scholarly journals Articulation, service use, managing and coping: understanding the needs of older people and carers living with dementia

2013 ◽  
Vol 3 (2) ◽  
pp. 1-17
Author(s):  
Josephine Tetley ◽  
Keyword(s):  
Decision Making ◽  
Service Use ◽  
Interview Data ◽  
Care Services ◽  
People With Dementia ◽  
Practical Support ◽  
Decision Making Processes ◽  
Key Issues ◽  
And Coping ◽  
The Impact

Background: There is increasing recognition of the need to involve people living with dementia in research that can impact on service developments in the field. Despite this, people with dementia are still under-represented and proxy/carer views have dominated discourses of care. For nursing, understanding the views and experiences of people living with dementia is particularly important for the development of effective person-centred practices. Aim and objectives: The aims of the research were to identify: The conditions that enable people living with dementia to participate effectively in decision making about the use and uptake of services The factors that affect access, uptake and use of care services for people living with dementia and their supporters Methods: A participatory and constructivist methodology guided the study; consistent with this, a mixed qualitative method approach was used to gather data. Participatory observation was used to identify key issues and key participants (four people living with dementia and four carers), who were then interviewed. The interview data were analysed using the constructivist data analysis processes of unitising and categorising. Findings: Three main themes were identified from the interview data; barriers to articulation of experiences; finding help and support; and managing and coping. The impact of these issues on the choice and decision-making processes of people living with dementia and their carers emerged in a range of ways and are presented here. Conclusions and implications for practice: Researchers and practitioners need to develop skills in engaging with conversations that may seem disjointed or to drift on to different topics The role of carers in interviews raises challenges, but ultimately researchers and practitioners need to balance and blend the views of carers while prioritising the voices of people living with dementia To be effective, services for people living with dementia and their carers, need to provide emotional and practical support

scholarly journals Decision-making for receiving paid home care for dementia in the time of COVID-19: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Clarissa Giebel ◽  
Kerry Hanna ◽  
Jacqueline Cannon ◽  
Ruth Eley ◽  
Hilary Tetlow ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Home Care ◽  
Home Care Services ◽  
Health Measures ◽  
Care Services ◽  
Decision Making Processes ◽  
The Uk ◽  
The Impact ◽  
Care Support

Abstract Background The lockdown imposed in the UK on the 23rd of March and associated public health measures of social distancing are likely to have had a great impact on care provision. The aim of this study was to explore the decision-making processes of continued paid home care support for dementia in the time of COVID-19. Methods Unpaid carers caring for a person living with dementia (PLWD) who were accessing paid home care before COVID-19 and residing in the UK were eligible to take part. Participants were interviewed over the phone and asked about their experiences of using paid home care services before and since COVID-19, and their decision-making processes of accessing paid home care since the outbreak and public health restrictions. Results Fifteen unpaid carers, who were also accessing paid care support for the PLWD before COVID-19, were included in the analysis. Thematic analysis identified three overarching themes: (1) Risk; (2) Making difficult choices and risk management; and (3) Implications for unpaid carers. Many unpaid carers decided to discontinue paid carers entering the home due to the risk of infection, resulting in unpaid carers having to pick up the care hours to support the person living with dementia. Conclusions This is the first study to report on the impact of COVID-19 on paid home care changes in dementia. Findings raise implications for providing better Personal Protective Equipment for paid carers, and to support unpaid carers better in their roles, with the pandemic likely to stay in place for the foreseeable future.

