Support Team Research Articles

Dementia patients in palliative care according to data from the German National Hospice and Palliative Care Register (2009–2021)

BackgroundPeople with dementia are less in focus of palliative care research than other patient groups even though the awareness of their palliative and end-of-life care needs is rising. Empirical data analyses on people with dementia in palliative care services are lacking.AimTo explore the prevalence of dementia diagnoses as per the ICD criteria among users of various palliative care settings and to compare use of palliative services, care pathways, and outcomes in people with and without a dementia diagnosis.DesignWe conducted retrospective analysis of dementia diagnoses as per ICD (F00-F03/G30) in the German National Hospice and Palliative Care Register between 2009 and 2021. The analysis used methods of descriptive and inferential statistics, including the Bonferroni correction for alpha error inflation.Setting/participantsWe limited the analysis to the subsample of people aged over 64.ResultsThe prevalence of dementia in the different settings of palliative care was lower than in the age-comparable population: Of the 69,116 data sets included in the analysis, a small minority (3.3%) was coded with dementia as the principal diagnosis. Among patients on inpatient palliative care wards, 0.8% (148 of 19,161) had a dementia diagnosis, as did 2.2% (52 of 2,380) of those under hospital palliative care support teams and 4.3% (2,014 of 46,803) of those receiving specialized palliative care at home.ConclusionsThe records of the German National Hospice and Palliative Care Register suggest that the prevalence of dementia is lower than one might expect from general population data, though numbers are in line with international studies on proportion of dementia patients receiving palliative care. Future research could usefully examine whether this discrepancy stems either from omissions in coding dementia as patients’ principal diagnosis respectively from lapses in documentation of a dementia diagnosis previously made, or from barriers to accessing palliative care services or even displays being excluded from palliative care when trying to access it.Trial registrationNo registration.

Advancements in reperfusion rates and quality of care for ST-segment elevation myocardial infarction: a ten-year evaluation of Salvador's STEMI network.

Continuous investment and systematic evaluation of program accomplishments are required to achieve excellence in ST-segment elevation myocardial infarction (STEMI) care, especially in resource-limited settings. Therefore, this study evaluates the impact of problem-driven interventions on reperfusion use rate in a long-term operating STEMI network from a low- to middle-income country. This is a healthcare improvement evaluation study of Salvador's public STEMI network in a quasi-experimental design, comparing data from 2009 to 2010 (pre-intervention) and 2019-2020 (post-intervention). There were evaluated all confirmed STEMI cases assisted in both periods. The interventions, implemented since 2017, included: expanding the support team, defining criteria to be a spoke, and initiating continuous education activities. The primary outcome was the rate of patients undergoing reperfusion, with secondary outcomes being time from door-to-ECG (D2E) and ECG-to-STEMI-team trigger (E2T). Over ten years, the network's coverage increased by 300,000 individuals, and expanded by 1,800 km2. A total of 885 records were analyzed, 287 in the pre-intervention group (182 men [63·4%]; mean [SD] age 62·1 [12·5] years) and 598 in the post-intervention group (356 men [59·5%]; mean [SD] age 61.9 [11·8] years). It was noticed a substantial increase in reperfusion delivery rate (90 [31%] vs. 431 [73%]; P = 001) and reductions in time from D2E (159 [83-340] vs. 29 [15-63], P = 001), and E2T (31 [21-44] vs. 16 [6-40], P = 001). The strategies adopted by Salvador's STEMI network were associated with significant improvements in the rate of patients undergoing reperfusion and in D2E and E2T. However, the mortality rate remains high.

Knowledge and Home Caregiver’s Experiences of Palliative Health Care Team Support in Pain Management of Cancer Patients in Rwanda

Knowledge and Home Caregiver’s Experiences of Palliative Health Care Team Support in Pain Management of Cancer Patients in Rwanda

First Peoples Wellness Circle and the Indigenous Mental Wellness and Trauma-Informed Specialist Workforce During COVID-19.

