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Balqis-Ali NZ, Saw PS, Anis-Syakira J, Fun WH, Sararaks S, Lee SWH, Abdullah M. Healthcare provider person-centred practice: relationships between prerequisites, care environment and care processes using structural equation modelling. BMC Health Serv Res 2022; 22:576. [PMID: 35488228 PMCID: PMC9052661 DOI: 10.1186/s12913-022-07917-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/04/2022] [Indexed: 11/20/2022] Open
Abstract
Background The translation of person-centred care concepts into practice requires fulfilment of necessary components, including person-centred values and practice held by the employees and having a supportive system. The objectives of this study were multifold: firstly, to evaluate the measurement model, secondly, to examine the roles of prerequisite or attributes of healthcare providers and care environment and how they affect delivery of person-centred processes; and finally, to examine the mediating effect of care environment towards the relationship between prerequisite and care processes. Methods A cross sectional study was conducted among healthcare providers working in primary care facilities in a state in Malaysia. The Person-centred Practice Inventory-Staff instrument (PCPI-S) was distributed and completed by respondents. The instrument structure, reliability and validity were assessed through confirmatory factor analysis, while the framework’s unidirectional hypothesis and the mediation path hypothesis were analysed using structural equation modelling. Results The overall goodness of fit verifies the original Person-centred Practice Framework, allowing some correlation errors. There were significant relationships between prerequisites of healthcare providers and care environment (β = 0.826, p < 0.001), as well as between care environment and care processes (β = 0.785, p < 0.001). This analysis also proved that care environment plays a partial mediating role in the relationship between prerequisites and care processes. Conclusions In order to successfully move towards delivering person-centred practice, it is imperative to equip healthcare providers with person-centred values and beliefs, while at the same time transform current work culture to align with person-centred care. This will allow successful delivery of person-centred processes. Trial registration NMRR-18-309-40,447. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07917-3.
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Affiliation(s)
- Nur Zahirah Balqis-Ali
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
| | - Pui San Saw
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.,Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Jailani Anis-Syakira
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Weng Hong Fun
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Sondi Sararaks
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.,School of Pharmacy, Taylor's University Lakeside Campus, Jalan Taylors, 47500, Subang Jaya, Selangor, Malaysia
| | - Mokhtar Abdullah
- MERITUS University, 49, The Boulevard, Mid Valley City, Lingkaran Syed Putra, 59200, Kuala Lumpur, Malaysia
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Kontrimiene A, Blazeviciene A, Liseckiene I, Raila G, Valius L, Jaruseviciene L. Partnership between Primary Health and Social Care Services in the Long-Term Care of Older People with Dementia: A Vignette Study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021; 58:469580211011933. [PMID: 33890509 PMCID: PMC8072849 DOI: 10.1177/00469580211011933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dementia is considered to be a significant cause of disability and dependency for older people worldwide and it raises difficulties in providing adequate formal and informal assistance. Research on the experience of long-term care (LTC)services for older people with dementia is scarce in Eastern European countries. This study aimed to understand the system of care for older people with dementia from the perspective of health and social care workers providing LTC services in Lithuania. A total of 72 primary health care and social care professionals from public and private institutions in Kaunas city participated in this study. One-to-one interviews were conducted with family physicians, community nurses, psychiatrists, psychiatric nurses, and social workers. A vignette situation of 2 fictitious patients with dementia and their informal caregiver was discussed during the interviews. Data were analyzed using thematic analysis by induction approach. The data revealed 2 main themes: LTC provision trajectory, and three-dimensional relationship perception in realization of LTC activities. LTC provision trajectory reflected activities performed as a response to the described situation embracing formal procedures for the endorsement of LTC needs as well as the range of LTC services. The three-dimensional perception of relationships in LTC services' implementation reflected the participants' personal approach toward LTC, relationship with different specialists, and the informal caregiver. Our study revealed the potential of complex measures that could be instrumental for the refinement of the caregiving process. First, a change in the additional care requirements endorsement logic is needed, shifting focus from medical diagnosis to functional abilities assessment. Second, to establish clear procedures for formal cooperation between the health and social care sectors in the trajectory of LTC service provision. Finally, to find an adequate balance between LTC and institutional care by creating a more comprehensive range of LTC services. A more consistent and coordinated delivery of services by both health and social care sectors seems to be an untapped resource for the improvement of the LTC potential.
