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Hearing voices can be a debilitating and traumatic experience, and psychiatric hospitals can feel unsafe and overstimulating to voice hearers. Research suggests this may prolong a service user’s admission time and lead to an unhelpful experience. Therefore, a hearing voices group (HVG) was developed to create a safe space where voice hearers could share their story with others with lived experience and access support.

The group was developed by the first author under the supervision of the inpatient psychology lead. Both a practice-based and expert by experience-based approach were considered during the development of the group structure. The group also aligned with the Hearing Voices Network and the Trust’s values. A questionnaire was developed to evaluate the effectiveness of the group using six five-point Likert scale questions and three open questions to collect the data, which was then analysed.

The themes from the qualitative data showed that staff and ward-based promotion of the group were paramount to ensuring patient engagement. The results also showed that voice hearers found the group therapeutic, and some found the coping skills shared to be beneficial and effective.

A large percentage of women (76%) reported that they had attended a HVG before. This was not the case for service users from the male unit and psychiatric intensive care unit. This result is considered to reflect the fact that women in that unit had the opportunity to attend more than once during their admission, rather than that they had accessed these groups in other settings or in the community. Therefore, in the future, it would be useful to change this question to “have you attended any other HVGs in the past, prior to this admission?”, which might be more appropriate for data collection.

To the best of the authors’ knowledge, this is the original work of the first author, who is an expert by experience and an assistant psychologist. The results suggest that HVGs can be beneficial for patients in acute and intensive mental health care and highlight some necessary adaptations and the importance of adopting an MDT approach in promoting therapeutic groups.

This study aims to evaluate the quality of a speech and language therapy (SLT) swallow service provided to adults with intellectual disability (ID) by exploring the process and outcome factors; to explore the process of what is done to and for the patient including identifying dysphagia, choking and pneumonia risk, typical interventions and management; examine clinical outcomes; and explore the relationship of outcomes with risk factors, satisfaction with the service and the impact of the service on the number of choking incidents and admissions to acute hospital with swallow concerns.

There were three specific work packages: (1) collecting and scrutinising patient data from the clinical record for adults with ID referred to the SLT swallow service over a six-month period. The researcher created aims, defined the limits to achieve the aims, designed a standardised data collection form, set out where data was in the clinical record, piloted, set limits for collection and trained reviewers; (2) gathering experience and satisfaction surveys from patients, caregivers and referrers over the six-month study period; and (3) monitoring choking adverse incident reports and hospital admission with swallow concerns for the whole ID population.

Choking and hospital admission were the main reasons for referral, and pneumonia risk significantly predicted dysphagia impairment. The research highlighted common dysphagia risk factors, interventions and recommendations for this population. The SLT swallow service is a quality service that is highly valued by patients, their caregivers and referrers. The service achieves significant clinical improvements, helps identify dysphagia and provides management to reduce associated risks.

This study found common dysphagia risk factors, interventions and recommendations; it also found that the therapy outcome measures/Royal College of Speech and Language Therapy online outcome tool was a meaningful outcome measure, and that pneumonia risk significantly predicted dysphagia impairment, all of which could inform the identified dysphagia research priorities for this population.

Naming usual care in treatment and recommendations could help ensure a fair service and could help form quality indicators. People with ID, their caregivers and staff generated valuable ideas for improvement, and further involvement work could create a logic model for the service. Other future work could explore the use of screening tools, increase multidisciplinary team working, improve access to instrumental assessments, raise awareness of swallowing and promote important oral health and medication reviews. By using this information to shape quality improvement work and policies, one can work toward addressing high health-related inequalities and preventable deaths associated with dysphagia in this vulnerable population.

It may be useful to raise awareness that adults with ID age earlier and that one should not exclude them from older people’s services because of an age threshold, often set higher than their life expectancy. This study highlighted a possible inequality of access issue for adults with ID who do not have direct care or day care staff. There is a need to increase access to awareness training so caregivers and general practitioners can recognise swallow difficulties and know how to make a referral for a swallow assessment.

Overall, the evaluation of the swallow service to adults with ID suggests that SLT have a quality service for adults with ID that is highly valued and provides significant clinical improvements. By building on these strengths, SLT could extend the reach, influence and impact of their services to help those adults with ID who have emerging swallow difficulties or who do not access the service.

