Staff Perceptions Research Articles

Perceived determinants of the use of coercion in inpatient child and adolescent psychiatry: a qualitative interview study with staff

BackgroundUnderstanding factors influencing the use of coercive practices in clinical psychiatry is necessary to develop strategies to reduce their use. However, there is little evidence regarding staff perceptions of such factors, particularly in inpatient child and adolescent psychiatry (CAP).MethodsWe conducted semi-structured interviews with nurses, senior consultants and heads of units in inpatient CAP in Sweden 2021 (N = 9). The interviews were transcribed verbatim and analysed using reflexive thematic analysis. Data on informal coercion were analysed separately using a deductive approach based on previously proposed hierarchies for informal coercion.ResultsWe identified one overarching theme of factors reported to influence the use of coercive practices: “Trust and distrust in coercive and non-coercive approaches”, in turn encompassing the two subthemes “Ward culture” and “Available resources and strain”. Our findings suggest a risk of a negative spiral of coercion emerging when there is low professional trust in non-coercive approaches and high trust in coercive methods. Informal coercion was used frequently and observed to occur in two distinct processes: one concerning continuous coercive escalation, and the other involving sustained efforts at the same coercion level.ConclusionsTrusting the efficacy of non-coercive approaches in inpatient CAP care appears critical for their success; a finding that may inform strategies to reduce coercion and address frequent use with individual patients.

Interactive oral assessment: Staff perceptions, challenges and benefits of this robust, authentic assessment design approach

ABSTRACT This paper aims to share outputs from a Quality and Qualifications Ireland (QQI) Transforming Assessment funded project. The objective of the project was to explore the impact of Interactive Oral Assessment (IO) at Dublin City University (DCU). Griffith University, Australia, pioneered IOs in their university in 2016 and has evidence to support their success in promoting academic integrity, engaging students and preparing them professionally. DCU introduced IOs in 2020 with the support of Griffith University. Initial research findings demonstrated that IOs were received favourably by students in DCU. This paper shares findings into the experience of academics using IOs, and presents underpinning relevant literature. The review covers the application and value of IOs, and IO planning and implementation. Research analysis of academic in-depth interviews shares the benefits and motivation for using IOs, along with the challenges, and supports required to ensure successful IO practice.

Public Health + Public Safety: Integrating Community Health Workers with Probation Officers to Improve Service Delivery for Justice-Involved Women.

Integrating public health and public safety strategies is becoming increasingly crucial to maximize positive outcomes for justice-involved people. To date, there is little research exploring the integration of Community Health Workers (CHWs) into community supervision settings. This study utilizes a qualitative approach to explore staff and client (N = 12) perspectives on embedding a CHW into a gender-responsive probation supervision approach. Results from the thematic analysis of staff and clients' responses supported the integration of CHWs into community supervision. Emerging themes were grouped around staff perceptions of CHW's function and role as "navigators," creating a natural division of labor within the agency and operating as a safe resource for clients. Clients reported gaining additional personal and professional support through the embedded CHW within their supervision team. Results suggest that integrating public health professionals, particularly those with lived experience, can alleviate workload and decrease burnout while promoting client treatment needs.

Transforming Ableism in Physical Therapist Education One Student at a Time: A Case Report of a Student with Blindness.

The prevalence of students with disabilities in physical therapist education programs in the United States is <1%. This case report explored the experiences surrounding a specific, unique individual student with blindness or visual impairment (BVI) within the context of an entry-level physical therapist program. The purpose was not merely to describe 1 student's journey but to capture the complex dynamics and shifts in perceptions of students, faculty, staff, and clinicians. This case report retrospectively explored the perceptions of these individuals before, during, and after interactions with the student and examined ableist assumptions expressed by some individuals that vision is essential for Doctor of Physical Therapy (DPT) students and clinical practice. A recent DPT graduate (pseudonym J.M.) with BVI classified as "near total blindness," is now a licensed, full-time employee at an outpatient orthopedic clinic. We surveyed 36 individuals (20 students, 11 faculty, 2 staff, and 3 clinical instructors) who interacted with J.M. as a student, asking their perceptions about the education, clinical skills, and employment potential of a DPT student with BVI. An increase toward more favorable perceptions of individuals with BVI was exhibited for all of 10 Likert scale questions (X2[2] = 38.00 to 59.42). Qualitative analysis revealed 3 themes: accommodations, personal qualities, and setting with an overarching theme of an approbative shift in perceptions. The shift in perceptions about vision as essential for physical therapist practice is important and suggests that physical therapist education program applicant qualifications and essential functions regarding vision should be considered within the context of reasonable accommodations, individual characteristics, and lived experiences. Redefining physical therapist education program applicant qualifications and essential functions regarding vision may be warranted. For clinical instructors, the benefits may outweigh the challenges of mentoring a student with accommodations for BVI.

