Use it or lose it? Identifying reasons for the low use of psychosocial support by hospital staff.

BACKGROUND: Psychosocial support programs are a way for hospitals to support the mental health of their staff. However, while support is needed, utilization of support by hospital staff remains low. This study aims to identify reasons for non-use and elements that are important to consider when offering psychosocial support. METHODS: This mixed-method, multiple case study used survey data and in-depth interviews to assess the extent of psychosocial support use, reasons for non-use and perceived important elements regarding the offering of psychosocial support among Dutch hospital staff. The study focused on a time of especially high need, namely the COVID-19 pandemic. Descriptive statistics were used to assess frequency of use among 1514 staff. The constant comparative method was used to analyze answers provided to two open-ended survey questions (n = 274 respondents) and in-depth interviews (n = 37 interviewees). RESULTS: The use of psychosocial support decreased from 8.4% in December 2020 to 3.6% by September 2021. We identified four main reasons for non-use of support: deeming support unnecessary, deeming support unsuitable, being unaware of the availability, or feeling undeserving of support. Furthermore, we uncovered four important elements: offer support structurally after the crisis, adjust support to diverse needs, ensure accessibility and awareness, and an active role for supervisors. CONCLUSIONS: Our results show that the low use of psychosocial support by hospital staff is shaped by individual, organizational, and support-specific factors. These factors can be targeted to increase use of psychosocial support, whereby it is important to also focus on the wider hospital workforce in addition to frontline staff.

Health economic evaluations of interventions for supporting adult carers in the UK: a systematic review from the NICE Guideline.

BACKGROUND: Policy making increasingly needs cost-effectiveness evidence to inform resource allocation. The objective of this review is to identify and to investigate evidence evaluating the cost-effectiveness of interventions aimed to support adult carers, drawing on the National Institute for Health and Care guideline on Supporting Adult Carers. METHODS: The protocol of the review was aimed to identify the economic studies published from 2003 onwards on all types of interventions for supporting adult carers. The applicability to the review and methodological quality of included economic evaluations were assessed using pre-established checklists specified in the National Institute for Health and Care (NICE) manual for developing guidelines. RESULTS: Our search yielded 10 economic evaluations. The main types of strategies evaluated were psychological and emotional support, training, and education support interventions. We found that the interventions more likely to be cost-effective were usually tailored to the specific carers' circumstances and delivered face-to-face and were multi-component in nature, including elements of psycho-education, training, psychological and practical support. The narrative synthesis of results indicated a wide variation in cost-effectiveness findings and methodological quality. CONCLUSIONS: This article indicates that systematic reviews of economic evaluations can be considered as an appropriate means to support decision makers in allocating health and social care resources. Given the high economic and social impact of unpaid caring, and based on the research gaps identified, we recommend that future economics research should be targeted on interventions for identifying carers; and programs for providing carers with support and advice to help them to enter, remain in or return to paid work.

Organisational structures and processes for health and well-being: insights from work integration social enterprise.

BACKGROUND: Previous research on employee well-being for those who have experienced social and economic disadvantage and those with previous or existing mental health conditions has focused mainly on programmatic interventions. The purpose of this research was to examine how organisational structures and processes (such as policies and culture) influence well-being of employees from these types of backgrounds. METHODS: A case study ethnographic approach which included in-depth qualitative analysis of 93 semi-structured interviews of employees, staff, and managers, together with participant observation of four social enterprises employing young people. RESULTS: The data revealed that young people were provided a combination of training, varied work tasks, psychosocial support, and encouragement to cultivate relationships among peers and management staff. This was enabled through the following elements: structure and space; funding, finance and industry orientation; organisational culture; policy and process; and fostering local service networks.. The findings further illustrate how organisational structures at these workplaces promoted an inclusive workplace environment in which participants self-reported a decrease in anxiety and depression, increased self-esteem, increased self-confidence and increased physical activity. CONCLUSIONS: Replicating these types of organisational structures, processes, and culture requires consideration of complex systems perspectives on implementation fidelity which has implications for policy, practice and future research.

Psychosocial support for providers working high-risk exposure settings during a pandemic: A critical discussion.

Psychological first aid is a form of support designed to lessen disaster-related distress. In a pandemic, providers may need such support but with the high risk of exposure, such a program is offered only virtually. The research is scant for traditional post-disaster support and non-existent for virtual; therefore, by using related research this discussion considers the likelihood of providers accessing and benefiting from this program. The virtual platform is heralded as the responsible way to provide support in a pandemic but this standard may be ineffective and is inherently inequitable. As a global event, pandemics require containment strategies applicable on an international level; therefore, psychosocial support should also be developed with an international audience in mind. Online psychosocial support falls short of being such a strategy as it incorrectly assumes global internet access. Many low-income areas such as Sub-Saharan Africa will need support strategies which compliment local frontline staff and fit with community-driven initiatives, whereas wealthier countries may use a combination of onsite and online support. Provider psychosocial support needs in a pandemic, if articulated, are globally similar but how this support is offered requires contextually sensitive considerations not yet found in the literature.

