Home Practice
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2021 ◽  
pp. 1-23
Lin Chen ◽  
Qiang Zhu ◽  
Ling Xu ◽  
Yura Lee ◽  
Bum Jung Kim

Abstract Although research has shown that older nursing home residents can benefit from caring relationships with nurse aides, few studies have explored their dyadic, evolving relationship dynamics. Using a dyadic perspective, this study simultaneously explores caring relationships among older residents and nurse aides in Shanghai. In a government-sponsored nursing home in Shanghai, 20 matched resident–nurse aide dyads participated in semi-structured, in-depth interviews (N = 40). We performed thematic analysis to interpret and conceptualise the evolving caring relationships within dyads. Four types emerged during the evolution of caring relationships across the 20 dyads: (a) sharing strong rapport, (b) respecting each other, (c) hesitant responding, and (d) keeping emotional distance. Upon placement, all the residents kept emotional distance from nurse aides, and their assigned nurse aides provided care-giving by following nursing home regulations. As time passed, nurse aides began to create a family environment and tried to interact with residents on an emotional level; however, residents’ attitudes varied. The caring relationships in some dyads evolved as rapport and respect emerged, while others remained hesitant and distant. This suggests that residents and nurse aides prioritised caring relationships differently in terms of autonomy preservation and safety protection, respectively. This study sheds light on nursing home practice to facilitate building caring relationships between residents and nurse aides.

M.M.F Rusdha ◽  
W.A Edirisooriya

The corporate world was undergoing a phase of digital transformation overrecent past years which led to adopt the work from home practice in different industry contexts and this practice had been accelerated due to the COVID-19 outbreak. To obtain the optimum outcome from employees, it is the major responsibility of the organizations to ensure that they are satisfied enough with the new work settings since employee job satisfaction is one of the significant elements of an effective workforce. Therefore,the main objective of this study was to examine the impact of work from home on employee job satisfaction in Information Communication Industry (ICT) industry in Sri Lanka. Using the survey strategy, responses were collected through questionnaires from 384 employees from the ICT industry in Sri Lanka. The findings of this study concluded that there is a positive impact of work from home on employee job satisfaction in the ICT industry in Sri Lanka as work from home gives more freedom, autonomy, and work-life balance. Further, it identified that the ICT organizations in Sri Lanka use a high level of work home practice and their employees’ job satisfaction level is also relatively high. The theoretical contribution of this study is that it extends the employee job satisfaction literature by empirically testing and validating the work from home in a new context. Also, the findings of this research are useful for all the practitioners to increase employee job satisfaction by developing flexible and unique work from home practices. Accordingly, work from home could be used as a strong motivational strategy in the ICT industry as well as in other contexts.

Stroke ◽  
2021 ◽  
Marian C. Brady ◽  
Myzoon Ali ◽  
Kathryn VandenBerg ◽  
Linda J. Williams ◽  
Louise R. Williams ◽  

Background and Purpose: Optimizing speech and language therapy (SLT) regimens for maximal aphasia recovery is a clinical research priority. We examined associations between SLT intensity (hours/week), dosage (total hours), frequency (days/week), duration (weeks), delivery (face to face, computer supported, individual tailoring, and home practice), content, and language outcomes for people with aphasia. Methods: Databases including MEDLINE and Embase were searched (inception to September 2015). Published, unpublished, and emerging trials including SLT and ≥10 individual participant data on aphasia, language outcomes, and time post-onset were selected. Patient-level data on stroke, language, SLT, and trial risk of bias were independently extracted. Outcome measurement scores were standardized. A statistical inferencing, one-stage, random effects, network meta-analysis approach filtered individual participant data into an optimal model examining SLT regimen for overall language, auditory comprehension, naming, and functional communication pre-post intervention gains, adjusting for a priori–defined covariates (age, sex, time poststroke, and baseline aphasia severity), reporting estimates of mean change scores (95% CI). Results: Data from 959 individual participant data (25 trials) were included. Greatest gains in overall language and comprehension were associated with >20 to 50 hours SLT dosage (18.37 [10.58–26.16] Western Aphasia Battery–Aphasia Quotient; 5.23 [1.51–8.95] Aachen Aphasia Test–Token Test). Greatest clinical overall language, functional communication, and comprehension gains were associated with 2 to 4 and 9+ SLT hours/week. Greatest clinical gains were associated with frequent SLT for overall language, functional communication (3–5+ days/week), and comprehension (4–5 days/week). Evidence of comprehension gains was absent for SLT ≤20 hours, <3 hours/week, and ≤3 days/week. Mixed receptive-expressive therapy, functionally tailored, with prescribed home practice was associated with the greatest overall gains. Relative variance was <30%. Risk of trial bias was low to moderate; low for meta-biases. Conclusions: Greatest language recovery was associated with frequent, functionally tailored, receptive-expressive SLT, with prescribed home practice at a greater intensity and duration than reports of usual clinical services internationally. These exploratory findings suggest critical therapeutic ranges, informing hypothesis-testing trials and tailoring of clinical services. Registration: URL: https://www.crd.york.ac.uk/PROSPERO/ ; Unique identifier: CRD42018110947.

