Nitish Nachiappan, Sophie Ward, Nachiappan Chockalingam and Ruth Chambers
The ageing population is a global phenomenon that is occurring in many countries around the world, including the UK. According to the Office for National Statistics (ONS), the…
Abstract
Purpose
The ageing population is a global phenomenon that is occurring in many countries around the world, including the UK. According to the Office for National Statistics (ONS), the proportion of the UK population aged 65 years and over is projected to increase, reaching 25% by 2045. This increase will have a significant impact on a range of social and economic issues. One of the ways to reduce this impact is to improve self-care.
Design/methodology/approach
The availability of simple assistive devices can facilitate physical activity and help complete daily living activities. These devices can also help in the self-management of long-term health and well-being. To encourage self-care, it is essential to create awareness about these assistive products. Simple assistive products such as shoe horns, magnifying glasses or a sphygmomanometer that are readily available to buy from shops were grouped into four boxes or kits. The authors provided these simple devices to 175 community-dwelling older adults in deprived areas and followed them up via a phone survey after 4–6 weeks.
Findings
The authors recorded overall positive feedback on individual products and the kit. The results indicate that there was a sense of empowerment and ability by the recipients to take control of their health and well-being and management of their health condition using items contained in the kit provided.
Practical implications
The study results show that simple assistive products empower older adults to self-care and can provide a positive impact on their activities of daily living.
Originality/value
Previous studies have shown that regular exercise can enhance both physical and mental abilities and reverse certain chronic health issues. Simple household devices can aid in increasing physical activity. This work highlights how these devices enable older adults to take care of themselves, with a focus on capturing their personal perspectives and experiences.
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Karen Humphries, Caroline Clarke, Kate Willoughby and Sophie Collingwood
In 2019, the world was hit by a life threatening severe acute respiratory syndrome causing a global pandemic; Coronavirus disease (COVID-19). In the UK, a nationwide “lockdown” of…
Abstract
Purpose
In 2019, the world was hit by a life threatening severe acute respiratory syndrome causing a global pandemic; Coronavirus disease (COVID-19). In the UK, a nationwide “lockdown” of public isolation and reduced social contact followed. The experience of COVID-19 and the lockdown for forensic secure mental health patients is yet to be understood. This study aims to explore this phenomenon from the patients’ perspective.
Design/methodology/approach
A qualitative approach was taken. Semi-structured interviews were carried out with six patients from a low secure unit in the UK, between November 2020 and March 2021.
Findings
Interpretive phenomenological analysis generated three superordinate themes from the data, providing insight into patients’ experience: “treading water”; how they managed: “learning to swim”; and what was helpful during this time: “in the same boat”.
Practical implications
Further consideration should be given to creating a sense of safety in wards, along with ways to continue to address the power imbalance. Interestingly, social connection may be cultivated from within the hospital setting and would benefit from further research.
Originality/value
To the best of the authors’ knowledge, this is the first study to explore secure patients’ experience of COVID-19 from the patients’ perspective, within a population often neglected within recovery research.
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Zana Khan, Sophie Koehne, Philip Haine and Samantha Dorney-Smith
The purpose of this paper is to describe the delivery of the first clinically led, inter-professional Pathway Homeless team in a mental health trust, within the King’s Health…
Abstract
Purpose
The purpose of this paper is to describe the delivery of the first clinically led, inter-professional Pathway Homeless team in a mental health trust, within the King’s Health Partners hospitals in South London. The Kings Health Partners Pathway Homeless teams have been operating since January 2014 at Guy’s and St Thomas’ (GStT) and Kings College Hospital and expanded to the South London and Maudsley in 2015 as a charitable pilot, now continuing with short-term funding.
Design/methodology/approach
This paper outlines how the team delivered its key aim of improving health and housing outcomes for inpatients. It details the service development and integration within a mental health trust incorporating the experience of its sister teams at Kings and GStT. It goes on to show how the service works across multiple hospital sites and is embedded within the Trust’s management structures.
Findings
Innovations including the transitional arrangements for patients’ post-discharge are described. In the first three years of operation the team saw 237 patients. Improved housing status was achieved in 74 per cent of patients with reduced use of unscheduled care after discharge. Early analysis suggests a statistically significant reduction in bed days and reduced use of unscheduled care.
Originality/value
The paper suggests that this model serves as an example of person centred, value-based health that is focused on improving care and outcomes for homeless inpatients in mental health settings, with the potential to be rolled-out nationally to other mental health Trusts.
Andy Cook and Julie Payne
The purpose of this paper is to describe family intervention (FI) with four families in which the service user is under the care of forensic mental health services. There is a…
Abstract
Purpose
The purpose of this paper is to describe family intervention (FI) with four families in which the service user is under the care of forensic mental health services. There is a focus on identifying how systemic practice is used or adapted in working with families who have a family member who has presented risk and caused harm.
Design/methodology/approach
Four case studies are used to provide a basis for the exploration of commonalities in practice between the cases and the utility of FI within forensic services, which have the dual purpose of promoting mental health recovery and reducing offending/risk behaviour.
Findings
Family work can be a key healing tool in the recovery journey of forensic service users and their families. An integrated systemic and psycho-educational FI approach was found to be appropriate in the cases described. Issues particular to forensic services are identified; these include the role of safety planning; the function of talking about the history of trauma in the family including the impact of offending behaviour; mediating difficult relationships between family members and professionals; and overcoming barriers to having difficult and emotive conversations.
Research limitations/implications
The absence of outcome assessments limits the findings to observational data and self-reported experiences from the authors.
