Developing Risk Assessment Criteria and Predicting High- and Low-Dengue Risk Villages for Strengthening Dengue Prevention Activities: Community Participatory Action Research, Thailand

Background:

Risk assessment criteria for predicting dengue outbreak must be appropriated at village levels. We aimed to develop risk dengue village prediction criteria, predict village dengue risk, and strengthen dengue prevention based on community participation.

Methods:

This participatory research conducted in Southern Thailand included the following 5 phases: (i) preparing communities in 3 districts; (ii) developing risk dengue village prediction criteria; (iii) applying computer program; (iv) predicting village dengue risk with 75 public health providers in 39 PCUs; and (v) utilizing findings to strengthen dengue prevention activities in 220 villages. Data collecting for prediction used secondary data from primary care units in the past 5 year and current year. Descriptive statistics used calculating criteria and comparing with standard level to adjust score of risk.

Results:

Risk dengue village assessment criteria had 2 aspects: dengue severity (3 factors) and dengue outbreak opportunity (3 factors). Total scores were 33 points and cut-off of 17 points for high and low dengue risks villages. All criteria were applied using computer program (http://surat.denguelim.com). Risk prediction involved stakeholder participation in 220 villages, and used for strengthening dengue prevention activities. The concept of integrated vector management included larval indices surveillance system, garbage management, larval indices level lower than the standard, community capacity activities for dengue prevention, and school-based dengue prevention. The risk prediction criteria and process mobilized villages for dengue prevention activities to decrease morbidity rate.

Conclusion:

Dengue risk assessment criteria were appropriated within the village, with its smallest unit, the household, included. The data can be utilized at village levels for evaluating dengue outbreak risks.

Health research in the Syrian conflict: opportunities for equitable and multidisciplinary collaboration

There is considerable global momentum from Syrian researchers, policy makers and diaspora to address health, security and development challenges posed by almost a decade of armed conflict and complex geopolitics that has resulted in different areas of political control. However, research funders have been so far reluctant to invest in large-scale research programmes in severely conflict-affected areas such as northern Syria. This paper presents examples of collaborations and programmes that could change this through equitable partnerships between academic and operational humanitarian organizations involving local Syrian researchers—a tremendous way forward to capitalize and accelerate this global momentum.

Several academic and humanitarian organizations have initiated collaborations to build new networks and partnerships for better research and policy engagement in Syria. The networks conducted two consecutive annual conferences in 2019 and 2020. Key messages from these conference include: (1) equitable partnerships between organizations and individual researchers must form the basis of conducting better research; (2) ensuring the inclusion of local Syrian researchers is crucial in the development of any viable partnership; (3) capacity strengthening in health research is urgently needed in Syria’s current phase of active conflict to inform, develop and implement strengthened and sustainable health systems in the post-conflict phase.

[Action Research on the Use of the Flipped Teaching Model in Obstetric Nursing Laboratory Classes]

BACKGROUND

Obstetric nursing laboratory courses typically involve both time and credit limitations. Using traditional teaching methods such as "teacher demonstrate, students imitate" in these courses provides insufficient opportunities for students to develop the ideal level of maternity nursing expertise. Lack of sufficient familiarity with the relevant techniques, procedures, and clinical scenarios prior to participation in internships reduces the level of safety in clinical care environments.

PURPOSES

(1) To explore the effectiveness as perceived by baccalaureate nursing students of an obstetric nursing laboratory classes based on a flipped teaching model; (2) To examine the application of a flipped teaching model in obstetric nursing laboratory classes as well as the problems encountered and the actions necessary to resolve these problems. The findings may be used as a reference for future teaching and guidance.

METHODS

This study used an action research framework as a guide and employed focus groups and questionnaires to collect student perceptions of the flipped teaching model.

RESULTS

The feedback of students was highly positive because the classes involved repeated practice, were integrated into the clinical context, and allowed active learning independent of time and space restrictions. These attributes affected learning efficiency positively. The following four themes emerged from the focus group analysis: helps improve self-directed learning, helps integrate into the clinical context, helps peers learn from each other, and helps bring teachers and students closer.

