scholarly journals Use of a Realist Evaluation to Understand what works when Delivering Healthcare in an Alternative Setting

2021 ◽  
Author(s):  
◽  
Kerry A. Dare

Evaluation Aims This thesis outlines the Realist Evaluation of Swansea University’s Health and Wellbeing Academy, answering the evaluation question of, ‘Does the Health and Wellbeing Academy work, for whom does it work, in what ways and why?’ Methods The evaluation was split into three components including a Stakeholder Perspective Exploration, and Realist Evaluations of two programmes. Mixed methods were used to collect data from a range of stakeholders including programme users and facilitators, outlining the conditions in which the academy works, for whom and why. Findings and Recommendations Findings indicate the academy ‘works’ and is progressing towards its value of focusing on population needs by complementing the NHS, its mission of enhancing student placement opportunities, and its aim of providing holistic, person-centred care. Findings reveal that utilising the unique skill set of stakeholders affiliated with its university context (e.g., academic health care staff) are beneficial in achieving aims, values, and missions. Findings indicate the Academy facilitates internal, ‘home-grown’ programmes more so than external programmes, and that external programmes would benefit from a dedicated champion/manager to ensure the programmes longevity. Findings indicated that offering evidence-based programmes are successful at improving service user outcomes within this setting and again, suggest that unique contextual factors of the Academy (e.g., skillset of academics) facilitate the development of valuable programmes for Academy provision. Further, findings indicate the Academy offers a service in-line with visions outlined in core Welsh healthcare policy and is well-placed to contribute to the transformation of the Welsh NHS. Recommendations for the Academy to progress towards other aims include utilising the skillset of internal stakeholders to develop a research and evaluation framework, clarifying its aims, and outlining practical steps towards achieving these, by developing a logic model of the Academy, to ensure join-up between service areas, ensuring that programmes are operating in consistent and measurable way.

Author(s):  
E. Rydwik ◽  
L. Anmyr ◽  
M. Regardt ◽  
A. McAllister ◽  
R. Zarenoe ◽  
...  

Abstract Background The knowledge of the long-term consequences of covid-19 is limited. In patients, symptoms such as fatigue, decreased physical, psychological, and cognitive function, and nutritional problems have been reported. How the disease has affected next of kin, as well as staff involved in the care of patients with covid-19, is also largely unknown. The overall aim of this study is therefore three-fold: (1) to describe and evaluate predictors of patient recovery, the type of rehabilitation received and patients’ experiences of specialized rehabilitation following COVID-19 infection; (2) to study how next of kin experienced the hospital care of their relative and their experiences of the psychosocial support they received as well as their psychological wellbeing; (3) to describe experiences of caring for patients with COVID-19 and evaluate psychological wellbeing, coping mechanisms and predictors for development of psychological distress over time in health care staff. Methods This observational longitudinal study consists of three cohorts; patients, next of kin, and health care staff. The assessments for the patients consist of physical tests (lung function, muscle strength, physical capacity) and questionnaires (communication and swallowing, nutritional status, hearing, activities of daily living, physical activity, fatigue, cognition) longitudinally at 3, 6 and 12 months. Patient records auditing (care, rehabilitation) will be done retrospectively at 12 months. Patients (3, 6 and 12 months), next of kin (6 months) and health care staff (baseline, 3, 6, 9 and 12 months) will receive questionnaires regarding, health-related quality of life, depression, anxiety, sleeping disorders, and post-traumatic stress. Staff will also answer questionnaires about burnout and coping strategies. Interviews will be conducted in all three cohorts. Discussion This study will be able to answer different research questions from a quantitative and qualitative perspective, by describing and evaluating long-term consequences and their associations with recovery, as well as exploring patients’, next of kins’ and staffs’ views and experiences of the disease and its consequences. This will form a base for a deeper and better understanding of the consequences of the disease from different perspectives as well as helping the society to better prepare for a future pandemic.


