pregnant women. The scope of vaccination among pregnant and lactating women being realized in developed part of world is a promising prospect in prevention of COVID-19 infections. However, developing nations require attention from private stakeholders, health and social care organizations to ensure right of health for all.

The perception of professionals in the socio‐health field about the support services provided for families with a member with neurodegenerative disease

AbstractBackgroundIn the Spanish case, the social organization of care is characterized by being family oriented. This means that the involvement of the family in the care of its members is high in relation to the participation of other social actors, such as the State, the market, or the community. Neurodegenerative diseases (ND) significantly affect the quality of life of the person, but also that of their family, precisely because of their high involvement in care. Families require support services to increase their well‐being, and several studies have shown the impact that the absence of support services has on the Family Quality of Life (FQoL). Considering this, the main objective of this study is to find out the perception of professionals working in the socio‐health field about the adequacy and sufficiency of the services available to people with ND and their families in the Spain‐Portugal cross‐border area.MethodThis research has been developed through qualitative methodology. Three focus groups were held. They involved: 1) public social services personnel; 2) public health services staff; 3) workers in the services offered by private initiatives. All of them carried out their work in the cross‐border area studied. With the support of the Atlas.ti software and following a deductive coding model, the data obtained were systematically coded and interpreted.ResultsInitial research results suggest that professionals in the socio‐health field agree on their perceptions of the adequacy and sufficiency of support services provided for families with a member with ND. They consider that:1) most support services are aimed solely at the needs of the person with a ND and therefore contribute little to improving the FQoL;2) support services considered very adequate for the improvement of the FQoL are very insufficient; 3) the characteristics of the environment (small population, geographical dispersion, etc.) significantly limit support services in rural areasConclusionThe support services provided for families with a member with ND are scarce and inadequate, and therefore contribute little to improving the FQoL. There is a need to improve access and adapt support services to the needs of families.

Winners and Losers in Palliative Care Service Delivery: Time for a Public Health Approach to Palliative and End of Life Care.

Background: Consumer experience of palliative care has been inconsistently and selectively investigated. Methods: People in Western Australia who had experienced a life limiting illness in the past five years were recruited via social media and care organisations (2020) and invited to complete a cross sectional consumer survey on their experiences of the care they received. Results: 353 bereaved carers, current carers and patients responded. The winners, those who received the best quality end-of-life care, were those who were aware of palliative care as an end-of-life care (EOLC) option, qualified for admission to and were able to access a specialist palliative care program, and with mainly a cancer diagnosis. The losers, those who received end-of-life care that was adequate rather than best practice, were those who were unaware of palliative care as an EOLC option or did not qualify for or were unable to access specialist palliative care and had mainly a non-cancer diagnosis. Both groups were well supported throughout their illness by family and a wider social network. However, their family carers were not adequately supported by health services during caregiving and bereavement. Conclusions: A public health approach to palliative and end of life care is proposed to integrate tertiary, primary, and community services through active consumer engagement in the design and delivery of care. Therefore, suggested strategies may also have relevance in many other international settings.

Ensuring the quality and quantity of personal protective equipment (PPE) by enhancing the procurement process in Northern Ireland during the coronavirus disease 2019 pandemic: Challenges in the procurement process for PPE in NI

This article outlines the purchasing process for personal protective equipment that was established for Health and Social Care in Northern Ireland in response to the outbreak of coronavirus disease 2019. The Business Services Organisation Procurement and Logistics Service, who are the sole provider of goods and services for Health and Social Care organisations, was faced with an unprecedented demand for personal protective equipment in response to the coronavirus disease 2019 pandemic. The usual procurement process was further complicated by changing messages within guidelines which resulted in confusion and anxiety when determining whether or not a product would meet the required safety guidance and was therefore suitable for purchase. In order to address these issues in a rapidly changing and escalating scenario the Department of Health asked the Business Services Organisation Procurement and Logistics Service to work with the Medicines Optimisation Innovation Centre to maximise the availability of personal protective equipment whilst ensuring that it met all requisite quality and standards. A process was implemented whereby the Medicines Optimisation Innovation Centre validated all pertinent essential documentation relating to products to ensure that all applicable standards were met, with the Business Services Organisation Procurement and Logistics Service completing all procurement due diligence tasks in line with both normal and coronavirus disease 2019 emergency derogations. It is evident from the data presented that whilst there were a significant number of potential options for supply, a large proportion of these were rejected due to failure to meet the quality assurance criteria. Thus, by the process that was put in place, a large number of unsuitable products were not purchased and only those that met extant standards were approved.

