In search of self after stroke: a longitudinal qualitative study in the context of client-centred rehabilitation.

PURPOSE: The aim was to illuminate the experiences of stroke survivors returning to everyday life in the year following stroke, in the context of client-centred rehabilitation. METHODS: Four men who participated in a client-centred rehabilitation program were followed during the first year after stroke. Semi-structured interviews were conducted, allbut the first in the participants' home. The data were analysed using a grounded theory approach. RESULTS: The results revealed a process with the overarching core category; The "new" self becomes reality through challenging everyday experiences, and five main categories driving the process: 1) Striving for structure in a "new" chaotic world, 2) Homecoming an ambiguous experience, 3) Reaching the "new" self through reflections of self-understanding, 4) Socialising in new circumstances, and 5) Realising a new reality. CONCLUSIONS: While in hospital, stroke survivors can have unrealistic expectations. When at home they can begin to realise their actual capacity . To find a "new" self after a stroke can involve time-consuming and taxing processes of reflections of self-understanding. Engagement in self-selected meaningful and valued activities can support stroke survivors' reconstruction of the "new" self but not all stroke survivors may succeed in finding their "new" self during the first year after stroke.

Involving Health Professionals in the Development of Quality and Safety Dashboards: Qualitative Study.

BACKGROUND: Dashboards are an important tool for hospitals to improve quality and safety performance. However, implementing quality and safety dashboards often does not increase performance due to a lack of use by health professionals. Including health professionals in the development process of quality and safety dashboards can improve their use in practice. Yet, it remains unclear how a development process involving health professionals can be executed successfully. OBJECTIVE: The aim of this study is twofold: (1) to delineate how a process whereby health professionals are included in the development of quality and safety dashboards can be facilitated and (2) to identify the factors that are important to consider in order to make that process successful. METHODS: We conducted a qualitative, in-depth exploratory case study in which we analyzed 150 pages of internal documents and interviewed 13 staff members regarding the development of quality and safety dashboards within 2 care pathways of a hospital that has experience in such development. The data were analyzed inductively using the constant comparative method. RESULTS: We found that the development of quality and safety dashboards in collaboration with health professionals was facilitated through a five-stage process: (1) familiarizing participants with dashboards and the development process; (2) brainstorming about potential indicators to be included in the dashboard; (3) prioritizing, defining, and selecting indicators to be included in the dashboard; (4) examining how the indicators can be visualized; and (5) implementing the dashboard and following up on its use. To enhance the success of the process, 3 factors were deemed important. The first is to create and maintain broad involvement, ensuring that various professions are represented and take ownership of the dashboard. Here, potential barriers include gaining engagement from peers not directly involved in the process and maintaining involvement after the initial implementation of the dashboard. Second, unburdening, whereby quality and safety staff facilitate a structured process that has little additional burden for professionals. For this, time management and a lack of collaboration with departments responsible for delivering the data might be an issue. Lastly, focusing on relevance for health professionals, which refers to the inclusion of indicators with value for health professionals. For this factor, a lack of consensus on how indicators should be defined and registered might be a barrier. CONCLUSIONS: Health care organizations seeking to develop quality and safety dashboards in collaboration with health professionals can use a 5-stage process. To enhance the success of the process, organizations are advised to focus on 3 key factors. For each of the key factors, potential barriers should be taken into account. Engaging in this process and attaining the key factors could increase the likelihood that the dashboards are used in practice.

Putting sheep scab in its place: A more relational approach.

