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Objective: To explore the perspectives of patients and hearing care providers (HCPs) about an adult remote hearing-aid delivery service implemented during the COVID-19 pandemic. Design: Service evaluation via surveys. The patient survey measured satisfaction with the service, perceived hearing-aid handling skills, and preferences for future services. The HCP survey explored the impact of teleaudiology on outcomes compared to in-person care and factors important for successful teleaudiology. Study sample: 378 patients and 14 HCPs. Results: Patients were highly satisfied with the service and self-reported good hearing-aid handling skills. However, 2 in 3 patients said they would prefer a future hearing-aid fitting to be in-person rather than remote. HCPs thought teleaudiology had positive impacts on convenience, accessibility, and flexibility, but negative impacts on communication, rapport, and the quality of care. HCPs considered computer literacy and individual preferences to be important for successful remote care; the age of the patient was considered less important. Conclusions: Patients were generally highly satisfied with the service and for 1 in 3 it was their preferred mode of future hearing-aid fitting. Future services should be aware that a one-size-fits-all approach will not satisfy all patients and that teleaudiology should be offered on the basis of individual preference. [ABSTRACT FROM AUTHOR]

This article reports on a two-year study of a community-based suicide postvention support service in the UK. Attention centres on the implementation of four integrated elements within the service model: multi-agency working with real-time suicide surveillance, persistent pro-active contact; volunteer-led support; continuous open-ended support. Our approach involved analysing utilisation data and qualitative techniques, including in-depth interviews with a diverse group of stakeholders. The study is the first of its kind to provide an in-depth examination of an innovative approach focusing on the integrated model and its constituent components. Our findings offer evidence-based examples of collaborative service efforts in implementing real-time interventions, with agencies working together to provide timely, co-ordinated, proactive responses and support with the potential to alleviate suffering and prevent loss of life. The value of volunteer-led support and open-ended access and associated challenges are emphasised. Findings hold promise for international impact with policy implications for services worldwide. [ABSTRACT FROM AUTHOR]

Service robots are used in all aspects of the service industry and improve business efficiency dramatically. However, service robot failures are also prevalent. This paper explores the interaction effect between symbolic service recovery and service robot social perception on service evaluations, the underlying mechanism, and the boundary conditions. Through three experiments with multiple service scenarios, such as hotel, restaurant, and tourist attraction, we find that service robots with warm perceptions using humor responses for a service recovery result in better service evaluations, whereas service robots with competent perceptions using rational responses for a service recovery result in better service evaluations. In addition, our research verifies the mediating role of perceived relief and perceived sincerity and identifies the moderating role of the locus of responsibility. We conclude by discussing the implications of these findings for marketers in the services and hospitality industries.服务机器人已经应用在服务行业的各个方面并显著提高企业的效率，但服务机器人服务失败也很普遍。本文探讨了象征性服务补救与服务机器人社会感知对消费者服务评价的交互作用，影响机制及边界条件。通过3个不同服务场景的实验，如酒店、餐馆和旅游景点，我们发现温暖感知的服务机器人使用幽默的回复方式来进行服务补救会使消费者有更好的服务评价; 而能力感知的服务机器人使用理性的回复方式来进行服务补救则更佳。此外，我们的研究验证了感知宽慰和感知真诚的中介作用，并确定了责任点的调节作用。最后，我们讨论了这些发现对服务和酒店业营销人员的影响。 [ABSTRACT FROM AUTHOR]

AbstractThis service evaluation explored experiences of adoptive parents and support workers accessing videoconferencing-based therapeutic support. Adoptive parents from 18 families who accessed remote therapeutic support between July and December 2020 completed questionnaires and semi-structured interviews were conducted with six social workers. Questionnaires were analyzed descriptively, and interviews were analyzed thematically. Parental responses indicated that accessing such support was accessible and met family needs. Three interview themes were identified: accessibility of support package, relationships and communication, and looking to the future. Findings suggest that a mixture of face-to-face and remote support is preferrable, however, modality preferences differ per family. Recommendations for services offering remotely delivered therapy via VC are made based on the findings, including (1) provide families with a choice of modality for therapeutic work, (2) provide more time to develop a therapeutic relationship, (3) consider a face-to-face meeting prior to online sessions, (4) provide training for staff and families on digital technology, (5) use remote support to provide brief packages of support, and (6) involve support workers to provide consistent support. Suggestions for further research are outlined. [ABSTRACT FROM AUTHOR]

Crisis Resolution and Home Treatment Teams (CRHTTs) provide mental health support for people experiencing crises and its employees are at high risk of occupational stress. Reflective Practice Groups (RPGs) hold promise for reducing staff burnout. However, to date, there have been no evaluations of RPGs delivered in CRHTT settings. This study aimed to explore staff experiences of RPGs delivered in one CRHTT. All CRHTT staff members who had attended at least one RPG were approached to take part. Participants completed two supervision questionnaires and a semistructured interview. Descriptive statistics were calculated to quantify staff experiences and qualitative themes were generated using thematic analysis. Thirteen people participated, all of whom reported positive experiences of RPGs. Three qualitative themes also emerged comprising 'core components of RPGs' 'benefits to staff' and 'challenges of RPG delivery'. Staff value RPGs delivered in CRHTT settings, which may reduce staff burnout and contribute to workforce development. [ABSTRACT FROM AUTHOR]