CONCLUSIONS / IMPLICATIONS FOR PRACTICE

This study demonstrated an actual implementation of the flipped teaching model in obstetric nursing laboratory classes as well as assessed the learning perceptions of students. This teaching method provides opportunities for teachers and students to discuss and practice nursing skills, strengthen students' self-directed learning capabilities, and improve students' learning motivation. The author recommends that this innovative teaching strategy may be used to teach various subjects and different disciplines in nursing.

An integrative literature review of the implementation of advance care planning in hospital settings

AIMS AND OBJECTIVES

To identify and synthesise existing literature about action research in the implementation of advance care planning in a hospital setting.

BACKGROUND

Despite the proven added value of advance care planning, there is a lack of wide integration of this concept. There are several obstacles known for the implementation but it remains unclear how these can be overcome. Action research is described in the literature as a plausible way to overcome obstacles to the implementation of quality enhancing projects.

DESIGN

An integrative literature review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and reported in accordance with the PRISMA statement.

METHODS

We searched databases MEDLINE, EMBASE, CINAHL and Web of Science to identify executed action research for the implementation of advance care planning programs within a hospital setting, from January 2005 until November 2019. Studies were assessed for comprehensiveness and were supplemented by studies in reference lists of included articles. A quality appraisal and a thematic synthesis were performed on all included studies.

RESULTS

Five studies met inclusion criteria. Interventions focused on both nurses, physicians and hospitalised patients. Interventions targeted three different themes: identifying at-risk patients, adapting documentation to the local context and using communication improvement tools.

CONCLUSIONS

A Supportive and Palliative Care Indicators Tool is proposed to identify patients in need of advance care planning to work more efficiently. Furthermore, adapting documentation and instruments to a specific care context are shown to make advance care planning more effective. Communication challenges can be addressed by promoting communication skills and increase stakeholder self-confidence.

Aging well: an update

Population aging is a global phenomenon, and Japan is one of the front-runners of rapidly aging societies. In 2030, one-third of the Japanese population will be at least 65 years of age and 20% will be at least 75 years of age. The working age population is shrinking. Healthy aging is a crucial issue for both individual well-being and the sustainability of society. Along with biomedical research, the importance of the living environment and lifestyle has been long recognized and extensively studied. The issues have been identified and now it is time to establish solutions and actions - action-targeted research. The Institute of Gerontology at the University of Tokyo launched a social experiment, redesigning existing communities where people could live for 100 years and remain healthy, active, and connected, while still maintaining a sense of security. This requires co-creation by citizens, researchers, government, and industry. The ultimate goal is to make linkages among longevity, health, and wealth, and to build a sustainable society.

Clinical nurse specialist role implementation structures, processes and outcomes: Participatory action research

AIM

To develop, implement and evaluate the clinical nurse specialist's role within a specialist medical healthcare hospital. A secondary aim was to assess the feasibility of the 'Clinical Nurse Specialist Conceptualisation, Implementation, and Evaluation framework' in the role implementation.

BACKGROUND

Implementation of advanced practice nursing roles is an increasing practice around the globe; however, the implementation of these roles is multidimensional, complex process. Clear implementation strategies are needed.

DESIGN

Participatory action research was conducted in Finland between 2017-2018.

METHODS

The researchers adopted an outsider approach to work with staff, considered as co-researchers, within two participating units. A combination of several methods, such as focus group interviews, action-learning groups and researcher reflective field journal, was used to gather data. The 'Clinical Nurse Specialist Conceptualisation, Implementation, and Evaluation framework' was used to structure the processes undertaken, and the Donabedian structure, process and outcome model was used to structure and analyse the results. The study was reported using the EQUATOR guideline for participatory action research.

RESULTS

The results demonstrated the complexity of the role implementation process. Four implementation themes of need analysis, role design, role implementation and role evaluation were examined and described through their structures, processes and outcomes. The 'Clinical Nurse Specialist Conceptualisation, Implementation and Evaluation framework' was validated for its appropriateness guiding the role implementation process.

CONCLUSIONS

Role implementation is a complex process which structured, practical guidelines may facilitate. The examined framework may facilitate the role implementation process conducted within organisations.

RELEVANCE TO CLINICAL PRACTICE

This research provides complimentary information for individuals and organisations aiming to develop a clinical nurse specialist or other advanced practice nursing roles. Furthermore, we describe a participatory action research process, which offers the means for self-reflection and planning of purposeful actions to improve the conditions of clinical practice.

