scholarly journals Residents’ and Relatives’ Experiences of Acute Situations: A Qualitative Study to Inform a Care Model

2021 ◽  
Author(s):  
Kornelia Basinska ◽  
Patrizia Künzler-Heule ◽  
Raphaëlle Ashley Guerbaai ◽  
Franziska Zúñiga ◽  
Michael Simon ◽  
...  

Abstract Background and Objectives As new models of care aiming to reduce hospitalizations from nursing homes emerge, their implementers must consider residents’ and relatives’ needs and experiences with acute changes in the residents’ health situations. As part of the larger INTERCARE implementation study, we explored these persons’ experiences of acute situations in Swiss nursing homes. Research Design and Methods 3 focus groups were conducted with residents and their relatives and analyzed via reflexive thematic analysis. Results The first theme, the orchestra plays its standards, describes experiences of structured everyday care in nursing homes, which functions well despite limited professional and competency resources. The second theme, the orchestra reaches its limits, illustrates accounts of acute situations in which resources were insufficient to meet residents’ needs. Interestingly, participants’ perceptions of acute situations went well beyond our own professional view, that is, changes in health situations, and included situations best summarized as “changes that might have negative consequences for residents if not handled adequately by care workers.” Within the third theme, the audience compensates for the orchestra’s limitations, participants’ strategies to cope with resource limitations in acute situations are summarized. Discussion and Implications Our findings suggest differences between care providers’ and participants’ perspectives regarding acute situations and care priority setting. Alongside efforts to promote staff awareness of and responsiveness to acute situations, care staff must commit to learning and meeting individual residents’ and relatives’ needs. Implications for the development and implementation of a new nurse-led model of care are discussed.

Author(s):  
Gloria Puurveen ◽  
Heather Cooke ◽  
Rupali Gill ◽  
Jennifer Baumbusch

AbstractBackground and ObjectivesCurrent nursing home policy emphasizes the need for collaborative, team-based care planning in which families and/or residents are actively involved. Resident care conferences are common where care providers, families, and/or residents discuss and coordinate resident care needs and evaluate care goals. This study critically examines the process, structure, and content of care conferences to expand our understanding of how resident care is negotiated among care providers and families in this context.Research Design and MethodsThis study was part of a larger critical ethnography examining the negotiation of care work among care providers, families, and residents in three purposively selected nursing homes in British Columbia, Canada. Thirty-seven care conferences were observed. Field notes and interview data were thematically analyzed with a focus on what was said, who said what and to whom, whose voice was privileged, and how power manifested between care providers, families, and/or residents.ResultsAs illustrated by three key themes, Exclusion by Process—Following Script, Exclusion by Content—Scripted Reports, and Exclusion through Devalued Knowledge, families were overtly and covertly excluded from contributing to the care conferences. As such, families’ presence did not guarantee open communication or active solicitation of their perspectives.Discussion and ImplicationsThe use of predetermined agendas and processes, clinically generic reporting, and technical jargon reproduced the structural inequality between care providers and families making collaboration difficult to effectively negotiate. For care conferences to meaningfully contribute to person-centered care, it is imperative that mutual exchange be promoted and families empowered to participate as equals.


2021 ◽  
Vol 9 (E) ◽  
pp. 382-385
Author(s):  
Mohsen Khosravi ◽  
Alireza Ganjali

AIM: We aimed to understand the early warning signs and symptoms of occupational burnout as red flags among health care workers during the COVID-19 pandemic. METHODS: Based on the suggestions of the International Federation of Red Cross and Red Crescent Societies [8], health-care providers need to be trained to increase three components of resilience across the three levels of individual, team, and organization so that they can optimally manage their psychological responses to catastrophes. RESULTS: It seems that both targeted individual and organizational strategies are critical for the overall wellness of health care workers during the COVID-19 pandemic. CONCLUSION: Health care workers experience high levels of burnout during the COVID-19, which warrants attention and support from health policy-makers and practitioners. Current evidence demonstrated that health-care staff could gain significant benefits from interventions to modify burnout syndrome, especially from organization-directed interventions.


