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1 – 10 of 29Karine Gaudreault, Joël Tremblay and Karine Bertrand
Those who care for people with schizophrenia and substance use disorders (PLS-SUD) are faced with the complex demands of a long journey to recovery. For the carers, this…
Abstract
Purpose
Those who care for people with schizophrenia and substance use disorders (PLS-SUD) are faced with the complex demands of a long journey to recovery. For the carers, this translates into specific needs related to various areas of their lives. However, few studies have contributed to the understanding of these carers’ needs. The purpose of this qualitative evaluative study is to identify, understand and prioritize the needs of PLS-SUD carers in the context of intervention design from the viewpoint of carers themselves (n = 9), those they were accompanying (n = 5) and other key actors involved (n = 10).
Design/methodology/approach
A design of action research was employed. Data analysis was done in three phases: concept map analysis, thematic analysis and transversal analysis of the results from two focus groups, 28 interview transcriptions and a logbook.
Findings
Over 60 needs were identified. After review, 39 of those were selected for prioritization. For needs related to the carers’ role as clients of the health-care system, the committee prioritized the needs for support, sharing with other carers and improving their own well-being. For the role of supporter, knowledge about substance use disorders and their interactions with psychotic disorders as well as skills such as communication and problem resolution were considered priorities. Needs to be prioritized relating to the role of partner were fewer.
Research limitations/implications
The results of this study highlight the diversity and complexity of the needs experienced by carers.
Originality/value
This is among the first needs surveys carried out by stakeholders to describe the needs of PLS-SUD carers.
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Emma Wolverson, Leanne Hague, Juniper West, Bonnie Teague, Christopher Fox, Linda Birt, Ruth Mills, Tom Rhodes, Kathryn Sams and Esme Moniz-Cook
Recovery Colleges were developed to support the recovery of people with mental health difficulties through courses co-produced by professionals and people with lived experience…
Abstract
Purpose
Recovery Colleges were developed to support the recovery of people with mental health difficulties through courses co-produced by professionals and people with lived experience. This study aims to examine the use of Recovery Colleges to support people with dementia.
Design/methodology/approach
A survey was circulated to UK Recovery College and memory service staff, exploring provision, delivery and attendance of dementia courses. Open responses provided insight into participant views about recovery in post-diagnostic support and the practicalities of running dementia courses.
Findings
A total of 51 Recovery College staff and 210 memory service staff completed the survey. Twelve Recovery College dementia courses were identified across the UK. Three categories emerged from the qualitative data: post-diagnostic support, recovery in the context of dementia, challenges and areas of innovation.
Originality/value
This study highlights the benefits and practicalities of running Recovery College courses with people with dementia. Peer-to-peer learning was seen as valuable in post-diagnostic support but opinions were divided about the term recovery in dementia.
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Lorna de Witt, Kathryn A. Pfaff, Roger Reka and Noeman Ahmad Mirza
Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review…
Abstract
Purpose
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?
Design/methodology/approach
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.
Findings
“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.
Originality/value
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.
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Vikki McCall, Kenneth Gibb and Yang Wang
The ageing and disabled population is fast growing, which emphasises the need to effectively modify current homes and environments to support healthy ageing and increasingly…
Abstract
Purpose
The ageing and disabled population is fast growing, which emphasises the need to effectively modify current homes and environments to support healthy ageing and increasingly diverse health needs. This paper aims to bring together findings and analyses from three adaptations-focussed projects, drawing on perspectives from key stakeholders alongside the lived experiences of service users acquiring adaptations.
Design/methodology/approach
Following an Adaptations Framework developed from interviews and focus groups with older people and key stakeholders, the paper discusses barriers experienced by older people and front-line workers in receiving and delivering adaptations through all stages of the process.
Findings
This paper reveals how experiences around adaptations might diverge with unseen, hidden investment and need amongst individuals, and how conceptual and cost-focussed evidence gaps impact wider understandings of adaptations delivery. In so doing, this paper highlights how the adaptations process is perceived as a “fight” that does not work smoothly for either those delivering or receiving adaptations services.
