Tackling multimorbidity: staff perceptions of the transition from single-condition rehabilitation to a specialist-generalist model

2021 ◽  
Vol 28 (8) ◽  
pp. 1-10
Author(s):  
Aynsley Cowie ◽  
Kathy Good ◽  
Janet McKay ◽  
Jane Holt
Keyword(s):  
Focus Groups ◽  
Peer Support ◽  
Rehabilitation Programme ◽  
Rehabilitation Services ◽  
Service Users ◽  
Staff Perceptions ◽  
Rehabilitation Team ◽  
New Model ◽  
Active Rehabilitation ◽  
Specialist Rehabilitation

Background/aims The Healthy and Active Rehabilitation Programme is a specialist-generalist approach to targeting multimorbidity, which was developed through reconfiguring single-condition rehabilitation pathways. This project examined staff perceptions of the transition from specialist rehabilitation, to delivering this new model. Methods A total of 18 staff from the Healthy and Active Rehabilitation Programme (eight nurses, seven exercise instructors, two physiotherapists, one occupational therapist) participated in three focus groups, generating three key themes: apprehension, confidence growth, and integrated working. Results Despite initial apprehension around the Healthy and Active Rehabilitation Programme's impact on the existing service, the service users, and their clinical roles, staff developed confidence in the service and in their broader roles. Integrated working within the Healthy and Active Rehabilitation Programme has enhanced their awareness of the wider rehabilitation team, and provides valuable peer support. Conclusions This project provides valuable information for single-condition rehabilitation services that are considering delivery of specialist-generalist care to help target multimorbidity.

scholarly journals Producing a new website for a paediatric liaison mental health team with our service users

2020 ◽  
Vol 9 (4) ◽  
pp. e001128
Author(s):  
Alexander Adams ◽  
Virginia Davies ◽  
Bethany Stubbs
Keyword(s):  
Mental Health ◽  
Focus Groups ◽  
Patient Experience ◽  
Service Users ◽  
Health Issues ◽  
Web Page ◽  
Mental Health Team ◽  
Children And Young People ◽  
Specific Feedback ◽  
Source Of Information

IntroductionOnline resources are an important source of information about mental health issues and services for children and young people. Our service’s website had an out-of-date appearance and was aimed at professionals. More importantly, comments in our routinely collected patient experience data indicated that service users did not know what to expect when coming to our service.MethodsWe followed the model for improvement by testing out changes in plan, do, study and act cycles that included a review of recently updated child and adolescent mental health services’ and youth charities’ websites, designing a new web page for our service and then testing out the website in focus groups. We used routinely collected patient experience data to assess impact on wider patient satisfaction.ResultsFocus groups involving patients, parents and professionals judged the new website to be clearer, more attractive and easier to understand. Routine patient experience data did not reveal any website-specific feedback.ConclusionThis study demonstrates that it is easy and possible to create an attractive and accessible website for a mental health service using quality improvement methodology. In order to capture and integrate ongoing feedback about a service’s website from service users, routinely collected patient experience measures would need to ask specific questions related to this area. In this study, preproject and postproject patient experience data did not generate any specific comments.

scholarly journals A Longitudinal Qualitative Analysis of the Way Peer Support Specialist Roles Change Over Time in a Psychiatric Hospital Setting in Asia

2021 ◽  
Author(s):  
Daniel Poremski ◽  
Jonathan Kuek ◽  
Yuan Qi ◽  
Ziqiang Li ◽  
Kah Lai Yow ◽  
...  
Keyword(s):  
Lived Experience ◽  
Peer Support ◽  
Service Use ◽  
Hospital Setting ◽  
Service Users ◽  
Role Clarity ◽  
Job Descriptions ◽  
Spheres Of Influence ◽  
Pass Through ◽  
Time Required

AbstractThe current study seeks to determine how peer support roles change as peer support specialists’ positions within organizations and departments mature. We followed ten peer support specialists over the course of a year, interviewing them at three points, starting approximately three months after they began working as peer support specialists. We used an inductive process to analyze our data and followed guidelines on the structuring of longitudinal qualitative trajectories to divide the data into watershed moments. Our participants worked in a variety of departments in the hospital, and their service use experiences generally echo those of their service users. Participants appear to pass through four phases over the course of their employment as peers: early beginnings, establishing the role, role narrowing, and role sustainability. Services wishing to integrate new peers must be aware of the time required for integration. Having general job descriptions limited to specifying that peers are expected to use their lived experience to support current service users may lead to uncertainty amongst new and existing staff. Without role clarity, peers may struggle to find their place. Pairing new staff with mentors may limit this burden. As roles consolidate, boundaries may emerge. If these boundaries narrow the role of the PSS, they may no longer find the role appealing. They may then choose other caregiver roles with wider or different spheres of influence. Organizations may benefit by clearly indicating if they expect peer support positions to be static or transitionary.

