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Validation of a conceptual framework aimed to standardize and compare care integration initiatives: the project INTEGRATE framework
- Authors:
- CALCIOLARI S, et al
- Journal article citation:
- Journal of Interprofessional Care, 36(1), 2022, pp.152-160.
- Publisher:
- Taylor and Francis
The development of integrated care initiatives to overcome service delivery fragmentation has become a global concern. Yet, the lack of guidance in their design and delivery has led to a high risk of project failure. Several authors have proposed driving ideas and strategies to foster care integration but a comprehensive conceptual framework building on the evidence and different perspectives of scientific contributions is still needed. The objective of this article is to explain the process of development and validation of a comprehensive framework that could be used either to standardize descriptions of existing care integration initiatives or as a conceptual basis for reflecting on the effective design of new programs or projects. In an initial phase, we used a comprehensive list of 175 items resulting from a literature review in order to identify a 'core set' of relevant framework items. subsequent phases, we validated the newly developed framework. External experts supported the validation phases. The iteration process resulted in a framework of 40 items grouped into seven dimensions: Person-centered care, Clinical integration, Professional integration, Organizational integration, Systemic integration, Functional integration, and Normative integration. The validated framework proved to be understandable and relevant to identify analytical aspects fostering care integration. It could be adapted as a useful tool to inform the design and implementation of new integrated care interventions as well as to generate standardized description of initiatives to perform insightful comparisons. (Edited publisher abstract)
Supporting healthy relationships among minority ethnic parents: a practical guide
- Authors:
- GHIARA Virginia, et al
- Publisher:
- Early Intervention Foundation
- Publication year:
- 2022
- Pagination:
- 56
- Place of publication:
- London
This practical guide for local areas has been developed to improve understanding of how risk factors among minority ethnic families can impact on parental conflict and in turn on child outcomes. The guide provides an overview of the research evidence and data on the impact of parental conflict on minority ethnic child outcomes, and of the factors that can increase the risk of parental conflict among minority ethnic families. The document covers: how research evidence can be put into practice to inform your local strategy; recommendations on how to engage minority ethnic parents; details of healthy relationship and parenting interventions and how to ensure support is culturally appropriate; and a summary of measurement tools that can be used to measure parental conflict, co-parenting, and child outcomes with minority ethnic families. This guide is intended to provide practical advice to local authorities taking part in the national Reducing Parental Conflict Programme. This beta version was first published for testing on 30 March 2022. (Edited publisher abstract)
How to scale up quality and safety program with the home care accreditation
- Authors:
- BRUNELLI Laura, et al
- Journal article citation:
- International Journal of Integrated Care, 22(1), 2022, p.19. Online only
- Publisher:
- International Foundation for Integrated Care
Introduction: The growing number of older people and the increasing burden of non-communicable diseases highlight the need for the integration between social and health services. To ensure high quality home care, common and consistent standards are essential. Our aim is to develop a validated accreditation tool for home care. Description: An integrated home care accreditation tool was developed including 26 standards and 144 items divided into six domains: Organization and Governance, Patient Safety and Risk Management, Professionals knowledge, Skills and Competences, Information and Communication, Care Integration, and Improvement and Innovation. Expert evaluation was conducted between August and November 2019; relevance and feasibility (RF) and expert agreement were analysed. Discussion: A total of 21 experts participated in the validation process, with a response rate of 53%. A good RF score and agreement were obtained for 70% of the items and 65% of the standards. The best scores were obtained for Individualized care project(RF 8.4, agreement 100%),Integrated care pathways(RF 7.5, agreement 81%),Access to the integrated health and social care system(RF 8.1, agreement 86%), and Multidimensional assessment of needs(RF 8.1, agreement 86%). Conclusion: The existence of an integrated health and social care accreditation tool would help to improve the quality of home care, and make patients’ quality of life better and safer. (Edited publisher abstract)
Measurement indicators of age-friendly communities: findings from the AARP age-friendly community survey
- Authors:
- KIM Kyeongmo, et al
- Journal article citation:
- Gerontologist, 62(1), 2022, pp.e17-e27.
