12 results
Search Results
2. An exploration of organizational climate in community-based opiate prescribing services; a mixed methods study.
- Author
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Kelly, Peter, Searby, Adam, and Goodwin, John
- Subjects
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THERAPEUTIC use of narcotics , *COMMUNITY health services , *CORPORATE culture , *CROSS-sectional method , *SUBSTANCE abuse , *SUPERVISION of employees , *MEDICAL care use , *PROFESSIONAL autonomy , *TEAMS in the workplace , *INTERVIEWING , *MULTIPLE regression analysis , *LABOR turnover , *LEADERSHIP , *PEER relations , *MULTIVARIATE analysis , *WORKING hours , *PHYSICIAN practice patterns , *RESEARCH methodology , *ORGANIZATIONAL change , *PROFESSIONAL employee training , *CLINICAL competence , *JOB stress , *ATTITUDES of medical personnel , *COMMUNICATION , *DRUGS , *DRUG prescribing , *TELECOMMUNICATION , *ORGANIZATIONAL goals , *PSYCHOSOCIAL factors , *HEALTH facility employees , *HEALTH care rationing - Abstract
Assessing the internal dynamics of organizations has been shown to provide information that can help planners and policymakers improve service delivery. A good organizational climate, which in this study incorporates mission clarity, team cohesion, staff autonomy, communication, levels of stress, and openness to change has been shown to be of particular importance. Still, there is a dearth of evidence in this area, and while relationships between organizational factors have been identified, little is known about the mechanisms that might underpin these relationships, and there is little understanding of how to address deficits once they are identified. The objective of this study was to identify relationships between program factors that influence organizational climate and to explore which mechanisms might underpin these relationships. This paper reports on a cross-sectional, concurrent, mixed-methods study design, across twelve discrete community-based prescribing service providers (organizations) in Ireland. Data was obtained using a staff survey [ n = 132] which utilized measurements of organizational readiness to change and one-to-one interviews [ n = 12]. Quantitative data was analyzed using multivariate linear regression modeling which assessed relationships between variables, while interviews were analyzed using an abductive approach, both types of data were synthesized at the interpretation stage. A range of interdependent factors were considered to affect the climate of organizations. Surveys identified that specific types of resources, such as physical infrastructure, training, and staffing resources were important for supporting a good organizational climate, while programs with greater needs had a poorer climate. Opportunities for professional growth, the skill sets of staff, and having access to e-communication were also significant. Interviewees reported that rigid organizational hierarchies and bureaucracy, philosophical views of addiction, stress, and staff turnover were influenced by the provision of fewer resources. Interdependent factors such as leadership, supervision, staff relationships, and collective training, also thought to be influenced by resources, were considered to positively influence programs. Resources were not the only challenge identified, and practices within programs and how existing resources are used were also thought to contribute both positively and negatively to the internal dynamics of services. Key findings in this study identified that the organization of effective services is influenced by a range of specific factors, some of which can be addressed without additional resources. Overall, staff views of organizations can provide us with valuable information to support service improvement. Using a mixed methods approach can not only identify where relationships between organizational variables exist but can also help us to understand the mechanisms that underpin these relationships and, importantly, how to address deficits once they are identified. In order to improve how substance misuse services work, the need for a long-term systemic approach to program development, which incorporates some of the findings from this study, is required. • Resources: ie. staffing, training, and office resources will likely influence a treatment program's organizational climate. • Programs with higher identified needs were less likely to have a favorable organizational climate. • Having greater growth opportunities was positively associated with; mission clarity, autonomy, and communication. • There is a likely interdependence between organizational domains with no indication of a hierarchy of importance. • How resources are used, not just their availability, was thought to influence to the organizational climate. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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3. Supporting family carers of people with dementia: A discrete choice experiment of public preferences.
