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Improving outcomes for trauma-experienced individuals through the delivery of trauma awareness training for multi-organisational public sector workers
- Authors:
- RICHMOND Erin, et al
- Journal article citation:
- Journal of Mental Health Training Education and Practice, 17(1), 2022, pp.27-35.
- Publisher:
- Emerald
Purpose: In support of the national requirement “to ensure that Scotland has a workforce that is fully aware of the impact of trauma, and is equipped to respond appropriately to people who have experienced trauma at any age”, Trauma Awareness Training was delivered to various public sector organisations across Dumfries and Galloway. Research has shown that trauma can significantly impact quality of life (Svanberg, Bonney and McNair, 2011; Bentall et al., 2014). A trauma-informed practice workshop was created and evaluated in response to a need for training within public services for individuals working with clients whom have experienced trauma. Design/methodology/approach: From May 2018 to December 2019, 10 one-day Trauma-Awareness Training courses were delivered, engaging 224 public service workers from Police Scotland, Scottish Fire Service, Relationship Scotland, Shelter Scotland and DandG Council staff working with trauma-experienced individuals. The training was delivered via PowerPoint, short videos, whiteboard explanations/drawings and case examples. The morning workshop concentrated on defining psychological trauma, understanding the psychological process of Post-Traumatic Stress Disorder (PTSD) and the subsequent consequences. The afternoon session focussed primarily on complex PTSD, the role of adverse childhood experiences, attachment and emotional regulation/dysregulation and trauma-focused working with the wider multi-disciplinary workforce. The training concluded with participants developing strategies for coping with trauma. Participants were asked to complete three questionnaires: pre-training questionnaire on perceived knowledge of trauma and delivering trauma practice. Post-training questionnaire on perceived knowledge of trauma and delivering trauma practice to assess change and training evaluation. A third questionnaire was issued seven months after training to establish the impact of training on practice. Findings: Findings evidence a positive impact on person-centred care. In terms of quality improvement, participants felt: The training was relevant across services and raised awareness of the importance of trauma-informed practice. They had a greater awareness of trauma-related issues with individuals. Confident in implementing learned skills to assist those who have experience of trauma. They could build better relationships with their service users, with patients feeling more understood. Originality/value: Project findings identified a need for multi-organisational working and consultancy from psychological services to improve access to services. Ultimately, brief trauma-awareness training for staff can lead to more positive experiences for patients. (Edited publisher abstract)
Making personalised short breaks meaningful: a future research agenda to connect academia, policy and practice
- Authors:
- SEDDON Diane, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 22(2), 2021, pp.81-94.
- Publisher:
- Emerald
Purpose: There is a growing policy impetus to promote carer well-being through the provision of personalised short breaks. However, understanding of what makes for a successful personalised short break is limited. This paper aims to identify key evidence gaps and considers how these could be addressed. Design/methodology/approach: A scoping review mapping the evidence base relevant to respite and short breaks for carers for older people, including those living with dementia, was completed. National and international literature published from 2000 onwards was reviewed. The scoping review focused on well-being outcomes, identified by previous research, as being important to carers. Findings: Most studies investigating the outcomes of short breaks for carers supporting older people focus on traditional day and residential respite care. Although there have been developments in more personalised break options for carers, research exploring their impact is scarce. There is limited knowledge about how these personalised breaks might support carers to realise important outcomes, including carer health and well-being; a life alongside caring; positive caregiving relationships; choices in caring; and satisfaction in caring. Three priority lines of inquiry to shape a future research agenda are identified: understanding what matters – evidencing personalised short break needs and intended outcomes; capturing what matters – outcomes from personalised short breaks; and commissioning, delivering and scaling up personalised short breaks provision to reflect what matters. Originality/value This paper contributes to the development of an outcome-focused research agenda on personalised short breaks. (Edited publisher abstract)
Improving emotional well-being for hospital-based patients with dementia
- Authors:
- PETTY Stephanie, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 22(1), 2021, pp.56-67.