- Publisher:
- Oxford University Press
Background and Objectives: Cities and counties worldwide have adopted the concept of “age-friendly communities.” These communities aspire to promote older adults’ well-being by providing a safe, affordable built environment and a social environment that encourages their participation. A major limitation in this field is the lack of valid and reliable measures that capture the complex dimensionality and dynamic nature of the aging–environment interface. Research Design and Methods: This study uses data from the AARP 2016 Age-Friendly Community Surveys (N = 3,652 adults aged 65 and older). The survey includes 62 indicators of age-friendliness, for example, outdoor spaces, transportation, housing, social participation, and community and health services. The researchers randomly split the sample into 2 equal subsamples for confirmatory factor analysis (CFA) and structural equation modeling (SEM). Results: CFA results indicated that both the 5-factor model and the second-order factor model adequately fit the data. In the SEM 5-factor model, outdoor space (β = 0.134; p = .017), social participation (β = 0.307; p < .001), and community and health services (β = −0.149; p = .008) were associated with self-rated health, the outcome of interest. The path coefficients of housing and transportation were not significant. In the second-order factor model, people who lived in more age-friendly communities reported better self-rated health (β = 0.295; p < .001). Discussion and Implications: these findings show that the Age-Friendly Community Survey measures demonstrate reliability and concurrent validity. To promote older adults’ well-being, practitioners, policymakers, and researchers should focus on improving their built and social environments. They can use these measures for short- and long-term planning, monitoring, and evaluating age-friendly community initiatives. (Edited publisher abstract)
Developing a Scale of Care Work-related Quality of Life (CWRQoL) for long-term care workers in England
- Authors:
- HUSSEIN Shereen, et al
- Journal article citation:
- International Journal of Environmental Research and Public Health, 19(2), 2022, Online only
- Publisher:
- Molecular Diversity Preservation International and Multidisciplinary Digital Publishing Institute
Background: Long-term care (LTC) workers are subjected to structural and inherent difficult conditions that are likely to impact their quality of life at work; however, no agreed scale measures it. This study aims to develop a scale to measure the work-related quality of life among LTC workers in England (CWRQoL). The study establishes the domains/sub-domains of CWRQoL, investigates the tool’s utility and collates information on existing supporting strategies for CWRQoL. Methods: We adopt a mixed-methods approach employing inductive/deductive processes at three stages: (1) a scoping review of the literature; (2) interviews and focus groups with frontline LTC workers, managers and LTC stakeholders; and (3) a content validity consensus survey. Results: CWRQoL is composed of seven domains (and 23 sub-domains). Additional domains to those in the literature include financial wellbeing, sufficient time for building relations, managing grief and emotions associated with client death and end of life care. Stakeholders identified several benefits and challenges related to the CWRQoL tool’s utility. COVID-19 significantly impacted LTC workers’ mental wellbeing and spillover between work and home. Conclusions: The study highlighted the complex nature of CWRQoL and provided a solid ground for developing and validating a CWRQoL scale. (Edited publisher abstract)
Development and psychometric evaluation of the Dementia Public Stigma Scale
- Authors:
- KIM Sarang, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 37(2), 2022,
- Publisher:
- Wiley
Objectives: Dementia is a stigmatised condition and dementia-related stigma is associated with low self-esteem, poor psychological wellbeing, social isolation and poor quality of life in people living with dementia and their families. There is, however, a lack of valid measures that accurately quantify dementia-related stigma in the general public. This study reports the initial psychometric evaluation of a new tool designed to measure dementia-related public stigma amongst community dwelling adults. Methods: A sample of 3250 individuals aged 18 and over completed an online survey on their beliefs and feelings regarding dementia and people living with dementia, and their behavioural intentions towards people living with dementia. Exploratory factor analysis (EFA) using Maximum Likelihood with oblique rotation was performed to extract factors. Confirmatory factor analysis (CFA) was used to confirm the factor structure using goodness-of-fit index (GFI), the comparative fit index (CFI), and the root mean square error of approximation (RMSEA) to evaluate the model fit. Internal consistency was measured for the final scale version. Results: EFA resulted in a 16-item, 5-factor model (Fear and discomfort, Negative perceptions, Positive perceptions, Burden, and Exclusion) that explained 50.43% of the total variance. The CFA-estimated model demonstrated a good fit; all fit indices were larger than 0.95 (GFI = 0.967, CFI = 0.959) and smaller than 0.05 (RMSEA = 0.048). The final scale showed moderate to high reliability scores ranging from α = 0.738 to 0.805. Conclusions: The Dementia Public Stigma Scale is a tool with reliability, and some demonstrated validity. This scale can be used to measure the public stigma of dementia amongst adults and may be used in the development and evaluation of interventions aimed at dementia-related stigma reduction. (Edited publisher abstract)
Does the indicator of relative need (IoRN2) tool improve inter-professional conversations?
- Authors:
- BARRON Wendy, et al
- Journal article citation:
- Journal of Integrated Care, 29(4), 2021, pp.452-463.
- Publisher:
- Emerald
Purpose: This paper provides an overview of an improvement project that explored whether the implementation of IoRN2, a validated freely available tool designed for any health or social care professional to use, resulted in improved conversations across professions within an integrated rehabilitative reablement service. Design/methodology/approach: A qualitative descriptive evaluative approach was applied underpinned by quality improvement Lean and Total Quality Management (TQM) to capture perceptions, variables and IoRN2 value-add. Professionals' (N = 8) across Nursing, Allied Health Professions, Social Work, Quality Improvement and Support Workers participated in one-to-one semi-structured <1 h interviews. Recurring themes and experiences were identified. Findings: IoRN2 improved collaborative conversations. The evaluation of the tool demonstrated greatest impact when all professionals were IoRN2 trained. Participants, regardless of profession, believed that their conversations, professional relationships and outcomes improved when using IoRN2. When differing judgments arose with colleagues who were not IoRN2 trained, fear and tension emerged around trust, cultural manners and power play causing disconnects. Incorporating IoRN2 led to psychologically safe environments where trust, confidence and motivation to explore new creative conversations enhanced strength-based outcomes and helped to generate transformational change. Research limitations/implications: The small sample size offered transferable learning worthy of larger future study. The project lead was also the reablement service manager, which may have generated unintended influence. Originality/value: IoRN2 has the potential to improve how HSC professionals converse, acting as a catalytic tool for system-level integration, transformation and sustainable improvement. (Edited publisher abstract)
Screening children with a history of maltreatment for PTSD in frontline social care organisations: an explorative study
- Authors:
- DUFFY Michael, et al
- Journal article citation:
- Child Abuse Review, 30(6), 2021, pp.594-611.
