Managing emotional and psychological distress in older people

2018 ◽  
Vol 22 (4) ◽  
pp. 234-242
Author(s):  
Felicity Chapman

Purpose Much has been written about helping those with dementia. But what about those for whom distress is not primarily related to a neurological cause and there is no psychiatric history? The purpose of this paper is to offer a guide for allied health professionals and family carers to manage distress in older people who are able to engage in language based communication and who are experiencing significant change or loss. Design/methodology/approach This practice informed paper draws on the authors’ extensive experience working as a mental health social worker who specializes in work with older people in the community and in care, with family carers and in educating allied health professionals on how to manage presentations of distress in older people. Findings Three foundational management strategies are discussed: understand the reason for distress, implement the C.A.R.E. Plan and maximize comfort in exploration and referral. Research limitations/implications This viewpoint piece has not been substantiated through research and does not reflect training in the field of clinical geropsychology. Originality/value The ideas in this paper are original and are practical solutions to common problems that can be faced by workers or family in close contact with older people. The information can be applied immediately to whatever setting is relevant for the reader and is written in easy to understand language. Furthermore, its aim is not only to increase skill and confidence for the reader but also to promote the emotional and psychological wellbeing of older people.

2020 ◽  
Vol 33 (4) ◽  
pp. 339-349
Author(s):  
Lisa Beasley ◽  
Sandra Grace ◽  
Louise Horstmanshof

Purpose The purpose of this paper is to review the literature on the response and adaption to change of allied health professionals. Understanding how individuals respond and adapt to change is essential to assist leaders to manage transformational change effectively. Contemporary health-care environments are characterised by frequent and rapid change, often with unrealistic and challenging time frames. Individuals operate independently, but also as members of teams, professions and organisations. Therefore, having a sound understanding of individual response to change is important for change leaders. In the Australian context, allied health professionals represent a quarter of the health-care workforce. There is a significant gap in understanding how allied health professionals respond and adapt to change. Design/methodology/approach A scoping review was designed to report on the nature and extent of the literature on the response and adaption to change in the context of allied health professionals. Change leaders in the health-care environment face a number of complex challenges when attempting to facilitate change. While this scoping review did not identify any specific literature on the response and adaption to change of allied health professionals, it did however provide information on change models and factors to take into consideration when implementing a change process. Findings The results of this scoping review identified findings in two main areas with regard to response and adaptation of allied health to change: a review of change management literature at the organisation level and change management for allied health. Most of the literature described organisational level change management without providing a structural framework for change. At the professional individual level, the literature focused on specific clinical interventions, rather than on the response and adaption to change for allied health. Minimal literature was identified in regard to the response and adaption to change of allied health professionals. In an environment characterised by continuous change and policy reform, a greater understanding of the response and adaption to change by allied health is a priority for research, policy and practice. Research limitations/implications This scoping review was undertaken to explore the response and adaption to change of allied health. It sought to identify the factors that may explain why certain disciplines within the allied health professional group responded to change differently. Scoping reviews do not set out to comprehensively source all relevant literature but rather to ascertain the nature and extent of the published literature in the field. Therefore, it is possible that a systematic review might uncover additional relevant papers. However, this scoping review provides a clear indication of the nature and extent of the literature in allied health. Practical implications Social implications This scoping review will assist change leaders to gain a better understanding of theoretical frameworks of individual, team and organisational change processes and the impacts these have individually and collectively on change processes. Originality/value To the best of the authors’ knowledge, this scoping review is the first of its kind to identify the minimal literature available on the way allied health professionals respond and adapt to change.


BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018226 ◽  
Author(s):  
Ingrid C M Rosbergen ◽  
Sandra G Brauer ◽  
Sarah Fitzhenry ◽  
Rohan S Grimley ◽  
Kathryn S Hayward