Members of the Indigenous mental wellness and trauma-informed specialist workforce - including Mental Wellness Teams (MWTs), Crisis Support Teams (CSTs), the Indian Residential Schools Resolution Health Support Program workforce, and other community-based cultural support workers - are often the primary and urgent care providers for individuals and families in need of culturally safe supports. While fulfilling a critical role, these teams contend with distinct challenges stemming from colonial impacts and health systems that continue to undermine Indigenous mental wellness and cultural traditions of healing. During the COVID-19 pandemic, increasing rates of mental illness and substance use among Indigenous populations strained the already overworked and under-resourced mental wellness workforce. First Peoples Wellness Circle sought out and embraced new approaches for meaningful virtual engagement to sustain and enhance workforce wellness and capacity by facilitating culturally relevant and culturally led connections from coast to coast to coast.

Experience of care from the perspectives of inpatients with palliative care needs: a cross-sectional study using a patient reported experience measure (PREM)

BackgroundImproving palliative care for inpatients is urgently needed. Data from patient-reported experience measures (PREM) can assist in identifying areas for focused improvement. This study aimed to describe patient reported experience of care in inpatients with palliative care needs, to inform a baseline understanding of care experience and identify key areas for improvement.MethodsCross-sectional study design where inpatients with palliative care needs were invited to complete ‘consideRATE,’ a patient reported experience measure of care, over six months in 2022. Inpatients with palliative care needs receiving care on an oncology, general medicine/renal and general medicine/respiratory ward (n = 3) at an Australian metropolitan hospital were screened for eligibility. Carers could provide proxy responses where inpatients were unable to participate. Descriptive statistics were used to analyse quantitative ratings, whilst free text responses were analysed using integrated thematic analysis.ResultsOne-hundred and twenty participants (108 patients and 12 carers) completed consideRATE. The questions with the highest number of ‘very good’ responses were attention to symptoms, attention to feelings and attention to what matters most; the questions with the lowest number of ‘very good’ responses was attention to patients’ affairs, what to expect, and the environment of care. Almost half (n = 57, 48%) indicated that attention to patients’ affairs ‘did not apply’ to their inpatient stay. Analysis of 532 free text responses across 8 questions highlighted the importance of feeling supported, feeling informed, feeling heard and navigating the clinical environment.ConclusionEnabling inpatients with palliative care needs to provide feedback about their experience of care is one method of ensuring improvements matter to patients. Supporting clinical teams to understand and use these data to make tailored improvements is the next step in this multi-phase research.

Unravelling the predictive role of work rules on compassion satisfaction and career satisfaction among professionals of obstetrics and gynaecology: The mediating effect of team support

Abstract Work rules are an important guiding principle that regulates professional behaviour in organizational settings, however, the mechanism through which work rules affect physicians’ compassion satisfaction and career satisfaction remains unknown. Additionally, existing literature mainly focuses on direct associations, overlooking team support’s potential mediating role. This creates a research gap regarding team support as a mediator between work rules and both compassion and career satisfaction, requiring further scholarly investigation. Hence, the present study aims to investigate team support as a mediator between work rules and both compassion and career satisfaction in Obstetrics and Gynaecology (Obs and Gynae) physicians. A cross-sectional survey was distributed to 347 participants between 24 and 60 years (M = 31.22; SD = 6.81) in tertiary care hospitals. Participants were approached through purposive and convenient sampling techniques. A structural equation modelling through AMOS was analysed to study the complex interlinkages among the variables. The study found significant mediation of team support between work rules and career satisfaction (b = 0.077, 95% CI = 0.052, 0.106, P = 0.000). Also, an indirect significant path of team support is found between work rules and compassion satisfaction (b = 0.032, 95% CI = 0.020, 0.044, P = 0.000). Teamwork has far-reaching implications for healthcare professionals’ well-being, team dynamics, patient care quality, and the overall effectiveness of healthcare organizations. Filling this research gap enables healthcare professionals to foster more supportive work environment, benefiting both physicians and the patients they serve.

