scholarly journals The Fundamental Paradox in the Grief Literature: A Critical Reflection

2007 ◽  
Vol 55 (3) ◽  
pp. 199-218 ◽  
Author(s):  
Lauren J. Breen ◽  
Moira O'Connor
Keyword(s):  
Service Provision ◽  
Critical Reflection ◽  
Service Providers ◽  
Complicated Grief ◽  
Sociocultural Factors ◽  
Grief Theories

A key theme in the bereavement literature is the recognition that every grief experience is unique and dependent on many variables, such as the circumstances of the death, characteristics of the bereaved individual, their relationship with the deceased, the provision and availability of support, and a myriad of sociocultural factors. Concurrently, there are corresponding efforts to define “normal” grief and delineate it from “complicated” grief experiences. The discord between these two potentially opposing statements remains a paradox evident within the three major tensions within the thanatological literature—the dominance of grief theories, the medicalization of grief, and the efficacy of grief interventions. Three recommendations for moving beyond the paradox are discussed—the provision of improved grief education for service providers, the bereaved, and the wider community; the conduct of research that emphasizes the context of grief and is relevant to service provision; and the examination of current grief interventions.

scholarly journals Service providers’ use of harm reduction approaches in working with older adults experiencing abuse: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Donna Goodridge ◽  
Kerstin Stieber Roger ◽  
Christine A. Walsh ◽  
Elliot PausJenssen ◽  
Marina Cewick ◽  
...  
Keyword(s):  
Older Adults ◽  
Harm Reduction ◽  
Professional Practice ◽  
Service Provision ◽  
Service Providers ◽  
Qualitative Interviews ◽  
Risk Environment ◽  
Intervention Process ◽  
Process Enactment ◽  
Humanistic Approach

Abstract Background Although abuse experienced by older adults is common and expected to increase, disclosure, reporting and interventions to prevent or mitigate abuse remain sub-optimal. Incorporating principles of harm reduction into service provision has been advocated as a strategy that may improve outcomes for this population. This paper explores whether and how these principles of harm reduction were employed by professionals who provide services to older adults experiencing abuse. Methods Thematic analysis of qualitative interviews with 23 professionals providing services to older adults experiencing abuse across three Western provinces of Canada was conducted. Key principles of harm reduction (humanism, incrementalism, individualism, pragmatism, autonomy, and accountability without termination) were used as a framework for organizing the themes. Results Our analysis illustrated a clear congruence between each of the six harm reduction principles and the approaches reflected in the narratives of professionals who provided services to this population, although these were not explicitly articulated as harm reduction by participants. Each of the harm reduction principles was evident in service providers’ description of their professional practice with abused older adults, although some principles were emphasized differentially at different phases of the disclosure and intervention process. Enactment of a humanistic approach formed the basis of the therapeutic client-provider relationships with abused older adults, with incremental, individual, and pragmatic principles also apparent in the discourse of participants. While respect for the older adult’s autonomy figured prominently in the data, concerns about the welfare of the older adults with questionable capacity were expressed when they did not engage with services or chose to return to a high-risk environment. Accountability without termination of the client-provider relationship was reflected in continuation of support regardless of the decisions made by the older adult experiencing abuse. Conclusions Harm reduction approaches are evident in service providers’ accounts of working with older adults experiencing abuse. While further refinement of the operational definitions of harm reduction principles specific to their application with older adults is still required, this harm reduction framework aligns well with both the ethical imperatives and the practical realities of supporting older adults experiencing abuse.

scholarly journals Development of clinical guidelines for service provision of functional electrical stimulation to support walking: mixed method exploration of stakeholder views

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
C Bulley ◽  
C Meagher ◽  
T Street ◽  
A Adonis ◽  
C Peace ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Clinical Guidelines ◽  
Service Provision ◽  
Clinical Guideline ◽  
Service Providers ◽  
Delphi Consensus ◽  
Stakeholder Views ◽  
Key Stakeholders ◽  
The Uk