Hospital Staff Perceptions of a Legislative Mandate for Methicillin-Resistant Staphylococcus aureus Screening

2011 ◽  
Vol 32 (6) ◽  
pp. 573-578 ◽  
Author(s):  
Matthew E. Wise ◽  
Stephen G. Weber ◽  
Amy Schneider ◽  
Meg Stojcevski ◽  
Anne Marie France ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Focus Group ◽  
Focus Groups ◽  
Hospital Staff ◽  
Negative Consequences ◽  
Staff Perceptions ◽  
Methicillin Resistant ◽  
Chicago Area ◽  
Use Of Resources ◽  
Implementation Plans

Objective.In August 2007, Illinois passed legislation mandating methicillin-resistant Staphylococcus aureus (MRSA) admission screening for intensive care unit patients. We assessed hospital staff perceptions of the implementation of this law.Design.Mixed-methods evaluation using structured focus groups and questionnaires.Setting.Eight Chicago-area hospitals.Participants.Three strata of staff (leadership, midlevel, and frontline) at each hospital.Methods.All participants completed a questionnaire and participated in a focus group. Focus group transcripts were thematically coded and analyzed. The proportion of staff agreeing with statements about MRSA and the legislation was compared across staff types.Results.Overall, 126 hospital staff participated in 23 focus groups. Fifty-six percent of participants agreed that the legislation had a positive effect at their facility; frontline staff were more likely to agree than midlevel and leadership staff (P < .01). Perceived benefits of the legislation included increased awareness of MRSA among staff and better knowledge of the epidemiology of MRSA colonization. Perceived negative consequences included the psychosocial effect of screening and contact precautions on patients and increased use of resources. Most participants (59%) would choose to continue the activities associated with the legislation but advised facilities in states considering similar legislation to educate staff and patients about MRSA screening and to draft clear implementation plans.Conclusion.Staff from Chicago-area hospitals perceived that mandatory MRSA screening legislation resulted in some benefits but highlighted implementation challenges. States considering similar initiatives might minimize these challenges by optimizing messaging to patients and healthcare staff, drafting implementation plans, and developing program evaluation strategies.

Nine-Month Longitudinal Impact of Peer Support Workers’ Recovery Attributes on Service Users’ Recovery in Hong Kong

2021 ◽  
pp. appi.ps.2020000
Author(s):  
Winnie W. S. Mak ◽  
Amanda C. M. Fu ◽  
Larry Auyeung ◽  
Winnie W. L. Cheng ◽  
Randolph C. H. Chan ◽  
...  
Keyword(s):  
Hong Kong ◽  
Peer Support ◽  
Longitudinal Impact ◽  
Service Users

scholarly journals Combining online and offline peer support groups in mental health care: A qualitative study of service users� experiences (Preprint)

2018 ◽  
Author(s):  
Monica Strand ◽  
Deede Gammon ◽  
Lillian Sofie Eng ◽  
Cornelia Ruland
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Peer Support ◽  
Support Groups ◽  
Local Community ◽  
Mental Health Problems ◽  
Service Users ◽  
Face To Face ◽  
Individual Interviews

BACKGROUND Peer support groups for people with long-term mental health problems are at the heart of recovery-oriented approaches in mental health care. When conducted face-to-face (offline) or on the Internet (online), peer support groups have proven to have differing strengths and weaknesses. Little is known about the benefits and challenges of combining the two formats. OBJECTIVE The aim of this study was to gain insights into the benefits and challenges of combining online and offline peer support groups facilitated through an Internet intervention designed to support recovery processes. METHODS In this exploratory and descriptive study, an e-recovery portal called ReConnect was used by service users in two mental health communities in Norway for 6-12 months. The portal included an online peer support forum which also facilitated participation in local in-person ReConnect-cafés. Both formats of peer support were facilitated by an employed service user consultant with lived experience of mental health problems and with training in peer support. Qualitative data about service users’ experiences of using the portal were collected through focus groups and individual interviews and inductively analyzed thematically with focus on benefits and challenges of peer support online and offline. RESULTS A total of 14 service users 22-63 years of age with various diagnoses, receiving services at both primary and specialist levels of mental health care participated in three focus groups and 10 individual interviews. Two main themes were identified in the analysis: 1) balancing anonymity and openness, and 2) enabling connectedness. These themes are further illustrated with the subthemes: i) dilemmas of anonymity and confidentiality, ii) towards self-disclosure and openness, iii) new friendships, and iv) networks in the local community. Three of the subthemes mainly describe benefits. Challenges were more implicit and cut across the subthemes. Identified challenges were linked to transitions from anonymity to revealing one’s identity, how to protect confidentiality, or to participation at face-to-face meetings in the local community. CONCLUSIONS Our study suggests that online peer support groups and offline meetings complement each other, and the combination is mainly beneficial to users. The identified benefits appeared to arise from participants’ options of one format or the other, or that they could combine formats in ways that suited their individual values and comfort zones. We also identified challenges related to combination of formats, and both formats require appropriate facilitation of peer support. Combining online formats that enable anonymity, a non-judgmental atmosphere, and 24/7 accessibility regardless of location, with offline formats that foster local, in-person community ties, is a promising concept for facilitating recovery-oriented care, and warrants continued research.

scholarly journals Stroke Telerehabilitation in Calabria: A Health Technology Assessment

