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Article
Publication date: 28 August 2024

Isabelle Latham, Dawn Brooker and Kay de Vries

This paper describes a model of “Learning to care” derived from a study exploring how care workers in care homes learn to care for people living with dementia. The “Learning to…

Abstract

Purpose

This paper describes a model of “Learning to care” derived from a study exploring how care workers in care homes learn to care for people living with dementia. The “Learning to care” model is primarily informal in nature in which influences such as formalised training and organisational culture impact care outcomes indirectly rather than directly.

Design/methodology/approach

This study used a focused, critical ethnographic approach in two care homes in England resulting in 63 h of observation of care of people living with advanced dementia, 15 semi-structured interviews and 90 in-situ ethnographic interviews with care staff.

Findings

The findings reveal a three-level model of learning to care. At the level of day-to-day interactions is a mechanism for learning that is wholly informal and follows the maxim “What Works is What Matters”. Workers draw on resources and information within this process derived from their personal experiences, resident influences and care home cultural knowledge. Cultural knowledge is created through a worker’s interactions with colleagues and the training they receive, meaning that these organisational level influences affect care practice only indirectly via the “What Works is What Matters” mechanism.

Originality/value

This study makes an original contribution by explaining the nature of day-to-day informal learning processes as experienced by care workers and those living with dementia in care homes. In particular, it illuminates the specific mechanisms by which organisational culture has an effect on care practice and the limitations of formal training in influencing such practice.

Details

Journal of Workplace Learning, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1366-5626

Keywords

Open Access
Article
Publication date: 24 January 2024

Bonnie Poksinska and Malin Wiger

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a…

Abstract

Purpose

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

Design/methodology/approach

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

Findings

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

Practical implications

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

Originality/value

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 16 August 2024

Tiffany Cheng Han Leung, Robin Stanley Snell and Daisy Lee

We identify lessons from a project sponsored by a large charitable trust, which sought to build capability for end-of-life (EOL) care in Hong Kong through interdisciplinary and…

Abstract

Purpose

We identify lessons from a project sponsored by a large charitable trust, which sought to build capability for end-of-life (EOL) care in Hong Kong through interdisciplinary and multi-agency collaboration.

Design/methodology/approach

An in-depth case study drawing on 21 in-depth interviews with diverse stakeholders was conducted. Lyman et al.’s (2018) model of organisational learning (OL) in healthcare settings was applied to analyse the relative emphasis on particular contextual factors and mechanisms, and to identify outcomes perceived to have been achieved.

Findings

Infrastructure such as materials for assessment and education received the most emphasis among the contextual factors and deliberate learning such as training sessions received the greatest attention among the mechanisms. While perceptions indicated that desired outcomes were being achieved in terms of social impact, there were relatively few mentions of “soft” factors such as enhanced motivation, leadership or OL skills among staff.

Originality/value

This study extends the literature on how to create valuable social impact through OL. While prior studies have examined social impact in terms of solutions for social and environmental problems, ours is one of the few that examines how improvements are made to organisations’ capability to deliver such impacts in the context of healthcare.

Details

Journal of Health Organization and Management, vol. 38 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 25 July 2024

Märt Vesinurm, Inka Sylgren, Annika Bengts, Paulus Torkki and Paul Lillrank

This article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and…

Abstract

Purpose

This article aims to clarify the concepts used to understand, analyze and improve a patient’s progress through a health service system. A patient pathway describes plans and intentions. Within it, we distinguish between the clinical pathway of decisions and interventions and the care pathway of supportive activities. As a patient pathway is implemented, it turns into a patient journey of what is done, what happens to a patient’s medical condition and what is experienced and felt. We introduce “patient journey disruption” (PJD) as a concept describing the events that need to be prevented from happening to accomplish integrated, coordinated and seamless care.

Design/methodology/approach

The method used in this paper is concept analysis. First, an expert steering group worked to refine the concept of PJDs; second, an analysis of similar concepts from related fields was done to root the concept into existing theories, and third, semi-structured interviews with professionals and patients were done to test the concept of PJDs in the home care context.

Findings

PJDs are agency-based harmful events in the execution of the care pathway that deviate the patient journey from what can be reasonably expected. PJDs are management failures, which is why they should be studied by healthcare operations management (HOM) and service science scholars with the intention to find ways to prevent them from happening.

Research limitations/implications

This study has limitations, including presenting conceptual ideas and preliminary results that are only indicative.

Practical implications

We believe that the introduction of the concept of PJDs into the literature provides a new, systematic way of approaching the different shortcomings in our healthcare production systems. Moreover, by systematically identifying different PJDs, interventions can be designed and targeted more appropriately.

