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Cooperation between voluntary organisations and volunteers within healthcare services contributes to the development of public welfare. The coordination process between healthcare services and volunteers must therefore be studied to understand associated challenges and best practices. This paper presents a systematic literature review of studies that have used qualitative methods. The review was conducted to identify the knowledge base concerning these issues. The search was performed in 4 April 2019 on five databases: EbscoHost, Ovid, Scopus, Emerald and Svemed+. The selection criteria included papers published between 1 January 2009 and 4 April 2019. In total, 5,340 papers were extracted; after removing duplicates and screening titles and abstracts, 49 papers were independently read by two of the authors. Ten papers addressed the research question and were thus included for further investigation. The Critical Appraisal Skills Programme (CASP) checklist was used to check the eligibility of the papers, all of which were found to be of sufficient quality for analysis. A thematic analysis for synthesising qualitative research was used to identify key challenges in the coordination process and the best practices needed to deal with these challenges. The findings demonstrated the pursuit of a common understanding between employees and volunteers and described challenges in organising the associated work. The main solution applied to these challenges was the involvement of a volunteer coordinator. Although several identified challenges remained unresolved, the papers selected for this review provide an overall picture of volunteer cooperation in health services. [ABSTRACT FROM AUTHOR]

Health and social care professionals' competencies have traditionally been separated because of the different aims of the two professions. These competencies need to be integrated, to make sure that seamless services are provided that meet the often complex needs of patients and clients in a coordinated and timely way. The aim of this integrative review was to identify, describe and synthetise previous studies on integrated competencies in health and social care. Electronic literature searches were carried out on the CINAHL, ProQuest, PsycInfo, PubMed, Scopus and SocIndex databases for peer‐reviewed scientific papers that were published in English between 1 January 2007 and 31 December 2019. This identified 3,231 papers, after duplicates were removed, and 18 focused on the integration of social workers' competencies with health care. Other types of integration were not found. The value added by integrating social workers' competencies with health care focused on engaging working orientation, improving communication with family members, increasing understanding of service resources and mastering successful discharge procedures so that they met comprehensive, complex health and well‐being needs. Social workers added value when they worked with multi‐professional teams, but there were challenges to integrating competencies and these were related to professional collaboration and fragmented leadership. In future, more attention needs to be paid to diversifying and optimising the integration of professional health and social care competencies that meet clients' and patients' care and service needs. It is also vital to focus on developing the professional and leadership strategies that are needed to combine those competencies. [ABSTRACT FROM AUTHOR]

Abstract: The ways in which mobile phones have transformed the boundaries of time and space and the possibilities of communication have profoundly affected our lives. However, there is little research on the use of mobiles in social care though evidence is emerging that mobile phones can play an important role in delivering services. This paper is based on a scoping review of the international literature in this area. A typology of mobile interventions is suggested. While most mobile phone interventions remain unidirectional and sit within traditional social care service provider–service user relationships, a minority are bi‐ or multidirectional and contain within them the potential to transform these traditional relationships by facilitating a collective development of social networks and social capital. Such transformations are accompanied by a range of issues and dilemmas that have made many service providers reluctant to engage with new technologies. We suggest that our typology is a useful model to draw on when researching the use of mobile phones in social care to support and empower isolated, marginalised and vulnerable service users. [ABSTRACT FROM AUTHOR]

Crisis intervention services for people experiencing psychological distress and suicidal ideation are frequently described by the people accessing them as failing to meet their needs. This paper reports a prominent finding from a realist evaluation of Taranaki Retreat—a charitable, non‐clinical organisation in New Zealand, which offers free respite for people experiencing acute distress. Using qualitative methods, the study aimed to move beyond vague notions regarding the helpfulness of respite, to a deeper understanding of the contextual factors and mechanisms which generate outcomes for such an intervention. Participant observation, focus groups with staff, semi‐structured interviews with service users, and analysis of service users' case notes were conducted over a six‐month period in 2018. The most prominent finding from the study related to 'genuine care'—care which is interpreted by the recipient as being motivated by a genuine desire to help. We present this finding as to the central mechanism in a wider programme theory developed through the realist evaluation study. We also present five key features of the care participants were offered at Taranaki Retreat which contributed to their common interpretation regarding the motivations behind this care. Upon considering the centrality of this mechanism we conclude that, in designing crisis interventions, greater consideration should be given to how the intervention can demonstrate genuine care. Having highlighted the ways in which the structure of charitable organisations appears conducive for interpretations of genuine care, we further conclude that the provision of comprehensive crisis intervention by charitable organisations should be further explored and supported. [ABSTRACT FROM AUTHOR]

Adults with intellectual disabilities experience significant physical and mental health needs when compared to their typically developing peers. Previous research evidences that many people with intellectual disabilities have negative encounters within acute hospitals. The aim of this systematic review was to identify the specific views and experiences of adults with intellectual disabilities when accessing acute hospital services arising from the available literature. The review commenced in June 2019 and was updated in May 2020. A systematic search of five electronic databases including CINAHL Plus, MEDLINE, Web of Science, SCOPUS and PsycINFO was undertaken. Studies published from 2014, peer‐reviewed, written in English and referred to adults with intellectual disabilities aged 18 plus and acute hospital settings were included. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines and the Critical Appraisal Skills Programme quality assurance checklist were used to review all selected papers. Five studies from a total of 421 were deemed suitable for inclusion in the review as the voices of adults with intellectual disabilities were present. Poor communication from healthcare staff towards adults with intellectual disabilities emerged in four studies while the use of the hospital passport and the intellectual disability liaison nurse to significantly improve the hospital experience for adults with intellectual disabilities was identified in two of the studies. Following a systematic and thematic analysis of the studies, three main overarching themes emerged: communication; information sharing; and compassion and respect. Despite the national and international focus on improving healthcare for people with intellectual disabilities, this review highlights lack of communication, inadequate information sharing and issues related to compassionate care and respect. The review identifies the possibility that an increased use of hospital passports and an extension of the intellectual disability liaison nursing roles may enhance the hospital experience for people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

A need for people‐centred health and social support systems is acknowledged as a global priority. Most nations face challenges in providing safe, effective, timely, affordable, coordinated care around the needs and preferences of people who access integrated health and social care (IHSC) services. Much of the current research in the field focuses on describing and evaluating specific models for delivering IHSC. Fewer studies focus on person‐centred experiences, needs and preferences of people who use these services. However, current international guidance for integrated care sets a precedence of person‐centred integrated care that meets the health and well‐being needs of people who access IHSC services. This integrative literature review synthesises empirical literature from six databases (CINAHL; MEDLINE; AMED; TRIP; Web of Science and Science Direct; 2007–2019). This review aims to better understand the experiences and health and well‐being needs of people who use IHSC services in a community setting. Twenty studies met the inclusion criteria and results were thematically analysed. Three overarching themes were identified, including relationships, promoting health and well‐being and difficulty understanding systems. Findings of this review indicate that relationships hold significance in IHSC. People who access IHSC services felt that they were not always involved in planning their care and that there was a lack of clarity in navigating integrated systems; subsequently, this impacted upon their experiences of those services. However, service user and informal carer voices appear to be underrepresented in current literature and studies that included their views were found to be of low quality overall. Collectively, these findings support the need for further research that explores the person‐centred experiences and needs of people who access IHSC. [ABSTRACT FROM AUTHOR]