- Publisher:
- Wiley
Traumatic experiences during childhood are common and often lead to chronic mental health conditions such as posttraumatic stress disorder (PTSD). The primary aim of this study was to determine whether a well-validated screening tool for PTSD administered in frontline services effectively identifies diagnosable PTSD in young people with a history of maltreatment. In total, 141 young people in community care settings were screened using three screening instruments (Child Revised Impact of Events Scale-8; Generalised Anxiety Disorder-2; Patient Health Questionnaire-2). Participants described a range of adverse life events: 110 of the 141 participants reported at least one adverse life experience (mean number for the total sample was 2.8), with 44.2 per cent (n = 46) experiencing at least one form of interpersonal trauma; and 102 participants (72.3 per cent) screened positively for probable PTSD and subsequent mental health assessments confirmed this condition in 64.7 per cent of these participants. Further, 36.9 per cent (n = 52) and 46.8 per cent (n = 66) met the threshold for probable depression and anxiety, respectively. Three items were associated with positive PTSD screens: a history of being on the child protection register, previous mental health contact and interpersonal index trauma. Interpersonal traumas were also associated with higher risks of offending. It seems feasible to use screening measures effectively within frontline social care services if staff are provided with appropriate training and support to identify young people with PTSD who may benefit from evidence-based mental health therapies. (Edited publisher abstract)
Development and psychometric testing of the mealtime engagement scale in direct care providers of nursing home residents with dementia
- Authors:
- LIU Wen, et al
- Journal article citation:
- Gerontologist, 61(8), 2021, pp.e410-e420.
- Publisher:
- Oxford University Press
Background and Objectives: Mealtime engagement is defined as verbal and nonverbal assistance provided by caregivers to guide and motivate care recipients in eating. Quality mealtime engagement is critical to improve mealtime difficulties and intake among older adults with dementia requiring eating assistance. Few tools are feasible and valid to measure mealtime engagement. This study developed and tested the Mealtime Engagement Scale (MES). Research Design and Methods: Items were developed based on literature review and expert review and finalized based on content validity and corrected item-total correlation. A secondary analysis of 87 videotaped observations capturing 18 nursing home staff providing mealtime care to residents with dementia was conducted. Internal consistency, interrater reliability, and intrarater reliability were assessed. Concurrent and convergent validity were examined through correlation (rs) with the Relational Behavior Scale (RBS) and the Mealtime Relational Care Checklist (M-RCC), respectively. Results: The 18-item MES was developed with adequate content validity (Scale-content validity index [CVI] = 1.00; Scale-CVI/Average = 0.962–0.987). Each item is scored from 0 (never) to 3 (always). The total scale score ranges from 0 to 54. Higher scores indicate greater mealtime engagement. The MES had very good internal consistency (Cronbach’s α = 0.837), outstanding interrater reliability (interclass correlation = 0.920), outstanding intrarater reliability (interclass correlation = 0.956), adequate concurrent validity based on strong correlation with the RBS (rs = 0.821, p < .001), and fair convergent validity based on weak correlation with the M-RCC (rs = 0.219, p = .042). Discussion and Implications: Findings provide preliminary psychometric evidence of MES to measure mealtime engagement. Future testing is needed among more and diverse samples in different care settings to accumulate psychometric evidence. (Edited publisher abstract)
The GCP2 assessment tool for neglect: understanding how the Graded Care Profile 2 supports families and practitioners to achieve change
- Authors:
- MARGOLIS Rachel, et al
- Publisher:
- NSPCC
- Publication year:
- 2022
- Place of publication:
- London
The Graded Care Profile 2 (GCP2) is an assessment tool that helps practitioners take a strengths-based approach to measuring the quality of care a child is receiving and supports them to identify neglect. This study sought to find out if using the GCP2 could benefit, and/or contribute to positive changes for, families who undergo the assessment. For example, if there were any changes to parents’ mental health or wellbeing after an assessment using the GCP2. Using a case study approach, interviews were held with the practitioner who carried out the assessment, the parent/carer assessed, and an additional professional (for example, a family support worker or schoolteacher) working closely with the family. Four local authorities, where the GCP2 was well established, participated in the research. This study shows how assessments using the GCP2 can help bring about positive changes for families. Parents can develop new skills, their mental health can improve, as can their help seeking behaviours and relationships with others. There is also potential for children to experience changes following an assessment. These changes include improvements to behaviour, development and health, and safer living spaces. They may be seen as an indirect outcome of the assessment, associated with positive changes experienced by their parents. In addition, using the GCP2 can support practitioners in making informed decisions about cases. (Edited publisher abstract)