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As populations are ageing and the global average life expectancy is rising, the provision of care for older people is an increasingly salient issue. This paper aims to focus on family-provided care for older immigrants, examining how older immigrants and care providers experience and construct family caregiving.

Based on interviews with care recipients, family care providers, municipal staff and representatives for migrant organisations in Sweden, this study presents a typology of family caregiving for older immigrants.

The authors found three caregiving types, namely, solely family-provided care and a combination of family care and public care (predominantly one or the other). The decision to select family-provided or publicly-funded care depends on personal and institutional factors.

The paper makes three empirical contributions to the literature on care provision for older immigrants. Firstly, this study provides insights into the structural and personal factors that shape care-giving arrangements for older immigrants. Secondly, this study examines the perspectives of care recipients and care providers on family-provided care. Care expectations differ between both groups and sometimes result in intergenerational disagreement. Thirdly, in terms of institutional support, this study finds that the Swedish state’s notion of individual needs does not match the needs of immigrant elderly and their caregivers. The paper places the care types in a broader discussion about eldercare provision in the Swedish welfare state, which has experienced a decline in publicly funded care services and an increase in family caregiving in the past 30 years. In addition, it addresses questions of dignified ageing from a minority perspective.

People with complex health conditions must often navigate landscapes of uncoordinated public, private and voluntary health-care providers to obtain the care they need. Complex health conditions frequently transcend the scope of typical health-care service systems. The purpose of this paper is to explore and characterize such unique assemblages of actors and services as “user-defined ecosystems”.

Building on literature on customer ecosystems, this paper introduces the concept of the user-defined ecosystem (UDE). Using an abductive approach, the authors apply the concept in an interpretive, qualitative study of ten families with special needs children.

This study uncovers complex UDEs, where families actively combine a broad range of services. These ecosystems are unique for each family and extend beyond the scope of designed service ecosystems. Thus, the families are forced to assume an active, coordinating role.

This paper shows how to identify ecosystems from the user’s point of view, based on the selected user unit (such as a family) and the focal value-creating function of the ecosystem for the user.

This paper highlights how service providers can support and adapt to UDEs and, thus, contribute to user value and well-being. This can be used to understand users’ perspectives on service and systems in health and social care.

This study develops the concept of the UDE, which represents a customer-focused perspective on actor ecosystems and contrasts it with a provider-focused and a distributed perspective on ecosystems. This study demonstrates the practical usefulness of the conceptualization and provides a foundation for further research on the user’s perspective on ecosystems.

The family's role in patient care was greatly altered by Law 180. This law, introduced in Italy in 1978, led to a gradual phasing out of custodial treatment for psychiatric patients. This different mindset, which views the family as an alternative to institutionalization, leads to it being seen as an essential entity in the setting up of community service dynamics. We interviewed health professionals in order to understand obstacles of collaboration between family members and mental health care workers. The goal was to uncover actions that promote collaboration and help build alliances between families and psychiatric workers. Results showed that health professionals view the family as a therapeutic resource. Despite this view, family members were rarely included in patient treatment. The reasons is: the structures have a theoretical orientation of collaboration with the family but, for nurses not are organized a few meeting spaces with family members. Services should create moments, such as multi-family groups or groups of information, managed by nurses and not only by doctors. These occasions it might facilitate the knowledge between professionals and family members.

The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their child with ASD. Parents are the main integrators of long-term educational and healthcare service for their child with ASD.

Design/methodology/approach included (1) a sentiment analysis of discussion forum posts from an autism message board using a rule-based sentiment analysis tool that is specifically attuned to sentiments expressed in social media and (2) a qualitative content analysis of one-on-one interviews with parents of children diagnosed with ASD, complemented with interviews with experienced educators and clinicians.

Findings reveal the link between customized service integration and long-term benefits. Both parents and service providers emphasize the need to integrate healthcare and educational service to create holistic long-term care for a child with ASD. Parents highlight the benefits of varied services, but availability or cost are burdens if the service is not publicly provided, or covered by insurance. Service providers' lack of experience with ASD and people's ignorance of the challenges of ASD are burdens.

Ensuring health outcomes for a child with ASD requires an integrated service system and long-term, customer-centric service process because the scope of service covers the child's entire childhood. Customized educational and healthcare service must be allocated and budgeted early in order to reach the goal of a satisfactory service output for each child.

This is the first service research to focus on parents' challenges with obtaining services for their child with ASD. This paper provides service researchers and managers insight into parents' perceptions of educational and healthcare service value (i.e. benefits vs. burdens) received for their child with ASD. These insights into customer-centric perceptions of value may be useful to research and may help service providers to innovate and provide integrated service directly to parents, or indirectly to service providers, who serve children with ASD.

While studies on service users’ participation and their perceptions on the quality of services exist, agreement between family members’ and practitioners’ assessments of the family’s situation has received less interest. The purpose of this paper is to investigate agreement and its effect on outcomes by comparing the viewpoints of three groups of informants (children, mothers and practitioners) in the context of statutory child protection in two study groups – one applying a systemic approach (SPM) and a service-as-usual control group (SAU).

A quasi-experimental repeated-measures study design was applied. Outcome data comprised 112 cases (SPM cases n = 56 and SAU cases n = 56) at three sites. Data was collected from all participants at baseline and six months later.

First, practitioners’ analyses of a child’s need for protection did not meet family members’ expressed need for help. Second, child–mother agreement on the need for service intervention at T1 predicted a decrease in practitioner-assessed abuse or neglect from T1 to T2. In this sample, no differences were found between the two groups.