10.2196/15688 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e15688
Author(s):  
Centaine L Snoswell ◽  
John B North ◽  
Liam J Caffery

Background Telehealth is a disruptive modality that challenges the traditional model of having a clinician or patient physically present for an appointment. The benefit is that it offers the opportunity to redesign the way services are offered. For instance, a virtual health practitioner can provide videoconference consultations while being located anywhere in the world that has internet. A virtual health practitioner also obviates the issues of attracting a specialist medical workforce to rural areas, and allows the rural health service to control the specialist services that they offer. Objective The aim of this research was to evaluate the economic effects of 3 different models of care on rural and metropolitan hospital sites. The models of care examined were patient travel, telehealth using videoconferencing, and employment of a virtual health practitioner by a rural site. Methods Using retrospective activity data for 3 years, a return on investment (ROI) analysis was undertaken from the perspective of a rural site and metropolitan partner site using a telehealth orthopedic fracture clinic as an example. Further analysis was conducted to calculate the number of patients that would be required to attend the clinic in each model of care for the sites to break even. Results The only service model that resulted in a positive ROI for the rural site over the 3-year period was the virtual health practitioner model. The breakeven analysis demonstrated that the rural site required the lowest number of patients to recoup costs in the virtual health practitioner model of care. The rural site was unable to recoup its costs within the travel model due to the lack of opportunity for reimbursement for services and the requirement to cover the cost of travel for patients. Conclusions Our model demonstrated that rural health care providers can increase their ROI by employing a virtual health practitioner.


2020 ◽  
Author(s):  
Asmita V Manchha ◽  
Nicole Walker ◽  
Kïrsten A Way ◽  
Danielle Dawson ◽  
Ken Tann ◽  
...  

Abstract Background and Objectives The stigma of working in aged care can discredit and devalue those working in gerontology. This overlooked workforce issue may underpin complex staffing challenges like chronic worker shortages and inadequate care delivery. Our review synthesizes the existing literature and introduces a conceptual framework based on linguistics to reconcile disparate conceptualizations and negative consequences of this stigma. Research Design and Methods We conducted a systematic review and assessed peer-reviewed articles published from 1973 to 2019 across 5 databases. Fifty-nine articles were selected based on criteria grounded in stigma theory. Results Only 10 articles explicitly used the term “stigma” when conceptualizing the stigma of working in aged care. An additional 49 articles conceptualized this stigma in terms of stigma processes (e.g., status loss). Findings from a deeper examination using a linguistic analysis revealed societal groups predominantly conceptualized stigma in 3 distinct ways based on (a) unfavorable character judgment of aged care workers, (b) lower value placed on aged care work, and (c) negative emotional reactions towards working in aged care. Last, stigma was associated with adverse psychological and job-related consequences. Discussion and Implications Reconceptualizing this workforce issue and recognizing it as a societal challenge will enable policymakers to design evidence-based interventions at industry and societal levels. We propose workforce challenges in the aged care sector such as attraction, retention, and well-being may lessen with interventions aimed at mitigating the stigma of working in aged care.


2016 ◽  
Vol 18 (5) ◽  
pp. 266-276 ◽  
Author(s):  
Jill Manthorpe ◽  
Esther Njoya ◽  
Jess Harris ◽  
Caroline Norrie ◽  
Jo Moriarty

Purpose The purpose of this paper is to present an analysis of media reactions to the BBC Television Panorama programme, Behind Closed Doors’ and to set this in the context of interviews with care staff about their reflections on publicity about poor practice in the care sector. Design/methodology/approach This paper reports on an analysis of media reactions to recent exposé of abuse in social care in England and data from an interview-based study of care workers. The interviews were analysed to consider the impact of such media reports on staff and to explore their views of action that might be need to be taken about care failings. Findings There are mixed reactions to exposé of poor care on television and to the debates that precede and follow their broadcast. Debates occur in print and on television, but also in social media. The particular exposé of care home practices by the Panorama programme, Behind Closed Doors, led to debate in England about the potential role of covert cameras in care homes. The interviews revealed that while care staff are affected by scandals in the media about social care, they do not necessarily focus on themes that the media stories subsequently highlight. Overall some are disenchanted while others have ideas of what needs to change to improve practice. Care staff consider that there remain problems in raising concerns about practices and some staff feel unable to stay in workplaces where they have made complaints. Research limitations/implications The care workers interviewed may not be representative of the sector and they may have wished to provide socially acceptable answers to the researchers. Practice was not observed. Practical implications Local Safeguarding Adult Boards may wish to develop a communications strategy to deal with requests for reactions to media reports locally and nationally. Safeguarding practitioners may wish to prepare for increased referrals following media coverage of poor care in their areas. They may later be able to use media reports to discuss any local differences of interpretation over matters such as prosecutions for abuse. Trainers and educationalists may wish to clarify the importance given by care providers to raising concerns, the ways in which difficult conversations can be held, and the protections available to whistle-blowers or those raising concerns – with local examples to provide assurance that this is not mere rhetoric. Originality/value Television reports of problems with social care attract wide media interest but the authors know very little about how care workers respond to depictions of their work and their occupational grouping. This paper links media and expert commentator reactions to television exposé with data acquired from interviews with those on the frontline of care.


