Enhancing engagement in meaningful occupation in a dementia town: A qualitative evaluation of MOED – The meaningful occupational engagement intervention for people with dementia

Introduction Engagement in meaningful everyday life occupations is linked to well-being. However, people with dementia are often deprived of engagement. As a response, a Danish Dementia Town was established with the intention of transforming care services to improve opportunities for meaningful engagement. The evidence-based The meaningful occupational engagement intervention for people with dementia (MOED) intervention was developed and implemented in dementia town to enhance meaningful occupational engagement. The purpose of this paper is to evaluate the content, impact and implementation process of MOED. Method To evaluate MOED, we applied a program theory-based qualitative approach, building on participant observations and informal conversations with people with dementia ( n = 7) and staff ( n = 9). Data were analysed from a hermeneutic approach to gain an in-depth understanding of how MOED influenced meaningful occupational engagement and to evaluate the implementation process. Findings The main theme ‘Engagement in meaningful occupations – a conditional and fragile process’ emerged along with three subthemes: ‘Creating an everyday space of meaning: Conditions of the intervention’, ‘Occupational engagement as an opportunity to blossom: Impact of the intervention’ and ‘Professional identity, culture and reflections: Contextual barriers to changes to working practice’. Together, the subthemes illustrate how engagement in meaningful occupations arose. However, opportunities to engage in meaningful occupations were fragile, as they depended on various factors within the context. Conclusion Engagement in meaningful occupations emerged when MOED was applied in accordance with the program theory, as it seemed to create spaces where people with dementia could engage in meaningful occupations and they could blossom over time. However, MOED was only partially implemented in accordance with the developed program theory, as several contextual barriers influenced the sustainability of the intervention. MOED showed potential to support improvement in dementia care activity programmes to enhance opportunities to engage in meaningful occupations in everyday life for people living with dementia.

Age-Friendly Community Practice: Understanding the Role of Community Events

To advance an emerging empirical knowledge base for age-friendly community initiatives (AFCIs), we conducted a qualitative descriptive study to explore one manifestation of age-friendly practice: community events (CEs). We aimed to illuminate how AFCI core teams describe CEs as part of their practice and how they perceive the value of CEs for age-friendly progress. Using inductive coding, we analyzed data from semi-structured interviews (n=24) with eight core teams across three time points spanning the early to mid-implementation phases of the AFCIs. Two predominant themes emerged. First, CEs were described as important for working toward age-friendly goals concerning older residents’ social participation and inclusion. Second, core teams described the longer-term strategic value of CEs, such as building interorganizational partnerships; providing deeper insight on aging in community; and fostering older adults’ leadership as part of the initiative. We discuss implications for advancing transdisciplinary program theory to guide more sustainable and effective AFCIs.

A Rapid Realist Review of Quality Care Process Metrics Implementation in Nursing and Midwifery Practice

Quality measurement initiatives promote quality improvement in healthcare but can be challenging to implement effectively. This paper presents a Rapid Realist Review (RRR) of published literature on Quality Care-Process Metrics (QCP-M) implementation in nursing and midwifery practice. An RRR informed by RAMESES II standards was conducted as an efficient means to synthesize evidence using an expert panel. The review involved research question development, quality appraisal, data extraction, and evidence synthesis. Six program theories summarised below identify the key characteristics that promote positive outcomes in QCP-M implementation. Program Theory 1: Focuses on the evidence base and accessibility of the QCP-M and their ease of use by nurses and midwives working in busy and complex care environments. Program Theory 2: Examines the influence of external factors on QCP-M implementation. Program Theory 3: Relates to existing cultures and systems within clinical sites. Program Theory 4: Relates to nurses’ and midwives’ knowledge and beliefs. Program Theory 5: Builds on the staff theme of Programme Theory four, extending the culture of organizational learning, and highlights the meaningful engagement of nurses and midwives in the implementation process as a key characteristic of success. Program Theory 6: Relates to patient needs. The results provide nursing and midwifery policymakers and professionals with evidence-based program theory that can be translated into action-orientated strategies to help guide successful QCP-M implementation.

