Search results
1 – 10 of 104Patients with autism spectrum disorder (ASD) present with specific assessment, specific difficulties, needs and therapeutic issues and therefore are a challenging group for…
Abstract
Purpose
Patients with autism spectrum disorder (ASD) present with specific assessment, specific difficulties, needs and therapeutic issues and therefore are a challenging group for forensic services. Given the challenge that individuals with ASD present to forensic services, the suggested increase in the number of this group within this setting and the relatively little amount of research which suggests they face a number of difficulties within the prison environment, the purpose of this paper is to identify and review all the studies which have been carried out investigating any aspect of ASD in relation to secure hospital settings.
Design/methodology/approach
Seven internet-based bibliographic databases were used for the present review. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.
Findings
A total of 12 studies were included in this review; 3 looked at the prevalence of ASD in secure psychiatric hospitals. One study evaluated the clinical utility of the AQ screening tool to assess self-reported autistic traits in secure psychiatric settings. Three explored any type of characteristics of patients with ASD detained in secure psychiatric hospitals. One study investigated the experiences or quality of life of patients with an ASD detained in secure psychiatric care. Two studies investigated awareness, knowledge and/or views regarding patients with ASD held by staff working within secure psychiatric hospitals. Lastly, three studies (one of which was also included in the prevalence category above) looked at the effectiveness of interventions or treatment of patients with ASD in secure psychiatric hospitals. Clinical recommendations and future research directions are discussed.
Originality/value
To the author’s knowledge, this is the first review to explore what research has been carried out looking specifically at patients with ASD in relation to secure forensic settings.
Details
Keywords
Lisa Wood, Nicholas J.R. Wood, Shannen Vallesi, Amanda Stafford, Andrew Davies and Craig Cumming
Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting…
Abstract
Purpose
Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting people to safe and secure housing needs to be part of the health system response. The paper aims to discuss these issues.
Design/methodology/approach
This mixed-methods paper presents emerging findings from the collaboration between an inner city hospital, a specialist homeless medicine GP service and Western Australia’s inaugural Housing First collective impact project (50 Lives 50 Homes) in Perth. This paper draws on data from hospitals, homelessness community services and general practice.
Findings
This collaboration has facilitated hospital identification and referral of vulnerable rough sleepers to the Housing First project, and connected those housed to a GP and after hours nursing support. For a cohort (n=44) housed now for at least 12 months, significant reductions in hospital use and associated costs were observed.
Research limitations/implications
While the observed reductions in hospital use in the year following housing are based on a small cohort, this data and the case studies presented demonstrate the power of care coordinated across hospital and community in this complex cohort.
Practical implications
This model of collaboration between a hospital and a Housing First project can not only improve discharge outcomes and re-admission in the shorter term, but can also contribute to ending homelessness which is itself, a social determinant of poor health.
Originality/value
Coordinated care between hospitals and programmes to house people who are homeless can significantly reduce hospital use and healthcare costs, and provides hospitals with the opportunity to contribute to more systemic solutions to ending homelessness.
Details
Keywords
Sofie Østergaard Jaspers, Dorte Raaby Andersen, Iben Louise Karlsen, Lars Peter Sønderbo Andersen, Paul Maurice Conway, Johnny Dyreborg and Birgit Aust
Work-related violence is a major occupational safety and health (OSH) issue. According to the concept of violence prevention climate, managers play a pivotal role in preventing…
Abstract
Purpose
Work-related violence is a major occupational safety and health (OSH) issue. According to the concept of violence prevention climate, managers play a pivotal role in preventing the risk of violence at work. However, research on this is scarce. The objective of this study was, therefore, to examine line managers' use of violence preventive practices in high-risk sectors.
Design/methodology/approach
The authors employed three different sources of data (semi-structured interviews and field notes from both leadership seminars and coaching sessions) that were collected in the context of an intervention study in Denmark aimed at improving violence prevention. The authors conducted a thematic analysis of violence prevention experiences among 16 line managers – eight from the prison and probation services and eight from psychiatric hospitals.
Findings
Using an existing prevention framework, the authors categorized the descriptions into three types of violence preventive practices used by the line managers across the two sectors: “preventing violence”, “managing episodes of violence” and “promoting the positive”. Especially the category “promoting the positive” is often neglected in the intervention literature.
Originality/value
The study identified new aspects of managers' violence preventive practices than those included in the violence prevention climate concept. Such knowledge may help organizations devise improved systems for violence prevention in high-risk sectors.
Details
Keywords
Sami Abdulrahman Alhamidi and Seham Mansour Alyousef
The aim of this study is to investigate the roles of psychiatric mental health nurses during their work experiences in inpatient clinical settings.
Abstract
Purpose
The aim of this study is to investigate the roles of psychiatric mental health nurses during their work experiences in inpatient clinical settings.
Design/methodology/approach
A focus group of 10 graduate psychiatric nurses with more than two years’ practice in inpatient psychiatric settings reflected on their last six months’ work placements and continuous employment. The transcripts and field notes were analyzed through thematic analysis of inductive data.
Findings
Two main themes emerged: management roles and clinical roles. The participants reflected on caring activities and obstacles encountered in fulfilling their professional roles.
Originality/value
Multiple practice issues emerged. The participants perceived that psychiatric nurse specialists are required to perform more caring functions than practicable in the inpatient setting due to an excess of noncaring duties, structural minimization of the caring role and inadequate training. They felt that many of the functions performed were not within their expectations of the caring role of a psychiatric nurse specialist and believed that changes in nurse education and attention to clarification of nurses’ roles might enhance the role they play in patient care.
Details
Keywords
Alina Haines, Elizabeth Perkins, Elizabeth A. Evans and Rhiannah McCabe
The purpose of this paper is to investigate the operation of multidisciplinary team (MDT) meetings within a forensic hospital in England, UK.
