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  • The Impact of the Pandemic on Mental Health in Ethnically Diverse Mothers: Findings from the Born in Bradford, Tower Hamlets and Newham COVID-19 Research Programmes

    McIvor, C.; Vafai, Y.; Kelly, B.; O'Toole, S.E.; Hays, M.; Badrick, E.; Iqbal, Halima; Pickett, K.E.; Cameron, C.; Dickerson, J. (2022-11)
    Restrictions implemented by the UK Government during the COVID-19 pandemic have served to worsen mental health outcomes, particularly amongst younger adults, women, those living with chronic health conditions, and parents of young children. Studies looking at the impact for ethnic minorities have reported inconsistent findings. This paper describes the mental health experiences of mothers from a large and highly ethnically diverse population during the pandemic, using secondary analysis of existing data from three COVID-19 research studies completed in Bradford and London (Tower Hamlets and Newham). A total of 2807 mothers participated in this study with 44% White British, 23% Asian/Asian British Pakistani, 8% Other White and 7% Asian/Asian British Bangladeshi backgrounds. We found that 28% of mothers experienced clinically important depressive symptoms and 21% anxiety symptoms during the pandemic. In unadjusted analyses, mothers from White Other, and Asian/Asian British Bangladeshi backgrounds had higher odds of experiencing symptoms, whilst mothers from Asian/Asian British Indian backgrounds were the least likely to experience symptoms. Once loneliness, social support and financial insecurity were controlled for, there were no statistically significant differences in depression and anxiety by ethnicity. Mental health problems experienced during the pandemic may have longer term consequences for public health. Policy and decision makers must have an understanding of the high risk of financial insecurity, loneliness and a lack of social support on mother’s mental health, and also recognise that some ethnic groups are far more likely to experience these issues and are, therefore, more vulnerable to poor mental health as a consequence.
  • A qualitative analysis of stressors affecting 999 ambulance call handlers' mental health and well-being

    Powell, Catherine; Fylan, Beth; Lord, Kathryn; Bell, F.; Breen, Liz (Emerald, 2022)
    Purpose The 999 ambulance call handler is critical in responding to emergency patient treatment; however, the call handlers are often a hidden component of the healthcare workforce and an under-researched group. The objective of this study is to understand stress triggers experienced by 999 ambulance call handlers that could lead to burnout and examine personal and organisational mechanisms and strategies which reduced the risk of burnout. Design/methodology/approach A single interview case study approach applying qualitative methods was undertaken. Participants were identified through a purposive sample of 999 ambulance call handlers with the Yorkshire Ambulance Service National Health Service Trust (UK). Participants were interviewed via telephone between July 2019 and September 2019. Findings In total, 18 staff participated in this study. Societal factors including public incivility and media representation and organisational factors, such as a demanding environment, lack of appreciation and career progression, training issues and protocols were key stressors. Organisational well-being services were helpful for some, but for others lacked accessibility and appropriateness. Positive public feedback and speaking with peers bolstered well-being. 999 ambulance call handlers suggested that sufficient breaks, co-design or feeding back on training and protocols and creating more informal opportunities to discuss ongoing everyday stressors as methods to reduce stress and burnout. Originality/value This paper explores a previously under researched area on stressors and potential burnout in 999 call handlers. This paper highlights the need for improved organisational support services and appropriate public and sector peer recognition of the role of ambulance 999 ambulance call handlers.
  • Determinants of overweight and obesity and preventive strategies in Pacific countries: a systematic review

