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Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.

The quality of maternal healthcare training is the most optimal degree of health in the delivery of effective, efficient and quality healthcare in midwifery discipline. Student accoucheurs studying at the Free State School of Nursing are faced with resistance, discrimination, rejection and unacceptability by pregnant women during their clinical placement at the Free State maternal healthcare institutions. This results in poor quality of training of student accoucheurs in maternal healthcare. Considerable studies have been conducted on males in midwifery nursing, but no guidelines have been developed to facilitate student accoucheurs' acceptance and improvement of the quality of training in maternal healthcare, hence the purpose of this study.

A descriptive, explorative qualitative design was used in this study. Qualitative focused group discussions (n = 32) were conducted through purposeful sampling method. Data was analysed thematically.

Three main categories emerged: student accoucheurs' related factors with social interactions and relations as a theme; maternal healthcare users’ related factors with transcultural diversity and socio-economic status as themes; nurse training institutions and maternal healthcare institutions service providers-related factors with gender inequality in the work place as a theme. Ultimately, the guidelines to facilitate acceptance and improvement of quality training of student accoucheurs in maternal healthcare institutions were developed and recommended for implementation.

The paper developed guidelines to facilitate acceptance and improvement of quality training of student accoucheurs in Free State maternal healthcare institutions.

The aim of this study is to investigate the roles of psychiatric mental health nurses during their work experiences in inpatient clinical settings.

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.

Two main themes emerged: management roles and clinical roles. The participants reflected on caring activities and obstacles encountered in fulfilling their professional roles.

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.

The purpose of this paper is to explore the influence of peer mentoring on critical care nursing students’ learning outcomes in critical care units.

A qualitative exploratory research design was used to conduct the study. Ten critical care nursing students were recruited from critical care units in the five private and two public hospitals. Descriptions of their experiences were gained through individual face-to-face interviews.

The study reinforces peer mentoring as a vital strategy in helping the critical care nursing students to attain their learning outcomes. However, peer mentoring was not consistent in all hospitals and there were no structured support systems to ensure that peer mentoring was formalized. Making peer mentoring a vital component in the registered nurses core competencies would enable efficiency and guarantee the viability of peer mentoring.

Mentors for the critical care nursing students were not included in the study.

The study identified a need for incorporating a formalized mentorship programme into the core competencies of all qualified critical care nurses, the unit mentor to familiarise themselves with the prescribed learning objectives of the critical care nursing student and an allocation of supernumerary time for the critical care nursing student and mentors to allow for formal mentoring responsibilities to take place.

The study reinforces peer mentoring as a vital strategy in helping the critical care nursing students to attain their learning outcomes and conscietises registered nurses of their responsibility as mentors.

Intervention evaluations have not always accounted for long-term implementation of interventions. The purpose of this paper is to explore implementation of a primary care intervention during the lifespan of the trial and beyond.

Eight general practices participated in the trial (four control and four intervention). In-depth interviews (with nine GPs and four practices nurses who delivered the intervention) and observation methods were employed. Thematic analysis was utilized and Normalization Process Theory (NPT) constructs were compared with emergent themes.

Macro-level policy imperatives shaped practice priorities which resulted in the “whole system” new intervention not being perceived to be sustainable. Continued routinization of the intervention into usual care beyond the lifespan of the funded study was dependent on individualized monitoring and taking forward tacit knowledge.

The authors discuss the implications of these findings for sociological theories of implementation and understanding outcomes of research led complex interventions.

The study describes the complex interplay between macro processes and individual situated practices and contributes to understanding if, how, and why interventions are sustained beyond initial “research push”. The value of the study lies in describing the conditions and potential consequences of long-term implementation, which might be translated to other contexts.

In the early to mid-twentieth century, psychiatrist-led occupational therapy departments emerged in Irish psychiatric hospitals. This marked a transition towards establishing rehabilitative services in institutional settings. This paper aims to examine the development of occupational therapy in Grangegorman Mental Hospital and its auxiliary hospital, Portrane Mental Hospital from 1934-1954.

Historical documentary research methods were used to analyse primary source data from Grangegorman Committee Minutes, Inspector of Mental Hospital Reports, Boroughs of Mental Hospitals, Department of Foreign Affairs documents and newspaper archives. The archival data was analysed using both a chronological and thematic approach.

The main key event emerged in 1935 when four Grangegorman nursing staff were sent to Cardiff Mental Hospital to undergo a six month training course in occupational therapy. The following themes emerged – “establishing occupational therapy in Grangegorman and Portrane”; “the role of short-course trained nursing staff in providing occupational therapy services” and “therapeutic rationales vs hospital management rationales”.

This study throws light on the early practitioners of occupational therapy in Grangegorman and highlights the complexities of occupational therapy’s role origins in mid-twentieth century Ireland. In line with contemporaneous psychiatric hospitals, the occupational therapy activities promoted in Grangegorman were mainly handicraft or productivity based. The absence of patients’ voices means there are limitations to determining the therapeutic nature of this early occupational therapy service.