Background: The evidence for the effectiveness of online EMDR for PTSD is scarce. Objective: This service evaluation aimed to assess how online EMDR compared to in-person EMDR, in terms of its potential effectiveness and acceptability to therapists and patients. Method: The evaluation was carried out in the Cardiff and Vale University Health Board Traumatic Stress Service. We compared the outcome of therapy (PTSD scores at end of treatment), number of sessions, drop-out rate, and adverse events using linear/logistic regression in those receiving online EMDR over a 12-month period with those who had received in-person therapy in the year previous to that. Interviews with therapists and clients who had provided or undertaken online EMDR explored their views and experiences of treatment. Interviews were analysed thematically. Results: 33 people received in-person EMDR (15.3 sessions, SD = 1.4), and 45 received online EMDR (12.4 sessions, SD = 0.9). 24 individuals completed therapy in-person, and 32 online. There was no evidence of a difference in therapy completion, drop-out rates or adverse events between the two delivery modes. There was weak evidence that those who completed EMDR online and had available data (N = 29), had slightly lower PTSD scores at the end of therapy compared to those who received in-person EMDR (N = 24) (17.1 (SD = 3.2) versus 24.5 (SD = 3.0), mean difference = 7.8, 95% CI −0.3, 15.9, p =.06). However, groups were not randomised and only those who completed treatment were analysed, so estimates may be biased. 11 patients and five therapists were interviewed. Overall, both therapists and clients viewed online EMDR as safe and effective. Benefits mentioned by clients included feeling more in control and not having to travel. Clients' concerns related to lack of privacy and 'transition time/space' between therapy and their daily lives. Conclusion: Results suggest that online EMDR is an acceptable, safe and effective alternative to in-person EMDR for PTSD in this service. This service evaluation assessed how online Eye Movement Desensitisation and Reprocessing (EMDR) compared to in-person EMDR in people with PTSD. Individuals receiving online EMDR had lower PTSD scores at the end of therapy, but the evidence for this was weak and as this was not a randomised trial we do not know whether this was due to the mode of therapy or other characteristics of clients receiving online therapy. Clients and therapists generally viewed online EMDR as being safe and effective, and supported the availability of online EMDR for PTSD. [ABSTRACT FROM AUTHOR]

Many patients referred for psychodynamic psychotherapy are also seen by other services. Due to the complex interplay between psychological distress, physical symptoms and care-seeking behaviour, engagement with a psychotherapy department has the potential either to increase or decrease use of other services. This service evaluation compared 268 patients' service use in the year preceding and following contact with an NHS psychodynamic psychotherapy department using t-tests. There were no significant changes from before therapy to afterwards for the sample as a whole. However, for sub-groups who made regular use of services at baseline, a full course of psychotherapy (16+ sessions) was associated with a statistically significant reduction in outpatient contacts, both for mental health (N = 32, mean 11.69 appointment per year pre-therapy vs 5.16 post-therapy, p = 0.01) and medical services (N = 23, from mean 9.65 to 3.00, p < 0.01). No compensatory changes were found in either A&E or inpatient contacts, suggesting this represents an overall reduction in service use. Due to the study design, it was not possible to establish causality; there may be other reasons for this observed reduction such as natural illness course. These findings tentatively support the existing literature that psychodynamic psychotherapy is associated with a reduction in use of wider services. [ABSTRACT FROM AUTHOR]

To identify client and service factors associated with changes in health-related quality of life following community rehabilitation. We conducted a retrospective observational cohort study within a community rehabilitation program. Health-related quality of life was measured using the EuroQol five Dimensions, five response level version (EQ-5D-5L). Our primary outcome was the Visual Analogue Scale (VAS) rating of overall health. Analyses were stratified by diagnostic group: traumatic orthopaedic, elective orthopaedic, neurological, medical, and other. The association between client and service factors and discharge VAS scores, adjusted for baseline scores were determined using multivariable regression. EQ-5D-5L data were available for 981 of 1350 participants. Treatment intensity was associated with a seven-point increase (β = 7.22, 95%CI 2.28–12.2, p = 0.004) in VAS scores for traumatic orthopaedic participants. For neurological participants, there was a positive interaction between comorbidities and intensity of therapy (β = 7.9, 95%CI 2.75–13.1, p = 0.003), indicating that greater therapy intensity in those with higher comorbidity scores was associated with an improvement in VAS scores. Age was negatively associated with VAS scores for traumatic orthopaedic participants and socioeconomic status was positively associated with VAS scores for elective orthopaedic participants. Treatment intensity is a modifiable service factor that may positively influence health-related quality of life. In addition to providing information on client progress towards attainment of individual treatment goals, routine collection of patient reported outcome measures within a community rehabilitation program can elicit information that can inform rehabilitation service improvement. Clients of a community rehabilitation program with a neurological or medical condition demonstrate the least improvement in overall health profile and may require additional rehabilitation or supports. Across all diagnostic groups, problems with anxiety and depression were least likely to improve following receipt of community rehabilitation. Improving access to psychological services and associated referral pathways in community rehabilitation services could improve these outcomes. Initiatives aimed at increasing intensity of therapy such as targeted triage and resource allocation, may improve health-related quality of life for clients of a community rehabilitation program with traumatic orthopaedic conditions. For clients with a neurological condition, initiatives aimed at increasing intensity of therapy may improve health-related quality of life in more complex patients with comorbid health conditions. [ABSTRACT FROM AUTHOR]

The Library and Information Center (LIC) of Patras' University and the Hellenic Open University Distance Library and Information Center constitute two academic libraries that serve two different academic institutions types. By the time of the first phase of the outbreak (spring 2019) they attempted to respond multidimensionally to the emerging needs, aspiring tο a seamless provision of services. Currents' research primary objective is to record and compare their actions identifying any differences in their crisis management behavior. The study offers an overview of services offered by libraries that have limited resources and presents their attempt to remain effective under any circumstances. [ABSTRACT FROM AUTHOR]

Many governments have implemented indirect policy instruments as an alternative to direct instruments for providing public services. However, the effectiveness of the instruments from the perspective of recipients has not yet been compared in depth in the literature. This study investigates the recipients' evaluation of the differences between public housing and housing vouchers, which were exogenously assigned by the government to recipients, using ordered logit and generalized ordered logit models to analyze data collected in 2019 from Korean military personnel. The findings indicate that the evaluations of the services delivered by housing vouchers were more positive than those of public housing, and the magnitude of the difference between evaluations varied according to the attributes of the household decision makers and the rural or urban location of the leased house. These findings provide empirically grounded contributions to the selection of policy instruments and uncover the contexts in which each policy instrument may be implemented for the best effect. [ABSTRACT FROM AUTHOR]