We’re Moving Online: Lessons Learned During the COVID-19 Pandemic to Support Adaptive Leisure Time Physical Activity in the Virtual Environment

Throughout the COVID-19 pandemic, people with disabilities were particularly inactive and online programs offered new opportunities for their engagement in leisure time physical activity (LTPA). However, research regarding how virtual adaptive LTPA programs were developed and delivered is limited. This case study examined the staff perceptions of developing and delivering virtual adaptive LTPA for people with disabilities to better understand the barriers and facilitators organizations experienced during its implementation. Five semi-structured interviews conducted with staff of a community-based organization specializing in adaptive LTPA explored the process of transitioning to a virtual format, challenges and facilitators, and lessons learned. Interviews were analyzed using inductive content analysis and organized around three themes. Systematic development of virtual programs suggested that supporting the organization, staff and members facilitates virtual adaptive LTPA. Creativity and resourcefulness in delivering programs highlighted the importance of flexible management and using staff skills. Effects of transitioning to virtual programming emphasized positive impacts of virtual LTPA such as connectedness, health benefits, and expanded organizational reach. The results of this study emphasize the benefits of virtual adaptive LTPA and highlight key management factors that organizations can use to provide virtual opportunities for adaptive LTPA for people with disabilities.

A Pilot Study on Understanding the Contextual Factors Impacting the Implementation of an Antibiotic Stewardship Program in a Single Health Center Serving Rural and Underserved Communities in the United States—A Mixed-Methods Approach

Objective: This study aimed to identify contextual factors influencing the implementation of an antibiotic stewardship program (ASP) in a rural primary care center serving underserved communities. Methods: A mixed-methods approach guided by the Consolidated Framework for Implementation Research (CFIR) was employed. Data were collected through semi-structured interviews, focus groups, and surveys with clinical staff and leadership at a Federally Qualified Health Center (FQHC). The CFIR framework was used to explore barriers and facilitators within the clinic’s inner and outer settings, focusing on staff perceptions, challenges, and readiness for ASP implementation. Results: Strong staff support for ASPs was identified, with participants emphasizing their potential to improve patient outcomes and antibiotic prescribing practices. Barriers included insufficient training, a high workload, and patient pressure to prescribe antibiotics. Leadership commitment, enhanced communication systems, and tailored educational materials were identified as critical facilitators for successful implementation. Participants highlighted the need for accessible educational tools and streamlined protocols to improve engagement and compliance. Conclusions: Implementing an ASP in rural and underserved settings is feasible but requires addressing site-specific challenges. The insights from this study underscore the importance of understanding contextual factors to inform evidence-based strategies for ASP adoption. The structured use of CFIR provided a comprehensive framework to guide implementation efforts, ultimately supporting better antibiotic use and public health outcomes in resource-constrained healthcare settings.

Drivers and barriers to promoting self-care in individuals living with multiple long-term health conditions: a cross-sectional online survey of health and care professionals

BackgroundSelf-care is an important part of preventing unwarranted decline in poor health linked to multimorbidity and in maintaining or improving health. Health and social care professionals provide support for self-care, which can positively influence health and care outcomes. It is important to understand the extent to which they perceive their support to be effective and what barriers to its uptake and desired outcomes exist. This study investigated the knowledge, attitudes, and perceptions of front-line staff in England concerning drivers and barriers to promoting self-care in service users with multimorbidity.MethodsA cross-sectional online survey was administered via the Imperial College Qualtrics platform. Questions were asked about perceived drivers and barriers to promoting self-care in individuals with multimorbidity, including mental health. The quality of the survey was assessed by completing the Checklist for Reporting Results of internet E-Surveys (CHERRIES).ResultsExtant barriers associated with service-users’ ability and opportunity for self-care identified by seventy H&SCPs in England were feelings of loneliness and social isolation (18.9%; n = 54) and mobility and access issues (14.3%; n = 41). The methods most commonly used to support self-care were social prescribing (18%; n = 55), helping service users monitor their symptoms (15.4%;n = 47), and referring to recognised programmes to support self-management (14.1%; n = 43). The factors most identified as positively affecting service users to self-care included knowledge and understanding about the benefits of self-care (92.5%; n = 62), support to improve limitations caused by a health condition (92.5% n = 62), and support to improve mental health and wellbeing (91% n = 61). Gaps in H&SCPs knowledge were reported, including how to improve practical interactions to sustain health seeking behaviours by service users (32.2%; n = 48), health coaching (21.5%; n = 32), and knowledge about effective self-care interventions (20.1%; n = 30). Most respondents (92.9%; n = 64) reported that the COVID-19 pandemic highlighted the need for self-care, and 44.9%(n = 31) agreed that the pandemic had a positive impact on their ability to promote self-care among service users.ConclusionsSelf-care is important for service users who live with multimorbidity. H&SCPs identified loneliness, social isolation, mobility and access to services, and support in understanding or complying with a medical regimen as key obstacles to self-care for service users. Extant barriers identified by H&SCPs were associated with service users’ ability and opportunity to sustain self-care, especially relating to feelings of loneliness and experiences of social isolation, mobility and access issues.

