Search results

The aim of this study is twofold: (1) to gain insight into the different perspectives on the relationship between patient and person centeredness and (2) to learn more about the differences between non-academic and academic stakeholders in the healthcare system.

This mixed-methods study includes a scoping review on person and patient centeredness and in-depth interviews with patients, caregivers, staff and management of healthcare organizations. The data were analyzed by following the six phases of Braun and Clarke.

The analysis of the data showed four different perspectives on patient versus person centeredness: (1) they are synonyms; (2) one term is favorite; (3) they should be in balance; and (4) person centeredness is the surplus on top of patient centeredness.

There are different perspectives on patient versus person centeredness. Perspectives differ between people and can change over time. Some people feel like a patient all the time, other people feel like a person all the time, and some feel like a patient at one point in time and as a person at another point in time.

These different perspectives can have important implications for the so-called moments of truth. In their role as patients, people value functional encounters and in their identity as people they value meaningful encounters with caregivers.

By unraveling these different perspectives, novel insights were found in the different perspectives people can take.

The purpose of this paper is to examine the use and applicability of cultural probes – an explorative participatory method to gain insights into a person’s life and thoughts – to achieve person-centeredness and active involvement in self-management education for people with chronic illness.

An education toolkit inspired by the ideas of cultural probes was developed and feasibility tested in 49 education settings in Denmark. Questionnaires, interviews, and observations were used to collect data, which were analysed using descriptive statistics, analysis of variance, and systematic text condensation.

Educators emphasized the applicability of the toolkit, and between 69 and 82 per cent of educators reported that the toolkit supported them in facilitating person-centred education and active involvement to a high or very high degree. Most educators (81 per cent) reported that they would like to apply the toolkit again in future education to a high or very high degree. Five categories of educator experiences were identified: interaction and activity; person-centeredness; group dynamics and synergy; openness; and light and cheerful atmosphere. Educators talked significantly less in situations where the toolkit was applied. This indicates the ability of the toolkit to facilitate talk among participants and thereby let participants become the focal point of education. Applying cultural probes in patient education targeting people with chronic illness seems to be a useful method to achieve patient-centeredness and active involvement in patient education and to support educators in facilitating this process.

Introducing fully flexible education toolkits inspired by cultural probes may, in the future, lead to improved self-management patient education among people with chronic illness.

No occupational therapy outcome measures have been designed specifically for recovery-orientated services.This paper aims to identify occupational therapy outcome measures relevant to mental health practice and assess them against recovery principles adopted by Irish Mental Health Services.

A narrative review methodology was used to appraise outcome measures against CHIME recovery principles.

A systematic search across 13 databases identified eight well-established outcome measures commonly used within occupational therapy mental health literature. The included outcome measures were appraised using a recovery alignment tool.

All outcome measures connected to some recovery processes. Those using semi-structured interview formats and notably the Canadian Occupational Performance Measure (COPM) had the strongest alignment to recovery processes.

This is the first known review which provides some validation that the included outcome measures support recovery processes, yet the measures rely heavily on therapist’s skills for processes to be facilitated. It recommends that ways to better support the process of partnership in occupational therapy mental health outcome measures be explored and further research be undertaken.

This paper aims to highlight the benefits of the 360 SF diagnostic audit for assessing person centeredness of a domiciliary agency and to highlight the challenges they face with some suggested actions. These are exemplars of what is raised in policy and recent reports relating to personalisation, dignity and integration of health and social care and have wider implications for all agencies as they strive to resolve issues for the client.

The approach is a case study describing results of the audit in relation to challenges that include practice development needs, inter agency co‐ordination, collaboration and co‐operation for the achievement of relationship based person centered outcomes in quality improvement work. The pilot study involved data gathered from the clients, relatives and staff, which were analyzed resulting in findings, conclusions and suggestions for ongoing improvement from which action plans were devised and implemented.

The audit results provide examples of the primary interface relationship and co‐ordination challenges, highlighting leaning needs for staff delivering person centred care in domiciliary settings.