The decline of language and communication abilities is common among people living with dementia and impacts on many areas of everyday life, including active participation in social activities and decision‐making. Despite a growing body of supporting evidence for approaches that address language and communication decline in dementia, the concept of communication rehabilitation is largely neglected in this population. This paper reports on the content validation of a novel tool, the Communication Support Needs Assessment Tool for Dementia (CoSNAT‐D). The tool has been developed to assist in the initial identification of communication difficulties and related support needs of people living with dementia. Importantly, the CoSNAT‐D is the only available tool that takes a three‐way informed approach, considering the view of the person living with dementia, their carer and an administering healthcare professional. Content validity was established between September and December 2018 using a modified Delphi approach. An international expert panel rated 32 items of a face‐validated item pool regarding their importance and relevance through an iterative feedback process. Consensus was pre‐determined at 70% of agreement for both importance and relevance of an item. Data were analysed using descriptive statistics and qualitative content analysis of comments provided in each round. Twenty‐eight experts working in dementia, language and communication participated in the Delphi survey. Qualitative analysis resulted in the addition of five items, of which three reached the required consensus in Round 3. Consensus was established for 35/37 items in three rounds. The pilot version of the CoSNAT‐D demonstrates adequate content validity and face validity. The use of the CoSNAT‐D may assist a range of healthcare professionals in the decision‐making process about appropriate next management steps, and thereby improve the care path for people with dementia and language and communication impairment. The establishment of further psychometric properties is warranted. [ABSTRACT FROM AUTHOR]

Social determinants profoundly impact health. Many primary care practices now seek to screen their patients for health‐related social needs (HRSN) and refer them to resources in the community. However, there is little empirical evidence to guide communication with patients in order to ensure their comfort with the process and increase the likelihood that it results in positive outcomes. This paper describes the first phase of the Improving Messaging Around Gaps in Needs and rEfferals (IMAGINE) study—a multi‐phase study aiming to develop and test patient‐centred messages about screening and referral for HRSN. In this initial qualitative phase, our objective was to identify communication strategies that might make western Colorado primary care patients more comfortable with the HRSN screening and referral process. From May to July 2020 we interviewed 10 staff members responsible for HRSN screening from primary care practices participating in the western Colorado Accountable Health Communities (AHC) initiative and 20 patients from 2 of these practices. We used a rapid qualitative analysis process that involved summarising interview transcripts across key domains of interest and then identifying emergent themes within each domain using a data matrix. Through this process, we examined current communication about HRSN screening, as well as suggestions for messages and other strategies that could improve communication. In most practices, the AHC Screening Tool was handed to patients by front desk staff at check‐in with little explanation as to its purpose. Patients and staff alike recommended that patients be provided with information that: normalises the screening and referral process; assures privacy; clarifies that the purpose is to help and support rather than judge or report; emphasises community benefits; and respects patient autonomy. Interviewees also suggested broader strategies to support more effective communication, such as practice staff and clinicians building trusting relationships with patients and understanding and acknowledging the complex structural barriers that often prevent patients from accessing meaningful assistance. These findings provide actionable suggestions for improving communication about HRSN screening and referral in primary care settings. The next steps include developing specific messages based on these findings and testing their impact on screening tool completion rate, referral uptake, and patient‐reported comfort with the process. [ABSTRACT FROM AUTHOR]

This paper reports and discusses the weekly Clapping for Carers – described as 'front‐line heroes' that took place across the United Kingdom during the first national lockdown of the coronavirus pandemic. Data are drawn from a UK‐wide online survey of health and social care workers, completed in May to July 2020. The survey received 3,425 responses of which 2,541 were analysed; free‐text comments were categorised. One question asked specifically: 'Do you think the "Clap for Carers" was a helpful response from the public?', and 815 comments were provided. Responses were extracted from these 815 free‐text comments and categorised as follows: unequivocally Yes, predominantly Yes, mixed feelings, predominantly No and unequivocally No. Most comments revealed mixed feelings about the helpfulness of Clapping with only a minority being entirely supportive. The free‐text comments offer some explanations for these views with many feeling that Clapping distracted from the severity of the pandemic and the inadequate resources. The free‐text comments reveal workforce concerns that the support demonstrated for the frontline workforce in Clapping might be transitory and that it may not translate into workforce improvements and political commitment to further funding of health and social care. Some saw the value of Clapping as illustrative of community cohesion. There was little mention of Clapping for heroes, and where it was the notion of heroism was rejected. The demonstration of public support in Clapping for Carers may have directly benefitted the public, but only indirectly the workforce. Future recruitment data may help discern if public support has translated into a desire to join the workforce. [ABSTRACT FROM AUTHOR]

The redefining of human immunodeficiency virus (HIV) from an acute disease to a manageable chronic illness has reshaped the focus of care, emphasising clinical outcomes and sidelining the complex social barriers many people living with HIV (PLHIV) still face. This parallels changes in the location of HIV care in Australia, with many PLHIV seeking care from private general practitioners whose ability to address complex social issues is constrained by limitations of time and resources. In response, peer navigation has emerged as a model of care implemented by some HIV‐based community health organisations seeking to support PLHIV's biomedical and psychosocial needs. However, there is limited understanding of how peer navigation operates in community settings or of the way these programmes integrate with primary care. This paper is the first to explore peer navigation from the perspective of general practitioners (GPs), with experience in treating PLHIV, to understand the role they see for peer navigators (PNs) in supporting PLHIV. Semi‐structured in‐depth interviews were conducted with six GPs (11.5% of specialty HIV GPs in Queensland, Australia) to examine their views and experiences of peer navigation in the context of HIV care. GPs highlighted the complexities of care for PLHIV and the need for additional resources and supports for psychosocial care. GPs valued peer navigation as part of a patient support network and bridge to health and social care systems. PNs normalised HIV, alleviating fear and stigma, educating and translating clinical information for patients. However, a key challenge was the absence of direct communication pathways with PNs. Peer navigation has clear potential in supporting the care of PLHIV, to alleviate constraints in GP settings and expand HIV care beyond the clinic. [ABSTRACT FROM AUTHOR]

Dementia affects majority of older residents in nursing homes and physiotherapists are regularly involved with this population. However, little is known about the role of physiotherapists who treat residents with dementia in nursing homes. The aim of this paper was to report on an interpretivist qualitative exploration of the perceptions of both the providers of and referrers to domiciliary physiotherapy for residents with dementia in nursing homes in London. In 2015, we conducted semi‐structured interviews with 10 purposively sampled participants – two were providers of physiotherapy for residents with dementia in nursing homes, five were referrers to these providers and three occupied dual roles. A thematic analysis of the verbatim transcripts identified three main themes. First were perceptions of a multifaceted but unclear role, focused on both conventional 'physical' physiotherapy interventions and specialist care, the latter being reliant on knowledge and confidence that physiotherapists did not always feel they possessed. Second were the stated challenges to the role, including the focus and organisation of the nursing home setting, with perceived lack of emphasis on rehabilitation; the progressive and demanding nature of dementia itself; a lack of continuity of nursing home and visiting health professional staff with associated need to entrust physiotherapy intervention to multiple others and the final challenge was the difficulty measuring impact. Third, despite the challenges, enablers of the role were experienced, namely collaborative working and positive previous experiences of referrers. Joining these themes were underpinning concepts of complexity and uncertainty in relation to the physiotherapy role in this setting. This paper highlights a need for enhanced collaborative working in clinical practice, enabled at organisational level, to help address some of the uncertainties expressed around the physiotherapists' role with residents with dementia in nursing homes and thereby enable improvements to processes and outcomes of their interventions. [ABSTRACT FROM AUTHOR]

The vulnerability of deafblind people is considered axiomatic; they are seen not only as a vulnerable group but also as one of the most vulnerable. This paper aims to synthesise existing knowledge to determine what is known about such vulnerability. A comprehensive literature search was undertaken between April 2013 and May 2014. The review method was informed by systematic review principles. An approach based on a 'hierarchy of evidence' would have reduced the amount of literature reviewed significantly, to the point where synthesis would not be possible. Included material was appraised and an interpretative rather than aggregative approach to synthesis adopted. Drawing on principles of critical interpretive synthesis, rather than being a determiner of whether material should be included or excluded, a critique of the literature is offered within the synthesis. Twenty-eight references were identified for inclusion, originating from the UK, USA, Australia, Continental Europe and the Nordic Countries. No empirical studies specifically examining the experience of vulnerability of deafblind people were found. However, deafblind people describe feelings of vulnerability in studies exploring their experiences more generally, and in personal accounts of living with the impairment. Literature produced by practitioners and specialist organisations also explores the topic. Deafblind people are identified as a population 'at risk' of various adverse outcomes, particularly when compared to the non-deafblind majority, and deafblind people describe being and feeling vulnerable in various situations. The literature largely relates to negative outcomes and includes significantly less exploration of positive risk taking, coping capacity and resilience. Deafblind people do not appear to describe themselves as being vulnerable as a permanent state, suggesting a need for greater exploration of the experience among all sections of this heterogeneous population, with consideration of the concepts of resilience and coping capacity. [ABSTRACT FROM AUTHOR]

