scholarly journals The Breast Service Psychosocial Model of Care Project

2009 ◽  
Vol 33 (4) ◽  
pp. 560
Author(s):  
Bruce G Mann ◽  
Lauren K Williams

Objective: It has been consistently demonstrated that many women with breast disease will experience psychosocial distress at some stage along the patient journey. Psychosocial care has recently gained more prominence and is increasingly recognised as an important aspect of care offered to patients with breast cancer. The purpose of this project was to develop a model that improved the way psychosocial services were provided to patients. The aim of this paper is to describe the process in developing this psychosocial model of care for patients with breast disease. Methods: Using in-depth semi-structured interviews with a sample of patients and staff, we examined psychosocial concerns experienced by breast patients and the factors associated with the effective assessment and delivery of psychosocial care. The project was approved by the Royal Women?s hospital ethics secretariat as a quality assurance project. Results: An inductive analysis of staff responses indicated that a standardised screening and referral pathway was needed in a context of well defined staff roles and a multidisciplinary team environment. An inductive analysis of patient responses indicated that psychosocial concerns were common, but varied, and a tailored approach to the provision of psychosocial care was warranted. Discussion: In line with these findings, a standardised assessment and referral pathway was developed for The Breast Service that may be extended for use in other clinical settings and tumour streams.

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041548
Author(s):  
Cristian Ochoa-Arnedo ◽  
Joan Carles Medina ◽  
Aida Flix-Valle ◽  
Dimitra Anastasiadou

IntroductionPsychosocial interventions for patients with breast cancer (BC) have demonstrated their effectiveness at reducing emotional distress and improving quality of life. The current digitisation of screening, monitoring and psychosocial treatment presents the opportunity for a revolution that could improve the quality of care and reduce its economic burden. The objectives of this study are, first, to assess the effectiveness of an e-health platform with integrated and stepped psychosocial services compared with usual psychosocial care, and second, to examine its cost–utility.Methods and analysisThis study is a multicentre randomised controlled trial with two parallel groups: E-health intervention with integrated and stepped psychosocial services vs usual psychosocial care. An estimated sample of 338 patients with BC in the acute survival phase will be recruited from three university hospitals in Catalonia (Spain) and will be randomly assigned to one of two groups. All participants will be evaluated at the beginning of the study (T1: recruitment), 3 months from T1 (T2), 6 months from T1 (T3) and 12 months from T1 (T4). Primary outcome measures will include number of clinical cases detected, waiting time from detection to psychosocial intervention and proportion of cases successfully treated in the different steps of the intervention, as well as outcomes related to emotional distress, quality of life, post-traumatic stress and growth, treatment adherence and therapeutic alliance. Secondary outcomes will include the acceptability of the platform, patients’ satisfaction and usability. For the cost–utility analysis, we will assess quality-adjusted life years and costs related to healthcare utilisation, medication use and adherence, work absenteeism and infrastructure-related and transport-related costs.Ethics and disseminationThis study was approved by the Ethics committee of the Institut Català d’Oncologia network in Hospitalet, Spain. Findings will be disseminated through peer-reviewed journals, reports to the funding body, conferences among the scientific community, workshops with patients and media press releases.Trial registration numberOnline Psychosocial Cancer Screening, Monitoring and Stepped Treatment in Cancer Survivors (ICOnnectat-B),NCT04372459.


Following on Felice Perlmutter's work on the managerial role of social workers in social services, this article contributes to the still limited knowledge on the role of social workers in middle-management positions in formulating new policies `on the ground`. The study expands knowledge about policies determined by team managers in local social service departments in Israel. It occurs in the nexus between street-level bureaucracy, professionalism and managerial positions. Semi-structured interviews with 28 team managers revealed that they formulated `new` policies with regard to the provision of psychosocial services and material assistance (who gets what, when and how). This occurs when they resist official policy, when it is vague or non-existent. Most of their policy decisions are not documented and draw upon consultations with colleagues and superiors though not with clients. The team managers perceive these policies as a means for achieving balance between clients' well-being and budgetary constraints. Yet their decisions lack transparency, are decided upon without public discourse and may lead to greater inequity between clients


2016 ◽  
Vol 50 (5) ◽  
pp. 785-791 ◽  
Author(s):  
Eliza Maria Rezende Dázio ◽  
Márcia Maria Fontão Zago ◽  
Silvana Maria Coelho Leite Fava

