scholarly journals Remote Health Care Provision in Care Homes in England: An Exploratory Mixed Methods Study of Yorkshire and the Humber

Technologies ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 24 ◽  
Author(s):  
Louise Newbould ◽  
Gail Mountain ◽  
Steven Ariss ◽  
Mark Hawley
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Urban Areas ◽  
Health Care Services ◽  
Qualitative Interviews ◽  
Care Home ◽  
Mixed Methods Study ◽  
Care Homes ◽  
Health Care Provision ◽  
Care Provision

An increasing demand for care homes in the UK, has necessitated the evaluation of innovative methods for delivering more effective health care. Videoconferencing may be one way to meet this demand. However, there is a lack of literature on the provision of videoconferencing in England. This mixed-methods study aimed to map current attitudes, knowledge and provision of videoconferencing in the Yorkshire and Humber region of England. Qualitative interviews with care home managers, a scoping review and field notes from a Special Interest Group (SIG) informed the development of a descriptive convenience survey which was sent out to care home managers in the Yorkshire and Humber region of England. The survey had a 14% (n = 124) response rate. Of those who responded, 10% (n = 12) reported using videoconferencing for health care; with over 78% (n = 97) of respondents’ care homes being based in urban areas. Approximately 62% (n = 77) of the 124 respondents had heard of videoconferencing for health care provision. Of those who reported not using videoconferencing (n = 112), 39% (n = 48) said they would consider it but would need to know more. The top ranked reason for not introducing videoconferencing was the belief that residents would not be comfortable using videoconferencing to consult with a healthcare professional. The main reason for implementation was the need for speedier access to services. Those already using videoconferencing rated videoconferencing overall as being very good (50%) (n = 6) or good (42%) (n = 5). Those who were not using it in practice appeared sceptical before implementing videoconferencing. The main driver of uptake was the home’s current access to and satisfaction with traditionally delivered health care services.

scholarly journals Optimal NHS service delivery to care homes: a realist evaluation of the features and mechanisms that support effective working for the continuing care of older people in residential settings

2017 ◽  
Vol 5 (29) ◽  
pp. 1-204 ◽  
Author(s):  
Claire Goodman ◽  
Sue L Davies ◽  
Adam L Gordon ◽  
Tom Dening ◽  
Heather Gage ◽  
...  
Keyword(s):  
Health Care ◽  
Older People ◽  
Phase 1 ◽  
Care Home ◽  
Care Homes ◽  
Health Care Provision ◽  
Care Provision ◽  
Phase 2 ◽  
Care Home Staff ◽  
Health Related

BackgroundCare homes are the institutional providers of long-term care for older people. The OPTIMAL study argued that it is probable that there are key activities within different models of health-care provision that are important for residents’ health care.ObjectivesTo understand ‘what works, for whom, why and in what circumstances?’. Study questions focused on how different mechanisms within the various models of service delivery act as the ‘active ingredients’ associated with positive health-related outcomes for care home residents.MethodsUsing realist methods we focused on five outcomes: (1) medication use and review; (2) use of out-of-hours services; (3) hospital admissions, including emergency department attendances and length of hospital stay; (4) resource use; and (5) user satisfaction. Phase 1: interviewed stakeholders and reviewed the evidence to develop an explanatory theory of what supported good health-care provision for further testing in phase 2. Phase 2 developed a minimum data set of resident characteristics and tracked their care for 12 months. We also interviewed residents, family and staff receiving and providing health care to residents. The 12 study care homes were located on the south coast, the Midlands and the east of England. Health-care provision to care homes was distinctive in each site.FindingsPhase 1 found that health-care provision to care homes is reactive and inequitable. The realist review argued that incentives or sanctions, agreed protocols, clinical expertise and structured approaches to assessment and care planning could support improved health-related outcomes; however, to achieve change NHS professionals and care home staff needed to work together from the outset to identify, co-design and implement agreed approaches to health care. Phase 2 tested this further and found that, although there were few differences between the sites in residents’ use of resources, the differences in service integration between the NHS and care homes did reflect how these institutions approached activities that supported relational working. Key to this was how much time NHS staff and care home staff had had to learn how to work together and if the work was seen as legitimate, requiring ongoing investment by commissioners and engagement from practitioners. Residents appreciated the general practitioner (GP) input and, when supported by other care home-specific NHS services, GPs reported that it was sustainable and valued work. Access to dementia expertise, ongoing training and support was essential to ensure that both NHS and care home staff were equipped to provide appropriate care.LimitationsFindings were constrained by the numbers of residents recruited and retained in phase 2 for the 12 months of data collection.ConclusionsNHS services work well with care homes when payments and role specification endorse the importance of this work at an institutional level as well as with individual residents. GP involvement is important but needs additional support from other services to be sustainable. A focus on strategies that promote co-design-based approaches between the NHS and care homes has the potential to improve residents’ access to and experience of health care.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Case Management in Primary Care for Frequent Users of Health Care Services: A Mixed Methods Study