Abstract
Purpose
The purpose of this paper is to investigate the operation of multidisciplinary team (MDT) meetings within a forensic hospital in England, UK.
Design/methodology/approach
Mixed methods, including qualitative face to face interviews with professionals and service users, video observations of MDT meetings and documentary analysis. Data were collected from 142 staff and 30 service users who consented to take part in the research and analysed using the constant comparison technique of grounded theory and ethnography.
Findings
Decisions taken within MDT meetings are unequally shaped by the professional and personal values and assumptions of those involved, as well as by the power dynamics linked to the knowledge and responsibility of each member of the team. Service users’ involvement is marginalised. This is linked to a longstanding tradition of psychiatric paternalism in mental health care.
Research limitations/implications
Future research should explore the nuances of interactions between MDT professionals and service users during the meetings, the language used and the approach taken by professionals to enable/empower service user to be actively involved.
Practical implications
Clear aims, responsibilities and implementation actions are a pre-requisite to effective MDT working. There is a need to give service users greater responsibility and power regarding their care.
Originality/value
While direct (video) observations were very difficult to achieve in secure settings, they enabled unmediated access to how people conducted themselves rather than having to rely only on their subjective accounts (from the interviews).
Details
Keywords
Jaana Asikainen, Katri Vehviläinen-Julkunen, Eila Repo-Tiihonen and Olavi Louheranta
Inpatient violence is a substantial problem in psychiatric wards and de-escalation is difficult. When managing instances of violence through verbal techniques fail, mental…
Abstract
Purpose
Inpatient violence is a substantial problem in psychiatric wards and de-escalation is difficult. When managing instances of violence through verbal techniques fail, mental health-care staff may use restrictive practices. The Six Core Strategies and debriefing exist for managing violence and restrictive practices in different mental health settings. Debriefing is used to get patients’ views on restrictive practices, ensure proper patient care and strengthen the role of patients as experts. This study aims to provide new information on debriefing implementation and how debriefing was used among different patient groups in a forensic hospital.
Design/methodology/approach
Quantitative seclusion time and debriefing reports (n = 524) were examined with Poisson regression analysis. Fisher’s exact test was used to determine the associations between debriefing and seclusion/restraint.
Findings
Debriefing (n = 524) was provided in 93% of violent episodes, which is an excellent result on an international level. There was significant variation in how often debriefing was used (p < 0.001) among different patient groups, i.e. dangerous, difficult-to-treat patients and criminal offenders whose sentences have been waived. Previous debriefing research has rarely specified what types of psychiatric patients have been subjected to seclusion or restraint.
Practical implications
The implementation of debriefing requires multiprofessional work within the organization and wards.
Originality/value
Debriefing seems to stimulate reflection at every level of a health-care organization, which fosters learning and can ultimately change clinical practices. The use of debriefing can strengthen the role of patients as well as professionals.
Details
Keywords
Karin Nilsson, Bodil J. Landstad, Kerstin Ekberg, Anna Nyberg, Malin Sjöström and Emma Hagqvist
This aim of this study was to explore how hospital-based physicians in Sweden experienced the challenges in working conditions related to the provision of care during the initial…
Abstract
Purpose
This aim of this study was to explore how hospital-based physicians in Sweden experienced the challenges in working conditions related to the provision of care during the initial response to the COVID-19 pandemic in 2020 when hospitals transitioned to pandemic care.
Design/methodology/approach
The study has a qualitative design. Twenty-five hospital-based physicians were interviewed about their experiences from working in a hospital while healthcare organisations initially responded to COVID-19 pandemic in 2020. A thematic analysis was used to analyse the empirical material.
Findings
The analysis resulted in four themes: involuntary self-management, a self-restrictive bureaucracy, passive occupational safety and health (OSH) management, and information overload. These themes reflect how the physicians perceived their work situation during the pandemic and how they tried to maintain quality care for their patients.
Practical implications
The study gives valuable insights for formulating preparedness in regard to crisis management plans that can secure the provision of care for future emergencies in the healthcare services.
Originality/value
This paper shows that a crisis management plans in the healthcare services should include decision structures and management, measures of risk assessment and OSH management, and the maintenance of personnel wellbeing. A prepared healthcare management can preserve quality care delivery while under crisis.
Details
Keywords
Annie Williams, Hannah Bayfield, Martin Elliott, Jennifer Lyttleton-Smith, Honor Young, Rhiannon Evans and Sara Long
Using a mixed methodology comprising interviews, case file analysis and descriptive statistics, this study aims to examine the experiences of all 43 young people in Wales subject…
Abstract
Purpose
Using a mixed methodology comprising interviews, case file analysis and descriptive statistics, this study aims to examine the experiences of all 43 young people in Wales subject to secure accommodation orders between 1st April 2016 and 31st March 2018.
Design/methodology/approach
Children in the UK aged 10–17 years who are deemed to be at a significant level of risk to themselves or others may be subject to a secure accommodation order, leading to time spent in a secure children’s home (SCH) on welfare grounds. Following a rise in the number of children in Wales referred to SCHs for welfare reasons, this paper describes these young people’s journeys into, through and out of SCHs, giving insight into their experiences and highlighting areas for policy and practice improvements.
Findings
Findings indicate that improvements in mental health support and placement availability are key in improving the experiences of this particularly vulnerable group of young people throughout their childhood.
Practical implications
Other practical implications of the study’s findings, such as improvements in secure transport arrangements, are also discussed.
Originality/value
While the findings are limited by the reliance on self-report methods and the size of the study, namely, the small number of young people with experience of SCHs who were able to participate, the findings build on the existing knowledge base around children’s residential accommodation and provide new insights into how best to support these children.
Details