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This study aims to co-develop a Frailty, Health and Care Needs Assessment (FHCNA) questionnaire for people experiencing homelessness and explore the feasibility of its use by non-clinical staff in homeless hostels.

The FHCNA, aimed at identifying frailty and other health and care priorities for people experiencing homelessness, was co-designed in workshops (online and in person) with homelessness and inclusion health staff. Its feasibility was tested by staff and their clients in two hostels, with pre- and post-study focus groups held with hostel staff to gain input and feedback.

The FHCNA was co-developed and then used to collect 74 pairs of resident and key worker inputted data (62% of eligible hostel residents). The mean age of clients was 48 years (range 22–82 years). High levels of unmet need were identified. Over half (53%) were identified as frail. Common concerns included difficulty walking (46%), frequent falls (43%), chronic pain (36%), mental health issues (57%) and dental concerns (50%). In total, 59% of clients reported difficulty in performing at least one basic activity of daily living, while only 14% had undergone a Care Act Assessment. Hostel staff found using the FHCNA to be feasible, acceptable and potentially useful in facilitating explorations of met and unmet health and social care needs of hostel clients. By identifying unmet needs, the FHCNA has the potential to support staff to advocate for access to health and social care support.

To the best of the authors’ knowledge, this is the first study to co-develop and feasibility test a questionnaire for use by non-clinically trained staff to identify frailty and other health and care needs of people experiencing homelessness in a hostel setting.

This study aims to evaluate how a community psychiatry model, referred to as the Mental Health Action Trust (MHAT) in India, provides decentralized care and comprehensive services to people with severe mental illness living in poverty. Using the complex adaptive system (CAS) framework, the authors aim to understand the factors that contribute to the diverse outcomes of the MHAT community mental health programme as observed in four different locations.

Four MHAT clinics were purposively chosen from two districts in Kerala. A comparative case study methodology was used to document each clinic’s MHAT services and activities, as found during field visits and interviews with staff members and volunteers.

The study shows that all four clinics met the basic aim of providing free, quality mental health care to the poorest populations, although not all aspects of the comprehensive model could be equally provided. Alignment with the MHAT vision, appropriate leadership, the relationship with partners and their level of community engagement determined the varied success between clinics.

The current study evaluation stresses that community ownership is crucial. Careful attention must be paid to the characteristics of selected partners, including their leadership styles and ability to garner resources.

The increasing financial burden and complexity of health-care services, exacerbated by factors such as an ageing population and the rise of chronic conditions, necessitate comprehensive and integrated care approaches. While co-created service design has proven valuable in transforming some service industries, its application to the health-care industry is not well understood. This study aims to examine how health consumers are involved in health-care service co-creation.

The study searched 11 electronic databases for peer-reviewed articles published between 2010 and 2019. Additionally, hand searches of reference lists from included studies, Google^© citation searches and searches for grey literature were conducted. The Whittemore and Knafl integrative framework guided the systematic review, and Callahan’s 6 Ws framework was used to extract data from the included articles, facilitating comparisons.

The authors identified 21 articles, mainly from the UK, North America and Australia. Despite the need for more research, findings reveal limited and geographically narrow empirical studies with restricted theory and method applications. From these findings, the authors constructed a conceptual model to enhance nuanced understanding.

This study offers four contributions. First, it introduces the Health Service Design Transformation Model for Comprehensive Consumer Co-Creation, illustrating health consumers’ multifaceted roles in shaping services. Second, consumer vulnerabilities in co-creating services are identified, linked to diverse consumer groups, power dynamics and decision complexity. Third, this study suggests broadening participant inclusion may enhance consumer-centricity, inclusivity and innovation in service design. Finally, the research agenda explores consumer experiences, organizational dynamics, value outcomes and co-creation theory for health-care service advancement.

Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

To facilitate the reception and care of discharged patients, streamlining processes at the University Hospital and promoting a seamless transition to continuity of care services post-discharge.