Visual perceptual deficits are frequently underdiagnosed in stroke survivors compared to sensory vision deficits or visual neglect. To better understand this imparity, we evaluated current practice for screening post-stroke visual perceptual deficits. We conducted a survey targeted at professionals working with stroke survivors involved in screening visual perceptual deficits across the United Kingdom and the Republic of Ireland. Forty orthoptists and 174 occupational therapists responded to the survey. Visual perceptual deficit screening was primarily conducted by occupational therapists (94%), with 75∼100% of stroke survivors screened per month. Respondents lacked consensus on whether several common post-stroke visual deficits were perceptual or not. During the screening, respondents primarily relied on self-reports and observation (94%), while assessment batteries (58%) and screening tools were underutilised (56%) and selected inappropriately (66%). Respondents reported lack of training in visual perception screening (20%) and physical/cognitive condition of stroke survivors (19%) as extremely challenging during screening. Visual perceptual deficits are screened post-stroke at a similar rate to sensory vision or visual neglect. Underdiagnosis of visual perceptual deficits may stem from both reliance on subjective and non-standardised screening approaches, and conflicting definitions of visual perception held among clinicians. We recommend increased training provision and use of brief performance-based screening tools. Lack of agreement among clinicians on what constitutes as visual perceptual or sensory vision deficits may prove problematic, as precise and exact language is often required for clinical decision-making (e.g., referrals). Biases for more familiar visual (perceptual) deficits held among clinicians during the screening process may lead to other visual deficits being missed. To avoid problems being missed, clinicians should aim to use standardised assessments rather than stroke survivor self-report and observations of function when screening for visual perceptual difficulties. [ABSTRACT FROM AUTHOR]

Cultural Ecosystem Service (CES) evaluation is the basis for various environmental management and policymaking for nature-based tourism destinations including national parks. As an innovative data sourcing method, geolocated social media data promotes the rapid growth in CES research. Based on 58 empirical research articles using geolocated social media data, we review the current status and challenges of CES research and suggest some future CES research directions. We find that current geolocated social media based quantitative CES evaluation studies concentrate in photo density analysis, quantitative analysis of photo contents, photo viewshed analysis and economic values analysis. We also find that factors affecting CES spatial and temporal distributions fall in two major categories: biophysical and social/infrastructure. We think that future CES research can be improved by theoretical extension, methodological integration and service co-creation. [ABSTRACT FROM AUTHOR]

Mental illness in people experiencing homelessness is common and a key reason for attendance at emergency departments and admission to hospital. This paper describes how the KHP Pathway homeless team impacted use and cost of health and wider services. The Pathway model had never been adopted by a mental health hospital, and there had never been an economic analysis to evaluate service use before and after intervention. Service use was measured using an adapted version of the Client Service Receipt Inventory (CSRI) with a simple before and after design at admission, 3 months and 6 months after discharge from hospital. During the first 3-month follow-up, over half the participants saw a GP, with an increase in the proportion seeing a psychiatrist, social worker and a mental health nurse. Attendance at emergency departments was substantially lower than at baseline. The mean total service cost was £818 at base line and £414 at 3 months. The adapted version of the CSRI demonstrates that patients seen by the Pathway Homelessness Team were supported to use community and scheduled health and care services. The service overcomes barriers, frequently experienced by people experiencing homelessness, in accessing support and community healthcare in the UK. [ABSTRACT FROM AUTHOR]

Shared decision-making is a principle of health care delivery across the world. The first international standard decision aid for tinnitus care was developed in 2018. This decision aid is in use across the UK. It is free to use and access from the British Tinnitus Association website. Our objective was to compare routine care with the care that also included the decision aid as part of care for their patients. A multi-site service evaluation included pre–post comparison of decisional conflict in sequential new patients seeking help with tinnitus. Informal interviews with staff and service managers explored how practical and feasible the decision aid was in routine practice. We present data from four contrasting clinical services, including services in England and Wales, acute and community services and those operated by Hearing Therapists and Audiologists. Across these contrasting services, the inclusion of the decision aid was associated with a reduction in decisional conflict in patients. The decision aid was feasible to administer, acceptable to patients and clinicians without creating a burden in appointments. These evaluations suggest that the decision aid is feasible to administer and reduces patient decisional conflict. It appears to benefit clinical services in practice. [ABSTRACT FROM AUTHOR]

Sexual problems are routinely dealt with in National Health Service (NHS) clinics across the UK. This is a service evaluation of the Maudsley Psychosexual Service situated in South London. It incorporates retrospective information on 609 referred patients over a three year period (2015–2017) with complex and persistent sexual problems. The majority of patients were referred from within the South London area of which 65% were male, mean age 40 with the female mean age being 34 years. Of referred individuals with varied sexual problems the greater numbers 78% came via primary care, 10% from acute medical service and 8% from acute psychological services. Of patients who were both assessed and treated 65% completed their planned treatment. These patients improved to below the cut-off point for distress and showed improvement in condition. The majority of referrals identified as white whilst those identifying as Black, Asian or Mixed Ethnic were notably under-representative of the patient community. Of those patients completing treatment 79% did so with a mean of 19 sessions supporting our treatment protocol for complex and persistent sexual problems. Given the financial challenges the NHS is experiencing it is fitting this evaluation indicates patients in this service are receiving care appropriate for their needs. [ABSTRACT FROM AUTHOR]

Attempts to secure improved outcomes with persistent medically unexplained physical symptoms (MUS/PPS) are in their early stages of development and effective implementation in the United Kingdom remains inconsistent. There are scant systematically examined process and outcome studies in this field published in peer reviewed journals. Moreover, persistent sexual symptoms no longer appear in listed examples of MUS/PPS in the professional literature and consequently few studies can be found on 'what works' for improved outcomes with this group of sufferers. A systematic evaluation of an NHS Community Psychosexual Counselling Service delivered within an Integrated Contraception and Sexual Health Service for adults with persistent sexual dysfunction is summarised. The findings from the synthesis of evaluated research, professional guidance and a particular practice, at clinic cohort and embedded case levels, revealed common themes of engagement across the therapy divides when addressing "medically unexplained" physical symptoms. This supports future research in this area and calls for the inclusion of persistent sexual symptoms. The extracted themes from the therapy process may be used as tools to enhance skills of engagement with unresolved PPS in similar settings in which the individual seeks help to achieve improved outcomes. [ABSTRACT FROM AUTHOR]