This paper raises important practice development issues both inside and outside the agency's responsibility. Use of the tool would support cultural and interface relationship issues affecting the client experience and highlight ways to assist the achievement of collaborative ways of working needed for the integration of health and social care.

The 360 SF (DS) can help organisations provide evidence to CQC and the public for their performance and identify the close interface relationships and their effectiveness in delivering co‐ordinated and integrated health and social care.

The 360 SF DOM has highlighted with evidence the challenges of the systemic culture at the interface, in particular the nature and quality of collaboration, communication and practice development needs across the organisational divide to deliver person centred care and support.

The purpose of this paper is to qualitatively evaluate the impact of therapeutic horticulture (TH) on social integration for people who have mental health problems.

A qualitative grounded theory approach captured the perceptions about TH from people with mental health problems. Data were collected using semi-structured focus group and interviews from a purposive sample (n=7) and were analysed using a constant comparative approach.

Four key themes emerged from the analysis: “a space to grow”, “seeing the person”, “learning about each other through nature” and “connecting to nature and others”. The findings suggest that TH enabled participants to integrate socially, engage with nature and develop confidence.

TH is a potential approach that can help combat social isolation. The findings from this research have implications for people working towards supporting people who are socially excluded. However, this was a pilot study with a small sample size of seven people with mental health problems, whilst four key themes emerged, the saturation of concepts rather than the sample size were saturated to provide an emic perspective of the phenomena.

TH provides a person centred approach that enables people with mental health problems to re-engage and connect with their fellow human beings. Using TH could help improve the public health and well-being of local communities through re-connecting people to the environment and reduce social isolation.

TH embody the principles of empowerment, person centeredness and can support people with mental health problems to integrate socially.

There is limited evidence about the influence that TH have on mental health and social integration. The use of TH is an area that is gathering evidence and this small study highlights the perceived potential benefits of this approach.

The sequelae of acquired brain injury can lead to a complex array of risks. This research explores professionals' perspectives on those risks, focussing on how psycho‐social risks are assessed and managed.

A self completion questionnaire was designed, and distributed to a range of professionals working in brain injury services.

A total of 177 participants completed an anonymous questionnaire. Principal components analysis produced three factors, which were given the labels “User‐friendliness”, “Person‐centeredness” and “Coherence”. Inconsistencies were identified in approaches to risk assessment and management. Participants also reported particular beneficial approaches, such as multi‐disciplinary discussions, and using assessments to guide rehabilitation.

The convenience sampling approach limits the generalisablity of the findings. However, the study was adequately powered, reliable, and valid.

The findings of this research, existing literature, and clinical experience are drawn together in a proposed model for managing risk. This model, which incorporates the three factors identified through statistical analysis could guide effective risk management, documentation and associated procedures. The model presents a framework for service design and provision, as well as providing a focus for future research.

It is likely that more active engagement in risk assessment on the part of professionals, services, and those who access services, will be engendered if the process is able to become more user‐friendly, person‐centred, and coherent, across and within service provision.

Despite legislative calls for regular training and effective communication in relation to risk, this is not the routine experience of professionals working in brain injury services. The findings of the present research offer a new, structured process, for overcoming the challenge for embedding legislation and research findings into practice.

Managing patients in advanced age is complex, especially when it comes to multi-morbidities and polypharmacy. The purpose of this qualitative study is to investigate challenges, opportunities and potential solutions from a primary healthcare provider perspective.

Fifty-seven participants joined in group discussions on challenges and opportunities of working with advanced age. Participants included general practitioners (GPs), practice nurses, students and administration staff working in ten general practices. A thematic analysis was developed, supported by NVivo software.

Poor lines of communication and fragmentation of services between differing levels of health care services available for older people were highlighted. This has implications for quality of care and equity of services. Participants also reported challenges in treatment and funding regimes.

The small sample size and regional nature of the study, along with the semi-structured nature of the group discussions and rigorous thematic analysis, indicate that this qualitative data is transferable, dependable, confirmable and credible. Comparing the views of tertiary and community services would be useful.

