Support Workers Research Articles

Connection, disconnection and reconnection in peer support: a summary of the case of “Christopher”

Purpose The purpose of this service user paper and narrative is to highlight that peer support is not a continuous, easy or uniform process but given to disruption, fragmentation, breakdowns in relationships and hurdles. This is illustrated in a summary of the case of “Christopher”. Design/methodology/approach A reflective journal was kept, and participant observation was conducted for just under a year on the ward where Christopher was under Section. Findings Peer support can be given to fissure, breakages in relationships and discontinuity. This can negatively impact the mental health of peer support workers. With this in mind, it is vitally important to ensure that the people who take up this role are appropriately trained, supported and supervised. There needs to be a focus on “restorative” supervision and supervision by someone with experience of the peer support role as well as buddying between peer workers. Originality/value There is an abundance of literature and research on peer support in the community but little in the inpatient setting, making this paper novel and a contribution to understanding peer support on mental health wards.

Designing the Food and Lifestyle Information Program (FLIP) culinary nutrition intervention for adults with mild-to-moderate intellectual disability.

People with intellectual disability have diverse needs and experience higher rates of diet-related chronic disease such as type 2 diabetes compared to people without disability. However, they are infrequently included in development and implementation of interventions to address diet-related chronic disease. The present study describes the process to plan, develop and refine the Food and Lifestyle Information Program (FLIP) culinary nutrition intervention for adults with mild-to-moderate intellectual disability. The project was initiated by a disability service provider and was guided by the Cook-Ed™ model and inclusive research principles. Initially the disability service provider and academic research team members co-designed pre-program consultation and pilot studies, and draft program resources. Pre-program consultation explored paid disability support worker (n = 10) perceptions of cooking and food skills, nutrition priorities and optimal program format, which guided further program drafting. Program resources and pilot study design were further developed and refined with co-researchers with lived experience of intellectual disability who attended a pre-pilot and then pilot study sessions as remunerated co-facilitators. Key characteristics of the FLIP intervention arising from pre-program consultation included providing cooking task instruction in small steps, enabling participant choice in program activities, promoting an inclusive and social atmosphere, and providing paper-based resources. FLIP intervention co-design was enabled through ongoing input from the disability service provider and people with lived experience of intellectual disability. Evaluation of FLIP feasibility, acceptability and preliminary effectiveness to improve diet-related health is underway.

Experiences of family caregivers taking care getting lost of persons with dementia: a qualitative study

BackgroundGetting lost with family members who have dementia is a significant source of stress for family caregivers. In Taiwan, family caregivers develop strategies to deal with dementia persons who may get lost. This study aimed to explore the experiences of family caregivers caring for persons with dementia who have been lost outside the home.MethodsA descriptive phenomenological method was used. The COREQ checklist was used to ensure the explicit reporting of data. A total of 20 family caregivers caring for persons with dementia who were lost outside their homes were selected from hospital outpatient clinics and a day care center in northern Taiwan using purposive sampling. Data were analyzed using the Giorgi analysis method.ResultsFive main themes emerged: (i) surprised persons with dementia lost outside, (ii) using strategies to prevent persons with dementia from getting lost, (iii) using strategies to find lost persons with dementia, (iv) exhaustion in long-term care persons with dementia, and (v) coping with the care load. It was found that family caregivers were surprised, nervous, and worried about persons with dementia being lost outside. They used the first strategy to supervise persons with dementia to prevent external losses. In addition, long-term supervision of persons with dementia led to mental exhaustion in the family caregivers. Finally, the family caregivers learned about loss prevention strategies and obtained family support and care replacement workers to reduce the care burden.ConclusionsIt is essential to teach family caregivers early to prevent persons with dementia from losing external strategies. Nurses also provide long-term care services to reduce the care burden on family caregivers.