This case study describes the process librarians at a large research university used to evaluate a systematic review searching service. PubMed, Embase, CINAHL, and Scopus were searched for studies with a local, health sciences author. Data on librarian involvement, search quality, and standards adherence were recorded. Results of the assessment indicate a gradual increase in librarian authorship or acknowledgement over time, a moderate improvement in adherence to reporting standards over time, and insight into which departments better adhere to standards. Ideas for improving the quality and reach of the service while ensuring sustainability are discussed. [ABSTRACT FROM AUTHOR]

Objective: In university-based randomised trials the Cool Little Kids parenting group program for temperamentally inhibited preschool children reduced the risk for anxiety disorders. The present study was a 'real world' service-delivery evaluation to assess family effects pre-post intervention. Method: Postgraduate clinical psychology interns received training and supervision from a clinical psychologist to deliver Cool Little Kids in socioeconomically diverse areas of Melbourne, Australia. Service evaluation participants (N = 38) were parents of children in the year before starting school who received an inhibition screening pamphlet at their preschool, self-referred into the program, and consented to complete a pre-post questionnaire to gain family case feedback. Service evaluation questionnaires were validated measures of child mental health, parenting practices and parent wellbeing, and elicited feedback on intervention acceptability. Results: 92% of the sample (n = 35) returned the post-intervention questionnaire. 66% of parents attended most of the intervention (5-6 groups) and the rest attended at least half (3-4 groups). Pre-post findings for children were reductions in clinical internalising problems (CMFWQ 54% to 11%, p < .001; SDQ-emotional 37% to 14%, p = .008) and anxiety symptoms (all PASr subscales). Pre-post findings for parents were improvements in parenting (over-involved/protective 1.75 to 1.61, p = .005; nurturing 52.77 to 55.54, p = .025) and stress (9.52 to 7.22, p = .002). Parents' quantitative and qualitative feedback on 'usefulness' of the program was highly positive. Conclusion: This service evaluation supports implementing Cool Little Kids in the community for parents who are motivated to engage in parenting groups. Further service evaluations with low income/education and diverse cultural backgrounds would be worthwhile. [ABSTRACT FROM AUTHOR]

Service evaluations in music therapy often have local, functional and immediate goals, such as ensuring quality and continuing funding. However, given the amount and type of information collected in service evaluation projects from therapists, clients and those around them, such – often unpublished – projects may constitute a hidden treasure trove of information particularly about the perceived impact of music therapy services. In addition to exploring potentially challenging aspects of service evaluations in music therapy, this article considers how these can contribute to the understanding of music therapy through analysis of five service evaluations. These service evaluations share a common approach (Nordoff-Robbins) and area of work (neuro-rehabilitation) and were informed by sociocultural epistemologies underpinning contemporary Nordoff-Robbins practices. Such epistemologies consider people’s everyday experiences and contexts, and encourage an exploration of the music therapy service in its entirety. It is from this perspective that this study explores the impact of music therapy services in neuro-rehabilitation settings as perceived and reported by clients and those around them. Although the perceived impact of music therapy beyond the client has been previously discussed, this seems to have been less emphasised in neuro-rehabilitation settings where the focus tends to remain on the client and their rehabilitation progress. We discuss how the context-sensitive nature of such evaluations can enable the potential for identification of areas of impact that can feed back into practice as well as generate research questions. [ABSTRACT FROM PUBLISHER]

Following the success of antiretroviral therapy, an expanding cohort of adolescents with perinatally acquired HIV (PaHIV) is transitioning into adult care. Dedicated multidisciplinary transitional care HIV services have been established in the UK. However, published data on patient satisfaction with such services are sparse. A single centre survey of patient satisfaction was conducted in January 2014, and results compared to a previous similar survey in 2009. Patients were asked to complete a questionnaire regarding views of their care using a 7-point Likert scale. 51/96 attended within the time period and all completed the survey, compared with 21 in 2009. Ninety-two percent were satisfied with the care provided by the clinic, compared to 100% in 2009. The proportion who felt moving to their current service had a positive effect on their health increased from 68% in 2009 to 81% in 2014. Ninety-two percent were satisfied with the overall care provided by the clinic, compared to 100% in 2009. Ninety-four percent agreed that staff knew how to talk and listen to young people, 96% agreed staff were able to explain their treatments and problems clearly in a way that they could understand. Ninety-six percent felt that a clinic specifically for young people was useful. Despite a marked increase in clinic attendees and unchanged levels of service provision, patient satisfaction remained high. Patients strongly value the provision of dedicated services for young people. [ABSTRACT FROM AUTHOR]

Purpose:To evaluate the impact of a person-centred, community rehabilitation service on outcomes for people with a neurological condition, in the first year of service. Method:A prospective, observational, pre-post study was conducted with 206 people who had a neurological condition and attended the rehabilitation service to restore function (e.g., Stroke); maximize recovery in an ongoing situation (e.g., Spina Bifida); or maximize function and independence while preparing for inevitable decline (e.g., Parkinson’s Disease). Outcomes were measured via self-report questionnaires, prior to, and following three months of rehabilitation. The primary outcome was achievement of self-identified goals, measured by the Patient-Specific Functional scale. Secondary outcomes included the Lawton Instrumental Activities of Daily Living (IADL) scale, EQ-5D-5L European Quality of Life scale, and ICECAP-O – Index of Capability for Older Adults and health and medical resource use. Results:Participants demonstrated significant goal achievement and a significant reduction in health and medical resource use. There were small positive changes in the Lawton IADL, EQ-5D-5L, and ICECAP-O however these changes were not significant. Conclusions:In the first year of operation, the community rehabilitation service made a significant impact on outcomes for individuals with a neurological condition. Further research is required to identify appropriate measures of activities of daily living and quality of life that reflect person-centred rehabilitation outcomes for restoring function, maximizing function, or preparing for functional decline.Implications for RehabilitationSelf-identified goals are an important guide for achievement of meaningful outcomes for individuals with a neurological condition.Person-centred outcome measures are required to evaluate the benefits of a person-centred community rehabilitation service for individuals with a neurological condition. [ABSTRACT FROM AUTHOR]