scholarly journals Person-centered dementia care in home care services – highly recommended but still challenging to obtain: a qualitative interview study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari-Anne Hoel ◽  
Anne Marie Mork Rokstad ◽  
Ingvild Hjorth Feiring ◽  
Bjørn Lichtwarck ◽  
Geir Selbæk ◽  
...  
Keyword(s):  
Decision Making ◽  
Home Care ◽  
Shared Decision Making ◽  
Care Service ◽  
Home Care Services ◽  
Shared Decision ◽  
Care Services ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Abstract Background Dementia is one of the main causes of disability and dependence in older people, and people with dementia need comprehensive healthcare services, preferably in their own homes. A well-organized home care service designed for people with dementia is necessary to meet their needs for health- and social care. Therefore, it is important to gain knowledge about how people with dementia experience the home care service and if the service responds to their wishes and needs. The aim of this study was to explore the experience of home care services among people with dementia, to understand the continuity in services, how the service was adapted to people with dementia, and how the patient experienced person-centered care and shared decision-making. Methods We used a qualitative, exploratory design based on a phenomenological-hermeneutic approach and performed individual in-depth interviews with persons with dementia. A convenience sample of 12 persons with moderate to severe degrees of dementia from four Norwegian municipalities participated in the study. The interviews were conducted in February 2019. Results The findings identified that the participants appreciated the possibility to stay safely in their own homes and mostly experienced good support from staff. They expressed various views and understanding of the service and experienced limited opportunities for user involvement and individualized, tailored service. The overall theme summarizing the findings was: “It is difficult for people with dementia to understand and influence home care services, but the services facilitate the possibility to stay at home and feel safe with support from staff.” Conclusion The participants did not fully understand the organization of the care and support they received from the home care services, but they adapted to the service without asking for changes based on their needs or desires. Although person-centered care is recommended both nationally and internationally, the participants experienced little inclusion in defining the service they received, and it was perceived as unclear how they could participate in shared decision-making.

scholarly journals Analyzing Factors Affecting the Sustainability of Land Management Practices in Mecha Woreda, Northwestern Ethiopia

2021 ◽  
Vol 13 (13) ◽  
pp. 7007
Author(s):  
Habtamu Nebere ◽  
Degefa Tolossa ◽  
Amare Bantider
Keyword(s):  
Decision Making ◽  
Land Management ◽  
Land Degradation ◽  
Quantitative Data ◽  
Management Practices ◽  
Short Term ◽  
Factors Affecting ◽  
Decision Making Processes ◽  
Household Heads ◽  
The Impact

In Ethiopia, the practice of land management started three decades ago in order to address the problem of land degradation and to further boost agricultural production. However, the impact of land management practices in curbing land degradation problems and improving the productivity of the agricultural sector is insignificant. Various empirical works have previously identified the determinants of the adoption rate of land management practices. However, the sustainability of land management practices after adoption, and the various factors that control the sustainability of implemented land management practices, are not well addressed. This study analyzed the factors affecting the sustainability of land management practices after implementation in Mecha Woreda, northwestern Ethiopia. The study used 378 sample respondents, selected by a systematic random sampling technique. Binary logistic regression was used to analyze the quantitative data, while the qualitative data were qualitatively and concurrently analyzed with the quantitative data. The sustained supply of fodder from the implemented land management practices, as well as improved cattle breed, increases the sustainability of the implemented land management practices. While lack of agreement in the community, lack of enforcing community bylaws, open cattle grazing, lack of benefits of implemented land management practices, acting as barrier for farming practices, poor participation of household heads during planning and decision-making processes, as well as the lack of short-term benefits, reduce the sustainability of the implemented land management practices. Thus, it is better to allow for the full participation of household heads in planning and decision-making processes to bring practical and visible results in land management practices. In addition, recognizing short-term benefits to compensate the land lost in constructing land management structures must be the strategy in land management practices. Finally, reducing the number of cattle and practicing stall feeding is helpful both for the sustainability of land management practices and the productivity of cattle. In line with this, fast-growing fodder grass species have to be introduced for household heads to grow on land management structures and communal grazing fields for stall feeding.

scholarly journals Sustainable Investments in Responsible SMEs: That’s What’s Distinguish Government VCs from Private VCs

2021 ◽  
Vol 14 (1) ◽  
pp. 25
Author(s):  
Jeaneth Johansson ◽  
Malin Malmström ◽  
Joakim Wincent
Keyword(s):  
Decision Making ◽  
Investment Decisions ◽  
Societal Impact ◽  
Venture Capitalists ◽  
Decision Making Processes ◽  
Micro Level ◽  
Sustainable Investments ◽  
Private Venture ◽  
The Impact ◽  
Level Performance

