Staff Relationships Research Articles

Gratitude despite unease among Swedish male forensic psychiatric patients with substance use disorders: an interview study

ABSTRACT Purpose Forensic psychiatric inpatient care in Sweden is characterized by strict regulations and adherence to court-mandated rules, with a median care time of 7 years. Comorbity has significant clinical implications, impacting health and well-being, violent behaviour and criminal recidivism, and prolonging inpatient stays. This study investigated the individual experiences and perspectives of Swedish patients in forensic psychiatric care with substance use (SU) disorders, focusing on past, present and future orientations. Methods Ten male forensic psychiatric inpatients were individually interviewed following a semi-structured interview guide. A qualitative content analysis was conducted to inductively analyse the participants’ experiences. The study adhered to the Standards for Reporting Qualitative Research. Results Under the main theme of “embracing harmony in opposition”, three categories emerged: (1) unveiling the beginning of SU and its impact on navigating challenges in care, (2) exploring current confined care and gratitude despite unease and (3) yearning for a somewhat normal life. Conclusions Participants’ subjective perspectives underscored the importance of factors such as forensic nurses/healthcare providers in forensic psychiatry considering the patients’ life narratives, their aspirations for the future, their need for a secure environment and patient—staff relationships. These findings highlight the need for structural interventions that emphasize the importance of tailored and comprehensive health plans within rehabilitation.

STRYV365 peak team and Brain agents: teacher perspectives on school impact of a trauma-informed, social-emotional learning approach for students facing adverse childhood experiences.

Adverse childhood experiences (ACEs) have a profound impact on children's and adolescents' academic performance and overall wellbeing. In contrast, positive childhood experiences help mitigate the negative effects of ACEs on health and wellbeing. Trauma-informed and social-emotional learning (SEL) programs in schools may address these impacts, with school staff playing a pivotal role in ensuring their success and influencing school outcomes. This study aimed to assess the strengths, weaknesses, and areas for improvement in the STRYV365 peak team and Brain Agents programs. The aim was to refine program implementation and determine the preliminary effects on students, teachers, and the broader school environment. To achieve this goal, four focus groups were conducted after the program concluded, involving 17 school leaders, administrators, and teachers from four urban schools serving students in fifth through ninth grades. The audio transcripts were professionally transcribed and analyzed by four co-authors using Dedoose for inductive coding, leading to the identification of major themes and subthemes. Three key themes were identified from transcripts: school-wide perspectives of STRYV365 programs, strengths and impacts of STRVY365 programs, and suggestions for program improvement. School staff noted that the peak team was particularly engaging for students, helping them develop SEL skills and foster both peer-to-coach and peer-to-peer relationships. Additionally, the STRYV365 programs were found to enhance student-teacher relationships and staff relationships. Teachers expressed strong interest in taking a more active role in future programming. Overall, this study highlights the importance of teacher and administrator involvement in maintaining consistent SEL activities for urban youth. The findings also suggest that short-term, 4-week SEL programs can have a positive effect on school culture, as well as on student-teacher relationships and teacher-teacher relationships.

Responsibility of follow-up regarding medical recommendations in primary care and challenging patients: The perspective of doctors, nurses, pharmacists, and administrative staff

ObjectiveThis study examines the way healthcare staff describe challenging patients and perceive responsibility for follow-up of patients with chronic conditions. MethodsInterviews were conducted with 46 healthcare staff (15 primary care physicians/12 nurses/15 administrative staff/4 pharmacists) at 12 clinics in Israel. They were audiotaped, transcribed, and thematically analyzed using Atlas qualitative data analysis software. ResultsParticipants defined patients as “challenging” either because they are less likely to follow medical recommendations or are felt to overconsume care. Staff believed that patients did not follow medical recommendations because they were indifferent, unaware, in denial about deteriorating medical condition, or fear of the unknown. Participants generally perceived a shared responsibility for follow-up between the staff and the patient. Staff who endorsed closer relationships with staff members expressed empathy toward challenging patients and felt responsible for follow-up. ConclusionsHealthcare staff perceive themselves as partially responsible for helping patients follow up with medical recommendations. Cohesive staff relationships may promote higher levels of empathy toward challenging patients and may contribute to helping patients follow up with recommended care.Practice implicationsTo improve follow-up with medical recommendations, there is a need to develop and test interventions to promote more cohesive ties among clinic staff.

