scholarly journals Strengths-Based Interprofessional Practice and Education: Transforming Care Through Disruption

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 578-578
Author(s):  
Teri Kennedy

Abstract This is a conceptual paper proposing a new model of Strengths-Based Interprofessional Practice and Education (SB-IPE), incorporating appreciative inquiry and narrative, and its application to improve health and social care practice and policy for older adults. Within people, families, communities, and teams are people who understand their assets and culture, hold a collective wisdom derived from their individual biographies and shared history, and are deeply invested in their success. This wisdom and experience can be mined for strengths and best practices to improve health and social care for older adults and their families. The conceptual framework of the model and relationship between concepts are explained, reviewing and synthesizing relevant literature on the strengths perspective, interprofessional practice and education, evolution of the patient voice, appreciative inquiry, and narrative to leverage the voices and experiences of older adults, their families, and interprofessional teams. Providing person-, family-, and community-centered health and social care through SB-IPE involves eliciting, listening to, and processing stories and narratives, then coalescing and co-creating person/family/team narratives throughout the trajectory of care. Appreciate inquiry and narrative can be harnessed to imagine an improved experience of care for older adults and their families. Incorporating the potential disruption of the voices and perspectives of older adults and their families offers value for health and social care delivery and policy innovation. Application of the SB-IPE model holds promise for harnessing these voices and collective experiences leading from disruption to transformation of health and social care practice, health professions education, policy, and research.

2021 ◽  
Author(s):  
Madison Milne-Ives ◽  
Rohit Shankar ◽  
Daniel Goodley ◽  
Kristen Lamb ◽  
Richard Laugharne ◽  
...  

BACKGROUND Healthcare is shifting towards a more person-centred model, however, people with intellectual and developmental disabilities can still experience difficulties in accessing equitable healthcare. Given these difficulties, it is important to consider how principles such as empathy and respect can be best incorporated into health and social care practices for people with intellectual and developmental disabilities, to ensure they are receiving humanising and equitable treatment and support. OBJECTIVE The purpose of this scoping review is to provide an overview of the current research landscape and knowledge gaps regarding the development and implementation of interventions based on humanising principles that aim to improve health and social care practices for people with intellectual and developmental disabilities. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and Population, Intervention, Comparator, Outcome, and Study (PICOS) frameworks will be used to structure the review. Six databases (PubMed, MEDLINE, Embase, CINAHL, PsycInfo, and Web of Science) will be searched for articles published in English in the previous 10 years that describe or evaluate health and social care practice interventions under-pinned by humanising principles of empathy, compassion, dignity, and respect. Two reviewers will collaboratively screen and select references based on the eligibility criteria and extract the data into a predetermined form. A descriptive analysis will be conducted to summarise the results and provide an overview of interventions in three main care areas: health care, social care, and informal social support. RESULTS Results will be included in the scoping review, which will be submitted for publication by December 2021. CONCLUSIONS This scoping review will summarize the state of the field of interventions that are using humanising principles to improve health and social care for adults with intellectual and developmental disabilities.


2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Marica Cassarino ◽  
Katie Robinson ◽  
Rosie Quinn ◽  
Fiona Boland ◽  
Marie E Ward ◽  
...  

Abstract Background Introducing Health and Social Care Professional (HSCP) teams to the emergency department (ED) has increasingly demonstrated benefits for ED patient and process outcomes. However, there is a dearth of research exploring the views of key ED stakeholders on the role of HSCP teams in care delivery the ED. This qualitative study investigated the perspectives of a wide range of ED stakeholders about HSCPs teams working in the ED. Methods A total of 65 participants including older adults who had recently attended the ED and their carers/relatives, ED doctors and nurses, HSCPs and pre-hospital staff participated in four World Café style focus groups and individual interviews across two Irish hospital sites. Written and audio-recorded data were transcribed and thematically analysed. Results Overall, participants expressed positive views on HSCPs working in teams in the ED, with benefits for patients, staff members and the hospital (Theme 1). Having an ED-based HSCP team was described as promoting effective and timely decision-making and a more integrated approach to patient care, particularly for frail older adults with complex needs (Theme 2). Barriers and enablers for effective implementation were identified at multiple levels (Theme 3) including the ED physical environment, (e.g., space and equipment), operational factors (e.g., working hours), and relations (e.g., patient-staff or staff-staff communication); factors at system level included availability of community resources and financial pressures. Conclusion Our study indicates overall acceptability of HSCPs working in teams in the ED and positive views on their contribution to enhance the quality care of older adults. However, a number of operational and relational factors need to be considered to ensure feasibility and effectiveness. This information is crucial to inform implementation.