Improving Acute Stroke Care with an Implementation Science Guided Acute Stroke Nurse Pilot Project

Improving Acute Stroke Care with an Implementation Science Guided Acute Stroke Nurse Pilot Project

Evaluating models of interaction between the pedagogical university and the regional educational system: Guidelines and expectations of the stakeholders

Introduction. Changes in the position of the pedagogical university in the regional education system determine the need to harmonize the goals and expectations of the stakeholders in order to improve the quality of their joint activities. The aim of this study is to compare the perceptions of the academic staff and the teaching staff of regional educational setting about the interaction between the pedagogical university and the regional education system, reflecting their experiences, expectations and evaluation of the interaction. Materials and Methods. The research methodology was based on the typology of models of interaction between a pedagogical university and regional education: presence, cooperation and integration. The empirical base of the study is formed by the survey data of 2205 respondents from different regions of Russia, representing pedagogical universities and regional education systems. The respondents were asked to evaluate the involvement of a pedagogical university in the regional education system, to choose the preferred and rejected forms of interaction, to report on their direct experience of participation in the interaction between a pedagogical university and a regional education system. Results. The findings of the study indicated that there were discrepancies in the perceptions of the utility and accessibility of diverse models of interaction among representatives of universities and regional education systems. Academic staff demonstrates a greater degree of engagement in diverse formats of interaction with regional education systems. However, their priorities diverge from the expectations espoused by representatives of the regional education. The discrepancy between the emphasis on the model of presence, which defines the core function of the university as supplying teaching staff for the education system, and its inadequate efficacy in addressing the deficit of teachers, has been identified. It has been demonstrated that respondents with greater experience of collaboration are inclined towards the integrative model of interaction and are more satisfied with its outcomes. Conclusions. The study has demonstrated that the models of interaction between teacher education institutions and regional education systems require transformation towards greater integration and cooperation. This is necessary in order to eliminate divergent expectations and create conditions for sustainable cooperation. Strengthening coordination mechanisms, developing practice-oriented and integration formats of interaction, and creating a system for monitoring the effectiveness of interaction will facilitate this transformation.

Effect of the Protect Youth Human Trafficking Prevention Program on School Staff Knowledge and Perceptions of and Confidence in Responding to Human Trafficking in Schools

Effect of the Protect Youth Human Trafficking Prevention Program on School Staff Knowledge and Perceptions of and Confidence in Responding to Human Trafficking in Schools

Exploring staff perceptions regarding alarm fatigue and practices among nurses: A multicentre study in the Northern Emirates.

Exploring staff perceptions regarding alarm fatigue and practices among nurses: A multicentre study in the Northern Emirates.

Barriers and facilitators to increasing physical activity in medium secure mental health settings: An exploration of staff perceptions

Barriers and facilitators to increasing physical activity in medium secure mental health settings: An exploration of staff perceptions

An early evaluation of team consistency and scope optimization in team-based cancer care