    Tong, T.J.; Mohammadnezhad, Masoud; Alqahtani, N.S. (2022-09)
    Objective: This study aimed to explore more on contributing factors and prevention of overweight and obesity among Pacific islanders. Methods: Using Cochrane library guideline, four electronic databases, PubMed, Embase, Scopus and CINAHL, were systematically searched from 2010 to 2020. Search strategy included key concepts, free text terms, and database-controlled vocabulary terms to identify articles on determinants and preventative strategies of overweight and obesity in the Pacific countries. A data extraction sheet was developed to extract relevant information required for analysis and theme development for this study. Results: A total of 22 articles were summarized and categorized. Determinants of overweight and obesity identified two themes: environmental related factors 13.6% (3/22) and sociocultural related factors 27.3% (6/22). The preventative strategies of overweight and obesity was categorized into behavioural change 22.7% (5/22), school-related 18.2% (4/22), and policies 50% (11/22). The quality assessment of articles showed “Good” 68.2% (15/22), and “Fair” 31.8% (7/22). Conclusion: This study highlighted two contributing, non-medication factors affecting overweight and obesity are both environmental and socio-cultural issues. Overweight and obesity preventative strategies identified in the Pacific context considered behavioural change, knowledge enhancement, and policy development. Further research should aim at exploring the current preventative strategies in-depth, to appreciate the most feasible and recommended preventative approach within the Pacific society.
  • "It's a waste of time coming here, better go to private clinics with wider options for treatment": patient's perception on dental services provided in Fiji

    Nair, R.D.; Mohammadnezhad, Masoud (2022-09)
    Oral health can influence the quality of an individual's life. Patient's perception of the service plays a vital role in understanding the reasons as to why a patient may be satisfied or dissatisfied with the service that they accessed at a dental setting. As no studies have been done in Fiji until now, this study aimed to explore the perceptions of patients on services provided by the largest dental clinic in the Central/Eastern division in Fiji. A qualitative study was used to collect data from patients who visited the Colonial War Memorial Hospital (CWMH) dental clinic in Suva Fiji from 5th August to 31st October, 2020. All patients above the age of 18 of both genders and from any ethnicity who visited the CWMH dental clinic during the period of data collection were included the study. A total of 25 participants were interviewed for this study using the in-depth interview method till data saturation occurred. A semi-structured open-ended questionnaire was used to collect data using face-to-face in-depth interviews. The data were transcribed and analyzed using manual thematic analysis process to gather the themes and sub-themes for the results. A total of 25 patients were interviewed, with a majority (n = 14) being men and 15 were of I-Taukei background. Five themes emerging from data analysis include: Waiting time before treatment, Cost of Treatment, Accessibility of services, Privacy and confidentiality and Range of treatment options. The patients had an expectation to get the best treatment but face many hurdles while trying to get the treatment that they expect. The shortfalls on the part of this dental clinic caused an onset of negative perception among its users. This study shows an overall dissatisfaction with regards to services delivery among the patients who use the CWMH dental clinic for dental care purposes. The decision makers need to look into the genuine concerns that have been raised by patients in order to create improvements in services delivery and create an array of satisfaction for its patients.
  • Psychological and overall well-being of Italian young adults in transition to adulthood: Evidence from a sequential explanatory mixed-methods study

    Di Napoli, I.; Di Martino, Salvatore; Agueli, B.; Arcidiancono, C.; Esposito, C. (2022)
    Transitioning to adulthood is a fundamental yet challenging phase in human development. Despite its relevance, the literature has paid little attention to the impact that transitioning to adulthood has on multiple aspects of individual well-being. This is one of the few attempts that has employed a sequential explanatory mixed-methods study to explore how the path to adulthood impacted on the psychological and overall well-being of Italian young adults. In the quantitative phase, we employed two-step cluster analysis to assign 45 young adults, who had completed the Italian I COPPE scale of multidimensional well-being, to three clusters based on their level of change in psychological and overall well-being. Results from mixed design ANCOVA revealed that participants belonging to the high change cluster showed the highest significant positive change over time with respect to well-being. In the qualitative phase, 17 individuals took part in focalized narrative interviews, which aimed at exploring significant events, barriers, and facilitators, which had impacted on their well-being during the transition to adulthood. The textual material was analysed through the Grounded Theory Methodology. It emerged that the state of transition was associated with some triggering events and a temporary negative impact on the interviewees' well-being. However, findings also revealed that people assigned to different clusters had put in place or learned several resources, skills, and copying strategies, which led to different transitional and well-being outcomes.
  • Perceptions of Dental Health Professionals (DHPs) on job satisfaction in Fiji: A qualitative study

