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1 – 10 of 19Varsha Shukla, Rahul Arora and Sahil Gupta
The present study examines the fluctuations in Socioeconomic and demographic (SED) factors and the prevalence of Non-Communicable Diseases (NCDs) across clusters of states in…
Abstract
Purpose
The present study examines the fluctuations in Socioeconomic and demographic (SED) factors and the prevalence of Non-Communicable Diseases (NCDs) across clusters of states in India. Further, it attempts to analyze the extent to which the SED determinants can serve as predictive indicators for the prevalence of NCDs.
Design/methodology/approach
The study uses three rounds of unit-level National Sample Survey self-reported morbidity data for the analysis. A machine learning model was constructed to predict the prevalence of NCDs based on SED characteristics. In addition, probit regression was adopted to identify the relevant SED variables across the cluster of states that significantly impact disease prevalence.
Findings
Overall, the study finds that the disease prevalence can be reasonably predicted with a given set of SED characteristics. Also, it highlights age as the most important factor across a cluster of states in understanding the distribution of disease prevalence, followed by income, education, and marital status. Understanding these variations is essential for policymakers and public health officials to develop targeted strategies that address each state’s unique challenges and opportunities.
Originality/value
The study complements the existing literature on the interplay of SEDs with the prevalence of NCDs across diverse state-level dynamics. Its predictive analysis of NCD distribution through SED factors adds valuable depth to our understanding, making a notable contribution to the field.
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Henriikka Anne-Mari Seittu, Anneli Hujala and Minna Kaarakainen
Integrated care (IC) is mainly studied from the perspectives of organisations or employees. However, less research is focussed on how patients themselves experience person-centred…
Abstract
Purpose
Integrated care (IC) is mainly studied from the perspectives of organisations or employees. However, less research is focussed on how patients themselves experience person-centred (PC) IC in practice. This context-specific, small-scale study examines what PC-IC means to older patients who went through joint replacement surgery (JRS).
Design/methodology/approach
The data consists of ten in-depth interviews of older patients, focussing on their experiences of care during their patient journey related to joint knee or hip replacement surgery. The data were analysed with thematic analysis.
Findings
Three central dimensions of PC-IC for older patients were identified: information sharing, continuity of care and compassionate encountering. Human validation and compassionate encountering were experienced as important aspects of PC-IC. Compassionate encountering was concretised through professionals’ very small everyday practices, which made the patient feel comfortable and respected. Instead, probably due to the medical and quite straight-forward nature of the joint replacement care process, patients seem to be pleased to trust the expertise of professionals and did not necessarily expect an active role or participation in the decision-making.
Originality/value
This Finnish case study focusses on the patients’ authentic perceptions of what is central to person-centred IC in the specific context of JRS.
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Caroline Shulman, Rafi Rogans-Watson, Natasha Palipane, Dan Lewer, Michelle Yeung and Briony F. Hudson
This study aims to co-develop a Frailty, Health and Care Needs Assessment (FHCNA) questionnaire for people experiencing homelessness and explore the feasibility of its use by…
Abstract
Purpose
This study aims to co-develop a Frailty, Health and Care Needs Assessment (FHCNA) questionnaire for people experiencing homelessness and explore the feasibility of its use by non-clinical staff in homeless hostels.
Design/methodology/approach
The FHCNA, aimed at identifying frailty and other health and care priorities for people experiencing homelessness, was co-designed in workshops (online and in person) with homelessness and inclusion health staff. Its feasibility was tested by staff and their clients in two hostels, with pre- and post-study focus groups held with hostel staff to gain input and feedback.