Researchers question the impact of governmental venture capitalists (GVC) compared to private venture capitalists (PVC), but we know little about why this difference occurs and if this criticism is justified. We observed a group of GVCs and developed a new model that describes the way that GVCs process signals pre- and post-decisions. Certain macro level factors severely undermine micro level performance, causing GVCs to financially underperform with respect to PVCs. This helped us to understand that GVCs do not make investment decisions in the same way as PVCs, and what undermines the performance of GVCs’ decision-making processes. The main goals of GVCs are to promote investments in responsible SMEs, mobilizing societal impact. We discuss that the criticism of GVC needs to be more nuanced, as they have a different role than PVC in the financial system as providers of sustainable investments in responsible SMEs.

scholarly journals Pharmacy premises licensing policy formulation: experience from Ghana

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Augustina Koduah ◽  
Reginald Sekyi-Brown ◽  
Joseph Kodjo Nsiah Nyoagbe ◽  
Daniel Amaning Danquah ◽  
Irene Kretchy
Keyword(s):  
Decision Making ◽  
Pharmacy Practice ◽  
Policy Formulation ◽  
Policy And Practice ◽  
Select Committee ◽  
Limited Participation ◽  
Pharmacy Council ◽  
Decision Making Processes ◽  
Regulatory Bodies ◽  
The Impact

Abstract Background Licences to operate pharmacy premises are issued by statutory regulatory bodies. The Health Institutions and Facilities Act (Act 829) and Health Professions Regulatory Bodies Act (Act 857) regulate pharmacy premises and the business of supplying restricted medicines by retail, respectively, and this could create a potential regulatory overlap for pharmacy practice in Ghana. We theorise that the potential overlap of regulation duties stems from how law-makers framed issues and narratives during the formulation of these Acts. Objective To describe the policy actors involved, framing of narratives and decision-making processes relating to pharmacy premises licensing policy formulation. Methods A qualitative study was conducted and data gathered through interviewing eight key informants and reviewing Hansards, reports, bills, memoranda and Acts 829 and 857. Data were analysed to map decision-making venues, processes, actors and narratives. Results The Ministry of Health drafted the bills in July 2010 with the consensus of internal stakeholders. These were interrogated by the Parliament Select Committee on Health (with legislative power) during separate periods, and decisions made in Parliament to alter propositions of pharmacy premises regulations. Parliamentarians framed pharmacies as health facilities and reassigned their regulation from the Pharmacy Council to a new agency. The Pharmacy Council and the Pharmaceutical Society of Ghana could not participate in the decision-making processes in Parliament to oppose these alterations. The laws’ contents rested with parliamentarians as they made decisions in venues restricted to others. Legislative procedure limited participation, although non-legislative actors had some level of influence on the initial content. Conclusion Implementation of these laws would have implications for policy and practice and therefore understanding how the laws were framed and formulated is important for further reforms. We recommend additional research to investigate the impact of the implementation of these Acts on pharmacy practice and business in Ghana and the findings can serve as bargaining information for reforms.

scholarly journals Perceptions of midwives on shortage and retention of staff at a public hospital in Tshwane District

Curationis ◽  
2019 ◽  
Vol 42 (1) ◽  
Author(s):  
Mosehle S. Matlala ◽  
Thanyani G. Lumadi
Keyword(s):  
Decision Making ◽  
Design Method ◽  
Quality Care ◽  
Sampling Technique ◽  
The Status ◽  
Generic Qualitative ◽  
Tertiary Hospitals ◽  
Decision Making Processes ◽  
Group Interviews ◽  
The Impact

Background: Midwifery is the backbone of women and child healthcare. The shortage of staff in maternity units is a crisis faced by many countries worldwide, including South Africa.Objectives: This study aims to explore the perceptions of midwives on the shortage and retention of staff at a public institution.Method: The study was conducted at one of the tertiary hospitals in Tshwane District, Gauteng Province. A total of 11 midwives were interviewed through face-to-face and focus group interviews. An explorative, descriptive generic qualitative design method was followed, and a non-probability, purposive sampling technique was used. Thematic coding analysis was followed for analysing data.Results: The impact of shortage of midwives was reported to be directly related to poor provision of quality care as a result of increased workload, leading to low morale and burnout. The compromised autonomy of midwives in the high obstetrics dependency units devalues the status of midwives.Conclusion: Midwives are passionate about their job, despite the hurdles related to their day-to-day work environment. They are demoralised by chronic shortage of staff and feel overworked. Staff involvement in decision-making processes is a motivational factor for midwives to stay in the profession. The midwives need to be in the centre of the decision-making processes related to their profession. The revision of the scope of practice and classification of midwifery profession away from general nursing complex by the South African Nursing Council (SANC) could place midwifery in its rightful status.

