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Working towards integrated client-oriented care and services: a qualitative study of the perceptions of Finnish health and social care professionals
- Authors:
- KALLIO Hanna, et al
- Journal article citation:
- International Journal of Care Coordination, 25(1), 2022, pp.46-52.
- Publisher:
- Sage
Introduction: Client orientation is an essential principle that underlines the delivery of high-quality health and social care. Despite this, little is known about how the health and social care professionals perceive this principle. The aim of this qualitative study was to describe the integrated perceptions of health and social care professionals of client orientation and the requirements for competencies and care and service systems. Methods: The 29 participants were Finnish health and social care professionals and the data were collected with asynchronous online discussions in a closed Internet-based group from November 2017 to January 2018 and analysed with inductive content analysis. Results: Client orientation was a core value in health and social care and services due to the humane approach required and the client's rights and responsibilities. It also required the professionals to have specific competencies and collaborate. The system elements that supported client orientation were an integrating and responsive service system, service availability and accessibility, guidance, leadership, resources and the effective use of technology. Discussion: Professionals need additional training and structural support from their organizations if they were to deliver efficient, flexible, high-quality client-oriented health and social care and services. (Edited publisher abstract)
Social work training intervention to increase referral rates for preventive psychosis services: a randomized trial
- Authors:
- DeVYLDER Jordan E., et al
- Journal article citation:
- Research on Social Work Practice, 32(3), 2022, pp.322-327.
- Publisher:
- Sage
Social workers are employed in a broad range of community settings, in which they may be able to identify youth with emerging psychotic symptoms and facilitate connection to specialized services. Methods: This randomized controlled trial tested the efficacy of a training intervention for social workers (N = 959) intended to increase the volume of referrals and rate of successful referrals to specialized early psychosis services. Results: During the 2-year study period, referrals to the early intervention program nearly doubled, t (df = 11) = 5.46, p < 0.001. Additionally, the rate of successful referrals was greater among social workers who received the active training (41.7%) compared to the other referral sources (19.2%), X2 (df = 1, n = 311) = 3.69, p = 0.055. Conclusions: The active training was associated with a marginally greater rate of successful referrals. Overall referrals increased greatly during the training period although this could not be linked to specific participants, suggesting contamination effects may have increased community awareness of early intervention services. (Edited publisher abstract)
Impact of social work services on the resilience of migrant children
- Authors:
- HUANG Dan, et al
- Journal article citation:
- Research on Social Work Practice, 32(3), 2022, pp.345-355.
- Publisher:
- Sage
Purpose: This study examines the effectiveness of social work services designed to enhance resilience among migrant children in urban China. Methods: the researchers selected four primary schools (i.e., two public and two private migrant schools) in the X District, Guangzhou City, China. A total of 461 valid samples were surveyed for analysis. Three regression models were employed to explain the influence of social work services on students' resilience. Results: Social work services exert a positive and significant influence on the resilience of migrant children. Concretely, social work services in terms of educational activities, interest activities, and psychological counseling affected the resilience of migrant children after controlling for the impact of social capital, self-efficacy, and individual and household economic status. Moreover, students who participated in educational activities exhibit superior resilience. Discussion: Social work organizations should provide more participation opportunities and diversified service items to migrant children. (Edited publisher abstract)
The relationship between cognitive function and performance in instrumental activities of daily living in older adults
- Authors:
- TOTH Cheryl, et al
- Journal article citation:
- British Journal of Occupational Therapy, 85(2), 2022,
- Publisher:
- Sage
Introduction: Deficits in cognition have been found to be associated with problems in performing daily activities; however, it is unknown what specific domains of cognition are related to each daily activity. Method: Thirty-six occupational therapists identified the 20 most important instrumental activities of daily living for older adults and the cognitive demands required. Thirty-two older adults rated the perceived mental effort when performing these activities. They were assessed on their cognitive functions. Descriptive statistics were used to report the results. The Pearson correlation coefficient was used to identify relationships between cognitive functions and perceived mental effort. Results: Activities relating to 'communication', 'financial management', 'health management' and 'safety and emergency management' require more cognitive demands. Results from the older adults showed the highest significant correlations in immediate memory and 'paying bills' (r = 0.54), delayed memory and 'following emergency procedures' and 'paying bills' (rs = 0.52), and executive functioning and 'making and keeping medical appointments' (r = -0.49). Conclusion: Findings contribute to the emerging understanding of specific cognitive domains related to the instrumental activities of daily living. The results can be used to reframe and improve intervention strategies for individuals with cognitive decline to maintain or improve performance in daily activities. (Edited publisher abstract)
Impacts of therapeutic horticulture on happiness and loneliness in institutionalized clients with mental health conditions
- Authors:
- MOURAO Isabel, et al
- Journal article citation:
- British Journal of Occupational Therapy, 85(2), 2022, pp.111-119.