Research limitations/implications
The paper suggests a systematic failure such that the adaptations process needs to be rehauled, reset and prioritised within social and public policy if the housing, health and social care sectors are to support healthy ageing and prepare for the future ageing population.
Originality/value
The paper brings together insights from key stakeholders alongside service users' experiences of adaptations to highlight key policy drivers and barriers to accessing and delivering adaptations.
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Sharyn Rundle-Thiele, Taylor Jade Willmott, Nadine McKillop, Pamela Saleme Ruiz and Anna Kitunen
Recognising current, significant rates of youth sexual violence and abuse (YSVA) and the need for more comprehensive prevention approaches to combat this social issue, new…
Abstract
Purpose
Recognising current, significant rates of youth sexual violence and abuse (YSVA) and the need for more comprehensive prevention approaches to combat this social issue, new approaches are required to ensure that agency is given to the people who are most affected and who know their lives the best. This paper aims to report a youth-led (Young Voices United [YVU] Committee) participatory design approach aimed at delivering the highest level of engagement to understand what people agree is needed to reduce YSVA in their own communities.
Design/methodology/approach
The seven-step co-design (Trischler et al., 2019) process was implemented following ethical clearance. Over five months, 13 group co-design sessions involving 102 young people aged 12–25 years, 17 parents/caregivers (including young mums) and 9 teacher/guidance officers were conducted. Purposive sampling was undertaken to ensure that young people who had previously experienced YSVA or were most at risk of experiencing YSVA were overrepresented. Convenience sampling was used to gain wider community involvement in co-design. Four sessions were facilitated by YVU members, who were aged between 12 and 25 years, and more than 66 people helped the design team. Inductive thematic analysis identified emergent themes across completed co-design sessions.
Findings
New ideas and solutions to prevent YSVA can be identified by young people who have previously experienced violence, carers, other young people and community members. A core finding in this study is the need for positive relationship role models and an enhanced understanding of consent. Education and training, a community promotional campaign, sector involvement, capacity-building and consideration of the unique needs of different target audiences were key ideas emerging from youth-led co-design. The YVU Committee provided recommendations for resource prioritisation.
Social implications
This youth-led co-design process empowered the community. Project stakeholders have since formed partnerships won funding and used that funding to co-design and trial a new programme aiming to provide a safe haven for young people at risk of YSVA. The pilot programme delivers a safe and supportive environment for young people delivered at a time when it is needed most. Other geographical areas are now seeking to replicate the programme. The co-design processes and tools detailed in this study can be adapted to the design of programmes for those already engaged with the youth justice system and should be considered as part of a public health approach to effectively prevent and respond to YSVA and other youth crimes.
Originality/value
This paper advances understanding, providing a practical approach that ensures youth views are given weight [audience and influence described in Lundy’s (2007) participatory framework]. This paper explains how the YVU Committee, established at the commencement of the project, oversaw the community co-design effort, which followed Trischler et al.’s (2019) seven-step co-design process. Ideas were generated, and consensus views were consolidated, delivering the highest level of engagement according to Willmott et al.’s (2022) methodology, agent of change, training and engagement taxonomy. The participatory design method led to high levels of community engagement, and the success of the project is attributed to the establishment of the YVU Committee and stakeholder support.
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Ane Bast, Marit Engen and Maria Røhnebæk
This paper aims to explore the role of frontline employees (FLEs) as mediators in transformative service processes within services targeting vulnerable users.
Abstract
Purpose
This paper aims to explore the role of frontline employees (FLEs) as mediators in transformative service processes within services targeting vulnerable users.
Design/methodology/approach
This paper is based on a case study of the development and implementation of a dementia village, and the data consist of documents, in-depth interviews and field observations.