Screening Children with a History of Maltreatment for PTSD in Frontline Social Care Organisations: An Explorative Study

Traumatic experiences during childhood are common and often lead to chronic mental health conditions such as posttraumatic stress disorder (PTSD). The primary aim of this study was to determine whether a well‐validated screening tool for PTSD administered in frontline services effectively identifies diagnosable PTSD in young people with a history of maltreatment. In total, 141 young people in community care settings were screened using three screening instruments (Child Revised Impact of Events Scale‐8; Generalised Anxiety Disorder‐2; Patient Health Questionnaire‐2). Participants described a range of adverse life events: 110 of the 141 participants reported at least one adverse life experience (mean number for the total sample was 2.8), with 44.2 per cent (n = 46) experiencing at least one form of interpersonal trauma; and 102 participants (72.3 per cent) screened positively for probable PTSD and subsequent mental health assessments confirmed this condition in 64.7 per cent of these participants. Further, 36.9 per cent (n = 52) and 46.8 per cent (n = 66) met the threshold for probable depression and anxiety, respectively. Three items were associated with positive PTSD screens: a history of being on the child protection register, previous mental health contact and interpersonal index trauma. Interpersonal traumas were also associated with higher risks of offending. It seems feasible to use screening measures effectively within frontline social care services if staff are provided with appropriate training and support to identify young people with PTSD who may benefit from evidence‐based mental health therapies.Key Practitioner Messages There is strong evidence of the link between childhood adversities and poor mental health, including PTSD. This study found that a short instrument can be embedded within social care services to screen children and young people for PTSD. It is important that frontline staff have the necessary training and tools to understand the effects of trauma and screen children's mental health in order to facilitate access to effective therapies at an early stage.

The organisation of resilient health and social care following the COVID-19 pandemic – A critical review

Abstract As second presentation, a recent Opinion by the Expert Panel on effective ways of investing in Health (EXPH) will be shared and used as point of reference to assess what the key components are of a future Partnership. This Opinion on the organisation of health and social care following the COVID-19 pandemic (1) identifies the building blocks of resilient health and social care systems, (2) explores the elements and conditions for capacity building to strengthen health system resilience, (3) addresses healthcare provision for vulnerable patient groups and how to sustain such provision in a system under stress, and (4) sets out an approach to develop and implement “resilience tests” of Member State's health systems. The recommendations target a number of key areas, including: enhancing workforce training and resilience, identifying and reducing disinformation, fostering interprofessional and inter-sectoral collaboration with community health workers and informal care givers for example, strengthening primary and mental health care, and a number of other priorities. An overarching recommendation is to enhance investment from the European Commission in the development and implementation of (a) comprehensive resilience testing of health systems that use qualitative and quantitative data collection methodologies to generate meaningful, actionable results for health system transformation, and (b) corresponding learning communities within and across Member States to share lessons learned through this process. Based on this work, what are the priorities for a Partnership, and how can it add value to existing initatives?

5.A. Workshop: Transforming health and care systems - building a European Partnership under Horizon Europe

Health and care systems have been facing increasing challenges. The COVID-19 pandemic has highlighted that improvements are urgently needed to reach high quality, efficient, accessible, health promoting, people-centred, resilient, health and care systems for all EU citizens. The workshop will be built around the preparations for a proposed EU Partnership on Transforming health and care systems as part of the new Horizon Europe Programme. In a first presentation, the Partnership will be clarified in more detail, including its main objectives to be achieved by 2030. The presentation will also share the outcomes of a consultation process among European stakeholders, among others involving decision makers and research funding bodies to identify common goals and priorities, which will feed into a Strategic Research and Innovation Agenda. Second, the work of the Expert Panel on effective ways of investing in Health (EXPH) will be presented, and in particular its Opinion on the Organisation of Resilient Health and Social Care Following the COVID-19 Pandemic. One of its main recommendations has been the need for investment in the development and implementation of health systems data collection methodologies to generate meaningful, actionable results for health system transformation. Similarly, it is important to establish corresponding learning communities within and across Member States to share lessons learned through this process. What does this mean for a future Partnership and what should be its priorities? As third presentation, the Partnership is evaluated from the context of the EU Presidency by Slovenia in the second half of 2021. What are the goals of the EU Presidency and how can a Partnership facilitate alignment with the overall EU political ambition to accelerate the transformation towards sustainable health and care systems? The last element also opens the floor to workshop participants. What health systems research pirorities are key to address from their perspectives and how would workshop audiences prefer to enhance synergies between EU and national level initiatives, including those from within the EPH conference community.Key messages An EU Partnership can help transform health and care systems to become more sustainable, efficient and resilient.Consultation of workshop participants is key to identify synergies at EU and national level and specific priority areas within such a Horizon Europe Partnership.