There is a growing interest in English-speaking jurisdictions, including Australia, North America, Canada, the United Kingdom and New Zealand, about the prevention of sexual abuse perpetrated by children against other children. The aim of this review was to identify opportunities for research, policy and practice which could enhance the prevention agenda relating to the perpetration of sexual abuse by children through conducting a Critical Interpretive Synthesis. Eleven electronic databases were searched in the period from 22 April to 23 May 2013 and included: SocINDEX, Social Services Abstracts, Applied Social Sciences Index and Abstracts, Family and Society Studies Worldwide, Project Muse, PsychINFO, Family and Society Plus, Jstor, Expanded Academic ASAP, Web of Science and Google Scholar. Key individual journals were also searched, including Child Abuse and Neglect and the Journal of Interpersonal Violence, as well as the grey literature. The search was guided by the research question: How could the prevention agenda relating to sexual abuse perpetrated by children be enhanced? The systematic literature search yielded 3323 titles, and 34 of these papers were included in the final synthesis. The authors identified five domains operating in the evidence base: characteristics, causes, communications, interventions and treatments. A synthesising construct emerged from the review: prevention-enhancing interactions. This construct referred to the potential for enhancing the prevention agenda which exists as the evidence domains interact with one another, and with the public health model of prevention. The authors consider this review to be a timely contribution to the current agenda pertaining to sexual abuse perpetrated by children. It provides researchers, policy makers and practitioners in the field with an evidence-informed conceptualisation of opportunities for enhancing prevention work. [ABSTRACT FROM AUTHOR]

It is widely acknowledged that many women prefer to receive their antenatal care in the community. This paper explores one explanation for why this may be the case. The paper is based on a qualitative study of 19 primagravidae, aged between 16 and 30 years, who were interviewed using the technique of repeated in-depth interviewing. The aim of the research was to explore the relationship between women's experiences of pregnancy and the maintenance of self-identity during this time. The research findings indicate that the relationship between the midwife and her antenatal patient can foster both a sense of similarity to others and a sense of personal uniqueness, which appear essential to the maintenance of self-identity during pregnancy. Good communication seems to be an essential tool for the community midwife, as it allows patients to normalise their experiences and yet feel that their experiences of pregnancy are unique. The findings indicate that continuity of care may be important in fostering a sense of similarity to others and that continuity of carer may be required to ensure uniqueness. [ABSTRACT FROM AUTHOR]

Despite a growing burden of stroke in low‐middle‐income countries, research on patient's experiences and access to rehabilitation services remains limited. This study explores the experiences of stroke patients in relation to access and use of stroke rehabilitation services, coping strategies and strategies to improve care in Ghana. A cross‐sectional study was conducted. A total of 136 adult stroke patients hospitalised and subsequently discharged in three major referral hospitals in Ghana participated in the study. A paper‐based questionnaire was used to collect data. Data were inputted into STATA version 12, cleaned and analysed using descriptive statistics and Chi‐Square tests. Findings showed that stroke patients experience stroke differently. Early detection (awareness) of stroke symptoms at onset was low (29.4%). Hypertension was the major (58.1%) predisposing risk factor for stroke, followed by diabetes (14.7%). Multiple barriers impede access to outpatient rehabilitation services: high cost of medications (43.4%), transportation constraints (10.3%), long waiting time (6.6%), forgetfulness about appointment (4.4%), limited education on rehabilitation (20.6%), lack of community support (12.5%) and ineffective communication with healthcare providers (5.2%). Recommended strategies to improve access to rehabilitation care included public education on stroke and its associated risk, reduction in the cost of drugs and increased stroke rehabilitation funding by the NHIS, especially for physiotherapy consultation and training support to caregivers on patient care. Given the difference in stroke experience and barriers in accessing rehabilitation care, multi‐level health policy and service delivery reforms are needed to improve access to rehabilitation care, including national public awareness campaigns on early signs of stroke and subsidised cost of stroke rehabilitation. [ABSTRACT FROM AUTHOR]

Family caregivers (FCGs) are an integral part of the healthcare system. Currently, FCGs provide 70%–90% of the care required by community‐dwelling children and adults living with complex chronic conditions and frailty. Despite FCG's contributions and the growing proportion of distressed caregivers, support for FCGs has not been a health system priority. Researchers have proposed training to enhance the competencies of health providers to work effectively with FCGs. In the absence of best practices for the competency indicators for caregiver‐centred care, we have developed a competency framework for training the health workforce to support FCGs. The objectives in this paper are fourfold: (a) a brief review of stakeholder engagement that led to the development of the competencies the health workforce needs to support FCGs, (b) a description of the process used to name the competency domains, (c) a report on the Modified Delphi process (conducted 2019) used to validate the domain indicators, and (d) a description of the competency framework. We adopted a caregiver and a multilevel interdisciplinary stakeholder codesign approach throughout the competency development process. The competency domains include: (a) Recognising the Caregiver Role, (b) Communicating with FCGs, (c) Partnering with FCGs, (d) Fostering Resilience in FCGs, (e) Navigating Health and Social Systems and Accessing Resources, and, (f) Enhancing the Culture and Context of Healthcare. Our Caregiver‐Centred Care Competencies for the health workforce are only a first step in supporting FCGs in their vital roles. There are few education and training resources to enable and empower health providers to support FCGs, there is an urgent need to develop training resources for the health workforce to recognise and support FCGs. [ABSTRACT FROM AUTHOR]

In light of the challenges posed by an ageing population and tighter public budgets, governments worldwide are seeking innovative ways of improving health service delivery. Volunteers can contribute to such improvement, but this requires effective coordination and communication between volunteers and healthcare employees. In this case study, conducted in two Norwegian municipalities during September–October 2017, the aim was to understand how collaboration and coordination is carried out between several stakeholders: volunteers, volunteer family members of healthcare service users and healthcare employees. Our results show that daily cooperation was largely unsystematic, and stakeholders employed various informal communication procedures. Recruitment of volunteers was based on word of mouth and was coordinated by telephone and email. All processes were paper based, including contracting and confidential agreements. This unsystematic approach resulted in uncoordinated activities characterised by time‐consuming processes, with no quality assurance. We concluded that stakeholders would benefit from a technology solution that supports more systematic processes of recruitment, management and monitoring. This article outlines the challenges and needs for information exchange and communication between stakeholders. Furthermore, it describes possible functionality in a digital system that can address these needs, and hence improve coordination, quality of services and resource use. [ABSTRACT FROM AUTHOR]

The home‐care workforce is in high demand globally. Home‐care workers provide care for people at home, including practical and personal care, as well as other tasks such as medication management. We conducted a systematic review with the aims of understanding methods of observation that have been employed to study home care and to explore how these methods have enabled researchers to understand the quality of home care. We searched the literature using PubMed and CINAHL databases in May 2018, with no limits applied to date of publication. We searched for MeSH terms of 'Home Care Services', 'Home Health Care', 'Home Nursing' and 'Observation*'. Across 15 eligible studies, the types of observation methods employed were categorised as structured, guided and unstructured. The characteristics of these methods, such as the level of participation adopted by the observer, varied across the studies. Three themes were developed through a narrative synthesis of the included studies' findings: 'The impact of care delivery and organisational factors', 'Observing relationships and communications', and 'People and places behind closed doors'. We conclude that methods of observation are a fairly novel, yet rich and meaningful way of exploring home‐care practice. Researchers undertaking observations should consider elements such as the number of researchers observing and the potential for variations, how and when to record the observations, possible triangulation of data, the researcher's reflective stance as an observer, as well as ethical considerations. [ABSTRACT FROM AUTHOR]