Maternity support workers’ experiences of workplace trauma and post-traumatic stress symptoms

BackgroundMaternity support workers (MSWs) are now a key part of the maternity workforce. They work in environments with potential exposure to traumatic events, but little is known about their rates of exposure or psychological responses. ObjectivesWe aimed to identify the proportion of MSWs reporting exposure to a traumatic work event and consequential rates of post-traumatic stress disorder (PTSD). We also aimed to identify factors associated with PTSD and to describe levels of burnout, empathy, and functional impairment, and to explore their potential associations with PTSD symptoms. MethodsMSWs were recruited via the Royal College of Midwives newsletter, which is sent to all MSW members, and via social media on the College MSW Facebook page. Participants completed an online survey. They provided information on demographic details, job role, and exposure to traumatic events, and completed questionnaires covering PTSD symptoms related to work events, related functional impairment, burnout, and empathy. Data were analysed via correlations and multiple regression. FindingsOf 98 respondents, 88 had been exposed to a traumatic work event; 79 of these through being present and nine through hearing about traumatic events. Of those exposed, 14.8% (n = 13) participants had probable PTSD, while a further 5.7 % (n = 5) met the subclinical threshold. Over a third (35.2 %) of the sample showed high levels of emotional exhaustion, a key feature of burnout, and 27.3 % reported functional work impairment. PTSD symptoms were associated with younger age, higher empathic concern, and direct exposure to traumatic perinatal events. Conclusions and clinical implicationsMSWs are routinely exposed to traumatic events at work and are at risk of work-related PTSD. Younger and more empathic staff appear more at risk, although our methods could not distinguish cause and effect. It must also be noted that the survey took place during the COVID-19 pandemic, and findings could be influenced by this context. MSWs need to be routinely included in programmes to support staff in relation to trauma exposure at work.

Piloting a new cross-sector model of care to support parents with cancer: feasibility and acceptability of the Parent Support Worker role

PurposeA new Parent Support Worker (PSW) service was piloted in three Australian hospitals. This study assesses the feasibility and acceptability (including preliminary effectiveness) of the service in supporting cancer patients with children.MethodsA multi-site, mixed-methods study collected quantitative and qualitative data on the effectiveness of the service (pre post-test, n = 36), qualitative and quantitative data on acceptability of the service (survey, n = 43), and qualitative data on acceptability (semi-structured interviews, n = 13). Feasibility was assessed through rates of service uptake amongst referred parents.ResultsOf 1133 parents referred, 810 (71%) accepted to receive the service, suggesting high interest in PSW support. Interviewees likewise reported that the service was accessible and facilitated further referrals, indicating good feasibility. Surveys completed three months after accessing PSW support showed high acceptability and satisfaction. Additionally, there was preliminary evidence of service impacts: parents’ distress, parenting concerns, parenting efficacy, and stress about situations of concern improved significantly from pre- to post-service (all p < 0.005). Interviewees further described how their emotional coping and confidence to support and communicate with their children had improved through contact with the service.ConclusionThe PSW service, integrated into a novel cross-sector model of care, showed to be feasible and acceptable to parent patients and their partners and improved psychological and parenting outcomes. The study suggests refinements to the service and the need for future larger studies to explore the effectiveness of the service in improving parents’ outcomes. This study complements previous evidence on the implementation of the PSW service in hospitals.

A balancing act: integrating the expertise of youth peer workers in child and adolescent mental health services.

The socio-relational focus of youth peer support workers (YPSWs) poses a challenge when YPSWs are embedded in medical oriented contexts common to child and adolescent mental health services (CAMHS); as it requires YPSWs to find a balance between being a peer on one hand, and adhering to professional boundaries and medical standards set out by CAMHS on the other. To create a suitable position for YPSWs in CAMHS, this study investigated the unique socio-relational contributions YPSWs can make to CAMHS in addition to clinicians, and identified how these contributions can be embedded within CAMHS. This study reports on 37 semi-structured interviews conducted in the Netherlands with youth (n = 10), YPSWs (n = 10), and clinicians (n = 17). Overall, the unique socio-relational contributions YPSWs can make include: their ability to build authentic trusting relationships with youth by providing empowerment, promoting autonomy, valuing stillness in recovery, reducing isolation, recognizing strengths, and navigating life inside and outside of (residential) mental healthcare and beyond classification. Moreover, prerequisites to safeguard the integration of YPSWs and these socio-relational contributions were also identified, including YPSWs achieving stability in recovery, recent lived experiences with mental health challenges, and organizational support in terms of suitable treatment climate, resources to enhance flexibility of YPSWs, and shared goals regarding youth peer support work. Overall, YPSWs view youth holistically and foster a connection with youth based on youthfulness and recent lived experience. Involving YPSWs is an important step forward to drive positive transformation in CAMHS.