ObjectiveAn enriched environment embedded in an acute stroke unit can increase activity levels of patients who had stroke, with changes sustained 6 months post-implementation. The objective of this study was to understand perceptions and experiences of nursing and allied health professionals involved in implementing an enriched environment in an acute stroke unit.DesignA descriptive qualitative approach.SettingAn acute stroke unit in a regional Australian hospital.ParticipantsWe purposively recruited three allied health and seven nursing professionals involved in the delivery of the enriched environment. Face-to-face, semistructured interviews were conducted 8 weeks post-completion of the enriched environment study. One independent researcher completed all interviews. Voice-recorded interviews were transcribed verbatim and analysed by three researchers using a thematic approach to identify main themes.ResultsThree themes were identified. First, staff perceived that ‘the road to recovery had started’ for patients. An enriched environment was described to shift the focus to recovery in the acute setting, which was experienced through increased patient activity, greater psychological well-being and empowering patients and families. Second, ‘it takes a team’ to successfully create an enriched environment. Integral to building the team were positive interdisciplinary team dynamics and education. The impact of the enriched environment on workload was diversely experienced by staff. Third, ‘keeping it going’ was perceived to be challenging. Staff reflected that changing work routines was difficult. Contextual factors such as a supportive physical environment and variety in individual enrichment opportunities were indicated to enhance implementation. Key to sustaining change was consistency in staff and use of change management strategies.ConclusionInvestigating staff perceptions and experiences of an enrichment model in an acute stroke unit highlighted the need for effective teamwork. To facilitate staff in their new work practice, careful selection of change management strategies are critical to support clinical translation of an enriched environment.Trial registration numberANZCTN12614000679684; Results.


2015 ◽  
Vol 7 (2) ◽  
pp. 106-116 ◽  
Author(s):  
Rebecca Flower ◽  
Defne Demir ◽  
John McWilliams ◽  
Dianne Johnson

Purpose – The purpose of this paper is to investigate the relationships between components of the psychological contract, organisational justice, and negative affectivity (NA), with key employee outcomes (i.e. organisational commitment, job satisfaction, depression, and psychological distress) among allied health professionals. Design/methodology/approach – In total, 134 (response rate of 46 per cent) Australian allied health professional completed a questionnaire. Findings – Multiple regressions revealed that higher NA was associated with lower organisational commitment, lower job satisfaction, and higher levels of depression. The psychological contract variable, breach, was associated with depression. Informational justice was associated with organisational commitment. Distributive justice was associated with job satisfaction. Research limitations/implications – This research is limited by its cross-sectional design and that the data were self-reported. The results obtained suggest the potential utility of collecting longitudinal data to replicate and extend the results. Practical implications – While NA may be beyond management control, it may be ameliorated by attention to improving communication of management decisions and by sensitivity to the elements implicit in psychological contracts. The negative consequences of contract breach may be offset by informational and distributive justice. Originality/value – This study is one of the first to examine multiple measures of the psychological contract in addition to organisational justice and NA. Further, this study adds to the literature for allied health professionals, where little is known about factors contributing to their turnover.


2017 ◽  
Vol 41 (1) ◽  
pp. 111 ◽  
Author(s):  
Kajtek Kielich ◽  
Lynette Mackenzie ◽  
Meryl Lovarini ◽  
Lindy Clemson

Objective The study aimed to explore Australian general practitioners’ (GPs) perceptions of falls risk screening, assessment and their referral practices with older people living in the community, and to identify any barriers or facilitators to implementing evidence-based falls prevention practice. Methods Hardcopy surveys and a link to an online survey were distributed to 508 GPs working at one Medicare Local (now part of a Primary Care Network) located in Sydney, Australia. Data were analysed using descriptive statistics and key themes were identified from open text responses. Results A total of 37 GPs returned the survey. Only 10 (27%) GPs routinely asked older people about falls, and five (13.5%) asked about fear of falls during clinical consultations. Barriers to managing falls risk were identified. GPs estimated that they made few referrals to allied health professionals for falls interventions. Conclusions GPs were knowledgeable about falls risk factors but this did not result in consistent falls risk screening, assessment or referral practices. Due to the small sample, further research is needed with a larger sample to augment these results. What is known about the topic? Falls are a common and serious health issue for older people and fall prevention is vital, especially in the primary care setting. General practitioners (GPs) are key health professionals to identify older people at risk of falls and refer them to appropriate health professionals for intervention. Evidence-based falls prevention interventions exist but are not easily or routinely accessed by older people. What does this paper add? GPs believe that previous falls are an important falls risk factor but they do not routinely ask about falls or fear of falls in clinical practice with older people. GP referral rates to allied health professionals for falls prevention are low, despite evidence-based falls prevention interventions being provided by allied health professionals. There are several barriers to GPs providing falls prevention assessment and intervention referrals, particularly using the current primary health systems. What are the implications for practitioners? GPs need to recognise their potential significant contribution to falls prevention in the community and may require tailored training. Sustainable evidence-based referral pathways need to be developed so that older people can be referred to allied health professionals for falls prevention interventions in the primary care setting, and better local networks need to be developed to allow this to occur. Policy makers may have to address the identified barriers to multidisciplinary practice and funding of services to facilitate effective falls prevention programs in primary care.