Practical implications
FI can be safely and effectively used within forensic settings, facilitated by practitioners competent in working with trauma and complexity, as an integrated component of the therapeutic treatment.
Originality/value
There are recognised barriers to the provision of FI within forensic settings, with limited research regarding the application of such therapies with forensic patients and their families. This paper adds to the small pool of knowledge regarding useful applications of FI in such settings.
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Emily Glorney, Sophie Raymont, Amy Lawson and Jessica Allen
Religion and spirituality are well-researched concepts within the field of psychology and mental health yet they have rarely been researched in high-secure services within the UK…
Abstract
Purpose
Religion and spirituality are well-researched concepts within the field of psychology and mental health yet they have rarely been researched in high-secure services within the UK. Research in mental health and prison contexts suggests benefits of religion/spirituality to coping, social support, self-worth, symptoms of depression and anxiety and behavioural infractions. The purpose of this paper is to investigate the role of religion/spirituality in high-secure service users’ personal recovery.
Design/methodology/approach
Semi-structured interviews were carried out with 13 male patients in a high-secure hospital, with primary diagnoses of mental illness (n=11) or personality disorder (n=2). Participants were from a range of religious/spiritual backgrounds and were asked about how their beliefs impact their recovery and care pathways within the hospital. Data were analysed using interpretative phenomenological analysis.
Findings
Three superordinate themes were identified: “religion and spirituality as providing a framework for recovery”; “religion and spirituality as offering key ingredients in the recovery process”; and “barriers to recovery through religion/spirituality”. The first two themes highlight some of the positive aspects that aid participants’ recovery. The third theme reported hindrances in participants’ religious/spiritual practices and beliefs. Each theme is discussed with reference to sub-themes and illustrative excerpts.
Practical implications
Religion/spirituality might support therapeutic engagement for some service users and staff could be more active in their enquiry of the value that patients place on the personal meaning of this for their life.
Originality/value
For the participants in this study, religion/spirituality supported the principles of recovery, in having an identity separate from illness or offender, promoting hope, agency and personal meaning.
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Jean Bosco Byukusenge, Eva Adomako, Stephanie Lukas, Cyprien Mugarura, Josette Umucyo, Sophie Mukagatare, Odette Ahishakiye, Clotilde Nyirangondo and Rex Wong
Complete health documentation during childbirth can reduce complications and improve maternal and foetal outcomes. One such document is the partograph which allows health workers…
Abstract
Purpose
Complete health documentation during childbirth can reduce complications and improve maternal and foetal outcomes. One such document is the partograph which allows health workers to record and follow the labour progress. However, the completion rates of partograph remain low in some hospitals. This study describes the implementation of a quality improvement project to increase the completion rate of partograph in a district hospital in Rwanda.
Design/methodology/approach
The project team tackled the root cause of partograph incompletion by implementing a labour monitoring guideline, assigning patients and duties to midwives and by providing support and supervision.
Findings
The intervention successfully increased overall partograph completion rates from 11 to 61 per cent, p < 0.001. This study also showed that completeness of the partograph was statistically associated with a decrease in foetal deaths and higher Apgar score with p < 0.001 for both.
Practical implications
This study describes the establishment of a quality improvement project following the strategic problem solving approach to increase the completion rate of partograph documentation. The intervention was simple, data-driven and cost-neutral. The team achieved its objectives by integrating staff input, obtaining commitment from the multidisciplinary team and applying leadership skills.
Originality/value
The results are useful for hospitals in limited resources settings wishing to improve overall partograph completion and improve foetal and maternal outcomes during labour, in an efficient and cost-neutral way.
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Liz Matykiewicz and Robert McMurray
The purpose of this paper is to consider the ways in which certain occupational, organizational and political positions become active sites of leadership construction. Taking as…
Abstract
Purpose
The purpose of this paper is to consider the ways in which certain occupational, organizational and political positions become active sites of leadership construction. Taking as their example the introduction of the Modern Matron in the English National Health Service (NHS) this paper considers how new forms of gender transcending leadership are constituted relationally through a dynamic interplay of historical, nostalgic, social, political and organizational forces.
Design/methodology/approach
The research was conducted within an interpretive paradigm of social constructivism and draws on data from semi‐structured interviews with a purposive sample of 16 Modern Matrons working in a single English NHS Trust. In keeping with inductive, qualitative research practice, data has been analysed thematically and ordered using descriptive, hierarchical and relational coding.
Findings
Their contention is that the Modern Matron presents as a site for relational leadership in respect of both self and other. This paper argues that the construction of Modern Matron usefully points to the ways in which multiple discourses, practices and relations may be intertwined in defining what it is to lead in contemporary organizations. This paper highlights the extent to which leadership is an on‐going relational co‐construction based – in this instance – in the interplay of four factors: nostalgic authority, visibility, praxis and order negotiation. Together, these produce a mode of leading that is neither heroic nor popularist.
Research limitations/implications
Further research might consider how competing temporal, political and organizational imperatives encourage the development of particular sites for leadership, and how such leadership is then re‐performed in practice, as well as the affects/effect on individual and organisational performance.
Originality/value
The data provides opportunity to consider the “lived experience” of leaders in sites that are traditionally gendered female in non‐standard/public sector settings. Moreover, this paper presents empirical evidence in support of leadership as socially constructed and relational, borne of tension between different temporal, spatial and experiential factors, the on‐going negotiation of which both utilises and transcends masculinized and feminized gender performances. The result is a form of “leading” which is often subtle, difficult to identify and self‐effacing.