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Bedenik T, Kearney C, Ní Shé É. Trust in embedding co-design for innovation and change: considering the role of senior leaders and managers. J Health Organ Manag 2024; 38:36-44. [PMID: 38448232 PMCID: PMC10945738 DOI: 10.1108/jhom-07-2023-0207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and mangers in developing and enhancing a culture of trust in their organizations to enable co-design, with the potential to drive innovation and change in healthcare. DESIGN/METHODOLOGY/APPROACH Using social science analyses, the authors argue that current co-design literature has limited focus on interactions between senior leaders and managers, and healthcare staff and service users in supporting co-designed innovation and change. The authors draw on social and health science studies of trust to highlight how the value-based co-design process needs to be supported and enhanced. We outline what co-design innovation and change involve in a health system, conceptualize trust and reflect on its importance within the health system, and finally note the role of senior leaders and managers in supporting trust and responsiveness for co-designed innovation and change. FINDINGS Healthcare needs leaders and managers to embrace co-design that drives innovation now and in the future through people - leading to better healthcare for society at large. As authors we argue that it is now the time to shift our focus on the role of senior managers and leaders to embed co-design into health and social care structures, through creating and nurturing a culture of trust. ORIGINALITY/VALUE Building public trust in the health system and interpersonal trust within the health system is an ongoing process that relies upon personal behavior of managers and senior leaders, organizational practices within the system, as well as political processes that underpin these practices. By implementing managerial, leadership and individual practices on all levels, senior managers and leaders provide a mechanism to increase both trust and responsiveness for co-design that supports innovation and change in the health system.
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Affiliation(s)
- Tina Bedenik
- School of Population
Health,
Royal College of Surgeons in
Ireland, Dublin, Ireland
| | - Claudine Kearney
- Graduate School of Healthcare
Management,
Royal College of Surgeons in
Ireland, Dublin, Ireland
| | - Éidín Ní Shé
- Graduate School of Healthcare
Management,
Royal College of Surgeons in
Ireland, Dublin, Ireland
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2
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Fattori F, Zisman-Ilani Y, Chmielowska M, Rodríguez-Martín B. Measures of Shared Decision Making for People With Mental Disorders and Limited Decisional Capacity: A Systematic Review. Psychiatr Serv 2023; 74:1171-1175. [PMID: 37194313 DOI: 10.1176/appi.ps.202200018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVE Shared decision making (SDM) is a health communication model to improve treatment decision making and is underused for people with mental health conditions and limited, impaired, or fluctuating decisional capacity. SDM measures are essential to enhancing the adoption and implementation of SDM practices, yet no tools or research findings exist that explicitly focus on measuring SDM with such patients. The aim of this review was to identify instruments that measure SDM involving individuals with mental health conditions and limited decisional capacity, their family members, and their health and social care providers. METHODS A systematic review was performed by searching the PubMed, Embase, Web of Science, and PsycInfo databases. The authors included peer-reviewed, quantitative articles published in English during 2009-2022 that focused on adults (≥18 years old). All authors performed the screening independently. RESULTS A total of 7,956 records were identified, six of which met the inclusion criteria for full-text review and five of which were analyzed (one full-text article was not available). No instruments were identified that measured forms of SDM involving patients with mental health conditions and limited, impaired, or fluctuating decisional capacity. CONCLUSIONS Measurement instruments to address and assess SDM in health care-related communication processes involving individuals with a mental health condition and limited decisional capacity are needed.