The present paper examines the developing role of the medicines counter assistant (MCA) based in community pharmacies in the UK. In recent years, community pharmacies have been promoted as sources of primary care advice, and this has been accompanied by an increase in the number of pharmacy-only medicines made available for purchase without prescription. At the forefront of these changes is the MCA, who responds to requests for medicines and also advises customers seeking guidance on treating minor illness. This paper uses qualitative data drawn from non-participant observation of interactions between MCAs and customers in six community pharmacies in the south-west region of the UK. The data show communication in the pharmacy to be a complex process, characterised by multiple discourses including medical, retail and pharmaceutical information. At times, the different discourses worked in equilibrium, but there were also regular occurrences of clashes between the different discourses, where interaction became problematic. The authors argue that the current focus on pharmacy protocols to structure communication is, in some cases, too rigid for meaningful interaction and does not acknowledge the complexity of the encounter. A specific way forward for developing the interaction is discussed. [ABSTRACT FROM AUTHOR]

Academics, social care practitioners, and policymakers speak different languages. If academic research is to have an impact on society, it must be understandable and convincing to the end users. We argue that the conceptualisation of social care "need" is different among these stakeholders, leading to poor communication between them. Academics should use concepts that have more meaning to practitioners. We propose resurrecting a little‐used concept from the 1970s, "interval of need", to help to bridge this gap. The interval of need concept identifies how often people require help, supplementing the usual data about types of tasks where assistance is needed. The history of the concept is described, followed by a test of its usefulness for today's researchers by applying it to data from the English Longitudinal Study of Ageing. An updated version of interval of need is proposed. Validation checks were conducted against mortality data, and through conceptual validation from a social work practitioner. The nature of the dataset limited comparability with previous studies. However, we conclude that the interval of need concept has promising scope to enhance communication of research findings, potentially leading to improved outcomes for service users. This paper strives to mark a turning point in the language and analysis of social care, ensuring that academic investigation in this field is convincing and clear to practitioners and policymakers. [ABSTRACT FROM AUTHOR]

Worldwide, a growing burden of health and social issues now affect young people. Interagency collaboration and the "integration" of health and social care services are advocated to address the increasingly complex needs of at‐risk youth and to reduce barriers to accessing care. In New Zealand, Youth‐One‐Stop‐Shops (YOSSs) provide integrated health and social care to young people with complex needs. Little is known about how YOSSs facilitate collaborative care. This study explored the collaboration between YOSSs and external agencies between 2015 and 2017 using a multiple case study method. This paper reports qualitative focus group and individual interview data from two of four case sites including six YOSS staff and 14 external agency staff. Results showed participants regarded collaboration as critical to the successful care of high needs young people and were positive about working together. They believed YOSSs provided effective wraparound collaborative care and actively facilitated communication between diverse agencies on behalf of young people. The main challenges participants faced when working together related to the different "world views" and cultures of agencies which can run contrary to collaborative practice. Despite this, some highly collaborative relationships were apparent and staff in the different agencies perceived YOSSs had a lead role in co‐ordinating collaborative care and were genuinely valued and trusted. However without the YOSS involvement, collaboration between agencies in relation to young people was less frequent and rarely went beyond limited information exchange. Establishing and maintaining trusting interpersonal relationships with individual staff was key to successfully negotiating agency differences. The study confirms that collaboration when caring for young people with high needs is complex and challenging, yet agencies from diverse sectors value collaboration and see the YOSS integrated wraparound approach as an important model of care. [ABSTRACT FROM AUTHOR]

It is well documented that Health care assistants (HCAs) provide the most hands‐on care to residents in aged care facilities, and play a critical role in the provision of care to dementia residents. Over the last 25 years, a philosophy of person‐centred care has become the preferred approach to care and this has meant that HCAs are encouraged to get to know the resident very well. This paper reports the experiences of HCAs in caring for people at end‐of‐life, identifies the skills required for their work and examines the education provided against these skills. Semi‐structured interviews were conducted in 49 facilities (n = 34) across New Zealand and data analysed thematically, with the aim of critically examining the adequacy of education for health care assistants which meets their needs within a person‐centred environment. The results confirm that the skills include traditional tasks of care (showering, feeding, toileting, and dressing) but the increasingly important communication and de‐escalation skills, both verbal and non‐verbal, have become central to their care skills. Education provided has not sufficiently shifted focus to include these more complex skills. Provision of educations that acknowledges the increased complexities of their role needs to be provided. As well, facilities need to be challenged to reconsider the HCA's position in the facility care tem. [ABSTRACT FROM AUTHOR]

This study explores the impact of mental capacity in relation to breast screening for women with intellectual disabilities in the UK. Participation in breast screening is considerably lower for women with intellectual disabilities compared to the general population. Barriers to screening include poor mobility and behavioural difficulties. There is currently no research which primarily explores the relationship between mental capacity and breast screening for this group of individuals. This paper presents the results of a cross‐sectional survey of 131 women with intellectual disabilities supported by eight Social Care Providers within England and Wales. The data were collected between January 2017 and July 2017. The current research explores the decision‐making process surrounding breast screening, considering the impact of associated risk factors during this process. Participants completed a specifically created survey addressing the aforementioned issues. The results indicated that women who lacked capacity, were less likely to engage in breast screening. It was also demonstrated that the process outlined in the Mental Capacity Act (MCA; 2005) was not always followed; women were not routinely assessed if there were doubts regarding their decision‐making ability around breast screening and best interest meetings (BIM) were not always held if the person lacked capacity. In order to be able to generalise the current findings, further research is needed to gain a broader understanding of how professionals make decisions around breast screening for women with intellectual disabilities in case the individuals are unable to decide this independently. [ABSTRACT FROM AUTHOR]

This paper examines the healthcare needs of community‐dwelling older people living in Porto, Portugal, diagnosed with moderate or severe dementia, linked to functional dependency, cognitive decline, limitations in the activities of daily life, and frailty levels. A sample of 83 participants was recruited. Data were collected between 2013 and 2017. A sociodemographic questionnaire, the Clinical Dementia Rating (CDR), the Barthel Index (BI), the Lawton and Brody Instrumental Activities of Daily Living (IADL) Scale, and the Edmonton Frail Scale (EFS) were used. A set of 26 healthcare needs was defined to support the assessment. The Pearson chi‐square or Fisher's exact test (as appropriate) was used to examine the association of the needs (unmet and met) with the levels of dementia and frailty. Participants were diagnosed previously with moderate or severe dementia and benefited from a structured home‐care program. There was a high number rated as "severe dementia," "fully dependent," "severely or fully dependent in the activities of daily living (ADL)," and "severe frailty." There were statistically significant differences among needs identified in people with moderate or severe dementia and moderate or severe frailty. The most prevalent healthcare needs in the sample were food preparation, medication/taking pills, looking after their home, toilet use, sensory problems, communication/interaction, bladder, bowels, eating and drinking, memory, sleeping, and falls prevention. In particular, the study identifies a set of needs that are present simultaneously in both frailty and dementia stages. This study underlines that despite well‐structured home‐care programs for people with dementia, unmet health needs remain. Timely healthcare needs assessment may help professionals to avoid fragmented care and to tailor quality‐integrated interventions, including the emotional and psychological balance of the caregiver. [ABSTRACT FROM AUTHOR]

Abstract: Although there is already general recognition of the fact that many relatives provide unpaid care for family members, there is still little awareness that children, adolescents and young adults under 25 also provide such care. Until recently, the situation of young carers and young adult carers, as those young persons are referred to in international research, has not been in the focus of professionals, research and the public in Switzerland. Between September 2015 and October 2016, 30 interviews in seven cantons were conducted with 16 young carers aged 10–17 and 14 young adult carers aged 18–25. The interviews were recorded, transcribed and analysed following a grounded theory approach. This paper now presents the first qualitative data on Swiss young carers and young adult carers. It explores their sociodemographic backgrounds, the nature and intensity of caring tasks they carry out, their pathways into caring as well as the role of communication with family members, extended family, professionals and peers. Our findings provide a first insight in the lives of young carers and young adult carers in Switzerland and illustrate, as well, the challenges they face. [ABSTRACT FROM AUTHOR]