Abstract Background Over the past 20 years Functional Electrical Stimulation (FES) has grown in clinical use to support walking in people with lower limb weakness or paralysis due to upper motor neuron lesions. Despite growing consensus regarding its benefits, provision across the UK and internationally is variable. This study aimed to explore stakeholder views relating to the value of a clinical guideline focusing on service provision of FES to support walking, how people might use it and what should be included. Methods A mixed methods exploration sought the views of key stakeholders. A pragmatic online survey (n = 223) focusing on the study aim was developed and distributed to the email distribution list of the UK Association for Chartered Physiotherapists Interested in Neurology (ACPIN). In parallel, a qualitative service evaluation and patient public involvement consultation was conducted. Two group, and seven individual interviews were conducted with: FES-users (n = 6), their family and carers (n = 3), physiotherapists (n = 4), service providers/developers (n = 2), researchers (n = 1) and distributors of FES (n = 1). Descriptive analysis of quantitative data and framework analysis of qualitative data were conducted. Results Support for clinical guideline development was clear in the qualitative interviews and the survey results. Survey respondents most strongly endorsed possible uses of the clinical guideline as ensuring best practice and supporting people seeking access to a FES service. Data analysis and synthesis provided clear areas for inclusion in the clinical guidelines, including current research evidence and consensus relating to who is most likely to benefit and optimal service provision as well as pathways to access this. Specific areas for further investigation were summarised for inclusion in the first stage of a Delphi consensus study. Conclusions Key stakeholders believe in the value of a clinical guideline that focuses on the different stages of service provision for FES to support walking. A Delphi consensus study is being planned based on the findings.

scholarly journals Carer experience of end-of-life service provision: a social network analysis

2018 ◽  
Vol 10 (2) ◽  
pp. e20-e20 ◽  
Author(s):  
Rosemary Leonard ◽  
Debbie Horsfall ◽  
John Rosenberg ◽  
Kerrie Noonan
Keyword(s):  
Social Network ◽  
Social Network Analysis ◽  
Network Analysis ◽  
End Of Life ◽  
Service Provision ◽  
End Of Life Care ◽  
Service Providers ◽  
Informal Networks ◽  
Formal Service ◽  
Similar Density

ObjectiveTo identify the position of formal service providers in the networks of those providing end-of-life care in the home from the perspective of the informal network.MethodsUsing third-generation social network analysis, this study examined the nature and strength of relationships of informal caring networks with formal service providers through individual carer interviews, focus groups of caring networks and outer network interviews.ResultsService providers were usually highly valued for providing services, equipment, pain management and personalised care for the dying person plus support and advice to the principal carer about both caring tasks and negotiating the health system. However, formal service providers were positioned as marginal in the caring network. Analysis of the relative density of relationships within networks showed that whereas relationships among family and friends had similar density, relationships between service providers and family or friends were significantly lower.ConclusionThe results supported the Circles of Care model and mirror the perspective of formal service providers identified in previous research. The research raises questions about how formal and informal networks might be better integrated to increase their effectiveness for supporting in-home care.

Connecting Theory With Practice: The Institutional Evolvement of U.S. Counties Functioning as Regional Service Providers

2017 ◽  
Vol 48 (8) ◽  
pp. 808-821 ◽  
Author(s):  
Jayce L. Farmer
Keyword(s):  
Service Provision ◽  
Service Providers ◽  
Institutional Arrangements ◽  
County Government ◽  
Home Rule ◽  
Long Term Effects ◽  
Government Structure ◽  
County Governments ◽  
Regional Service

This study extends the literature on county government structure by examining the three basic forms of county governments and their long-term effects on regional service spending. An examination of 1,532 U.S. counties between 1977 and 2012 reveals that those with the commission government form produce on average less regional service spending than those with reformed government structures. Examining the two major distinctions in reformed government types reveals that elected executive governments spend on average more than those with the commission-administrator form. However, the amount of increase for elected executive spending was very minor. The findings also reveal that the ability to establish home rule charters alters the effects of government structure for commission and commission-administrator counties. Meanwhile, charter-enabling laws matter little regarding the effects for elected executive counties. The analytical results lead to four major points for consideration regarding the link between county service provision and county institutional arrangements.

Employing proactive interaction for service failure prevention to improve customer service experiences

2017 ◽  
Vol 27 (1) ◽  
pp. 164-186 ◽  
Author(s):  
Hyunju Shin ◽  
Alexander E. Ellinger ◽  
David L. Mothersbaugh ◽  
Kristy E. Reynolds
Keyword(s):  
Customer Service ◽  
Service Provision ◽  
Service Providers ◽  
Service Failure ◽  
Marketing Research ◽  
Theory And Practice ◽  
Future Research ◽  
Content Type ◽  
Failure Prevention ◽  
Patronage Behavior