[The effects of the "Tabepo Check Sheet," which lists 10 food groups, on the dietary variety of older adults in a metropolitan area]

Objectives　This study examined the effects of checking the "Tabepo Check Sheet," which has 10 food groups, on changes in dietary variety among older adults living in Japanese metropolitan areas.Methods　We used baseline and two-year follow-up data from a community-wide intervention to prevent frailty in Ota City, Tokyo. A total of 8,635 non-disabled residents (4,145 men and 4,490 women) aged 65-84 years who responded to the self-administered questionnaire surveys in 2016 and 2018, were included in the two analyses. In 2018, we asked about their experience with the "Tabepo Check Sheet," which had been distributed among participating communities from three districts in Ota City since July 2017. The "checked group" consists of those who answered "habitually check" or "have checked." Dietary variety was assessed using the Dietary Variety Score (DVS). We performed propensity score matching with a 1:1 ratio (checked group vs. non-checked group) for the following variables: demographic, socioeconomic, physical, medical, and lifestyle variables, and DVS. After propensity score matching, 876 participants from the checked and non-checked groups were selected. We used a two-way ANOVA to examine the changes in DVS over two years. We also compared the rates of DVS ≤3 and ≥7 points in 2018 using multivariate adjusted logistic regression analysis.Results　In 2018, 11.9% of the respondents had checked the "Tabepo Check Sheet." The DVS mean±standard deviation in the checked and non-checked groups were 3.9±2.2 points and 3.9±2.3 points in 2016, respectively, and 4.5±2.4 points and 4.1±2.4 points in 2018, respectively. The DVS showed a significant interaction between checking experience and time (p<0.001). The rates of DVS ≤3 points in 2018 were 35.2% and 43.8% among the checked and non-checked groups, respectively. The multivariate adjusted odds ratio (OR) of DVS ≤3 points was 0.68 (95% confidence interval [95% CI] 0.56-0.83) in the checked group versus the non-checked group. The rates of DVS ≥7 points in 2018 were 21.7% and 16.8% among the checked and non-checked groups, respectively. The multivariate adjusted OR (95% CI) of DVS ≥7 points was 1.40 (1.10-1.78) in the checked versus the non-checked group.Conclusions　These results suggest that checking the "Tabepo Check Sheet" may improve dietary variety. However, the effects of dietary variety improvement may be weakened by the incidence of skipped meals, social isolation, frailty, and lack of social participation.

Strategies to Approach Medicines Litigation: An Action Research Study in Brazil

Background: In the last decades, litigation has been increasingly used to access medicines in Brazil. This phenomenon has led to the development of diverse strategies to reduce its negative impact on the organization of pharmaceutical services. In spite of that, managers still face difficulties dealing with lawsuits.

Objective: This study aims to report the planning and implementation of strategies to approach medicines litigation in a municipality located in the southeast region of Brazil.

Methods: Mixed methods were employed through an action research cycle. A network coordination team included researchers from university and municipal managers. The scenario analysis comprised the characterization of pharmaceutical services and the profile of medicines lawsuits. Afterward, strategies were planned to deal with the central problem identified. The action plan involved educational outreach visits and distribution of printed materials for health professionals, evaluated through opinion survey. Group conversations were conducted with the users of the public health system, followed by thematic analysis of reports.

Results: The characterization of pharmaceutical services in the municipality revealed that treatments supplied were in accordance with the National Medicines Policy. In addition, a sector was implemented to attend demands for non-incorporated medicines. In spite of the services available, the characterization of lawsuits indicated that the main claimants were users of the public health system, requiring non-incorporated medicines, with therapeutic alternatives available. Thus, educational outreach visits were held in 14 health units (23 physicians in total). Everyone who answered the evaluation declared that they were very satisfied with the approach. Group conversations with the users of the health system reached 227 participants in total. In regard to users’ perception about pharmaceutical services, thematic analysis of reports identified three main categories including aspects related to medicines provided, users assisted, and quality of service.

Conclusion: The study described the first cycle of an action research project to develop strategies to approach medicines litigation at the municipal level. The application of educational outreach visits for health professionals and group conversations with health system users is a promising approach to improve access to information about pharmaceutical services in Brazil.