    Kumar, S.; Mohammadnezhad, Masoud (2022-08-29)
    Reviewing factors that affect work challenges is crucial for any organization as it has an impact of organizational commitment for a better service delivery and job satisfaction. This study aimed to explore the perceptions of dental health professionals (DHPs) on work challenges and the impact it has on job satisfaction in Fiji. Materials and Methods: A descriptive, qualitative method approach (nationwide) was done commencing from August to November, 2021. DHPs who provide prosthetic services in Fiji were selected using purposive selection located at Nakasi Dental Clinic, Lautoka Dental Clinic, Labasa Dental Clinic, and Fiji National University. A total of 29 DHPs participated in the in-depth interview, and the responses were grouped into nine themes: working conditions, the location of practice, equipment and material, a lack of specialization, service delivery, organizational support, remuneration, career development, and promotions. A semi-structured open-ended questionnaire in the form of an interview via a virtual platform—Zoom was used for data collection. Thematic analysis was used to transcribe and analyze the audio recordings. Results: The findings from the study indicated that factors such as working conditions, the location of practice, equipment and material, a lack of specialization, service delivery, organizational support, remuneration, career development, and promotions were associated with work challenges. Conclusion: Gaps and areas for the improvement of work challenges and its impact on job satisfaction were identified for DHPs who provide prosthetic services in Fiji such as a need for more career and professional development pathways, improved infrastructure to support prosthetic service delivery, and better remuneration.
  • Frontline Health Care Workers’ (HCWs) perception of barriers to managing COVID-19 in Fiji

    Deo, A.; Mohammadnezhad, Masoud (2022-08-29)
    Background: Health Care Workers (HCWs) are at higher risk of COVID-19 infection with their efforts while protecting the greater community and also exposed to hazards, such as psychological distress, fatigue, and stigma. This study aimed to explore the perception of frontline HCWs on barriers of managing COVID-19 in Fiji. Methods: A qualitative study method was approached to conduct this study among the HCWs who worked on the frontline during the COVID-19 pandemic based at ten purposively selected health facilities in the Suva subdivision in the Central Division of Fiji. The Colonial War Memorial Hospital (CWMH), the Fiji Centre for Communicable Diseases (Fiji CDC), Twomey hospital laboratory, and CWMH laboratory did the main control and most of the operations of other divisions were monitored from these settings. A semi-structured open-ended questionnaire was used to collect data using in-depth interviews. The participants' responses were audio-recorded and were later transcribed and analyzed using thematic analysis. Results: A total of twenty-nine HCWs took part in the in-depth interview and the responses were grouped into four themes, which include: workload, poor communication, lack of resources, and hindrance to education. It was also found through this study that some of the HCWs felt tired, frustrated, got rude to patients, and found it difficult to handle situations, which affected them mentally and physically stressed. Conclusion: Managing the COVID-19 cases has been attributed to the presence of many barriers, such as workload, tiredness, frustration, and sometimes difficult-to-handle situations, and the HCWs were indeed affected mentally and physically. Regular training for HCWs and more awareness programs would help the general public to follow the preventive measures, which reduces the cases and would help the HCWs manage COVID-19 well.
  • Perinatal depression: Factors affecting help-seeking behaviours in asylum seeking and refugee women. A systematic review

    Firth, A.; Haith-Cooper, Melanie; Dickerson, J.; Hart, Andrew (2022)
    Purpose Perinatal depression is one of the most commonly diagnosed mental health conditions in the general maternity population but whilst the prevalence is thought to be much higher in asylum seeking and refugee (AS&R) women, it is less frequently identified and diagnosed by health care professionals. Method A systematic review was undertaken to address ‘what factors influence help-seeking behaviours in asylum seeking and refugee women with symptoms of perinatal depression’. The review focussed on women accessing care in high income countries. 12 studies met the eligibility criteria and a narrative synthesis was undertaken resulting in two main themes: women's perceptions of depression and access to healthcare and support services. Results Findings indicated that many of the influences on help-seeking were also present in the general population and women from ethnic minority populations, with the exception of migration experiences; but that women from a AS&R background may experience more of these barriers, exacerbating inequality in access to and engagement with healthcare. Conclusion Further research is needed to provide more detailed insight into the experiences of asylum seeking and refugee women to identify ways that barriers in help-seeking can be addressed.
  • Team based learning and nurse education: a systematic review

