scholarly journals 96 Service Priorities for People with Dementia in Ireland: A Mixed Methods Study of Health Care Professionals

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Fiona Keogh ◽  
Tom Pierse ◽  
Eamon O'Shea
Keyword(s):  
Mixed Methods ◽  
Health Care Professionals ◽  
Social Care ◽  
Unmet Need ◽  
Budget Constraint ◽  
Similar Proportion ◽  
People With Dementia ◽  
High Dependency ◽  
Health And Social Care ◽  
Wide Range

Abstract Background Public services for people with dementia living in the community face significant resource constraints. The aims of this study are to identify an optimum mix of services for six dementia case types and to gain a greater understanding of the resource allocation decision making process. Methods Irish datasets were used to identify dementia cases types representing 46% of cases in the datasets. Vignettes were prepared for six case types ranging from low to high dependency and needs. Carers, people with dementia and health and social care professionals (HSCPs) took part in mixed methods workshops. Initial findings for the HSCPs are reported here (N=23). HSCP participants firstly quantitatively identified an optimum care package for a set of six vignettes, then qualitatively discussed the needs and individual case factors that were driving service recommendations. The quantitative exercise was repeated with a budget constraint. The sessions finished with a discussion on service and case prioritisation. Results When no budget constraint is imposed, participants recommended the use of a wide range of services. Home help, in-home respite and day care services comprised 62% of spending in this scenario. When a budget constraint was imposed, participants focused on essential care and reduced services aimed at prevention, quality of life and carer support. Resources were not redistributed between cases (e.g. from low need to higher need cases) as a similar proportion of the budget was allocated to each of the cases in both scenarios. Conclusion People with dementia living in the community and their families have a wide range of health and social care needs. Optimum dementia care packages included a wide range of services to meet these needs. However, a budget constraint resulted in a much narrower range of services with consequent implications in terms of unmet need and a reactive rather than preventive approach to care.

scholarly journals A Web-Based Platform for People With Memory Problems and Their Caregivers (CAREGIVERSPRO-MMD): Mixed-Methods Evaluation of Usability (Preprint)

2017 ◽  
Author(s):  
Paraskevi Zafeiridi ◽  
Kevin Paulson ◽  
Rosie Dunn ◽  
Emma Wolverson ◽  
Caroline White ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Social Care ◽  
Informal Caregivers ◽  
Dropout Rate ◽  
Ease Of Use ◽  
Perceived Usefulness ◽  
Web Based ◽  
People With Dementia ◽  
Health And Social Care ◽  
Administration Time

BACKGROUND The increasing number of people with dementia (PwD) drives research exploring Web-based support interventions to provide effective care for larger populations. In this concept, a Web-based platform (CAREGIVERSPRO-MMD, 620911) was designed to (1) improve the quality of life for PwD, (2) reduce caregiver burden, (3) reduce the financial costs for care, and (4) reduce administration time for health and social care professionals. OBJECTIVE The objective of this study was to evaluate the usability and usefulness of CAREGIVERSPRO-MMD platform for PwD or mild cognitive impairment (MCI), informal caregivers, and health and social care professionals with respect to a wider strategy followed by the project to enhance the user-centered approach. A secondary aim of the study was to collect recommendations to improve the platform before the future pilot study. METHODS A mixed methods design was employed for recruiting PwD or MCI (N=24), informal caregivers (N=24), and professionals (N=10). Participants were asked to rate their satisfaction, the perceived usefulness, and ease of use of each function of the platform. Qualitative questions about the improvement of the platform were asked when participants provided low scores for a function. Testing occurred at baseline and 1 week after participants used the platform. The dropout rate from baseline to the follow-up was approximately 10% (6/58). RESULTS After 1 week of platform use, the system was useful for 90% (20.75/23) of the caregivers and for 89% (5.36/6) of the professionals. When users responded to more than 1 question per platform function, the mean of satisfied users per function was calculated. These user groups also provided positive evaluations for the ease of use (caregivers: 82%, 18.75/23; professionals: 97%, 5.82/6) and their satisfaction with the platform (caregivers: 79%, 18.08/23; professionals: 73%, 4.36/6). Ratings from PwD were lower than the other groups for usefulness (57%, 13/23), ease of use (41%, 9.4/23), and overall satisfaction (47%, 11/23) with the platform (P<.05). Qualitative comments related to both improvements for functionality and the platform interface. CONCLUSIONS Although caregivers and professionals were overall satisfied with the platform, further adaptations were recommended by PwD. This reiterates the importance of the involvement of end users in the development of Web-based interventions. Recommendations from users in this paper apply for the interface and functionality of a wider range of Web-based support interventions.