Findings
The FHCNA was co-developed and then used to collect 74 pairs of resident and key worker inputted data (62% of eligible hostel residents). The mean age of clients was 48 years (range 22–82 years). High levels of unmet need were identified. Over half (53%) were identified as frail. Common concerns included difficulty walking (46%), frequent falls (43%), chronic pain (36%), mental health issues (57%) and dental concerns (50%). In total, 59% of clients reported difficulty in performing at least one basic activity of daily living, while only 14% had undergone a Care Act Assessment. Hostel staff found using the FHCNA to be feasible, acceptable and potentially useful in facilitating explorations of met and unmet health and social care needs of hostel clients. By identifying unmet needs, the FHCNA has the potential to support staff to advocate for access to health and social care support.
Originality/value
To the best of the authors’ knowledge, this is the first study to co-develop and feasibility test a questionnaire for use by non-clinically trained staff to identify frailty and other health and care needs of people experiencing homelessness in a hostel setting.
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Srirang Kumar Jha, Shweta Jha and Amiya Kumar Mohapatra
The purpose of this paper is to emphasize the need for holistic geriatric health care in rural India. Many older people in Indian villages suffer from chronic ailments without any…
Abstract
Purpose
The purpose of this paper is to emphasize the need for holistic geriatric health care in rural India. Many older people in Indian villages suffer from chronic ailments without any relief or intervention because of inaccessible and unaffordable health-care services. This paper explores how holistic health care can be assured for older people in Indian villages.
Design/methodology/approach
This paper is based on reflections of the authors who have had experiences as caregivers to older persons within their respective families rooted in the Indian villages. Besides, they interacted with 30 older persons (18 males and 12 females in the age group of 60–80 years) living in the villages in three states of India, namely, Haryana, Rajasthan and Madhya Pradesh to develop a comprehensive viewpoint on the need of geriatric health care in rural India. Relevant reports, newspaper articles and research papers were also reviewed while developing viewpoints on such an important topic.
Findings
Geriatric health-care facilities in rural India are abysmal. The older people in the villages cannot leverage health-care facilities that are generally inaccessible, inadequate and unaffordable. Even the government support for medical treatment is minuscule. Furthermore, there is lack of trained health-care professionals at all levels, namely, doctors, nurses and paramedic personnel. Training opportunities in geriatrics are also negligible. The scenario vis-à-vis geriatric health care in rural India can be upturned by increasing public spending on health-care infrastructure, increasing numbers of health-care professionals and expanding training programmes in geriatrics.
Originality/value
This paper is based on the critical reflections of the authors as well as their informal interactions with some of the older people in the Indian villages.
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Watchara Tabootwong, Yoongtong Nathmontri and Chonticha Chantakeeree
This study aims to describe the experiences of critically ill elderly patients (CIEPs) who were treated using the high-flow nasal cannula (HFNC) after extubation.
Abstract
Purpose
This study aims to describe the experiences of critically ill elderly patients (CIEPs) who were treated using the high-flow nasal cannula (HFNC) after extubation.
Design/methodology/approach
A descriptive phenomenological approach was conducted to interview eleven CIEPs using face-to-face semi-unstructured interviews. Participants were selected through purposive sampling. Data were analyzed using Giorgi’s method.
Findings
Experiences of CIEPs included their fears of failure, getting comfortable and uncomfortable, as well as asking for assistance. Fears of failure were described as involving worsening symptoms related to their diseases and failure of HFNC leading to the need for reintubation. While receiving HFNC, their breathing was comfortable, and they were free from intubation. However, they were uncomfortable because of the sensation of burning in the nasal passages. Additionally, they asked for assistance from nurses in managing their symptoms, and the alarms of HFNC oxygen therapy devices resulted in fears of HFNC failure.
Originality/value
The paper indicates that CIEPs experienced physical and psychological impacts from HFNC oxygen therapy (e.g. burning sensation in the nose and fear of failure). Although they had comfortable breathing, being uncomfortable also occurred. Therefore, health-care professionals should support what CIEPs need and develop a program or guidelines for managing the complications of HFNC – neither burning noses nor psychological issues enhance the comfort of CIEPs – by considering age-related changes.