Co-design of health educational materials with people experiencing homelessness and support workers: a scoping review.

People experiencing homelessness are often marginalised and encounter structural barriers when seeking healthcare. Community-based oral health interventions highlighted the need of well-trained practitioners for the successful engagement of service users and behaviour change. However, a lack of adequate information and specific training has been previously reported. The adoption of inclusive approaches, such as co-design, to develop tailored and meaningful health promotion training and educational materials capable of addressing the specific needs of this group is required. Co-design entails active involvement of different groups in research processes that acknowledge participants' needs and expectations. This scoping review aims to identify the available literature on the participation of people experiencing homelessness and/or their support workers in co-designing health and oral health promotion training/educational materials, approaches adopted, and barriers and enablers to develop these materials. The Joanna Briggs Institute (JBI) Scoping Review Methodology informed the development of the scoping review. The protocol was registered on the Open Science Framework. Six electronic databases (Medline (OVID), PsychInfo (OVID), Scopus, Web of Science, Applied Social Sciences Index and Abstracts (ASSIA) (ProQuest) and CINHAL) were systematically searched using MeSH terms. An extensive grey literature search, consultation with experts and hand searching of reference lists took place. Records were screened independently and in duplicate using the Rayyan Qatar Computing Research Institute (QCRI) online tool, followed by qualitative content analysis involving descriptive data coding. Eight studies/materials were included. Key approaches adopted to co-design, enablers and barriers were captured. The enablers were inclusivity, a safe environment for positive participation, empowerment and flexibility, the barriers were difficulty in recruiting and sustaining participation, power differentials, and limited resources. The evidence in this area is limited. This scoping review provided foundations for further research to examine the impact of different components of the co-design process including the environment in which the co-design process is conducted. Further studies with experimental design and reported using appropriate study design frameworks detailing active components of the co-design process would strengthen the evidence base in this area.

Reflections from a Seminar Series Supporting Ukrainian Social Workers in Time of War: Professional Solidarity and Human Rights

Reflections from a Seminar Series Supporting Ukrainian Social Workers in Time of War: Professional Solidarity and Human Rights

Implementing a Hospital Call Center Service for Mental Health in Uganda: User-Centered Design Approach.