Background:Client feedback is an essential part of service evaluation and can aid both the development and delivery of client-centred services. The current study is an investigation into the experiences of women who have accessed a perinatal infant mental health (PIMH) service. The purpose of the service is to support vulnerable women to connect with and care for their infant, however it is not well understood how effectively the service supports the needs of the consumers. Method:One hundred and seventy-six women, discharged from the service within the past 36 months were invited to participate in the study. Forty of the discharged consumers were able to participate in a semi-structured telephone interview. Interviews were transcribed verbatim and interpreted using thematic analysis. Results:One superordinate theme, the service as a ‘Lifesaver’ and four subordinate themes describing the way in which the service met the needs of the participants were identified. More specifically, the themes included supportive counselling, trauma counselling, specialist interventions and assertive outreach. Overall, it was found that trusting therapeutic relationships with a regular clinician facilitated a safe environment conducive to counselling, which allowed for reflections on trauma, mental health and parenting. Implications:Findings from this study highlight the positive impact of PIMH services on consumers with a particular emphasis on the importance of the consumer–clinician relationship. Importantly, it was also found that dealing with past trauma was critically important for the women to enable them to move on with their lives as mothers. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the relationships between service evaluation, corporate image, switching barriers, and customers’ intentional loyalty. The proposed model was tested and valuated in the mobile services context. A field survey was conducted using a structured questionnaire about the investigated concepts. To test the proposed hypotheses, a model was constructed and estimated using the method of partial least squares. Findings indicate that service evaluation constructs have both direct and indirect effects, through customer satisfaction and corporate image, on customers’ intentional loyalty. The outcomes suggest that marketers, in their effort to develop more customer-oriented marketing plans, should consider both the pool-in factors, reflecting the value of the provided services, customer satisfaction, and corporate image, and the interactions among them, as well as the push-back factors, as they all impact on customers’ behavioral intentions. The research was limited to one service setting and the proposed model should be cross-validated in other service settings before the relationships among its components are fully clarified. Also, the use of cross-section design reduces inference ability regarding temporal changes in research constructs. This article contributes in adding to the body of the existing knowledge by considering both corporate image and switching barriers, along with service evaluation constructs, as antecedents of consumer’s intentions determination, resulting in a model that has not been investigated thus far. [ABSTRACT FROM AUTHOR]

This paper presents results of the research into perspectives of children with disabilities on the space within community-based services in Serbia. The concept of children's agency and participation is considered in the context of inclusion of children with disabilities in the evaluation of services. Using specially developed 'Me at the Centre' evaluation method, 20 children aged between 7 and 17 years receiving the home care, day-care centre and respite care services were interviewed in order to understand their perspectives on the services and the ways to improve them from the child perspective. The research results show that children with disabilities can make a significant contribution to the review and enhancement of community services designed for them. [ABSTRACT FROM AUTHOR]

Health promotion is an important component of long-term follow-up (LTFU) care for childhood cancer survivors (CCS). However, little information exists about how survivors perceive their own health promotion needs. As part of a service evaluation, 51 CCS who had previously attended the LTFU clinic took part in a single semistructured interview to seek their views on information they had received regarding late adverse effects (LAEs) of treatment, the purpose of LTFU, and the provision of health promotion information. Although most (93%) CCS were satisfied with the information received about LAEs, 37% desired further details. Over half (59%) believed that the purpose of LTFU was to screen for LAEs, whereas 31% felt that it was to check for relapse. No survivor reported health promotion to be an aim of LTFU; only 14% of CCS expected to receive healthy lifestyle advice, and fewer than 10% wanted dietary and physical activity advice. Most (88%) CCS felt that their hospital-based health care professional was best placed to give healthy lifestyle advice, but there was no consensus about the optimum timing for health promotion. CCS varied in their knowledge, needs, and wishes regarding LTFU care. The results of this evaluation strongly indicate that the profile of health promotion needs to be raised within our service and identifies issues that may be pertinent to similar services. Further research is needed to understand the views of CCS regarding health promotion and lifestyle behaviors, with the aim of tailoring and improving the delivery of effective health education to CCS. [ABSTRACT FROM PUBLISHER]

Introduction: A retrospective evaluation of pre- and post-operative audiometric data at a single large UK cochlear implant centre over 25 years was undertaken.Methods: Analysis of pre-operative hearing levels showed that there was a modest but significant reduction in average pre-operative hearing thresholds among patients referred between 1990 and 2015, particularly in the low frequencies.Outcomes: The proportion of those referred who would meet widely-accepted candidacy criteria for electro-acoustic stimulation (EAS) grew significantly over time but in the period 2011-2015 just 9% of those referred had sufficient residual hearing for EAS. On average, implant recipients lost 20 dB hearing at frequencies ≤1000 Hz as a result of the surgery.Conclusions: The findings suggest that hearing preservation is now widely achievable, and that both candidacy criteria and referrer education should take into account potential EAS benefit. [ABSTRACT FROM AUTHOR]

National health service (NHS) psychosexual clinics are key providers of services for sexual problems in the UK. This report is the second in a series of three which describes the Leeds Psychosexual Medicine Service. It covers a three-year period (2009–2012), presenting information relating to 1085 patients referred to the service during that time. The majority of patients were in the age range 18–40 years and 54% were male. In 76% of cases the referral was from primary care and a broad range of sexual problems were referred. Only 31% of the total referrals were found to have completed all planned sessions of their treatment. Of those who did, 82.99% showed an improvement in their condition (42.71% major, 22.92% moderate, and 17.36% minor improvement), with no change in 15.97% and a deterioration in 1.04%. In common with the results of the first in this series of reports, our data suggest that brief therapy lasting six to eight sessions is beneficial in most patients and that, with minimisation of patient non-attendance, the brief interventions which we are finding to be effective could be made more so. This review series remains relevant in the current context of severe financial constraints and pressures on the NHS. [ABSTRACT FROM PUBLISHER]

Background: Experience-based co-design (EBCD) is a methodology for service improvement and development, which puts service-user voices at the heart of improving health services. Aims: The aim of this paper was to implement the EBCD methodology in a mental health setting, and to investigate the challenges which arise during this process. Method: In order to achieve this, a modified version of the EBCD methodology was undertaken, which involved listening to the experiences of the people who work in and use the mental health setting and sharing these experiences with the people who could effect change within the service, through collaborative work between service-users, staff and managers. Results: EBCD was implemented within the mental health setting and was well received by service-users, staff and stakeholders. A number of modifications were necessary in this setting, for example high levels of support available to participants. Conclusions: It was concluded that EBCD is a suitable methodology for service improvement in mental health settings. [ABSTRACT FROM AUTHOR]

The article focuses on rehabilitation of people with aphasia. Topics discussed include use of a participatory learning and action research approach to involve people with aphasia as co-researchers in service evaluation; improving patients quality of life; and promoting understanding of health and illness experiences.