Robbing the cradle: Factors promoting lecturer-on-student transactional sex relationships at a South African university

While universities have been lauded as sanctuaries of peace where students and staff pursue educational goals, there has been a marked increase in the victimisation of students by staff members who have been known to hound students for sexual favours. This increase in unethical conduct continues regardless of "sound" policies regulating university student and staff relationships. Against this background, this study sought to explore the factors shaping the pervasive practice of transactional sex between staff and students at a university in rural South Africa. Underpinned by the sexual exchange theory, the study utilised an exploratory sequential mixed-methods design. The findings categorised into four key themes—academic reasons, impunity and power dynamics, financial constraints, and peer pressure and influence—highlight the entrenched nature of this practice within the university setting. The study recommended implementing and enforcing strict policies with clear consequences for perpetrators and establishing confidential reporting systems and dedicated support units for victims.

Assessment of the Relevance of Mentoring Roles in Nasarawa State University, Keffi

This paper assessed the relevance of mentoring roles in Nasarawa State University, Keffi. The major objectives of this paper were to assess the effects of mentoring roles in achieving the mandates of Nasarawa State University, Keffi, as well as the extent to which mentoring roles affected employees’ capacity in Nasarawa State University, Keffi. The survey method was employed with primary and secondary sources of data used. A sample size of 400 was used. After analyzing the collected data, it was revealed that mentoring at Nasarawa State University, Keffi was very relevant and had a positive effect on learning, staff relationships, innovation, and creativity. It was also found that mentoring was very relevant and had a positive effect on staff capacity development, career satisfaction, the discovery of new talents, self-confidence, motivation, and understanding of NSUK’s goals and objectives. Based on the findings, the paper recommended that there is a need to strengthen and expand mentoring programmes at Nasarawa State University, Keffi. This could be done by investing in resources and training for mentors, promoting a mentoring culture, and increasing awareness among staff and students about the benefits of mentoring. Also, NSUK should, as a matter of concern, implement a formal mentoring programme to provide opportunities for mentorship relationships to be established between experienced staff members and those seeking growth and development.

Pediatric practice experiences with second dose influenza vaccination: An AAP Pediatric Research in Office Settings (PROS) Study

ObjectivesExplore pediatric staff experiences administering the second influenza vaccine dose. Study designQualitative focus groups/interviews. MethodsAs part of the National Institutes of Health-funded Flu2Text randomized control trial of text message reminders for second influenza vaccine dose, we conducted seven focus groups and four individual interviews (n = 39 participants total) with clinicians and staff from participating practices from the American Academy of Pediatrics' Pediatric Research in Office Settings (PROS) Network. Of 37 participating practices, 10 were selected through stratified sampling of practices with highest (n = 5) and lowest (n = 5) randomized controlled trial effect sizes. A semi-structured discussion guide included questions that addressed parental, practice, and health system barriers/facilitators to second influenza vaccine dose administration. Using the Systems Model of Clinical Preventive Care as a conceptual framework, two investigators independently coded transcripts (Κ = 0.86, high agreement) with NVivo 12 Plus. Coding inconsistencies were resolved by consensus. ResultsClinicians/staff reported that administering the second influenza vaccine dose in a season was more complex than other childhood vaccines. They highlighted parental uncertainty about the need for the second dose and the difficulty and inconvenience of bringing children back to the office as important barriers. Caregiver–staff relationships were perceived as helpful in getting children vaccinated with their second dose and vaccine reminders were seen as important cues-to-action. ConclusionsEnsuring receipt of two doses of the influenza vaccine in a given season presents unique challenges. Themes identified provide a framework for understanding opportunities to bolster second dose receipt, including explaining why two doses are needed, offering flexible hours for vaccination, and sending vaccine reminders.