A range of potential strategies and solutions to the current fragmented services was offered by GPs. For example, adequately funded and staffed community-based health hubs; IT platforms enabling timely flow of patient information between primary and tertiary health providers and creation of medical, nursing and allied health roles aimed at improving synergy between GP and tertiary services.

Obtaining the perspectives of general practice highlights the challenges and complexities of caring for those in advanced age brings. These insights have not been previously been explored in-depth within this setting in New Zealand.

Considering the great need for palliative care in hospitals, it is essential for hospital staff to have palliative care knowledge. Palliative consultations have been shown to have positive effects on in-hospital care. However, barriers to contact with and uptake of palliative consultation advice are reported, posing a need for further knowledge about the process of palliative consultations. The purpose of this study therefore was to examine how palliative consultations in hospitals are practised, as perceived by consultants and health care professionals on receiving wards.

Focus groups with palliative care consultation services, health care personnel from receiving wards and managers of consultation services. Interpretive description and constant comparative method guided the analysis.

Variations were seen in several aspects of practice, including approach to practice and represented professions. The palliative consultants were perceived to contribute by creating space for palliative care, adding palliative knowledge and approach, enhancing cooperation and creating opportunity to ameliorate transition. Based on a perception of carrying valuable perspectives and knowledge, a number of consultation services utilised proactive practices that took the initiative in relation to the receiving wards.

A lack of policy and divergent views on how to conceptualise palliative care appeared to be associated with variations in consultation practices, tentative approaches and a bottom-up driven development. This study adds knowledge, implying theoretical transferability as to how palliative care consultations can be practised, which is useful when designing and starting new consultation services.

As marketization has gained ground in elderly care, satisfaction with care has come to play a crucial role in designing for high-quality care. Inspired by the service-profit chain (SPC) model, the authors aimed to gain a deeper understanding of the intricate interplay between supportive leadership practices, organizational climate, job satisfaction and service quality in predicting satisfaction with care.

A Swedish sample of frontline elderly care staff (n = 1,342) participated in a cross-sectional questionnaire study. Mediation analyses were conducted to test the proposed model.

As predicted, engaging in supportive leadership practices was directly and positively associated with satisfaction with care. In addition, as predicted, this relationship was partially mediated by organizational climate and job satisfaction. Moreover, job satisfaction predicted satisfaction with care with service quality explaining a statistically significant part of this relationship.

Managers in elderly care services may improve satisfaction with care in multiple ways but primarily by showing that they care about the staff and ensuring that they are satisfied with their working conditions. Employee job satisfaction seems to be particularly crucial for satisfaction with care, beyond what can be accounted for by care service quality.

The authors proposed a novel service-outcome model. Adding to the original SPC model, the model in this study suggested previously unexplored relationships including a direct path between leadership practices and satisfaction with service and a multiple-mediator model explaining this relationship. Also, new measures of organizational climate and supportive leadership were developed for which satisfactory reliability estimates were obtained.

The purpose of this paper is to present findings from a mixed methods study investigating leadership development of allied health practitioners within a large public healthcare organization in Australia.

The South Eastern Sydney Local Health District Allied Health Leadership Development Program was undertaken with an allied health cohort (n=16) between May 2014 and March 2015 and comprised all-day workshops, action learning sets and individual coaching. Using experiential learning, the program tested whether practice development methods and action learning approaches developed the leadership skills of participants compared with a control group (n=17). Descriptive statistics were collected to evaluate participant and program outcomes. Leadership, workplace culture and engagement measures were analyzed as part of the study.

The Allied Health Leadership Development Program received high ratings by participants. They reported enhanced skills in leading self and others through mechanisms such as critical reflection and facilitation, and greater confidence managing change and with engaging staff, colleagues and patients in decision making, affecting the quality and safety of healthcare. Statistically significant differences were found with transformational leadership elements, leadership outcomes, and measures of workplace culture and engagement after program completion for intervention group participants, compared with the control group.

Results provide new empirical evidence about the effectiveness of using practice development for allied health leadership development.

This low-cost leadership program can be replicated by other organizations.

Outcomes from an Allied Health Leadership Development Program have not been previously reported in the literature.