Originality/value

Managerial challenges regarding healthcare processes have been studied but have not been well defined. The concept of PJDs is an original, well-thought-out definition.

Article
Publication date: 16 September 2024

Ricardo Manuel Da Costa Melo, Eunice Cristina Ribeiro Lopes, José Luis Coelho Vilas Boas, Lúcia Batista Santos, Sandra Cristina Ferreira Amaro, João Miguel Almeida Ventura-Silva and Isabel de Jesus Oliveira

The impact of dependence on self-care on people’s lives is very significant, with consequences for the person and their caregivers. The purpose of this study is to map the…

Abstract

Purpose

The impact of dependence on self-care on people’s lives is very significant, with consequences for the person and their caregivers. The purpose of this study is to map the evidence on the factors that influence the empowerment of the person dependent on self-care on returning home.

Design/methodology/approach

Scoping review according to the criteria proposed by the Joanna Briggs Institute: population (people with a dependence on self-care), concept (factors that influence training) and context (return home after hospitalization in a medical-surgical context). The research was carried out from March 1 to April 30, 2022, in the databases CINAHL and MEDLINE (via EBSCO), Scielo, LILACS, Cuiden and MedicLatina; Gray literature searched RCAAP, DART-Europe and OpenGrey. Studies published in Portuguese, Spanish and English were included, with no time limit.

Findings

One hundred and eighty-one articles were obtained, which, after analysis according to the criteria, resulted in seven studies included for review, ranging from 2007 to 2021, with a level of evidence between 2. c and 4. a (according to Joanna Briggs Institute), and two thematic areas/four categories emerging.

Research limitations/implications

The need for information and training, the relationship and proximity with the health-care team, the design of nursing care targeted at the person’s level of dependence, education, gender, type of surgical intervention and postoperative period, physical space and lack of privacy and audiovisual media.

Originality/value

The perception of these factors proves to be important in the person’s training process, with the nurse’s role being highlighted due to their emphasis on the transition home.

Details

Working with Older People, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1366-3666

Keywords

Book part
Publication date: 3 October 2024

Nancy Côté, Jean-Louis Denis, Steven Therrien and Flavia Sofia Ciafre

This chapter focuses on the COVID-19 pandemic’s impact on the recognition through discourses of essentiality, of low-status workers and more specifically of care aides as an…

Abstract

This chapter focuses on the COVID-19 pandemic’s impact on the recognition through discourses of essentiality, of low-status workers and more specifically of care aides as an occupational group that performs society’s ‘dirty work’. The pandemic appears as a privileged moment to challenge the normative hegemony of how work is valued within society. However, public recognition through political discourse is a necessary but insufficient element in producing social change. Based on the theory of performativity, this chapter empirically probes conditions and mechanisms that enable a transition from discourse of essentiality to substantive recognition of the work performed by care aides in healthcare organizations. The authors rely on three main sources of data: scientific-scholarly works, documents from government, various associations and unions, and popular media reports published between February 2020 and 1 July 2022. While discourse of essentiality at the highest level of politics is associated with rapid policy response to value the work of care aides, it is embedded in a system structure and culture that restrains the establishment of substantive policy that recognizes the nature, complexity, and societal importance of care aide work. The chapter contributes to the literature on performativity by demonstrating the importance of the institutionalization of competing logics in contemporary health and social care systems and how it limits the effectiveness of discourse in promulgating new values and norms and engineering social change.

Details

Essentiality of Work
Type: Book
ISBN: 978-1-83608-149-4

Keywords

Article
Publication date: 27 August 2024

Gang Sheng, Huabin Wu and Xiangdong Xu

The implementation of the digital economy has had a considerable influence on the manufacturing industry, and this paper aims to address the important issues of how to capture the…

Abstract

Purpose

The implementation of the digital economy has had a considerable influence on the manufacturing industry, and this paper aims to address the important issues of how to capture the opportunities presented by digital innovation and promote the transformation and upgrading of the manufacturing industry, as well as the improvement of quality and efficiency.

Design/methodology/approach

Using panel data from 30 Chinese provinces and cities between 2010 and 2021, this study establishes the panel vector autoregression (PVAR) model and uses impulse response function analysis to evaluate the influence of the digital economy on the high-quality transformation and upgrading of China's small home appliance industry across five dimensions under the digital economy.

Findings

The development of digital infrastructure has not demonstrated a noteworthy capacity for advancing the transformation and upgrading of the small home appliance industry. Furthermore, digital industrialization has exerted a minimal restraining influence on this process. Nevertheless, digital governance has consistently exhibited a substantial impact on facilitating the transformation and upgrading of the small home appliance industry. While both industrial digitization and digital innovation hold significant potential for promoting the transformation and upgrading of the small home appliance industry, their sustainability remains limited.