A logic model of the implementation of a regional workforce strategy in positive behavioural support

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Steve Noone ◽  
Alison Branch ◽  
Melissa Sherring
Keyword(s):  
Large Scale ◽  
Social Care ◽  
Building Blocks ◽  
Logic Model ◽  
Competency Framework ◽  
Health Staff ◽  
Content Type ◽  
Behavioural Support ◽  
Health And Social Care ◽  
Wide Range

Purpose Positive behavioural support (PBS) as a framework for delivering quality services is recognised in important policy documents (CQC, 2020; NICE, 2018), yet there is an absence in the literature on how this could be implemented on a large scale. The purpose of this paper is to describe a recent implementation of a workforce strategy to develop PBS across social care and health staff and family carers, within the footprint of a large integrated care system. Design/methodology/approach A logic model describes how an initial scoping exercise led to the production of a regional workforce strategy based on the PBS Competence Framework (2015). It shows how the creation of a regional steering group was able to coordinate important developmental stages and integrate multiple agencies into a single strategy to implement teaching and education in PBS. It describes the number of people who received teaching and education in PBS and the regional impact of the project in promoting cultural change within services. Findings This paper demonstrates a proof of concept that it is possible to translate the PBS Competency Framework (2015) into accredited courses. Initial scoping work highlighted the ineffectiveness of traditional training in PBS. Using blended learning and competency-based supervision and assessment, it was possible to create a new way to promote large-scale service developments in PBS supported by the governance of a new organisational structure. This also included family training delivered by family trainers. This builds on the ideas by Denne et al. (2020) that many of the necessary building blocks of implementation already exist within a system. Social implications A co-ordinated teaching and education strategy in PBS may help a wide range of carers to become more effective in supporting the people they care for. Originality/value This is the first attempt to describe the implementation of a framework for PBS within a defined geographical location. It describes the collaboration of health and social care planners and a local university to create a suite of courses built around the PBS coalition competency framework.

scholarly journals Characteristics of value-based health and social care from organisations’ perspectives (OrgValue): a mixed-methods study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. e022635 ◽  
Author(s):  
Lena Ansmann ◽  
Hendrik Ansgar Hillen ◽  
Ludwig Kuntz ◽  
Stephanie Stock ◽  
Vera Vennedey ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Study Protocol ◽  
Social Care ◽  
Mixed Methods Study ◽  
Health And Social Care

scholarly journals Experiences of preparing children for a death of an important adult during the COVID-19 pandemic: a mixed methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e053099
Author(s):  
Elizabeth Rapa ◽  
Jeffrey R Hanna ◽  
Catriona R Mayland ◽  
Stephen Mason ◽  
Bettina Moltrecht ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Social Care ◽  
Psychosocial Support ◽  
Healthcare Team ◽  
Mixed Methods Design ◽  
Significant Relationships ◽  
Health And Social Care ◽  
The Uk ◽  
Parental Belief ◽  
Depth Interviews