    Tatterton, Michael J.; Fisher, M.J. (BMJ, 2022)
    Summary of: Alberti S, Motta P, Ferri P, Bonetti L. The effectiveness of team-based learning in nursing education: A systematic review. Nurse Educ Today. 2021 Feb;97:104721. doi: 10.1016/j.nedt.2020.104721. Epub 2020 Dec 11.
  • Profiles of social, cultural, and economic capital as longitudinal predictors of stress, positive experiences of caring, and depression among spousal carers of people with dementia.

    Sabatini, S.; Martyr, A.; Gamble, L.D.; Jones, I.R.; Collins, R.; Matthews, F.E.; Victor, C.R.; Quinn, Catherine; Pentecost, C.; Thorn, J.M.; et al. (2022-07)
    We explored (1) social, cultural, and economic capital in spousal carers of people with dementia; (2) profiles of carers with different levels of capital; (3) whether the identified profiles differ in levels of stress and positive experiences of caring, and likelihood of depression over time. Baseline (2014-2016), 12-month, and 24-month follow-up data were analyzed for 984 coresident spousal carers of people with dementia. We assessed social, cultural, and economic capital, stress, positive experiences of caring, depression. On average, carers reported infrequent social and cultural participation. Most carers were not socially isolated, trusted their neighbours, had education at least to age 16, and had an income aligned with the 2014 UK average. We identified four groups of carers with different levels of capital. Although on average stress was low, depression was infrequent, and positive experiences of caring were moderately frequent, the group of carers with lowest capital was the least stressed and reported the most positive experiences of caring over time. Compared to the two groups with better capital, those with poorer capital were more likely to be depressed over time. Social, cultural, and economic resources may decrease likelihood of depression, but not stress, in carers of people with dementia.
  • Attitudes toward own aging and cognition among individuals living with and without dementia: findings from the IDEAL programme and the PROTECT study

    Sabatini, S.; Martyr, A.; Ukoumunne, O.C.; Ballard, C.; Collins, R.; Pentecost, C.; Rusted, J.M.; Quinn, Catherine; Anstey, K.J.; Kim, S.; et al. (2022-08)
    It is unclear whether people with dementia (PwD) have more negative attitudes toward own aging (ATOA) than people without dementia and what factors influence ATOA among PwD. We investigated whether PwD have more negative ATOA than individuals without dementia and whether cognition and dementia subtype are associated with ATOA in PwD. Data from the IDEAL and PROTECT studies were used to compare ATOA between 1502 PwD (mean (SD) age = 76.3 (8.5)) and 6377 individuals without dementia (mean (SD) age = 66.1 (7.1)). Linear regressions and ANOVA were used. PwD reported slightly more negative ATOA than people without dementia; this relationship disappeared after controlling for depression and self-rated health. In PwD more positive ATOA showed negligible associations with better general cognition, memory performance, verbal fluency, and visuospatial ability. However, after adjusting for covariates only better visuospatial ability predicted more positive ATOA. Additional analyses showed that before and after controlling for covariates, individuals with poorer self-reported visual acuity have more negative ATOA. Amongst dementia subtypes, people with Parkinson's disease dementia and dementia with Lewy bodies reported most negative ATOA. ATOA between PwD and people without dementia do not differ. ATOA in PwD appear to be affected not by cognitive impairment but by other characteristics that vary across dementia subtypes. Among PwD, those with Parkinson's disease dementia and dementia with Lewy bodies may have higher risk of experiencing negative ATOA due to the motor and visual impairments that they experience.
  • A comparison of well-being of carers of people with dementia and their ability to manage before and during the COVID-19 pandemic: findings from the IDEAL study

