Staff Working Research Articles

Exploring the unconventional: health professionals’ experiences into medication-free treatment for patients with severe mental illness

Abstract Background In January 2017, the Norwegian government mandated the establishment of an inpatient unit for “medication-free treatment” for patients with severe mental illness at the University Hospital of North Norway in Tromsø. This study aims to explore the employees’ experiences with this unit. Method Focus group interviews were conducted October 2021 – February 2022. For analysis, the participants were divided into three groups; S (staff working at the medication-free unit), M (people involved in management at the unit) and T (therapists working elsewhere in the hospital). The analysis followed the Systematic Text Condensation and interviews were recorded, transcribed and analysed using NVivo software. Results Health professionals described their experiences with medication-free treatment through five main concepts: 1) Employees’ motivation; 2) Frames; 3) Network; 4) Relations; and 5) Patients’ motivation. Staff and management expressed strong motivation for an alternative to “treatment as usual,” focusing more on recovery and relationships than on the absence of medication. Therapists from other hospital areas highlighted resource allocation concerns and expressed a desire to learn from the unit. Challenges were acknowledged by all groups. Conclusion The term “medication-free treatment’’ might be misleadning. While patiens at the unit can use medications, there is a strong emphasis on patient autonomy and the option to taper off medication and live a life without them. The study adds valuable knowledge about the the experiences of employees working at a medication-free unit, and provides insights into the complexity of treating severe mental illness, both with and without medication. It highlights the importance of sufficient time, stability and resources to focus on each patient’s strengths and challenges. All employees agree that tailored measures in long-term treatment and a clear focus on recovery should be integral, even without an emphasis on “medication-free treatment”.

The Correlation Between Effort–Reward Imbalance at Work and the Risk of Burnout Among Nursing Staff Working in an Emergency Department—A Pilot Study

Background: Nurses in emergency rooms face high levels of psychological stress during their work, which is why they have an increased risk of burnout. The aim of this pilot study was to determine the extent to which effort–reward imbalance (ERI) at work is connected to the risk of burnout among emergency nurses. Methodology: Thirty-five nurses from the central emergency department of a maximum care provider, aged 35.1 ± 0.6 years, voluntarily participated in this pilot study. ERI was recorded using the Effort–Reward Imbalance questionnaire. The nurses were then divided into two groups: the nonrisk group (ERI ratio < 1, n = 19) and the risk group (ERI ratio ≥ 1, n = 16). The burnout dimensions were determined via the Maslach Burnout Inventory (MBI) and the burnout risk was then determined. Results: Nurses in the nonrisk group were significantly less emotionally exhausted (1.6 ± 1.1 points) and had a lower overall risk of burnout (MBI total score 1.2 ± 0.67 points) than the nurses of the risk group. (3.3 ± 1.5 and 2.2 ± 1.2 points, respectively). Eighteen nurses from the total sample had a medium or high risk of burnout. There is a correlation between the risk of burnout and the ERI ratio (r = 0.392, p < 0.05) and the ERI scale “job promotion” (r = −0.462, p < 0.05). Conclusions: The pilot study provides indications of a relationship between effort–reward imbalance at work and burnout risk in emergency nurses. These findings may improve rewards for nurses in the form of increased salary and/or recognition to reduce the risk of burnout among employees and avoid turnover. Further research is needed to investigate the influence of preventive measures on the risk of burnout and gratification crises, particularly with regard to the influence of status and recognition on the risk of burnout.