ObjectiveThe objectives of this study were to investigate how families prepared children for the death of a significant adult, and how health and social care professionals provided psychosocial support to families about a relative’s death during the COVID-19 pandemic.Design/settingA mixed methods design; an observational survey with health and social care professionals and relatives bereaved during the COVID-19 pandemic in the UK, and in-depth interviews with bereaved relatives and professionals were conducted. Data were analysed thematically.ParticipantsA total of 623 participants completed the survey and interviews were conducted with 19 bereaved relatives and 16 professionals.ResultsMany children were not prepared for a death of an important adult during the pandemic. Obstacles to preparing children included families’ lack of understanding about their relative’s declining health; parental belief that not telling children was protecting them from becoming upset; and parents’ uncertainty about how best to prepare their children for the death. Only 10.2% (n=11) of relatives reported professionals asked them about their deceased relative’s relationships with children. This contrasts with 68.5% (n=72) of professionals who reported that the healthcare team asked about patient’s relationships with children. Professionals did not provide families with psychosocial support to facilitate preparation, and resources were less available or inappropriate for families during the pandemic. Three themes were identified: (1) obstacles to telling children a significant adult is going to die, (2) professionals’ role in helping families to prepare children for the death of a significant adult during the pandemic, and (3) how families prepare children for the death of a significant adult.ConclusionsProfessionals need to: provide clear and honest communication about a poor prognosis; start a conversation with families about the dying patient’s significant relationships with children; and reassure families that telling children someone close to them is dying is beneficial for their longer term psychological adjustment.

scholarly journals 211 - Changes to post-diagnostic dementia support in England and Wales during the COVID-19 pandemic

2021 ◽  
Vol 33 (S1) ◽  
pp. 13-13
Author(s):  
Alison Wheatley ◽  
Marie Poole ◽  
Louise Robinson
Keyword(s):  
Social Care ◽  
Third Sector ◽  
Full Time ◽  
England And Wales ◽  
Team Meetings ◽  
Use Of Technology ◽  
People With Dementia ◽  
Health And Social Care ◽  
The Impact ◽  
Diagnostic Support

Background:The COVID-19 pandemic precipitated widespread change across health and social care in England and Wales. A series of lockdowns and UK Government guidance designed to reduce the spread of COVID-19 which emphasised social distancing and increased use of personal protective equipment led to changes such as increased use of remote consultation technologies and the closure of services deemed non-essential. This included many services for people with dementia and their families, such as day centres and dementia cafes.Objective:To explore the changes made to services during the pandemic and the impact of these changes on the delivery of good post-diagnostic dementia support.Method:Professionals who had previously been recruited to the ongoing PriDem qualitative study were approached for follow up interview. Eighteen interviews with a total of 21 professionals working in health, social care and the third sector were conducted using telephone or video conferencing.Interviews were audio recorded, transcribed and checked prior to thematic analysis.Results:Key themes emerging from preliminary analysis of the data include: uncertainty about the future and the need to adapt quickly to shifting guidance; changing job roles and ways of working; the emotional and physical impact of the pandemic on staff working with people with dementia and their families; and the impact of changes made (e.g. increased PPE, remote working) on the ability to deliver post-diagnostic support. However, there were also some unintended positive outcomes of the changes. These included the ability to include family members living at a distance in remote consultations, allowing for more robust history-taking, as well as the uptake of technology to facilitate cross-sector and multidisciplinary working between professionals.Conclusion:Delivering post-diagnostic dementia support during COVID-19 was challenging and forced dementia services to make adaptations. Participants expected that some of these changes would be incorporated into post-pandemic work, for example increased use of technology for multidisciplinary team meetings or blended approaches to patient-facing services involving both virtual and face to face work as appropriate. However, most participants agreed that it was not appropriate nor desirable to provide fully remote post-diagnostic support on a full time basis.