Identifying as lesbian, gay, and bisexual at work: atemporal associations between sexual identity disclosure and work team experiences

PurposeAlthough sexual identity disclosure in the workplace can be related to heightened adversity for lesbian, gay or bisexual (LGB) employees, disclosure can also serve as an avenue for LGB employees to attain additional resources. Much of the work done in today’s organizations is done in team-based structures, making it likely that LGB individuals disclose to members of their work teams. However, very limited prior research has examined the associations of sexual identity disclosure within work team experiences. This paper aims to take a first step in addressing this gap in research on the experiences of LGB employees in the workplace.Design/methodology/approachThis study takes a first step toward addressing this gap by examining the associations between LGB identity disclosure and critical team-specific attitudes and behaviors (i.e., trust in team, commitment to team, conflict with team, withdrawal from team) and the atemporal indirect role of perceived LGB identity support from the team through a cross-sectional survey of 159 employees.FindingsResults demonstrated that perceptions of a supportive LGB team climate atemporally mediated the association between disclosure and relevant workplace variables. Specifically, disclosure of sexual identity to one’s work team is directly and indirectly, through perceived identity support, positively associated with trust and commitment toward the team. Furthermore, disclosure was indirectly, through perceived identity support, negatively associated with conflict and withdrawal from the team. Theoretical and practical implications of these findings are discussed.Originality/valueThe results of this study highlight the importance of perceived identity support when individuals disclosure their sexual orientation in a team context.

Exploring the impact of social identity and team dynamics on mental health help-seeking behavior among collegiate athletes: a qualitative study

This study explores the influence of social identity and team dynamics on the mental health help-seeking behaviors of collegiate athletes. The research aims to understand how factors such as gender, ethnicity, and social status shape athletes' attitudes and actions regarding mental health assistance. Method: Using a mixed-method approach that included focus group discussions (FGDs) and in-depth interviews, data were collected from 30 athletes representing various sports disciplines, ensuring balanced representation in terms of gender, ethnicity, and social status.Result: Thematic analysis revealed significant themes: male athletes faced substantial stigma in seeking mental health assistance, viewing it as a sign of weakness, while female athletes were more open and supported by a culture of emotional expression. Minority athletes encountered additional barriers due to cultural stigma and a lack of culturally competent services, whereas majority athletes had better access to mental health resources. High-status athletes experienced pressure to maintain their image, leading to reluctance in seeking help, while low-status athletes faced challenges in accessing resources despite their willingness to seek help. Positive team dynamics, characterized by support and open communication, facilitated help-seeking behavior, while negative dynamics, such as bullying and lack of trust, created barriers. Conclusion: The study highlights the need for targeted interventions that address specific needs based on gender, ethnicity, and social status, promote mental health literacy, and foster supportive team environments. Future research should focus on the long-term effects of stigma-reduction interventions, culturally tailored mental health services, and the impact of team dynamics over time. These findings provide valuable insights for developing effective mental health support systems for collegiate athletes. Keywords: Cultural Competency, Ethnicity, Health Literacy, Social Identification, Athletes, Bullying

일반유아의 도전행동 개선을 위한 개별화교육 지원팀의 효과

Objectives The purpose of this study was to identify the competencies of occupational therapists as members of the individualized education team and to apply individualized education to children exhibiting challenging behaviors, thereby reducing the children's challenging behaviors and alleviating the educational difficulties faced by classroom teachers. Methods This 7-week study involved a 3-year-old boy in D Metropolitan City, aiming to create an individualized education plan through consultations with a specialized team including an occupational therapist and other professionals. Using ABC behavior charts and rating scales, we established and implemented short and long-term goals. The homeroom teacher applied these strategies three times a week, following guidelines designed to address the child's challenging behaviors. Results Following the intervention, notable improvements were observed in the child's behavior, with significant reductions in challenge behaviors and anxiety levels, as tracked by the ABC behavior chart and rating scales. Short-term goals showed marked progress, demonstrating the effectiveness of the tailored strategies. Positive feedback from the homeroom teacher and director highlighted the structured approach's success in addressing the child's needs and the potential benefits of professional guidance in educational settings. Conclusions The role of the individualized education support team for challenging behaviors in typical children was found to be effective in reducing challenging behaviors, and the necessity of the occupational therapist's role as a member of the individualized education team was confirmed. This study is a pilot study focusing on a single child, and future research aims to expand to various children to examine the impact of occupational therapists on challenging behaviors in typical children.