Look both ways before crossing: Using a triangulation of artbased methods to transform student – staff relationships as it relates to school climate (online first)

By engaging in an art(s) based action-research case study, youth from a Montréal school considered student-staff relationships as they relate to school climate. Three arts-based data collection methods (timeline, relational map, and photovoice) were used to gain awareness on how relationships with staff constituted the primary determinant of student behavior, student engagement, and a robust school climate. Positive relationships were found to be facilitated by staff who authentically engage with students’ lives outside the classroom, demonstrate equity and discretion in classroom management practices, and allow for redemption following rule infractions or conflicts.With the goal of enacting sustainable change in the school environment, participants collaborated in drafting a Call to Action addressed to the school’s administration, advocating for the creation of a student council as a space to voice their positions, build better communication with staff, and foster a healthy school climate. The paper thus illustrates how art(s) based action-research can contribute to transforming school environments.

The present situation of the nursing practice environment and its influence on nursing quality in a post-epidemic era: a cross-sectional study

BackgroundNursing Practice Environment is an important index to improve nursing quality and patient outcome. To explore the nursing practice environment in the COVID-19 ward during the period of COVID-19 and its impact on nursing quality to provide reference for setting up supporting nursing team in epidemic area in the future.MethodsA cross-sectional survey was conducted among 251 nurses working in COVID-19 ward in Shanghai, Hainan and Hunan in December 2022 through stratified proportional sampling. Structured questionnaires, including general information questionnaire, professional practice environment scale and nursing quality questionnaire, were used to investigate the patients. Pearson correlation was used to analyze the correlation between nursing practice environment and nursing quality, and multiple linear regression analysis was used to analyze the influencing factors of nursing quality in the COVID-19 ward.ResultsThe professional practice environment scale score was (3.34 ± 0.40), the nursing quality questionnaire score was (9.47 ± 0.81), both at a high level. Single factor analysis showed that nursing quality was related to educational background, physical condition, professional title, grade of the original hospital and composition of nursing staff in supported departments. Nursing quality were positively correlated with each nursing practice environment dimensions (in addition to teamwork). The results of regression analysis showed that the nursing practice environment in the COVID-19 ward had a positive impact on nursing quality.ConclusionsThe nursing practice environment and nursing quality of nurses in the COVID-19ward is generally very high. The education, working hospital level and nursing practice environment of nurses are the important factors influencing nursing quality. The relationship between nursing practice environment (include leadership and autonomy in clinical practice, staff relationships with physicians, control over practice, communication about patients, handling disagreement and conflict, internal work motivation and cultural sensitivity) and nursing quality is positive. It is suggested that the hospital should pay special attention to and improve nursing practice environment in order to improve nursing quality when setting up temporary ward in the future epidemic period of infectious diseases, ensure patient safety.Impact on clinical practiceResearch shows that an active nursing practice environment can improve the quality of care, and nursing managers create and maintain an active practice environment to improve the quality of care and ensure patient safety.

A confirmatory factor analysis of a job satisfaction scale for healthcare providers in emergency departments

ABSTRACT Objective Performance of health care providers in a hospital’s emergency department is crucial as they are the first liners in the hospital. This study used a confirmatory factor analysis to verify the validity and reliability of a newly developed multi-dimensional job satisfaction scale for healthcare providers in emergency departments. Method A convenience sampling method used to collect data from emergency departments of Jordan Middle District hospitals. A total of 286 healthcare providers from 11 hospitals participated in the study. The job satisfaction questionnaire was distributed in these hospitals from the beginning of June 2020 until the end of August 2020. Data analysis was performed using AMOS 21 after data entry into SPSS 25. Result A model of four-factor with 16 items yielded adequate goodness-of-fit values with good convergent and discriminant validity after model re-specification. Four confirmed factors in this study were the most common dimensions used in measuring job satisfaction. Namely; physical environment and workplace safety, supervisor support, promotion and compensation, and staff communication and relationship domains. Conclusion The job satisfaction scale was proven to provide a valid measurement model and reliable constructs measuring accurately job satisfaction of healthcare providers in emergency departments and exploring ways to improve their performance.