- Publisher:
- Emerald
Purpose: Improving hospital care for people with dementia is a well-established priority. There is limited research evidence to guide nursing staff in delivering person-centred care, particularly under conditions where patients are emotionally distressed. Misunderstood distress has negative implications for patient well-being and hospital resources. The purpose of this study is to use the expertise of nurses to recommend ways to care for the emotional well-being of patients with dementia that are achievable within the current hospital setting. Design/methodology/approach: A qualitative study was conducted in two long-stay wards providing dementia care in a UK hospital. Nursing staff (n = 12) were asked about facilitators and barriers to providing emotion-focused care. Data were analysed using thematic analysis. Findings: Nursing staff said that resources existed within the ward team, including ways to gather and present personal information about patients, share multidisciplinary and personal approaches, work around routine hospital tasks and agree an ethos of being connected with patients in their experience. Staff said these did not incur financial cost and did not depend upon staffing numbers but did take an emotional toll. Examples are given within each of these broader themes. Research limitations/implications: The outcome is a short-list of recommended staff actions that hospital staff say could improve the emotional well-being of people with dementia when in hospital. These support and develop previous research. Originality/value: In this paper, frontline nurses describe ways to improve person-centred hospital care for people with dementia. (Edited publisher abstract)
Person-centred care in Northern Ireland: learning from the experiences of adult social care users
- Author:
- CHAPMAN Alexandra
- Journal article citation:
- Journal of Integrated Care, 29(3), 2021, pp.242-253.
- Publisher:
- Emerald
Purpose: The move towards a “person-centred” or “personalised” system of adult social care has been at the heart of policy debates in Great Britain. However, policy developments in Northern Ireland are more limited than in other parts of the UK, and less attention has been paid to reforming adult social care. The purpose of this paper is to examine the views and experiences of adult social care users who receive care at home, to explore if and how a person-centred approach might work for older adults in Northern Ireland. Design/methodology/approach: Using a qualitative approach, semi-structured interviews were carried out with 12 people aged over 70 years who receive social care provision at home. Findings: The empirical findings show that social care users experienced limited involvement in their care planning process, reflecting a predominantly service-led approach. The importance of care worker continuity and consistency was crucial for all participants, particularly for maintaining discreet routines and promoting personal dignity. However many experienced different care workers which presented challenges caused by the inconsistency of carers. Research limitations/implications: The majority of participants in the study were women, despite attempts to achieve greater gender diversity. It was also difficult to recruit a range of ethnic groups for the study. It would be important for future studies to include these groups and to ensure their voices are represented in further work in this area. Nonetheless, the findings offer valuable insight into the views of adult social care users and can form a useful basis for future studies. Originality/value: The findings provide a more nuanced understanding of what people want and expect in social care to generate future policy debates and discussions in planning long-term adult social care provision in Northern Ireland. It also provides important and timely contribution to this area, where there is currently limited research and information available. (Edited publisher abstract)
A journey towards integrated person-centred care: a case study of a mental health perspective in the voluntary sector
- Author:
- KERMODE Louise
- Journal article citation:
- Journal of Integrated Care, 29(3), 2021, pp.334-345.