Providing formal care and support in the home has many benefits. Applying a human rights-based approach places the person and their human rights at the centre of all that a health and social care service does. There is a paucity of evidence on how to apply a human rights-based approach in practice when providing homecare. Increasing knowledge and understanding of human rights will empower health and social care practitioners to protect and promote human rights in formal homecare. The aim of this narrative review was to identify and describe human rights-based approaches in homecare, in order to promote awareness and understanding of a human rights-based approach. Five bibliographic databases were searched. Primary research studies pertaining to the delivery of formal homecare that included a human rights-based approach were eligible for inclusion. Sixteen articles were identified for inclusion. Quality appraisal and data extraction were conducted on included studies. A deductive framework analysis was used and concepts of a human rights-based approach that emerged from the literature as relevant to homecare were as follows: dignity and respect, autonomy, equality, participation, and communication. We found that homecare planning and delivery requires the integration of human rights, using approaches, such as person-centred care, partnerships in decision-making, supporting independence, and acknowledging a person's beliefs and cultures, in everyday practice. Findings from this review can support and enable service providers to apply human rights in everyday practice, ultimately for the benefit of people using homecare services. [ABSTRACT FROM AUTHOR]

Dementia is recognised as one of the major global health and social care challenges of present times. When the onset of dementia occurs in midlife, there is an increased possibility that there are children and young adults involved who are dependent on the parent concerned. The aim of the study was to describe health and social care professionals' experiences of identifying and supporting children and young adults with a parent with dementia. A qualitative descriptive approach was carried out with individual interviews of health and social care professionals, using a semistructured interview guide. Thirteen participants in rural and urban areas in Sweden were interviewed. The overarching theme, advocating a forgotten group with three categories were identified. They combine and reflect health and social care professionals' experiences of identifying and supporting children and young adults with a parent with dementia. Health and social care professionals who encountered children and young adults with a parent with dementia described how they were not sufficiently trained in supporting this group and identified a general shortage of available appropriate support services. The children and young adults were also described as a forgotten and overlooked group in need of affirmation and support in a more systematic way. [ABSTRACT FROM AUTHOR]

This study explored underlying reasons for the expression of dissatisfaction with services among Bangladeshi and Pakistani social care users in England and investigated, using a collaborative approach, how these could be addressed. In-depth interviews were conducted in Birmingham, Leeds and London during 2012-2013 with 63 Bangladeshi, Pakistani and white British service users and 24 social care managers, social workers and care workers. A further 34 cognitive interviews were conducted within the same study. Following data analysis, three collaborative workshops involving service users and providers were held to validate the findings and to draw out policy and practice recommendations. Analysis of the cognitive interviews showed that higher dissatisfaction among Bangladeshi and Pakistani service users reported in social care surveys was not due to questionnaire design. Instead in-depth interviews showed that dissatisfaction across all three groups was expressed along the social care journey, including accessing care, communication with social workers and the nature of care received. While many issues were common to all three groups, cultural differences also emerged as affecting experiences of social care. These included misunderstandings about family roles in care; gender issues, especially relating to women; language and communication barriers, alongside the need for a more nuanced approach to ethnic 'matching'; and continuing limited cultural understanding among care workers. The collaborative workshops identified practical actions that could address some of the issues identified. These covered raising awareness of services within communities; improving support for informal carers; service user input to assessments; consistent and ongoing sharing of information; improving access; and more efforts to diversify and appropriately train the social care workforce. In conclusion, the paper presents the reality of dissatisfaction among these groups and argues for more action involving communities and service providers to address these persistent issues collaboratively. [ABSTRACT FROM AUTHOR]

The lay caregiving role is integral to advanced cancer care but places carers' health at risk. A supportive General Practitioner ( GP) can help primary lay carers manage their health, if they disclose their concerns. A Needs Assessment Tool for Caregivers ( NAT-C) was developed for carers to self-complete and use as the basis of a GP consultation, then tested in a randomised controlled trial. This paper reports a qualitative research study to determine the usefulness and acceptability of the NAT-C in the Australian primary care setting. Convenience samples of 11 carers and 5 GPs were interviewed between September 2010 and December 2011 regarding their experiences with and perceptions of the NAT-C. Open-ended questions were used, and the transcripts were analysed qualitatively to identify themes and patterns. Three major themes were identified: (a) Acceptability of the intervention; (b) Impact of the intervention on the GP-patient relationship; and (c) Place of the intervention in advanced cancer care. This simple checklist was acceptable to carers, although some were uncertain about the legitimacy of discussing their own needs with their GP. Carer-patients could not be certain whether a GP would be willing or equipped to conduct a NAT-C-based consultation. Such consultations were acceptable to most GPs, although some already used a holistic approach while others preferred brief symptom-based consultations. Although the NAT-C was acceptable to most carers and GPs, supportive consultations take time. This raises organisational issues to be addressed so carers can seek and benefit from their GP's support. [ABSTRACT FROM AUTHOR]

Maternal mental health plays a vital role in the overall wellbeing of mothers, children, families, whānau (core support network) and communities. However, many mothers face mental health challenges during the transition to parenthood. In this study, we used an online story-sharing platform to collect the experiences of mothers who have faced unmet needs while using the Well Child Tamariki Ora (WCTO) service in Aotearoa New Zealand. From the 420 submitted stories, 125 stories related to mental health need while using the WCTO service. Using thematic analysis, we identified three main themes that highlighted the experiences of mothers with the service. This includes (1) making it seem that I'm coping: Mothers' fear of being judged; (2) i wish I had connected with my WCTO nurse: Fostering meaningful relationships to facilitate personal information sharing; and (3) beyond the baby: Mothers desire for recognition and support during WCTO visits. These findings point to several missed opportunities for WCTO providers to inquire about mental health and offer support needed by mothers. To address this, a relational approach to care would prioritise families and whānau as the focus of care rather than just monitoring the development of babies. [ABSTRACT FROM AUTHOR]

Chronic back pain is common, and its self-management may be a lifelong task for many patients. While health professionals can provide a service or support for pain, only patients can actually experience it. It is likely that optimum self-management of chronic back pain may only be achieved when patients and professionals develop effective partnerships which integrate their complementary knowledge and skills. However, at present, there is no evidence to explain how such partnerships can influence patients' self-management ability. This review aimed to explore the influence of patient-professional partnerships on patients' ability to self-manage chronic back pain, and to identify key factors within these partnerships that may influence self-management. A systematic review was undertaken, aiming to retrieve relevant studies using any research method. Five databases were searched for papers published between 1980 and 2014, including Cochrane Library, CINAHL, Medline, EMBASE and Psyc INFO. Eligible studies were those reporting on patients being supported by professionals to self-manage chronic back pain; patients being actively involved for self-managing chronic back pain; and the influence of patient-professional partnerships on self-management of chronic back pain. Included studies were critically appraised for quality, and findings were extracted and analysed thematically. A total of 738 studies were screened, producing 10 studies for inclusion, all of which happened to use qualitative methods. Seven themes were identified: communication, mutual understanding, roles of health professionals, information delivery, patients' involvement, individualised care and healthcare service. These themes were developed into a model suggesting how factors within patient-professional partnerships influence self-management. Review findings suggest that a partnership between patients and professionals supports patients' self-management ability, and effective communication is a fundamental factor underpinning their partnerships in care. It also calls for the development of individualised healthcare services offering self-referral or telephone consultation to patients with chronic conditions. [ABSTRACT FROM AUTHOR]