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Affiliation(s)
- Francesco Fattori
- Codici Ricerca e Intervento, Milan, Italy (Fattori); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani); Division of Psychology and Language Sciences, University College London, London (Chmielowska); Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, Toledo, Spain (Rodríguez-Martín)
| | - Yaara Zisman-Ilani
- Codici Ricerca e Intervento, Milan, Italy (Fattori); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani); Division of Psychology and Language Sciences, University College London, London (Chmielowska); Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, Toledo, Spain (Rodríguez-Martín)
| | - Marta Chmielowska
- Codici Ricerca e Intervento, Milan, Italy (Fattori); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani); Division of Psychology and Language Sciences, University College London, London (Chmielowska); Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, Toledo, Spain (Rodríguez-Martín)
| | - Beatriz Rodríguez-Martín
- Codici Ricerca e Intervento, Milan, Italy (Fattori); Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia (Zisman-Ilani); Division of Psychology and Language Sciences, University College London, London (Chmielowska); Department of Nursing, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, Toledo, Spain (Rodríguez-Martín)
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Carpenter CR, Leggett J, Bellolio F, Betz M, Carnahan RM, Carr D, Doering M, Hansen JC, Isaacs ED, Jobe D, Kelly K, Morrow-Howell N, Prusaczyk B, Savage B, Suyama J, Vann AS, Rising KL, Hwang U, Shah MN. Emergency Department Communication in Persons Living With Dementia and Care Partners: A Scoping Review. J Am Med Dir Assoc 2022; 23:1313.e15-1313.e46. [PMID: 35940681 PMCID: PMC10802113 DOI: 10.1016/j.jamda.2022.02.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To synthesize published research exploring emergency department (ED) communication strategies and decision-making with persons living with dementia (PLWD) and their care partners as the basis for a multistakeholder consensus conference to prioritize future research. DESIGN Systematic scoping review. SETTINGS AND PARTICIPANTS PLWD and their care partners in the ED setting. METHODS Informed by 2 Patient-Intervention-Comparison-Outcome (PICO) questions, we conducted systematic electronic searches of medical research databases for relevant publications following standardized methodological guidelines. The results were presented to interdisciplinary stakeholders, including dementia researchers, clinicians, PLWD, care partners, and advocacy organizations. The PICO questions included: How does communication differ for PLWD compared with persons without dementia? Are there specific communication strategies that improve the outcomes of ED care? Future research areas were prioritized. RESULTS From 5451 studies identified for PICO-1, 21 were abstracted. From 2687 studies identified for PICO-2, 3 were abstracted. None of the included studies directly evaluated communication differences between PLWD and other populations, nor the effectiveness of specific communication strategies. General themes emerging from the scoping review included perceptions by PLWD/care partners of rushed ED communication, often exacerbated by inconsistent messages between providers. Care partners consistently reported limited engagement in medical decision-making. In order, the research priorities identified included: (1) Barriers/facilitators of effective communication; (2) valid outcome measures of effective communication; (3) best practices for care partner engagement; (4) defining how individual-, provider-, and system-level factors influence communication; and (5) understanding how each member of ED team can ensure high-quality communication. CONCLUSIONS AND IMPLICATIONS Research exploring ED communication with PLWD is sparse and does not directly evaluate specific communication strategies. Defining barriers and facilitators of effective communication was the highest-ranked research priority, followed by validating outcome measures associated with improved information exchange.
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Affiliation(s)
- Christopher R Carpenter
- Department of Emergency Medicine, Washington University in St. Louis School of Medicine, Emergency Care Research Core, St. Louis, MO, USA.
| | - Jesseca Leggett
- Department of Emergency Medicine, Washington University in St. Louis School of Medicine, Emergency Care Research Core, St. Louis, MO, USA
| | | | - Marian Betz
- Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver, CO, USA
| | - Ryan M Carnahan
- Department of Epidemiology, The University of Iowa College of Public Health, Iowa City, IA, USA
| | - David Carr
- Department of Medicine and Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Michelle Doering
- Becker Medical Library, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | | | - Eric D Isaacs
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Deborah Jobe
- Person Living with Dementia, 2021-2022 Alzheimer's Association National Early Stage Advisory Group, St. Louis MO, USA
| | | | - Nancy Morrow-Howell
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Beth Prusaczyk
- Department of Medicine, Institute for Informatics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Bob Savage
- Person Living with Dementia, LiveWell Alliance, Plantsville, CT, USA
| | - Joe Suyama
- Department of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Kristin L Rising
- Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ula Hwang
- Department of Emergency Medicine, Yale University, New Haven, CT, USA
| | - Manish N Shah
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, USA
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Browne J, Dorris ER. What Can We Learn From a Human-Rights Based Approach to Disability for Public and Patient Involvement in Research? FRONTIERS IN REHABILITATION SCIENCES 2022; 3:878231. [PMID: 36189077 PMCID: PMC9397757 DOI: 10.3389/fresc.2022.878231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/03/2022] [Indexed: 12/01/2022]
Abstract
Public and Patient Involvement can align both the research process and its outcomes with the values, needs and expectations of society. By fostering the design of inclusive, engaged, and sustainable practices, research and research integrity can be improved. Devolving power to involve patients and relevant publics in deliberative decision making can produce better research outcomes. Disabled people are often categorized as “Hard to Reach.” There is a varied and complex ecosystem of societal challenges of living with a disability that reinforce this. However, if researchers are to meet their obligations under the UN Convention on the Rights of Persons with Disabilities, disabled people should be included in public and patient involvement for all research in which they have a stake. In this article we argue that a better understanding of rights-based approaches and the social model of disability within the wider research community can help to remove barriers to research involvement for disabled persons. We focus on articles 3, 4, and 9 of the Convention and discuss how the principles of participation, accessibility, and equality of opportunity can be applied to research involvement, and how their adoption can facilitate truly meaningful PPI in disability research.