A study of police personnel wellbeing in England and Wales whilst working during the Covid-19 pandemic

ABSTRACT This paper presents the findings of a mixed-method study exploring the self-reported negative impact on wellbeing of working in policing in England and Wales during the Covid-19 pandemic. For the first time, findings relating to the wellbeing of UK police and police staff are presented from two different points in time during the pandemic period – the initial ‘lockdown phase’ (March 2020) and Autumn 2021 as the UK began to return to pre-pandemic social behaviours. A first study presents data collected via electronic survey, completed in June 2021 by more than 500 UK police officers and staff, exploring how they felt initially about the Covid-19 pandemic and how they felt later in 2021. For example, how it affected their work and how they dealt with the changes in working practices. A second study presents an Interpretive Phenomenological Analysis of 18 interviews capturing the individual ‘life experiences’ of UK police officers and staff working in variety of policing roles during the pandemic. Key themes identified include the negative effects of working at home and the worry of spreading the disease to loved ones. Recommendations are made for how police forces can better support the wellbeing of officers and staff during pandemic scenarios and increase resilience. For example, by quickly identifying those officers and staff most vulnerable to the disease and/or most anxious generally at the start of a pandemic, to plan for how appropriate support can be provided, and acknowledge that police staff feel most isolated when working from home.

Project Team Rewards and Performance of Information Technology-Based Projects in Commercial Banks in Kenya

Purpose: The expected outcome of projects is to achieve a positive performance consistently. Yet, there is no agreed definition of project performance, which complicates the achievement of the purpose. Projects in Kenya are mostly complex and difficult to manage and project team management practices are mostly used in projects for effective functioning. However, project managers in Kenya have been focusing on technical constraints of projects and neglecting project teams’ related constraints. The objective of the study was to investigate the influence of project team rewards on project performance in commercial banks in Kenya. Methods: The study adopted a pragmatic research approach. A cross-sectional study design and explanatory research design were adopted in the study. The unit of analysis was 429 projects in the 39 commercial banks operating in Kenya as of close of business on 31st December 2020 categorized into 20 types of Information technology projects. The target population was 195 Information Technology project managers as well as 78 staff working in human resource department, 78 staff working in finance department, and 78 staff working in operations departments in the 39 commercial banks operating in Kenya. The study used stratified random sampling to choose 206 respondents from the study population. Secondary and primary data was employed in this study. Annual reports of commercial banks provided secondary data. In addition, a semi-structured questionnaire was adopted to obtain data. Qualitative data, which was obtained from open-ended questions, was analyzed by use of thematic analysis, and the results were presented in a descriptive form. Inferential and descriptive statistics will be used to analyze quantitative data with the help of Statistical Package for Social Sciences (SPSS version 26). Descriptive statistics included frequency distribution, mean, standard deviation, and percentages. Inferential statistics included univariate regression analysis and Pearson correlation. Results: The study found that project team rewards had a significant effect on performance of information technology-based projects in commercial banks in Kenya. Conclusion: The study recommends that commercial banks should also diversify and strengthen their reward structures to better align with team members’ contributions and achievements. They should further strengthen their recognition and promotion programs to ensure that these elements are consistently applied and effectively contribute to team performance.

Towards a New Era of Flexibility: Student and Staff Reflections on Online Learning

Higher Education is in the midst of a digital revolution, with institutions bidding to harness the potential of technology. Periods of online learning experienced during recent times have accelerated the move towards widespread adoption, affording institutions the opportunity to evaluate and reflect on digitally mediated approaches. This report focuses on student (n = 584) and staff (n = 54) experiences of online teaching and learning in a large UKHEI Psychology department. Findings from mixed methods surveys suggest that while staff and students were largely satisfied with the online teaching and learning experience, differences were evident in undergraduate and postgraduate perceptions. Further, a thematic analysis identified emergent themes from staff (teaching and working online, student engagement with online learning and looking to the future) and student (experiences of emergency provision, accessing support, and teaching methods) qualitative responses. This paper reflects on how the perceptions and experience of online learning will influence the future success of flexible online learning in a post-pandemic era of Higher Education.

“Every Day I was Crying about Something”: Lingering Effects of the COVID-19 Pandemic on People Working in Juvenile Prisons

Staff working in prison settings experience high rates of job-related stress which was amplified during the COVID-19 pandemic. Twenty staff members from a juvenile prison were interviewed to determine the unique mental health symptoms and stressors several years after initial shutdown procedures. Anxiety, PTSD symptoms, and sleep disturbances were reported; sometimes resulting in staff avoiding interactions with youth. Some positive aspects were noted, but overall, results indicated a continued need for mental health support and policy changes for staff. As noted by one participant, “If you don’t have the direct care staff, you don’t have a facility.”