Exploring school support stakeholders’ perceptions in identifying learning barriers: the case study of selected rural schools in the Eastern Cape

Identification of learning barriers is a critical issue for support provision in inclusive classes, as it informs individualised support plans for each learner who experiences barriers to learning. However, the school support stakeholders in Quintile 1 rural schools in South Africa face challenges in identifying learning barriers experienced by learners in their classes. Quintile 1 is a socially based ranking given to schools in poverty-stricken communities where most people are unemployed. This study focuses on identifying the perceptions of school support stakeholders in the identification of learning barriers in Quintile 1 rural schools. In this qualitative research study, a multiple case study design was used and 15 participants from three categories (teachers, principals, and school-based support team coordinators) were purposively sampled from three secondary and two primary rural schools due to the different roles expected from each category in the identification of learning barriers. Data were analysed using thematic content analysis. The findings revealed insufficient knowledge about the identification of learning barriers; lack of support in identifying learning barriers; lack of continuous in-service training on inclusive practices and education policies as barriers to the identification of learning barriers, which led teachers to perceive their roles in identifying learning barriers in a negative way. In general, this article contributes to understanding the complexities surrounding the identification of learning barriers for support provision in rural settings. It highlights areas for improvement in inclusive practices and supports structures to enhance the inclusivity and effectiveness of rural education systems.

Early Impressions and Adoption of the AtriAmp for Managing Arrhythmias Following Congenital Heart Surgery.

AtriAmp is a new medical device that displays a continuous real-time atrial electrogram on telemetry using temporary atrial pacing leads. Our objective was to evaluate early adoption of this device into patient care within our pediatric intensive care unit (PICU). This is a qualitative study using inductive analysis of semi-structured interviews to identify dominant themes. The study was conducted in a single-center, tertiary, academic 21-bed mixed PICU. The subjects were PICU multidisciplinary team members (Pediatric Cardiac Intensivists, PICU Nurse Practitioners, PICU nurses and Pediatric Cardiologists) who were early adopters of the AtriAmp (n = 14). Three prominent themes emerged: (1) Accelerated time from arrhythmia event to diagnosis and treatment; (2) Increased confidence in the accuracy of providers' arrhythmia diagnosis; and (3) Improvement in the ability to educate providers about post-operative arrhythmias. Providers also noted some learning curves, but none compromised medical care or clinical workflow. Insights from early adopters of AtriAmp signal the need for simplicity and fidelity in new PICU technologies. Our research suggests that such technologies can be pivotal to the support and growth of multi-disciplinary teams, even among those who do not participate in early implementation. Further research is needed to understand when and why novel technology adoption becomes widespread in high-stakes settings.

The Participatory Approach in Healthcare Establishments as a Specific French Organizational Model at Hospital Department Level to Prevent Burnout among Caregivers: What Are the Perceptions of Its Implementation and Its Potential Contributions by These Caregivers?