BackgroundThe British Columbia (BC) government has made significant investments towards the implementation of team-based care (TBC) in its provincial comprehensive cancer control program. TBC implementation involves purposeful efforts towards: (a) establishing/expanding multidisciplinary care teams, (b) optimizing scope of practice, and (c) increasing care team consistency. Study objectives include an early-phase evaluation of (i) the association between TBC elements and team effectiveness and (ii) staff perceptions of barrier and facilitators of team effectiveness.MethodsA series of five surveys over a 2-year period will be administered to prospectively evaluate the ongoing implementation of TBC. This study draws on data from the first of the five planned surveys, administered in May 2023. Eligible respondents included 299 program employees—spanning various roles such as physicians, nurses, and unit clerks—working within TBC at the time of survey deployment. The survey included both validated and researcher-developed questions that were either closed or open-ended, including measures of team composition, team consistency, team effectiveness, scope of practice, and demographics. Quantitative data were analyzed using descriptive and regression analysis; qualitative data were analyzed guided by interpretive description methodology.ResultsCollected responses totaled 121, with the majority of respondents being women (76%), full-time employees (90%), and working in direct patient care (77%). Regression analyses indicated that (i) higher frequency of consistently working with the same team members and (ii) lower proportion of shifts practicing below scope are both significant predictors of higher team effectiveness ratings. Qualitative data highlighted staffing levels as a driver of under- and over-utilized scopes of practice. Furthermore, effective communication, enhanced knowledge of each team member’s scope of practice, and strong interpersonal relationships were highlighted as contributing factors to effectiveness among multidisciplinary care teams.ConclusionsPreliminary findings from the first of five prospective surveys highlight team consistency and role optimization as drivers of effective teamwork in the early implementation of a team-based model of cancer care. Future research should explore contextual factors that influence cancer care staff and clinicians’ perceptions of effectiveness.

Culturally and Contextually Relevant Definitions of the Five Cs

This study aimed to investigate if and how the Five Cs were related to the perception of program outcomes in different PYD programs in Aotearoa/New Zealand. A qualitative, exploratory methodology was employed within a critical realist epistemology, including semi-structured interviews and focus groups with 110 youth, aged 12 – 25 years, and 17 staff in 14 different local PYD programs. Data were analyzed using framework analysis. Inductive analysis identified nine key program outcomes which were then assessed against the Five Cs, plus Contribution and Creativity, noting areas of similarity and local difference. The study concludes that although youth and staff perception of program outcomes broadly align with the Five Cs, belonging and positive identity, key themes in the data, are not well captured in current Five Cs definitions. Local definitions which highlight these contextual and cultural nuances are proposed. The findings provide a basis to further understand localized PYD in a global field and may be a valuable comparison point for others to explore the Five Cs in their contexts.

Flexible, adaptable, and supportive systems: qualitative description of factors underpinning an ideal mealtime delivery in rehabilitation care settings

Purpose Whilst evidence about mealtime delivery exists in acute and aged care settings, there is limited understanding of patient and staff preferences for rehabilitation settings. This study aimed to explore patient and staff perceptions about how mealtimes should be delivered to support rehabilitation goals of care. Method: This qualitative descriptive study involved semi-structured interviews with nine patients (previous or current admission) and ten staff from a single metropolitan rehabilitation service. Data were analysed using qualitative content analysis. Results Two key categories were identified, including (1) the role of mealtimes in patients’ rehabilitation, and (2) factors underpinning ideal mealtime delivery for rehabilitation. Mealtimes help to facilitate recovery, support socialisation, rest, and routine, but were also a time of frustration and challenge for patients. The ideal mealtime was described as creating a therapeutic experience, integrating systems and processes that support rehabilitation, systems that offer flexibility and choice, enhancing mealtime care through interdisciplinary collaboration, and using supportive mealtime care practices. Conclusion The ideal mealtime in rehabilitation should be underpinned by principles of flexibility, adaptability, and supportive care. Incorporating rehabilitation goals of care can be enabled through mealtime systems that encourage functional therapy activity, optimal nutrition, and time for rest and social engagement.

Evaluation of Universal Screening for Substance Use Risk on a Labor and Delivery Unit in Rural Pennsylvania.

Evaluation of Universal Screening for Substance Use Risk on a Labor and Delivery Unit in Rural Pennsylvania.

Eight Months into Reality: A Scoping Review of the Application of ChatGPT in Higher Education Teaching and Learning

Abstract ChatGPT has sparked heated discussion in higher education since its public release and increasing empirical studies have been made available examining its application to higher education teaching and learning. To capture and synthesize the initial scholarly developments in this topic, we undertook a scoping review of empirical research into the use of ChatGPT for higher education teaching and learning, published in the first eight months since its release. We identified 39 articles through a systematic literature search in the Web of Science and Scopus databases. Our analysis identified five thematic areas that extant research has contributed to, including (1) ChatGPT's performance in assessment; (2) ChatGPT's capacity in facilitating learning; (3) staff and students' perceptions of ChatGPT; (4) the adoption of ChatGPT, and; (5) ChatGPT-related policy implications. Drawing on the findings, we discuss current understanding and directions for future research in each of the thematic area. We then discuss issues emerged from the reviewed literature, including implications for improving research design, researching academic integrity, and explaining ChatGPT's pedagogical value in light of learning theories and other digital technologies.