Evolution of e-participation in Greek local government

2021 ◽  
pp. 1-15
Author(s):  
Constantina Costopoulou ◽  
Maria Ntaliani ◽  
Filotheos Ntalianis
Keyword(s):  
Decision Making ◽  
Big Data ◽  
Local Government ◽  
Local Governments ◽  
Local Community ◽  
New Technologies ◽  
Mobile Apps ◽  
Digital Technologies ◽  
Decision Making Processes ◽  
The Impact

Local governments are increasingly developing electronic participation initiatives, expecting citizen involvement in local community affairs. Our objective was to assess e-participation and the extent of its change in local government in Greece. Using content analysis for 325 Greek municipal websites, we assessed e-participation status in 2017 and 2018 and examined the impact of change between these years. The assessment regards two consecutive years since the adoption of digital technologies by municipalities has been rapid. The main findings show that Greek local governments have made significant small- to medium-scale changes, in order to engage citizens and local societies electronically. We conclude that the integration of advanced digital technologies in municipalities remains underdeveloped. We propose that Greek municipalities need to consider incorporating new technologies, such as mobile apps, social media and big data, as well as e-decision making processes, in order to eliminate those obstacles that hinder citizen engagement in local government. Moreover, the COVID-19 outbreak has highlighted the need for enhancing e-participation and policymakers’ coordination through advanced digital technologies.

An Analysis of Congestion During Running Events from the Perspective of Runners: Prevalence, Impact on Safety and Satisfaction, and Preferred Controls

2021 ◽  
Author(s):  
Sean Peckover ◽  
Aldo Raineri ◽  
Aaron T Scanlan
Keyword(s):  
Decision Making ◽  
Survey Data ◽  
Injury Risk ◽  
Likert Scale ◽  
Electronic Survey ◽  
Safety Concerns ◽  
The Future ◽  
Decision Making Processes ◽  
Cross Country ◽  
The Impact

This study aimed to examine the views of runners regarding their experiences with congestion during running events, including its prevalence, its impact on their safety and satisfaction, and their preferred controls to mitigate congestion. Runners (n = 222) with varied experience participating in running events (1-5+ years, 5-km races to Ultramarathons, and a mixture of road, trail, and cross-country events) completed an electronic survey. The survey was developed to assess the characteristics of respondents, whether they have experienced congestion during running events, the impact of congestion they have experienced during running events on their safety and satisfaction, and their preferred controls for congestion during running events. Survey data indicated runners had experienced some form of congestion prior to the race in the start corrals (93% of respondents), as the race started (97% of respondents), and during the race while running (88% of respondents). In turn, 73% of respondents indicated their experiences with congestion somewhat to extremely (i.e., rating of at least 3 on a 5-point Likert scale) negatively impacted their satisfaction with an event, while 43% of respondents indicated congestion somewhat to extremely negatively impacted their safety during an event. Regarding the impact of congestion on runner safety, 38% of respondents indicated they had slipped, while 27% of respondents indicated they had fallen during running events due to congestion. Further, congestion was attributed to injuries sustained (9%) and not finishing a race due to sustaining an injury (5%) during running events in some respondents. Respondents identified seeding runners based on previous run times (91%), use of wave starts (91%), and designing courses with limited pinch points, U-turns, and narrow paths (89%) as their most preferred controls to mitigate congestion during running events. Respondents resoundingly indicated self-seeding is not an effective method of managing congestion during running events. This study provides novel evidence that congestion is an issue for runners during running events, subsequently diminishing their satisfaction with events and posing safety concerns. In this way, race directors should involve runners in their decision-making processes when implementing appropriate controls to combat congestion for minimising injury risk to runners and ensuring a viable participant base remains attracted to their events in the future.

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