Findings
The analysis identifies FLEs as mediators in six different roles. These roles highlight how FLEs perform as mediators, acting in between and for vulnerable users and thus supporting their well-being. Specifically, the roles explicate the mediating role of FLEs in the design and planning of transformative changes and in daily work practices.
Practical implications
The different mediating roles of FLEs presented here should inform care providers and managers of how employees can become assets for supporting vulnerable users’ well-being during the design and planning stages of transformative change and through daily service work.
Originality/value
This paper offers novel insights into the multifaceted roles of FLEs in transformative services. The findings add to the current debate on mediation in transformative services and contribute to the literature by extending and refining the established conceptual and empirical understandings of the role of transformative service mediators in consumers’ well-being.
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Adekunle Sabitu Oyegoke, Saheed Ajayi, Muhammad Azeem Abbas and Stephen Ogunlana
Delay in housing adaptation is a major problem, especially in assessing if homes are suitable for the occupants and in determining if the occupants are qualified for the Disabled…
Abstract
Purpose
Delay in housing adaptation is a major problem, especially in assessing if homes are suitable for the occupants and in determining if the occupants are qualified for the Disabled Facilities Grant (DFG). This paper describes the development of two self-administered intelligent integrated assessment tools from the DFG Adapt-ABLE system: (1) The Home Suitability Assessment Platform, which is a preventive mechanism that allows assessment of the suitability of homes based on occupants’ mobility status and (2) an indicative assessment platform that determines if the applicants are qualified for the DFG to prevent lengthy delays.
Design/methodology/approach
The adopted method aligned with a development study approach: a grounded literature review, a severity measurement approach, two stakeholder engagement workshops, four brainstorming sessions and four focus group exercises. The system development relied on Entity–Relationship Diagram (ERD) technique for data structures and database systems design. It uses DFG context sensitivity with alignment with DFG guidance, interlinkages and interoperability between the assessment tools and other platforms of the integrated Adapt-ABLE system.
Findings
The assessment tools are client-level outcomes related to accessibility, usability and activity based on the assessment process. The home suitability platform shows the percentage of the suitability of a home with assessment results that suggest appropriate action plans based on individual mobility status. The indicative assessment combines the function of referral, allocation, assessment and test of resources into an integrated platform. This enables timely assessment, decision-making and case-escalation by Occupational Therapists based on needs criteria and the eligibility threshold.
Originality/value
These assessment tools are useful for understanding occupants’ perception of their physical housing environment in terms of accessibility, suitability and usability based on basic activities of daily living and their mobility status. The indicative self-assessment tool will substantially cut down the application journey. The developed tools have been recommended for use in the CSJ Disability Commission report and the UK government Guidance on DFGs for local authorities in England.
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This qualitative study set within Northern Ireland aims to explore professional perspectives on the application of evidence-informed practice to the adult safeguarding threshold…
Abstract
Purpose
This qualitative study set within Northern Ireland aims to explore professional perspectives on the application of evidence-informed practice to the adult safeguarding threshold screening process.
Design/methodology/approach
Data was gathered from seven social workers in one health and social care trust area, who perform the designated adult protection role, through individual semi-structured interviews in one region of Northern Ireland. The interview schedule comprised of a series of questions examining the role of the designated adult protection officer and included three vignettes (Appendix). A thematic analysis was undertaken using NVIVO software.
Findings
This paper reports main findings under the themes of: the role of the designated adult protection officer, threshold decision-making, evidence-informed practice and service improvement. One of the main findings was that professionals viewed the current process as too bureaucratic, and there was a desire to engage in more preventive safeguarding in collaboration with service users. There was a need to promote awareness of evidence-informed practice as it applies to the threshold screening process. Furthermore, the study raised the question of the need to consider the application of models or methods of assessment to the threshold screening process.