Psychosocial approaches and discursive gaps in intersex healthcare: findings from an Israeli-German action research study

In the past several decades, conflicting discourses have coexisted in the field of intersex studies, including the pathologising discourse of the biomedical disciplines and the affirmative, subjective psychosocial discourse of people born with intersex bodies and their advocates. Intersex activists call for a positive discourse on intersex bodies and a humanistic healthcare approach that accepts and protects intersex bodily autonomy to replace continuing harmful, traumatic treatments aimed at normalising variations of sex characteristics (VSC). Our awareness of the biomedical discursive dominance prompted us to initiate Inter-Care and Awareness, an intercultural German-Israeli action research project. This paper introduces the project and explores intercultural approaches to psychosocial intersex care using an action research framework. We describe how the project's goals, processes and outcomes created educational material on intersex which uses positive language, explores intersex in the Jewish tradition, improves the support offered to parents of intersex children, and examines cross-cultural differences that arose in the encounters between the Israeli and German participants. The analysis points to sociocultural themes that reflect intersex people's current status in Israel and Germany. Implications regarding the implementation of similar projects in other countries are discussed.

Empowering Through Psychodrama: A Qualitative Study at Domestic Violence Shelters

Psychodrama is a therapeutic method in which the stage is used to enact and reenact life events with the aim of instilling, among other positive changes, hope and empowerment in a wide range of populations suffering from psychological duress. The therapeutic process in psychodrama moves away from the classic treatment of the individual in isolation to treatment of the individual in the context of a group. In domestic violence situations, in which abusive men seek to socially isolate their victims from family and friends, the social support that psychodrama provides can positively influence the psychological health and well-being of the participants. This qualitative study examines the manner in which psychodramatic treatment can empower abused women residing in domestic violence shelters and help them regain control of their lives. An action research study of domestic violence survivors living in a women's shelter in Israel, over a 12-month period, demonstrates the role of psychodrama therapy in promoting the reduction of anxiety, stress, guilt, and self-blame, while reinforcing perceptions of self-worth and confidence. These findings contribute to our understanding of the potential of psychodrama in helping reshape life roles and reframe experiences within a creative process, with the aim of facilitating a transition from powerlessness to powerfulness among vulnerable populations.

Developing a community rehabilitation and lifestyle service for a remote indigenous community

PURPOSE

Community rehabilitation is an essential health service that is often not available to remote Australians. This paper describes the first cycle of a collaborative project, between local community members, allied health professionals and a university, to co-design a community rehabilitation and lifestyle service to support adults and older people to stay strong and age well in place.

METHODS

An action research framework was used to develop the service for adults in two remote communities, one being a discrete Aboriginal community. The first cycle involved planning for, and trialling of a service, with observations, reflections and feedback from clients, community members, university students and health service providers, to inform the subsequent service.

RESULTS

Over two years, stakeholders worked collaboratively to plan, trial, reflect and replan an allied health student-assisted community rehabilitation service. The trial identified the need for dedicated clinical and cultural supervision. During replanning, three key elements for culturally responsive care were embedded into the service: reciprocity and yarning; holistic community-wide service; and Aboriginal and Torres Strait Islander mentorship.

CONCLUSIONS

An action-research approach to co-design has led to the establishment of a unique community rehabilitation service to address disability and rehabilitation needs in two remote Australian communities.Implications for rehabilitationCo-design of community rehabilitation services between Aboriginal and Torres Strait Islander community members and the local allied health professionals can lead to development of an innovative service model for remote Aboriginal communities.Culturally responsive community rehabilitation services in Aboriginal and Torres Strait Islander communities requires holistic and community-wide perspectives of wellbeing.Incorporating Aboriginal and Torres Strait Islander ways of engaging and communicating, and leadership and mentorship for non-Indigenous allied health professionals and students are essential components for students-assisted culturally responsive services.

A learning process towards person-centred care: A second-year follow-up of guideline implementation

BACKGROUND

Research claims that 'learning by doing' creates new thinking, often leading to new practice.

OBJECTIVES

The aim was to explore and describe the staff learning process from the first to the second year when adopting person-centred care into clinical practice in a nursing home for persons with dementia.

METHOD

The data consisted of poster texts from staff and written notes by researchers obtained from the group discussions. The study involved 24 care units (200 staff). Content analysis was chosen as method to explore the learning process.