E-SOURCING STRATEGIES ON EFFICIENCY OF PROCUREMENT PROCESSES OF SUGAR FACTORIES IN KENYA

Sugar factories are increasingly confronted with greater global competition and changing markets environment despite their effort to use e-sourcing strategies as a key pillar to improve procurement performance. This has resulted in unnecessarily high operation costs, poor inventory control, unacceptable supplier appraisal standards and uncoordinated business activities in the procurement positions, thus affecting general performance. E-sourcing has become a powerful tool which facilitates accountability and audit-ability. This study sought to determine the effect of e- sourcing strategies on efficiency of procurement process of Sugar factories in Kenya. The study adopted a correlational research design where the target population was 165 who were the Head of Agriculture, Head of Finance, Head of Manufacturing, Head of ICT, Head of Marketing, Head of Purchasing and Procurement staff working in sugar factories in Kenya. The study findings are presented in form of tables, figures and graphs. The e-sourcing strategies; e-tendering strategy, e-prequalification strategy and e-evaluation strategy could only explain 59.8% of efficient procurement performance as shown by R2 of 0.598. The study recommends that sugar factories suppliers should procure document management software which will enables them to register their suppliers online and submitted their mandatory requirements online. The results of this research may guide in policy formulation for the sugar sub sector. KEY WORDS: E-Evaluation, E-Prequalification, E- Sourcing, E-Tendering, Efficiency of procurement process

The Discretionary Power of Street‐Level Bureaucrats From the Perspective of Illusio

ABSTRACTInterrogating the tension between care and control in the work of social services staff in Belgian immigration detention centres, this article sheds light on the uses of discretion from the perspective of Bourdieu's concept of illusio. I argue that social services staff's use of discretionary power must be understood at the crossroads of their belief in their professional ethos and the power relations within these centres, which enabled them to frame the element of control as something they had to deal with professionally, rather than something to which they contributed. This sheds light on both the uses of discretion as well as on the articulation of care and control in border humanitarianism.

An exploration into the prevalence and experience of neurodiversity among staff at a UK high-secure psychiatric hospital.

Whilst there is increasing recognition and interest in how staff who have neurodivergence are represented and contribute to industry, to date, there has been very little exploration of neurodivergence among healthcare staff and none with those working in forensic psychiatric services. To estimate the prevalence of neurodivergence among staff working in a UK high-secure psychiatric hospital and explore their experiences. All staff were invited to complete a confidential online self-report questionnaire consisting of both closed and open questions. A fifth of the staff responded (n=124), but two did not report their neurodivergent status, so were excluded. Nearly 40% of responders reported having some form of neurodivergence, with Attention Deficit Hyperactivity Disorder (ADHD) being the most common, followed by dyslexia, autism and dyspraxia. Over a third (36%) of those reporting neurodivergence said that they had chosen not to disclose this to the organisation and around a quarter (23%) reported not feeling valued or supported by the organisation. Of the staff cohort who responded, most expressed the view that neurodiversity in the workforce is beneficial to patient care, despite the majority being unsure whether neurodivergence is an advantage or a barrier for the individual themselves. Over half of staff completing the survey felt there was not enough awareness of neurodiversity among staff and that more training on the subject would be beneficial. This survey suggests gaps in our recognition and understanding of neurodivergence among hospital staff. Although the prevalence figure should be treated with caution, given the low response rate, in this first survey of neurodivergence among staff in a secure hospital, our findings suggest substantial numbers of staff with neurodivergence and the likelihood that neither they nor the organisation are optimising this situation. The further steps should include the development and evaluation of strategies exploring ways of improving recognition and relevant support for staff, as well as discovering ways in which neurodivergence in staff might inform and optimise care and treatment for patients.

