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1 – 10 of over 121000The chapter explores an overlooked theme across the literature: capturing the experience of childhood family disruption and transitional flux between foster family homes and the…
Abstract
The chapter explores an overlooked theme across the literature: capturing the experience of childhood family disruption and transitional flux between foster family homes and the independent sensemaking into the present of young care-experienced parents. The chapter draws upon research that constructed 20 biographical life story accounts of a diverse sample of foster care-experienced young people. The chapter aims to reflect upon the findings garnered from six of these accounts through extracting the narratives of a selection of participants who were to become or had become parents. This chapter makes sociological connections between past family disruption, demarcating present families of choice, and reconciliation of the past through experiencing parenting into the future within constructed ‘family displays’ (Finch, 2007). The chapter illustrates this phenomenon through narrative accounts offering a family history of parents who have experienced a variance of transitions between family units and who were negotiating, or had negotiated, their post-care independence through the role of becoming a parent themselves. The chapter highlights the symbolic value of parenting to the lives of young people who have experienced care in recalibrating their past familial experiences, as demonstrated through their family displays. Through the family displays of care-experienced parents, the importance of the relational context to youth transition ultimately reveals itself, as does the development of relational agency, and ultimately the role of parenting in developing a young person’s independent ‘post-care’ identity.
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“Let me back into the world” was the heart rending response by an older relative to a question about his wellbeing following a difficult period of illness and hospitalisation. As…
Abstract
Purpose
“Let me back into the world” was the heart rending response by an older relative to a question about his wellbeing following a difficult period of illness and hospitalisation. As his main carer, the author of the paper was struck, when visiting the hospital, by a small poster, on a notice board near to the entrance to the hospital ward, outlining the staff’s commitment to Compassion in Practice. Compassion in Practice was enshrined in the Compassion in Practice vision and strategy (Department of Health, NHS Commissioning Board, 2012) for building a culture of compassionate care across health and social care. A key element of the strategy was to make the values of care, compassion, courage, communication, competence and commitment, real and visible to patients and the public. The purpose of this paper is to seek to compare the values being stated with the care experience.
Design/methodology/approach
This paper records a personal perspective from a patient and their family carers of compassionate care in practice. This experience is one case study and does not seek to represent the experience of other patients and their families.
Findings
This highlights the importance of communication and demonstrates that care and compassion are human emotions and values that have to be lived in practice and are part of the interaction between patient, clinician and family. Simply believing in those core nursing values does not make them real for the patient in practice.
Originality/value
Both patient and the family carers had extensive experience of working in health and social care including the NHS. This account demonstrates the challenges of turning strategy into actions that can ultimately improve the patient experience of care.
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Diane Seddon, Kate Jones and Mari Boyle
This article presents the key findings from a collaborative study about the experiences and support needs of carers whose relatives are admitted into a nursing or residential care…
Abstract
This article presents the key findings from a collaborative study about the experiences and support needs of carers whose relatives are admitted into a nursing or residential care home. Drawing upon data from carers' qualitative accounts, it considers carers' post‐admission roles, responsibilities and profiles, and the contribution carers make to the continued care of their relative. Carers' post‐admission caring experiences are described in detail and differences between spouse carers and carers involved in looking after a parent are identified. A temporal model depicting the complex and dynamic nature of carers' postadmission experiences is presented. The implications for policy and practice are discussed.
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Rebecca Feo, Frank Donnelly, Åsa Muntlin Athlin and Eva Jangland
Globally, acute abdominal pain (AAP) is one of the most common reasons for emergency admissions, yet little is known about how this patient group experiences the delivery of…
Abstract
Purpose
Globally, acute abdominal pain (AAP) is one of the most common reasons for emergency admissions, yet little is known about how this patient group experiences the delivery of fundamental care across the acute care delivery chain. The purpose of this paper is to describe how patients with AAP experienced fundamental care across their acute care presentation, and to explicate the health professional behaviours, reported by patients, that contributed to their positive experiences.
Design/methodology/approach
A qualitative descriptive study, using repeated reflective interviews, was analysed thematically (n=10 patients).
