Leadership competencies of first-line nurse managers: a quantitative study

Purpose This paper aims to examine the leadership competencies of first-line nurse managers (FLNMs) at the unit level in the eastern region of Ghana. Design/methodology/approach The paper is a quantitative cross-section design. Findings Nurse managers exhibited a moderate level of knowledge and ability to apply leadership competencies. Gender, rank, qualification, professional experience, management experience and management training jointly predicted the leadership competencies of FLNMs [(R2 = 0.158, p = 0.016]. However, only management training was a significant predictor in the model. Practical implications Inappropriate leadership competencies have severe consequences for patients and staff outcomes. This situation necessitates a call for a well-structured program for the appointment of FLNMs based on competencies. Originality/value This study is the first in Ghana which we are aware of that examined the leadership competencies at the unit level that identifies predictors of leadership competencies.

Late ‘Early Intervention in Psychosis’: A Family School for Learning How to Live with Schizophrenia

The paper describes a family school for learning how to live with schizophrenia, which was founded in 1986 in Vienna, Austria, and is still running today. It was established in cooperation between professionals and the Austrian self-help association HPE of the relatives of persons with mental disorders. It addresses the needs of 10 families at a time, in cases where a son or a daughter was diagnosed with schizophrenia and had already experienced one or several episodes of the illness. The course lasts one and a half years and is organized according to the model of a weekly boarding school, where 10 children, the residents, stay in the school overnight from Sunday evening to Friday and take part in a structured program on cognitive, social and practical life skills. Ambulatory psychiatric treatment is taking place concurrently outside the school through local routine services. On weekends residents stay with their parents since the school is closed. Parents visit the school regularly to take part in joint activities with the residents. They also undertake night shifts in the school and attend a weekly parents group. In the regular encounters during everyday activities in the school, learning by doing occurs parents get to know the daughters and sons of other families and can learn to distinguish between disease-related and personality-related behavior. Residents can have similar learning experiences in relation to the parents of other residents. The main aim of the school is that parents learn to provide protected autonomy for the daughters or sons in question, in order to assist them after the end of the course in leading a life characterized by as much autonomy as possible after the end of the school.

Protocol for the Implementation and Evaluation of a Mindfulness-Based Intervention for Caregivers of Children with Mental Disorders in a Clinical Setting

Being a parent is complicated in typical circumstances, with a great psychological impact as well as feelings and experiences of great intensity. This impact is greater in families in vulnerable situations, such as those with children with mental health problems, receiving treatment in a clinical setting. Due to these challenges, parenting in these circumstances is often accompanied by experiences of stress. An approach that has shown evidence of effectiveness in mitigating the negative impact of stress is mindfulness-based interventions, including the Mindfulness-Based Stress Reduction intervention program. The Mindfulness-Based Stress Reduction intervention program is designed as a psychoeducational, instructional, multimodal, and structured program whose main objective is to provide strategies for the management, coping, and awareness of stress in order to reduce it. In this paper, a protocol for the implementation and evaluation of the original Mindfulness-Based Stress Reduction intervention program with the added positive parenting component is presented, in order to systematize the incorporation of a parenting component in the Mindfulness-Based Stress Reduction intervention program, analyze its effectiveness for parents whose children have mental health problems (in terms of stress, mindfulness, emotional intelligence, general health, and parental role), explore the mechanisms of change operating in this intervention as perceived by the participants, and examine the application of acquired strategies to daily life.

Reintroduction of running after ACL reconstruction with a hamstring graft: can we predict short-term success?

ABSTRACT Context: Return to running (RTR) after anterior cruciate ligament reconstruction (ACL-R) is a crucial milestone. However, there is uncertainty on how and when to start a running program. Objective: To explore the feasibility of a structured program to reintroduce running after ACL-R and to evaluate the predictive value of potential predictors of short-term success. Design: Longitudinal cohort study. Setting: Local Research Center / participant's home. Patients: Thirty-five participants were recruited after ACL-R. Intervention: Program with a progression algorithm to reintroduce running (10 running sessions in 14 days). Main outcome measures: The criterion for short-term success was no exacerbation of symptoms. Potential predictors included: (i) the International Knee Document Committee (IKDC) subjective knee form; (ii) ACL Return to Sport after Injury questionnaire; (iii) quadriceps and hamstring strength; (iv) Step-Down Endurance test; and (v) the modified Star Excursion Balance test. Descriptive statistics were performed to study the feasibility of the RTR program and Poisson regression analysis was used to evaluate predictors of success. Results: Of the 34 participants included, 33 completed the RTR program. Sixteen participants experienced some temporary exacerbation of symptoms, but only one had to stop the RTR program. Initial IKDC score was the only significant predictor of a successful RTR with an Area under the ROC curve of 80.4%. An ICKD cut-off of 63.7/100 differentiated responders and non-responders with the highest sensitivity and specificity (77.8% and 75.0%, respectively). There was a 3-fold greater chance of success with an IKDC score above this threshold. Conclusions: Our results confirm the feasibility of our RTR program and progression algorithm after ACL-R. Clinicians should use an IKDC score of >64 as a criterion to reintroduce running after ACL-R to increase the likelihood of short-term success.

