scholarly journals Needs-led research: a way of employing user involvement when devising research questions on the trust model in community home-based health care services in Norway

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ruth-Ellen Slåtsveen ◽  
Torunn Wibe ◽  
Liv Halvorsrud ◽  
Anne Lund

Abstract Background This paper presents a user involvement process, called needs-led research, conducted as a part of a doctoral degree project aiming to explore research priorities and, ultimately, to develop a final top 10 list of questions relevant to the field of research. There is evidence of a mismatch between what user groups within a research field find relevant to study and what is actually being done. User involvement is a method that can accommodate this, and there is a growing attention and amount of research in this field based on an understanding that people who receive health care services, and their next of kin and clinicians, are uniquely positioned to contribute to research in order to understand their experiences better and improve the services. This paper presents a user involvement process in a small-scale study, referred to as needs-led research, which concerns the ‘performance of the trust model in community home-based health care services’. The process was conducted as part of a doctoral degree project. Method The needs-led research process is inspired by the James Lind Alliance (JLA), which focuses on bringing together service users, next of kin and clinicians on equal terms to explore research priorities. The process consisted of five-steps, each of which involved representatives from service users, next of kin and clinicians: 1) narrowing down the theme; 2) steering group meeting; 3) gathering input through a survey; 4) data processing and interim priority setting; and 5) final priority setting. Results Almost 200 participants contributed during the five steps, 294 inputs were gathered, and 35 participants voted for the top 10 list. The top 10 list is presented. Conclusion This paper provides an example of how user involvement can be employed to devise research questions that are relevant for clinicians, service users, next of kin and service providers concerning the ‘performance of the trust model in home-based health care’. It also outlines some strengths and limitations of the process. The needs-led research process shows that user involvement in research is feasible for developing research questions in small-scale studies. We hope that the top 10 list presented will encourage future research to address issues of importance regarding the performance of the trust model in community home-based health care services.

2020 ◽  
Author(s):  
Ruth-Ellen Slåtsveen ◽  
Torunn Wibe ◽  
Liv Halvorsrud ◽  
Anne Lund

Abstract Background This article presents a user involvement process in Norway regarding the performance of the trust model within community home-based health care services. The process, referred to as needs-led research (NLR), is inspired by the James Lind Alliance (JLA) and focuses on bringing together service users, next of kin and clinicians, also referred to as stakeholders, on equal terms to explore research priorities in a priority-setting partnership.Method The following five-step process was followed, in which representatives from service users, next of kin and clinicians were involved in every step. Step 1: A meeting organised in the form of a workshop with service users, next of kin and clinicians to discuss and narrow the scope. Step 2: Steering group meeting. Step 3: Online survey to identify uncertainties regarding the scope. Step 4: Data review and interim prioritisation of research questions. Step 5: Online survey prioritising the final top 10 research questions.Results Almost 200 participants contributed during the five steps, 294 submissions were gathered, and 35 participants voted for the top 10 list. ConclusionThis NLR process was experienced as feasible, and the user involvement shows that it is appropriate and necessary to involve service users, next of kin and clinicians in creating research questions that are relevant to the field.


2018 ◽  
Vol 40 (2) ◽  
pp. 362-380
Author(s):  
Riitta Forsten-Astikainen ◽  
Pia Heilmann

Purpose This study examines in detail how a new occupational group in a field creates and defines its professional competences. The background of the study refers to a new way of organizing social and health care services that requires new type of expertise. The authors examine the professionals of this new sector – service agents and the competences – they need in a multi-professional networking organization. The goal of this organizational pilot project is to gather both experience and practical knowledge of how the “gatekeeper” model can work between the customer and the service provider. The purpose of this paper is to learn the service agents’ perspective on their own work, namely, how they create their work, what their visions of the future are, and what can be learned from the new organizing model. Design/methodology/approach Qualitative data collection and small-scale exploratory study of a new profession: eight service agents and their two supervisors were interviewed to raise awareness of what professional competences these new job contents require, how service agents can influence the content of their work, and what competence needs will emerge in the future. Findings The key findings indicate that service agents lack the courage to modify their own mission. When a new profession is created, they are uncertain about how to create self-content on their own terms. They assume they need a certain degree and to know something more than they already know. They do not dare define their own new professional territory, but rather wait for that definition to come from their organization or society. However, the results also show that some service agents have a hidden willingness to be creative even when there is a lack of courage. There is a need to take more initiative and for agents to think freely outside the box in this new situation. Research limitations/implications The number of interviewees is small and the context specific. However, the study gives an indication of the factors that need to be taken into account when the dissemination of the model starts. Originality/value The paper describes the results of the pilot project of a new profession and a customer-oriented model in the social and health care sector.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Johanna Kiili ◽  
Maritta Itäpuisto ◽  
Johanna Moilanen ◽  
Anu-Riina Svenlin ◽  
Kaisa Eveliina Malinen