(1) Background: Manifestations of burnout are regularly observed in the healthcare population. The participatory approach (PA) is a specific organization in the French health service aimed at preserving and improving the psychological health of these staff at work. The main objective of this study was to explore with healthcare professionals their perceptions of the effectiveness of the four PA components (multi-professional team meetings, in-service training, team support meetings and the project approach) implemented to date within French hospital departments, the methods of their implementation and the potential contributions of such an approach to their quality of working life and working conditions (QWLWC), and the quality of care provided. (2) Methods: Semi-structured qualitative interviews were conducted with 21 healthcare professionals in French hospital departments between March and April 2021. After they were recorded, the collected data was transcribed in full and subjected to thematic analysis. (3) Results: According to care providers, PA is only partially deployed in these departments today. Nevertheless, it is helping to develop multi-professional communication, and improves the quality of life at work as well as quality of care. (4) Conclusions: In the light of these results, the creation of a tool for the large-scale evaluation of PA implementation in hospitals emerges as essential, as its deployment in all hospital departments could help reduce the suffering of care professionals. In addition, a better articulation between the concepts of Magnet Hospitals and those of PA would prove heuristically promising.

“Being There for Each Other”: Hospital Nurses’ Struggle during the COVID-19 Pandemic

This study aims to explore the experiences of frontline hospital nurses over 18 months of struggle with the COVID-19 pandemic. The qualitative thematic analysis method was applied. Twenty-three nurses from nine tertiary hospitals in Israel were interviewed using semi-structured interviews via the ZOOM platform between August and September 2021. Interviews were video recorded and transcribed verbatim. Trustworthiness was assured by using qualitative criteria and the COREQ checklist. Results: Both negative and positive experiences were reported: threat and uncertainty along with awareness of their important mission; anxiety and helplessness alongside courage and heroism. Personal management strategies emerged: regulating overwhelming emotions and managing work–life balance. Team support emerged as the most meaningful source of nurses’ struggle with the pandemic. A sense of intimacy and solidarity enabled the processing of the shared traumatic experiences. Conclusions: A deeper understanding of nurses’ experiences through the pandemic was gained. Informal peer support has proven effective in struggling with the events. Formal interventions, such as affective–cognitive processing of traumatic events, need to be integrated into practice. Healthcare policymakers should promote better support for caregivers, which will contribute to their well-being and impact the quality of care they provide.

The Role of District Learning Support Officials in the Application of Concessions to Learners with Learning Disabilities

The dawn of democratic South Africa witnessed transformation in the education system where policy were developed to ensure education that cater all learners irrespective of their diverse abilities. Through the constitution post-1994 education policies ensures equitable access to education for all learners irrespective of their differences.The study intends to explore the role played by district based support team (DBST) in the application of learners identified with learning barriers in inclusive schools. The study was conducted in Matlosana local education office (MLEO), where qualitative study approach was employed. Participants were selected as personnel in the district office, teachers as people responsible for the implementation of inclusive education in inclusive schools, school based support team, departmental heads as people managing the implementation of inclusive education in schools. All participants were selected from four inclusive schools in Matlosana local education office. In this study data was collected through the use of semi structured interviews and video recorded.

Examining the Role of Stress and Team Support in Decision Making under Uncertainty and Time Pressure.

Stressors in hospital settings such as the complexity and uncertainty of tasks create stress among physicians, potentially leading to decision conflicts.Team support plays a fundamental role in mitigating the negative effects of stressors such as time pressure and uncertainty.Implementing stress management and team support interventions such as cognitive-behavioral therapy and mindfulness may enhance decision making among Obs and Gynae physicians.

Challenges Faced by Cancer Patients during the COVID-19 Pandemic, a Vision for the Future: A Qualitative Study.