Towards a Program Theory for Family-Focused Practice in Adult Mental Health Care Settings: An International Interview Study With Program Leaders

Objectives: In several high-income countries, family-focused practice programs have been introduced in adult mental health care settings to identify and support children whose parents live with mental health problems. Whilst their common goal is to reduce the impact of parental mental illness on children, the mechanisms by which they improve outcomes in different systems and settings are less well known. This kind of knowledge can importantly contribute to ensuring that practice programs achieve pre-defined impacts.Methods: The aim of this study was to develop knowledge about relationships between contextual factors, mechanisms and impact that could inform a program theory for developing, implementing, and evaluating family-focused practice. Principles of a realist evaluation approach and complex system thinking were used to conceptualize the design of semi-structured in-depth interviews with individuals who led the implementation of programs. Seventeen individuals from eight countries participated in the study.Results: Interviewees provided rich accounts of the components that programs should include, contextual factors in which they operated, as well as the behavior changes in practitioners that programs needed to achieve. Together with information from the literature, we developed an initial program theory, which illustrates the interconnectedness between changes that need to co-occur in practitioners, parents, and children, many of which related to a more open communication about parental mental health problems. Stigma, risk-focused and fragmented health systems, and a lack of management commitment were the root causes explaining, for example, why conversations about parents' mental illness did not take place, or not in a way that they could help children. Enabling practitioners to focus on parents' strengths was assumed to trigger changes in knowledge, emotions and behaviors in parents that would subsequently benefit children, by reducing feelings of guilt and improving self-esteem.Conclusion: To our knowledge, this is the first research, which synthesizes knowledge about how family-focused practice programs works in a way that it can inform the design, implementation, and evaluation of programs. Stakeholder, who fund, design, implement or evaluate programs should start co-developing and using program theories like the one presented in this paper to strengthen the design and delivery of family-focused practice.

MODEL OF PROFESSIONAL RETRAINING OF PEDAGOGICAL PERSONNEL IN THE CONDITIONS OF DUAL EDUCATION

В данной статье представлена теоретическая модель переподготовки педагогических кадров в условиях дуального обучения, состоящая из совокупности взаимосвязанных и взаимодополняющих компонентов, описаны основные субъекты системы переподготовки педагогических кадров в условиях дуального обучения: педагог, обучающийся в системе профессиональной переподготовки, наставник, преподаватели университета. В работе также описывается поэтапная экспериментальная работа по определению эффективности разработанной модели, приведены количественные и качественные результаты экспериментальной работы, которые, в свою очередь, позволили выявить педагогические условия, необходимые для эффективного функционирования модели переподготовки педагогических кадров в условиях дуального обучения. Экспериментальной базой исследования стало муниципальное автономное образовательное учреждение «Лицей № 4» г. Чебоксары Чувашской Республики. В экспериментальную группу для прохождения переподготовки в условиях дуального обучения были приглашены слушатели курсов профессиональной переподготовки, обучающиеся по программе «Теория и практика обучения иностранному языку». В данной статье представлены изменения уровней сформированности лингвистической и профессиональной компетенций у данных слушателей в ходе экспериментальной работы. На каждом этапе эксперимента была реализована работа по выполнению учебного плана, определены формы и методы работы наставников, осуществлялась профессиональная адаптация, корректировка профессиональных умений педагогов, обучающихся по программе переподготовки. This article presents the theoretical model of retraining of pedagogical personnel in the conditions of dual education, consisting of a set of interrelated and complementary components; describes the main subjects of the system of retraining of pedagogical personnel in the conditions of dual education: a teacher studying in the system of professional retraining, mentor, university teachers. The work also describes a step-by-step experimental work to determine the effectiveness of the developed model, provides quantitative and qualitative results of experimental work, which in turn made it possible to identify the pedagogical conditions necessary for the effective functioning of the model of retraining of pedagogical personnel in conditions of dual education. The experimental base of the research was the municipal autonomous educational institution “Lyceum No. 4” of the city of Cheboksary, Chuvash Republic. In the experimental group for undergoing retraining in the conditions of dual education were invited the listeners of professional retraining courses, enrolled in the program “Theory and Practice of Teaching a Foreign Language”. This article presents the changes in the levels of formation of linguistic and professional competences among these listeners in the course of experimental work. At each stage of the experiment, work was carried out to fulfill the curriculum, the forms and methods of work of mentors were determined, professional adaptation was carried out, and the professional skills of teachers who were trained in the retraining program were adjusted.

Linking Budgeting with Computational Thinking Pedagogy: Program Theory, Performance, and Budgeting

The pedagogy involved with preparing and delivering an analytically based course must contend with a number of important limitations or challenges. The challenges/limitations include needing a context for the use of the analytics being taught; others include where best to embed analytic courses in degree curriculum, determining content and delivery along with a number of additional limitations. A context can be created for these courses by establishing a base of usefulness of the course content and how it relates to other courses and to professional applications. However, one useful approach for a budgeting course is to put the analytics in a context of production and performance. These two significant elements of any problem-solving organization finance and budgeting process are significant features of teaching a course in budgeting. The article presented here is an illustration of a context-based approach along with features of pedagogy based in computational thinking which can be used to operationalize course elements while overcoming other salient limitations for analytic courses. The exemplar of a budgeting course is posed as an example.