This study highlights the importance of making explicit the viewpoints of children, parents and practitioners in casework and research to improve understanding of how their perspectives differ over the course of the process and how possible initial disagreements affect outcomes.

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.

Secondary customers often experience secondary vulnerabilities that manifest in family-centred transformative services as other- and self-related customer needs. Yet, a relational perspective on primary and secondary customers’ needs is lacking. The study analyses secondary customers’ needs and their relationship to primary customers’ needs to enhance well-being in customer entities. The service inclusion lens is used to understand customers’ experiences of vulnerability.

The study uses an exploratory approach. The data consists of ethnographic observations and interviews of elderly residents (primary customers), their family members (secondary customers) and nurses in two nursing homes.

Primary and secondary customers’ needs are interrelated (or unrelated) in four ways: they are separate, congruent, intertwined or discrepant. The vulnerability experiences fluctuate in intensity and over time, individually reflecting on these need dimensions.

The study contributes to service research concerning customers’ experiences of vulnerability, secondary customers and their inclusion in services. Primary customers’ service inclusion may increase/decrease secondary customers’ service inclusion and their experience of vulnerability. Moreover, secondary customers’ inclusion is often necessary to foster primary customers’ inclusion and well-being.

Fostering service inclusion and well-being for primary and secondary customers requires balanced inclusion and acknowledging the needs of both groups. Service providers may need to act as moderators within customer entities if discrepant needs occur.

The study addresses the under-researched areas of family members’ customer needs, their relation to primary customers’ needs, experiences of secondary vulnerability and context-related vulnerability.

The aim of this paper is to describe and detail a new workforce initiative developed by a third sector organisation: the Multi-Modality Practitioner (MMP) approach, in the provision of support for individuals and families presenting in the community with multiple and varied needs.

This paper presents a case study on a third sector organisation’s pioneering workforce initiative – the MMP approach.

The MMP approach has been developed as an alternative to existing approaches designed to address “single issues”, providing those working in the fields of health and social care and beyond, with a range of technically eclectic interventions from different modalities and approaches, to enable them to appropriately meet the needs of individuals and families presenting with multiple needs.

This case study is limited to providing a rationale for the development of the MMP approach and a description. It does not include any formal analysis as a future evaluative paper will report on an independent theory-based examination of the MMP approach via Theory of Change and Contribution Analysis methodologies.

This case study describes the innovative role that the MMP approach as a workforce innovation plays in meeting multiple needs in the community when deployed as either a stand-alone approach, or one that can be integrated with existing community-based services including, but not limited to, mental health, employability, addiction, housing, homelessness, public health and child and family services.

The MMP approach constitutes a disruptive, pionneering, client-centred, workplace innovation that is trauma-informed, relational, strengths-based and continuity of care focused, capable of supporting individuals and families with multiple needs, negating onward referral and with potential to reduce demand on public services. It also provides those working in a range of health and social care roles with the opportunity to expand their therapeutic repertoire through high-quality, multi-skilled training in evidence-based and societally important, technically eclectic interventions drawn from a range of modalities.

Pluralistic practice and multimodal theories have been in existence for over two decades, the MMP approach however, whilst sharing some of these concepts and philosophies, differs in that it provides those trained in the approach with a ‘toolkit’ of interventions that are technically eclectic, drawn from a range of modalities and approaches and aimed at meeting multiple needs in a pragmatic and accessible manner. Furthermore, the Diploma in Multi-Modality Practice is the first training course of its kind available at postgraduate level.

Indonesia subscribes to rights-based principles of family planning. However, a chasm between principles and practice has long been noted on a global basis, and progress has not been well-documented. This paper aims to assess the extent to which the Indonesian national family planning program has evolved in a manner that is consistent with rights-based principles.

The primary source of data was five Indonesian Demographic Health Surveys undertaken from 1997 to 2017. The analyses were organized around three major categories of family planning-related human rights. Trend analysis and logistic regression were used in analyzing the data.

Indonesian women have considerable autonomy in family planning decision, reporting that family planning decisions were mainly made by themselves or jointly with their spouse. Although contraceptive method awareness and demand for family planning are high, Indonesia fares poorly with regard to informed choice in contraceptive method selection. Access to family planning services is comparatively high as judged by contraceptive prevalence, family planning demand satisfaction and unmet need for family planning. However, significant geographic and socioeconomic inequity were observed on many indicators, with eastern Indonesian provinces consistently lagging behind.

This paper focuses on married couple, as Indonesia has a restrictive policy to limiting access and information of family planning for other groups, unmarried youth in particular.

This paper makes an important contribution to document how effectively the prohuman rights policy orientation toward family planning has been translated into services.

Family violence is a significant social and public health problem. In 2015 a Royal Commission into Family Violence was established in Victoria, Australia, following a number of family violence deaths that received a high coverage in the media. The commission findings were released in 2016. These emphasised the significant physical and psychological harm that is caused by family violence, and that this has wide ranging community impacts. Among the Commission's 227 recommendations a number pertained specifically to improving the response of the healthcare system, with a whole-of-hospital model for responding to family violence recommend-ed for all public hospitals.

Royal Melbourne Hospital (RMH) received a state government grant as part of the SHRFV project. RMH was formally partnered with Tweddle Child and Family Health Service and Dental Health Services Victoria, and also worked with associated service NorthWestern Mental Health, as part of the project. This document outlines the RMH Family Violence Training Framework, a whole-of-hospital transformation change project designed to implement Recommendation 95 from the Royal Commission. All funded services were encouraged to adapt the SHRFV project model to suit the local environment of their health service. This document outlines the RMH approach. RMH specifically focused on using an evidence based research and evaluation framework with a focus on in-depth training, underpinned by a clinical champions network.