- Author
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Teahan, Áine, Walsh, Sharon, Doherty, Edel, and O'Shea, Eamon
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SOCIAL support , *RESEARCH methodology , *SELF-control , *DEMENTIA patients , *PSYCHOLOGY of caregivers , *DEMENTIA , *DESCRIPTIVE statistics , *EMOTION regulation - Abstract
Community-based care for people with dementia is mainly provided by family carers, many of whom experience decreased mental, physical and financial well-being due to their caring role. Many countries are now implementing ageing-in-place policies that have increased pressure on family carers as care-work is redistributed from residential to community-based settings. Family caring responsibilities for people with dementia are made even more complicated by the economic, social and cultural expectations that underpin existing provision. Support for family carers is, therefore, an important policy topic across many countries. The focus of this paper is on the propensity of citizens to support enhanced care for family carers in Ireland, as demonstrated by their willingness-to-pay additional taxation to fund different combinations of carer support measures, developed through careful and sustained dialogue with multiple stakeholders, especially family carers themselves. We carried out a discrete choice experiment (DCE) with 509 members of the general public in Ireland between January and February 2021. Using mixed logit models, our findings show that citizens value four key attributes: regular caring breaks for family carers (day-care and long-break respite); financial compensation (carer's allowance); and emotional support (carer peer support groups). We also estimated the welfare impact of moving from current provision to enhanced support packages for family carers of people with dementia. The welfare gains accumulate to €1035.80 for the most complete levels of provision across the four support attributes. Overall, respondents in this paper showed empathy and understanding towards family carers of people with dementia through their willingness to contribute to funding additional services and supports. • We present findings of a DCE with 509 members of the general public in Ireland. • We estimate public preferences for supporting family carers of people with dementia. • Citizens are willing-to-pay increased taxation to support family carers. • These findings suggest strong public support for increased provision of services. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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4. The evaluation of an early graduate educational intervention.
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O'Connor, Tom, Moore, Zena, Watson, Chanel, Rohan, Niamh, Murray, Bridget, Burke, Anne Marie, Husain, Maryam, Patton, Declan, Shannon, Michael, Wynne, Mary, and Crowley, Ina
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RESEARCH methodology ,MIDWIVES ,NURSING practice ,SURVEYS ,JOB qualifications ,GRADUATES - Abstract
Literature points to a gap which exists in the preparedness of new nursing/midwifery graduates for clinical practice. In Ireland, a two year programme was established in 2013 for all new graduates employed by the public health system. This paper provides a report on the evaluation of the programme which aimed to gauge the impact of the programme on student experience, stakeholder opinion and on health service delivery. A mixed methods approach, combining qualitative and quantitative methodologies, was utilised. Students who undertook the programme, along with non-student stakeholders, were invited to participate. The quantitative element involved an online evaluation survey which was administered to all students participating in the programme, while the qualitative element involved interviews with the participants. Students believed the programme to be relevant to their practice and positively evaluated the use of blended learning, the support of tutors and the contribution to their professional development. Non-student stakeholders also positively evaluated the programme, but the direct impact on clinical practice was not particularly evident. The evaluation offers a positive view of this initiative and broadly supports the concept of early graduate education programmes. A number of recommendations are offered for the development of future programmes. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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5. Potential and challenges for learning during acute medical/surgical placement for intellectual disability, mental health and midwifery students.
- Author
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Mc Carthy, Jane, Graham, Margaret M., Tuohy, Dympna, O'Brien, Brid, Fahy, Anne, Hennessy, Therese, O'Sullivan, Deirdre, and Markey, Kathleen
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EXPERIENCE ,INTERNSHIP programs ,RECORDING & registration ,RESEARCH methodology ,PEOPLE with intellectual disabilities ,NURSING education ,PSYCHIATRIC nursing ,STUDENTS ,QUALITATIVE research ,MIDWIFERY education ,THEMATIC analysis - Abstract
In Ireland nursing and midwifery degree programmes involve four pathways to registration. Three of which, intellectual disability and mental health nursing and midwifery require students to undertake acute medical/surgical placements offering learning opportunities caring for patients with complex needs in settings beyond their core discipline. This paper focuses on findings from a descriptive qualitative study exploring intellectual disability and mental health nursing and midwifery students experiences of such placements. Data analysis identified three themes: Getting ready, Navigating the way and Getting through. Feelings of stress and uncertainty are described by participants when moving from familiarity within a chosen discipline to an unfamiliar environment. Findings have influenced specific placement structures with local health service partners. While our study focuses on an Irish context, findings have relevance for student education in other jurisdictions. Enhancing preparation and support for students undertaking unfamiliar placements needs to be a constant endeavour. Such foundations will foster valuable experiences where students can feel part of a team, gain confidence, enhance skills and transfer meaningful learning to their core practice discipline. Further research is needed to explore the views of preceptors, ward managers and Clinical Placement Coordinators. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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6. Co-learning for sustainable design: The case of a circular design collaborative project in Ireland.