2020 ◽  
Vol 26 (4) ◽  
pp. 246-252
Author(s):  
Jennifer DeDecker

Health-care workers are at risk of experiencing negative consequences for their own health and job performance due to a wide variety of stressors. Care providers suffer from varying expressions of a generalized symptom set that has been termed “burnout” or “compassion fatigue.” These terms can help us understand the phenomenon that is happening in our health system, but a strong understanding of the physical, mental, emotional, and psychological implications will increase the efficacy of treatment and benefit of preventive care. This article asserts that the term “compassion fatigue” is a misnomer, resulting in a misunderstanding of the causes and effects of compassion on the individual. This article challenges the term, positing that it has become outdated based on what we now know about the neuroscience of compassion, empathy, and mindfulness. Instead, this discussion offers the relevance of the term “empathic distress leading to empathic distress fatigue,” suggesting that contemplative practice, mindfulness, and compassion training can protect and empower health-care providers.


2019 ◽  
Author(s):  
Centaine L Snoswell ◽  
John B North ◽  
Liam J Caffery

BACKGROUND Telehealth is a disruptive modality that challenges the traditional model of having a clinician or patient physically present for an appointment. The benefit is that it offers the opportunity to redesign the way services are offered. For instance, a virtual health practitioner can provide videoconference consultations while being located anywhere in the world that has internet. A virtual health practitioner also obviates the issues of attracting a specialist medical workforce to rural areas, and allows the rural health service to control the specialist services that they offer. OBJECTIVE The aim of this research was to evaluate the economic effects of 3 different models of care on rural and metropolitan hospital sites. The models of care examined were patient travel, telehealth using videoconferencing, and employment of a virtual health practitioner by a rural site. METHODS Using retrospective activity data for 3 years, a return on investment (ROI) analysis was undertaken from the perspective of a rural site and metropolitan partner site using a telehealth orthopedic fracture clinic as an example. Further analysis was conducted to calculate the number of patients that would be required to attend the clinic in each model of care for the sites to break even. RESULTS The only service model that resulted in a positive ROI for the rural site over the 3-year period was the virtual health practitioner model. The breakeven analysis demonstrated that the rural site required the lowest number of patients to recoup costs in the virtual health practitioner model of care. The rural site was unable to recoup its costs within the travel model due to the lack of opportunity for reimbursement for services and the requirement to cover the cost of travel for patients. CONCLUSIONS Our model demonstrated that rural health care providers can increase their ROI by employing a virtual health practitioner.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 628-631
Author(s):  
Devangi Agrawal ◽  
Namisha Khara ◽  
Bhushan Mundada ◽  
Nitin Bhola ◽  
Rajiv Borle

In the wake of the current outbreak of novel Covid-19, which is now declared as a 'pandemic' by the WHO, people around the globe have been dealing with a lot of difficulties. This virus had come into light in December 2019 and since then has only grown exponentially. Amongst the most affected are the ones who have been working extremely hard to eradicate it, which includes the hospitals, dental fraternity and the health-care workers. These people are financially burdened due to limited practise. In the case of dentistry, to avoid the spread of the virus, only emergency treatments are being approved, and the rest of the standard procedures have been put on hold. In some cases, as the number of covid cases is rising, many countries are even trying to eliminate the emergency dental procedures to divert the finances towards the treatment of covid suffering patients. What we need to realise is that this is probably not the last time that we are facing such a situation. Instead of going down, we should set up guidelines with appropriate precautionary measures together with the use of standardised PPEs. The government should also establish specific policies to support dental practices and other health-care providers. Together, we can fight this pandemic and come out stronger.


Author(s):  
Raffaella Gualandi ◽  
Anna De Benedictis

Abstract In this letter to the Editor, we shed light on the rapid changes the Covid-19 virus has generated in hospital management. Recent experiences in the field aim to reorganizing hospital processes and policies. In this new scenario, new patient needs emerge, and a change in the hospital model of care should include them.


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