2018 ◽  
Vol 16 (3) ◽  
pp. 232-239 ◽  
Author(s):  
Catherine Hudon ◽  
Maud-Christine Chouinard ◽  
Marie-France Dubois ◽  
Pasquale Roberge ◽  
Christine Loignon ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Mixed Methods ◽  
Case Management ◽  
Health Care Services ◽  
Mixed Methods Study ◽  
Frequent Users ◽  
Care Services

Suicide attempt survivors’ experiences with mental health care services: A mixed methods study.

2020 ◽  
Vol 51 (2) ◽  
pp. 172-183
Author(s):  
Melanie A. Hom ◽  
Evan A. Albury ◽  
Marielle M. Gomez ◽  
Kirsten Christensen ◽  
Ian H. Stanley ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mixed Methods ◽  
Suicide Attempt ◽  
Mental Health Care ◽  
Health Care Services ◽  
Mixed Methods Study ◽  
Care Services

The Changing Landscape of Health Care Provision to American Indian Nations

2015 ◽  
Vol 39 (1) ◽  
pp. 1-24 ◽  
Author(s):  
Stephanie Rainie ◽  
Miriam Jorgensen ◽  
Stephen Cornell ◽  
Jaime Arsenault
Keyword(s):  
United States ◽  
Health Care ◽  
American Indian ◽  
Alaska Native ◽  
Health Care Services ◽  
The United States ◽  
Health Care Provision ◽  
Care Provision ◽  
Health Service Provision ◽  
Care Services

Health service provision has been an aspect of indigenous-United States relationships for over two hundred years, yet America's First Peoples continue to suffer from poor health outcomes when compared with other racial or ethnic groups in the United States. An important change over recent decades is that more and more tribes are managing their own health care services—a realignment of administration and authority that has the potential to substantially improve American Indian and Alaska Native health in years to come. This paper describes the history of health care provision to federally recognized American Indian tribes. It continues by documenting the sparse research literature on tribal management of health care services and identifying information still needed to bring knowledge of this topic up-to-date. Five challenges for tribal management of health-care services that should be considered by tribes and policymakers in their health-care efforts and brought to bear on future research are discussed. By addressing both tribal control of health-care services and the role of tribes in changes to federally provided health care, this paper adds the lens of tribal sovereignty to current discussions of the history and policy context for American Indian and Alaska Native health.

scholarly journals Experiences, Attitudes, and Needs of Users of a Pregnancy and Parenting App (Baby Buddy) During the COVID-19 Pandemic: Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Alexandra Rhodes ◽  
Sara Kheireddine ◽  
Andrea D Smith
Keyword(s):  
Social Support ◽  
Health Care ◽  
Mixed Methods Study ◽  
Health Care Provision ◽  
Care Provision ◽  
Web Based ◽  
Face To Face ◽  
Telephone Interviews ◽  
The United Kingdom ◽  
The Impact