Comparison of Job Satisfaction of Private and Public School Teachers in Godawari Municipality

This study analyzed the job satisfaction among teachers in private and public schools located within Godawari Municipality of Lalitpur district. The sample of the study contains five private schools and five public schools which were selected from ward number 9, 10, 11, 12 and 13 of Godawari Municipality of Lalitpur district, Nepal. 100 teachers were approached for the data collection, out of which, 94 responded. Out of 94 respondents, 49 were from public and 45 were from private schools. Data was collected in 2019. Different variables like working environment, salary, staff relationship and motivation were used to analyze the job satisfaction. The data were collected through field survey and 5 points Likert scale questionnaire was used. The data was analyzed through SPSS and it was found that the teachers of private schools were more satisfied in comparison to public schools in terms of working environment, staff relationship and motivation and there was no difference in the satisfaction between the private and public-school teachers.

Understanding Indigenous peoples experiences to inform recommendations for improving cultural safety and care in radiation therapy centres in Alberta, Canada

IntroductionRates of common cancers are continuously increasing among Indigenous peoples and are above the incidence rates of non-Indigenous Canadians. When considering the intersecting social determinants of health such as culture, geography, funding, and access to basic health services, these all contribute to the unique cancer burden faced by Indigenous people. Indigenous patients sometimes feel alienated by the word “cancer”, intimidated in the oncology setting and often avoid or delay seeking care, bypass screening and preventative care, and cease prescribed treatment before it is finished. Providing culturally competent, safe care to improve Indigenous health outcomes have been suggested and prioritized in health care systems across Canada. MethodsUsing an Indigenous methodology, sharing circles were held in Northern Alberta, Canada. Five Indigenous survivors of cancer and two Indigenous caregivers shared their experiences with oncology treatment in the radiation therapy centre. Results were transcribed verbatim and thematic analysis was conducted. ResultsThis resulted in four main themes (1) historical and cultural understandings (2) reduce systemic harm by having dedicated Indigenous staff, cultural competency, and Indigenous specific supports (3) meaningful time commitment and relationship building (4) importance of kinship and Indigenous-centred, family-and-patient-centred care. These themes fed into the development of nine recommendations for policy and decision makers to improve cultural safety in the Alberta radiation therapy centres. ConclusionSupport for Indigenous patients and caregivers is essential to improve care in the radiation therapy centres. The findings from this work will support recommendations for health decision and policy makers within radiation therapy centres, which may be transferable to other centres within oncology and health.

Perceptions of incarcerated people: prison conditions, public health, and justice in the United States

Carceral conditions in the United States may serve as a proxy for crises within justice and health systems. This study seeks to consider and measure prison climate from the perspective of incarcerated people. By examining within-facility differences in carceral experiences, results shed light on the complex nexus between the carceral context, health, and justice. We administered the Prison Climate Questionnaire (PCQ) to the complete population of incarcerated men in a correctional facility located in the Eastern United States. In this facility, housing units hold distinct populations, fulfill different functions, and can offer unique programming. We regress select items from the PCQ on a set of dummies corresponding to different residential units within the facility. Responses indicate low but relatively uniform perceptions of overall personal health, as well as access to, and satisfaction with, medical care. Between-unit differences emerge regarding staff relationships, experiences of discrimination, and levels of isolation. The perspectives of incarcerated people can, and should, play a role in understanding and conceptualizing the nature of the prison environment. Policy responses, especially those that impact the health and well-being of currently and formerly incarcerated people, can be informed by these perspectives.