Hospitalised patients undergo the Blaylock risk assessment screening score (BRASS), a screening tool identifying those at risk of complex discharge.

Pre-pandemic, patients with a medium-to-high risk of complex discharge were predominantly discharged to their residence or long-term care facilities. During the pandemic, coinciding with an overall reduction in hospitalisation rates, there was a decrease in patients being discharged to their residence.

The analysis of discharges, with the classification of patients into risk groups, revealed a coherence between the BRASS score and the characteristics of the studied sample. This tool aids physicians in decision-making by identifying the need for a planned discharge in a systematic and organised manner, preventing the loss of crucial information.

The goal of this article is to provide an overview of healthcare entrepreneurship, both in terms of its current trends and future directions.

The article engages in a systematic review of extant research on healthcare entrepreneurship using the scientific procedures and rationales for systematic literature reviews (SPAR-4-SLR) as the review protocol and bibliometrics or scientometrics analysis as the review method.

Healthcare entrepreneurship research has fared reasonably well in terms of publication productivity and impact, with diverse contributions coming from authors, institutions and countries, as well as a range of monetary and non-monetary support from funders and journals. The (eight) major themes of healthcare entrepreneurship research revolve around innovation and leadership, disruption and technology, entrepreneurship models, education and empowerment, systems and services, orientations and opportunities, choices and freedom and policy and impact.

The article establishes healthcare entrepreneurship as a promising field of academic research and professional practice that leverages the power of entrepreneurship to advance the state of healthcare.

The article offers a seminal state of the art of healthcare entrepreneurship research.

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?

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.

“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.

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.

Paramedics became nationally registered in 2018 in Australia. Prior to this, there was no central regulation of the profession with reliance on organisational regulation through employers. As paramedics expanded their scope, role and range of employers, especially outside statutory agencies, there was increasing need to engage in professional regulation. Regulation is more than a legal and bureaucratic framework. The purpose of the paper states that the way paramedics interact with their new regulatory environment impacts and is influenced by the professionalisation of the discipline. Regulation also redefines their positionality within the profession.

Two mixed-method surveys were undertaken. A pre-registration survey occurred in the month prior to regulation commencing (N = 419) followed by the second survey 31 months later (N = 407). This paper reports the analysis of qualitative data from the post-registration survey and provides comparison to the pre-registration survey which has been previously reported. Analysis was undertaken using interpretive phenomenological analysis (IPA).

Themes from the pre-registration survey continued however became more nuanced. Participants broadly supported registration and saw it as empowering to the profession. Some supported registration but were disappointed by its outcome, others rejected registration and saw it as divisive and oppressive.

Paramedics are beginning to come to terms with increasing professionalisation, of which regulation is one component. Changes can be seen in professional identity and engagement with professional practice; however, this is nascent and is deserving of additional research to track the profession as it continues to evolve.

This study, a narrative literature review, aims to examine the combined benefits of the active and passive use of social media (SM) for well-being (WB), physical and mental health during the COVID-19 pandemic.

A search strategy has been carried out in the databases: Riss, PubMed, Medline, Scopus and Google Scholar, including all the articles published until 19 October 2023.

SM offers various benefits, including global risk awareness, health information, social connections and support. With the natural increase in physical inactivity due to COVID-19 social restrictions, SM has been identified as an appropriate tool for promoting physical activity (PA) at home to improve health.

It suggests that the combined use of active and passive benefits of SM could potentially play an important role in public health by increasing individuals’ health behaviours. In addition, dissemination, sharing and social interaction of information provided by YouTube can encourage healthy behaviours, contribute to WB, physical and mental health and raise public health awareness.

The findings presented in this study highlight the combined benefits of differentiating the features of SM use. Compared to other SM platforms, YouTube can be used as a useful tool for home-based PA that promotes health by enabling people to remain active and avoid barriers to PA due to social restrictions during the global crisis. In addition, some recommendations from the findings may help protect against potential risks and improve public health outcomes during global crises, such as the COVID-19 pandemic, among the general public using SM.