Implementation of Unobtrusive Sensing Systems for Older Adult Care: Scoping Review

BackgroundThe continuous growth of the older adult population will have implications for the organization of health and social care. Potentially, in-home monitoring unobtrusive sensing systems (USSs) can be used to support formal or informal caregivers of older adults, as they can monitor deviant physical and physiological behavior changes. Most existing USSs are not specific to older adult care. Hence, to facilitate the implementation of existing USSs in older adult care, it is important to know which USSs would be more suitable for older adults.ObjectiveThis scoping review aims to examine the literature to identify current USSs for monitoring human activities and behaviors and assess their implementation readiness for older adult care.MethodsWe conducted a structured search in the Scopus, Web of Science, and ACM Digital Library databases. Predefined inclusion criteria included studies on unobtrusive sensor-based technology; experimental in nature; aimed at monitoring human social, emotional, physical, and physiological behavior; having the potential to be scalable in in-home care; and having at least 5 adults as participants. Using these criteria, we screened studies by title, abstract, and full text. A deductive thematic analysis based on the Proctor implementation framework along with an additional outcome of external validity was applied to the included studies to identify the factors contributing to successful implementation. Finally, the identified factors were used to report the implementation readiness of the included studies for older adult care.ResultsIn this review, 52 studies were included. Deductive analysis using the implementation framework by Proctor resulted in six factors that can contribute to the successful implementation of USSs in older adult care: study settings, age of participants, activities monitored, sensor setup, sensing technology used, and usefulness of USSs. These factors were associated with the implementation outcomes as follows: study settings and age of participants contributed to external validity, sensor setup contributed to acceptability, usefulness of USSs contributed to adoption, activities monitored contributed to appropriateness, and sensing technology used contributed to implementation cost. Furthermore, the implementation assessment of the included 52 studies showed that none of the studies addressed all the identified factors. This assessment was useful in highlighting studies that have addressed multiple factors; thus, these studies represent a step ahead in the implementation process.ConclusionsThis review is the first to scope state-of-the-art USSs suitable for older adult care. Although the included 52 USS studies fulfilled the basic criteria to be suitable for older adult care, systems leveraging radio frequency technology in a no-contact sensor setup for monitoring life risk or health wellness activities are more suitable for older adult care. Finally, this review has extended the discussion about unobtrusiveness as a property of systems that cannot be measured in binary because it varies greatly with user perception and context.

Implementation of patient-centred care: which system-level determinants matter from a decision maker’s perspective? Results from a qualitative interview study across various health and social care organisations

ObjectivesThe healthcare system is characterised by a high degree of complexity and involves various actors at different institutional levels and in different care contexts. To implement patient-centred care (PCC) successfully,...