Elena V. Donoso Brown ◽  
Sarah E. Wallace ◽  
Qianwen Liu

Purpose We aimed to describe the current practices of speech-language pathologists regarding the creation and implementation of home practice programs for persons with poststroke aphasia. Method Survey participants were American Speech-Language-Hearing Association–certified speech-language pathologists, had 30% of their caseload include persons with aphasia, and had recently created at least two home programs for persons with aphasia. Respondents completed a web-based survey on home program creation, training, technology, and methods for tracking adherence with closed and open-ended questions. Results We analyzed 80 complete surveys. Most of the participants ( n = 56) created home programs for greater than 75% of their caseload. Common interventions in home programs addressed functional practice and spoken expression. Participants describe instructional techniques including building skill practice in daily routines and guided practice. Applications of technology and formal mechanisms to monitor adherence were less frequently reported. Various factors were identified as facilitators and barriers to home program creation with environmental support from others and client factors (i.e., motivation, impairments) most evident. Conclusions This study provides insight into speech-language pathologists' home program creation and implementation. Results can be used to consider mechanisms to improve use of and adherence to home programs to further support recovery. Supplemental Material https://doi.org/10.23641/asha.16840204

Jen Murphy ◽  
Mark Elliot ◽  
William Whittaker ◽  
Rathi Ravindrarajah

IntroductionPoor access to general practice services has been attributed to increasing pressure on the health system more widely and low satisfaction among patients. Recent initiatives in England have sought to expand access by the provision of appointments in the evening and at weekends. Services are provided using a hub model. NHS national targets mandate extended opening hours as a mechanism for increasing access to primary care, based on the assumption that unmet need is caused by a lack of appointments at the right time. However, research has shown that other factors affect access to healthcare and it may not simply be appointment availability that limits an individual's ability to access general practice services. ObjectivesTo determine whether distance and deprivation impact on the uptake of extended hours GP services that use a hub practice model. MethodsWe linked a dataset (N = 25,408) concerning extended access appointments covering 158 general practice surgeries in four Clinical Commissioning Groups (CCGs) to the General Practice Patient Survey (GPPS) survey, deprivation statistics and primary care registration data. We used negative binomial regression to estimate associations between distance and deprivation on the uptake of extended hours GP services in the Greater Manchester City Region. Distance was defined as a straight line between the extended hours provider location and the patient's home practice, the English Indices of Multiple Deprivation were used to determine area deprivation based upon the home practice, and familiarity was defined as whether the patient's home practice provided an extended hours service. ResultsThe number of uses of the extended hours service at a GP practice level was associated with distance. After allowing for distance, the number of uses of the service for hub practices was higher than for non-hub practices. Deprivation was not associated with rates of use. ConclusionThe results indicate geographic inequity in the extended hours service. There may be many patients with unmet need for whom the extension of hours via a hub and spoke model does not address barriers to access. Findings may help to inform the choice of hub practices when designing an extended access service. Providers should consider initiatives to improve access for those patients located in practices furthest away from hub practices. This is particularly of importance in the context of closing health inequality gaps.

M. Gawrysiak ◽  
R. T. Pohlig ◽  
A. Chaoul ◽  
M. Vaughn ◽  
G. Rocco ◽  

AbstractAbundant research supports the benefits of participating in mindfulness meditation training programs including Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy. However, these well researched programs include a narrow range of meditation practices and research to date has minimally examined how home practice associates with favorable outcomes. The present study evaluated the 3 Doors Compassion Project (3DCP), a structured 9-months meditation program that teaches Tibetan Mind-Body practices and examined how frequency and duration of home practice associated with favorable outcomes. Twenty-seven medical and mental healthcare professionals completed assessments prior to, during, and following participation in the 3DCP program and recorded daily meditation practices. Study aims were to test general effectiveness of the 3DCP program and to test the hypotheses that frequency and duration of meditation home-practice would associate with improvements on mindfulness, stress, and depression. General linear mixed modeling demonstrated significant improvements throughout the duration of the 3DCP program for mindfulness, depression (p < .001) and stress (p < .05), with each variable evidencing incremental monthly improvements. Frequency of meditation (i.e., days practiced per month), but not time (i.e., minutes per month) was significantly associated with improvements throughout the 3DCP program. Results provide support for the benefits of the 3DCP while offering clinically useful information that can inform current guidelines for meditation home practice. As predicted, the 3DCP was associated with significant improvements on all outcomes. Favorable outcomes were linked to frequency, but not total time of meditation practice, which suggests that consistent meditation may be more helpful than extended meditation.