Reflective practice is used increasingly to enhance team functioning and service effectiveness; however, there is little evidence of its use in interdisciplinary teams. This paper presents the qualitative evaluation of the Interdisciplinary Management Tool ( IMT), an evidence-based change tool designed to enhance interdisciplinary teamwork through structured team reflection. The IMT incorporates three components: an evidence-based resource guide; a reflective implementation framework based on Structured, Facilitated Action Research for Implementation methodology; and formative and summative evaluation components. The IMT was implemented with intermediate care teams supported by independent facilitators in England. Each intervention lasted 6 months and was evaluated over a 12-month period. Data sources include interviews, a focus group with facilitators, questionnaires completed by team members and documentary feedback from structured team reports. Data were analysed qualitatively using the Framework approach. The IMT was implemented with 10 teams, including 253 staff from more than 10 different disciplines. Team challenges included lack of clear vision; communication issues; limited career progression opportunities; inefficient resource use; need for role clarity and service development. The IMT successfully engaged staff in the change process, and resulted in teams developing creative strategies to address the issues identified. Participants valued dedicated time to focus on the processes of team functioning; however, some were uncomfortable with a focus on teamwork at the expense of delivering direct patient care. The IMT is a relatively low-cost, structured, reflective way to enhance team function. It empowers individuals to understand and value their own, and others' roles and responsibilities within the team; identify barriers to effective teamwork, and develop and implement appropriate solutions to these. To be successful, teams need protected time to take for reflection, and executive support to be able to broker changes that are beyond the scope of the team. [ABSTRACT FROM AUTHOR]

The delivery of acute health care has changed with the adoption of new technologies to meet changing community needs. In response to this, hospital systems and governments have invested in alternative models of care, including hospital in the home (HITH), where acute care that would typically require inpatient treatment is provided in the patient's home. The academic literature presents evidence for comparable or improved patient outcomes associated with HITH interventions. However, it is currently unknown how consumers and providers view the model in the context of a new healthcare facility. This study aimed to elicit consumer and provider views about HITH and how the implementation of a HITH model of care in a new hospital could meet their healthcare needs. We adopted a qualitative approach for this research. Semistructured workshops and interviews were conducted via Zoom, where we presented patient vignettes of different models of care to consumers and providers and recorded their responses using scribes. Qualitative data were independently coded by pairs of researchers to identify themes and subthemes, and demographic data were aggregated. A total of 51 consumers and 35 providers attended the workshops. Consumers and providers frequently described similar themes, particularly accessibility, patient factors, and the health system consequences of HITH. However, the importance and focus of these topics varied across participants. Participants endorsed HITH as a flexible, patient-centred model with potential for wellbeing benefits. However, they noted the potential need for additional resources and increased anxiety among patients with lower health literacy. To address this, participants described the need for clear escalation protocols, communication channels, and expectations around HITH care. In conclusion, HITH is an established model that brings acute care into the homes of patients. The findings of this study support the provision of flexible acute care delivery to meet consumer needs and address the challenges encountered during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

In this paper, we report on key aspects of recruiting and retaining a small group of community dwelling older adults in to a study, piloting motion sensors in their homes for 8 weeks. This was to further understanding of older adults' falls at home. We consider our recruitment strategy in terms of informed consent and non-exploitation; planning and explaining, and our retention strategy in terms of communicating and recording and pacing and sharing data. Offering reflective analyses of our challenges and strategies may help develop skills that maximise the involvement of older adults in research, particularly technologies related research, whilst at the same time ensuring inclusive and non-exploitative research relationships. [ABSTRACT FROM AUTHOR]

Abstract People of Bangladeshi origin in the UK continue to experience poorer health and poorer healthcare than other sections of the community. Although communication with medical and nursing staff has long been recognised as key to the provision of effective healthcare services, efforts to overcome communication problems have often been minimal: many practitioners and patients rely on informal interpreters, usually family members, to assist them, despite the shortcomings of these arrangements. The present paper examines the experiences of 12 Bangladeshi people in Bradford, obtained during the course of a wider evaluation of diabetes services. All but one of the in-depth interviews were carried out in Sylheti and explored respondents’ experiences of diabetes and local services. Software- assisted analysis of the transcripts followed a framework approach. It was found that, in the absence of alternatives, informal interpreting support was a necessity for many people: making appropriate arrangements frequently involved disruption to family members’ routines and responsibilities, yet access to healthcare was often not possible without them. Despite the acknowledged problems, informal arrangements were often preferred: the benefits included greater privacy, support in the consultation, and a shared understanding of advice and instructions. Many patients nonetheless received poor quality care, although this appeared to be related less to language difficulties than to professional attitudes and methods of working. [ABSTRACT FROM AUTHOR]

The International Society for Pediatric and Adolescent Diabetes has identified school as a critical context for adolescents with type 1 diabetes (T1D) who typically hold a fluctuating, though growing, amount of responsibility for diabetes self-management across this time. When parents use frequent autonomy-supportive communication to maintain a mutually agreeable sharing of responsibility for diabetes management with their adolescent, better outcomes are achieved. There is, however, a dearth of research examining the way adolescent responsibility is managed at school. This cross-sectional study investigated adolescents' perspectives of sharing responsibility for T1D management at school and the extent to which these were concordant with parent perceptions. Sixty adolescents (10–19 years) and fifty-five parents completed questionnaires measuring the perceived impact of diabetes on adolescents' school activities and respective involvement in the management of responsibility for school-based diabetes care. Adolescent questionnaires also measured perceptions of autonomy supportiveness (Health Care Climate Questionnaire) and communication quality (frequency, mode, autonomy), in relation to diabetes management. Differences by age and inter-rater agreement between parent and adolescent dyads were examined. Results showed that parents and adolescents did not agree about their relative involvement in setting up diabetes management strategies or the impact of diabetes on school activities. There was no difference in the involvement of older adolescents relative to younger students. Adolescents predominantly communicated about school diabetes care in person, though some reported no communication with school staff (25%) or healthcare workers (36%). Only thirty nine (65%) reported having a diabetes school plan. Nineteen (32%) perceived little or no involvement in setting up diabetes care strategies for the year and most had not attended a school-related meeting. These results suggest more explicit inclusion of adolescents in formal school support strategies may better represent their unique perceptions of responsibility, enabling the consensual sharing of responsibility that is associated with better outcomes. [ABSTRACT FROM AUTHOR]

This article aims at exploring how community home care of older people is provided and organized at night. In times of welfare decline, organizational changes, and an increasing aged population, questions arise about home care and support for older people. In Sweden, as in many other Western countries, "ageing in place" is a guiding principle in care provision for older people, which put increasing pressure on home care services. Still, nighttime care represents a research gap within health and social care research, nationally and internationally. This telephone interview survey examines 41 operations managers' perceptions of organization and care provision and how they account for the goals and work of home care at nighttime in a selection of 37 Swedish municipalities. The analysis was inspired by thematic content analysis where three central themes were categorized: organizational context of nighttime care, working conditions, and challenges of nighttime care. Our results reveal that organizational context varied depending on the demography and size of the municipality. The work situation was characterized by constantly unforeseen events to manage. Multiple challenges were identified on societal and political levels, as were limited resources and recruitment problems. In conclusion, our analysis has identified unpredictability as a core feature of nighttime care work. The complexity of the provision of nighttime care was not recognized as important for the municipal organization. To provide high-quality care at night in ordinary housing, there is a need both to focus on organizational aspects and to have sufficient resources and time. [ABSTRACT FROM AUTHOR]