Promoting a thriving school community: Investigating the effectiveness of positive psychology interventions for improved teacher-student and staff relationships: A critical review

Promoting a thriving school community: Investigating the effectiveness of positive psychology interventions for improved teacher-student and staff relationships: A critical review

Promoting a thriving school community: Investigating the effectiveness of positive psychology interventions for improved teacher-student and staff relationships: A critical review

Promoting a thriving school community: Investigating the effectiveness of positive psychology interventions for improved teacher-student and staff relationships: A critical review

Resident worklife and wellness through the late phase of the pandemic: a mixed methods national survey study

BackgroundSystem contributors to resident burnout and well-being have been under-studied. We sought to determine factors associated with resident burnout and identify at risk groups.MethodsWe performed a US national survey between July 15 2022 and April 21, 2023 of residents in 36 specialties in 14 institutions, using the validated Mini ReZ survey with three 5 item subscales: 1) supportive workplace, 2) work pace/electronic medical record (EMR) stress, and 3) residency-specific factors (sleep, peer support, recognition by program, interruptions and staff relationships). Multilevel regressions and thematic analysis of 497 comments determined factors related to burnout.ResultsOf 1118 respondents (approximate median response rate 32%), 48% were female, 57% White, 21% Asian, 6% LatinX and 4% Black, with 25% PGY 1 s, 25% PGY 2 s, and 22% PGY 3 s. Programs included internal medicine (15.1%) and family medicine (11.3%) among 36 specialties. Burnout (found in 42%) was higher in females (51% vs 30% in males, p = 0.001) and PGY 2’s (48% vs 35% in PGY-1 s, p = 0.029). Challenges included chaotic environments (41%) and sleep impairment (32%); favorable aspects included teamwork (94%), peer support (93%), staff support (87%) and program recognition (68%). Worklife subscales were consistently lower in females while PGY-2’s reported the least supportive work environments. Worklife challenges relating to burnout included sleep impairment (adjusted Odds Ratio (aOR) 2.82 (95% CIs 1.94, 4.19), absolute risk difference (ARD) in burnout 15.9%), poor work control (aOR 2.25 (1.42, 3.58), ARD 12.2%) and chaos (aOR 1.73 (1.22, 2.47), ARD 7.9%); program recognition was related to lower burnout (aOR 0.520 (0.356, 0.760), ARD 9.3%). These variables explained 55% of burnout variance. Qualitative data confirmed sleep impairment, lack of schedule control, excess EMR and patient volume as stressors.ConclusionsThese data provide a nomenclature and systematic method for addressing well-being during residency. Work conditions for females and PGY 2’s may merit attention first.

Enhancing Resident and Staff Relationships

Enhancing Resident and Staff Relationships

The importance of individualised care, good communication and trust for reducing nasogastric tube feeding under physical restraint: qualitative multi-informant study.

Nasogastric tube (NGT) feeding against a patient's consent is an intervention that clinicians working in specialist mental health in-patient units may need to implement from time to time. Little research has explored clinician, patient and carer perspectives on good practice. To use qualitative data from people with lived experience (PWLE), parents/carers and clinicians, to identify components of best practice when this intervention is required. PWLE and parents/carers were recruited via BEAT UK's eating disorder charity. Clinicians were recruited via a post on The British Eating Disorders Society's research page. Semi-structured interviews were administered, transcribed and thematically analysed. Thirty-six interviews took place and overlapping themes were identified. Participants spoke in relation to three themes: first, the significance of individualised care; second, the importance of communication; third, the impact of staff relationships. Sub-themes were identified and explored. Good care evolved around positive staff relationships and individualised care planning rather than standard processes. The centrality of trust as an important mediator of outcome was identified, and this should be acknowledged in any service that delivers this intervention.