'A potentially ticking time bomb' - barriers for prevention, diagnosis, and treatment of cardiovascular disease in people with intellectual disabilities.

Research suggests that people with intellectual disabilities have a higher risk for cardiovascular disease than the general population. The aim of this study was to identify barriers for the prevention, diagnosis, and treatment of cardiovascular disease for people with intellectual disabilities. We conducted individual interviews with relatives and general practitioners and focus group interviews with staff working at an assisted home facility, a cardiac ward, an obesity clinic and two rehabilitation centres (n = 33) in Norway. Inductive approach and thematic analysis were used to analyse the data. We identified barriers on an individual and a structural level. The underlying reason for these barriers is that health problems, such as cardiovascular disease, are regularly overlooked as the condition of intellectual disability overshadows other possible diagnoses. This focus on intellectual disability rather than other explanations leads to shortcomings in the prevention, diagnoses, and treatment of cardiovascular disease in this group.

Working at home: Individual level drivers of MEPs’ focus on constituency work

Abstract This article investigates how Members of the European Parliament (MEPs) allocate resources between their parliamentary and constituency work, focusing on their staffing decisions. Specifically, it examines the distribution of MEPs’ staff between accredited assistants, based in the European Parliament (EP), and local staff working in their constituency. The study seeks to explain why some MEPs allocate a larger share of their staff to constituency work compared to others by testing several hypotheses related to the individual characteristics of MEPs while controlling for variations across Member States. Using a newly developed database with data on MEP assistants at three points during the 9th EP, the analysis reveals that Member State differences do not solely explain the variation in staff distribution. While there is no evidence that staff allocation is driven by strategic considerations to secure re-election, it depends significantly on their ideology and past political experience.

How, Why and When: Nursing Staff's Experiences of Working With Suicide Risk Assessment Instruments.

To describe psychiatric nursing staff´s experiences of working with suicide risk assessment instruments. Around the world, approximately 720,000 people die by suicide each year, of which almost 20% have an ongoing contact with specialist psychiatry during their last month alive. To identify which patients have an increased risk of suicide is a highly important task for nursing staff. Suicidal behaviour is complex and unpredictable. Nursing staff work closely with patients in everyday psychiatric care and often possess unique patient knowledge. These professionals must therefore be able to know when a patient's eventual suicidality requires further attention and efforts. A descriptive qualitative study. Convenience sampling including nursing staff with more than 2 years of experience in specialist psychiatry. The data collection took place through semi-structured interviews and was then analysed according to conventional content analysis. The nursing staff felt that a natural conversation is superior suicide risk assessment instruments and that experience and patient knowledge are the primary factors for facilitating a suicide risk assessment. This meant that some nursing staff rarely used suicide risk assessment instruments, although they sometimes could be a useful support in the conversation and provided a sense of personal security when documenting results. Suicide risk assessment instrument can be significant and helpful in certain cases, but the essential components of a suicide risk assessment consist of a conversation to understand the meaning of suicide from the patient's perspective. Psychiatric nursing staff contributed to this study by sharing their experiences through interviews.

Enfant présentant une allergie alimentaire en crèche : quelle est la place du Projet d’Accueil Individualisé ? Quels ressentis pour le personnel ?

