Health & social care in the community
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Health Soc Care Community · Nov 2013
Paediatric spinal fusion surgery and the transition to home-based care: provider expectations and carer experiences.
There are more than 12 million children with special healthcare needs (CSHCNs) in the United States, many of whom require specialised health-care to treat chronic physical and developmental conditions. This study is a qualitative investigation of programme, surgical and at-home recovery experiences among CSHCNs and their family carers who participated in a spine surgical care programme at a paediatric hospital in the Western United States. The programme is designed to manage increased surgical risk and the transition of care from hospital to home for children with severe scoliosis undergoing spinal fusion surgery. ⋯ The data also suggest meaningful differences in providers' and carers' expectations for surgery. Carers' disappointment with their recovery experiences and the perceived lack of post-discharge support impacted their interpretations of and perspectives on their surgical experience. Implications of this research for surgical care programmes include the need for assessment and provision of support for physical, social, and emotional burdens experienced by patients and carers at pre-surgical, surgical and at-home recovery phases.
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Health Soc Care Community · Nov 2013
Health literacy in relation to cancer: addressing the silence about and absence of cancer discussion among Aboriginal people, communities and health services.
Cancer outcomes for Aboriginal Australians are poorer when compared with cancer outcomes for non-Aboriginal Australians despite overall improvements in cancer outcomes. One concept used to examine inequities in health outcomes between groups is health literacy. Recent research and advocacy have pointed to the importance of increasing health literacy as it relates to cancer among Aboriginal people. ⋯ Participants proposed some practical strategies that could work to fill absences in knowledge and build on beliefs about cancer. These results were characterised by a silence about cancer, an absence of discussions of cancer and an acknowledgement of an already full health agenda for Aboriginal communities. To promote health literacy in relation to cancer would require a multi-layered programme of work involving grass-roots community education, workers and Board members of Aboriginal community-controlled health organisations and speciality cancer services, with a particular focus on programmes to bridge community-based primary care and tertiary level cancer services.
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Health Soc Care Community · Nov 2013
Changes to supervision in community pharmacy: pharmacist and pharmacy support staff views.
Pharmacists now offer increasing levels and ranges of clinical, diagnostic and public health services, which may require a pharmacist to be absent from the pharmacy premises. Currently, in the UK, many pharmacy activities legally require the direct supervision and physical presence of the pharmacist. This study aimed to explore the potential for changes to supervision, allowing pharmacist absence, and greater utilisation of pharmacy support staff. ⋯ Group discussion revealed some of the main challenges to supervision changes, including CPs' perceptions about their presence being critical to patient safety, reluctance to relinquish control, concerns about knowing and trusting the competencies of support staff, and reluctance by support staff to take greater professional responsibility. The findings of this study aim to inform a future consultation on changes to pharmacy supervision in the UK. The empowerment of pharmacy technicians as a professional group may be key to any future change; this may require clarity of their professional responsibilities, enhanced career progression and appropriate remuneration to match greater responsibility.
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Health Soc Care Community · Nov 2013
ReviewSystematic review of the effects of telecare provided for a person with social care needs on outcomes for their informal carers.
Telecare devices have been put forward as a potentially effective intervention to benefit the well-being and functioning of informal carers of people with social care needs, and to reduce the negative effects of providing care to a family member or friend. Much of the evidence used to support this view is qualitative, and therefore does not provide good-quality evidence to answer questions about its effect on carer outcomes. This review aimed to document and evaluate the quantitative evidence base for the effect of telecare interventions on outcomes for informal carers. ⋯ The evidence tentatively indicated that telecare exerts a positive effect on carer stress and strain, but there is no evidence to indicate benefits on burden or quality of life. The evidence is conflicting about the effect of telecare on the amount of time carers spend on their caring duties, and on relationships between the carer, cared-for person and other family members. Additional good-quality evaluations are required to establish the effects of telecare on informal carer outcomes.
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Health Soc Care Community · Nov 2013
'It ain't what you do it's the way that you do it': lessons for health care from decommissioning of older people's services.
Public sector organisations are facing one of the most difficult financial periods in history and local decision-makers are tasked with making tough rationing decisions. Withdrawing or limiting services is an emotive and complex task and something the National Health Service has always found difficult. Over time, local authorities have gained significant experience in the closure of care homes - an equally complex and controversial issue. ⋯ The current financial challenge means that public sector organisations need to make tough choices on investment and disinvestment decisions. Any such decisions need to be influenced by what we know constitutes best practice. Sharing lessons and experiences within and between sectors could well inform and develop decision-making practices.