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The purpose of this paper is to provide a literature review on what is known about unpaid family carers who are at risk of or have experienced abuse from the people they provide…
Abstract
Purpose
The purpose of this paper is to provide a literature review on what is known about unpaid family carers who are at risk of or have experienced abuse from the people they provide care for and relevant policy/legal and practice responses for affected family carers.
Design/methodology/approach
A literature search was carried out to locate literature relating to unpaid family carers who are at risk of or have experienced abuse from the people they provide care for. This also incorporated grey literature, including policy guidance and law, to determine the existing knowledge base, gaps in practice and areas that might require further research.
Findings
The findings suggest that although carer harm is serious, it is under-researched. In addition, the unique needs of unpaid family carers who are at risk of or have experienced abuse, violence and harm from the people they provide care for are subsumed in safeguarding policy/law processes and practice under the auspices of the protection of “adults at risk” rather than the protection of “carers at risk”.
Research limitations/implications
It is important that those who support unpaid family carers who are at risk of abuse and harm know about their unique safeguarding needs and concerns to offer appropriate support. It is also apparent that policy and law need to address the gap in provision relating to the unique safeguarding concerns involving the abuse of unpaid family carers by the people they provide care for. This paper is based on this literature review and not on other types of research.
Originality/value
The paper provides insights into what is known about the abuse of unpaid family carers by the people they provide care for, and the policy/legal and practice responses to affected unpaid family carers. It contributes to the body of knowledge on carer abuse and safeguarding carers from abuse and harm.
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Sally Moyle and Richard Waller
The ever-changing landscape of healthcare policy has impacted significantly on the development of nursing roles (Lloyd–Rees, 2016), and consequently seen the growth and…
Abstract
The ever-changing landscape of healthcare policy has impacted significantly on the development of nursing roles (Lloyd–Rees, 2016), and consequently seen the growth and transformation of existing professions and introduction of new healthcare roles. While the Emergency Nurse Practitioner (ENP) role is now well established within urgent care settings, it has evolved in an adhoc manner, responding to service demand. This has resulted in varying levels of job satisfaction and inconsistency in titles, uniform and scope of practice.
Using photographs or images to describe their perceptions of the role, experience and perceived professional identity, participants reported moving away from their traditional nursing practice into something different that bought new challenges and often conflict. Applying Bhabha's (1994) concept of the ‘third space’ to our findings suggests that ENPs have adopted a hybrid role that is operating within a ‘third (or hybrid) space’, where new identity is formed. Our participants' uncertainty around this (and that of others) could negatively impact the development of professional identity during transition into this new role.
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Sajay Arthanat, Hannah Rossignol, Elizabeth Preble, Kali Grimm, Marguerite Corvini, John Wilcox, Semra Aytur and Marcy Doyle
Telepresence robots have gained prominence as a novel technological modality for mobile videoconferencing. Although the technology has mass appeal in the realm of telehealth and…
Abstract
Purpose
Telepresence robots have gained prominence as a novel technological modality for mobile videoconferencing. Although the technology has mass appeal in the realm of telehealth and patient–health provider communication, its integration in community living settings for older adults has not been extensively studied. The aim of this study was to gather the perspectives of residents, trainers and staff at a retirement facility on their experience with a telepresence robot during and following a five-week wellness program.
Design/methodology/approach
The study employed semi-structured interviews with ten stakeholders who were involved in the wellness program followed by a qualitative content analysis of the data. The Unified Theory of Acceptance and Use of Technology served as the interview framework to explore the facilitators and barriers to the implementation of the robot.
Findings
Independent coding of the data by the study investigators identified discrete as well as interconnected categories among the stakeholders. Residents expressed their changing ideation of the robot, affinity toward the technology, preference for human connection and future value. Perspectives of the trainers, the fellow residents (ambassadors) and staff pertained to their need for increased engagement, growing comfort with the technology, usability challenges and importance of coordination and training.