The home environment is increasingly emphasized as a key factor in home falls among frail older people. In this study, we aimed at exploring and synthesizing empirical studies that considered the environmental factors of home falls among frail older people. We performed a systematic review to draw comprehensive conclusions regarding these environmental factors by searching MEDLINE, CINAHL, Embase, and Cochrane Library, as well as gray literature databases. Intervention and nonintervention studies that specifically reported home environmental factors related to falls in community-dwelling frail older people aged 65 years and over were selected. Of the 8374 studies initially retrieved, seven intervention and seven nonintervention studies were included in the analysis. In seven of the 14 studies, environmental hazards were evaluated using relevant assessment tools. Interventions were provided for the bathroom/toilet, bedroom, living room, and for slipping and tripping, identified as frequent fall locations and situations, respectively, through nonintervention studies. The most common intervention was to provide advice/counseling and disseminate information to enhance knowledge after visiting the home and evaluating the home environmental factors that could affect falls. In the majority of the studies, the intervention was of a multicomponent nature, and in only two intervention studies was there practical modification of the home environment to lower the fall risk. In all the four studies with statistically significant results, the intervention was provided by a multidisciplinary team. Through this review, we identified environmental factors for home falls, helping clinicians and health professionals gain a better understanding of the situation to prevent recurrence in frail older people who have experienced falls. The findings indicate that comprehensive standardized environmental evaluations should be conducted considering older people's functional characteristics and needs and that the intervention process requires the participation of older people with a multidisciplinary team. [ABSTRACT FROM AUTHOR]

Poor lifestyle practices, combined with excess weight gain and weight retention during the preconception, pregnancy and postpartum periods can increase health risks for mothers and their children. Little is known about how workplaces impact the health and well‐being of women of child‐bearing age, particularly across work roles and settings. This qualitative descriptive study explored the enablers and barriers to the healthy lifestyle practices and well‐being of women of reproductive age within an Australian community services organisation by capturing the perspectives of both the women and workplace executives. Eleven interviews were conducted with executives (n = 12), and three focus groups and three interviews were conducted with women (n = 16). Data were thematically analysed, and six main themes were identified: blurring of the role and work environment, clarity and equity in policy and entitlements, the nature of community services work, individual responsibility for health, tiered levels of support and a management‐driven culture of awareness and support. Barriers included high‐stress roles, work targets, sedentary work behaviours, lack of clarity around policies, funding and the emotional labour associated with community services work. Hands‐on leadership, open communication, work relationships, resourcing and manager training were identified as facilitators. While findings indicate agreement between executives and the women, many executives focused on the challenges associated with pregnancy in the high‐risk workplace environment and did not perceive specific barriers for those in non‐frontline roles. Management education to generate an understanding of women's needs during this life stage and increased resourcing to facilitate workplace well‐being would be beneficial. [ABSTRACT FROM AUTHOR]

Information and communication technology (ICT) can empower the older people and improve their quality of life by sustaining functional independence and effective communication. Nonetheless, in developing countries like India, technology acceptance and use among the older people is limited. Therefore, there is a need to systematically understand the plausible difficulties limiting technology use and the expectations of the older people regarding ICT use. Hence, the present study is a qualitative inquiry to explore the needs, attitudes and perceived limitations of the ICT platforms among the older people. Twenty healthy volunteers across various states of India, between 60 and 75 years were recruited online via purposive sampling. A brief demographic survey was administered online using Google Forms, followed by telephonic semi‐structured interviews. Thematic Analysis using inductive and deductive coding was employed to analyse the interview transcripts. Thematic analysis yielded four overarching themes‐ (i) Usability of ICT, (ii) Anxiety and privacy concerns, (iii) Self‐perception of technology use and (iv) Need for technology literacy. The emerging themes reflected the perceptions of the older people towards ICT and identified several psycho‐social factors impacting technology acceptance among the older people. The findings suggest that several psychological factors like anxiety, motivation, interest and self‐efficacy play a role in technology acceptance among the older people. Additionally, user‐friendly interfaces and training on technology use may enhance technology acceptance among older users. [ABSTRACT FROM AUTHOR]

Inadequate attendance to antenatal care has been associated with negative maternal and fetal outcomes, including stillbirth. This study aimed to identify facilitators and barriers to antenatal care attendance. A systematic search was conducted in March 2019 and updated in January 2021. Qualitative studies involving pregnant or post‐partum women up to 12 months from high‐income countries that provided data about facilitators and barriers to antenatal care attendance were sought. Meta‐ethnography was used to inform this meta‐synthesis. Fifteen studies were included in the analysis. Findings indicate that inadequate antenatal care attendance is influenced at different levels. Aspects like sociodemographic factors, difficulties navigating the health system, administrative delays, lack of flexibility and tailored care, constant change of carer and communication issues also act as barriers. These issues affect women's access to knowledge and the formation of women's beliefs and feelings towards seeking care. On the contrary, having a positive attitude towards the pregnancy, encountering empathetic healthcare professionals and availing of social support acted as facilitators. The reasons why women seek or delay attending antenatal care are multifactorial and can be explained using the Social Determinants of Health Framework. Any response needs to be taken across all levels of influence and not just focused on the individual. A better understanding of the barriers and facilitators to antenatal care might contribute to informing intervention or policy development addressing this issue. [ABSTRACT FROM AUTHOR]

Young people are known to face challenges when accessing healthcare and generally have low rates of health service utilisation. Use of telehealth might be one way to improve access, but evidence is needed from young people as to how acceptable it is. This online survey of 15‐ to 25‐year olds in the greater Wellington region of New Zealand sought young people's views on telehealth (phone and videocalls) as a means of accessing primary care. The survey included both forced‐choice questions and free‐text options. We report here on the free‐text data from open‐ended questions that were qualitatively analysed using template analysis. A total of 346 participants took part between August 6 and September 21, 2021, of whom 60% were female, 12% Māori (indigenous) ethnicity, and 38% had used telehealth methods of consulting previously. Analysis was undertaken of the free‐text comments that were provided by 132 participants (38%). Although those contributing comments described both benefits and drawbacks to using telehealth, more drawbacks were cited, with specific examples given to illustrate a range of concerns and potential limitations of telehealth including privacy, communication difficulties and compromised quality of care. Participants thought telehealth could be used successfully in specific situations, for example by people concerned about leaving the house due to anxiety, illness or being immunocompromised and for simple consultations or when the person knows exactly what they need. Respondents expressed a strong desire to be offered the choice between in‐person and telehealth consultations. Providing young people with a choice of consultation mode together with clear information about all aspects of a telehealth consultation is important if clinicians want young people to engage with this method of primary care service delivery. [ABSTRACT FROM AUTHOR]

This study aims to understand the effects that role‐diverse online communities have on informal carers, particularly in providing support. Australian Facebook communities used to support those involved in the National Disability Insurance Scheme (NDIS) were explored. Social network analysis of an NDIS‐centred community was conducted, based on 909 publicly visible interactions that occurred in May–June and August–September 2019. Two managers of informal NDIS communities were interviewed, the transcripts of which were analysed using NVivo. Results from the two analyses suggest that both an individual carer's attributes and the collective attributes of the network defined the capability of the network to support the carer, often depending on the experiences and expertise of those offering support. Support was unconstrained by role, though differing goals and expectations often impeded collaboration between roles. The outcomes of support provision were shown to affect not only individuals but also the collective network. However, while effective, community spaces currently lack organisational backing and resources available to informal communities are constrained. Findings drawn from this study, which we believe are applicable to a broader, international context, are three‐fold. Firstly, it is recommended that informal support communities clearly define purpose and create multiple channels to ensure that all participants can meet their needs. Secondly, the benefits of participation to organisations should be further explored. Finally, the use of social network analysis as a method in this study has provided significant insights into the communication patterns and activities of the community under study. Future use of SNA in similar studies may provide further insight into the effectiveness and interactions of community‐based support methods. [ABSTRACT FROM AUTHOR]