Establishing the Geriatric Emergency Department Intervention in Queensland Emergency Departments: A Qualitative Implementation Study Using the i-PARIHS Model

Background Frail older adults require specific, targeted care and expedited shared decision making in the emergency department (ED) to prevent poor outcomes and minimise time spent in this chaotic environment. The Geriatric Emergency Department Intervention (GEDI) model was developed to help limit these undesirable consequences. This qualitative study aimed to explore the ways in which two hospital implementation sites implemented the structures and processes of the GEDI model and to examine the ways in which the i-PARIHS (innovation-Promoting Action on Research Implementation in Health Services) framework influenced the implementation. Methods Using the i-PARIHS approach to implementation, the GEDI model was disseminated into two hospitals using a detailed implementation toolkit, external and internal facilitators and a structured program of support. Following implementation, interviews were conducted with a range of staff involved in the implementation at both sites to explore the implementation process used. Transcribed interviews were analysed for themes and sub-themes. Results There were 31 interviews with clinicians involved in the implementation, conducted across two hospitals, including interviews with the two external facilitators. Major themes identified included: (i) elements of the GEDI model adopted or (ii) adapted by implementation sites and (iii) factors that affected the implementation of the GEDI model. Both sites adopted the model of care and there was general support for the GEDI approach to the management of frail older people in the ED. Both sites adapted the structure of the GEDI team and the expertise of the team members to suit their needs and resources. Elements such as service focus, funding, staff development and service evaluation were initially adopted but adaptation occurred over time. Resourcing and cost shifting issues at the implementation sites and at the site providing the external facilitators negatively impacted the facilitation process. Conclusions The i-PARIHS framework provided a pragmatic approach to the implementation of the evidenced-based GEDI model. Passionate, driven clinicians ensured that successful implementation occurred despite unanticipated changes in context at both the implementation and host facilitator sites as well as the absence of sustained facilitation support.

Creating Agents of Change through Doctoral Learning

The proposed article seeks to provide a case study of a doctoral program aspiring to create change through student progress and provide an overview of how they have structured program curricula to promote academic and professional growth and empower students to become global leaders. Further, this proposed article is focused on providing a focus on the importance of learning technologies and how doctoral students develop the skill sets and expertise needed to employ technology into educational and organizational contexts to enhance academic outcomes, instructional approaches, and employee productivity. Particularly, information will be provided on the importance of providing students access to cutting edge technologies that are transforming the landscape of educational and organizational learning.

Improving Cancer MDT performance in Western Sydney – three years’ experience

Background While multidisciplinary teams (MDTs) are now considered an essential part of cancer care decision-making, how they perform varies widely. The authors hypothesised that a comprehensive, multipronged improvement program, and associated annual member survey, could strengthen MDT performance across a whole cancer service. Methods The study comprised the introduction of a structured program, the Tumour Program Strengthening Initiative (TPSI) linked with an annual survey of member’s perceptions of their performance. Three iterations of the survey have been completed (2017, 2018 and 2019). Generalised estimating equations (GEEs) were used to test for a difference in the proportion of positive survey responses between 2017 and 2019 adjusted for team clustering. Results Twelve teams participated in TPSI. One hundred twenty-nine, 118 and 146 members completed the survey in 2017, 2018 and 2019, respectively. Of the 17 questions that were asked in all three years, nine showed significant improvement and, of these, five were highly significant. Documenting consensus, developing Terms of Reference (TORs), establishing referral criteria and referring to clinical practice guidelines showed most improvement. Questions related to patient considerations, professional development and quality improvement (QI) activities showed no significant change. Conclusions TPSI resulted in sustained and significant improvement. The MDT survey not only allowed MDT members to identify their strengths and weaknesses but also provided insights for management to flag priority areas for further support. Overall program improvement reflected the strengthening of the weakest teams as well as further improvement in highly performing MDTs. Importantly, the initiative has the potential to achieve behaviour change amongst clinicians.

Literature and Art Therapy, as an Applied Model Used by Restorative Justice - Case Study: Minors at Kavaja Minors Institution in Albania

The purpose of this paper is to analyze the restoration process of juveniles who are serving their sentences at Kavaja Minors Institution, through the therapy of literature and art. In order to understand the process, it is essential to answer the following questions: does art therapy have a transformative effect on the psychology of adolescents who have problems with the law? If so, how and to what extent does it affect and by what means do we measure the result? Methods that were used in order to process the data were the empirical, analytical, comparative and descriptive ones. The data were registered before and after sixteen therapeutic sessions that were essentially related to reading literature and dealing with other arts. If art therapy is utilized through a structured program to ensure informal education (ie, discovering oneself and others by creating and practicing process), it may help to improve adolescents' behaviors. Juveniles that are in re-education institutions may even ameliorate their psychological conditions if they are engaged to literature and art therapy. Art in itself deals with the personal dimension and consequently the interpersonal one, giving minors the opportunity to self-heal and later to self-regulate. The findings of this case study justify the importance of art therapeutic sessions in transforming and improving behaviors, learning and commitment to the creative process. This therapy was difficult to implement during the closure of institutions due to COVID-19. As a result, some of the therapeutic sessions were performed virtually and indirectly. Literature and art therapy improves young people emotionally, mentally and promotes their artistic skills. Their creativity and artistic performance (poetry, essays, debate, drama, role-play, dance and singing) remain an important proof of this restoration process. Received: 8 January 2021 / Accepted: 22 February 2021 / Published: 5 March 2021