Adaptive leadership of doctors during COVID-19

Purpose This study aims to examine the adaptive leadership of doctors during COVID-19 to understand the leadership competencies required for adaptive events. Design/methodology/approach Phenomenology-based qualitative design was used. Data were collected from six doctors from the state of Kerala, India using semi-structured interviews. Findings Five themes were identified. The first theme, core leadership shows that doctors perceive leaders as educators, learners and social beings. The second theme, adaptive challenges, describes the ambiguous pandemic-related challenges that doctors are facing including, unusual occupational demands, information overload, sociocultural issues and personal intricacies. The third theme reflects that for doctors, adaptive work during the pandemic included – new learning to address unique issues, changing perspectives and establishing and maintaining a safe and engaging workplace environment. The fourth theme describes the adaptive leadership competencies such as regulating distress, providing direction, maintaining disciplined action, fostering collaboration, empowering, understanding organizational linkages, strategic vision and communication skills. The fifth theme elucidates the lacunae in leadership training as perceived by the doctors. Research limitations/implications The findings can help in developing and enhancing competency frameworks for doctors’ adaptive leadership. Originality/value This is one of the earliest studies to systematically examine components of adaptive leadership for doctors during COVID-19 and identify associated competencies.

Using a Theoretical Framework in a Qualitative Metasummary About Fatigue Adaptation After Stroke

We describe how we used a theoretical framework, Adaptive Leadership Framework for Chronic Illness (ALFCI), to complete a qualitative metasummary in a scoping review of 26 articles. We abstracted and grouped qualitative findings relevant to fatigue adaptation in stroke survivors using constructs of the ALFCI as 4 main themes: 1) adaptive challenges, 2) adaptive work, 3) adaptive leadership and collaborative work, and 4) technical challenges and technical work. We found that stroke survivors encountered different aspects of challenges (e.g., physical dysfunction vs. mental distress) and utilized various adaptive work (e.g., conserving energy vs. restructuring normality) as well as what stroke survivors needed from healthcare professionals (e.g., basic knowledge about fatigue). The ALFCI provides a useful lens to synthesize qualitative findings regarding fatigue adaptation and therefore researchers can target different problems that need to be tackled for stroke survivors, care partners, or healthcare professionals, respectively.

Adaptive Challenges and Family Support: Patient Self-Management during Treatment for Chronic Hepatitis C

The authors describe a family’s adaptive challenges and adaptive work during a family member’s treatment for Chronic Hepatitis C. We audiorecorded index and final clinical visits and interviewed participants (patients and providers) following the visits. We interviewed by telephone and reviewed medical records over the course of treatment. Transcripts were analyzed using directed content analysis. Three themes were identified: family adaptive challenges, patient-described aspects of family members’ adaptive challenges, and family adaptive work. There were four subthemes related to family adaptive work. The adaptive leadership framework for chronic illness provided direction for future family intervention.

Daurah Fikih Salat di Pondok Pesantren Ibnu Qayyim Bone sebagai Upaya Melahirkan Generasi Unggul

Ibnu Qayyim Islamic Boarding school is a formal educational institution, located in Walannae Village, Tanete Riattang Subdistrict, Bone Regency.This boarding school has two levels of education, namely Integrated Islamic Junior High School (SMP IT) Technology and Vocational High School (SMK) with the department of Network Computer Engineering. The purpose of KKN STIBA Makassar class IV is to carry out community service which is one of the tri dharma pillars of higher education. The method of community service implementation in the cottage begins with mapping the problems and needs of students by using instruments made independently combined with SOAR analysis. After conducting a needs analysis, the next stage is the preparation of an adaptive work program with cottage conditions. Among the work programs implemented by students of KKN STIBA Makassar class IV is Daurah Fikih Salat. The result of the implementation of this KKN is the improvement of the understanding of students around taharah and prayer that is seen in the ordinances of wudoo' and prayer movements that are getting better and right.

Abstract P115: Fatigue Adaptation Among Stroke Survivors: A Sc oping Review

Introduction: No study has systematically examined stroke survivors’ challenges with fatigue. We use the Adaptive Leadership Framework for Chronic Illness (ALFCI) to synthesize what survivors’ challenges are with fatigue and how they respond or collaborate with others to achieve poststroke fatigue adaptation. Methods: We searched PubMed, CINAHL, Embase, and PsycInfo using PRISMA-ScR guidelines, gathering studies between 2012 and 2020. Qualitative studies or qualitative findings in mixed-method studies were included if they described stroke survivors’ (cerebral infarction, TIA, and brain hemorrhage) experiences with fatigue and/or care partners’ experiences to help survivors adapt to fatigue. We excluded studies which were not full-text English and did not report empirical data (e.g., literature review or editorial). We used interpretive synthesis to analyze the published qualitative data. Results: Of 714 papers identified, we retained 25 papers (22 qualitative and 3 mixed-method studies). Using ALFCI to synthesize data, we found that survivors with fatigue had many types of adaptive challenges. Fatigue made them less productive and it affected their cognitive, language, and physical functions, as well as sleeping patterns and social activities. To respond to these challenges, survivors did adaptive work such as changing mindset, using energy-conservation strategies, restructuring routines, and exercising. Care partners, health professionals, and others showed leadership by helping survivors adapt to fatigue by giving information about fatigue, assessing survivors’ fatigue levels, reducing survivors’ workload, and collaboratively negotiating for new daily routines. However, some studies indicated survivors needed fatigue education from professionals. No study interviewed care partners to examine their experiences helping survivors adapt to fatigue. Conclusions: Survivors had many types of challenges and responses towards fatigue. Care partners and others showed leadership by facilitating survivors with fatigue adaptation. Future studies can identify targets for interventions to address poor adaptation to fatigue and also explore care partners’ perspectives.

Adaptive work in the primary health care response to domestic violence in occupied Palestinian territory: a qualitative evaluation using Extended Normalisation Process Theory

Background A health system response to domestic violence against women is a global priority. However, little is known about how these health system interventions work in low-and-middle-income countries where there are greater structural barriers. Studies have failed to explore how context-intervention interactions affect implementation processes. Healthcare Responding to Violence and Abuse aimed to strengthen the primary healthcare response to domestic violence in occupied Palestinian territory. We explored the adaptive work that participants engaged in to negotiate contextual constraints. Methods The qualitative study involved 18 participants at two primary health care clinics and included five women patients, seven primary health care providers, two clinic case managers, two Ministry of Health based gender-based violence focal points and two domestic violence trainers. Semi-structured interviews were used to elicit participants’ experiences of engaging with HERA, challenges encountered and how these were negotiated. Data were analysed using thematic analysis drawing on Extended Normalisation Process Theory. We collected clinic data on identification and referral of domestic violence cases and training attendance. Results HERA interacted with political, sociocultural and economic aspects of the context in Palestine. The political occupation restricted women’s movement and access to support services, whilst the concomitant lack of police protection left providers and women feeling exposed to acts of family retaliation. This was interwoven with cultural values that influenced participants’ choices as they negotiated normative structures that reinforce violence against women. Participants engaged in adaptive work to negotiate these challenges and ensure that implementation was safe and workable. Narratives highlight the use of subterfuge, hidden forms of agency, governing behaviours, controls over knowledge and discretionary actions. The care pathway did not work as anticipated, as most women chose not to access external support. An emergent feature of the intervention was the ability of the clinic case managers to improvise their role. Conclusions Flexible use of ENPT helped to surface practices the providers and women patients engaged in to make HERA workable. The findings have implications for the transferability of evidenced based interventions on health system response to violence against women in diverse contexts, and how HERA can be sustained in the long-term.