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Bakırlıoğlu, Yekta and McMahon, Muireann
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SUSTAINABLE design , *DESIGN services , *DESIGN research , *DESIGN education , *RESEARCH methodology - Abstract
Incorporating concerns of sustainability and circularity into design practice is undoubtedly important for both design research and education. There is a need to equip novice designers with the skills to facilitate a sustainability-focused future, whilst also collaborating with industry to implement these concerns into contemporary design practices. On the one hand, SMMEs and small teams in other sectors (i.e. public) lack the resources and time to improve their knowledge, to explore alternative ways of conducting business and to transform their design practices. Contrarily, novice designers (i.e. design students) can access state-of-the-art knowledge on sustainability and experiment with sustainable design practices throughout their education, yet they lack insights into market realities around implementation. Similarly, design researchers and educators are on the fore-front of developing sustainability-focused design methodology through research, but they often lack exposure to the industry. If the parties were all to work together, however, the sharing of resources, knowledge and experiences become valuable commodities in creating more sustainable design practices. This paper outlines an on-campus Design for Circular Economy and Sustainability training programme where industry worked with interns and academics to address real-world challenges. The project forms a part of a larger EU collaboration. The programme aimed to create a co-learning environment for novice designers, industry partners and design researcher/educators. Here all stakeholders could exchange their knowledge and insights and learn from each other to explore and experiment with practically implementing sustainability in real-world contexts. This paper briefly introduces the development of the programme and explores how and what co-learning occurred for the different stakeholders. Finally, the paper discusses how the outcomes of this programme subsequently affected the practices of industry partners. The programme offered a unique environment to prepare novice designers for the real world and provided researcher/educators with valuable insights on how to facilitate such a transition. The industry partners utilised this experience and outcomes to review their practices and kick-start the transition towards sustainable businesses. • Interns are exposed to real-life innovation practices for sustainability. • Co-learning equips collaborators for real-life sustainable innovation. • Novice designers gained experience for more responsible future practices. • Industry partners explored ways of transforming their businesses. • Educators gained insights into real-life challenges faced by industry. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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7. Patient classification systems used to classify nursing intensity and assess nursing staffing resources in home health care: A scoping review.