Adoption of positive health and related concepts in practice

Introduction:In 1948, the World Health Organization defined health as ‘a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity’. More recently, broader concepts of health are being adopted, such as Positive Health. This movement has led to a bigger emphasis on people’s abilities rather than their limitations. In the Netherlands, a wide range of initiatives is taking place in which a broad concept of health is being adopted. These initiatives include different types of organizations and collaborations of organizations (e.g. health and social care organizations, municipalities) that use the concept to optimize health and social care delivery and ultimately improve health outcomes. The aims of our study were: 1. to identify the initiatives that adopt a broad concept of health and 2. to understand the perspectives of different actors (i.e. policy-makers, health and social care professionals, citizens) on using a broad concept of health.Methods: Stakeholders from a wide range of initiatives received an online survey which focused on the initiatives’ characteristics (e.g. organizations involved, targeted populations, activities undertaken to operationalize the adoption of a broad concept of health). The survey was completed by 96 respondents, of which 15 were invited for an interview to understand experiences and perspectives on adopting a broad concept of health including its consequences for health and social care delivery and health outcomes.Results: Initiatives in which broad concepts of health were adopted took place in a wide range of settings (e.g. municipalities, health and social care providers, citizens, employers, schools, sporting clubs) and targeted a wide range of populations (e.g. older people, youth, employees, people with a low socio-economic status). Although respondents were highly motivated and positive about the adoption of a broader concept of health, at the same time they were struggling with how to adopt the concept at different levels of the health and social care system. More than 50% of the initiatives aimed to evaluate the impact of the adoption of the broad concept of health. However, most respondents found it difficult to capture impact and searched for appropriate evaluation methods and indicators for this context. Discussion, conclusion, and lessons learned: The adoption of broader concepts of health is a current issue in the Netherlands. Different types or organizations and stakeholders have embraced these concepts, but there is large variation in how the concepts are operationalized. There is an urgent need to exchange lessons learned, and to work towards meaningful indicators to measure experiences, outcomes and processes of working with a broader concept of health.Limitations:The majority of the stakeholders in our study adopted the Positive Health concept. Insight into the adoption of other concepts therefore remains limited.Suggestions for future research:A participatory action research approach is recommended in future studies targeted on the needs of the different stakeholders at different levels working with a broad concept of health. Such approaches will, through an iterative cycle of research, action, and reflection, further facilitate mutual learning.

Crossing intersectoral boundaries to reach out to vulnerable populations with chronic conditions in five European regions

Introduction: Vulnerable people with chronic conditions should be a priority of policy and interventions. Very often, however, they are hard-to-reach and reluctant “to come to see us”. This paper describes the intersectoral alliances used in the EU funded project EFFICHRONIC to identify and enrol hard-to-reach vulnerable populations with chronic conditions to participate in a self-care programme. Methods: The recruitment approach combined population-based and individual strategies. Vulnerability maps based on specific deprivation indices were developed to prioritize the intervention in those areas with higher vulnerability. Within those areas, potential participants were individually recruited following a variety of recruitment strategies. Results: To reach the vulnerable population, alliances with local and regional authorities, health services, social care organizations and civil society were generated across the EFFICHRONIC sites. As a result of this collaborative effort, a total number of 2.951 vulnerable participants distributed over the 5 European countries have been engaged. Discussion: Forging cross-sectoral alliances has been both enriching and challenging. Our key learnings from this experience include: create a persuasive vision; identify the right agents in the territory, the key people in the organisations and the influential leaders within the community; keep continuous liaison and communications, and ensure effective leadership. Conclusion: Our learnings can contribute to future improvements for policy and practice.