- Publisher:
- Sage
Introduction: Therapeutic horticulture (TH) can be considered a non-pharmacological approach to support psychiatric treatments for the improvement of physical and mental health, but information is lacking on whether it has advantages as compared to more conventional occupational therapies (OTs). Method: The study focused on institutionalized 25 clients attending TH among other OTs and 15 clients attending OT other than TH. The measures used were the 'Subjective Happiness Scale' (SHS) and the 'Social and Emotional Loneliness Scale for Adults' (SELSA-S), along with sociodemographic and clinical data. The study design was descriptive, observational and cross-sectional. Results: Scores obtained from the SHS and SELSA-S were generally similar for both groups, although 40% of clients in the TH group perceived relaxation. These are in agreement with previous studies performed with chronic schizophrenia clients reporting that TH might effectively decrease depression/anxiety symptoms, but the feeling of hopelessness and quality of life did not change, probably due to long-term institutionalization and required medication that may limit other effects. Within the TH group, clients preferred specific horticultural tasks and more days/week attending activities decreased loneliness and increased happiness. Conclusion: TH interventions as an integrative treatment option merits further study on both process and outcome evaluation, to maximize its effectiveness. (Edited publisher abstract)
The mechanisms of implementation support - findings from a systematic integrative review
- Authors:
- ALBERS Bianca, et al
- Journal article citation:
- Research on Social Work Practice, 32(3), 2022, pp.259-280.
- Publisher:
- Sage
Purpose: Mechanisms of Change (MoC) explain how strategies used to enhance the uptake of evidence in social and human services enable change in the behaviors of individual practitioners, organizational leaders or entire organizations, and systems. One such strategy is the use of implementation support practitioner (ISPs). This study examines the mechanisms through which ISPs facilitate behavior supportive of the implementation of research-supported interventions. Methods: A systematic, integrative review was conducted. The conceptualization of MoCs built on a model by Dalkin and colleagues. Results: Based on a unique combination of knowledge, skills, and attitudes, ISPs install trust in and among their stakeholders and utilize this trust to promote meaningful and relevant learning; provide ongoing opportunities for learning, reflection, and support; help to span boundaries; and positively motivate stakeholders. Discussion: ISPs do not represent a short cut to better implementation. They represent an additional implementation challenge that requires dedicated attention and resources. (Edited publisher abstract)
Measuring with quality: the example of person-centred care
- Authors:
- CRIBB Alan, WOODCOCK Thomas
- Journal article citation:
- Journal of Health Services Research and Policy, 27(2), 2022, pp.151-156.
- Publisher:
- Sage
- Place of publication:
- London
Qualitative data analysis should be embedded in routine health service measurement, management and organizational practices. The rigorous use of such analyses should become an institutional norm, comparable to the routine use of quantitative data. Our case is intended to have general relevance, but we develop it by reference to person-centred care and patient-centred outcome measures (PCOMs). The increased use of qualitative data analysis of individualized PCOMs is a crucial complementary counterweight to steps towards the standardization of PCOMs. More broadly, our argument is that health care organizations cannot make confident judgements about whether they are offering appropriate care without collecting qualitative data on what matters to individual patients. Introducing properly supported and conducted qualitative data analyses is important in its own right, and also helps underpin the validity and usefulness of quantitative measurement. (Edited publisher abstract)
The contribution of professions to the governance of integrated care: towards a conceptual framework based on case studies from Denmark
- Authors:
- BURAU Viola, KUHLMANN Ellen, LEDDERER Loni
- Journal article citation:
- Journal of Health Services Research and Policy, 27(2), 2022, pp.106-113.