Purpose Children are gradually attaining recognition as service users and their involvement in service development has been advanced in recent years. This study draws on empirical research in social and health-care services designed for children and families. The purpose of this paper is to analyse how professionals understand children’s involvement as experts by experience. The focus is on professionals’ views and intergenerational relations. Design/methodology/approach The research data comprise 25 individual and 10 group interviews with managers and professionals working in social and health-care services in one Finnish province. The data were analysed using qualitative thematic analysis. Findings The professionals recognised the value of children’s service user involvement. However, they concentrated more on the challenges than the possibilities it presents. Health-care professionals emphasised parental needs and children’s vulnerability. In turn, the professionals from social services and child welfare non-governmental organisations perceived children as partners, although with reservations, as they discussed ethical issues widely and foregrounded the responsibilities of adults in protecting children. In general, the professionals in both domains saw themselves as having ethical responsibility to support children’s service user involvement while at the same time setting limits to it. Originality/value This study confirmed the importance of taking intergenerational relations into account when developing children’s service user involvement. The results indicate that professionals also need to reflect on the ethical challenges with children themselves as, largely owing to the generational position of children as minors, they rarely perceive them as partners in ethical reflection.


Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 240
Author(s):  
Agneta Malmgren Fänge ◽  
Björg Thordardottir ◽  
Metuge Ankhesnamon Ya-Nyonge ◽  
Connie Lethin

Informal caregivers have a leading role when implementing health care services for people with cognitive disorders living at home. This study aims to examine the current evidence for interventions with dual satisfaction with health care services for people with cognitive disorders and their caregivers. Original papers with quantitative and mixed method designs were extracted from two databases, covering years 2009–2018. Thirty-five original papers reported on satisfaction with health care services. The International Classification of Health Interventions (ICHI) was used to classify the interventions. Most interventions had a home-based approach (80%). Reduction in caregiver depression was the outcome measure with the highest level of satisfaction. Interventions to reduce depression or increase cognitive performance in persons with cognitive disorders gave the least satisfaction. Satisfaction of both caregivers and persons with cognitive disorders increased their use of services. In the ICHI, nearly 50% of the interventions were classified as activities and participation. A limited number of interventions have a positive effect on satisfaction of both the persons with cognitive disorders and the caregiver. It is important to focus on interventions that will benefit both simultaneously. More research is needed with a clear definition of satisfaction and the use of the ICHI guidelines.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Trude Fløystad Eines ◽  
Ingunn Pernille Mundal ◽  
Cecilie Katrine Utheim Grønvik

Pasient – og brukermedvirkning er en lovfestet rettighet som skal sikre pasienter og brukere økt innflytelse i helse og omsorgstjenesten. Forskning viser imidlertid at helsepersonell anvender en paternalistisk tilnærming i sin yrkesutøvelse, noe som truer pasienters rettigheter. Helsepersonell anbefales derfor å ta i bruk tjenestedesign som metodikk for å øke den reelle medvirkningen og involveringen av pasienter og brukere. Formålet med økt bruker- og pasientmedvirkning og involvering er å utvikle tjenester av høy kvalitet med utgangspunkt i brukernes behov. Behovsdrevne tjenester vil oppleves som nyttige og meningsfulle for brukerne. Det er derfor viktig at helsepersonell forstår verdien av brukermedvirkning i kvalitetsarbeid og tilegner seg kunnskap om tjenestedesign. Can service design promote expanding user participation and user involvement in health care services? Patient- and user participation is a legislative right intending to ensure service users involvement in health care services. However, research shows that healthcare professionals employ a paternalistic approach in their professional practice, which may threaten patients' rights. Healthcare professionals are recommended to use service design as a methodology to increase the genuine user participation and user involvement, aiming to develop high-quality services based on users' needs. Demand-driven services may be perceived as beneficial and meaningful for the patients. Therefore, the health professionals’ knowledge and comprehension of the value of user participation and service design are of importance.