The importance of training non-psychology healthcare professionals to offer psychological support to people with cancer is becoming increasingly recognized. This small-scale pilot project sought to identify the training and support needs of oncology staff and to evaluate the effectiveness of a Level 2 Psychological Support Training Program workshop. Semi-structured interviews with five members of multidisciplinary oncology staff identified that training needs were primarily around communication skills, recognizing and dealing with emotions, offering support and empathy, and self-care. Pre and post-training questionnaires developed with these themes in mind revealed that the Level 2 Training Program workshops run in this network of hospitals are effective in increasing participants’ levels of perceived knowledge and confidence across each of these domains. Recommendations are made for further enhancing this effectiveness. [ABSTRACT FROM AUTHOR]

Background Evidence suggests exercise may benefit patients with advanced progressive illness and some hospice day services now provide dedicated gym space. However, supporting data for such a service development are limited. We describe patient referrals, interventions, feedback, and potential impact of a nine-session, outpatient, hospice-based, circuit exercise programme. Methods Consecutive referrals to physiotherapy over a 6-month period commencing March 2013 were followed prospectively. Physical function (short physical performance battery (SPPB), grip strength), fatigue (Functional Assessment of Chronic Illness Therapy), psychological well-being (General Health Questionnaire), and patient satisfaction (FACIT-PS) were assessed pre- and post-programme. Results Of 212 referrals, 61 (29%) with a range of cancer and non-cancer diagnoses (median [inter-quartile range] survival 67 [50–137] days) were considered appropriate for the circuits of whom 54 (89%) started. There were no statistical differences between those completing and not-completing with regards to age, diagnosis, social status, or survival. In completers (n = 28), 4-m gait speed (mean Δ [95% confidence intervals] 0.23 [0.03, 0.44] m/seconds), five sit-to-stand time (mean Δ −5.44 [−10.43, −0.46] seconds) and overall SPPB score changed statistically, while grip strength did not (mean Δ 0.65 [−1.39, 2.96] kg). Psychological well-being, quality of life, and fatigue remained unchanged. Patients felt the physiotherapists gave clear explanations, understood their needs, and would recommend the service to others. Conclusion A hospice-based programme is one way to offer exercise to a range of patients with advanced progressive illness. Despite excellent feedback, only half of patients completed the nine-session programme in full and evidence of benefit was limited. Future work should explore the broader benefits of participation and whether delivering programmes or elements of them in shorter time frames is more beneficial. [ABSTRACT FROM AUTHOR]

Background Occupational therapy aims to maximize patients' independence and is thus particularly relevant in palliative care where a loss of function is both common and distressing for patients. However, there is evidence that health professionals have a limited understanding of its role and remit, with the consequence that timely referrals are not made. Method A service evaluation was undertaken to establish colleagues' understanding of the palliative care occupational therapy service and its perceived benefit to patients in one local primary care area. A mixed methods approach was used, combining an online survey and focus groups. One hundred people were invited to complete the questionnaire, with a 58% response rate. Twenty-five people subsequently participated in two focus groups. Results Participants believed that the service achieved its aims. The main reasons for referral to the occupational therapy service were for the provision of equipment, or advice about equipment to support independent community living. Facilitating patients' preferred place of care was ranked next in importance. Participants did not feel that they were sufficiently aware of the full range of occupational therapy services available, and suggested that the provision of education and information would be effective in raising awareness of the remit of the specialist occupational therapy service. Conclusion From the professional service users' perspective, the specialist community palliative care occupational therapy service makes a valuable contribution to maintaining patients' independence, comfort, and quality of life, and is associated with supporting patients' preferred place of care. Areas highlighted for development include clear communication pathways, and education and information strategies regarding the role of the palliative care occupational therapist. [ABSTRACT FROM AUTHOR]

Sexual problems are common and patients seek treatment from various clinicians. Specialist psychosexual clinics within the NHS in the UK are one of the key providers of sexual medicine services. This retrospective service evaluation covers a population of 846 patients referred over a three-year period to the Leeds Psychosexual Medicine Service. Of patients referred, 65% were males and the majority of patients were in the age range of 18–40 years. Of referrals, 70% were from primary care physicians, with complaints of a broad range of sexual problems. Around half of the referred patients failed to attend either their first or subsequent appointments. A third of the total referrals completed all planned sessions of their treatment. Of these, 70% showed major improvement and only a small proportion (6.5%) either showed no change or worsening of their problems. Our data suggests that brief therapy lasting four to eight sessions is beneficial in most patients. This evaluation is timely as there are financial constraints on the NHS currently and with improved service delivery models, which aim to minimise patient non-attendance, brief interventions can be effective. [ABSTRACT FROM PUBLISHER]

Objective:This study investigated the views and experiences of obese pregnant and post-natal women who had declined or disengaged from an evidence-based weight management service, and their reasons for doing so.Background:Despite significant risks of maternal obesity to both mother and baby, the majority of obese women offered tailored weight management support during or after pregnancy declined to use it, and many women who accepted the service disengaged soon after.Methods:Semi-structured interviews regarding women’s views and experiences were conducted with obese pregnant and post-natal women who declined the service (N= 7) and women who disengaged from the service (N= 11) and analysed thematically.Results:Four main themes were identified. ‘First contact counts’ related to inadequate explanation of the service by the referrer, being offended by the referral, and negative expectations of the service. ‘Missed opportunities for support’ describes what support declining women identified as desirable, such as regular weight monitoring. ‘No need for help’, and ‘Service not meeting needs’ related to personal choices regarding weight management, including not wanting support and preferring group-based services.Conclusions:While some obese pregnant and post-natal women did not want any type of weight management support, many did but failed to engage with the service on offer due to a variety of barriers. A more sensitive and transparent referral process and further tailoring of the service to meet individual needs may increase uptake and continued use of this service. The inclusion of non-participants and non-completers formed a valuable element of service evaluation. [ABSTRACT FROM PUBLISHER]