Synthesis for health services and policy: case studies in the scoping of reviews

Background For systematic reviews to be rigorous, deliverable and useful, they need a well-defined review question. Scoping for a review also requires the specification of clear inclusion criteria and planned synthesis methods. Guidance is lacking on how to develop these, especially in the context of undertaking rapid and responsive systematic reviews to inform health services and health policy. Objective This report describes and discusses the experiences of review scoping of three commissioned research centres that conducted evidence syntheses to inform health and social care organisation, delivery and policy in the UK, between 2017 and 2020. Data sources Sources included researcher recollection, project meeting minutes, e-mail correspondence with stakeholders and scoping searches, from allocation of a review topic through to review protocol agreement. Methods We produced eight descriptive case studies of selected reviews from the three teams. From case studies, we identified key issues that shape the processes of scoping and question formulation for evidence synthesis. The issues were then discussed and lessons drawn. Findings Across the eight diverse case studies, we identified 14 recurrent issues that were important in shaping the scoping processes and formulating a review’s questions. There were ‘consultative issues’ that related to securing input from review commissioners, policy customers, experts, patients and other stakeholders. These included managing and deciding priorities, reconciling different priorities/perspectives, achieving buy-in and engagement, educating the end-user about synthesis processes and products, and managing stakeholder expectations. There were ‘interface issues’ that related to the interaction between the review team and potential review users. These included identifying the niche/gap and optimising value, assuring and balancing rigour/reliability/relevance, and assuring the transferability/applicability of study evidence to specific policy/service user contexts. There were also ‘technical issues’ that were associated with the methods and conduct of the review. These were choosing the method(s) of synthesis, balancing fixed and fluid review questions/components/definitions, taking stock of what research already exists, mapping versus scoping versus reviewing, scoping/relevance as a continuous process and not just an initial stage, and calibrating general compared with specific and broad compared with deep coverage of topics. Limitations As a retrospective joint reflection by review teams on their experiences of scoping processes, this report is not based on prospectively collected research data. In addition, our evaluations were not externally validated by, for example, policy and service evidence users or patients and the public. Conclusions We have summarised our reflections on scoping from this programme of reviews as 14 common issues and 28 practical ‘lessons learned’. Effective scoping of rapid, responsive reviews extends beyond information exchange and technical procedures for specifying a ‘gap’ in the evidence. These considerations work alongside social processes, in particular the building of relationships and shared understanding between reviewers, research commissioners and potential review users that may be reflective of consultancy, negotiation and co-production models of research and information use. Funding This report has been based on work commissioned by the National Institute for Health Research (NIHR) Health Services and Delivery Research (HSDR) programme as three university-based evidence synthesis centres to inform the organisation, delivery and commissioning of health and social care; at the University of Exeter (NIHR 16/47/22), the University of Sheffield (NIHR 16/47/17) and the University of York (NIHR 16/47/11). This report was commissioned by the NIHR HSDR programme as a review project (NIHR132708) within the NIHR HSDR programme. This project was funded by the NIHR HSDR programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 15. See the NIHR Journals Library website for further project information.

Mental wellbeing in doctors: the measure matters! development of a core outcome set for measuring wellbeing in doctors

AimsTo achieve a consensus Core Outcome Set for measuring mental wellbeing in doctors.Hypothesis: A minimum set of valid, reliable and practical wellbeing measures is needed for doctors.BackgroundThe importance of doctors’ mental wellbeing to everyone using Health Care is highlighted by the levels of burnout reported in doctors around the world. In 2019 a number of UK policy documents made recommendations for the wellbeing of doctors, but how those wellbeing interventions are evaluated needs to be defined. Core Outcome Sets are increasingly being used in medicine to prevent waste in research, by recommending the inclusion of a minimum set of valid, reliable and practical measures. An operational definition and Core Outcome Set for wellbeing in doctors is needed to meaningfully progress the work in this field.MethodThe Centre for Workforce Wellbeing (C4WW), a collaboration between the University of Southampton and Health Education England, was created to support research into the nature, assessment and enhancement of wellbeing in physicians. A Systematic Review of wellbeing measures used in doctors and the robustness of those measures, along with surveys of 250 UK doctors of all grades and specialities and patient and public involvement is informing what a core outcome set could be. A Delphi Study among 37 UK experts has been initiated to establish the consensus Core Outcome Set.ResultPublication of research into doctors’ wellbeing is growing internationally. In the UK alone data are being captured by multiple national organisations including: the Care Quality Commission, General Medical Council, British Medical Association and the Royal Colleges. Health and Social Care Organisations are, therefore, keen to “do something” and are spending money on wellbeing interventions with little, or no, evidence base and a lack of appropriate, comparable evaluation. A Core Outcome Set for measuring wellbeing in doctors is ethically required to reduce waste, to replace burnout measures and to refine wellbeing interventions.ConclusionWellbeing measures that actually measure wellbeing, and not burnout, which are validated, reliable and practical, are needed to inform local organisational, national government and international research policy. An absence of burnout does not equate to wellbeing. The focus of measurement needs to shift to capture in what contexts we thrive, not just survive. If everyone used the same Core Outcome Set to measure mental wellbeing, direct comparisons could be made, and money invested, in creating infrastructure, processes and cultures that really work.Health Education England funded PhD.

Exploring high mortality rates among people with multiple and complex needs: a qualitative study using peer research methods

ObjectiveTo explore the perceived reasons underlying high mortality rates among people with multiple and complex needs.DesignQualitative study using peer research.SettingNorth East of England.ParticipantsThree focus group discussions were held involving (1)...