RESULT

The staff described the actions that they took during year 1 and year 2, in which five categories emerged, activities, environment, information, priorities and staff routines. With researchers' analysis the categories together created the learning process and formed a sub-theme. They further formed an overarching theme from simplicity to complexity and consensus. Staff changes year 1 pertained more to planning and doing, while year 2 changes constituted a larger complexity of person-centred care with reflection, collaborative learning and a mind-set change.

CONCLUSION

Staff chose the development area, and the learning process was illuminated by the researchers. This underscores the value to visualise and verbalise the steps of change as well as include these steps in the design of an implementation process. The concept of person-centred care could be viewed on different levels. The findings may contribute to a more comprehensive understanding of staff learning process when implementation of person-centred care.

IMPLICATIONS FOR PRACTICE

Making staff's learning process visible can be a guide for improvement and change from a generic care towards person-centred care. The Regional Board of Research Ethics approved the study (Reg no. 2010/1234-31/5).

Developing a Web-Based Shared Decision-Making Tool for Fertility Preservation Among Reproductive-Age Women With Breast Cancer: An Action Research Approach

Background

The pregnancy rate after cancer treatment for female survivors is lower than that of the general population. Future infertility is a significant concern for patients with breast cancer and is associated with a poor quality of life. Reproductive-age patients with breast cancer have safe options when choosing a type of fertility preservation method to be applied. Better information and support resources aimed at women to support their decision making are needed.

Objective

The objective of this study was to develop a web-based shared decision-making tool for helping patients with breast cancer make decisions on fertility preservation.

Methods

We used the action research cycle of observing, reflecting, planning, and acting to develop a web-based shared decision-making tool. The following four phrases were applied: (1) observe and reflect—collect and analyze the decision-making experiences of patients and health care providers; (2) reflect and plan—apply the initial results to create a paper design and modify the content; (3) plan and act—brainstorm about the web pages and modify the content; (4) act and observe—evaluate the effectiveness and refine the website’s shared decision-making tool. Interviews, group meetings, and constant dialogue were conducted between the various participants at each step. Effectiveness was evaluated using the Preparation for Decision-Making scale.

Results

Five major parts were developed with the use of the action research approach. The Introduction (part 1) describes the severity of cancer treatment and infertility. Options (part 2) provides the knowledge of fertility preservation. The shared decision-making tool was designed as a step-by-step process (part 3) that involves the comparison of options, patient values, and preferences; their knowledge regarding infertility and options; and reaching a collective decision. Resources (part 4) provides information on the hospitals that provide such services, and References (part 5) lists all the literature cited in the website. The results show the web-based shared decision-making meets both patients’ and health providers’ needs and helps reproductive-age patients with breast cancer make decisions about fertility preservation.

Conclusions

We have created the first web-based shared decision-making tool for making fertility preservation decisions in Taiwan. We believe female patients of reproductive age will find the tool useful and its use will become widespread, which should increase patient autonomy and improve communication about fertility preservation with clinicians.

Trial Registration

Clinicaltrials.gov NCT04602910; https://clinicaltrials.gov/ct2/show/NCT04602910

What can we do about occupational violence in emergency departments? A survey of emergency staff

AIMS

To explore and collate solutions for occupational violence from emergency department (ED) staff.

BACKGROUND

Despite publications highlighting the progressively worsening issue of occupational violence in EDs and its detrimental impacts, few strategies aimed to reduce or manage it have been discussed in the literature.

METHODS

This was a cross-sectional study involving ED staff. Participants completed an electronic survey that prompted interventions for occupational violence. Free-text data were analysed and logically categorized using validated techniques.

RESULTS

Participants (N = 81) suggested 24 interventions: 12 were classified as prevention strategies, 10 as response strategies and two as recovery strategies. Prevention and response strategies for occupational violence targeted key participants: patients, staff and ED environment. Recovery strategies centred around staff management of the personal impacts of incidences of occupational violence and on systems in place to support them after occupational violence incidents.

CONCLUSION

Solutions to occupational violence should be multifaceted encompassing prevention, response and recovery for patients, staff and the ED environment.

IMPLICATIONS FOR NURSING MANAGEMENT

No single, universal intervention can be endorsed to reduce or mitigate the impacts of occupational violence in EDs. However, a combination of the interventions (strategies) discussed in this paper can be recommended.