ContextThe nursery welcomes children from a few months to the age of 3 years, age range where there is an increase in cases of anaphylaxis related to food allergies (FA). ObjectivesTo draw up an inventory of the training and knowledge of staff with regard to FA. Observe the organization of the Individualized Reception Project (IRP) in the nursery. Take stock of the feelings and possible apprehensions of professionals to work on a daily basis with a child with FA. MethodsSurvey conducted in 2023 with 50 staff working in different childcare facilities. ResultsSeventy-four per cent had initial training on FA, 64% had no training on FA since taking a position in nursery and 66% never handled an adrenaline auto-injector (AAI). Twenty-one per cent of the structures have an internal medicine cabinet to support an inaugural reaction of FA and 14% are equipped with AAI (internal stock not taking into account the AAI of possible IRP). Sixty-eight per cent know that they are allowed to apply the IRP themselves in emergency situations in the nursery, in connection with the ministerial circular of 2021. Sixty-six per cent are comfortable in the daily reception of the child with FA, 38% are comfortable with the handling of the AAI. ConclusionGiven the increasing frequency of FA in small children, it is necessary for early childhood professionals to be better trained and informed during their studies and in the nursery, especially on the administration of AAI. It is desirable that an in-house pharmacy be equipped with AAI for the management of inaugural FA.

Effect of Organizational Cynicism Behaviors on Nursing Staff Work Embeddedness

Effect of Organizational Cynicism Behaviors on Nursing Staff Work Embeddedness

Evaluation of a public health workplace staff psychosocial risk assessment and wellbeing initiative

Abstract Adverse psychosocial work environments can have a detrimental effect on staff wellbeing causing chronic stress leading to burnout. Despite legislation mandating regular risk assessments, only one third of workplaces assess psychosocial risks. A 2020 European report identified one of the main barriers being a reluctance to talk openly about psychosocial issues. This paper describes an evaluation of a staff psychosocial risk assessment and wellbeing initiative in a Public Health Department in Ireland. The initiative commenced in October 2022 during a period of major health service organisational change. Informed by positive organisational psychology conceptual frameworks, guided by the European Psychosocial risk assessment framework (PRIMA-EF) and utilising the HSE Work Positive (CI) survey tool it was possible to constructively identify and categorise psychosocial risks across the Public Health team. In the evaluation, a mixed methods approach was used based on Donabedian’s structures, processes and outcomes overarching framework and Nielsen’s Model of Process Evaluation Framework. The first three iterative quality improvement cycles of the intervention were reviewed. The evaluation demonstrated that all of Nielson’s three indicators for a successful organisational level staff wellbeing intervention had been met: there was evidence of improvement in both working conditions and staff wellbeing; iterative quality improvement cycles including appreciative inquiry staff collaborative engagement ensured staff views and key learning was captured; new organisational structures within the Department enabled the sustainability of this process. The evaluation indicates that the staff psychosocial risk assessment process is beneficial for staff wellbeing and that the methods used are appropriate. The resources used in this process continue to be readily available within the health service organisation. The evaluation supports continuation of this process in its present form. Key messages • This evaluation supports staff psychosocial risk assessment and mitigation processes and provides a framework for healthcare managers to implement such processes and comply with legislation. • This evaluation indicates that effective and sustainable collaborative staff engagement can be achieved using a positive focus which builds on team strengths and harnesses collective wisdom.

Physical activity promotion in Aged care: a participatory approach

Abstract Introduction Aged care facilities (ACF) constitute an increasingly important, yet challenging setting for health promotion - given it is a highly sedentary pseudo-total institution characterized by structured daily routines within a paradigm of care for residents perceived as fragile and vulnerable. A participatory approach with residents, significant others, staff, and management might be a promising pathway to address intrapersonal, sociocultural, organizational, environmental, and political determinants of physical activity in this specific context. We will present processes and results from a research project, funded by the German Ministry of Health (2019-2023), on physical activity promotion in ACFs. Methods Our co-creation approach involved residents, significant others, staff, and management from seven nursing homes in Southern Germany. Methods included 800hrs on-site observations, semi-structured interviews (n = 31), Photovoice (n = 27 participants, n = 169 photos), as well as future workshops (n = 14) for intervention co-development (n = 14) and co-evaluation workshops (n = 7). Data analysis used reflexive thematic analysis with MaxQDA20. Results Implemented interventions (n = 57) addressed individual, social, environmental, and organizational factors. Activity promotion was integrated into care concepts and mission statements, staff work descriptions, as well as informal internal routines. Of the interventions implemented, 33% were rated as more successful, 43% as successful, and 19% as less successful than anticipated. Conclusions Participation can initiate structural and cultural change towards physical activity. However, the analyses also emphasized the critical role of staff training, along with the involvement of significant others and external service providers, as essential components for achieving sustainable change. Key messages • Participatory approaches integrate physical activity into aged care, fostering cultural shifts for resident well-being. • Success requires staff training, engaging residents’ support networks, balancing empowerment with protection.