Exploring a process-oriented way of working – a case study involving primary and specialised care

BackgroundHealth care organisations have a long history of dividing work and tasks into decentralised functions and units by forming divisions and departments with delegated power. New ways of working, such as process-oriented approaches, have been called for to address challenges such as staffing shortages and resource constraints. There is limited understanding of the interplays that will occur in health care organisations during a shift from a traditional decentralised structure to a process-oriented approach. This study aims to explore the perceptions of health care staff and leaders when introducing a process-oriented routine.MethodWe conducted interviews and focus groups with 29 participants in specialised and primary care in order to explore their experiences of a newly introduced routine regarding on-demand consultation, aimed at enhancing communication and patient coordination in a Swedish health care region. The participants included operating managers, schedulers and physicians. Data were analysed using reflexive thematic analysis in accordance with Braun & Clark’s guidance.ResultsThe findings encompass three main themes when introducing a process-oriented routine: Creates a readiness to act, The critical role of trust for adopting on-demand consultation in everyday practice and Challenges associated with transformation. The results show that health care staff and leaders are positive about the new way of working, but the readiness to act is challenged by issues of trust, as well as cultural components and structural factors such as experienced resource constraints.ConclusionOur results underscore the need to consider not only organisational aspects but also social and individual relational factors when introducing a process-oriented way of work into a decentralised and complex health care system.

Effect of Mother-Baby Friendly Facility Accreditation on Midwifery Staff’s Perceptions of Obstetric Mistreatment

Objective(s): This study aimed to evaluate the impact of Mother-Baby Friendly Facility (MBFBF) accreditation on midwifery staff's perceptions of obstetric mistreatment. The hypothesis tested was that MBFBF-associated training and policy changes would improve awareness and reduce tolerance toward mistreatment practices during childbirth. Study Design: This single-center observational pre-post study was conducted in the obstetrics and gynecology unit of a tertiary hospital. Data collection occurred before and after MBFBF accreditation, granted in November 2024. The study included 122 midwifery staff with at least one years of clinical experience before accreditation. Perceptions of obstetric mistreatment were assessed using the Turkish version of the Perception of Obstetric Violence in Students Questionnaire (PercOV-S Q). Statistical analyses included Wilcoxon signed-rank, Mann-Whitney U, and Kruskal-Wallis tests to evaluate changes in scores and subgroup differences. Results: Significant improvements were observed in perceptions of mistreatment, with overall PercOV-S Q scores increasing from 95.50 (87.00–107.00) pre-intervention to 110.50 (83.50–129.00) post-intervention (p = 0.027). Key areas of improvement included informed consent (Q1: p &lt; 0.001), privacy (Q2: p &lt; 0.001), and respectful communication (Q3: p = 0.017). Subgroup analysis showed statistically significant differences in five selected questions (p &lt; 0.001), while other areas showed trends toward improvement. Conclusion(s): The MBFBF accreditation process and associated training significantly enhanced midwifery staff's awareness of obstetric mistreatment, aligning with international guidelines. These findings underscore the importance of structured education and institutional reform in fostering respectful, patient-centered care. Expanding MBFBF accreditation programs globally could contribute to reducing obstetric mistreatment and improving maternal health outcomes.

The Forensic Humor Project: An Interview Study on Forensic Mental Health Inpatients Experience With and Use of Humor

ABSTRACT Introduction The literature suggests that humor is of central importance in the staff–patient relationship. However, within forensic mental health, the most recent review underlines a scarcity of research focusing on the use of humor from a forensic patient perspective. Therefore, this study investigated the characteristics of forensic mental health inpatients' perceptions of staff and their own use of humor within a forensic mental health setting. Method The project explored this through semistructured interviews with 11 forensic mental health inpatients and subsequent thematic analysis. Results Overall, the patients found that staff should keep practicing humor during admission. The study showed that inpatients viewed the use of humor in terms of “identity” and “community and closer relationships” providing possibilities for “contagious social therapy” if managed according to “power: insight, context, and intention.” These elements of humor were used to “deescalate conflicts” and to create a “positive therapeutic alliance” if carried out with (a) relational sensitivity, (b) situational sensitivity, (c) person-centeredness, and (d) humor being power informed. Conclusion The inpatients recommended nursing staff use of humor during admission.