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Affiliation(s)
| | - Emma R. Dorris
- PPI Ignite Network at UCD, University College Dublin Research Office, University College Dublin, Dublin, Ireland
- *Correspondence: Emma R. Dorris
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Usher R, Stapleton T. Assessment of older adults' decision-making capacity in relation to independent living: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e255-e277. [PMID: 34288195 DOI: 10.1111/hsc.13487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/26/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
With a growing global ageing population, approaches to assess and support decision-making are becoming more pertinent. This scoping review aimed to identify and map current knowledge on assessment of older adults' decision-making capacity in relation to independent living. A five-stage scoping review framework was followed. Inclusion criteria were papers on assessment approaches used to evaluate decision-making capacity of older adults, aged 60 years and over for independent living, including studies involving people with cognitive impairment and dementia. Five databases were searched for publications with eligibility criteria from January 2000 to December 2020; 4,118 results were retrieved from sources, resulting in 29 publications being analysed, eight of which were research reports. Publication characteristics and methodologies varied; however, many common components of decision-making capacity assessment for independent living were identified including cognitive, functional, environmental and risk assessment. Overall, a multidisciplinary approach was recommended, and consideration of the person's values and preferences is noted in many publications. Decision-making capacity assessment for independent living of older adults requires multicomponent, multidisciplinary assessment. Future work is needed to examine this from the perspective of older adults and their caregivers.
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Affiliation(s)
- Ruth Usher
- Department of Occupational Therapy and Occupational Science, University College Cork, Cork, Ireland
| | - Tadhg Stapleton
- Discipline of Occupational Therapy, Trinity College Dublin, Dublin, Ireland
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Usher R, Stapleton T. Assessing Older Adults’ Decision-Making Capacity for Independent Living: Practice Tensions and Complexities. J Appl Gerontol 2022; 41:1264-1273. [PMID: 35060410 PMCID: PMC9024017 DOI: 10.1177/07334648211065029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Decision-making capacity (DMC) is a salient issue due to increasing ageing populations and associated dementia-related diseases. Legislative and policy developments emphasise older adults’ rights to participate in decision-making. Fifty-two occupational therapists working with older adults from a range of practice settings in Ireland participated in focus groups to discuss their contribution to multidisciplinary assessments of older adult’s DMC for independent living. Findings indicate lack of shared understanding of DMC and conflicting philosophies of practice and highlight the need for a comprehensive and multidisciplinary approach. Findings also highlight that older people are often excluded from care-planning, and independent living options are determined by availability of community services rather than their preferences. Future research will attempt to inform practice in assessing and supporting older adults’ DMC for independent living.
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Affiliation(s)
- Ruth Usher
- Department of Occupational Therapy and Occupational Science, University College Cork, Ireland
| | - Tadhg Stapleton
- Discipline of Occupational Therapy, Trinity College Dublin, Ireland
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Ní Shé É, McDonald FEJ, Mimmo L, Ross XS, Newman B, Patterson P, Harrison R. What Are the Psycho-Social and Information Needs of Adolescents and Young Adults Cancer Care Consumers with Intellectual Disability? A Systematic Review of Evidence with Recommendations for Future Research and Practice. CHILDREN (BASEL, SWITZERLAND) 2021; 8:1118. [PMID: 34943314 PMCID: PMC8699987 DOI: 10.3390/children8121118] [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] [Received: 09/21/2021] [Revised: 11/17/2021] [Accepted: 11/26/2021] [Indexed: 11/17/2022]
Abstract
People with intellectual disability have unmet health needs and experience health inequalities. There is limited literature regarding cancer care for children, adolescents, and young adults (AYA) with intellectual disability despite rising cancer incidence rates in this population. This systematic review aimed to identify the psycho-social and information support needs of AYA cancer care consumers with intellectual disability to generate recommendations for future research and cancer care service delivery enhancement. We searched eight databases yielding 798 articles. Following abstract and full-text review, we identified 12 articles meeting our inclusion criteria. Our three themes related to communication and accessible information; supports and system navigation, cancer service provider training, and reasonable adjustments. There was a lack of user-friendly, accessible information about cancer and screening programs available. Both paid and family carers are critical in accessing cancer supports, services, and screening programs for AYA with intellectual disability. Ongoing training should be provided to healthcare professionals regarding the importance of care screening for AYAs with intellectual disability. This review recommends that AYA with intellectual disability and their family carers be involved in developing tailored cancer services. This should focus on enabling inclusive screening programs, accessible consent, and challenging the enduring paternalism of support services via training and appropriate communication tools.