Although Indigenous groups continue to experience extensive health disparities, little research explores the role of structural barriers in contributing to health disparities for state‐recognised tribes, who do not receive healthcare services from the Indian Health Service. In addition, much research focuses on discrete physical health outcomes, without utilising community‐based approaches to allow participants to identify healthcare priorities and needs in their own voices. In partnership with a community advisory board, a qualitative descriptive methodology was used to conduct 31 life‐course interviews with participants of a state‐recognised tribe in the Gulf South region of the United States to explore healthcare experiences. Participants identified unmet healthcare needs and healthcare infrastructure barriers. Some of the most common barriers and unmet healthcare needs included: Long Distance to Healthcare Services and Difficulty in Accessing Specialists, Need for Increased Communication, Long Hospital or Appointment Wait Times, Unmet Mental Health Needs, Need for Substance Use or Abuse Prevention Programs and Need for Health Education. These findings highlight some of the structural barriers that exacerbate existing health disparities and suggest important areas of intervention, such as including a focus on mental health needs. Increased healthcare resources and recognition of sovereignty for this state‐recognised tribe are also needed to begin to address these barriers. In addition, because of the long history of exploitation of Indigenous communities, healthcare interventions should meaningfully include Indigenous tribes in the development and implementation of any healthcare programs. [ABSTRACT FROM AUTHOR]

Despite unprecedented advancement in educational opportunities and access to information, maternal health literacy (MHL) and health numeracy (HN) skills remain low in North America. By enhancing MHL, the educated civic public—those who have the capacity, skills, and knowledge to apply prose and numerical health information—engages more proactively in public health practice. The purpose of this scoping review was to map the existing empirical evidence on MHL to work toward a better understanding of the practical implications for public health. We explored MHL and HN through the following research question: "How are maternal health literacy and health numeracy conceptualised in public health planning, implementation, and evaluation?" First, we employed a five‐stage methodological framework for scoping reviews and used PRISMA‐P to systematically identify eligible articles. Then, we used thematic analysis and an inductive approach guided by the research aims to identify themes related to how MHL and HN are conceptualised in empirical studies and developed an evidence table. Finally, two different reviewers coded articles using an inductive approach into six themes. We identified 1733 articles through a systematic search of five databases. After screening all the articles, 52 articles were included for thematic analysis. The final themes were: (i) sociocultural demographics; (ii) self‐efficacy; (iii) communication; (iv) information seeking and operationalisation; (v) health status; and (vi) reasoning. The research evidence demonstrated limitations concerning the impact of sociocultural background on a mother's recognition of health problems and the extent of which patient‐centred care is culturally and linguistically appropriate. The research evidence revealed an opportunity to address the sociocultural linguistic experience of mothers within public health practice. Our research team supports moving away from the biomedical model of evidence‐based medicine and adopting evidence‐based practice ensures healthcare providers develop a holistic understanding of the maternal health needs of socioculturally diverse mothers. [ABSTRACT FROM AUTHOR]

International health and social care systems are experiencing unprecedented pressure and demand. 'Single‐handed care' initiatives seek to identify whether all or part of a homecare package involving more than one care worker can be safely reduced to a single worker. Little is known about these initiatives across local authorities. The aim of this study was to identify, describe and explain current processes and practices for single‐handed care initiatives and double‐handed homecare reviews. An electronic survey link was sent to each local authority with social care responsibilities in England. The questions covered a range of areas in relation to single‐handed care processes and included a combination of pre‐coded and free‐text responses. Responses were received from 76 (50%) local authorities. Findings were that over 12,000 reviews were reported within a year with a median of 141 (IQR 45–280) from 53 authorities that provided figures. Reviews were usually led by a local authority occupational therapist. On average, 540 min was spent per review, including conducting and organising the review, documentation, and travel. In nearly half the authorities, double handed care remained at least partially in place following at least 80% of the reviews and remained wholly in place following at least 60%. Local authorities also reported some resistance from homecare providers when implementing single‐handed care. The findings have confirmed anecdotal evidence that reviews of double‐handed homecare packages are common practice within local authorities. Given the amount of time taken with these reviews, and paucity of evidence on outcomes for people receiving them, further research should evaluate this. [ABSTRACT FROM AUTHOR]

The existing psychosocial Support activities in the Northern Territory, Australia, are mostly delivered through individualised outreach and client‐centred Support programs and do not currently have a strong Peer focus. To address this gap, a Peer‐Led Education Pilot was developed and implemented in Darwin, Australia. The pilot was comprised of three separate but overarching stages, and each stage was independently evaluated. In this article, results from Stage 1 will be presented, with a specific focus on the role of Peer‐to‐Peer communication in improving participants' mental health and Recovery skills. This stage involved the delivery of the My Recovery program to self‐nominated participants, and the evaluation was aimed at reporting on the appropriateness and effectiveness of the program. The evaluation was qualitative in design involving individual pre‐ and post‐program interviews with program participants (npre = 14, npost = 16) between August and October 2019. The program was well received by participants and helped build their capacity to understand and self‐manage their mental health and/or alcohol and other drug issues in an inclusive, non‐clinical, non‐judgemental space. The results highlighted the importance of including a strong Peer focus in the existing psychosocial Support services available for people with mental health issues in Darwin. The findings also underscored the inclusion of those with lived experience of mental health challenges in the design and delivery of such programs. [ABSTRACT FROM AUTHOR]

Previous studies on palliative care have assessed the phenomenon of Information Concealment (IC), confirmed its relevance and emphasised the need to have a scale for its assessment. The aim of this study was to design and validate such an instrument. The sample comprised 150 palliative caregivers (23 men and 127 women). The dimensionality of the items of the Information Concealment Scale for Caregivers (ECOI) was assessed using Exploratory Factor Analysis and an optimal implementation of parallel analysis. Reliability and criterion validity were analysed using sample data. The ECOI comprises three factors: Concealment or dissimulation about the disease, misrepresentation of the real situation and control of the information. The scale has excellent reliability and shows criterion validity. Therefore, the ECOI is a reliable and valid instrument to objectively measure IC among Spanish caregivers in palliative care settings. [ABSTRACT FROM AUTHOR]

The online world may provide an alternative means to engage young people and students with suicidal feelings, who are typically reluctant to seek help. We aimed to map, characterise and obtain user evaluation of current online suicide support for this group in order to assess the usefulness of current provision and how it may be improved. We conducted a mixed‐methods study, comprised of an internet search, content analysis of site features and qualitative interviews with site users: 9 young people and 4 general practitioners. Data collection took place in 2019 and 2020 in the UK. Young people participants were recruited through the well‐being networks of a large University in South‐West England and via a national young person's mental health app. General practitioners were recruited locally through professional networks. We identified a wide range of easily accessible online support, including examples of interactive services, such as live chat and text messaging, but a lack of support that is both suicide‐specific and young adult‐specific, and an absence of online suicide or mental health crisis support services tailored specifically for students. Qualitative data showed that clarity, brevity and immediacy are the most important facets of engaging crisis help for young people, and that young people may prefer to use text‐based rather than verbal forms of communication when seeking help. Few services provided access to active peer support, outside of lived‐experience stories, which were evaluated as both valuable and potentially harmful. There is a need to further develop tailored suicide specific online crisis support for young people and students, which is able to 'speak to' their age‐specific needs and preferences. While lived experience may provide a valuable means of supporting young audiences, caution is required since this may have unintended negative consequences and further research is needed to understand the safe framing of such material. [ABSTRACT FROM AUTHOR]

South Africa faces a critical shortage of mental health service professionals and support for young people with common mental health disorders is inadequate. Social relationships that provide support to adolescents in South African communities are increasingly declining due to socio‐economic pressures. Developing ethical digital mental health innovations has potential to address provide services particularly in rural communities where mental health facilities are scarce. The active involvement of young people is critical to maximising uptake and reducing apathy on the use of digital innovations for mental health. Using the nominal group technique this study engaged young people in identifying stakeholders for setting up a community‐based mental health intervention in a rural community. Use of nominal group technique for stakeholder analysis proved to a useful tool for engaging young people. The stakeholder identification and analysis provided a base for inclusivity in developing digital innovations for mental health through identifying multi‐sector community stakeholders. It revealed that young people in the community have varying perceptions about the level of power and interest which their peers, family members, local leaders, health workers and social development organisations have in developing digital mental health interventions. This research contributes to our understanding of the ways in which to leverage young people's participation in project planning and decision‐making and building strong teams and alliances for developing digital innovations for mental health in marginalised rural communities. [ABSTRACT FROM AUTHOR]