Purpose Services marketing research continues to be largely focused on firms’ reactive interactions for recovering from service failure rather than on proactive customer interactions that may prevent service failure from occurring in the first place. Building on previous studies that assess the efficacy of implementing proactive interaction in service provision contexts, the purpose of this paper is to compare the influences of proactive interaction to prevent service failure and reactive interaction to correct service failure on customer emotion and patronage behavior. Since proactive interaction for service failure prevention is a relatively underexplored and resource-intensive approach, the authors also assess the moderating influences of customer and firm-related characteristics. Design/methodology/approach The study hypotheses are tested with survey data from two scenario-based experiments conducted in a retail setting. Findings The findings reveal that customers prefer service providers that take the initiative to get to them before they have to initiate contact for themselves. The findings also identify the moderating influences of relationship quality, situational involvement, and contact person status and motive. Originality/value The research contributes to the development of service provision theory and practice by expanding on previous studies which report that proactive efforts to prepare customers for the adverse effects of service failure are favorably received. The results also shed light on moderating factors that may further inform the exploitation of resource-intensive proactive interaction for service failure prevention. An agenda is proposed to stimulate future research on proactive customer interaction to prevent service failure in service provision contexts.

Legal, Regulatory, and Institutional Framework of Water and Sanitation Services in the Eastern and Southern Africa Region

2021 ◽  
Author(s):  
Yvonne Magawa
Keyword(s):  
Southern Africa ◽  
Service Provision ◽  
Service Providers ◽  
Disease Outbreaks ◽  
Sanitation Services ◽  
Regulatory Cooperation ◽  
Development Goals ◽  
Eastern And Southern Africa

Deteriorating quality of service provision and disease outbreaks (such as cholera) led to the institution of water supply and sanitation (WSS) sector reforms in Eastern and Southern Africa region in the 1990s. The realization of the urgent need to improve the performance of the sector, especially as related to health impacts, resulted in the formulation of new policy and legal and institutional frameworks to reorganize the sector and establish regulators who could address networked and nonnetworked WSS systems. Regulators as policy implementers have the delicate role of balancing the interests of government, service providers, and consumers. Decision- makers continue to design, implement, and evaluate the outcomes associated with new frameworks. Regional regulatory cooperation can accelerate improvements in service provision to meet the United Nations Sustainable Development Goals through development of common frameworks and approaches for WSS that can be adapted to unique country situations.

Customer Value Dimensions in E-Healthcare Services

2018 ◽  
pp. 42-55
Author(s):  
Kirsti Lindberg-Repo ◽  
Apramey Dube
Keyword(s):  
Value Creation ◽  
Service Provision ◽  
Customer Value ◽  
Healthcare Service ◽  
Service Providers ◽  
Healthcare Services ◽  
Limited Attention ◽  
Customer Expectations ◽  
Temporal Aspect ◽  
Narrative Techniques

Healthcare services have been extensively researched for customer value creation activities. There has been, however, limited attention on the dimensions of customer value, as reported by customers themselves, in e-healthcare services. The purpose of this paper is to investigate customer value dimensions in which customers experience e-healthcare services. Narrative techniques were used to investigate customer experiences of e-healthcare services offered by eight private Finnish providers. The findings show that customers evaluate e-healthcare services in four value dimensions: 1) The outcome of e-healthcare service (‘What'), 2) The process of e-healthcare service (‘How'), 3) The responsiveness and temporal aspect of e-healthcare service (‘When'), and, 4) The location of e-healthcare service provision (‘Where'). The value dimensions reflect customer expectations that service providers can fulfill for improved customer value creation. To the best of the authors' knowledge, this study is one of the first researches to investigate customer value dimensions in e-healthcare services in Finland.

scholarly journals Partnering for change

2019 ◽  
Vol 34 (3) ◽  
pp. 255-272 ◽  
Author(s):  
Martha L.P. MacLeod ◽  
Neil Hanlon ◽  
Trish Reay ◽  
David Snadden ◽  
Cathy Ulrich
Keyword(s):  
Primary Healthcare ◽  
Health Authority ◽  
Service Provision ◽  
Service Providers ◽  
Processes Of Change ◽  
Content Type ◽  
The Status ◽  
Managing Risk ◽  
Healthcare Transformation