    Gamble, L.D.; Parker, S.; Quinn, Catherine; Bennett, H.Q.; Martyr, A.; Sabatini, S.; Pentecost, C.; Collins, R.; Dawson, E.; Hunt, A.; et al. (2022)
    Background: Social restriction measures imposed to curb the spread of COVID-19 in the United Kingdom impacted on carers of people with dementia, limiting access to support services and increasing perceived burden of caring. Few studies have compared data collected both during and before the pandemic to examine the effect of these changes. Objective: To explore whether the COVID-19 pandemic affected the well-being of carers of people with dementia living in the community, and their ability to cope with their caring responsibilities. Methods: Analysis was conducted on two groups of carers who were enrolled in the IDEAL programme; the ‘pre-pandemic group’ (n = 312), assessed at two time points prior to the pandemic, and the ‘pandemic group’, assessed prior to and several months into the pandemic (n = 156). For the pre-pandemic group, carers were matched 2:1 to carers in the pandemic group on certain characteristics. Differences in change over time between the two groups on self-reported well-being, quality of life, coping, perceived competence, and role captivity, were investigated using mixed effect modelling. Results: Compared to the pre-pandemic group, those in the pandemic group appeared to cope better and had more stable self-rated competency and role captivity. They did not differ in terms of well-being or quality of life. Conclusion: Despite reports of negative impacts on carers early in the pandemic, the findings suggest the pandemic had little negative longer-term impact on carers of people with dementia, and in fact they appeared to have a more positive attitude towards coping several months into the pandemic.
  • A systematic review: study on challenges faced by dental interns in the workforce: suggestions for Pacific Nations

    Nair, R.D.; Gohil, D.A.; Reddy, V.R.; Mohammadnezhad, Masoud (Sage, 2022)
    Aim: To identify challenges faced by dental interns in the workforce and to suggest Pacific Island Countries (PIC) on further research in this area. Materials and Methods: A comprehensive search of Medline, Embase, Scopus and ProQuest databases was conducted using relevant keywords. All studies, published from 1st January 2000 to 31st January 2021, were taken into consideration. Removal of duplicates and screening the full-text articles using eligibility criteria were used to finalise the number of articles. The significant findings and conclusions were extracted and grouped under themes. Results: A total of 16 studies met the inclusion criteria, involving dental interns, medical interns, postgraduate and undergraduate. Five themes were identified as the main challenges faced by dental interns in the workplace including workplace bullying, handling medical emergencies, community placement, lack of interdisciplinary approach and poor record keeping. Conclusion: There is a need for PIC to conduct research and surveys, to identify the challenges its dental interns may be facing. This will create an ideal foundation from which strategies and initiatives can be implemented and enforced in the dental internship programme. Ensuring that oral health services are delivered efficiently and oral status of the Pacific is not compromised.
  • Healthcare workers' perceptions on diabetic foot ulcers (DFU) and foot care in Fiji: a qualitative study