2021 ◽  
pp. 152483992110035
Author(s):  
Jennifer Utter ◽  
Sally McCray

Family meals provide a unique opportunity for families to eat well and engage positively with each other. In response to the challenges presented by the COVID-19 (coronavirus disease 2019) pandemic, a new initiative to support health care staff to share healthy meals with their families was developed. At a hospital in Queensland, Australia, dietetic staff collaborated with the on-site food service retailer to develop and offer a range of hot meals that staff could take home for their families at the end of their day. The meals were nutritious, reasonably priced, and designed to feed a family of four. The dietetic staff worked with the hospital marketing department and staff health and wellness program to promote the initiative. Over the 3 months that it has been running, nearly 300 meals have been purchased. Anecdotal comments from the food service retailer highlighted that the initiative was a good thing to do for staff to maintain a positive reputation of the business. The staff evening meal initiative is a healthy, affordable, educational, and socially engaging alternative to takeaway meals and food delivery by app, and it is mutually beneficial for health care staff and the on-site food retailer. The initiative also offers a unique opportunity for promoting nutrition and social engagement during stressful times.


2019 ◽  
Vol 46 (1) ◽  
pp. 44-54
Author(s):  
Deb Mitchell ◽  
Kelly-Ann Bowles ◽  
Lisa O'Brien ◽  
Anne Bardoel ◽  
Terry Haines

2002 ◽  
Vol 6 (4) ◽  
pp. 309-323 ◽  
Author(s):  
Anne-Marie Aish ◽  
Inga-Lill Ramberg ◽  
Danuta Wasserman

2021 ◽  
Vol 24 (2) ◽  
pp. 54-64
Author(s):  
Zeibeda (Zeb) Sattar ◽  
Stephanie Wilkie ◽  
Jonathan Ling

Purpose This paper aims to explore residents' perceptions of a refurbishment programme to sheltered housing schemes and its impact on their well-being. Design/methodology/approach The methodology draws upon a realist evaluation framework. Four participatory appraisals (PAs) and 19 interviews with residents were conducted in the sheltered housing schemes. Ages of participants ranged from 50 to 99 years. Findings Two categories of residents were identified: healthy active older adults and older frail adults (or over 85+). Residents said their social and emotional well-being improved from the provision of indoor and outdoor communal areas. Older frail residents only accessed the new communal spaces when staff took them in their wheelchairs. The physical changes increased opportunities for social connections for residents. Conservatories and sensory gardens were most popular. Residents felt that structured activities in the new spaces and digital training would improve their social activities. Research limitations/implications The participatory methods spanned over an hour, and some residents felt too tired to complete the full session. Practical implications A practical limitation was that some sensory rooms were not fully completed at the time of the evaluation. Originality/value This paper adds the following: Perceptions of residents of a refurbishment programme in sheltered housing and the impact on their well-being. Perceptions of residents about social activities after a refurbishment programme. Perceptions of residents about the impact of physical changes to their sheltered housing schemes and impact on their internal accessibility to the improvements.


2007 ◽  
Vol 122 (5) ◽  
pp. 573-578 ◽  
Author(s):  
Peter J. Levin ◽  
Eric N. Gebbie ◽  
Kristine Qureshi

The federal pandemic influenza plan predicts that 30% of the population could be infected. The impact of this pandemic would quickly overwhelm the public health and health-care delivery systems in the U.S. and throughout the world. Surge capacity for staffing, availability of drugs and supplies, and alternate means to provide care must be included in detailed plans that are tested and drilled ahead of time. Accurate information on the disease must be made available to health-care staff and the public to reduce fear. Spokespersons must provide clear, consistent messages about the disease, including actions to be taken to contain its spread and treat the afflicted. Home care will be especially important, as hospitals will be quickly overwhelmed. Staff must be prepared ahead of time to assure their ability and willingness to report to work, and public health must plan ahead to adequately confront ethical issues that will arise concerning the availability of treatment resources. The entire community must work together to meet the challenges posed by an epidemic. Identification and resolution of these challenges and issues are essential to achieve adequate public health preparedness.


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