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Article
Publication date: 11 July 2023

Gina Myers and Christopher Kowal

Violence toward frontline health-care workers (HCWs) from patients and visitors is a pervasive issue that ranges from verbal and psychological abuse to physical assault. The…

Abstract

Purpose

Violence toward frontline health-care workers (HCWs) from patients and visitors is a pervasive issue that ranges from verbal and psychological abuse to physical assault. The emergence of the COVID-19 pandemic has led to increased reports of escalated verbal workplace aggressions (VWPAs); however, most studies have been conducted internationally. Studies based in the USA have focused on physical violence experienced by nurses and paramedics in emergency situations. The purpose of this study is to learn about the experiences of different levels of frontline HCWs with VWPA from patients and visitors and discover ways to address this issue.

Design/methodology/approach

This qualitative descriptive study asked registered nurses, licensed practical nurses and patient care technicians from one health-care system about their experiences with patient and visitor VWPA using an anonymous, voluntary open-ended survey and in-person interviews. In all, 31 participants completed the survey and 2 were interviewed. Data were analyzed using content analysis.

Findings

Three themes emerged from the data: the experience, moving through and moving forward. Frontline HCWs described experiences of VWPA, indicating its forms, frequency and conditions. They used coping, along with personal and professional measures, to manage and move through the situation. Moving forward was captured as suggestions for the future and conveyed hope for a perfect state.

Originality/value

The experiences of frontline HCWs offered insight into how they perceive and cope with difficult encounters. Recommendations relate to not only implementing interventions that support frontline HCWs but also creating a culture where aggression is not tolerated and addressing perpetrator behavior is a priority.

Details

Journal of Aggression, Conflict and Peace Research, vol. 16 no. 2
Type: Research Article
ISSN: 1759-6599

Keywords

Article
Publication date: 2 May 2024

Sophie Wood, Annie Williams, Nell Warner, Helen Ruth Hodges, Aimee Cummings and Donald Forrester

Secure children’s homes (SCHs) restrict the liberty of young people considered to be a danger to themselves or others. However, not all young people referred to SCHs find a…

Abstract

Purpose

Secure children’s homes (SCHs) restrict the liberty of young people considered to be a danger to themselves or others. However, not all young people referred to SCHs find a placement, and little is known about the outcomes of the young person after an SCH or alternative placement. The purpose of this paper is to understand which characteristics most likely predict allocation to an SCH placement, and to explore the outcomes of the young people in the year after referral.

Design/methodology/approach

A retrospective electronic cohort study was conducted using linked social care data sets in England. The study population was all young people from England referred to SCHs for welfare reasons between 1st October 2016 to 31st March 2018 (n = 527). Logistic regression tested for differences in characteristics of SCH placement allocation and outcomes in the year after referral.

Findings

In total, 60% of young people referred to an SCH were allocated a place. Factors predicting successful or unsuccessful SCH allocation were previous placement in an SCH (OR = 2.12, p = 0.01); being female (OR = 2.26, p = 0.001); older age (OR = 0.75, p = 0.001); and a history of challenging behaviour (OR = 0.34, p = 0.01). In the year after referral, there were little differences in outcomes between young people placed in a SCH versus alternative accommodation.

Originality/value

The study raised concerns about the capacity of current services to recognise and meet the needs of this complex and vulnerable group of young people and highlights the necessity to explore and evaluate alternatives to SCHs.

Details

Journal of Children's Services, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1746-6660

Keywords

Article
Publication date: 29 March 2024

Anup Kumar

The COVID-19 outbreak reached a critical stage when it became imperative for public health systems to act decisively and design potential behavioral operational strategies aimed…

Abstract

Purpose

The COVID-19 outbreak reached a critical stage when it became imperative for public health systems to act decisively and design potential behavioral operational strategies aimed at containing the pandemic. Isolation through social distancing played a key role in achieving this objective. This research study examines the factors affecting the intention of individuals toward social distancing in India.

Design/methodology/approach

A correlation study was conducted on residents from across Indian states (N = 499). Online questionnaires were floated, consisting of health belief model and theory of planned behavior model, with respect to social distancing behavior initially. Finally, structural equation modeling was used to test the hypotheses.

Findings

The results show that perceived susceptibility (PS), facilitating conditions (FC) and subjective norms are the major predictors of attitude toward social distancing, with the effect size of 0.277, 0.132 and 0.551, respectively. The result also confirms that the attitude toward social distancing, perceived usefulness of social distancing and subjective norms significantly predict the Intention of individuals to use social distancing with the effect size of 0.355, 0.197 and 0.385, respectively. The nonsignificant association of PS with social distancing intention (IN) (H1b) is rendering the fact that attitude (AT) mediates the relationship between PS and IN; similarly, the nonsignificant association of FC with IN (H5) renders the fact that AT mediates the relationship between FC and IN.