    Ranuve, M.S.; Mohammadnezhad, Masoud (2022-08)
    To explore the perception of healthcare workers (HCWs) on diabetic foot ulcers (DFU) and foot care in Rotuma, Fiji. Using a qualitative study design, two focus group discussions (FGDs) were conducted among HCWs. A semistructured open-ended questionnaire was used to guide the discussion session. Each FGD was audiorecorded and was transcribed. The transcriptions were then manually analysed using thematic analysis. Rotuma hospital, Fiji. HCWs who were working in Rotuma hospital for at least a year and were involved in clinical foot care of type 2 diabetes mellitus patients were included. There were five main themes, namely, depth of knowledge, quality of care in practice, factors of influence on practice, lack of resources and capacity building. Participants had superficial knowledge that showed lack of in-depth scientific knowledge. A lack of staffing in the clinics affected the delivery of service. Additionally, patients defaulting clinics, late presentations with DFU and traditional medicine also affected the quality of healthcare service in clinics. There was also a need for a multidisciplinary team to prevent and manage DFU. HCWs mostly advised on glycaemic control and ignored offering foot care advice in clinics due mainly to the lack of sound knowledge on foot care. There was also a lack of resources, infrastructure, space and professional development opportunities, which negatively impacted how HCWs deliver foot care services to patients. HCWs lack significant in-depth knowledge on DFU and foot care. In addition, these are the availability of traditional medicine that delays presentations to hospital, further reducing the quality of services. HCWs need to keep their knowledge and skills updated through regular in-service training on foot care. Resources, infrastructure and supply chains need to be maintained by those in power to ensure HCWs deliver quality foot care services.
  • Addressing health corruption during a public health crisis through anticipatory governance: Lessons from the COVID-19 pandemic

    Gonzalez Aquines, Alejandro; Kowalska-Bobko, I. (2022-07)
    Corruption in the health sector costs over 500 billion USD every year, weakening health system preparedness and response to health crises like the COVID-19 pandemic. The lack of resources to deal with a shock limit the capacity to protect the population, exposing them to a greater risk of infection and mortality. There is an urgent need to improve health policy to reduce corruption in the health sector during times of crisis. This article aims to propose a prepare and response strategy to address corruption during times of health crises. We first explore the inherent characteristics of health systems that make them vulnerable to corruption and present the different faces corrupt practices take. We then explain why anticipatory governance is fundamental in addressing corruption in health systems and draw upon examples of corruption during the COVID-19. Finally, we conclude by proposing that anticipatory governance could decrease the impact of corruption during health crises by increasing the availability of resources required to improve the population’s health.
  • Positive experiences in dementia care-giving: findings from the IDEAL programme

    Quinn, Catherine; Toms, G.; Rippon, I.; Nelis, S.M.; Henderson, C.; Morris, R.G.; Rusted, J.M.; Thom, J.M.; van den Heuvel, E.; Victor, C.; et al. (2022)
    There is a growing evidence base that identifying positive experiences in providing care can have a beneficial influence on carer wellbeing. However, there is a need to better understand what carers identify as the positive aspects of care-giving. The aim of this study is to explore the satisfying aspects of providing care to people with dementia. This study utilised Time 1 data from 1,277 carers of people in the mild-to-moderate stages of dementia taking part in the IDEAL (Improving the experience of Dementia and Enhancing Active Life) cohort study. Responses from 900 carers who answered the open-ended question ‘What is your greatest satisfaction in caring for your relative/friend?’ were analysed using thematic analysis. From the responses, 839 carers detailed satisfactions. Eight themes were identified, pertaining to three groups of beneficiaries: carers, people with dementia and the dyad. Perceived benefits for carers included identifying aspects of personal growth, seeing glimpses of the person, feeling they were making a difference and doing their duty. For the person with dementia, these included retaining independence, receiving good quality care and being happy. Dyadic benefits concerned the continuation of the relationship between carer and person with dementia. The findings highlight the need to take a dyadic approach when conceptualising positive experiences in providing care. Further research is needed to understand the role these positive experiences play and to develop interventions. Professionals working with carers should identify and validate these experiences.
  • Exploratory study of fathers providing Kangaroo Care in a Neonatal Intensive Care Unit