Originality/value
This in-depth exploration of the role of designated adult protection officers in Northern Ireland provides a valuable insight into the complexity involved in managing adult safeguarding referrals and investigations. This study adds to the existing knowledge base, identifies potential service improvements and highlights the gap in evidence-based practice as it applies to the threshold screening process. Threshold screening of adult safeguarding referrals remains a subjective process and is open to interpretation and differences in professional judgement. The study highlights the need to consider the application of quality improvement methodology to the threshold screening assessment and the need to promote the exchange of safeguarding knowledge.
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Rebecca Stenberg and Maria Wolmesjö
The purpose of this paper is to give an account for preparative collaboration between the police and municipal eldercare in Sweden concerning missing persons with dementia.
Abstract
Purpose
The purpose of this paper is to give an account for preparative collaboration between the police and municipal eldercare in Sweden concerning missing persons with dementia.
Design/methodology/approach
Design/methodology/approach used was a qualitative case study design, consisting of one focus group with representatives for the participating organisations, followed by directed content analysis.
Findings
The findings showed a lack of current collaboration and reluctance to new collaborative initiatives. However, when focussing on preparative collaboration of coordinated responses to missing incidents, possibilities for improvement could be identified. The improvements concerned updated personnel response checklists, along with suggestions for an elaborate life story document in eldercare, with police access. Finally, better coordination of the return of the found person and a follow up were proposed.
Research limitations/implications
It is suggested that collaboration must be given different meanings and use different approaches adapted to the different phases in a rescue operation. In the preparation and the response phase, the focus should be on coordination of the resources available. In the pre-planning and prevention phases, as well as in evaluation and learning, horizontal collaboration is more suitable. The amount of data in this study is a research limitation which calls for further research.
Practical implications
It is suggested that collaboration must be given different meanings and use different approaches adapted to the different phases in a rescue operation. In the preparation and the response phase, the focus should be on coordination of the resources available. In the pre-planning and prevention phases, as well as in evaluation and learning, horizontal co-operation is more suitable.
Originality/value
The originality/value of this paper can be found in the novelty of missing person research in Sweden, and in practical suggestions for preparative collaboration concerning persons with dementia who go missing. Finally, it can be found in the suggested need for a more dynamic and process-sensitive view of collaboration in SAR or rescue operations.
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John McEwan McManus, Styliani Gkika and Elaine Swift
Hearing voices can be a debilitating and traumatic experience, and psychiatric hospitals can feel unsafe and overstimulating to voice hearers. Research suggests this may prolong a…
Abstract
Purpose
Hearing voices can be a debilitating and traumatic experience, and psychiatric hospitals can feel unsafe and overstimulating to voice hearers. Research suggests this may prolong a service user’s admission time and lead to an unhelpful experience. Therefore, a hearing voices group (HVG) was developed to create a safe space where voice hearers could share their story with others with lived experience and access support.
Design/methodology/approach
The group was developed by the first author under the supervision of the inpatient psychology lead. Both a practice-based and expert by experience-based approach were considered during the development of the group structure. The group also aligned with the Hearing Voices Network and the Trust’s values. A questionnaire was developed to evaluate the effectiveness of the group using six five-point Likert scale questions and three open questions to collect the data, which was then analysed.
Findings
The themes from the qualitative data showed that staff and ward-based promotion of the group were paramount to ensuring patient engagement. The results also showed that voice hearers found the group therapeutic, and some found the coping skills shared to be beneficial and effective.
Research limitations/implications
A large percentage of women (76%) reported that they had attended a HVG before. This was not the case for service users from the male unit and psychiatric intensive care unit. This result is considered to reflect the fact that women in that unit had the opportunity to attend more than once during their admission, rather than that they had accessed these groups in other settings or in the community. Therefore, in the future, it would be useful to change this question to “have you attended any other HVGs in the past, prior to this admission?”, which might be more appropriate for data collection.
Originality/value
To the best of the authors’ knowledge, this is the original work of the first author, who is an expert by experience and an assistant psychologist. The results suggest that HVGs can be beneficial for patients in acute and intensive mental health care and highlight some necessary adaptations and the importance of adopting an MDT approach in promoting therapeutic groups.
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