Exploring restrictive measures using action research: A participative observational study by nursing staff in nursing homes

AIM

In nursing homes, nursing staff have a key role in the use of restrictive measures. However, their active role in reducing restrictive measures has so far been limited. The aim of this study is to explore how and when the application of restrictive measures in nursing homes occurs including underlying factors, together with nursing staff.

DESIGN

Participatory action research was chosen for a bottom-up understanding of the use of restrictive measures.

METHOD

Two Dutch nursing homes participated in 2016/2017 with 18 nursing staff members in the action research team. Nursing staff carried out 33 observations followed by a reflective interview.

RESULTS

Nursing staff observed a wide range of restrictions, including restrictions in freedom of choice, not being able to go outside, not being in charge of medication, and a directive/unresponsive care attitude. Factors influencing restrictions included habits and institutionalization, cognitive ability of the resident, availability of personnel, and responsibility for safety. A responsive care attitude and raising awareness were seen as good practices to enhance freedom.

CONCLUSIONS

By taking a distant view on their work, nursing staff discovered a broad range of restrictions, including 'less obvious' restrictions. Active forms of learning may position nursing staff to discuss and reduce restrictive measures.

IMPACT

What problem did the study address?: Restrictive measures are still common in nursing homes. Despite their key role in using restrictive measures, nursing staff's active role in research has been limited. What were the main findings?: By participating as researchers, nursing staff gained a broader perspective on restrictive measures. Many 'less obvious' restrictions were related to routines and institutionalization and were considered as eye opening by nursing staff. Where and on whom will the research have impact?: Active forms of learning such as observing and reflecting has the potential to position nursing staff as 'agents of change'.

Co-Creating Descriptors and a Definition for Person-Centred Coordinated Health Care: An Action Research Study

The aim of this study was to co-create a definition and generic descriptors for person-centred coordinated care for Ireland generated from service users’ narratives. An overarching action research approach was used to engage and empower people to tangibly impact health policy and practice. Through focus groups and a qualitative survey, primary data were collected from a national sample of health services users, caregivers and health care service users’ representative groups. Thematic analysis was used to analyse the data. Three major themes were co-produced as essential care elements. These were: ‘My experience of healthcare’, ‘Care that I am confident in’ and ‘My journey through healthcare’. Through an IPPOSI partner project steering group and their membership groups’ contribution, these themes were further refined into a definition of person-centred coordinated care and nineteen related generic descriptors. Key findings demonstrate that within complex, fragmented healthcare systems, the subjective expectations of service users should be integrated into care delivery, with a scaffolding of services to meet service users’ needs between care settings and disciplines and over time.

Integrating family and friend support, information technology, and diabetes education in community-centric diabetes self-management

OBJECTIVE

Diabetes self-management (DSM) education, social support, and information technology interventions can improve patient engagement and health. A major challenge is animating, integrating, and accessing resources in under-resourced, rural communities. Set in an island community in Hawai'i, this study piloted a program that integrated friend-and-family support, community health services, telehealth-enabled DSM education, and mobile technologies by activating the community's social capital to support the program.

MATERIALS AND METHODS

An action research approach informed the design and implementation of a community-based DSM program that included: friends and family support, telehealth classes, personalized consultations, Bluetooth-enabled blood glucose monitors, and text messaging support. Outcomes were evaluated using biometric data, surveys, interviews, and participant observations.

RESULTS

The study spanned 9 months with 7 dyads, each with 1 individual with type 2 diabetes and a friend or family member. Six of the 7 participants with diabetes experienced reduced hemoglobin A1c percentages, with 3 reducing by more than 1%. The seventh participant maintained a hemoglobin A1c level within American Diabetes Association recommended ranges. DSM knowledge and self-care behaviors improved overall. Interviews and participant observations highlighted program strengths and social challenges associated with the interpersonal relationships between the members of the dyads.

CONCLUSIONS

A community-centric diabetes program can enhance understanding of diabetes etiology, DSM activities, and communication skills for effective disease management support in under-resourced rural communities. Social capital among community members, leveraged with health information technology, can catalyze and integrate limited health system resources for DSM and social support as a cost-effective strategy to develop community-centric chronic healthcare management initiatives.

Providing targeted psychological support to frontline nurses involved in the management of COVID-19: An action research

Aim

To develop and implement a targeted psychological support scheme for frontline nurses involved in the management of coronavirus disease 2019 (COVID‐19).