Mindfulness ◽  
2021 ◽  
Kelly Birtwell ◽  
Rebecca Morris ◽  
Christopher J. Armitage

Abstract Objectives While brief mindfulness-based interventions (MBIs) show promise, stakeholder involvement in their design is lacking and intervention content can vary substantially. The aim of this study is to explore stakeholder perspectives of brief MBIs, brief MBI content, and adapting existing MBIs. Methods In this convergent mixed methods design study, 22 mindfulness teachers and 20 mindfulness course attendees completed an online UK-based survey. Twenty-six participants were female, and mean age was 50.8 years. Data from closed questions were analysed using descriptive and inferential statistics, and data from open questions were analysed using reflexive thematic analysis. Results Findings suggest a brief MBI could comprise five 80-min sessions and include focused attention practice, informal mindfulness, inquiry, psychoeducation, and 20 min of daily home practice. Opinions of some elements differed among participants, such as the body scan, poetry, and the sitting with difficulty practice. Four themes were generated from participants’ comments about their attitudes to brief MBIs, which were generally positive but expressed concerns about insufficient content and poor delivery. Three themes were generated about adapting MBIs, suggesting tensions between adhering to a curriculum and meeting group needs. Five themes were generated from views about the content and characteristics of MBIs, highlighting the importance of accessibility, teacher training, and participant safety. Conclusions Brief MBIs may increase access to mindfulness training, yet there is a need for adequate governance and transparency regarding their strengths and limitations. Clarity and evidence of MBI mechanisms along with scientific literacy in teachers will support fidelity-consistent modifications.

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512500047p1
Kate De Castro ◽  
Elena Donoso Brown ◽  
Sarah Wallace ◽  
Rachael Neilan

2021 ◽  
Vol 36 (Supplement_1) ◽  
D Lelaidier

Abstract text Objective , We report in this presentation the use for couples undergoing infertility treatment of a new way of accompaniment. Hypnosis associated with learning of self-hypnosis is a solid support to valid an appeased uptake of an infertility program and lower the emotional charge associated with such treatments. Main enhance emotional comfort in couples undergoing infertility treatment. Secondary patients feelings after results of the attempt (whether failure or success), pregnancy rates. Contains During a first meeting family and historical back ground is analyzed as well as medical file and causes for infertility. Then a first specific session is proposed in relation with underlying problems using ericksonian hypnosis. For example sessions using amnesia can be used in patients having had traumatic experiences. Comfort and wellbeing suggestions are used after each hypnosis session. Two other sessions can be proposed at office, one called “the two chests” first one to pack all past failures and second to collect present or past successes regarding all fields. These successes will be resourceful to refer to. The second session will be to enhance self-confidence using contes. In order to enhance autonomy patients are given 4 audio sessions prerecorded to home practice. Three of them are specific to intra uterine insemination or embryo transfer. One is called FIVETE to listen the day before medical procedure, one is called SIMPLE INDUCTION to start just before and throughout the procedure. One to do after procedure at home called DO NOTHING. Patients are called few weeks after the attempt for debrief and results.

2021 ◽  
Vol 11 (1) ◽  
Anne Schienle ◽  
Isabella Unger

AbstractPlacebos, that are administered with deception, can reduce stress and increase relaxation. The present study investigated an open-label placebo (OLP) to improve the effects of Progressive Muscle Relaxation (PMR) training. A total of 160 psychology students were randomly assigned to a 14-day PMR course with or without daily OLP treatment. The placebo was administered along with an explanation of placebo effects and the verbal suggestion that the OLP activates the body’s natural relaxation response. The relaxation instructions for home practice were delivered via a smartphone app, which was also used for the evaluation of the exercises. The participants of the OLP group completed more PMR exercises (M = 9.75) than the group without a placebo (M = 8.15). The two groups did not differ in reported exercise-related changes in relaxation level. On average, the OLP group rated the effects of the placebo as very low and was characterized by a higher drop-out rate compared to the group without OLP. Some participants experienced the OLP as negative. In conclusion, factors that influence the acceptance of OLP treatment require further investigation.

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