    Dong, Q.; Steen, M.; Wepa, Dianne; Eden, A. (2022)
    Aim and Objectives: To explore fathers' views and experiences of providing Kangaroo Care (KC) to their baby cared for in a Neonatal Intensive Care Unit (NICU). Background: Kangaroo Care has been known to improve the health outcome for preterm, low birth weight and medically vulnerable term infants and achieve the optimal perinatal health wellbeing for parents and infants. Historically, mothers are considered as the dominant KC providers, whereas fathers are spectators and have been overlooked. Little is known about the fathers' perspectives in providing KC in NICUs. Methods: Individual semi-structured interviews were conducted with 10 fathers who delivered KC to their baby when in the NICU. Data were analysed using Braun and Clarke's six-phase thematical framework. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was followed to report this qualitative study. Findings: Fathers in this study identified they were passing a silent language of love and connecting with their baby by the act of KC in a challenging environment. Three themes emerged: ‘Positive psychological connection’, ‘Embracing father-infant Kangaroo Care’ and ‘Challenges to father-infant Kangaroo Care’. Conclusion: The findings of this study show KC enhances the bonding and attachment between fathers and infants. The conceptualisation of the paternal role in caregiving to a newborn is evolving as a contemporary practice. Further research is warranted to confirm or refute the study findings. Policies and facilities should be modified to include father–infant KC within the fields of neonatal care. Relevance to Clinical Practice: It is important for nurses and other health professionals to support and enable fathers to give KC. Father–infant KC is recommended in neonatal care settings.
  • Effects of social restrictions on people with dementia and carers during the pre-vaccine phase of the COVID-19 pandemic: Experiences of IDEAL cohort participants

    Pentecost, C.; Collins, R.; Stapley, S.; Victor, C.; Quinn, Catherine; Hillman, A.; Litherland, R.; Allan, L.; Clare, L. (2022)
    This qualitative study was designed to understand the impact of social distancing measures on people with dementia and carers living in the community in England and Wales during a period of social restrictions before the COVID-19 vaccination roll-out. We conducted 12 semi-structured interviews with people with dementia aged 50-88 years, living alone or with a partner, and 10 carers aged 61-78 years, all living with the person with dementia. Three of the interviews were with dyads. Participants were recruited during November and December 2020. We used framework analysis to identify themes and elicit suggestions for potential solutions. We identified three interrelated themes. People with dementia experienced a fear of decline in capabilities or mood and attempted to mitigate this. Carers noticed changes in the person with dementia and increased caring responsibilities, and for some, a change in the relationship. Subsequently, reduced confidence in capabilities to navigate a new and hostile environment created a cyclical dilemma of re-engaging where an inability to access usual activities made things worse. People with dementia and carers experienced neglect and being alone in their struggle, alongside feeling socially excluded during the pandemic, and there was little optimism associated with the upcoming vaccine programme. People found their own solutions to reduce the effects of isolation by keeping busy and being socially active, and practising skills deemed to help reduce the progression of dementia. This and some limited local public initiatives for the general public facilitated feelings of social inclusion. This study adds understanding to existing evidence about the longer-term experience of social isolation several months into the pandemic. It highlights the importance of health and community groups and suggests how services can find ways to support, include, and interact with people with dementia and carers during and after social restrictions.
  • Recruitment and retention of care workers: A rapid review