Abstract OBJECTIVE To understand the meanings that male university students assign to the condition of users of alcohol and other drugs. METHOD An exploratory study using a qualitative approach, with inductive analysis of the content of semi-structured interviews applied to 20 male university students from a public university in the southeast region of Brazil, grounded on the theoretical-methodological referential of interpretive anthropology and ethnographic method. RESULTS Data were construed using content inductive analysis for two topics: use of alcohol and/or drugs as an outlet; and use of alcohol and/or other drugs: an alternative for belonging and identity. CONCLUSION Male university students share the rules of their sociocultural environment that values the use of alcohol and/or other drugs as a way of dealing with the demands and stress ensuing from the everyday university life, and to build identity and belong to this social context, reinforcing the influence of culture.


2021 ◽  
Vol 38 ◽  
Author(s):  
Julia Corrêa GOMES ◽  
Fernanda Kimie Tavares MISHIMA-GOMES ◽  
Clarissa Mendonça CORRADI-WEBSTER

Abstract The literature highlights the existence of weaknesses in the psychosocial care network, especially in the treatment of children and adolescents that use drugs. The study aimed to comprehend, based on the Winnicottian theoretical framework, how a Residential Care Unit has been providing care to children and adolescents with needs arising from drugs use in situations of social vulnerability. Semi-structured interviews, with eight care providers, and 65 hours of participant observation were carried out. From the thematic analysis, three themes were constructed: (1) Setting: regarding attention to basic needs and construction of a routine; (2) View: regarding empathy and expansion of perspectives; (3) Aggressiveness: regarding new ways of relating. Important actions are aimed at constructing care for this specific population, as this is a current theme with recent and weakly structured public policies.


2021 ◽  
Author(s):  
Jennifer E Butterly

The changing demographics of illness necessitate the provision of complex care practices designed to meet the individual needs of families from diverse backgrounds. Providing psychosocial care to paediatric patients, child life specialists integrate processes designed to better understand their patients, thus informing their plans of care. Through the use of Grounded Theory, this study involves 7 child life specialists from a large city in Ontario and explores the processes implemented by child life specialists in getting to know their patients and families. Data obtained from semi-structured interviews and a reflective journaling exercise was examined for evidence of cultural influence and a greater understanding of child life specialists' perceived comfort and ability was explored. The results of this study suggest child life specialists engage in culturally responsive practices, however several barriers and challenges exist. Resource needs are identified and implications for practice are examined.


2021 ◽  
Author(s):  
Tom May ◽  
Henry Aughterson ◽  
Daisy Fancourt ◽  
Alexandra Burton

Aims: Non-healthcare keyworkers face distinct occupational vulnerabilities that have received little consideration within broader debates about ‘essential’ work and psychological distress during the COVID-19 pandemic. The aim of this study was therefore to explore the impact of the pandemic on the working lives and mental health and wellbeing of non-healthcare keyworkers in the UK.Methods: In-depth, semi-structured interviews were conducted with 23 participants employed in a range of non-healthcare keyworker occupations, including transport, retail, education, postal services and the police force. Interviews were audio-recorded and transcribed verbatim. Data were analysed using a reflexive thematic approach. Results: Keyworkers experienced adverse psychological effects during the COVID-19 pandemic, including fears of COVID-19 exposure, contagion and subsequent transmission to others, especially their families. These concerns were often experienced in the context of multiple exposure risks, including insufficient PPE and a lack of workplace mitigation practices. Keyworkers also described multiple work-related challenges, including increased workload, a lack of public and organisational recognition and feelings of disempowerment. Conclusion: In efforts to reduce psychosocial concerns among non-healthcare keyworkers, there is a need for appropriate support during the COVID-19 pandemic and in preparation for other infections (e.g. seasonal influenza) in the future. This includes the provision of psychological and workplace measures attending to the intersections of personal vulnerability and work conditions that cause unique risks and challenges among those in frontline keyworker occupations.


2021 ◽  
Vol 74 (suppl 3) ◽  
Author(s):  
Aline Silvia Esteves Morais ◽  
Gisele Fernandes Tarma Cordeiro ◽  
Angela Aparecida Peters ◽  
Tatiana Marques dos Santos ◽  
Rosa Gomes dos Santos Ferreira ◽  
...  