2021 ◽  
Vol 30 ◽  
Author(s):  
Shiyu Lu ◽  
Tianyin Liu ◽  
Gloria H. Y. Wong ◽  
Dara K. Y. Leung ◽  
Lesley C. Y. Sze ◽  
...  

Abstract Aims Late-life depression has substantial impacts on individuals, families and society. Knowledge gaps remain in estimating the economic impacts associated with late-life depression by symptom severity, which has implications for resource prioritisation and research design (such as in modelling). This study examined the incremental health and social care expenditure of depressive symptoms by severity. Methods We analysed data collected from 2707 older adults aged 60 years and over in Hong Kong. The Patient Health Questionnaire-9 (PHQ-9) and the Client Service Receipt Inventory were used, respectively, to measure depressive symptoms and service utilisation as a basis for calculating care expenditure. Two-part models were used to estimate the incremental expenditure associated with symptom severity over 1 year. Results The average PHQ-9 score was 6.3 (standard deviation, s.d. = 4.0). The percentages of respondents with mild, moderate and moderately severe symptoms and non-depressed were 51.8%, 13.5%, 3.7% and 31.0%, respectively. Overall, the moderately severe group generated the largest average incremental expenditure (US$5886; 95% CI 1126–10 647 or a 272% increase), followed by the mild group (US$3849; 95% CI 2520–5177 or a 176% increase) and the moderate group (US$1843; 95% CI 854–2831, or 85% increase). Non-psychiatric healthcare was the main cost component in a mild symptom group, after controlling for other chronic conditions and covariates. The average incremental association between PHQ-9 score and overall care expenditure peaked at PHQ-9 score of 4 (US$691; 95% CI 444–939), then gradually fell to negative between scores of 12 (US$ - 35; 95% CI - 530 to 460) and 19 (US$ -171; 95% CI - 417 to 76) and soared to positive and rebounded at the score of 23 (US$601; 95% CI -1652 to 2854). Conclusions The association between depressive symptoms and care expenditure is stronger among older adults with mild and moderately severe symptoms. Older adults with the same symptom severity have different care utilisation and expenditure patterns. Non-psychiatric healthcare is the major cost element. These findings inform ways to optimise policy efforts to improve the financial sustainability of health and long-term care systems, including the involvement of primary care physicians and other geriatric healthcare providers in preventing and treating depression among older adults and related budgeting and accounting issues across services.


BJGP Open ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. bjgpopen20X101013
Author(s):  
Jonathan Donald Kennedy ◽  
Serena Moran ◽  
Sue Garrett ◽  
James Stanley ◽  
Jenny Visser ◽  
...  

BackgroundRefugees and asylum seekers have specific health and social care needs on arrival in a resettlement country. A third group — migrants with a refugee-like background (refugee-like migrants) — are less well defined or understood.AimUsing routinely collected data, this study compared demographics, interpreter need, and healthcare utilisation for cohorts of refugee-like migrants and refugees.Design & settingA retrospective cohort study was undertaken in Wellington, New Zealand.MethodData were obtained for refugee-like migrants and refugees accepted under the national quota system (quota refugees), who enrolled in a New Zealand primary care practice between 2011 and 2015. Data from the primary care practice and nationally held hospital and outpatient service databases, were analysed. Age and sex standardisation adjusted for possible differences in cohort demographic profiles.ResultsThe cohorts were similar in age, sex, deprivation, and interpreter need. Refugee-like migrants were found to have similar, but not identical, health and social care utilisation to quota refugees. Primary care nurse utilisation was higher for refugee-like migrants. Clinical entries in the primary care patient record were similar in rate for the cohorts. Emergency department utilisation and hospital admissions were similar. Hospital outpatient utilisation was lower for refugee-like migrants.ConclusionThis research suggests that health, social care, and other resettlement services should be aligned for refugee-like migrants and quota refugees. This would mean that countries accepting quota refugees should plan for health and social care needs of subsequent refugee-like migrant family migration. Further research should investigate matched larger-scale national health and immigration datasets, and qualitatively explore factors influencing health-seeking behaviour of refugee-like migrants.


Author(s):  
Susanna Nordin ◽  
Jodi Sturge ◽  
Maria Ayoub ◽  
Allyson Jones ◽  
Kevin McKee ◽  
...  

