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1 – 10 of 40Catriona George, Nuno Ferreira, Rosalind Evans and Victoria Honeyman
The purpose of this paper was to systematically review the association between behavioural and psychological symptoms of dementia (BPSD) and the development of carer burden…
Abstract
Purpose
The purpose of this paper was to systematically review the association between behavioural and psychological symptoms of dementia (BPSD) and the development of carer burden. Although this association has been well established in the literature, it is not clear whether there are individual symptoms or clusters of symptoms that are particularly burdensome for carers.
Design/methodology/approach
A systematic review of the available literature was carried out to determine whether any specific symptom or cluster of symptoms was most closely associated with carer burden. In addition, the categorisation of behavioural symptoms, conceptualisations of burden and methods of measurement used were examined and quality of the studies appraised.
Findings
A total of 21 studies measured the association between at least one individual symptom or symptom cluster and carer burden, with all studies finding at least one symptom to be significantly associated with burden. The majority of studies were of fair to good quality. However, there was considerable heterogeneity in focus, analysis, recruitment and measurement of behaviour and burden.
Originality/value
Symptoms, which were found to be significantly associated with carer burden, were aggression/agitation, frontal systems behaviour, disinhibition, disrupted eating and sleeping behaviour, unusual motor behaviour, anxiety and psychotic symptoms. However, because of the heterogeneity of studies, there was insufficient evidence to establish whether any symptoms are more important than others in the development of carer burden. Future focus on clarifying the dimensions of carer burden and the mechanisms by which BPSD impact negatively on carers could inform the development of effective interventions.
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Catriona George, Mandy Boyce, Rosalind Evans and Nuno Ferreira
This study aims to investigate the feasibility and acceptability of a new group intervention, using an acceptance and commitment therapy (ACT) approach, developed for dementia…
Abstract
Purpose
This study aims to investigate the feasibility and acceptability of a new group intervention, using an acceptance and commitment therapy (ACT) approach, developed for dementia caregivers. Preliminary data regarding the effectiveness of the intervention was also collected.
Design/methodology/approach
A quasi-experimental design is used involving pre- and post-intervention data from four different intervention sites, along with three-month follow-up data. Data on attendance, attrition and qualitative feedback was also collected as an indication of acceptability. A total of 23 people currently caring for a family member with dementia attended the ACT group intervention for five sessions. Detailed evaluation forms were collected at the end of each group, along with four self-report questionnaires: Zarit Burden Interview, Positive Aspects of Caregiving Scale, Dementia Management Strategies Scale and Experiential Avoidance in Caregiving Questionnaire.
Findings
Findings indicate that the group intervention was feasible and acceptable to caregivers, with subjective change reported in understanding of behavioural changes in the care-recipient, ability to handle negative emotions and valued living. These changes were not reflected in the outcome measures, with only one change reaching statistical significance (reduction in “intolerance of negative thoughts and emotions towards the relative”). Suggestions are made regarding possible alternative outcome measures for future studies to capture participants’ experience more fully, along with potential adaptations and future directions for the intervention.
Originality/value
This study provides preliminary evidence of the acceptability and feasibility of a group therapeutic intervention based on ACT for informal caregivers of dementia.
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Rosalind Lau and Anastasia Hutchinson
Over the past 15 years, mental health organisations have taken steps to move towards providing services that are more recovery-oriented. This review was undertaken to explore what…
Abstract
Purpose
Over the past 15 years, mental health organisations have taken steps to move towards providing services that are more recovery-oriented. This review was undertaken to explore what is known about service users’ experience of services that have introduced a recovery-oriented approach to service provision. There is limited research evaluating consumers’ lived experiences of recovery-orientated care; a scoping review was chosen to provide an overview of the available research in this area (Munn et al., 2018). The purpose of this review was to summarize and synthesize current qualitative research exploring consumers’ experience of recovery orientated mental health care provision.
Design/methodology/approach
This scoping review was undertaken as outlined by Arksey and O'Malley (2005). The five steps consisted identifying the research question; searching for relevant studies; selecting the studies; charting the studies; and collating, summarising and reporting the findings.
Findings
Three key themes emerged from this review: translation of recovery policy to practice; ward environment; and recovery principles with five subthemes: engagement; not being listened to; shared decision-making; informational needs; and supportive and collaborative relationships. The themes and subthemes identified in each of the 18 studies are presented in Table 3.