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Affiliation(s)
- Éidín Ní Shé
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
- Centre for Health Systems and Safety, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW 2190, Australia; (B.N.); (R.H.)
| | - Fiona E. J. McDonald
- Canteen Australia, Sydney, NSW 2042, Australia; (F.E.J.M.); (X.S.R.); (P.P.)
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2052, Australia
| | - Laurel Mimmo
- School of Women’s and Children’s Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia;
- Clinical Governance Unit, The Sydney Children’s Hospitals Network, Westmead, NSW 2145, Australia
| | | | - Bronwyn Newman
- Centre for Health Systems and Safety, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW 2190, Australia; (B.N.); (R.H.)
| | - Pandora Patterson
- Canteen Australia, Sydney, NSW 2042, Australia; (F.E.J.M.); (X.S.R.); (P.P.)
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2052, Australia
| | - Reema Harrison
- Centre for Health Systems and Safety, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW 2190, Australia; (B.N.); (R.H.)
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Carlini J, Bahudin D, Michaleff ZA, Plunkett E, Shé ÉN, Clark J, Cardona M. Discordance and concordance on perception of quality care at end of life between older patients, caregivers and clinicians: a scoping review. Eur Geriatr Med 2021; 13:87-99. [PMID: 34386928 PMCID: PMC8359918 DOI: 10.1007/s41999-021-00549-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 07/26/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND This scoping review aimed to investigate the presence of discordance or concordance in the perceptions of end-of-life (EOL) care quality between consumers (i.e. patients aged over 60 in their last years of life and/or their informal caregivers) and clinicians, to inform further improvements in end-of-life care service delivery. METHODS A scoping review of qualitative and quantitative studies was systematically undertaken by searching for English language publications in MEDLINE database and manual reference search of eligible articles. Thematic analysis was employed to identify and extract common concordance and discordance themes leading to the development of analytical constructs. Articles were eligible for inclusion if they reported on consumers' (i.e. older patients aged 60 + years in their final years of life and/or their informal caregivers) and clinicians' (doctors, nurses, social workers, etc.) perspectives on quality of medical, surgical or palliative/supportive care administered to older adults in the last year of life across all healthcare settings. RESULTS Of the 2736 articles screened, 21 articles were included. Four themes identified concordance between consumers' and clinicians' perceptions of care quality: holistic patient care; coordinated care that facilitated EOL; the role of family at EOL; and impact of prognostic uncertainty on care planning. Three themes emerged for discordance of perceptions: understanding the patient needs at EOL; capacity of healthcare system/providers to accommodate family needs; and knowledge and communication of active or palliative care at EOL. CONCLUSIONS While progress has been made on promoting patient autonomy and respecting the family role in representing patient's best interest, gaps remain in terms of care coordination, communication of prognosis, public understanding of the meaning of goals of care including de-escalation of management and enactment of advance care directives by clinicians for people with diminished decision capacity. Public understanding of the meaning of "comfort" care and the need to prevent over-treatment are essential for their satisfaction with care and their ability to embrace the concept of a good death.