Information and communication technology (ICT) can potentially support older adults in making decisions and increase their involvement in decision-making processes. Although the range of technical products has expanded in various areas of society, knowledge is lacking on the influence that ICT has on older adults’ decision-making in everyday situations. Based on the literature, we aimed to provide an overview of the role of ICT in home-dwelling older adults’ decision-making in relation to health, and health and social care services. A scoping review of articles published between 2010 and 2020 was undertaken by searching five electronic databases. Finally, 12 articles using qualitative, quantitative, and mixed-method designs were included. The articles were published in journals representing biology and medicine, nursing, informatics, and computer science. A majority of the articles were published in the last five years, and most articles came from European countries. The results are presented in three categories: (i) form and function of ICT for decision-making, (ii) perceived value and effect of ICT for decision-making, and (iii) factors influencing ICT use for decision-making. According to our findings, ICT for decision-making in relation to health, and health and social care services was more implicitly described than explicitly described, and we conclude that more research on this topic is needed. Future research should engage older adults and health professionals in developing technology based on their needs. Further, factors that influence older adults’ use of ICT should be evaluated to ensure that it is successfully integrated into their daily lives.


2021 ◽  
Vol 32 (2) ◽  
pp. 65-68
Author(s):  
Linda Nazarko

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.


2021 ◽  
Author(s):  
Kimberley J Smith ◽  
Christina Victor

Abstract Background and Objectives Loneliness is proposed to be linked with increased service use. This review examined the association of loneliness and health and social care utilisation (HSCU) in older adults from the general population. Research Design and Methods Four databases were screened for studies that examined the association of loneliness (predictor) with HSCU (outcome) in older adults (defined as majority of sample 60 or older). Study quality was assessed with the NIH scale for observational cohorts and cross-sectional studies. Results We identified 32 studies, of which 9 prospective studies were evaluated as being good or good-fair quality. Two good-fair quality studies found loneliness at baseline was associated with subsequent admission to a residential care home. There was emerging evidence that loneliness was associated with emergency department use (n=1), and CVD-specific hospitalisation (n=1). Once adjusted for confounders the highest quality studies found no association of baseline loneliness with physician utilisation, outpatient service utilisation, skilled nursing facility use, and planned or unplanned hospital admissions. The remaining, studies were cross-sectional, or of fair to poor quality, and inadequate to reliably determine whether loneliness was associated with a subsequent change in HSCU. Discussion and implications There was heterogeneity in study design, measurement, and study quality. This generated an inconsistent evidence base where we cannot determine clear inferences about the relationship between loneliness and HSCU. Only one consistent finding was observed between two good-fair quality studies regarding care home admission. To determine clinical implications and make reliable inferences additional good quality longitudinal research is needed.


Author(s):  
Maonolis Tsiknakis

This chapter provides an overview and discussion of virtual communities in health and social care. The available literature indicates that a virtual community in health or social care can be defined as a group of people using telecommunications with the purposes of delivering health care and education, and/or providing support. Such communities cover a wide range of clinical specialties, technologies and stakeholders. Examples include peer-to-peer networks, virtual health care delivery and E-Science research teams. Virtual communities may empower patients and enhance coordination of care services; however, there is not sufficient systematic evidence of the effectiveness of virtual communities on clinical outcomes. When practitioners utilize virtual community tools to communicate with patients or colleagues they have to maximize sociability and usability of this mode of communication, while addressing concerns for privacy and the fear of de-humanizing practice, and the lack of clarity or relevance of current legislative frameworks. Furthermore, the authors discuss in this context ethical, legal considerations and the current status of research in this domain. Ethical challenges including the concepts of identity and deception, privacy and confidentiality and technical issues, such as sociability and usability are introduced and discussed.


2019 ◽  
Vol 33 (3) ◽  
pp. 122-129
Author(s):  
Axel Kaehne

Integrating health and social care services remains one of the most difficult undertakings in the field of care delivery. One of the key requirements for success in integration programmes is a shared vision amongst care providers. Shared visions may contain views as to what the new services should look like, how it should operate and what it should be able to achieve. The paper reports findings of an evaluation of a service integration programme in the North of England. It confirms that a programme consensus on issues such as aims and objectives and programme logics is seen by participants as a key to success. Yet, the study also found that there is a specific window of opportunity in integration programmes when participating organisations start on relatively high levels of commitment and enthusiasm which tend to tail off relatively quickly. The paper closes with a discussion about the implications of the findings for programme designers and service planners.


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