- Publisher:
- Emerald
Purpose: Person-centred care is a fundamental component of any service. This case study aims to explore the delivery of person-centred care in the voluntary sector, discussing how integrating support can be achieved to benefit individuals. It identifies challenges, best practice and learning that can be applied across sectors and promotes further enquiry. Design/methodology/approach: This case study is the result of a service audit at a mental health charity. The findings are a blend of reflections, observations and examples from service delivery, synthesised with national policy to provide evidence of best practice and processes that enable person-centred care. Findings: A focus on need not diagnosis, creating accessible and inclusive services, employing dual trained practitioners, having a varied skill mix along with holistic self-assessment tools are all enablers for integrated person-centred support. Multi-agency assessment frameworks, collaboration across services, cross-agency supervision and a shared vision for integration and person-centred care support services to coordinate more effectively. Barriers to integrated person-centred support include complex physical and mental health needs and harmful risk and safeguarding. The diversity of the voluntary sector, a lack of resources along with complex and competitive funding also hinder integration. Originality/value: This case study provides a valuable insight into the voluntary sector and shares its findings to enhance best practice. It aims to promote interest and invites further research into health and social care delivery by the voluntary sector. As this delivery continues to increase, it is vital to examine the interface between the voluntary and statutory sector. Through better understanding and further research across all sectors, the author can identify how they can achieve person-centred outcomes and deliver the national policies. (Edited publisher abstract)
Will the real “Mrs Smith” please stand up: a critical examination of the role of vignettes in integrated service development and delivery
- Authors:
- GEORGE Thomas, et al
- Journal article citation:
- Journal of Integrated Care, 29(3), 2021, pp.254-261.
- Publisher:
- Emerald
Purpose: To explore the use of fictitious vignettes representing older people and the extent to which they serve as an effective resource in developing service provision and transforming health and social care. Design/methodology/approach: Based on a critical review of research and academic discourse. Findings: Fictitious vignettes or case studies of older adults, such as “Mrs Smith”, may be a useful means to promote communication with and between health and social care colleagues about current services and transforming or re-organising service provision. However, we argue that while there may be a role for vignettes, care should be taken in their use. The potential to “homogenise” older people into the “typical” patient personified by Mrs Smith may do very little to challenge age- based stereotypes and assumptions. Moreover, vignettes cannot match the potential value and importance of older men and women directly participating in the evaluation and development of services. Practical implications: This article argues that changing the way services are organised and delivered must be underpinned by critical reflection of the assumptions which underpin attitudes towards old age, including our tendency to define older people by chronological age and to homogenise “the elderly” into a single group. The value of participatory methods which meaningfully involve older citizens in both evaluating and planning services could contribute significantly to innovation in service development. Social implications: This paper highlights the critical importance of challenging age-based stereotypes and ageist policy and practice. Recognising old age as being characterised by diversity and difference could challenge the tendency to see old age, especially advanced old age, as an inevitable problem. Originality/value: This article offers a critical perspective on the use of vignettes. (Edited publisher abstract)
Person-centred integrated care with a health promotion/public health approach: a rapid review
- Authors:
- BURDETT Teresa, INMAN Joanne
- Journal article citation:
- Journal of Integrated Care, 29(3), 2021, pp.357-371.
- Publisher:
- Emerald
Purpose: Due to the need for the development of person-centred integrated models of care with a population health approach, this paper explored contemporary literature in this arena. Design/methodology/approach: A systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Papers included in this review focused upon person-centred integrated care and a health promotion/public health approach (January 2018–October 2020). Papers were excluded due to not being written in English, not fitting the age criteria and not being peer reviewed. Findings: Eight studies met the inclusion criteria and three overarching themes were identified with regards to person-centred integrated care as a health promotion/public health approach: Core components; Development, implementation, and evaluation of models of care and relationship to population health and wellbeing outcomes. Research limitations/implications: The need for person-centred integrated care as a health promotion/public health approach, to enhance population health and well-being outcomes requires further research to continue to develop, implement and evaluate models of care. Originality/value: The international scope of this contemporary review brought together the three concepts of person-centred integrated care and public health, exploring the translation of policy into practice (WHO, 2016). The juxtaposition of public health approaches in the background/consequential or foreground/active agent demonstrates how promotion, prevention and population health can be re-valued in integrated people-centred health services (WHO, 2016). (Edited publisher abstract)
Technical assistance needs for realizing person-centered thinking, planning and practices in United States human service systems
- Authors:
- CROFT Bevin, PETNER-ARREY Jami, HIERSTEINER Dorothy
- Journal article citation:
- Journal of Integrated Care, 29(3), 2021, pp.262-273.