Consumers with co-occuring mental health, substance use and physical impairments present with a wide array of needs that cannot be addressed by one sole agency. The Complex Needs Assessment Panel and Integrated Support (CNAPIS) was developed to coordinate care and service delivery for young adults with co-occuring disorders. Utilising a multi-method evaluation approach, consumer interviews and file reviews were completed appraising the service's effectiveness. Results from the initial evaluation are encouraging regarding meeting the programme's objectives, including improving the quality and availability of support, coordinating care, service integration, flexibility in service delivery and responding to consumer's needs. Further evaluation is required to determine the longer term benefits of such programmes. [ABSTRACT FROM AUTHOR]

Within the health and social care sector in the United Kingdom, the management of death and bereavement has become increasingly challenging. This service evaluation sought to explore the bereavement care offered to individuals living in one Health and Social Care Trust catchment area of Northern Ireland. Qualitative interviews were conducted with key government and voluntary agency staff. The findings indicated that much of the bereavement provision is based on the interest and initiative of individual staff members, with few processes to assess the level of bereavement care needed and those best skilled to provide it. Recommendations are made for a bereavement care strategy that outlines a bereavement needs assessment process, identifying the scope of interventions and protocols for practice. [ABSTRACT FROM AUTHOR]

Wait time is a continuing issue in healthcare services. U.S. studies reveal wait time is inversely related to healthcare service outcome as well as patient behavior and attitudes. However, Taiwan, despite being an important center for global healthcare services, has not been the subject of much research attention regarding wait time and its impact on patient perceptions and behavior. In the authors’ exploratory study, patients in Taiwan completed a self-report questionnaire on how wait time and service quality characteristics relate to service outcome. Results indicate the influence of healthcare service quality and wait time on service outcome. Contributions, limitations, and research and managerial implications are discussed. [ABSTRACT FROM PUBLISHER]

Postpartum haemorrhage is a major cause of maternal morbidity and mortality worldwide. A recent Cochrane review of carbetocin (long-acting oxytocin analogue) concluded that its use decreased additional uterotonic requirements, however, no included studies compared its use against intravenous bolus oxytocin. The majority of studies of carbetocin have considered its use in vaginal delivery; no studies have examined the economic implications of its use. This study describes a clinical and financial evaluation undertaken at a United Kingdom District General Hospital surrounding the introduction of carbetocin for prophylaxis against postpartum haemorrhage at caesarean deliveries. A range of clinical outcomes were observed including frequency of postpartum haemorrhage, estimated blood loss, transfusion requirements, change in haemoglobin or haemodynamics, use of additional uterotonics and perioperative recovery. Finally, a composite financial analysis was performed. No clinically significant benefit was found, however associated costs increased by £18.52/patient. [ABSTRACT FROM AUTHOR]

With globalization in its full toll, customers today have awareness about and access to various foreign entertainment forms such as movies, music and performing arts like theatre and circus. This has magnified the need and scope of the studies on country of origin (COO) effects with respect to entertainment. However, upon reviewing the literature, it is found that, though voluminous literature exists in product context, only few studies have addressed COO effects in service contexts with negligible contribution pertaining to the domain of entertainment. This article tries to address this gap by finding out whether consumers attribute COO effects to various entertainment forms emanating from abroad. This study undertaken in an Indian urban youth context proves the existence of COO effects in consumers' evaluation of various foreign entertainment forms. [ABSTRACT FROM AUTHOR]

During the first 18 months after establishment of the Behaviour Assessment and Intervention Service (BAsIS), 31 clients living in Sydney Residential Aged Care Facilities were referred. Following comprehensive assessment, the BAsIS team recommended primarily psychosocial and environmental interventions that were case-specific and causality-focused. Behavioral observations and standardized measures of mood, behavior, and carer stress in relation to caring for the resident were collected at initial assessment, and at 6 to 8 weeks after implementation of the BAsIS program. Twenty-two residents completed BAsIS programs. Following BAsIS interventions, there was a significant improvement in resident mood and a significant reduction in carer stress. The results support the feasibility of a case-specific, causality-focused approach in addressing challenging behaviors in long-term care, and suggest that improved mood for nursing home residents and reduced carer stress can be achieved with relative cost effectiveness. [ABSTRACT FROM AUTHOR]

Background: Although the research and development (R&D) initiative in the NHS clearly encompasses a wide range of research activities, existing guidance emphasizes efficacy (explanatory) research, namely the generation of new knowledge under rigorous scientific conditions. Aims: We argue that this needs to be counter-balanced with an equivalent emphasis on effectiveness (pragmatic) research, being those activities that improve the effects of new knowledge within the NHS. Method: Treating the efficacy framework for complex interventions as one half of a research knowledge pyramid, we set out a parallel effectiveness (service improvement/evaluation) framework. Results: With the aid of local examples, we show how this pyramid approach can facilitate R&D training, specifically in relation to clinical psychology. Conclusions: Our pyramid of research knowledge redresses the current emphasis on explanatory research and indicates how we can apply a more balanced model, hopefully aiding professionals who teach or practise effectiveness research. Declaration of interest: None. [ABSTRACT FROM AUTHOR]

This impact evaluation has been conducted to establish the effectiveness of involving patients in clinical audit and service improvement. Due to the national reconfiguration of primary care trusts (PCTs) where PCTs have been dramatically reduced, some trusts need to secure current structures and processes within the new PCT. Therefore a review of patient involvement in clinical audit and service improvement was carried out in order to continue this partnership work in the new PCT arrangements. In June 2003 a Commission for Health Improvement clinical governance review in Sheffield South West Primary Care Trust was conducted, highlighting patients' lack of involvement in developing and improving services within primary care. Based on these findings, the PCT proposed to create and train a panel of patients and carers to be actively involved in clinical audit and service improvement projects. In April 2004, a clinical audit patient panel (CAPP) was introduced, and an impact evaluation was carried out to establish the level of CAPP individual members' influence on a healthcare organisation, identifying patient involvement and partnership working. It would appear that the CAPP is managed in a structured process that ensures that it is supported, recognised and provided with robust training and information. The CAPP has demonstrated compliance with key national directives including the NHS Plan (2000), Section 11 of the Health and Social Care Act (2001) and the Kennedy Report (2001). Through effective communication and board recognition, the CAPP is a panel of patients who are encouraged and supported to be 'on the inside' of an organisation, able to assist the trust in developing and improving services within primary care. CAPP members have demonstrated this by implementing their knowledge and skills of quality improvement, clinical audit and most importantly by being a patient, carer or member of the public. The panel does not currently include a PCT member of staff. Challenges faced by the panel were around the change in culture towards actively involving patients and carers. Healthcare professionals and the public working together sharing information that is confidential and liable to cause concern at some time, for many, will result in a shift of culture. The CAPP has demonstrated that if recognised and managed effectively, patients and healthcare staff can succeed in effective partnership working. [ABSTRACT FROM AUTHOR]