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Affiliation(s)
| | | | - Ida Liseckiene
- Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Leonas Valius
- Lithuanian University of Health Sciences, Kaunas, Lithuania
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A one-year longitudinal qualitative study of peer support services in a non-Western context: The perspectives of peer support workers, service users, and co-workers. Psychiatry Res 2017; 255:27-35. [PMID: 28511051 DOI: 10.1016/j.psychres.2017.05.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 05/05/2017] [Indexed: 01/21/2023]
Abstract
This study explored the changing views of key stakeholders (peer support workers, their co-workers, and service users) about peer support services in a non-Western community, using a longitudinal qualitative approach. Five trainee peer support workers (PSWs), 15 service users, and 14 co-workers were interviewed over a 12-month period, under the auspices of the Peer Support Workers Project (also known as the Mindset project) in Hong Kong. A total of 77 interviews were transcribed and thematic analyses were conducted across the participant groups at three different time points (training, work placements, and employment). During the initial implementation of the services, uncertainty about the role of the PSWs were reported. However, trusting and beneficial relationships with service users were gradually built, showing growing resilience and confidence over time. The participants realized that PSWs' experiences of mental illnesses were a unique asset that could help service users to alleviate their own somatic symptoms and improve their connections with others. Our findings highlight that the perceptions of peer support services changed from confusion to viewing PSWs as an asset, to an awareness of the importance of family support, and to the belief that implementing such a program will benefit both service users and PSWs.
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Gammage RJ, Foster JL. Leadership in community mutual support groups for mental health: A qualitative case study from the leaders' perspective. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2017. [DOI: 10.1002/casp.2327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Rebecca J. Gammage
- Department of Psychology; University of Cambridge; Cambridge UK
- Doctorate Programme in Clinical Psychology, Department of Psychology; University of Hertfordshire; Hatfield UK
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The Role of Self-Care for Parents in Recovery From Substance Use Disorders: An Integrative Review of Parental Self-Care. J Addict Nurs 2016; 27:180-9. [PMID: 27580191 DOI: 10.1097/jan.0000000000000133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Lack of stress modifiers, such as self-care behaviors (SCBs), can increase vulnerability to drug use for parents in recovery from substance use disorders (SUDs). PURPOSE The purpose of this integrative review was to determine how the existing literature describes, conceptualizes, and measures SCB for parents in the general population for its application to parents with a history of SUD. METHODS Framed by Bandura's Social Cognitive Theory of Substance Abuse, four qualitative and five quantitative studies identify SCB, although only one study describes SCB of parents in recovery. RESULTS Few studies addressed parental SCB, and most of those studies focused on behaviors for new mothers with or without SUDs during the early child years. CONCLUSIONS Exploring the role of SCB in relation to parental well-being for the general population is a needed area for further research, even more so for parents who are recovering from SUDs.
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Moreno EM, Moriana JA. User involvement in the implementation of clinical guidelines for common mental health disorders: a review and compilation of strategies and resources. Health Res Policy Syst 2016; 14:61. [PMID: 27507569 PMCID: PMC4979121 DOI: 10.1186/s12961-016-0135-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/19/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is now broad consensus regarding the importance of involving users in the process of implementing guidelines. Few studies, however, have addressed this issue, let alone the implementation of guidelines for common mental health disorders. The aim of this study is to compile and describe implementation strategies and resources related to common clinical mental health disorders targeted at service users. METHODS The literature was reviewed and resources for the implementation of clinical guidelines were compiled using the PRISMA model. A mixed qualitative and quantitative analysis was performed based on a series of categories developed ad hoc. RESULTS A total of 263 items were included in the preliminary analysis and 64 implementation resources aimed at users were analysed in depth. A wide variety of types, sources and formats were identified, including guides (40%), websites (29%), videos and leaflets, as well as instruments for the implementation of strategies regarding information and education (64%), self-care, or users' assessment of service quality. CONCLUSIONS The results reveal the need to establish clear criteria for assessing the quality of implementation materials in general and standardising systems to classify user-targeted strategies. The compilation and description of key elements of strategies and resources for users can be of interest in designing materials and specific actions for this target audience, as well as improving the implementation of clinical guidelines.