Research limitations/implications
This review highlights the different degree to which service users have received recovery-oriented recovery care. In the majority of cases, most service users reported few opportunities for nursing engagement, poor communication, inadequate information provision, a lack of collaborative care and mostly negative experiences of the ward environment. Because of the limited studies on mental health service users’ lived experiences of a recovery-oriented service, more clinical studies are needed and in different cultural contexts.
Practical implications
On hindsight, the authors should have included service users in this review process as consumer inclusion is progressively emphasised in mental health educational and research activities. This review highlights that not all studies have involved service users or consumers in their research activity.
Social implications
Service users need relevant information in a timely manner to participate in decision-making regarding their treatment and care. This review found that either no information was provided to the service users or it was provided in a limited and fragmented manner. This review also found inpatients reported limited opportunities to have meaningful participation in decision-making about their care. These findings have important social implications, as greater consumer engagement in the design and delivery of mental health services will increase community trust in the care provided. This in turn has the potential to facilitate greater community engagement in preventative mental health care.
Originality/value
This is the first review to systematically synthesis consumers perspectives on the extent to which service providers are achieving the goal of implementing recovery-orientated practice into their service provision. Despite important policy changes, the findings of this review demonstrate that more work is needed to truly operationalise and translate these principles into practice.
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Paul Hodgkin, Rosalind Eve, Ian Golton, James Munro and Gill Musson
This paper dicusses the experience of a team in Sheffield who have established a 3‐year programme, the FACTS project, which aims to develop a framework for changing clinical…
Abstract
This paper dicusses the experience of a team in Sheffield who have established a 3‐year programme, the FACTS project, which aims to develop a framework for changing clinical practice in primary care. The lessons learnt from the project, which involves a variety of change techniques, are described including the need to tailor programmes to local needs and cultures as well as the use of marketing as a strategy for change.
Gaëtane Jean-Marie and Tickles
Many Black women continue to negotiate their way within higher education institutions, which are influenced by social class, race, and gender biases. Several scholars contend that…
Abstract
Many Black women continue to negotiate their way within higher education institutions, which are influenced by social class, race, and gender biases. Several scholars contend that Black women’s objectification as the “other” and “outsider within” (Collins, 2000; Fitzgerald, 2014; Jean-Marie, 2014) is still apparent in today’s institutions yet many persist to ascend to top leadership positions (Bates, 2007; Epps, 2008; Evans, 2007; Hamilton, 2004; Jean-Marie, 2006, 2008). In particular, the inroads made by Black women administrators in both predominantly white colleges (PWIs) as well as historically black colleges and universities (HBCUs) depict a rich and enduring history of providing leadership to effect social change in the African American community (i.e., uplift the race) and at large (Bates, 2007; Dede & Poats, 2008; Evans, 2007; Hine, 1994; Miller & Vaughn, 1997). There is a growing body of literature exploring Black women’s leadership in higher education, and most research have focused on their experiences in predominantly white institutions (Bower & Wolverton, 2009; Dixon, 2005; Harris, Wright, & Msengi, 2011; Jordan, 1994; Rusher, 1996; Turner, 2008). A review of the literature points to the paucity of research on their experiences and issues of race and gender continue to have an effect on the advancement of Black women in the academy. In this chapter, we examine factors that create hindrance to the transformation of the composition, structure, and power of leadership paradigm with a particular focus on Black women administrators and those at the presidency at HBCUs. From a review of the literature, our synthesis is based on major themes and subthemes that emerged and guide our analysis in this chapter. The chapter concludes with recommendations for identifying and developing Black women leaders to diversify the leadership pipeline at HBCUs and other institutions for the future.
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Discusses the issue of damages in the Court of Appeal decision in Banque Bruxelles Lambert SA v. Eagle Star Insurance [1995]. Suggests that policy issues, whether or not made…
Abstract
Discusses the issue of damages in the Court of Appeal decision in Banque Bruxelles Lambert SA v. Eagle Star Insurance [1995]. Suggests that policy issues, whether or not made explicit, must inevitably be considered in reaching a conclusion as to which party ought to be liable for damages for economic loss due to a fall in the property market. To do otherwise is to risk making the valuer the insurer of all of the client’s risks.