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Open Access
Article
Publication date: 1 January 2024

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.

Details

Housing, Care and Support, vol. 27 no. 1
Type: Research Article
ISSN: 1460-8790

Keywords

Open Access
Article
Publication date: 25 September 2020

Raphael Rogans-Watson, Caroline Shulman, Dan Lewer, Megan Armstrong and Briony Hudson

The purpose of this paper is to assess frailty, geriatric conditions and multimorbidity in people experiencing homelessness (PEH) using holistic evaluations based on comprehensive…

4772

Abstract

Purpose

The purpose of this paper is to assess frailty, geriatric conditions and multimorbidity in people experiencing homelessness (PEH) using holistic evaluations based on comprehensive geriatric assessment (CGA) and draw comparisons with general population survey data.

Design/methodology/approach

Cross-sectional observational study conducted in a London-based hostel for single PEH over 30 years old in March–April 2019. The participants and key workers completed health-related questionnaires, and geriatric conditions were identified using standardised assessments. Frailty was defined according to five criteria in Fried’s phenotype model and multimorbidity as the presence of two or more long-term conditions (LTCs). Comparisons with the general population were made using data from the English Longitudinal Study of Ageing and the Health Survey for England.

Findings

A total of 33 people participated with a mean age of 55.7 years (range 38–74). Frailty was identified in 55% and pre-frailty in 39%. Participants met an average of 2.6/5 frailty criteria, comparable to 89-year-olds in the general population. The most common geriatric conditions were: falls (in 61%), visual impairment (61%), low grip strength (61%), mobility impairment (52%) and cognitive impairment (45%). All participants had multimorbidity. The average of 7.2 LTCs (range 2–14) per study participant far exceeds the average for even the oldest people in the general population.

Originality/value

To the best of authors’ knowledge, this is the first UK-based study measuring frailty and geriatric conditions in PEH and the first anywhere to do so within a CGA-type evaluation. It also demonstrates the feasibility of conducting holistic evaluations in this setting, which may be used clinically to improve the health outcomes for PEH.

Details

Housing, Care and Support, vol. 23 no. 3/4
Type: Research Article
ISSN: 1460-8790

Keywords

Article
Publication date: 20 June 2023

Zana Khan, Sophie Park and Georgia Black

This article aims to present a systematic review and synthesis of evidence on the experiences, role and use of IPE in IH fields by using a meta-ethnographic approach including key…

Abstract

Purpose

This article aims to present a systematic review and synthesis of evidence on the experiences, role and use of IPE in IH fields by using a meta-ethnographic approach including key concepts, reciprocal and refutational translation and lines of argument. Inclusion health (IH) practice suggests that the needs of excluded groups are more effectively addressed through collaborative working. Interprofessional education (IPE) occurs when two or more professions engage in shared practice and learning, resulting in improved collaboration and quality of care. Studies on IPE to train staff in fields relating to IH exist, but without a settled consensus on the best approaches/activities to foster inclusive practice.

Design/methodology/approach

This synthesis is underpinned by a meta-ethnographic approach. It provides explicit stages of data collection and interpretation, while providing space to engage with emerging themes and concepts iteratively (reflecting on author experiences) and inductively (reasoning and interpretation). This study made use of electronic databases and journals for English language peer reviewed articles between 2000 and 2020. Of the 2217 articles, 19 papers were included. The lead author and reviewer completed the review process and a second reviewer reviewed 10% at each stage. The quality was assessed using a modified CASP checklist. Iterative analysis involved PPI and staff stakeholders.

Findings

A total of 16 concepts embedded in 19 papers provide insight into the nature of IPE in IH (IH) for staff. It was found that IPE in IH covers a broad group of practitioners and is a complex activity involving individual and organisation readiness, practical and pedagogical factors, influenced by setting, method, curriculum, lived experience, reflection and a learner-driven approach. Barriers to design, implementation and translation into practice were also found to exist.

Practical implications

Most studies used a combination of core learning and group work. Educational modes include mentoring or coaching, reflective practice, immersive learning and people lived experience of exclusion involved in or facilitation thematically centred in trauma-informed informed care, cultural competence, communities of practice and service learning. The aim of these methods was to promote collaboration through identifying shared experiences, problems and tensions and critical reflection of services and organisations. Such transformative learning is reported to challenge stigma, discrimination and misinformation and promote collective empowerment to address social injustice through human connection. Effective models of IPE re-instated the therapeutic relationship and alliances between patients and staff.