Findings
Two themes were identified: developing genuine, caring relationships with health professionals and being informed about one’s care. Patients reported that health professionals established genuine professional–patient relationships despite the busy care environment but perceived this environment as impeding information-provision. Patients were typically accepting of a lack of information, whereas poor professional–patient relationships were seen as inexcusable.
Practical implications
To provide positive fundamental care experiences for patients with AAP, health professionals should establish caring relationships with patients, such as by using humour, being attentive, and acknowledging patients’ physical pain and emotional distress; and should inform patients about their care, including allowing patients to ask questions and taking time to answer those questions.
Originality/value
This is the first Australian study to explore the experiences of patients with AAP across the acute care delivery chain, using a novel method of repeated interviews, and to demonstrate how fundamental care can be delivered, in clinical practice, to ensure positive patient experiences.
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Lorna de Witt, Kathryn A. Pfaff, Roger Reka and Noeman Ahmad Mirza
Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review…
Abstract
Purpose
Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health careservices?
Design/methodology/approach
The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, Embase, Sociological Abstracts and Abstracts in Social Gerontology that yielded 17 papers eligible for review.
Findings
“There’s always something positive and something negative” is the overarching metaphor for answering the review question. Findings highlight positive and negative tensions within ethnoculturally diverse older adults’ health care use experiences of understanding and being understood, having trust in providers and the health care system, having needs, preferences and resources met and desire for self-care over dependency. The majority of experiences were negative. Tipping points towards negative experiences included language, fear, provider attitudes and behaviours, service flexibility, attitudes towards Western and traditional health care and having knowledge and resources.
Originality/value
The authors propose concrete actions to mitigate the tipping points. The authors discuss policy recommendations for health care system changes at the micro, meso and macro service levels to promote positive experiences and address mainstream service policy inequities.
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Hayley Alderson and Carrie Harrop
When teaching in or around the subject of care-experienced young people, it is important for information to be presented in a way that not only creates an understanding of the…
Abstract
When teaching in or around the subject of care-experienced young people, it is important for information to be presented in a way that not only creates an understanding of the prevalence of care experience but also emphasises the myriad of life challenges associated with experiences of being involved in the care system.
It is known that out of the 12 million children living in England, just under 400,000 (3%) are known to the social care system at any one time and just over 82,000 of these children are ‘looked after’, under the legal guardianship of local authorities in England.
It will not be unusual for students to come to university with little or no exposure to or understanding of children in care, their lives or what it means to be care experienced. Therefore, teaching in this area needs to draw attention to the reasons as to why care experiences result in hardships, this can be done by identifying why care experience is a sensitive subject area. This chapter identifies some (but not all) of the common adversities that care-experienced young people often face inclusive of changes in accommodation and placement instability, insecure relationships, poor mental health, disrupted education, substance misuse, and poverty.
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Angela Burrows, Claire Warner, Jennifer Heath and Saskia Keville
Mental health (MH) and caring can be demanding for those directly and indirectly impacted. An under-researched area is that of professionals’ personal experiences of caring for a…
Abstract
Purpose
Mental health (MH) and caring can be demanding for those directly and indirectly impacted. An under-researched area is that of professionals’ personal experiences of caring for a loved one with MH difficulties. This study aims to provide an in-depth exploration of psychologists’ experiences of caring and its impact on clinical practice.
Design/methodology/approach
A total of 11 psychologists with experiences of caring for a loved one with a diagnosed MH condition and/or MH distress participated in semi-structured interviews focused on caring experiences and its impact. Transcripts were analysed using thematic analysis.
Findings
Themes identified were as follows: personal and professional roles; the emergence of a carer identity; carer stress and strain; impact on professional practice; and dual positioning.
Originality/value
This study highlighted the knowledge and value of listening to professionals with lived experiences. Their ability to understand stigmatisation through personal caring experiences may facilitate the mitigation of this for vulnerable people attending clinical services.
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Oti Amankwah, Weng Wai Choong and Naana Amakie Boakye-Agyeman
With challenges in health-care facilities management (FM) and adequacy of health-care resources constraints in most developing countries, improving patient’s health-care experience…
Abstract
Purpose
With challenges in health-care facilities management (FM) and adequacy of health-care resources constraints in most developing countries, improving patient’s health-care experience has become of strategic importance in public health-care delivery. This paper aims to investigate the mediating effect of adequacy of health-care resources on the relationship between the quality of health-care FM services and patient’s health-care experience.