Mental health conditions are a significant public health problem globally, responsible for >8 million deaths per year. In addition, they lead to lost productivity, exacerbate physical illness, and are associated with stigma and human rights violations. Uganda, like many low- and middle-income countries, faces a massive treatment gap for mental health conditions, and numerous sociocultural challenges exacerbate the burden of mental health conditions. This study aims to describe the development and formative evaluation of a digital health intervention for improving access to mental health care in Uganda. This qualitative study used user-centered design and design science research principles. Stakeholders, including patients, caregivers, mental health care providers, and implementation experts (N=65), participated in focus group discussions in which we explored participants' experience of mental illness and mental health care, experience with digital interventions, and opinions about a proposed digital mental health service. Data were analyzed using the Consolidated Framework for Implementation Research to derive requirements for the digital solution, which was iteratively cocreated with users and piloted. Several challenges were identified, including a severe shortage of mental health facilities, unmet mental health information needs, heavy burden of caregiving, financial challenges, stigma, and negative beliefs related to mental health. Participants' enthusiasm about digital solutions as a feasible, acceptable, and convenient method for accessing mental health services was also revealed, along with recommendations to make the service user-friendly, affordable, and available 24×7 and to ensure anonymity. A hospital call center service was developed to provide mental health information and advice in 2 languages through interactive voice response and live calls with health care professionals and peer support workers (recovering patients). In the 4 months after launch, 456 calls, from 236 unique numbers, were made to the system, of which 99 (21.7%) calls went to voicemails (out-of-office hours). Of the remaining 357 calls, 80 (22.4%) calls stopped at the interactive voice response, 231 (64.7%) calls were answered by call agents, and 22 (6.2%) calls were not answered. User feedback was positive, with callers appreciating the inclusion of peer support workers who share their recovery journeys. However, some participant recommendations (eg, adding video call options) or individualized needs (eg, prescriptions) could not be accommodated due to resource limitations or technical feasibility. This study demonstrates a systematic and theory-driven approach to developing contextually appropriate digital solutions for improving mental health care in Uganda and similar contexts. The positive reception of the implemented service underscores its potential impact. Future research should address the identified limitations and evaluate clinical outcomes of long-term adoption.

'If I Don't Have My Support Worker in the Room…': A Multi-perspective Mixed Methods Study of Remote Daily Living Support for Neurodivergent Young Adults.

Information technology is increasingly being employed for providing support and interventions in disability and health service contexts. This study aimed to investigate service users' and support workers' perspectives on remote support in daily living for young adults with neurodevelopmental conditions. Using a convergent mixed methods approach, we integrated qualitative and quantitative findings from survey responses and focus groups. Young service users (aged 18 to 29) diagnosed with ADHD and/or autism (n = 35) and support workers (n = 64) from four municipalities in Sweden responded to a survey designed to tap into their lived experiences and views. The topic was explored further in focus groups with young service users (n = 7) and support workers (n = 3). Open-ended survey questions were analyzed using qualitative content analyses and complemented with information from the focus groups, while closed survey questions were summarized descriptively. Inferences were merged in a joint display. While participants reported having access to digital devices, service routines for remote contact were not in place. Service users were more hesitant than support workers in endorsing remote support, expressing concerns that this approach would be inferior to in-person support (e.g., owing to miscommunications and insufficient social and emotional contact). Still, both groups expressed that remote contact may at times be a beneficial complement to in-person meetings, increasing accessibility and user choice. Service providers planning to implement remote support elements should explore the demand, acceptability, and organizational readiness for this approach. Moving forward, user engagement will be crucial to meet individual preferences, values, and needs.

A Comparative Study of Organizational Grief Support and Burnout Among Nursing Home Staff.

The purpose of this study was to examine the relationship between dimensions of grief support (recognition of the relationship, acknowledgement of the loss, and inclusion of the griever) and aspects of burnout (emotional exhaustion, depersonalization, and personal accomplishment) among nursing home staff. Data were collected from 553 nursing home workers from 37 nursing home facilities in 5 states during fall of 2022. Responses to the Maslach Burnout Inventory and Grief Support Health Care Scale were analyzed for this study. The study found that recognizing the relationship with deceased patients led to a decrease in exhaustion and depersonalization among workers while simultaneously enhancing their sense of personal accomplishment. Including the griever in the support process lowered all burnout subscales for nursing home staff. Acknowledging the loss was associated with higher levels of personal accomplishment. Registered nurses, nurse practitioners, and physicians experienced higher levels of exhaustion and depersonalization compared to other nursing home staff. Behavioral health workers had the highest personal accomplishment, whereas direct support workers reported the lowest. These findings have important implications for improving the well-being of nursing home staff, emphasizing the importance of organizational grief support, and tailored interventions to address burnout among different healthcare provider roles in nursing homes.