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Affiliation(s)
- Eliana M Moreno
- Department of Psychology, University of Cordoba, Calle San Alberto Magno S/N, 14071, Cordoba, Spain. .,Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital, Avda Menéndez Pidal s/n, 14004, Cordoba, Spain.
| | - Juan Antonio Moriana
- Department of Psychology, University of Cordoba, Calle San Alberto Magno S/N, 14071, Cordoba, Spain.,Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Reina Sofia University Hospital, Avda Menéndez Pidal s/n, 14004, Cordoba, Spain
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Gillard S, White R, Miller S, Turner K. Open access support groups for people experiencing personality disorders: do group members' experiences reflect the theoretical foundations of the SUN project? Psychol Psychother 2015; 88:87-104. [PMID: 24872313 DOI: 10.1111/papt.12031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 03/06/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The SUN Project is an innovative, open access support group, based in the community, for people experiencing personality disorders, developed in response to UK Department of Health policy advocating improvements in personality disorders services. The aim of this article is to critically explore where and how the theoretically informed model underpinning the SUN Project is reflected in the view and experiences of people attending the project. DESIGN This article reports an in-depth, qualitative interview-based study employing a critical realist approach. METHODS As part of a larger study about self-care and mental health, in-depth qualitative interviews were held with 38 people new to the SUN Project, and again 9 months later. Data were extracted that were relevant to core components of the project model and were subjected to thematic analysis. The critical realist approach was used to move back and forth between empirical data and theory underpinning the SUN project, providing critical insight into the model. RESULTS Participant accounts were broadly concordant with core components of the SUN Project's underlying model: Open access and self-referral; group therapeutic processes; community-based support; service users as staff. There were some tensions between interviewee accounts and theoretical aspects of the model, notably around the challenges that group processes presented for some individuals. CONCLUSIONS The model underlying the SUN Project is useful in informing good practice in therapeutic, community-based peer support groups for people experiencing personality disorders. Careful consideration should be given to a limited multi-modal approach, providing focused one-to-one support for vulnerable individuals who find it hard to engage in group processes. PRACTITIONER POINTS Facilitated peer support groups based in the community may act as a powerful therapeutic resource for people experiencing personality disorders. Promoting open access and self-referral to support groups may increase feelings of empowerment and engagement for people experiencing personality disorders. Some individuals experiencing personality disorders who could potentially benefit from therapeutic groups may need focused one-to-one support to do so.
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Kemp V, Fisher C, Lawn S, Battersby M, Isaac MK. Small steps: barriers and facilitators to physical health self-management by people living with mental illness. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2014. [DOI: 10.1080/14623730.2014.931069] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Gillard SG, Edwards C, Gibson SL, Owen K, Wright C. Introducing peer worker roles into UK mental health service teams: a qualitative analysis of the organisational benefits and challenges. BMC Health Serv Res 2013; 13:188. [PMID: 23705767 PMCID: PMC3673834 DOI: 10.1186/1472-6963-13-188] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 05/18/2013] [Indexed: 11/21/2022] Open
Abstract
Background The provision of peer support as a component of mental health care, including the employment of Peer Workers (consumer-providers) by mental health service organisations, is increasingly common internationally. Peer support is strongly advocated as a strategy in a number of UK health and social care policies. Approaches to employing Peer Workers are proliferating. There is evidence to suggest that Peer Worker-based interventions reduce psychiatric inpatient admission and increase service user (consumer) empowerment. In this paper we seek to address a gap in the empirical literature in understanding the organisational challenges and benefits of introducing Peer Worker roles into mental health service teams. Methods We report the secondary analysis of qualitative interview data from service users, Peer Workers, non-peer staff and managers of three innovative interventions in a study about mental health self-care. Relevant data was extracted from interviews with 41 participants and subjected to analysis using Grounded Theory techniques. Organisational research literature on role adoption framed the analysis. Results Peer Workers were highly valued by mental health teams and service users. Non-peer team members and managers worked hard to introduce Peer Workers into teams. Our cases were projects in development and there was learning from the evolutionary process: in the absence of formal recruitment processes for Peer Workers, differences in expectations of the Peer Worker role can emerge at the selection stage; flexible working arrangements for Peer Workers can have the unintended effect of perpetuating hierarchies within teams; the maintenance of protective practice boundaries through supervision and training can militate against the emergence of a distinctive body of peer practice; lack of consensus around what constitutes peer practice can result in feelings for Peer Workers of inequality, disempowerment, uncertainty about identity and of being under-supported. Conclusions This research is indicative of potential benefits for mental health service teams of introducing Peer Worker roles. Analysis also suggests that if the emergence of a distinctive body of peer practice is not adequately considered and supported, as integral to the development of new Peer Worker roles, there is a risk that the potential impact of any emerging role will be constrained and diluted.
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