ABSTRACT Objective: To analyze how the nursing team from a Psychosocial Care Center II relates its insertion in the service with the work process. Methods: Descriptive, analytical research outlined as a case study with a qualitative approach. The data were collected through semi-structured interviews with nursing professionals and went through content analysis subsidized by Bardin’s work. Results: Two thematic categories emerged: a) Ways of intake in the nursing services at the Psychosocial Care Center; b) Setbacks in nursing routine at the Psychosocial Care Center. Final considerations: The fact that the professionals have not planned to work in mental health nor have training impacts the rhythm of psychosocial care development at the Psychosocial Care Center, forcing them to seek training in the field after admission. Unmotivated by the working conditions, the nursing team suffers from the absence of an interdisciplinary partnership and goes to great lengths to approach psychosocial care.


2021 ◽  
pp. 147332502110451
Author(s):  
Felicity Moon ◽  
Christine Mooney ◽  
Fiona McDermott ◽  
Peter Poon ◽  
David W Kissane

Policy and research acknowledge that the quality of end-of-life care in hospitals can be poor, with families reporting significant concerns regarding physical and psychosocial care. In order to design appropriate evidenced-based care approaches, we conducted qualitative research examining the perspectives of bereaved families of patients who received end-of-life care in our health network. This paper reports on ethical dilemmas facing practitioner-researchers conducting interviews with bereaved families. We recruited 40 bereaved family members to participate in semi-structured interviews discussing the care a loved one received while a patient under the general medicine units. Bereaved participants expressed grief, humour and anger regarding their experience, and several reported perceptions of negligent and harmful care. Irrespective of the protocols in place to mitigate distress, this posed an ethical dilemma for the practitioner-researcher as a member of the health network, who needed to balance clinical and research roles when responding to distress. The practitioner-researcher’s own bias and assumptions emerged when analysing families’ distressing recollections. More broadly, the issues discussed have clinical implications for models of hospital bereavement support. Participants’ use of photos and mementos jointly served to include the presence of the deceased in the research interview, but also highlighted the potential to utilise visual methods to examine sensitive research issues. It helps every practitioner-researcher to distinguish between research-oriented goals and clinical responsibilities to care provision as they consider their human research ethics application before beginning any research.


2021 ◽  
pp. 026921632110433
Author(s):  
David Russell ◽  
Michelina D Stoddard ◽  
Natalie Morgan ◽  
Margaret V McDonald ◽  
Ritchell Dignam ◽  
...  

Background: Urinary incontinence is prevalent among patients receiving home hospice and presents multiple care management challenges for nurses and family caregivers. Aim: This study sought to understand how urinary incontinence influences the psychosocial care of patients receiving home hospice and the strategies that nurses employ to maximize patient and family comfort. Design: Qualitative descriptive study using semi-structured interviews. Setting/participants: Nurses employed at a large not-for-profit hospice agency in New York City. Results: Analyses of 32 interviews revealed three primary themes. First, nurses considered urinary incontinence to be associated with multiple psychosocial issues including embarrassment for patients and caregiver burden. Second, nurses described urinary incontinence as a threat to patient dignity and took steps to preserve their continence function. Third, nurses assisted patients and their families to cope with urinary incontinence through normalization, reframing incontinence as part of the disease process, mobilizing caregiving assistance, and encouraging use of continence supplies such as diapers and liners. Conclusion: Urinary incontinence influences the psychosocial care of patients receiving home hospice and nurses employ strategies to maximize patient and family comfort. Additional research is needed to examine the psychosocial benefits of facilitated discussions with patients and family members about incontinence, provision of caregiving support, and distribution of comprehensive incontinence supplies to patients with fewer resources.


2015 ◽  
Vol 25 (60) ◽  
pp. 95-104 ◽  
Author(s):  
Magda Diniz Bezerra Dimenstein ◽  
Viktor Gruska ◽  
Jader Ferreira Leite

Since psychiatric crisis treatment is crucial in mental health care, this study aimed to characterize the psychiatric crisis in the hospital emergency services of Natal/RN. Semi-structured interviews were conducted with 33 professionals employed in four local public hospitals. The results revealed the absence of adequate beds for psychiatric conditions, scarcity of psychiatric drugs, lack of clarity regarding diagnostic criteria, treatment based on chemical restraint and inpatient care as a priority strategy. Furthermore, there is fragmentation of the work processes with physician centrality in the management of crisis, disarticulation between hospitals and other services of the psychosocial care network and systematic referrals to psychiatric hospital. We conclude that the configuration of the local hospital network does not present satisfactory responsiveness to psychiatric crisis situations and its clinical and institutional weaknesses reflect the process of psychiatric reform in the region.


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