Background

Nurses play a vital role in managing the ongoing COVID‐19 pandemic, while confronting enormous challenges and psychological problems.

Methods

Action research design was adopted to develop and provide a targeted psychological support scheme to 1,496 frontline nurses. Data regarding nurses’ feedback were collected from WeChat group chat, letters and comments on theme lectures. Subsequently, qualitative content analysis was conducted using MAXQDA.

Results

A targeted psychological support scheme was formed via three action cycles according to nurses’ needs. Frontline nurses received psychological assistance from a research team, which offered (1) a sense of belonging, (2) a sense of professional value and pride, and (3) a sense of being protected and confident.

Conclusion

The researchers successfully provided targeted psychological support to nurses, and nurses were motivated and became more confident when their needs were addressed.

Implications for Nursing Management

Nurses have various types of psychological needs, which could be addressed by targeted support. It is suggested that nurse managers should identify nurses’ needs in real time and provide appropriate support through multidisciplinary collaboration to improve their confidence and enhance their resilience.

Unmute the Organization Through Serious Play

In this article, we sketch up an action research process designed to give voice to those who traditionally have not had a voice in organizations. In particular, the research process was structured around "serious play" and designed as a talk show, where researchers played parts, including a talk show host, and where questions pertaining to organizational life were discussed in depth. The structure of the discussion was construed based on reflective teams, i.e., two actors performing a dialogue (talk show host and guest) and a silent group (audience) as listeners. The key research question concerns in what ways such an action research process is replicable? Applying a critical lens, we argue that even if strong claims of replicability are not met, as in being able to reproduce results and/or generalize them, this is outside the point. Rather, as we set out to apply a qualitative research design to achieve cogenerative learning effects, we advance an understanding of replicability-as-recoverability. This entails giving explicit grounds for our epistemic anchoring in critical realism and sketching out a research design which is sufficiently clear and transparent to undergo critical scrutiny.

How Generative Mindfulness Can Contribute to Inclusive Workplaces

Humanistic management and mindfulness practices can potentiate one another to foster an inclusive society. By moving beyond a limited instrumental understanding of mindfulness practice to a generative mindfulness that incorporates a recognition of the rich nature of the human mind, awareness of cultural practices, and deeply rooted ethical foundations, managers can create organizational cultures that honor the sacred in every human being. A set of interviews with noted consultants and researchers on mindfulness and leadership suggests convergence on this perspective, as does the experience of a university administrator in developing an anti-racist agenda for a large U.S. university. This article is based on both the personal experience and scholarly research of its authors and suggests ways that humanistic management education can contribute to creating inclusive workplaces through incorporating generative mindfulness in executive development as well as undergraduate programs.

Evaluation of the effectiveness of student learning and teacher instruction on team-based learning during quality control of diagnostic imaging

Background: Team-Based Learning (TBL), which is a student-centered instructional approach, has been applied in various health-related courses, but research on the effectiveness of TBL in radiologic technology is limited. More research is needed to examine the effectiveness of TBL within the field of radiologic technology as well as to study teachers' reflective practices for instructional development in TBL.Objectives: This study examines the effectiveness of TBL on students' learning and course instructors' instructional development during quality control activities in diagnostic imaging.Design: This study employed an action research approach with mixed-methods. The study was categorized using four TBL modules as the topics: film/screen receptors and processors, radiography, mammography, and computed tomography. Quantitative data included pre-test scores on individual readiness assurance tests (IRAT-pre), group readiness assurance tests (GRAT), and post-test scores on individual readiness assurance tests (IRAT-post). Qualitative data included students' responses to open-ended questions about their experience with TBL and transcripts of instructors' interviews.Results: Forty junior college students participated in the study. A non-parametric test was conducted to compare the scores. The results showed that the GRAT score was significantly higher than the IRAT-pre-score, and the IRAT-post score was significantly higher than the IRAT-pre-score. The IRAT-post score was significantly higher than the GRAT score for the first and fourth modules, but IRAT-post score was significantly lower than the GRAT score on the second and third modules. Using direct content analysis, five themes were coded around instructional development, while 15 themes were coded to understand students' experiences with TBL.Conclusions: TBL can be an effective instructional approach to improve students' understanding of radiologic technology content. The results of this research can help instructors decide what action plan to implement to increase the effectiveness of TBL when further employing it for radiologic technology courses.