An exploration of organizational climate in community-based opiate prescribing services; a mixed methods study

IntroductionAssessing the internal dynamics of organizations has been shown to provide information that can help planners and policymakers improve service delivery. A good organizational climate, which in this study incorporates mission clarity, team cohesion, staff autonomy, communication, levels of stress, and openness to change has been shown to be of particular importance. Still, there is a dearth of evidence in this area, and while relationships between organizational factors have been identified, little is known about the mechanisms that might underpin these relationships, and there is little understanding of how to address deficits once they are identified. The objective of this study was to identify relationships between program factors that influence organizational climate and to explore which mechanisms might underpin these relationships. MethodsThis paper reports on a cross-sectional, concurrent, mixed-methods study design, across twelve discrete community-based prescribing service providers (organizations) in Ireland. Data was obtained using a staff survey [n = 132] which utilized measurements of organizational readiness to change and one-to-one interviews [n = 12]. Quantitative data was analyzed using multivariate linear regression modeling which assessed relationships between variables, while interviews were analyzed using an abductive approach, both types of data were synthesized at the interpretation stage. ResultsA range of interdependent factors were considered to affect the climate of organizations. Surveys identified that specific types of resources, such as physical infrastructure, training, and staffing resources were important for supporting a good organizational climate, while programs with greater needs had a poorer climate. Opportunities for professional growth, the skill sets of staff, and having access to e-communication were also significant. Interviewees reported that rigid organizational hierarchies and bureaucracy, philosophical views of addiction, stress, and staff turnover were influenced by the provision of fewer resources. Interdependent factors such as leadership, supervision, staff relationships, and collective training, also thought to be influenced by resources, were considered to positively influence programs. Resources were not the only challenge identified, and practices within programs and how existing resources are used were also thought to contribute both positively and negatively to the internal dynamics of services. ConclusionKey findings in this study identified that the organization of effective services is influenced by a range of specific factors, some of which can be addressed without additional resources. Overall, staff views of organizations can provide us with valuable information to support service improvement. Using a mixed methods approach can not only identify where relationships between organizational variables exist but can also help us to understand the mechanisms that underpin these relationships and, importantly, how to address deficits once they are identified. In order to improve how substance misuse services work, the need for a long-term systemic approach to program development, which incorporates some of the findings from this study, is required.

Hospital corridors as lived spaces: The reconfiguration of social boundaries during the early stages of the Covid pandemic.

This article explores the meanings and uses of a hospital corridor through 98 diary entries produced by the staff of an English specialist hospital during the early stages of the COVID-19 pandemic. Drawing on Lefebvre's (1991, The production of space. Blackwell) threefold theorisation of space, corridors are seen as conceived, perceived and lived spaces, produced through and enabling the reconfiguration and reinterpretation of social interactions. The diaries depict two distinct versions of the central hospital corridor: its 'normal' operation prior to the pandemic when it was perceived as a social and symbolic space for collective sensemaking and the 'COVID-19 empty corridor' described as a haunting place that divided hospital staff along ostensibly new social and moral boundaries that impacted negatively on lived work experiences and staff relationships. The mobilisation of the central hospital corridor in the daily social construction of meaning and experience during a period of organisational and societal crisis suggests that corridors should not be only seen as a material backdrop for work relationships but as social entities that come into being and are maintained and reproduced through the (lack of) performance of social relations.

Factors Associated With Service Referrals and Uptake in Early Head Start: The Importance of Care Setting.

Secondary analysis of the Early Head Start Family and Child Experiences Survey 2018 data set (Baby FACES 2018) explored links between family risk events and referral-making and referral uptake among families receiving Early Head Start (EHS) services. Referrals to both behavioral health and entitlement programs were considered. Results showed that referrals to behavioral health programs were much more likely to be given to families receiving care from home-based care than center-based care, and that referrals were slightly more likely to be given to families who did not have any family risk events. Several factors also moderated the relationship between family risk and referrals, including perceived closeness of the parent/caregiver-EHS staff relationship, family conflict, and caregiver depression. There were no observed effects for referrals to entitlement programs. Caregiver depression weakened the link between family risk and service uptake for entitlement programs.