Purpose Despite many calls to strengthen connections between health systems and communities as a way to improve primary healthcare, little is known about how new collaborations can effectively alter service provision. The purpose of this paper is to explore how a health authority, municipal leaders and physicians worked together in the process of transforming primary healthcare. Design/methodology/approach A longitudinal qualitative case study was conducted to explore the processes of change at the regional level and within seven communities across Northern British Columbia (BC), Canada. Over three years, 239 interviews were conducted with physicians, municipal leaders, health authority clinicians and leaders and other health and social service providers. Interviews and contextual documents were analyzed and interpreted to articulate how ongoing transformation has occurred. Findings Four overall strategies with nine approaches were apparent. The strategies were partnering for innovation, keeping the focus on people in communities, taking advantage of opportunities for change and encouraging experimentation while managing risk. The strategies have bumped the existing system out of the status quo and are achieving transformation. Key components have been a commitment to a clear end-in-view, a focus on patients, families, and communities, and acting together over time. Originality/value This study illuminates how partnering for primary healthcare transformation is messy and complicated but can create a foundation for whole system change.

scholarly journals Mental health promotion for gay, lesbian, bisexual, transgender and intersex New Zealanders

2013 ◽  
Vol 5 (2) ◽  
pp. 105 ◽  
Author(s):  
Jeffery Adams ◽  
Pauline Dickinson ◽  
Lanuola Asiasiga
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
General Population ◽  
Service Provision ◽  
Social Acceptance ◽  
Service Providers ◽  
Mental Health Promotion ◽  
Factors Affecting ◽  
Key Informants ◽  
New Zealanders

INTRODUCTION: A number of studies have identified that gay, lesbian, bisexual, transgender, and intersex (GLBTI) people have poorer mental health than the general population. This article describes current mental health promotion and service provision for GLBTI people in New Zealand, and the views of stakeholders on current service delivery and concerns facing the sector. METHODS: An email survey of service providers gathered descriptive data about mental health promotion and services provided for GLBTI people. Data obtained from interviews with key informants and online submissions completed by GLBTI individuals were analysed thematically. FINDINGS: Five organisations provide clear, specific and utilised services and programmes to some or all of the GLBTI populations. Twelve GLBTI-focused mental health promotion resources are identified. The analysis of data from key informants and GLBTI respondents identified factors affecting mental health for these populations occurring at three levels—macro-social environment, social acceptance and connection, and services and support. CONCLUSION: While GLBTI individuals have the same basic mental health promotion and service provision needs as members of the general population, they have additional unique issues. To enhance the mental health of GLBTI New Zealanders, a number of actions are recommended, including building sector capacity, allocating sufficient funding, ensuring adequate research and information is available, and reducing stigma, enhancing young people’s safety, and supporting practitioners through training and resources. An important role for government, alongside GLBTI input, for improving mental health is noted. KEYWORDS: General practice; mental health; sexuality; social discrimination

Child Sexual Abuse and the Complexities of Gender, Power, and Sexuality

2020 ◽  
pp. 088626052090919
Author(s):  
Rhoda Reddock ◽  
Sandra D. Reid ◽  
Tisha Nickenig
Keyword(s):  
Sexual Abuse ◽  
Action Research ◽  
Child Sexual Abuse ◽  
Trinidad And Tobago ◽  
Research Methodology ◽  
Service Providers ◽  
Sociocultural Factors ◽  
Community Based Interventions ◽  
Research Activities ◽  
The Caribbean

This article contributes to the still limited analysis of gender and sexuality in the exploration of HIV infection in the Caribbean. In Trinidad and Tobago, child sexual abuse was identified as a prevalent behavior. This motivated a gendered exploration of the sociocultural factors underlying child sexual abuse and the link with HIV. Using a qualitative action research methodology, researchers sought to understand the patterns of behavior, sociocultural and gendered meanings, and significance of child sexual abuse; to sensitize stakeholders to these issues; and to develop multidisciplinary community-based interventions and policies. This article reports on the analysis of data collected from the interventions carried out as part of the action research methodology, as well as a range of national and community-specific action research activities including ethnographic case studies, national stakeholders meetings, and a study of service providers. It provides a nuanced understanding of the meanings, underlying assumptions, perceptions, and taboos associated with child sexual abuse in Trinidad and Tobago, as well as new ways of understanding child sexual abuse in the Caribbean. Findings showed that the social and gender context for child sexual abuse involves several interconnecting factors located within a framework of gender ideologies and expressions, sexual expectations and behaviors, and social norms based on patriarchal values. These findings would be of significance for the prevention of child sexual abuse and the associated HIV risk in Trinidad and Tobago, and the management of victims and perpetrators of child sexual abuse.

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