BACKGROUND The COVID-19 pandemic has impacted the lives of expectant parents and parents of young babies, with disruptions in health care provision and loss of social support. OBJECTIVE This study investigated the impact of the COVID-19 pandemic and its associated lockdown on this population through the lens of users of the UK National Health Service–approved pregnancy and parenting smartphone app, Baby Buddy. The study aims were threefold: to gain insights into the attitudes and experiences of expectant and recent parents (with babies under 24 weeks of age) during the COVID-19 pandemic; to investigate whether Baby Buddy is meeting users’ needs during this time; and to identify ways to revise the content of Baby Buddy to better support its users now and in future. METHODS A mixed methods study design combining a web-based survey with semistructured telephone interviews among Baby Buddy users in the United Kingdom was applied. Data were collected from April 15 to mid-June 2020, corresponding to weeks 4-13 of the lockdown in the United Kingdom. RESULTS A total of 436 expectant (n=244, 56.0%) and recent (n=192, 44.0%) parents responded to the web-based survey, of which 79.1% (n=345) were aged 25-39 years and 17.2% (n=75) spoke English as their second language. Of the 436 respondents, 88.5% (386/436) reported increased levels of anxiety around pregnancy, birth, and being a new parent, and 58.0% (253/436) were concerned about their emotional and mental health. Of the 244 pregnant respondents, 43.4% (n=106) were concerned about their physical health. Telephone interviews with 13 pregnant women and 19 recent parents revealed similarly increased levels of anxiety due to reduced health care provision and loss of support from friends and family. Although a minority of respondents identified some positive outcomes of lockdown, such as family bonding, many telephone interviewees reported feeling isolated, disregarded, and overwhelmed. Recent parents were particularly anxious about the impact of the lockdown on their baby’s development and socialization. Many interviewees were also concerned about their physical health as a consequence of both limited access to face-to-face medical appointments and their own poorer dietary and physical activity behaviors. Across both samples, 97.0% (423/436) of respondents reported that Baby Buddy was currently helping them, with many commenting that its role was even more important given the lack of face-to-face support from health care and parenting organizations. Greater speed in updating digital content to reflect changes due to the pandemic was suggested. CONCLUSIONS The COVID-19 pandemic has created heightened anxiety and stress among expectant parents and those with a young baby, and for many, lockdown has had an adverse impact on their physical and mental well-being. With reductions in health care and social support, expectant and new parents are increasingly relying on web-based resources. As a free, evidence-based app, Baby Buddy is well positioned to meet this need. The app could support its users even more by actively directing them to the wealth of existing content relevant to their concerns and by adding content to give users the knowledge and confidence to meet new challenges.

scholarly journals Perceived Needs Among Asylum Seekers in Sweden: A Mixed Methods Study

2020 ◽  
Vol 17 (14) ◽  
pp. 4983
Author(s):  
Karin Hugelius ◽  
Maya Semrau ◽  
Marie Holmefur
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Asylum Seekers ◽  
Health Care Services ◽  
Health Care Systems ◽  
Well Being ◽  
Mixed Methods Study ◽  
Cross Sectional ◽  
Humanitarian Emergency ◽  
Perceived Needs

The health and well-being of asylum seekers in high-income countries is a concern from both individual and community perspectives. This study aims to describe the perceived needs of adult asylum seekers in Sweden. A mixed methods study was conducted that combined a non-randomized descriptive cross-sectional assessment of perceived serious needs using the Humanitarian Emergency Settings Perceived Needs Scale (HESPER) Web with 85 adult asylum seekers and focus group discussions with 14 adult asylum seekers in Sweden. Descriptive and comparative statistics were used for the quantitative part, and thematic analysis for the qualitative part. The total number of perceived serious needs reported by respondents ranged from zero to 13 needs per person with a mean of four needs (SD 2.71). The most commonly perceived serious needs were related to income or livelihood, separation from loved ones, being displaced from home, distress, and concerns about accessing adequate health care services. Many of the perceived needs appeared to be related to experiences of being dependent, in limbo, and vulnerable. Addressing people’s current perceived needs can contribute to resilience and well-being and therefore should be considered in health care systems that cater to immigrants.

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