Social implications

This review also calls for the development of health and care workers’ professionalism in relation to their own reflexivity, establishing anti-racist curricula, challenge stigma and ensuring clinicians are aware of and able to negotiate tension and difference identified within the consultation and between themselves. Apart from developing generalist skills, this analysis suggests that IPE in IH may be able to challenge stigma and discrimination towards IH groups by destabilising existing norms and siloed working with the aim of achieving robust interprofessional practice.

Originality/value

IPE in IH is a complex activity affected by individual and organisation readiness, setting, experiential, practical and pedagogical factors. Models of teaching are focused on re-instating the therapeutic relationship. There are no systematic reviews in this field and previously there was no settled consensus on the best approaches and learning activities to foster inclusive and collaborative practice.

Details

Journal of Integrated Care, vol. 31 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Content available
Book part
Publication date: 4 June 2021

Abstract

Details

The Emerald International Handbook of Technology-Facilitated Violence and Abuse
Type: Book
ISBN: 978-1-83982-849-2

Article
Publication date: 9 June 2022

Andrea Jimenez, Sara Vannini and Andrew Cox

The aim of this paper is to introduce a holistic decolonial lens for Library and Information Studies (LIS). As such it centres in the following questions: what does decolonisation…

Abstract

Purpose

The aim of this paper is to introduce a holistic decolonial lens for Library and Information Studies (LIS). As such it centres in the following questions: what does decolonisation mean in the context of LIS? How can a holistic approach help improve our understanding of the field?

Design/methodology/approach

This is a conceptual paper that draws on theoretical analysis and discussion with in-depth examination of two cases of librarianship and information for development.

Findings

The paper presents a decolonial framework for interpreting and comprehending LIS-specific issues. As a result, we believe it is critical to recognise three interconnected types of colonial legacies and identify ways in which LIS academics and practitioners can consider these in the context of their research and work.

Research limitations/implications

The paper introduces a holistic framework for thinking about decoloniality in the LIS discipline. Further work should consider how this framework can be useful for other LIS fields.

Practical implications

The framework is of practical significance for LIS academics and practitioners who wish to take a decolonial approach to their research and thinking. We provide questions intended to lead to action.

Originality/value

The paper provides a holistic decolonial approach to critically reflect on research and teaching practices in the context of LIS.

Details

Journal of Documentation, vol. 79 no. 1
Type: Research Article
ISSN: 0022-0418

Keywords

Article
Publication date: 9 May 2022

Leo Appleton and Hazel Hall

The research was undertaken to explore the role of the UK public library as a public sphere and the ways in which this role relates to the epistemic, community and political…

Abstract

Purpose

The research was undertaken to explore the role of the UK public library as a public sphere and the ways in which this role relates to the epistemic, community and political functions of public libraries.

Design/methodology/approach

A longitudinal, multi-location focus group approach was developed and deployed in three phases. Data were collected from 53 active public library users in a total of 24 focus groups conducted in eight different public library services in England and Scotland in 2015–2016 (Phase 1), 2016–17 (Phase 2) and 2017–18 (Phase 3). Data collected were transcribed and coded using NVivo 10- for thematic analysis.

Findings

The public library's role as public sphere aligns closely with its epistemic functions, adding a dimension to information services provision beyond access to “traditional” print and online sources. New information and knowledge emerge through the person-to-person interactions in public library space. Through such exchanges, the community function of public libraries is made evident, notably as a platform for citizens to participate actively in society, including its democratic processes.

Originality/value

Unlike much extant prior work on public library value dominated with accounts of societal and/or economic impact, w hich is frequently based on the analysis of quantitative data, here the fundamental epistemic value of public library services is demonstrated. This research also adds an important perspective to the domain of Information Society Studies where, to date, the place of the public library as public sphere has been treated as peripheral.

Details

Journal of Documentation, vol. 79 no. 1
Type: Research Article
ISSN: 0022-0418

Keywords

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