Early experiences of peer support workers starting employment in a mental health charity: a case study

In recent years a plethora of job roles has emerged across the voluntary and community sector (VCS) and public sector that explicitly request lived experience (LE) of mental health challenges. These roles are often situated in the ‘frontline’ workforce providing direct support to people accessing services. This article shares early learning about the experiences of people who have lived experience of mental health challenges employed as paid peer support workers (PSWs) within a mental health charity. The findings are drawn from fieldwork conducted over a three-month period with five recently employed PSWs, conducted as a component of the author’s doctoral study. The data corpus included interviews, fieldwork observation notes from ‘walk the frontline’ (WTF) activities, and the collation of WhatsApp voice notes sent by the PSWs to the researcher. The article presents nine key themes that emerged from the data and categorises these into three areas: Firm up – those that were broadly positive denoting good practice; Fine tune – those that require further refinement; and Focus – those which signal a need for concentrated attention and further exploration. Taking these findings into account, a tentative schematic model is offered which suggests sequential ‘conditions’ to be considered when developing PSW programmes. This has relevance to voluntary sector organisations (VSOs) who are considering recruiting and deploying PSWs to support frontline service delivery.

The importance of sleep for support workers

The importance of sleep for support workers

Feasibility and impact of a physical activity and lifestyle program for Aboriginal families with Machado-Joseph disease in the Top End of Australia.

Physical activity and lifestyle programs are scarce for people with hereditary ataxias and neurodegenerative diseases. Aboriginal families in the Top End of Australia who have lived with Machado-Joseph disease (MJD) for generations co-designed a physical activity and lifestyle program called the Staying Strong Toolbox. The aim of the present study was to explore feasibility and impact of the program on walking and moving around. A mixed-methods, multiple case study design was used to pilot the Staying Strong Toolbox. Eight individuals with MJD participated in the program for 4 weeks. Participants tailored their own program using the Toolbox workbook. Families, support workers and researchers facilitated each individual's program. Feasibility was determined through program participation, adherence, coinciding or serious adverse events, participant acceptability and cost. Impact was determined through measures of mobility, ataxia, steps, quality of life, wellbeing and goal attainment, assessed before and after the program. All participants completed the program, averaging five activity sessions per week, 66 minutes per session, of walking (63.5%), strengthening/balance-based activities (16%), cycling (11.4%) and activities of daily living, cultural and lifestyle activities (10.5%). Seven participants were assessed on all measures on three occasions (baseline, pre-program and post-program), while one participant could not complete post-program measures due to ceremonial responsibilities. All had significant improvements in mobility, steps taken and ataxia severity (p<0.05) after the program. Quality of life and wellbeing were maintained. The program helped participants remain 'strong on the inside and outside'. Participants recommended implementation in 4-week blocks and for the program to be shared internationally. The Staying Strong Toolbox program was feasible for families with MJD. The program had a positive impact on walking and moving around, with participants feeling stronger on the outside (physically) and inside (emotionally, spiritually, psychosocially). The program could be adapted for use by other families with MJD.

A Good Investment: Expanding Capacity to Care for Older Adults in the Home and Community Care Sector Through Increased Personal Support Worker Wages.

Most older adults prefer to age in place, which for many will require home and community care (HCC) support. Unfortunately, HCC capacity is insufficient to meet demand due in part to low wages, particularly for personal support workers (PSWs) who provide the majority of paid care. Using Ontario as a case study, this paper estimates the cost and capacity impacts of implementing wage parity between PSWs employed in HCC and institutional long-term care (ILTC). Specifically, we consider the cost of increased HCC PSW wages versus expected savings from avoiding unnecessary ILTC placement for those accommodated by HCC capacity growth. The expected increase in HCC PSW retention would create HCC capacity for approximately 160,000 people, reduce annual health system costs by approximately $7 billion, and provide an 88 per cent return on investment. Updating wage structures to reduce turnover and enable HCC capacity growth is a cost-efficient option for expanding health system capacity.