2015 ◽  
Vol 29 (3) ◽  
pp. 393-412 ◽  
Author(s):  
John Rodwell ◽  
Andre Gulyas

Purpose – Allied health professionals are vital for effective healthcare yet there are continuing shortages of these employees. Building on work with other healthcare professionals, the purpose of this paper is to investigate the influence of psychological contract (PC) breach and types of organisational justice on variables important to retention among allied health professionals: mental health and organisational commitment. The potential effects of justice on the negative outcomes of breach were examined. Design/methodology/approach – Multiple regressions analysed data from 113 allied health professionals working in a medium-large Australian healthcare organisation. Findings – The main negative impacts on respondents’ mental health and commitment were from high PC breach, low procedural and distributive justice and less respectful treatment from organisational representatives. The interaction between procedural justice and breach illustrates that breach may be forgivable if processes are fair. Surprisingly, a betrayal or “aggravated breach effect” may occur after a breach when interpersonal justice is high. Further, negative affectivity was negatively related to respondents’ mental health (affective outcomes) but not commitment (work-related attitude). Practical implications – Healthcare organisations should ensure the fairness of decisions and avoid breaking promises within their control. If promises cannot reasonably be kept, transparency of processes behind the breach may allow allied health professionals to understand that the organisation did not purposefully fail to fulfil expectations. Originality/value – This study offers insights into how breach and four types of justice interact to influence employee mental health and work attitudes among allied health professionals.


2020 ◽  
Vol 31 (2) ◽  
pp. 709-724
Author(s):  
Bianca N. Jackson ◽  
Suzanne C. Purdy ◽  
Helena D. Cooper Thomas

PurposeHighly-experienced allied health professionals have the opportunity to perform at the expert-level by sharing knowledge and skills with more junior staff, with the aim of upskilling the workforce. The study explored the current motivators, aspirations and the role of work in the life of highly-experienced practitioners, revealing factors that hinder or support them to further develop their own expertise and be inspiring role-models and mentors for less experienced staff.Design/methodology/approachTaking a grounded theoretical research design, we report on interviews with 45 allied health practitioners with at least seven years of professional experience from different professions and across organisational sectors. Transcripts were coded iteratively in conjunction with reviewing the literature, and cases were categorised to form a conceptual typology of work orientation.FindingsFour work orientations are characterised capturing the diversity of the allied health workforce, particularly in relation to two dimensions of personal fulfilment and future ambition. The relationship between the types and expert-level performance is discussed, leading to recommendations for support that can be implemented to develop and sustain expert-level performance within a community.Originality/valueA new view of work orientation is introduced that relates expert-level performance with meaningful work. The findings highlight a diversity of work orientation for highly-experienced allied health professionals, that all require managerial awareness. Once recognised, the four types would benefit from different supports that could develop and maintain expert-level performance in those that seek it. Alternatives are also available for those that do not. Implications for workforce policy are discussed.


Author(s):  
Rosalie Coppin ◽  
Greg Fisher

Purpose – Mentoring is widely used in the health sector, particularly for early career professionals in the public health system. However, many allied health professionals are employed in private practice and rely on their professional association to provide mentoring support and training. This mentoring context is under-researched. The paper aims to discuss these issues. Design/methodology/approach – A purposeful sample of 15 allied health professionals were interviewed using semi-structured interviews that were then analyzed using template analysis. Findings – The many-to-many group mentoring program delivered valuable knowledge, diagnostic skills and networking opportunities but did not provide inclusion, role modeling or psychosocial support to participants. Also identified were structural and operational issues including; the role of the coordinator in addressing contribution reluctance and participant confidence, confidentiality issues, lack of mentor training and overall organization of the program. Practical implications – Group mentoring is a valuable method of delivery for professional associations. The many-to-many group mentoring model is beneficial in a situation where the availability of mentors is limited. Further, the importance of having a dedicated program coordinator and a skilled facilitator is emphasized. Originality/value – This research contributes to the limited literature on many-to-many group mentoring by reviewing the effectiveness of an existing many-to-many group mentoring program for allied health professionals delivered by a professional association.


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