Participation in an action research project on vaccine services for children: relationship with vaccine delays

Multicomponent interventions are effective in improving vaccine coverage. However, few studies have assessed their effect on timely vaccination. The aim of this study was to compare the proportion of children with vaccine delays at 2- and 12-month visits according to whether or not health centers have participated in an action research project on the organization of vaccination services for 0-5-year-olds. The action research project included a multicomponent intervention and was conducted between 2011 and 2015 in Quebec, Canada. An ecological before/after design was used for this analysis. A total of 264,579 DTaP-IPV-Hib (2-month visits) and 240,541 Men-C-C (12-month visits) vaccine doses were administered during 2011-2012 to 2014-2015 fiscal years, including 19% in 14 participating health centers and the remaining in 78 nonparticipating centers. Vaccine delays demonstrated a more pronounced decreasing trend in participating versus nonparticipating health centers (p < .0001 at 2 and 12 months). Between 2011-2012 and 2014-2015, participating centers managed to eliminate 35% of their vaccine delays at 2-month visits and 33% at 12-month visits, whereas nonparticipating centers eliminated 19% of delays at both visits. Our results are consistent with a positive impact of the multicomponent intervention, despite the fact that it had not specifically aimed at decreasing vaccine delays.

Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC)-Phase 2

Californians Linking Action with Science for Prevention of Breast Cancer (CLASP-BC) is part of California Breast Cancer Research Program’s (CBCRP) Initiative strategic priority to disseminate and implement high-impact, population-based primary prevention interventions. CLASP-BC is informed by six years of funded program dissemination and implementation (D&I) research and evaluation conducted by the Canadian Partnership Against Cancer (CPAC) through its Coalitions Linking Action and Science for Prevention (CLASP). In its second phase, CLASP-BC will fund multi-sector, multi-jurisdictional initiatives that integrate the lessons learned from science with the lessons learned from practice and policy to reduce the risk of developing breast cancer and develop viable and sustainable infrastructure models for primary prevention breast cancer programs and research evidence implementation. Applications will be solicited from research, practice, policy, and community teams to address one or more of the intervention goals for the 23 risk factors identified in Paths to Prevention: The California Breast Cancer Primary Prevention Plan (P2P), expanding upon existing primary prevention efforts into two or more California jurisdictions, focused on disadvantaged, high risk communities with unmet social needs. The lessons learned from CLASP-BC will be widely disseminated within the participating jurisdictions, across California and, where applicable, to jurisdictions outside the state.

Intergroup 'Skype' Quiz Sessions in Care Homes to Reduce Loneliness and Social Isolation in Older People

Video calls using software such as Skype, Zoom and FaceTime can improve socialisation among older people and family, however it is unknown if video calls are able to improve socialisation among older people and their peers. Twenty-two residents across three British care homes engaged with each other using ‘Skype quiz’ sessions with the support of staff once a month over an eight-month trial. Video calls were accessed via a ‘Skype on Wheels’ intervention that comprised a wheeled device that could hold an iPad, or through Skype TV. Residents met other residents from the three care homes to build new friendships and participate in a thirty-minute quiz session facilitated by eight staff. Staff were collaborators who recruited older people, implemented the intervention and provided feedback that was analysed using thematic analysis. Residents enjoyed being able to see other residents’ faces and surroundings. Analysis of the field notes revealed five themes of: residents with dementia remember faces not technology, inter and intra connectedness, re-gaining sense of self and purpose, situational loneliness overcome and organisational issues create barriers to long-term implementation. Inter-care home connection through video calls to reduce feelings of loneliness in residents seems acceptable and a feasible, low cost model, especially during times of public crisis such as COVID-19.

Intervening on Burnout in Complex Organizations - The Incomplete Process of an Action Research in the Hospital

Health professionals are at high risk for developing burnout symptoms. Directed at reducing the organizational variables affecting professionals’ burnout, an action research was developed in a specific sector of a large hospital, with 59 doctors, 66 nurses, and 42 ancilliary professionals. Researchers conducted 11 interviews, one focus group, and 20 h of in loco observation. Professionals report demotivation and the need to address the emotional part of their job. Nonetheless, the hierarchy blocked the proposed intervention possibilities. Organizational factors are unequivocally relevant, particularly in complex settings with emotionally charged interactions, and the direct hierarchy is pivotal for facilitating organizational change.