- Author
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Flo, Jill, Landmark, Bjørg, Tønnessen, Siri, and Fagerström, Lisbeth
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ANALYSIS of variance , *CINAHL database , *CLASSIFICATION , *STATISTICAL correlation , *HOME care services , *WORKING hours , *MEDICAL information storage & retrieval systems , *INTERVIEWING , *RESEARCH methodology , *MEDLINE , *NURSES , *NURSING , *PATIENTS , *EMPLOYEES' workload , *SYSTEMATIC reviews , *INTER-observer reliability , *RESEARCH methodology evaluation ,RESEARCH evaluation - Abstract
To identify the patient classification systems used to classify nursing intensity in the assessment of nursing staffing resources currently used in home health care, with a special emphasis on validity, reliability and staff allocation. Scoping review of internationally published and grey literature, based on a methodological framework by Arksey and O'Malley. Searches of the electronic databases Cinahl, Medline, Embase and SweMed, the websites Google and Google Scholar and hand searches of reference lists occurred. Eligibility criteria included (A) a focus on patient classification systems measuring nursing intensity and workload in home health care and (B) published in English between January 2007 and March 2019. In level one testing two team members screened titles and abstracts, in level two testing two team members determined which papers should undergo a full text review. Data were extracted using structured extraction by one team member and verified by two other members. Thirteen peer-reviewed articles and grey literature documents were identified, from Canada, Ireland, the UK, the USA, Scotland, Turkey and the Netherlands. Four patient classification systems had been tested for both validity and reliability. Validity was tested through face validity, predictive validity, concurrent validity or content validity index. Reliability was tested through stability, internal consistency, observer agreement or inter rater reliability. One patient classification system had been tested only for reliability, through interrater reliability and observer agreement. Two patient classification systems had been evaluated through summative evaluation; one qualitatively through focus group interviews and one through semi-structured interviews. Only one patient classification system had been validity and reliability tested and evaluated. Overall, the patient classification systems in the included papers (13) were considered to have benefits and to be appropriate for the measurement of patients' needs, workload and allocation of staff, although specific information was not always given. Little has been published on validity or reliability tested patient classification systems linked to staffing allocation in home health care in the past decade. Limited research was seen where a patient classification system was considered to be fully operational in home health care. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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8. Embodying health identities: A study of young people with asthma.
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Monaghan, Lee F. and Gabe, Jonathan
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ASTHMA , *CHRONIC diseases , *INTERVIEWING , *RESEARCH methodology , *SOCIOLOGY , *QUALITATIVE research , *SOCIOECONOMIC factors , *THEMATIC analysis - Abstract
The embodiment of health identities is a growing area of interest. Questions posed in this literature include: how important is the body in our understandings/experiences of health, how are everyday definitions of health and self embodied despite chronic illness, and how do social relations influence these interpretations? Mindful of such questions, this paper draws on a qualitative study of mild to moderate asthma among young people in Ireland. In-depth interviews were undertaken with 31 respondents aged between 5 and 17, including boys ( n = 15) and girls ( n = 16) from different class and ethnic backgrounds. Core themes included: the importance of play, physical activity and sport; diet/nutrition; and physical appearance. Asthma sometimes presented challenges in relation to specific domains, notably strenuous physical activity, though in many other respects its potential impact was discursively minimised. Attentive to various modalities of the lived body, we illustrate how health identities are negotiated among young people diagnosed with a chronic illness. Connections are also made with the sociology of childhood and (ill) health, which views young people as active agents. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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9. Trust in me: Allegiance choices in a post-split terrorist movement.
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Morrison, John F.
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ASSOCIATIONS, institutions, etc. , *DECISION making , *INTERVIEWING , *LEADERSHIP , *PHENOMENOLOGY , *RESEARCH methodology , *PRACTICAL politics , *RESEARCH , *TERRORISM , *TRUST , *MEMBERSHIP - Abstract
This paper analyses exploratory research into how individual members form allegiances in the aftermath of a split in a terrorist movement, specifically the Irish Republican Movement. While the allegiance decision making is not a violent act in itself the decision made often times constitutes a choice between the retention of terrorism as a dominant tactic and the move towards a peaceful, political solution. It may be intuitive to believe that individuals will make such decisions based on the reasoning for the divide or the ideology of the groups. However, through the analysis of over forty interviews with leadership and rank and file members of the Irish Republican Movement the issue of personal trust is shown to be central to the decision-making process, especially in relation to the rank and file of the membership. This finding is concluded through the application of interpretative phenomenological analysis of four core splits in Irish republicanism from 1969 to 1997. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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10. What helps young care leavers to enter the world of work? Possible lessons learned from an exploratory study in Ireland and Catalonia.