The purpose of this study explores the perspective of key informants (educators, preceptors and former students) of the Kintampo Project, on the perceived effectiveness, gains and challenges in delivering this large-scale training innovation in Ghana. The problem of mental health care neglect in Ghana is gradually improving. The Kintampo Project which trained mental health workers in Ghana has played a critical role in increasing access to mental health care.

This qualitative study explored participants' perspectives on the Kintampo Project in three broad areas: perceived effectiveness, gains and challenges. In all, 17 interviews were conducted with former students, preceptors and educators from the project. The interviews were digitally audio-recorded, transcribed, coded and analysed using deductive and thematic methods.

The participants perceived the project to have been successful in increasing the number of mental health workers in Ghana. The project provided a route for career progression for those involved. However, the Kintampo Project faced accreditation issues, low recognition, improper integration and remuneration of trained staff in the Ghana Health Service. This study points to the fact that the sustainability of mental health training in Ghana can be obstructed, because of this career path being less attractive. Further research is needed to explore how best to achieve sustainability of similar mental health innovations.

This paper shares the views of participants in the Kintampo Project.

The purpose of this study is to investigate the psychosocial factors that impact the academic performance of nursing students.

A cross-sectional study was conducted with 767 nursing students from three nursing colleges in Thailand. Instruments included Counseling Center Assessment for Psychological Symptoms and Rosenberg Self-Esteem Scale. Path model analyses with the maximum likelihood method were utilized to examine the proposed model. Model fit was estimated using multiple indexes, including chi-square/df ratio (χ²/df), comparative fit index (CFI), Tucker-Lewis index (TLI) and the root mean square error of approximation (RMSEA).

Results indicated that family distress, emotional negativity, self-esteem and substance use were factors that related to nursing students' academic performance. Findings of path analyses indicated that the model demonstrated good fit: χ² (2, N = 767) = 3.11, p = 0.48; χ²/df = 1.56; CFI = 1.00; TLI = 0.99; RMSEA = 0.027, (90% CI = [0.000, 0.082], PCLOSE = 0.68).

While prior research has examined some facets leading to academic success for nursing students, psychosocial factors have not received adequate attention. This study presents a model of family and individual psychosocial factors that impact academic performance of nursing students along with recommendations to help improve their well-being.

The purpose of this paper is to present the use of a free code computational tool, Patent2net, in the search of patents for the implementation of distance learning aimed at Continuing Medical Education.

This technical report is based on the extraction, organization and availability, in the format of graphs and dynamic tables, and also based on information in other patents on the subject, made available in the Espacenet database.

As a result, it was possible to identify a Chinese patent, free for reproduction in Brazil, which describes an e-learning system that simulates 3D scenarios for training nursing teams.

The paper has used one unique patent database, but containing more than 100m documents.

The selected patent can contribute to the improvement of care and behavioral techniques of the health professionals.

The training of health professionals can improve the public and supplementary health systems.

This is the first paper in that de technometric analisys of patents was used to solve a problem regarding the training of health professionals.

This paper aims to emphasize the need for a strategic approach to employee retention beyond financial benefits. This is directly proportional to employee retention. Bringing out the retention measures preferred by employees, depicting the relationship of demographic profile with employee retention tendency and exploring implications giving importance to beyond paycheque factors are the objectives of the study.

This study uses applied qualitative approach with a realistic view to collect the details of retention measures and practices from purposively selected 36 health-care experts by the conduct of interview using a one-to-one discussion with written notes. With quantitative approach, opinion survey was administered to receive the perceived opinion of randomly selected 350 health-care employees on paycheque and on beyond paycheque factors boosting their intention to stay. Bhattacharya and Ramachandran’s health-care study framework on retention was applied for the identification of the factors.

Both paycheque and beyond paycheque benefits are important for retention. Most respondents prefer beyond paycheque factors practiced at sampled hospital. Age, marital status and residence of employees are significantly associated with retention. The strategic initiatives of the sampled hospital to retention concerning motivational needs of employees in the workplace are thank you board, camp head, ad act camp, success corner and so forth.

Addressing health-care work and relationship-related issues in terms of employee retention giving importance to beyond paycheque benefits – remedy for compassion fatigue health-care employees face in routine works, meeting promises made by management regarding paycheque or beyond paycheque benefits, employees participative in decisions in medical, clinical and in functional areas, reducing workload and role stress by the conduct of role analysis.

Many research studies are emphasizing the contribution of financial benefits to employee retention. Only a few studies have been carried out exploring and emphasizing the importance of beyond financial benefits motivating employee retention. This is the study of evidence from a hospital that gives strategic importance to beyond paycheque elements as well as paycheque elements.