Practical implications

The organization should logically join independent innovation and open innovation, construct an industrial ecosystem for the profound convergence of the digital economy and compact household appliances, use digital-wise science and technology to empower the establishment of brand effects, strengthen the portrayal of the digital standard framework for the intelligent compact household appliance industry, advance the development of a public stage for computerized administrations in the compact household appliance industry and develop a strategy ecosystem for computerized assets in the compact household appliance industry.

Originality/value

This study offers systematic evidence of the relationship between the digital economy and the development of the small home appliance industry. The results of this research contribute to the literature on the impact of the digital economy on the manufacturing sector and provide a logical explanation for the transformation and upgrading of the small home appliance industry within the context of the digital economy.

Details

Chinese Management Studies, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1750-614X

Keywords

Open Access
Article
Publication date: 2 April 2024

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.

Details

Journal of Integrated Care, vol. 32 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 6 October 2023

Asem Abdalrahim, Mohammad Suliman, Mohammed ALBashtawy, Abdullah Alkhawaldeh and Wafa'a Ta'an

This paper aims to explore examine the therapeutic potential of head-mounted display (HMD)-based Virtual Reality Relaxation Therapy (VRRT) sessions for people individuals with…

Abstract

Purpose

This paper aims to explore examine the therapeutic potential of head-mounted display (HMD)-based Virtual Reality Relaxation Therapy (VRRT) sessions for people individuals with dementia in Jordan.

Design/methodology/approach

This cross-sectional survey recruited 75 dementia-diagnosed elderly individuals from three Jordanian care homes. A VRRT intervention comprising 10 tailored RT sessions held over the course of five weeks was administered to the participants. Apathy, cognitive performance, anxiety and depression were evaluated before and after the intervention to determine any changes. The Person-Environment Apathy Rating Scale's (PEARS) Arabic translation's validity and reliability were also evaluated.

Findings

The VRRT intervention yielded noteworthy results in reducing apathy, as indicated by a substantial decrease in PEARS scores from 17.20 to 11.15. The findings of the study revealed that the participants demonstrated enhanced cognitive abilities, as evidenced by a significant rise in their Saint Louis University Mental Status ratings, which increased from 15.11 to 19.70. The levels of anxiety and depression exhibited a significant decrease subsequent to the implementation of VRRT, with anxiety levels decreasing from 13.66 to 8.23 and depression levels decreasing from 13.62 to 9.33. Furthermore, a notable 70% of participants demonstrated statistically significant decreases in indifference.

Practical implications

This study makes a significant contribution to the advancement of innovative treatment approaches aimed at addressing the needs of the aging population, hence enhancing health outcomes and raising the quality of care in Jordan.

Originality/value

The effectiveness of VRRT in reducing apathy among Jordanian senior citizens residing in nursing homes has not yet been fully investigated. Therefore, this paper seeks to assess the effectiveness of HMD-based VRRT by conducting pre- and post-intervention evaluations. This research aims to provide valuable insights into the applicability and significance of VRRT in the Jordanian context, contributing to the development of culturally appropriate and cutting-edge therapeutic interventions for older individuals in Jordan. Through this study, the authors aim to promote improved health and elevated standards of care for this population.

Details

Working with Older People, vol. 28 no. 3
Type: Research Article
ISSN: 1366-3666

Keywords

Book part
Publication date: 3 October 2024

Annie J. Murphy

This study examines the construction of essential labour during the early months of the COVID-19 pandemic in the United States. Research questions include: (1) How have government…

Abstract

This study examines the construction of essential labour during the early months of the COVID-19 pandemic in the United States. Research questions include: (1) How have government policies shaped designations of essential versus non-essential labour? (2) What are the consequences of these designations for essential workers? To address these questions, the author employs a case study of custodial services employees at Prairie University, a large public university in a major Texas city (Prairietown). The author begins with an examination of federal, state, and municipal guidelines about COVID-19 safety and critical infrastructure in order to understand the policy landscape within which custodial employees at Prairie University were formally deemed essential. Drawing on theories of non-nurturant care work, the author shows how government guidelines for essential work released during the early period of the COVID-19 pandemic discursively invisibilized cleaning labourers. The author then demonstrates how this invisibilization contributed to Prairie University custodial services staff members’ exposure to COVID-19. The author concludes by considering the implications of the findings for future research on care work and the construction of essential labour.

Details

Essentiality of Work
Type: Book
ISBN: 978-1-83608-149-4

Keywords

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