Children Who Give Care Are Overlooked.

Charlie and A.J. Poole were 10 and 9 years old in 2013 when their grandmother, Helen Pomakoy, moved in with them. Her Alzheimer's had been getting worse, and the boys' mother, Sara, decided that bringing her to their McLean, Virginia, home was the best option.

Mobbing as a Predictor of Health Risk Behaviours and Seeking Specialist Support in Non-university Teachers / [El acoso psicológico como predictor de conductas de riesgo para la salud y la búsqueda de apoyo especializado en los docentes no universitarios]

The purpose of this study was to investigate whether experiencing mobbing can predict different health risk behaviours, such as smoking, alcohol intake, increased use of medication as a consequence of psychological disorders at work, and the need to seek specialist support in non-university teachers (N = 9,350). The results of the factorial analysis confirmed the one-dimensionality of the scale and its invariance by gender and educational stage. Results for the predictive model showed that the total score on a mobbing scale predicts the increase in both alcohol intake and tobacco use, a greater use of medication as a consequence of psychological or psychosomatic health disorders at work, and the need to seek support from a specialist to overcome some personal crises related to work. Likewise, the consumption of alcohol and tobacco were positively correlated, whereas the search for specialist support was more related to the increase in the use of medication.(AU)

El objetivo del estudio fue investigar si el acoso psicológico predecía conductas de riesgo no saludables en forma de aumento del consumo de tabaco y alcohol y aumento del consumo de medicamentos por trastornos psicológicos asociados al trabajo, así como la búsqueda de apoyo de profesionales en docentes no universitarios (N = 9,350). Un análisis factorial inicial confirmó la unidimensionalidad de la escala de mobbing y su invarianza por género y etapa educativa. Los resultados del modelo predictivo mostraron que la puntuación en acoso predice el aumento de consumo de alcohol y de tabaco y mayor uso de medicamentos debido a problemas de salud psicológicos o psicosomáticos derivados del trabajo, así como la necesidad de buscar apoyo de especialistas para superar crisis personales relacionadas con el trabajo. El aumento del consumo de alcohol y de tabaco correlacionan positivamente. La búsqueda de apoyo especializado está más relacionada con el aumento del uso de medicamentos.(AU)

Dificuldades percebidas por estudantes de enfermagem da Guiné-Bissau em ensino clínico / Difficulties perceived by nursing students in Guinea-Bissau in clinical teaching

A formação graduada de enfermeiros na Guiné-Bissau encontra-se em processo de transformação, acompanhando o desenvolvimento técnico, científico e pedagógico operado a nível internacional. Esta formação caracteriza-se por períodos de ensino na escola, com aulas teóricas, teórico-práticas e práticas laboratoriais, com alternância entre períodos de ensino clínico em diferentes instituições e serviços de saúde. A transição dos estudantes da escola para o contexto real da prática clínica é, muitas das vezes, marcada por sentimentos angústia e receio. Torna-se assim oportuno compreender as principais dificuldades percebidas por estudantes de enfermagem da Guiné-Bissau no processo de socialização profissional operado em contexto clínico. Trata-se de um estudo descritivo de natureza interpretativa, com o objetivo principal de conhecer a perceção dos estudantes sobre as dificuldades em contexto de ensino clínico, de forma a responder à questão de investigação: ?quais as dificuldades percebidas por estudantes de enfermagem da Guiné-Bissau em ensino clínico??. Contou-se com a participação de 39 estudantes do 2.º ano do Curso Geral de Enfermagem da Escola Nacional de Saúde da Guiné-Bissau, que já tinham realizado ensino clínico e que acederam participar no estudo. Recorreu-se ao inquérito por questionário para recolha de informação. Os resultados deste estudo demostram que existem dificuldades percebidas pelos estudantes de enfermagem da Escola Nacional de Saúde da Guiné-Bissau, nomeadamente, a falta de apoio emocional, o medo, a má logística e alojamento, inexistência de materiais e instrumentos de trabalho nos hospitais, por vezes influenciadas por professores e enfermeiros que os acompanham no ensino clínico, em virtude das suas marcadas dificuldades. Esperamos subsidiar o conhecimento sobre os processos de ensino, de aprendizagem e de avaliação dos estudantes de Enfermagem da Guiné-Bissau, contribuindo para a definição de estratégias de supervisão das aprendizagens mais adequadas e, para a planificação de formação específica para os seus supervisores.