The effect of service robot use on tourism staff career identity: an experimental study

ABSTRACT Based on cognitive-affective system theory and using tour guides, hotel and attraction staff as subjects, three experimental studies investigated the effect of using service robots on career identity. The results were that: (1) the use of service robots significantly affected career identity; (2) emotional exhaustion mediated the relationship between service robot use and career identity; and (3) years of work experience and staff age positively moderated the main effect. The findings provide meaningful implications for managers to more effectively deploy service robots and enhance staff career identity.

Positive behaviour support in Irish residential services: Perspectives of frontline staff, management and clinicians on implementation challenges

ABSTRACT Background The current study explored the perspectives of staff working with adults with intellectual disabilities and behaviours that challenge. We sought insight into their understanding of procedural fidelity and challenges faced when implementing behaviour support. Method We interviewed 15 staff members supporting adults with intellectual disabilities in residential settings. Participants included five front-line staff, five residential managers, and five clinicians. Interviews were transcribed and thematic analysis conducted. Results Issues identified by the participants related to four main themes: (1) Organisational and environmental constraints; (2) Understanding and monitoring of procedural fidelity; (3) Theory versus practice; (4) There's nothing positive about behaviour support. Conclusion Across staff groups, lack of understanding of fidelity emerged, as well as minimal accountability regarding behaviour support. Front-line staff felt isolated and under pressure. Greater emphasis on partnership, practice leadership, and positive feedback may give front-line staff the support needed to use behavioural interventions with high fidelity.

Factors influencing physical activity and sedentary behaviour in contact centres during the COVID-19 pandemic and their relevance for the future of hybrid working.

The COVID-19 pandemic changed the way many industries work, including contact centres, with some employees working from home and new on-site restrictions/measures in place representing even greater challenges for employers around staff engagement and wellbeing. This study aimed to understand the interplay of individual, social, environmental and organisational factors influencing physical activity and sedentary behaviour in UK contact centre employees, how the pandemic impacted these factors, and their relevance for the future of hybrid working. Individual interviews (n = 33) were conducted with participants (staff working full and part time, on site and from home) from four UK contact centres. A topic guide based on the ecological model was developed to understand current barriers and facilitators to physical activity and (reducing) sedentary behaviour during and outside of working hours. Thematic analysis was carried out using a codebook and a deductive coding approach to identify themes. Three key insights are provided. First, participants felt they were generally sitting more and moving less since the first UK-wide lockdown. Second, factors which negatively impacted on these behaviours were evident across all levels of the ecological model. These included individual and social barriers (e.g., lack of motivation and preferable physical activity options) as well as environmental and organisational barriers (e.g., poor home office setup, back-to-back virtual meetings). There were a mix of new and existing barriers (exacerbated by the pandemic) and several of these were linked to homeworking. Third, organisational support requirements (e.g., homeworking ergonomic support) and existing facilitators (such as the provision of informational support and flexible working arrangements) were identified. Solutions to reduce sedentary behaviours and increase physical activity in contact centres need to address barriers from the individual to the organisational level. Whilst the study was undertaken in the UK, the results are like to be applicable globally. Clinical trial registration: The trial for the wider project has been registered on the ISRCTN database: http://www.isrctn.com/ISRCTN11580369.

Personnel reserve: training of medical personnel

In the article we consider the existing approaches to the training of nursing staff. The study is based on the analysis of scientific literature, regulatory legal acts regulating the activities of nursing staff and their own supervision of the work of an educational institution and the work of young staff.