Teaching person-centered practice to pre-registration physiotherapy students: a qualitative study.

INTRODUCTION: There has been a call for healthcare to consider more explicitly the needs of the individual patient by adopting a person-centered approach to practice. Consideration needs to be given to how this is taught to pre-registration physiotherapy students. PURPOSE: To understand how first-year pre-registration physiotherapy students envision their philosophy of practice and how person-centered aspects of that philosophy might be implemented in a clinical setting. METHODS: Semi-structured interviews were carried out with 10 first-year physiotherapy students. Data were analyzed using thematic analysis. RESULTS: Five themes were identified: 1) understanding the person and their direction of travel; 2) contextual factors that impact on the delivery of person-centered practice; 3) awareness of personality traits; 4) doing the small things; and 5) the person-centered learning curve. CONCLUSION: Understanding the person and knowing what is important to them is central to the participant's philosophy of practice. They drew on specific personality traits such as listening, being patient, or using small talk to develop rapport to better understand the person they were working with. Despite the challenge of high-pressured, under resourced healthcare contexts, student physiotherapists would strive to do the small things for each person they were working with. Practice-based learning settings presented a steep learning curve and appeared to be important in developing person-centered skills which were introduced in the university setting.

Incidence and impact of incivility in paramedicine: a qualitative study.

BACKGROUND: Incivility or rudeness is a form of interpersonal aggression. Studies suggest that up to 90% of healthcare staff encounter incivility at work with it being considered 'part of the job'. METHODS: Qualitative, in-depth, semistructured interviews (n=14) undertaken between June and December 2019. Purposive sampling was used to identify front-line paramedics working for one NHS Ambulance Trust. Interviews lasted between 16 and 45 min, were audiorecorded, verbatim transcribed and analysed using thematic analysis. RESULTS: Four themes were identified: paramedics reported a lack of respect displayed both verbally and non-verbally from other professional groups. The general public and interdisciplinary colleagues alike have unrealistic expectations of the role of a paramedic. In order to deal with incivility paramedics often reported taking the path of least resistance which impacts on ways of working and shapes subsequent clinical decision-making, potentially threatening best practice. Finally paramedics report using coping strategies to support well-being at work. They report that a single episode of incivility is easier to deal with but subsequent episodes compound the first. CONCLUSIONS: This study highlights the effect incivility can have on operational paramedics. Incivility from the general public and other health professionals alike can have a cumulative effect impacting on well-being and clinical decision-making.

'A fifty mile round trip to change a lightbulb': An exploratory study of carers' experiences of providing help, care and support to families and friends from a distance.

While the role of carers has been widely investigated, the experiences of those who care from a distance have been little explored, especially in the United Kingdom. However, contemporary patterns of family life suggest that this may be a significant experience for many. This exploratory study employed an anonymous online survey, conducted April-November 2017, to collect data about specific issues (experiences, challenges and satisfactions) faced by carers living at a distance requiring at least 1 hr travel time (each way) from the person they support. One hundred and twenty-eight participant responses were analysed. Qualitative (thematic) analysis identified that 'distance carers' carry out multiple care tasks, both when with, and apart from, the person they care for. Distance creates specific challenges for carers who have to work to 'bridge the distance gap' and who cannot 'just drop in' and see the person they support. Distance further exposes carers to emotional, financial and temporal demands. The use of technologies or the availability of a wider support network may support distance carers, and some explore the viability of relocation. However, these potential support strategies were identified as 'fragile' and at risk of breaking down. Despite the challenges identified, distance carers also reported satisfactions derived from supporting their relative/friend. While the numbers of those providing distance care are unknown, this research suggests that this is a significant carer group, whose needs should be recognised in health and social care policy, practice and research.

aDolescents gEnder surVey, rEsponsible coupLes evaluatiOn, and capacity building Project in India (DEVELOP): a study protocol.

Domestic violence and assault (DVA) against women is a serious concern in India. This affects the health and wellbeing of victims and their dependents. Published evidence has documented a variety of reasons for such violence in Indian societies, paving a pathway to design, implement, and evaluate intervention models to address this issue. DEVELOP is a research study designed by UK and Indian research teams to plan future projects to address gender-based discrimination and DVA against women and girls in India. This study protocol provides detailed information on the objectives, research methods, data collection, storage, analysis, and dissemination plans of the DEVELOP phase 1 work (2018-19). The first component is a survey of adolescent boys and girls from rural areas of the Maharashtra state of India to understand their gender equality related knowledge and beliefs. The insight gathered will be used to design interventions targeted at adolescent populations through future research and development programmes. Secondly, an evaluation of the 'Responsible Couples' project will be conducted to assess its success and challenges, and to inform future programme activities and strategy. The 'Responsible Couples' project is implemented in 40 villages of Maharashtra state to improve relationships in married couples, prevent violence against women, intervene during violence, and to provide support services for women and their family members. Research findings will be disseminated though public engagement events in India, international conferences, and peer reviewed publications. Secondly, our two key partners (SWISSAID and HMF) will benefit from such evidence to inform their on-going as well as forthcoming projects on gender equality in India.  Research findings will be also useful for local government authorities and non-government agencies striving to advance gender equality.

Sexual health information seeking: a survey of adolescent practices.

AIMS AND OBJECTIVES: To identify sources of information and support preferred by young people to understand adolescent practices as adolescents develop a sexual health knowledge base. BACKGROUND: Statistics suggest that adolescents are not always making safe sexual health decisions. It is essential to develop an understanding of preferred sources of information and support to structure health and education services so that adolescents develop skills and knowledge to make safer choices. DESIGN: A cross-sectional survey design. METHODS: A wide-ranging questionnaire was developed using validated questions, drawn from similar adolescent lifestyle surveys and adapted with guidance from an advisory group; 2036 13-16-year-olds responded. Two questions, reporting information sources adolescents find useful and sources of approachable support, are considered here. RESULTS: Adolescents find informal sources more useful and experience higher levels of comfort accessing informal support especially from their best friends and mothers. Of formal provision, school-based sources are preferred; however, sexual health information seeking is gendered and changes across year groups. The range of sexual health information sources adolescents access increases with age, and how they access these information sources changes as sexual activity increases and the information becomes more relevant. CONCLUSIONS: The findings support the targeting of sexual health provision in relation to age and gender and suggest a youth-focused approach to formal provision, including outreach working and a collaborative relationship with adolescents and parents. RELEVANCE TO CLINICAL PRACTICE: The findings contribute to an understanding of sources of information and support preferred by adolescents. In particular, they need to reconsider how services external to the school may be developed so they are youth-focused and approachable. Nurses need to consider how best to work in partnership with adolescents and their families to disseminate accurate information and develop relevant services.