    Randell, Rebecca (2021-12)
    Introduction: Challenges in the recruitment and retention of care workers is a long-standing issue [1]. However, these challenges have worsened during the Covid-19 pandemic. In October 2021, there was an average staff vacancy rate of 17% [2], and in November 2021, care homes feared they would lose around 8% of their care home staff as a direct result of the policy of vaccination being a condition of deployment in care homes [3]. This has profound impacts, not only on those in care homes and receiving care at home, but on the health service as a whole, with 33% of social care providers limiting or stopping admissions from hospital [2]. Therefore, this review was undertaken to identify learning about how to support recruitment and retention of care workers during the pandemic. Methods: To identify strategies that are currently being used to support recruitment and retention of care workers, a Google search was undertaken, combining termsthat referred to the setting or role (“social care”, “care worker”) and the topics of interest (recruitment, retention), and for some searches adding in terms that referred to the type of literature being sought (“case study”). Through this, we identified that research on recruitment and retention of care workers since the pandemic was already being published and so a search was also undertaken on Google Scholar for research published since 2020. This was supplemented by a review of websites recommended by an expert working in the area: Care England, National Care Forum, Care Forum, Care Choices, Care Workers Charity, National Association of Care & Support Workers, and Skills for Care. We also reviewed the websites of NHS Confederation, NHS Employers, and the Local Government Association. Inclusion criteria were reports that included recommendations and/or examples of strategies to recruit and retain the social care workforce. While we focused on reports published since the start of the pandemic, given that recruitment and retention of care workers is a long-standing challenge, we also included some significant reports that were published before then. A number of the documents included did not provide a publication date. While many of the reports identified discussed the problems that have led to the social care workforce crisis, we limit our discussion of these in this report, instead focusing on possible solutions. Findings: From the Google and Google Scholar searches, 190 records were screened and 22 potentially relevant documents were reviewed in detail for possible inclusion. Alongside this, seven potentially relevant documents from the websites listed above were reviewed in detail for possible inclusion. From this, 21 relevant documents were identified and included in this review. These included seven documents reporting case studies, one Government report, one report based on a survey of employers, four reports based on surveys of care workers, two reports based on interviews with stakeholders, one report based on interviews and focus groups with care workers, managers, and commissioners, and one based on interviews with care workers. It quickly became apparent that potential strategies for improving recruitment of care workers were closely interlinked with strategies for improving retention of care workers. Below we consider those strategies relevant to both, before moving on to consider specific recruitment strategies and strategies focused specifically on increasing retention.
  • A scoping review: Strategic workforce planning in health and social care

    Prowse, Julie M.; Sutton, Claire; Eyers, Emma; Montague, Jane; Faisal, Muhammad; Neagu, Daniel; Elshehaly, Mai; Randell, Rebecca (2022-04)
    Aim This aim of this scoping review was to undertake a detailed review of the pertinent literature examining strategic workforce planning in the health and social care sectors. The scoping review was tasked to address the following three questions: 1. How is strategic health and social care workforce planning currently undertaken? 2. What models, methods, and tools are available for supporting strategic health and social care workforce planning? 3. What are the most effective methods for strategic health and social care workforce planning? Methods The scoping review utilised the five-stage scoping review framework proposed by Arksey and O’Malley (2005). This includes identifying the research question; identifying relevant studies; study selection; charting the data and collating, summarizing, and reporting the results. The search included a range of databases and key search terms included “workforce” OR “human resource*” OR “personnel” OR “staff*”. Relevant documents were selected through initially screening titles and abstracts, followed by full text screening of potentially relevant documents. Results The search returned 6105 unique references. Based on title and abstract screening, 654 were identified as potentially relevant. Screening of full texts resulted in 115 items of literature being included in the synthesis. Both national and international literature covers strategic workforce planning, with all continents represented, but with a preponderance from high income nations. The emphasis in the literature is mainly on the healthcare workforce, with few items on social care. Medical and dental workforces are the predominate groups covered in the literature, although nursing and midwifery are also discussed. Other health and social care workers are less represented. A variety of categories of workforce planning methods are noted in the literature that range from determining the workforce using supply and demand, practitioner to population ratios, needs based approach, the utilisation of methods such as horizon scanning, modelling, and scenario planning, together with mathematical and statistical modelling. Several of the articles and websites include specific workforce planning models that are nationally and internationally recognised, e.g., the workload indicators of staffing needs (WISN), Star model and the Six Step Methodology. These models provide a series of steps to help with workforce planning and tend to take a more strategic view of the process. Some of the literature considers patient safety and quality in relation to safe staffing numbers and patient acuity. The health and social care policies reviewed include broad actions to address workforce planning, staff shortages or future service developments and advocate a mixture of developing new roles, different ways of working, flexibility, greater integrated working and enhanced used of digital technology. However, the policies generally do not include workforce models or guidance about how to achieve these measures. Overall, there is an absence in the literature of studies that evaluate what are the most effective methods for strategic health and social care planning. Recommendations The literature suggests the need for the implementation of a strategic approach to workforce planning, utilising a needs-based approach, including horizon scanning and scenarios. This could involve adoption of a recognised workforce planning model that incorporates the strategic elements required for workforce planning and a ‘one workforce’ approach across health and social care.

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