Practical implications

The results of the study are helpful to policymakers to handle operations management of nudges like social distancing.

Originality/value

The research is one of its kind that explores the behavioral aspects of handling social nudges through FC.

Details

Journal of Facilities Management , vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1472-5967

Keywords

Open Access
Article
Publication date: 12 February 2024

Anna-Leena Kurki, Elina Weiste, Hanna Toiviainen, Sari Käpykangas and Hilkka Ylisassi

The involvement of clients in service encounters and service development has become a central principle for contemporary health and social care organizations. However, in…

Abstract

Purpose

The involvement of clients in service encounters and service development has become a central principle for contemporary health and social care organizations. However, in day-to-day work settings, the shift toward client involvement is still in progress. We examined how health and social care professionals, together with clients and managers, co-develop their conceptions of client involvement and search for practical ways in which to implement these in organizational service processes.

Design/methodology/approach

The empirical case of this study was a developmental intervention, the client involvement workshop, conducted in a Finnish municipal social and welfare center. The cultural-historical activity theory (CHAT) framework was used to analyze the development of client involvement ideas and the modes of interaction during the intervention.

Findings

Analysis of the collective discussion revealed that the conceptions of client involvement developed through two interconnected object-orientations: Enabling client involvement in service encounters and promoting client involvement in the service system. The predominant mode of interaction in the collective discussion was that of “coordination.” The clients' perspective and contributions were central aspects in the turning points from coordination to cooperation; professionals crossed organizational boundaries, and together with clients, constructed a new client involvement-based object. This suggests that client participation plays an important role in the development of services.

Originality/value

The CHAT-based examination of the modes of interaction clarifies the potential of co-developing client-involvement-based services and highlights the importance of clients' participation in co-development.

Details

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

Keywords

Book part
Publication date: 30 April 2024

Kimberly M. Baker

This study is a radical interactionist analysis of family conflict. Drawing on both a negotiated order perspective and Athen's theory of complex dominative encounters, this study…

Abstract

This study is a radical interactionist analysis of family conflict. Drawing on both a negotiated order perspective and Athen's theory of complex dominative encounters, this study analyzes the role that domination plays in conflicts among intimates. As the family engages in repeated conflicts over roles, the family also engages in negotiations over the family order, what role each party should play, interpretations of past events, and plans for the future. These conflicts take place against a backdrop of patriarchy that asymmetrically distributes power in the family to determine the family order. The data from this study come from a content analysis of mothers with substance use problems as depicted in the reality television show Intervention. The conflicts in these families reveal that these families develop a grinding family order in which families engaged in repeated conflict but also continued to operate as and identify as a family. These conflicts are shaped by and reinforce patriarchal expectations that mothers are central to family operation. The intervention at the end of each episode offered an opportunity for the family to engage in a concerted campaign to try to force the mother into treatment and reestablish the family order.

Abstract

Purpose

This study aims to evaluate and summarize the effectiveness of cognitive behavioral therapy (CBT) and internet-based CBT (ICBT) interventions on relapse prevention and severity of symptoms among individuals with major depressive disorder (MDD). CBT is one of the most used and suggested interventions to manage MDD, whereas ICBT is a novel effective proposed approach.

Design/methodology/approach

The review was conducted following the preferred reporting items for systematic review and meta-analysis protocol. A comprehensive and extensive search was performed to identify and evaluate the relevant studies about the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD.

Findings

A total of eight research studies met the inclusion criteria and were included in this systematic review. RCT studies were conducted to assess and evaluate the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD. It has been found that CBT is a well-supported and evidently based effective psychotherapy for managing depressive symptoms and reducing the relapse and readmission rate among patients diagnosed with MDD. The ICBT demonstrated greater improvements in depressive symptoms during major depressive episodes among patients with MDDS. The ICBT program had good acceptability and satisfaction among participants in different countries.

Research limitations/implications

Despite the significant findings from this systematic review, certain limitations should be acknowledged. First, it is important to note that all the studies included in this review were exclusively conducted in the English language, potentially limiting the generalizability of the findings to non-English speaking populations. Second, the number of research studies incorporated in this systematic review was relatively limited, which may have resulted in a narrower scope of analysis. Finally, a few studies within the selected research had small sample sizes, which could potentially impact the precision and reliability of the overall conclusions drawn from this review. The authors recommend that nurses working in psychiatric units should use CBT interventions with patients with MDD.