Originality/value
Older adults' outlook and comfort with telepresence robots improve with continuing exposure to the technology for healthcare and social connectivity needs. However, in-person care is also preferred initially and periodically to engage with their health providers meaningfully and effectively via the robot. To address long term feasibility and usability, the authors propose a hierarchical approach when integrating telepresence robots in community living facilities for older adults. Information technology education, staff training and reliable internet connectivity are the precursors to optimizing the value and perceived usefulness of the technology.
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Reimara Valk and Benito Versluijs
The purpose of this paper is to explore the reintegration process of Wounded, Injured or Sick Employees (WISE) of the Dutch Military Armed Forces.
Abstract
Purpose
The purpose of this paper is to explore the reintegration process of Wounded, Injured or Sick Employees (WISE) of the Dutch Military Armed Forces.
Design/methodology/approach
The research method is an exploratory, qualitative case study. A purposive sampling was drawn, including 10 WISE, and 6 reintegration stakeholders. A total of 16 interviews were conducted to explore the individual, organisational and socio-environmental factors that influence reintegration of WISE.
Findings
Findings show the importance of involvement and participation of members of the social environment in the reintegration process. Findings show that the complexity of the plethora of WISEs' injuries and disabilities requires a more person-centric reintegration approach with personalized-customized provisions, rather than a policy-driven approach to the reintegration, in order to enhance the reintegration experience and to arrive at beneficial individual and organisational reintegration outcomes.
Research limitations/implications
This cross-sectional study on a limited sample of WISE and reintegration stakeholders does not allow for making inferences about the long-term effects of the reintegration process on reintegration outcomes of the wider population of WISE. Future longitudinal research, encompassing a larger sample, could examine the long-term career, organisational and societal implications of reintegration of WISE within and outside the Military Armed Forces.
Practical implications
This paper presents a “Wounded Warrior Workplace Reintegration Program”, aimed at deriving beneficial outcomes for all stakeholders involved in the reintegration trajectory.
Originality/value
This paper contributes to the literature by presenting a Model of Occupational Reintegration of WISE that considers the factors at an individual, social-environmental, and institutional level as determinants of successful reintegration.
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Obinna Chinedu Okezue, Madonna Uzoigwe, Livinus Ekene Ugwu, Jeneviv Nene John, Davidson Okwudili John and Ukamaka Gloria Mgbeojedo
This study aims to explore the level of independence among persons with disabilities (PWDs) towards their use of public buildings’ facilities, as well as assess the anxiety and…
Abstract
Purpose
This study aims to explore the level of independence among persons with disabilities (PWDs) towards their use of public buildings’ facilities, as well as assess the anxiety and relevant challenges regarding such use.
Design/methodology/approach
In a cross-sectional survey design, 91 consenting PWDs were recruited via purposive sampling at diverse locations and invited to complete self-report questionnaires on their use of public buildings’ facilities.
Findings
Only 19 PWDs (20.9%) were able to independently use such facilities. The participants’ level of anxiety, observed to be mostly severe (41.7%), was significantly associated with sex and affected body region (p < 0.05). Most PWDs identified “lack of amenities” (85.7%), “inconvenience” (78%) and “safety issues” (59.4%) as relevant challenges towards the use of public buildings’ facilities.
Research limitations/implications
This research emphasises the urgent need to universally improve PWDs’ level of independence towards the use of public buildings’ facilities alongside eradicating anxiety and challenges experienced towards such use. Accessibility ought to be promoted among PWDs, with specific attention given to women and those affected in multiple body regions; as such populations are prone to experiencing substantial anxiety. This approach should entail the provision of barrier-free facilities as well as ensuring their safe and convenient use by PWDs.
Originality/value
This study sought and provided key feedback from PWDs on the current built environment, which ought to be considered by relevant stakeholders to improve accessibility, promote well-being and contribute towards meeting the global goals of reducing inequality and making cities/communities inclusive, safe, resilient and sustainable.
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