Teams across a wide range of contexts must look beyond task performance to consider the affective, cognitive and behavioral health of their members. Despite much interest in team health in practice, consideration of team health has remained scant from a research perspective. The purpose of this paper is to address these issues by advancing a definition and model of team health.

The authors review relevant literature on team stress, processes and emergent states to propose a definition and model of team health.

The authors advance a definition of team health, or the holistic, dynamic compilation of states that emerge and interact as a team resource to buffer stress. Further, the authors argue that team health improves outcomes at both the individual and team level by improving team members’ well-being and enhancing team effectiveness, respectively. In addition, the authors propose a framework integrating the job demands-resources model with the input-mediator-output-input model of teamwork to illustrate the behavioral drivers that promote team health, which buffers teams stress to maintain members’ well-being and team effectiveness.

This work answers calls from multidisciplinary industries for work that considers team health, providing implications for future research in this area.

Malnutrition has a significant effect on the onset and progression of infective pathology. The malnutrition status in COVID-19 cases are not understood well. Prognostic Nutritional Index (PNI) is a new and detailed assessment of nutrition and inflammation cases. This study aims to investigate the effect of PNI on mortality in COVID-19 patients.

In total, 334 patients (males, 142; females, 192; 64.5 ± 12.3 years of age) with COVID-19 bronchopneumonia were enrolled in this investigation. Cases were divided into two groups with respect to survival (Group 1: survivor patients, Group 2: non-survivor patients). Demographic and laboratory variables of COVID-19 cases were recorded. Laboratory parameters were calculated from blood samples taken following hospital admission. PNI was calculated according to this formula: PNI = 5 * Lymphocyte count (10⁹/L) + Albumin value (g/L).

When the patients were assessed with respect to laboratory values, leukocytes, neutrophils, CRP, ferritin, creatinine and D-Dimer parameters were significantly lower in Group 1 patients than Group 2 patients. Nevertheless, serum potassium value, lymphocyte count, calcium and albumin values were significantly higher in Group 1 cases than in Group 2 cases. PNI value was significantly lower in Group 2 cases than in Group 1 cases (39.4 ± 3.7 vs 53.1 ± 4.6).

In this retrospective study of COVID-19 cases, it can be suggested that PNI may be a significant risk factor for mortality. In conclusion of this research, high-risk patients with COVID-19 can be determined early, and suitable medical therapy can be begun in the early duration.

A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot.

This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels.

The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals.

This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.

Many town centres in England exhibit high retail property vacancies and require regeneration. Several alternatives for the replacement of town centre retail (TCR) have been suggested, one of which is healthcare. The healthcare sector in England is in distress, with the National Health Service (NHS) tackling extensive patient waiting lists, whilst operating from an ageing estate. This paper is an introductory study that uses seven carefully selected personalised surveys to raise academic awareness of the importance and potential of integrating healthcare into town centres and calls for large-scale research to establish the statistical validity of the reported observations.

This study is developed from an interpretative standpoint. Through semi-structured interviews with key stakeholders specific to retail-to-healthcare conversions, this study reports stakeholders' perspectives on opportunities and limitations for such conversions to give direction for large statistical research in the future.

All participants support the integration of healthcare into town centres and agreed that diagnostic services, mental health support and primary care services are appropriate for provision within town centres. The participants advocate large-scale change in town centres in England, with integrated healthcare co-located with complementary services to fit with wider regeneration plans. Participants prefer adaptation of existing buildings where technically feasible and emphasise the importance of obtaining the buy-in of other stakeholders whilst expressing concerns about the uncertainty of capital funding availability.

This is the first study to analyse the practice of retail-to-healthcare conversions in town centres. These are still rare in England and projects are complex. The market experience is limited, and thus, the literature is scarce. This study fills this void and provides a starting point for future quantitative research in this area and informs the new town-planning policies.

The authors proposed a conceptual model by examining the influence of threats to their freedom on tourists’ psychological distance including social distance, spatial distance, and temporal distance, which effect psychological reactance and the consequent online Airbnb booking intentions. Furthermore, media intrusiveness as a moderator determines the boundary conditions between perceived threats to their freedom and social distance, spatial distance, and temporal distance.