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Affiliation(s)
- Joan Carlini
- School of Business, Griffith University, Southport, QLD Australia
- Gold Coast University Hospital Consumer Advisory Group, Southport, QLD Australia
| | - Danial Bahudin
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD Australia
| | - Zoe A. Michaleff
- Institute for Evidence Based Healthcare, Bond University, Robina, QLD Australia
| | - Emily Plunkett
- Palliative Care Service, Robina Hospital, Robina, QLD Australia
| | - Éidín Ní Shé
- School of Population Health, University of New South Wales, Kensington, NSW Australia
| | - Justin Clark
- Institute for Evidence Based Healthcare, Bond University, Robina, QLD Australia
| | - Magnolia Cardona
- Institute for Evidence Based Healthcare, Bond University, Robina, QLD Australia
- Evidence Based Practice Professorial Unit, Gold Coast University Hospital, Level 2, PED building, 1 Hospital Boulevard, Southport, QLD 4215 Australia
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Donnelly S, Wilson AG, Mannan H, Dix C, Whitehill L, Kroll T. (In)Visible illness: A photovoice study of the lived experience of self-managing rheumatoid arthritis. PLoS One 2021; 16:e0248151. [PMID: 33684123 PMCID: PMC7939378 DOI: 10.1371/journal.pone.0248151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 02/19/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Chronic illnesses, such as Rheumatoid Arthritis (RA), are a growing burden on health care systems worldwide. Self-management emphasises the patient's central role in managing their illness. This is pertinent given the majority of care is provided by the individual themselves; yet how individuals make sense of self-management in everyday life is largely unseen. OBJECTIVE The purpose of this study was to capture the strengths and concerns of individuals with RA in self-managing their illness, raise awareness of their lived experience and spark a dialogue among stakeholders. METHODS A community-based participatory approach, Photovoice, was adopted. A purposive sample of participants were tasked with taking photographs to represent the challenges and solutions to living with RA. Group workshops and semi-structured interviews were conducted to facilitate reflection, dialogue and analysis. Data analysis followed Braun and Clarke's thematic analysis. Public exhibitions were held throughout the Autumn of 2019. RESULTS Eight women and three men (n = 11) across suburban and urban regions of Ireland were recruited (mean age 57 years, disease duration 4-21 years). Participants identified four main themes which reflected the lived experience of self-managing RA: (i) I'm Here but I'm Not, (ii) Visible Illness, (iii) Medicine in All its Forms, (iv) Mind Yourself. These themes captured the challenge of reduced agency, limited contribution and participation, and a complex relationship between visible and invisible illness. Solutions focused on improving psychological and emotional resilience, particularly through personal reflection and increased agency. CONCLUSIONS Our findings suggest that RA is experienced as a fluid relationship between states of masking and surfacing of illness shaped by contextual and situational factors. Photovoice was a highly effective tool to capture and communicate this complexity. Supporting increased agency among individuals with RA to control the (in)visibility of illness and disability can inform the development of future self-management support.
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Affiliation(s)
- Susie Donnelly
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
- School of Medicine and Medical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Anthony G. Wilson
- School of Medicine and Medical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Hasheem Mannan
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
- FLAME University, Pune, India
| | | | - Laura Whitehill
- School of Medicine and Medical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Thilo Kroll
- Centre for Interdisciplinary Research Education and Innovation in Health Systems (IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Ní Shé É, O’Donnell D, O’Shea M, Stokes D. New Ways of Working? A Rapid Exploration of Emerging Evidence Regarding the Care of Older People during COVID19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186442. [PMID: 32899652 PMCID: PMC7558069 DOI: 10.3390/ijerph17186442] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/21/2020] [Accepted: 08/29/2020] [Indexed: 12/15/2022]
Abstract
Health and social care staff have had to quickly adapt, respond and improve teamwork, as a response to the COVID-19 pandemic. Our objective was to rapidly summarize the emerging evidence of new ways of working in the care of older people during this period. We conducted an exploration of the emerging evidence within the timeframe of 1 March 2020 to 11 May 2020. To capture a broad perspective, we undertook thematic analysis of Twitter data which was extracted through a broad search for new ways of working in health and social care. For a more in-depth focus on the health and social care of older people, we undertook a systematic scoping of newspapers using the Nexis UK database. We undertook a validation workshop with members of the interprofessional working group of the Irish National Integrated Care Programme for Older People, and with researchers. A total of 317 tweets were extracted related to six new ways of working. There was evidence of using telehealth to provide ongoing care to patients; interprofessional work; team meetings using online platforms; trust and collaboration within teams; as well as teams feeling empowered to change at a local level. 34 newspaper articles were extracted related to new ways of working in the care of older people, originating in England (n = 17), Wales (n = 6), Scotland (n = 6), Ireland (n = 4) and Germany (n = 1). Four main themes were captured that focused on role expansion, innovations in communication, environmental restructuring and enablement. The results of this exploration of emerging evidence show that health and social care teams can transform very rapidly. Much of the change was based on goodwill as a response to the pandemic. Further analysis of empirical evidence of changing practices should include the perspectives of older people and should capture the resources needed to sustain innovations, as well as evaluate gaps in service provision.
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Affiliation(s)
- Éidín Ní Shé
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield 4 Dublin, Ireland; (É.N.S.); (M.O.)
| | - Deirdre O’Donnell
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield 4 Dublin, Ireland; (É.N.S.); (M.O.)
- Correspondence:
| | - Marie O’Shea
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield 4 Dublin, Ireland; (É.N.S.); (M.O.)
| | - Diarmuid Stokes
- Liaison Librarian for Health and Science, University College Dublin, Belfield 4 Dublin, Ireland;
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