Environmental Risk Assessment in Community Care: A Scoping Review.

Community care encompasses inherent risks for both clients and healthcare providers. Maintaining a safe environment for the delivery of care services ensures that any risk of unintentional or intentional personal harm is minimised. The aim of this scoping review is to (a) provide an overview of existing knowledge by summarising the current literature and (b) identify gaps pertaining to understanding and managing environmental risk in community care settings. Guided by the Population/Concept/Context approach and PRISMA guidelines, this paper used two questions to answer how a score-based tool for assessing client suitability in community care is developed and how an environmental screening tool assists with reducing risk to community care workers. Literature searches of CINAHL, PubMed (Medline), Web of Science and PsychINFO databases were conducted between September 2023 and November 2023. We included full text articles published from 2018 to 2023. The following four broad areas were identified as key components in the structure of an environmental screening tool: environmental factors, health factors, socioeconomic factors and cultural factors. The results of this review provide valuable information which can be utilised by care organisations to develop and/or refine tools to ensure the safety and wellbeing of workers within the community care sector.

What are the Clinical and Social Outcomes of Integrated Care for Older People? A Qualitative Systematic Review.

Introduction: Older people with multiple chronic conditions have most to gain from successful integrated care models but there is a need to understand current evidence of outcomes for older people. Methods: A qualitative meta-aggregation method was used for the review. Systematic searching of CINAHL, PubMed (Medline), Web of Science, PsycINFO, Scopus and Cochrane identified an initial 93 papers, of which 27 were reviewed. Studies were selected according to the pre-defined protocol and quality assessed using The Joanna Briggs Institute Critical Appraisal Tools (JBIQARI). Eleven, peer-reviewed, English-language papers published between 2000 to 2020 were included. Results: Thirty-three findings were extracted and aggregated into six categories. Three synthesised statements were identified denoting outcomes of integrated care for older people. These indicate social participation and connectedness for older people and their families; the older person feeling motivated to engage in health goals when their preferences were taken into consideration; and older people experiencing support and wellbeing when a therapeutic relationship with a key worker is established. Discussion and conclusion: There was scant evidence of the older person's voice within included studies and a limited focus on outcomes. Stronger evidence is needed to provide meaningful and robust evaluation of outcomes within integrated care models for the older person.

The 'fallacy of normalcy': A content analysis of women's online post-childbirth health-related support.

BACKGROUND: Online forums have changed traditional sources of seeking help because they provide an anonymous and non-judgemental environment particularly suited for women with post-childbirth problems. QUESTION: What support is given to mothers who have posted questions about post-childbirth morbidities? METHODS: A total of 333 messages posted on a post-childbirth online forum were loaded into NVIVO 12 Pro and were analysed using content and thematic analysis. Content analysis identified the major health problems, and thematic analysis was used for identifying motivations and the support offered. FINDINGS: Seventeen different health problems were discussed on posts, with a strong emphasis on pelvic problems, followed by mental health concerns. The key motivation for seeking online help identified using 'typology of advice solicitation' was request for opinion or information (48.85%). The two main support themes were: peer to peer support (82%) and normalisation (not always appropriate) of post-childbirth problems (18%). Most of the support offered was emotional (56.9%) followed by practical (22.7%) and informational support (20.4%). DISCUSSION: Postpartum adjustment of post-childbirth experiences can be supportive but if ill-informed may provide a barrier to safe and reliable health care. CONCLUSION: We recommend women have access to online forums moderated by healthcare providers who can notify participants when a problem requires support from a relevant health professional opinion.

Mothers' views of health problems in the 12 months after childbirth: A concept mapping study.

AIMS: To identify the health problems that women feel require help and subsequent help-seeking behaviour during the 12 months period after childbirth. BACKGROUND: Many women experience physical and mental health problems after childbirth, but there is a gap in understanding how they perceive their health after childbirth. Studies suggested they are inhibited in expressing their needs and so seek informal rather than professional help for their health problems. DESIGN: A mixed method concept mapping study. METHOD: Two groups of Australian women were recruited by an online platform and purposive sampling (N = 81) in 2017-2018, based on an established concept mapping methodology. A first group created 83 brainstorm statements about post-childbirth health problems and help-seeking and a second group sorted and rated the statements based on their perception of the prevalence of the issues and the help-seeking advice they would offer to others. Bradshaw`s Taxonomy of Needs was used to theoretically underpins the explanation of the results of women's felt need after childbirth. RESULTS: Multidimensional scaling resulted in six clusters of issues which were categorized into three domains: 'health issues and care', 'support' and 'fitness'. Despite being directly asked, about two-thirds of the women did not report experiencing any health problems. CONCLUSION: Our findings showed women had a broader perception of healthcare needs which included support and fitness. There is a potential gap in services for women who do not have good social support. IMPACT: Family and friends were a key source of help-seeking. Post-childbirth routine care was focused on infant care and limited to the first 6 weeks after childbirth. The content of current post-childbirth care must be reviewed.

Women's help-seeking behaviours within the first twelve months after childbirth: A systematic qualitative meta-aggregation review✰.

INTRODUCTION: Women within the first 12 months after birth often do not seek professional help for post-childbirth morbidities. This systematic review uses the Behavioural Model of Health Services Use (BMSHU) to assess the barriers and facilitators to women's help-seeking from health professionals during the first twelve months after childbirth. METHOD: A qualitative meta-aggregation was used for the review. Systematic searching of Medline via Ovid, CINAHL, EMBASE and Web of Science revealed an initial 691 papers, of which 48 were reviewed. Nine qualitative papers, peer-reviewed, English papers and published from 2000 to 2017, were identified. Studies selected according to the pre-defined protocol were assessed using The Joanna Briggs Institute Critical Appraisal Tools (JBIQARI). RESULTS: Seventy-five findings were identified from the approved articles and aggregated into seven categories. Key themes that emerged were that women did not seek help because they accepted problems as a part of the motherhood role or because they feared being judged negatively. Women shared their issues with family and friends as trusted people. Low health literacy was a barrier to seeking help, as was lack of access to proper care and poor advice from families. The women's cultural context was an essential influence in whether or not they sought help. According to BMSHU, a model of key influences on women's help-seeking for maternal morbidities introduced.

Preconcentration and determination of 2-mercaptobenzimidazole by dispersive liquid-liquid microextraction and experimental design.

A method was developed to determine 2-mercaptobenzimidazole in water and urine samples using dispersive liquid-liquid microextraction technique coupled with ultraviolet-visible spectrophotometry. It was essential to peruse the effect of all parameters that can likely influence the performance of extraction. The influence of parameters, such as dispersive and extraction solvent volume and sample volume, on dispersive liquid-liquid microextraction was studied. The optimization was carried out by the central composite design method. The central composite design optimization method resulted in 1.10 mL dispersive solvent, 138.46 µL extraction solvent, and 4.46 mL sample volume. Under the optimal terms, the calibration curve was linear over the range of 0.003-0.18 and 0.007-0.18 µg/mL in water and urine samples, respectively. The limit of detection and quantification of the proposed approach for 2-mercaptobenzimidazole were 0.013 and 0.044 µg/mL in water samples and 0.016 and 0.052 µg/mL in urine samples, respectively. The method was successfully applied to determination of 2-mercaptobenzimidazole in urine and water samples.