Design/methodology/approach
This cross-sectional study adopts a quantitative approach based on a questionnaire survey conducted on 660 patients of three teaching hospitals in Ghana. In total, 622 valid questionnaires were used for data analysis using partial least squares structural equation modelling.
Findings
The mediating effect of adequacy of health-care resources on the relationship between responsiveness and tangibility and patients’ health-care experience were supported, while that of empathy, reliability and assurance were not supported. The relationship between and adequacy of health-care resources and patients’ health-care experience was also supported.
Research limitations/implications
The study limitation is that it was only the teaching hospitals that were surveyed. In future studies, a comparative analysis can be conducted between both public and private hospitals. Other constructs and relationships such as the mediating effect of the quality of health-care administrative process on the relationship between FM service quality and patients’ health-care experience as well as the moderation effect of adequacy of health-care resource on the relationship between FM service quality and patients’ health-care experience can also be tested. Future studies on the same subject can use health-care workers as the respondents of the study.
Practical implications
The result should inspire health-care managers to prioritize attention on health-care FM to create and sustain a decent health-care environment. Facilities managers should ensure standards are not compromised by keeping health-care resources in good condition through the organisation and management of resources.
Originality/value
To the best of the authors’ knowledge, this paper is one of the pioneer studies to test the mediating effect of adequacy of health-care resources on the relationship between patient’s health-care experience and health-care FM service quality. The proposed framework can be adapted to various sectors and countries as this empirical validation extends knowledge.
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Anne-Marie Day, Andrew Clark and Neal Hazel
The disproportionate representation in juvenile justice systems of children who are, or have been, in the care of the state is a major cause of concern internationally. However…
Abstract
Purpose
The disproportionate representation in juvenile justice systems of children who are, or have been, in the care of the state is a major cause of concern internationally. However, the experiences of this particular group are largely absent from both policy debates and the international research base. This paper aims to correct that deficit by exploring the lived experiences of residential care, justice-involved children.
Design/methodology/approach
An interpretivist investigation of care experienced children’s perceptions of their experiences, involving semi-structured interviews with a purposive sample of 19 children in England who were simultaneously in residential care and subject to youth justice supervision. Data were analysed using thematic content analysis.
Findings
Care-experienced children described how their experiences of residential care environments and regimes have undermined their sense of how they see themselves, now and looking to the future. Against this background of disrupted identity, they also reported stigmatising interactions with staff that leave them feeling labelled both as a generic “looked-after child” and as a “bad kid”.
Research limitations/implications
The findings are based on the perceptions of a group of children in the criminal justice system, which, although reflecting the experiences of those with negative outcomes, may not be representative of all children in residential care.
Practical implications
The findings have implications for those responsible for the care and development of care-experienced children, as well policymakers concerned with reducing the numbers of care-experienced children in youth justice. Those responsible for the care and development of care-experienced children should consider steps to reduce how factors outlined here disrupt a child’s sense of self and introduce criminogenic labelling and stigma.
Originality/value
Despite a number of studies seeking to understand why the number of care experienced children in the youth justice system is disproportionate, there is very little empirical work that seeks to understand the experiences and perceptions of children currently both in care and the criminal justice system. This paper seeks to correct this deficit, by detailing how children who are both in residential care and subject to youth justice supervision view their care experiences. The implications of this for policy, practice and further research are then explored.
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Sabina De Rosis, Chiara Barchielli, Milena Vainieri and Nicola Bellé
User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on…
Abstract
Purpose
User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery.
Design/methodology/approach
65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables.
Findings
Patients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services.
Research limitations/implications
Different features referring to different nursing models make the difference in producing an excellent user experience with the service.
Practical implications
These findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations.
Originality/value
This is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations.
Highlights
This is one of the first studies on the relationship between provision models of nursing care and patient experience.
Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.
Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.
Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.
This is one of the first studies on the relationship between provision models of nursing care and patient experience.
Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.
Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.
Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.
Details