Cancer is a disease that affects various aspects of patients' lives. The COVID-19 pandemic has presented numerous challenges and difficulties for cancer patients, exacerbating their already vulnerable conditions. Identifying the challenges these patients face can be a practical step toward improving their quality of care in future pandemics. This qualitative study aims to identify the challenges cancer patients encounter during the COVID-19 pandemic. This is a qualitative study with a content analysis approach. Participants included 16 cancer patients hospitalized at Tabriz Shahid Ghazi Hospital in 2020. Sampling was conducted purposefully, and interviews were continued until data saturation was achieved. All interviews were recorded and transcribed at the earliest opportunity. The data were analyzed using content analysis based on the Lundman and Graneheim method. Data analysis led to the identification of four categories of challenges faced by cancer patients during the pandemic: Mental derangement and fear (fear of premature death, fear of contracting COVID-19, fear of disease recurrence), ineffective nurse-patient communication (personal protective equipment and distant care from nursing stations), economic instability (difficulties in providing for the family's livelihood and increased medical expenses), and reduced access to services (Contracting of infection among doctors and nurses and redirection of resources and services to COVID-19 patients). Participants expressed that these challenges were additional to their pre-existing difficulties and were intensified by the COVID-19 pandemic. Team support and interdisciplinary collaboration can be beneficial in addressing mental derangement and severe fears and solving problems comprehensively. Using various methods to facilitate safe and continuous communication between nurses and patients aside from their beds can give patients a greater sense of calmness. Financial facilitations can alleviate pressure on patients, and planning and communication strategies for accessing care and treatment services during a pandemic should be organized in advance.

Implementing Group Care

Centering-based group antenatal and postnatal care (gAPNC) can improve quality of care. Implementation benefi ts from enthusiasts and careful planning. A steering committee to oversee planning, implementation and evaluation keeps the fi re alive and can provide support for the whole implementation team. gAPNC can be adapted to the local needs to fit as best as possible with the implementing organisation and its population. Sustainability requires ongoing training and support for practitioners. This article provides insights, tips and tricks for those that are wishing to implement gAPNC.

1249 Supporting Emergency theatre Teams with the Use of ENT Equipment

1249 Supporting Emergency theatre Teams with the Use of ENT Equipment

Robotic-assisted coronary artery bypass grafting: how I teach it.

The first robotic cardiac operation was performed more than two decades ago. This paper describes the distinct steps and components necessary for teaching robotic-assisted minimally invasive direct coronary artery bypass (R-MIDCAB). It also provides a general overview of the surgical robotic setup and ways to troubleshoot potential complications. The focus of robotic training is not only on the surgeon but includes an entire dedicated cardiac team and administrative institutional support. This team approach ensures that R-MIDCAB can be performed safely and reproducibly. Meticulous planning, incremental learning, and teamwork are the main factors leading to program success and optimal patient outcomes. Robotic-assisted internal mammary artery (IMA) harvesting and coronary revascularization via a small, anterior mini-thoracotomy has provided an alternative to sternotomy in selected patients with coronary artery disease (CAD). Benefits include less postoperative atrial fibrillation, fewer blood transfusion, less time in the operating room (OR), less ventilatory support, fewer strokes, decreased intensive care unit stay and shortened postoperative length of stay all of which manifests as a decrease in institutional resource utilization. Recent data show that R-MIDCAB and hybrid coronary revascularization provides good long-term outcomes. In addition to patient satisfaction, there is an additional overall cost benefit to R-MIDCAB over traditional sternotomy coronary artery bypass grafting (CABG), secondary to decreased hospital length of stay. Robotically harvesting the IMA, operating on a beating heart, and performing anastomoses through a small incision all require advanced training and incremental learning. Increased experience generally leads to shortened surgical times and fewer complications.

Single case experiment evaluating the effectiveness of an adapted cognitive behavioural therapy intervention for an older adult with a fear of falling

Aim:A single case experiment was carried out for a 77-year-old woman who was referred to the older adult community mental health team for support with anxiety related to a fear of falling.Method:An AB design was implemented, using an adapted cognitive behavioural therapy graded exposure intervention to target her anxiety and fear of falling.Results:There was an overall reduction in the client’s anxiety and an increase in her activity levels.Conclusion:The adapted intervention resulted in decreased anxiety, psychological distress, and a fear of falling and an increase in the frequency of her walking.Consent:The client was provided with information about the purpose of the write up for this case study. She kindly provided informed written consent for the case study to be published within an academic journal. Some demographic details have been amended to protect her identity.