2022 ◽  
Vol 12 ◽  
Author(s):  
Contrada Marianna ◽  
Arcuri Francesco ◽  
Tonin Paolo ◽  
Pignolo Loris ◽  
Mazza Tiziana ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Low Income ◽  
Cognitive Rehabilitation ◽  
Low Income Countries ◽  
Rehabilitation Services ◽  
Stroke Patients ◽  
Post Stroke ◽  
Home Service ◽  
Rehabilitation System ◽  
Specialist Rehabilitation

Introduction: Telerehabilitation (TR) is defined as a model of home service for motor and cognitive rehabilitation, ensuring continuity of care over time. TR can replace the traditional face-to-face approach as an alternative method of delivering conventional rehabilitation and applies to situations where the patient is unable to reach rehabilitation facilities or for low-income countries where outcomes are particularly poor. For this reason, in this study, we sought to demonstrate the feasibility and utility of a well-known TR intervention on post-stroke patients living in one of the poorest indebted regions of Italy, where the delivery of rehabilitation services is inconsistent and not uniform.Materials and Methods: Nineteen patients (13 male/6 female; mean age: 61.1 ± 8.3 years) with a diagnosis of first-ever ischemic (n = 14) or hemorrhagic stroke (n = 5), who had been admitted to the intensive rehabilitation unit (IRU) of the Institute S. Anna (Crotone, Italy), were consecutively enrolled to participate in this study. After the discharge, they continued the motor treatment remotely by means of a home-rehabilitation system. The entire TR intervention was performed (online and offline) using the Virtual Reality Rehabilitation System (VRRS) (Khymeia, Italy). All patients received intensive TR five times a week for 12 consecutive weeks (60 sessions, each session lasting about 1h).Results: We found a significant motor recovery after TR protocol as measured by the Barthel Index (BI); Fugl-Meyer motor score (FM) and Motricity Index (MI) of the hemiplegic upper limbs.Conclusions: This was the first demonstration that a well-defined virtual reality TR tool promotes motor and functional recovery in post-stroke patients living in a low-income Italian region, such as Calabria, characterized by a paucity of specialist rehabilitation services.

Enhancing Access of Combat-Wounded Veterans to Specialist Rehabilitation Services: The VA Polytrauma Telehealth Network

2008 ◽  
Vol 89 (1) ◽  
pp. 182-187 ◽  
Author(s):  
Adam Darkins ◽  
Cathy Cruise ◽  
Michael Armstrong ◽  
John Peters ◽  
Michael Finn
Keyword(s):  
Rehabilitation Services ◽  
Specialist Rehabilitation

Meaningful Ways of Understanding and Measuring Change for People with Borderline Personality Disorder: A Thematic Analysis

2018 ◽  
Vol 46 (5) ◽  
pp. 528-540 ◽  
Author(s):  
Louise McCusker ◽  
Marie-Louise Turner ◽  
Georgina Pike ◽  
Helen Startup
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Borderline Personality ◽  
Complex Nature ◽  
Service Users ◽  
Starting Point ◽  
Wide Range ◽  
Measuring Change

Background:The effective treatment of Borderline Personality Disorder (BPD) presents healthcare providers with a significant challenge. The evidence base remains limited partially due to a lack of professional consensus and service user involvement regarding ways of measuring change. As a result, the limited evidence that is available draws on such a wide range of outcome measures, that comparison across treatment types is hindered, maintaining a lack of clarity regarding the clinical needs of this group.Aims:This investigation aimed to follow the National Institute of Clinical Excellence (NICE, 2009) research recommendations by asking service users about meaningful change within their recovery. This forms a starting point for the future development of a tailored outcome measure.Method:Fifteen service users with a diagnosis of BPD participated in three focus groups across two specialist Personality Disorder services. The focus groups were analysed using Thematic Analysis.Results:Two superordinate themes were synthesized from the data: (1) recovery to what?: ‘How do you rewrite who you are?’; and (2) conditions for change. Each superordinate theme further consisted of three subordinate themes which elucidated the over-arching themes.Conclusion:This investigation highlights the complex nature of measuring change in people who have received a BPD diagnosis. Further research is needed to develop meaningful ways of measuring change according to the needs and priorities of people with BPD.

Enhancing Successful Employment Outcomes for People with a Psychiatric Disability

1997 ◽  
Vol 3 (2) ◽  
pp. 57-64
Author(s):  
Maxie Ashton ◽  
Josephine Dowsett
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Focus Groups ◽  
Service Providers ◽  
Psychiatric Disability ◽  
Rehabilitation Services ◽  
Important Goal ◽  
Rehabilitation Process ◽  
Successful Employment

Work, for most people with psychiatric disability, is their most important goal and yet they often have more difficulty getting work and maintaining work than other disability groups. Six focus groups were held with consumers of mental health services to explore the reason for this and identify what rehabilitation services should do about this problem. The groups recommended many strategies which have been divided by the authors into three rehabilitation phases. Three check lists have been developed to assist service providers address the range of needs with consumers during the rehabilitation process and to identify service gaps.

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