- Publisher:
- Emerald
Purpose: The United States’ National Center on Advancing Person-Centered Practices and Systems provides technical assistance to human service systems on person-centered thinking, planning and practices. To apply for the Center's technical assistance, 33 state human service systems submitted applications and participated in interviews in which they detailed technical assistance needs. This technical paper examines themes that emerged from these technical assistance applications and interviews. These themes offer a view into barriers, obstacles and priorities for human service systems as they work toward more person-centered practices. Common themes point to key areas that, if enhanced, could result in a more person-centered system overall. Design/methodology/approach: The application process generated 33 applications containing technical assistance goals and priorities, summaries of recent and ongoing initiatives to advance person-centered approaches, measurement methods and anticipated challenges. Using thematic analysis, the authors organized the information into seven themes. Findings: Applicants identified seven themes to improve person-centered thinking, planning and practices: Staff Training and Competencies, Participant Engagement, Measurement and Quality Improvement, Cross-System Consistency in Planning and Practice, Payment and Managed Care, Cultural and Linguistic Responsiveness and Other Practice-Related Goals. They also articulated contextual factors that help or hinder systems efforts and a vision for an ideal person-centered system. Originality/value: The themes provide a unique window into human service system administrators' priorities for achieving more person-centered human service systems and the conditions that may promote or hinder systems change. (Edited publisher abstract)
Achieving person-centredness through technologies supporting integrated care for older people living at home: an integrative review
- Authors:
- MACINNES Julie, et al
- Journal article citation:
- Journal of Integrated Care, 29(3), 2021, pp.274-294.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to identify the range, type and outcomes of technological innovations aimed at supporting older people to maintain their independence within the context of integrated care at home. We also discuss key emergent themes relevant to the use of person-centred technology for older people in integrated care and propose recommendations for policy and practice. Design/methodology/approach: An integrative review methodology was used to identify and describe recent scientific publications in four stages: problem identification, literature search, data evaluation and data analysis. Findings: Twelve studies were included in the review. Three studies described remote consultations, particularly telemedicine; five studies described tools to support self-management; three studies described the use of healthcare management tools, and one study described both remote consultation and self-care management. Emergent themes were: acceptability, accessibility and use of digital technologies; co-ordination and integration of services; the implementation of digital technologies; and safety and governance. Several recommendations are proposed relevant to integrated care teams, technology developers and researchers. Originality/value: This review uniquely considers the extent to which novel digital technologies used in integrated care for older people are person-centred. (Edited publisher abstract)
Person-centred communication in long-term care with older people: a scoping review
- Author:
- LOMBARD Daniel
- Journal article citation:
- Journal of Integrated Care, 29(3), 2021, pp.306-333.
- Publisher:
- Emerald
Purpose: Interpersonal skills are increasingly important tools in long-term care with older people, especially against the backdrop of loneliness affecting older people and expectations for a person-centred, joined-up approach. However, the term is used as a composite and its definition lacks shape and focus. In existing literature, participants appear to be selected on the basis of specific illnesses rather than age. Better understanding of the features of everyday communication processes associated with person-centred care can lead to improvements in policy and practice. Design/methodology/approach: A scoping review examined communication features associated with person-centred care for older adults. This identified the extent and nature of literature. Several databases were searched; after screening and hand-searching, 31 were included. Findings were analysed for patterns and contradictions, against the objectives of person-centred and integrated care. Findings: Emotional intelligence and the ability to employ various communication styles are crucial skills of person-centred communication. Such approaches can have positive effects on the well-being of older people. Research limitations/implications: Some studies' validity was weakened by methodological designs being founded on value judgements. Practical implications: Using personalised greetings alongside verbal and non-verbal prompts to keep residents emotionally connected during personal care is considered good practice. Stimulating feedback from people using services and their relatives is important. Originality/value: The role of communication is highlighted in many professional guidance documents on person-centred and integrated care, but the process of implementation is decentralised to individual employers and workers. This paper draws on the findings of contemporary literature, grounded in naturalistic data, with implications for practice and policy. (Edited publisher abstract)