In two successive years, 2,012 practices surveyed over 400,000 patients per year in the UK using the Improving Practice Questionnaire (IPQ). In the second survey, of the 27 questionnaire items, a statistically significant improvement was seen in scores for 12 items, while scores were maintained for 13 items and significantly decreased for only two items, namely satisfaction with opening hours and contacting the practice by telephone. Scores for perceived practitioner capability were maintained regardless of practice size, showing a continued high level of satisfaction of over 80 per cent in this area. These scores could still be improved, particularly for considering the patient as a person and taking into account their personal situation in deciding possible treatments. Scores for the capacity of the practice to deliver a high-quality service with regard to supporting services and access were inversely correlated with practice size. Improvement in these scores indicated that listening to patients through the IPQ on more than one occasion can enable practices to significantly improve patient services, but larger practices need to work harder at it. Waiting time in the practice was the lowest scoring item but the efficiency of telephone systems was also poorly rated. There needs to be greater opportunity for patients to speak to practitioners on the phone and also to see the practitioner of their choice, particularly in large practices. [ABSTRACT FROM AUTHOR]

Between October 2003 and July 2004, the Statewide Virtual Reference Project (a Washington State Library initiative funded by LSTA) developed the Virtual Evaluation Toolkit, or VET. The purpose of VET was to help libraries improve virtual reference services, with resulting increased awareness, usage, and customer satisfaction. VET includes three levels of evaluation tools with information on their implementation and examples of the use of results, along with a generic final report based on three test site evaluations (an academic, public, and special library). The complete manual is available on the Web in order to provide practical and meaningful tools and recommendations that encourage libraries to use them and also to report on their use. [ABSTRACT FROM AUTHOR]

The emergence of e-society impacts in sophisticated ways our day-to-day lives. In turn, this affects the provision of social work and social support to communities, including young people. The development and subsequent evaluation in the United Kingdom (UK) of a virtual or on-line social work service for young people provides an opportunity to reflect on how e-provision may require fieldwork and academic staff to re-think the way communication skills are taught to students. doi:10.1300/J394v03n03_10 [ABSTRACT FROM PUBLISHER]

The purpose of this article is to investigate the meaning that service customers attach to the concept of quality and to four other concepts related to service evaluation: satisfaction, performance, attitude, and value. The service and the consumer behavior literature have devoted a lot of attention to the definition and positioning of these concepts. Nevertheless, it cannot be taken for granted that these theoretical distinctions arc clearly perceived by customers, and that if some differences are perceived, they are similar to those formulated by researchers. The authors believe this issue is important, since conceptual clarity affects both the accumulation of knowledge as well as the validity of measures. By comparing different sources, the literature, and the results of a qualitative study of service customers, the authors present a synthesis of the meaning that researchers and customers attribute to the aforementioned concepts. Results show that customers possess a fine-grained perception of the different concepts and that there is a good convergence between the literature and the customers' view. However, respondents also focus on some dimensions that are still overlooked by researchers, therefore providing additional contribution to the understanding of the meaning of quality and of the other evaluative concepts. [ABSTRACT FROM AUTHOR]

This paper is based on an analysis of the calls to a time-limited hotline specifically set up in response to the SARS crisis in Hong Kong in 2003. The findings of the study indicate that the arena and level of concern raised by the hotline callers are associated with the situation of the callers and the developmental phase of the disaster. The authors call for welfare service organizations to adopt a differential service focus for different phases of disaster development, when they are confronted with similar public health hazards in the future. The study also identifies the special role played by women in containing the epidemic, and suggests more gender sensitive intervention planning in addressing the needs of women in their gate-keeping and care-giving roles during an epidemic. [ABSTRACT FROM AUTHOR]

The article focuses on a research study which examines aspects of comfort level in social interaction among consumers in a foreign country and its impact on the service quality evaluation. Consumer assessment of services is determined to a great extent by inter-personal social interaction among unfamiliar people in an unfamiliar context. Understanding of the cross-cultural interaction comfort and its relationship with consumer evaluation of service forms the basis of this study. This study is conducted in the context of exchange of higher education services between educational institutions in the U.S. and international students.

Significant Event Analysis (SEA) is a practical, problem-solving technique that can help teams learn from their experiences and generate practical solutions to complex issues. It has mainly been conducted in Primary Health Care Teams (PHCTs) with the use of an external facilitator. Although SEA is envisioned to address issues of integration and complement routine audit, there is limited evidence that this has been achieved. This paper reports on a 1 day workshop during which team members were trained to use SEA to address issues of service integration. This paper presents an evaluation of the workshop in order to determine if SEA is a feasible tool to support and encourage team self-evaluation without external facilitation. The main barriers to SEA are discussed as well as the need for longitudinal research to assess the impact of SEA on integration of the team and wider service. [ABSTRACT FROM AUTHOR]

In today's technically sophisticated, information-rich environment, consumers are bombarded with information. Consequently colleges and universities must develop ways to get the prospective student to give their promotional material more than a cursory glance. Pre-purchase service evaluation has received little attention beyond the nature of cues used by consumers to categorize service alternatives. The studies presented in this paper examine the usefulness of Means-End Theory in developing effective recruitment brochures. Empirical evidence is presented that demonstrates college brochures that emphasize attributes (e.g., cost, location) over consequences (e.g., getting a job) or values (e.g., security) will generate greater interest in an educational institution. [ABSTRACT FROM PUBLISHER]