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Arnau-Sabatés, Laura and Gilligan, Robbie
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INTERVIEWING , *JOB evaluation , *RESEARCH methodology , *SOCIAL adjustment , *QUALITATIVE research , *SOCIOECONOMIC factors , *AT-risk people - Abstract
Work is important for promoting social inclusion, especially for marginalized or economically vulnerable populations. There is also evidence that work is associated with stability and social integration for young people who have left care. There is, however, little detailed evidence on how young care-leavers access, and remain in, the world of work. This paper seeks to address this issue. It reports on preliminary findings from a cross-national qualitative study conducted in Ireland and Catalonia. The study set out to explore factors influencing care-leavers' entry into, and progress within, the word of work. Semi-structured interviews were conducted with 22 young adults (10 from Ireland, 12 from Catalonia) aged between 23 and 33 years. The main criteria for inclusion were that study participants should have spent an extended period of time in care and have had substantial employment experience since leaving care. Preliminary analysis reveals different ‘pathways’ into the world of work for the young adults in the study, and a range of influences and circumstances related to these pathways. The implications of the findings for further research and for child welfare practice and policy and research are explored. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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11. Putting knowledge to trial: ‘ADHD parents’ and the evaluation of alternative therapeutic regimes
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Edwards, Claire and Howlett, Etaoine
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TREATMENT of attention-deficit hyperactivity disorder , *ALTERNATIVE medicine -- Evaluation , *INTERVIEWING , *RESEARCH methodology , *PSYCHOLOGY of parents , *QUALITATIVE research , *HEALTH literacy , *CHILDREN - Abstract
Abstract: The role of patients'' organisations in shaping (medical) knowledge about particular health conditions and illnesses sheds light on notions of informed patienthood and the dynamics of lay-expert knowledge in the context of medicalisation. This paper considers dynamics of knowledge production in relation to a specific condition area, Attention Deficit Hyperactivity Disorder (ADHD), by investigating how parents of children with ADHD are intervening in knowledge creation about the effectiveness of different treatments for the disorder. It draws on qualitative research carried out between 2009 and 2011 with organisations representing parents of children with ADHD in Ireland, to explore how parents have commissioned evaluations of alternative interventions to medication. Drawing on analysis of 12 semi-structured interviews with both parents and professionals active in the arena of ADHD, documentary evidence, and observation at parent organisations'' events, the study demonstrates how parents'' interventions have sought to expand the therapeutic domain of ADHD beyond the exclusive realm of biopsychiatry, and the dilemmas they face in making their experiences count in a context where the need for evidence has become paramount in the governance of health. [Copyright &y& Elsevier]
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- 2013
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12. Support in the workplace: How relationships with bosses and co-workers may benefit care leavers and young people in care.
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Arnau-Sabatés, Laura and Gilligan, Robbie
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LEGAL status of children , *CONTENT analysis , *FRIENDSHIP , *INTERGENERATIONAL relations , *INTERPERSONAL relations , *INTERVIEWING , *RESEARCH methodology , *MENTORING , *PSYCHOLOGICAL resilience , *SOCIAL integration , *SOCIAL networks , *WORK environment , *QUALITATIVE research , *SOCIAL support - Abstract
• The article explores how relationships in the workplace may be an important source of social support. • Support received from bosses and co-workers included being shown trust, being given recognition, and being mentored. • It appears that such support assists care experienced young people progress in the workplace and more widely. • Workplace may offer young people the opportunity to develop meaningful and long-term friendships beyond work. It is widely recognised that young people in care and care leavers may find challenges in accessing necessary social support. Their potential support network may be adversely affected by the issues behind their being originally admitted to care, and by later experiences during their time in care and after they leave care. In this article, we explore how relationships in the workplace may be an important source of support for some care experienced young people. Such support may assist their progress in the workplace and more widely. Drawing on a study of 22 young adults who left care in Catalonia and Ireland, this article reports on participants' experience of a range of support from bosses and co-workers. Support received included being shown trust, being given recognition, and being mentored. Participants also reported that employers and co-workers were very helpful, not only in terms of work issues, but also by providing emotional and personal support, and in many cases, by offering young people the opportunity to create meaningful and stable friendships beyond work. This paper highlights how the workplace may be a potential (and largely unrecognised) source of social support for care experienced young people. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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