Data was gathered from 491 Chinese travelers to provide empirical evidence. The authors performed data analysis in Amos 26.0 using structural equation modeling (SEM) and Hayes (2013) PROCESS macro.

The findings positively reinforced all the structural relationships of the study. Notably, media intrusiveness significantly moderates the association between perceived threats to their freedom and psychological distance (i.e. social distance, spatial distance, and temporal distance).

The findings contribute significantly to the field of social psychology, advertising, and consumer behavior derive prolific implications for policymakers and sharing economy platforms. Lastly, by identifying limitations, this research opens doors for future scholars.

Governments' acute precautionary measures in response to the COVID-19 outbreak have confined individual freedom across the globe. This study illuminates how tourists conceive these preventative measures as perceived threats to their freedom, and subsequently engage psychological reactance.

Health care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples demonstrating effective delivery of integrated care are essential.

In this article, we introduce UHN Connected Care Hub, an innovative model of care comprising an interdisciplinary team designing sustainable, shareable practices across the continuum of care alongside community and health organization partnerships.

We describe UHN Connected Care Hub’s ability to identify patients from high-risk population and collaborate to delivery timely care, in detailing the real world experience of this model of care in the organization of a centralized system of micro-clinics to administer a therapeutic for pre-exposure prophylaxis against COVID-19 (Tixagevimab/cilgavimab [Evusheld]) in a population of immunocompromised patients.

Having a centralized system of micro-clinics for care delivery presents opportunities for increased adaptability, patient accessibility, enhanced community partnerships and integratedness. Expansion in the scope of services could also create new opportunities in preventative therapies for optimizing the cost effectiveness and quality of health care provided at the population level.

There is limited evidence on how to efficiently deliver integrated care, particularly to vulnerable and co-morbid patients. We discuss how dynamic organizations with proper infrastructure and a network of healthcare partnerships may allow a more fluid response to rapidly changing policies and procedures and facilitate preparedness for future health care crises or pandemics.

Ireland’s ageing population has resulted in an increasing number of older adults living with frailty. Despite growing attention towards older adults’ and health professionals’ perspectives of frailty, occupational therapy research is limited. This study aims to explore occupational therapists’ perceptions of frailty and how their perceptions impact their approach to the assessment and management of frailty.

Using qualitative descriptive design, 19 occupational therapists working with older adults participated in online focus groups. Data were analysed using thematic analysis.

Perceptions of occupational therapists were constructed into three main themes: conceptualising frailty; management of frailty; and advancing frailty practice. Findings indicate that occupational therapists perceived frailty as a multidimensional concept but highlight a reluctance to use frailty terminology with patients. Findings also suggest that although occupational therapists are involved in provision of care for older adults living with frailty, the profession’s scope is not optimised in the assessment and management of frailty.

Findings provide insight into occupational therapists’ perceptions of frailty. Development of a shared understanding of frailty between clinicians and patients and enhancement of undergraduate frailty education are recommended to progress occupational therapy’s role in frailty management.

Institutional abuse is a worldwide phenomenon with the UK also subject to several high-profile abuse scandals perpetuated on people with learning disabilities and/or mental health conditions living within institutional settings. This study aims to provide a broad perspective of safeguarding practices within institutional care to inform practice and service development in this area.

A narrative overview was undertaken of a range of empirical evidence, discussion papers, enquiry reports, reports from regulatory bodies and professional guidance to explore safeguarding practices within institutional care for individuals with learning disabilities and/or mental health conditions.

A range of literature was identified that exposed and explored abuse in this context. Three key themes were identified: failings within institutional care; safeguarding issues and concerns; and good practice within institutional care. Whilst guidance is available, standards are explicit and protocols facilitate improvement potential in this area, a consistent message was that statutory recommendations for reform have not been effective.

This paper provides an important resource for practitioners and service providers involved in institutional care. An accessible overview of both the empirical evidence and grey literature on adult safeguarding within institutional settings is provided, along with a range of standards and resources that specify practice in these settings.