Supporting people with dementia during the COVID-19 pandemic

2021 ◽  
Vol 32 (2) ◽  
pp. 65-68
Author(s):  
Linda Nazarko
Keyword(s):  
Primary Care Practice ◽  
Social Care ◽  
Practice Nurse ◽  
Informal Support ◽  
Care Practice ◽  
Physical And Mental Health ◽  
Practice Nurses ◽  
People With Dementia ◽  
Care Workers ◽  
Health And Social Care

People with dementia have experienced great disruption to their lives due to the pandemic. Linda Nazarko highlights the way individuals have been affected and how the practice nurse can support them People with dementia and their caregivers have been severely affected by the COVID-19 pandemic. Isolation, a reduction in formal and informal support, and disruption to routine have contributed to feelings of loneliness and anxiety in people with dementia and their caregivers. The pandemic has led to staff shortages in health and social care, changes of care workers and a reduction in the level of support provided. These changes have affected the physical and mental health of people with dementia and increased their reliance on primary care. Practice nurses have a key role to play in supporting affected individuals.

The health and social care integration, with particular attention to the dimension of professional integration. A research across 12 italian regions

2012 ◽  
pp. 234-244
Author(s):  
Nicoletta Pavesi
Keyword(s):  
Health Care Professionals ◽  
Social Care ◽  
Daily Practice ◽  
Fully Integrated ◽  
Professional Integration ◽  
Care Integration ◽  
Self Sufficiency ◽  
Italian Regions ◽  
Health And Social Care ◽  
Experimental Project

This paper gives an account of a part of a wider research carried out on 12 italian Regions by title Experimental project of monitoring, evaluation and dissemination of knowledge on governance and national plans, regional and area plans within the policies of inclusion. In particular, it analizes the dimension of professional integration, both at the regulatory and daily practice levels. It clearly appears the shared conviction at the various levels for the need to operate in a way that is ever more oriented to integration, in so far as it represents a strategic means of welfare construction for citizens. In addition, in some regions testimonies of positive integration have been collected, especially in the field of non-self-sufficiency. Naturally, there are many difficulties that often make integration a practice entrusted to the goodwill of the health care professionals, rather than a process fully integrated in a system of policies and services.

scholarly journals The barriers and facilitators to implementing dementia education and training in health and social care services: a mixed-methods study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Claire A. Surr ◽  
Sahdia Parveen ◽  
Sarah J. Smith ◽  
Michelle Drury ◽  
Cara Sass ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Behaviour Change ◽  
Social Care ◽  
Education And Training ◽  
Barriers And Facilitators ◽  
Care Providers ◽  
Care Services ◽  
Health And Social Care ◽  
And Training ◽  
Dementia Education

Abstract Background The health and social care workforce requires access to appropriate education and training to provide quality care for people with dementia. Success of a training programme depends on staff ability to put their learning into practice through behaviour change. This study aimed to investigate the barriers and facilitators to implementation of dementia education and training in health and social care services using the Theoretical Domains Framework (TDF) and COM-B model of behaviour change. Methods A mixed-methods design. Participants were dementia training leads, training facilitators, managers and staff who had attended training who worked in UK care homes, acute hospitals, mental health services and primary care settings. Methods were an online audit of care and training providers, online survey of trained staff and individual/group interviews with organisational training leads, training facilitators, staff who had attended dementia training and managers. Data were analysed using descriptive statistics and thematic template analysis. Results Barriers and facilitators were analysed according the COM-B domains. “Capability” factors were not perceived as a significant barrier to training implementation. Factors which supported staff capability included the use of interactive face-to-face training, and training that was relevant to their role. Factors that increased staff “motivation” included skilled facilitation of training, trainees’ desire to learn and the provision of incentives (e.g. attendance during paid working hours, badges/certifications). “Opportunity” factors were most prevalent with lack of resources (time, financial, staffing and environmental) being the biggest perceived barrier to training implementation. The presence or not of external support from families and internal factors such as the organisational culture and its supportiveness of good dementia care and training implementation were also influential. Conclusions A wide range of factors may present as barriers to or facilitators of dementia training implementation and behaviour change for staff. These should be considered by health and social care providers in the context of dementia training design and delivery in order to maximise potential for implementation.

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