Factors influencing self-reported facial-protective equipment adherence among home care nurses and personal support workers: A multisite cross-sectional study

Facial-protective equipment (FPE) use increased during the SARS-CoV-2 pandemic. This study explored factors influencing home care personal support workers' (PSWs) and nurses' self-reported adherence to FPE. A cross-sectional, electronic, survey was distributed to PSWs and nurses (1,108 complete responses) at 3 home care agencies in Ontario, Canada, in May to June 2022. Descriptive, bivariate, and multivariable analysis were used to assess individual, environmental, and organizational factors influencing adherence. Among participants (786 PSWs, 322 nurses), 64% reported being adherent to both respiratory and eye FPE (Respiratory: 96%, Eye: 64%). Higher adherence was associated with facility-based work; better knowledge of FPE; prepandemic FPE use; good availability and convenient access; strong organizational support for health and safety; and Caribbean identity. Lower adherence was found for men; nurses with 2-year diplomas; shorter length of employment; communal transportation; and experiencing negative mental health effects from workplace infectious disease exposure. Agencies should prioritize increasing providers' knowledge of FPE, supporting mental well-being, fostering a supportive culture, and ensuring availability of FPE. The influences of gender, ethnicity, and role require further exploration. FPE adherence may be improved by addressing modifiable factors and developing population-specific strategies.

Are Mental Health "Peer Support Workers" Experts by Experience?

Are Mental Health "Peer Support Workers" Experts by Experience?

The Associated Factors with Breastfeeding Self-Efficacy Among Breastfeeding Women in Kalimantan Utara

Exclusive breastfeeding is important for the quality of children's health. Nevertheless, the proportion of exclusive breastfeeding at the Malinau City Health Center stands at a mere 45.6 percent, falling short of the 50 percent benchmark set by the World Health Organization (WHO). nursing self-efficacy is a significant element that affects nursing behavior. This study aims to determine the factors related to breastfeeding self-efficacy. This study was cross-sectional, with a sample of 147 mothers obtained by purposive sampling. Breastfeeding Self Efficacy (BSE) is measured using the Breastfeeding Self Efficacy Short-Form. Data was analyzed using the Chi-Square test. The results showed that there was a significant relationship between breastfeeding problems (p-value equals 0.001), family support (p-value equals 0.001), and health worker support (p-value equals 0.001) with breastfeeding self-efficacy. It is concluded that breastfeeding problems, family support, and health worker support were factors related to breastfeeding self-efficacy in breastfeeding mothers. Therefore, health workers and families are expected to support mothers when they have breastfeeding problems

Instructional Styles and Differentiated Instruction Practices of Teachers in Cluster Xiii, Davao City

This study aimed to determine the instructional styles and differentiated instruction practices of public elementary school teachers in Cluster XIII, Davao City. This study utilized the descriptive-correlational design with one hundred fifty elementary school teachers, selected using stratified random sampling technique. In gathering data, the researcher adapted a survey questionnaire both for the instructional styles and school differentiated instruction practices. Ethical considerations were observed in data collection. The collated data were subjected to statistical tests such as mean, Pearson’s r and multiple linear regression. Findings showed that the extent of instructional styles of elementary teachers is very extensive, which means that their instructional styles is always observed. The extent of differentiated instruction practices of elementary school teachers is very extensive, which means that their differentiated instruction practices is always observed. There was a moderate significant relationship between instructional styles and differentiated instruction practices. The domains of instructional styles that significantly influenced the differentiated instruction practices were modeling and delegating. With this, the Department of Education may allocate sufficient budget to ensure that schools have the resources they need to successfully implement differentiated education. This can provide access to a wide range of instructional materials, technology, and support workers to help fulfill varied learning needs.

Effectiveness of a peer-supported crisis intervention to reduce the proportion of compulsory admissions in acute psychiatric crisis interventions in an outreach and outpatient setting: study protocol for an exploratory cluster randomised trial combined with qualitative methods

IntroductionCompulsory admissions are associated with feelings of fear, humiliation and powerlessness. The number of compulsory admissions in Germany and other high-income countries has increased in recent years. Peer support has...