- Publisher:
- Sage
- Place of publication:
- London
Objective: Good governance of integrated care is key to better health care, but we know little about how professions can help make this happen. Our aim is to introduce a conceptual framework to analyse how professions contribute to the governance of integrated care, and to apply the framework to a secondary analysis of selected case studies from Denmark. Methods: We developed a framework, which identified the what, how and why of the contribution professions make to the governance of integrated care. We included five qualitative Danish studies, using coordination as an indicator of integrated care. We adopted a thematic approach in our analysis, combining deductive and inductive elements. Results: Health professions engage in highly diverse activities, which fall into closely connected clusters of more formal or more informal coordination. Professions apply many different adaptive mechanisms at different levels to fit coordination into local contexts. Professions are driven by interlocking rationales, where a common focus on patients connects organizational and professional concerns. Conclusions: Our analytical framework emerges as a useful tool for analysis. The contribution of professions to the governance of integrated care needs greater attention in health policy implementation as it can promote more effective governance of integrated care. (Edited publisher abstract)
An evaluation of five regional health information technology-based programmes to improve health and social care coordination: a quasi-experimental controlled before/after mixed design
- Authors:
- SALMI Louis-Rachid, et al
- Journal article citation:
- Journal of Health Services Research and Policy, 27(2), 2022, pp.122-132.
- Publisher:
- Sage
- Place of publication:
- London
Objectives: Health information technology (HIT) can help coordinate health and social actors involved in patients’ pathways. We assess five regional HIT-based programmes (‘Territoires de Soins Numériques’ or TSN) introduced in France, covering the period 2012-2018. Methods: This was a quasi-experimental controlled before/after mixed design. We used data from the French National Health Insurance database, qualitative and quantitative surveys, and information extracted from project documents and databases. We assessed the impact of TSN using four main impact indicators: emergency room visits, unplanned hospitalizations, avoidable hospitalizations and rehospitalization within 30 days. We also collected qualitative and secondary quantitative data covering perceived needs, knowledge, use, satisfaction, adoption and understanding of projects, pathway experience, impact on professional practices and appropriateness of hospitalizations. Results: TSN implemented a heterogeneous mix of HIT. Implementation was slower than expected and was not well documented. Users perceived the HIT as having a positive but weak overall effect. There were no significant differences in trends for the main impact indicators, nor on the appropriateness of hospitalizations, but favourable trends on secondary polypharmacy indicators. Conclusions: If similar innovations take place in future, they should be based on a logical framework that defines causal, measurable links between services provided and expected impacts. (Edited publisher abstract)
The effectiveness of personalisation on health outcomes of older people: a systematic review
- Authors:
- FATOYE Clara T., GEBRYE Tadesse, FATOYE Francis
- Journal article citation:
- Research on Social Work Practice, 32(2), 2022, pp.146-154.
- Publisher:
- Sage
Purpose: As people get older, they tend to have long-term conditions requiring health and social care intervention such as personalisation. Personalisation is person centred ensuring independence and control. To date, no systematic review has examined the effectiveness of personalisation. This review examined the effectiveness of personalisation in older people. Methods: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was undertaken. Databases searched included: Science Direct and Medline (PubMed) NHSEED and CINAHL. Inclusion criteria were older people living in their own homes receiving personalisation. Excluded were studies carried out in nursing homes. Newcastle-Ottawa Scale was used for quality of assessment. Results: Search yielded 151 published studies with titles and abstracts; 143 studies were excluded and eight included. Studies included showed health outcomes of older people receiving personalisation improved significantly. Conclusions: Review found evidence of improvement in quality of life and mobility in older people. (Edited publisher abstract)