Author(s):  
Thato Seutloali ◽  
Lizeka Napoles ◽  
Nomonde Bam

Background: Lesotho adopted primary health care in 1979, and community health workers (CHWs) were included in the programme to focus on health promotion, particularly to reach people in underserved rural areas. Although the CHW programme has been successful, the heavy burden of disease because of HIV and/or AIDS and tuberculosis shifted resources from health promotion to home-based care.Aim: The study explored the lived experience of CHWs in conducting health promotion activities in Lesotho.Setting: The study was conducted in four health centres in Berea district, Lesotho.Methods: A qualitative study was conducted using an interviewer guide translated from English into Sesotho for four CHW focus group discussions, four individual interviews of key informants and four semi-structured interviews with the health centre nurses.Results: The roles of CHWs in health promotion ranged from offering basic first aid and home-based care to increasing access to health care services by taking patients to the facilities and promoting behaviour change through health education. Their perceived successes included increased access to health care services and reduced mortality rates. CHW challenges involved their demotivation to carry out their work because of lack of or inconsistent financial incentives and supplies, work overload which compromises quality of their work and limited community involvement.Conclusion: This study concludes that CHWs are beneficial to health promotion and its various activities. They had a clear understanding of their roles and responsibilities, although they did not fully comprehend that what they were describing was, in fact, health promotion. When it came to advocacy, CHWs did not fully understand it, nor did they consider it as part of their roles, although they acknowledged its importance. Their role of increasing access to health care services by accompanying patients to the facilities has increased considerably because of changes in disease burden. This is affecting their ability to practise other health promotion activities which focus on disease prevention.


2020 ◽  
pp. 147332502093237
Author(s):  
Rita Sørly ◽  
Vår Mathisen and ◽  
Siv Kvernmo

The approach to standardized services in Norwegian mental health care is tailored to the needs of the majority population, focusing on diagnoses and overshadows an approach that understands, values and emphasizes Sámi storytelling and everyday life. This study aims to contribute knowledge regarding the promotion of user involvement in mental health care from the perspectives of Sámi mental health care users. A narrative approach offers an opportunity to unravel an indigenous approach to mental health care and user involvement. People organize their storytelling according to culturally available narratives. This paper focuses on 9 Sámi men’s and women’s stories related to user involvement in mental health care services. Through a thematic analysis of personal stories, we emphasize how the participants make sense of their needs as patients in a culturally adapted mental health context and their experiences living in Sámi core areas. The following four themes are identified as prerequisites for user involvement in services: (1) the expectation of raising children to be independent, (2) the importance of accepting and recognizing the Sámi identity, (3) the need to live in close relations with nature and family, and 4) the right to be in the Sámi mode. Based on the results of our analysis, we find that user involvement among Sámi mental health care users is related to important Sámi values and norms within the culture and that treatment without these important values ​​could adversely affect user involvement in mental health services.


Author(s):  
Mayadhar Panda ◽  
Sikata Nanda ◽  
Rama Chandra Giri

Background: Our aim was to study the socio demographic determinants of ASHA workers, to study the work profile of the ASHA workers, to assess the knowledge, awareness and practice of their roles and responsibilities in the delivery of health care services and to suggest specific recommendations on the ASHA scheme based on the study findings.Methods: The type of study was a cross sectional study, placed at Khordha district in Odisha. Time Period of this study was March to June 2018. 1218 ASHAs were finally included in the study. On the days of the monthly sector / block level meetings with ASHA workers they were appraised and accordingly a predesigned, pretested questionnaire was implemented to them.Results: Nearly 93% of ASHA workers were trained with module 1 to 5, first AID and DOTs training. Refresher training was given to 34% of ASHA workers, FTD/Malaria training was given to 88.4% of ASHA workers. 1218 (100%) ASHA’s helped in immunization. Majority of them 1199 (98.4%) accompanied delivery cases and 1198 (98.3%) were aware about family planning activities.Conclusions: Activities of ASHA’s should be increased with a corresponding increase in incentives, so that she can get up to Rs. 10000-15000 per month. IEC/BCC skills to ASHA may be built by short course certification. Other services like strengthening the role of ASHA on promotive and preventive health care particularly age at marriage, nutrition, home based care delay in first child birth and spacing between 1st and 2nd birth.


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