Practical implications

This paper, a review of the literature gives an overview of CBT and ICBT interventions to reduce the severity of depressive symptoms and prevent patients’ relapse and rehospitalization and shows that CBT interventions are effective on relapse prevention among patients with MDD. In addition, there is still no standardized protocol to apply the CBT intervention in the scope of reducing the severity of depressive symptoms and preventing depression relapse among patients with major depressive disorder. Further research is needed to confirm the findings of this review. Future research is also needed to find out the most effective form and contents of CBT and ICBT interventions for MDD.

Social implications

CBT is a psychological intervention that has been recommended by the literature for the treatment of major depressive disorder (MDD). It is a widely recognized and accepted approach that combines cognitive and behavioral techniques to assist individuals overcome their depressive symptoms and improve their overall mental well-being. This would speculate that effectiveness associated with several aspects and combinations of different approaches in CBT interventions and the impact of different delivery models are essential for clinical practice and appropriate selection of the interventional combinations.

Originality/value

This systematic review focuses on the various studies that explore the effectiveness of face-to-face CBT and ICBT in reducing depressive symptoms among patients with major depressive disorder. These studies were conducted in different countries such as Iran, Australia, Pennsylvania and the USA.

Details

Mental Health and Social Inclusion, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2042-8308

Keywords

Article
Publication date: 16 April 2024

Adam Clifford and Deena Camps

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Details

Advances in Autism, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-3868

Keywords

Open Access
Article
Publication date: 16 April 2024

Axel Wolf, Annette Erichsen Andersson, Ewa Wikström and Fredrik Bååthe

Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the…

Abstract

Purpose

Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.

Design/methodology/approach

Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.

Findings

The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.

Originality/value

There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.

Article
Publication date: 18 March 2024

A.J. Faas and Jhaid Parreno

The purpose of this study is to identify LGBTQ+ perceptions of and experiences with hazards, vulnerabilities and disasters in the San Francisco Bay Area in the USA and to…

Abstract

Purpose

The purpose of this study is to identify LGBTQ+ perceptions of and experiences with hazards, vulnerabilities and disasters in the San Francisco Bay Area in the USA and to co-develop applied projects to “queer” disaster knowledge production and risk reduction activities in the region.

Design/methodology/approach

This is a community science project in which we collaborate with community members to enhance both community and scientific knowledge with the goal of utilizing it to produce a positive change to pressing social issues and their underlying causes. We do this through a series of four focus group workshops to identify community priorities, hazards, vulnerabilities and local action. We follow this with further ethnographic research and projects to apply findings from phase one.

Findings

The authors have found that: LGBTQ+ people in the Bay Area have unique experiences with hazards, vulnerabilities and disasters; there are significant gaps in the representation of LGBTQ+ hazard exposure in local scientific models that we can address through alternative methodologies; and tabletop exercises, learning modules and podcasts help orient and train disaster response agencies and personnel on LGBTQ+ inclusive operations.

Originality/value

This initiative entails novel approaches to community science for disaster risk reduction and creative collaboration with community-based organizations to foster the development of LGBTQ+ inclusive disaster risk reduction and response.

Details

Disaster Prevention and Management: An International Journal, vol. 33 no. 2
Type: Research Article
ISSN: 0965-3562

Keywords

Book part
Publication date: 5 April 2024

Zhichao Wang and Valentin Zelenyuk

Estimation of (in)efficiency became a popular practice that witnessed applications in virtually any sector of the economy over the last few decades. Many different models were…

Abstract

Estimation of (in)efficiency became a popular practice that witnessed applications in virtually any sector of the economy over the last few decades. Many different models were deployed for such endeavors, with Stochastic Frontier Analysis (SFA) models dominating the econometric literature. Among the most popular variants of SFA are Aigner, Lovell, and Schmidt (1977), which launched the literature, and Kumbhakar, Ghosh, and McGuckin (1991), which pioneered the branch taking account of the (in)efficiency term via the so-called environmental variables or determinants of inefficiency. Focusing on these two prominent approaches in SFA, the goal of this chapter is to try to understand the production inefficiency of public hospitals in Queensland. While doing so, a recognized yet often overlooked phenomenon emerges where possible dramatic differences (and consequently very different policy implications) can be derived from different models, even within one paradigm of SFA models. This emphasizes the importance of exploring many alternative models, and scrutinizing their assumptions, before drawing policy implications, especially when such implications may substantially affect people’s lives, as is the case in the hospital sector.

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