Since the reintroduction of sheep scab within the UK, its prevalence has increased despite several industry-led initiatives to control and manage the disease. Some studies have suggested that initiatives or policies should instead focus on specific places, such as geographically high-risk areas for sheep scab, which could allow for a more targeted approach. However, this risk of sheep scab has been measured in set geographical areas, without the reference to the interplay of topography, host, pathogen and the way in which humans socially and culturally define risk and place, potentially limiting the effectiveness of preventative initiatives. Therefore, the aim of the current study was to understand how place influences sheep farmers' approaches to the identification and management of the risk of sheep scab in their flocks. Qualitative data was collected from 43 semi-structured interviews with sheep farmers from England, Scotland, and Wales and was analysed by using the constant comparative approach. The codes were grouped into four concepts that influenced farmers' decision-making strategies for sheep scab control: perception of place; risk identification; risk categorisation; and risk management. These concepts were used as an analytical framework to identify three different 'places': 'uncontrollable places', 'liminal places' and 'protective places'. Each place reflects a different sheep scab control strategy used by farmers and shaped by their perceptions of place and risk. The 'uncontrollable places' category represented farmers who were located in areas that were geographically high-risk for sheep scab and who experienced a high frequency of sheep scab infestations in their flocks. The risk posed by their local landscape and neighbouring farmers, who neglected to engage in preventative behaviours, led them to feel unable to engage in effective risk management. Thus, they viewed scab as uncontrollable. The farmers within the 'liminal places' category were characterised as farmers who were located in high-risk areas for sheep scab, but experienced low levels of sheep scab infestations. These farmers characterised the risks associated with sheep scab management in terms of needing to protect their reputation and felt more responsibility for controlling sheep scab, which influenced them to engage in more protective measures. The farmers within the 'protective places' category were characterised as farming within low-risk areas and thus experienced a low level of sheep scab infestations. These farmers also described their risk in terms of their reputation and the responsibility they held for protecting others. However, they sought to rely on their low geographical risk of sheep scab as a main source of protection and therefore did not always engage in protective measures. These results suggest that place-based effects have significant impacts on sheep farmers' beliefs and behaviours and thus should be considered by policymakers when developing future strategies for sheep scab control.

O exercício profissional do psicólogo do trabalho e das organizações: uma revisão da produção científica / The professional practice of the psychologist in the organization and work context: a review of scientific production

O objetivo da pesquisa foi analisar características da profissão de psicólogo da área da Psicologia Organizacional e do Trabalho a partir da produção científica sobre o tema. Foram identificados 22 artigos a partir de bases de dados eletrônicas, selecionados por meio de juízes. Por meio de uma leitura minuciosa dos textos, agrupou-se o conteúdo dos materiais em três eixos. No Eixo 1, foram identificadas três posições a respeito do papel do psicólogo neste contexto; no segundo, evidenciou-se as principais críticas a essa subárea; e o último eixo apresenta as prescrições apontadas pelos autores para a psicologia do trabalho. Desse quadro geral, conclui-se que há dois movimentos centrais na área: um de permanência de certas problemáticas do campo ao longo dos anos, e outro da coexistência de duas perspectivas ideopolíticas. Os resultados indicam a necessidade de que o campo, mais do que se polarizar, deve buscar o diálogo entre as duas posições a fim de avançar em questões nodais.(AU)

This paper analyzes features of the profession of psychologist in the area of Organizational and Work Psychology present in the scientific literature. Through a detailed reading, the content of texts were grouped in three axes. The results were arranged in three axes. The first one presents the role of the psychologist in the work context, the second axis brings out the major criticisms of the field, and the last assembles the requirements for improving development of the field. This scenario reveals two central movements in the area: one, the maintenance of certain issues over the years, and the other, the co-existence of two opposite ideopolitical perspectives, towards the organizations or towards the workers. The main conclusion refers to the idea that, rather than polarizing, the field needs to seek dialogue between these two positions in order to move forward on central topics.(AU)

O exercício profissional do psicólogo do trabalho e das organizações: uma revisão da produção científica / The professional practice of the psychologist in the organization and work context: a review of scientific production

O objetivo da pesquisa foi analisar características da profissão de psicólogo da área da Psicologia Organizacional e do Trabalho a partir da produção científica sobre o tema. Foram identificados 22 artigos a partir de bases de dados eletrônicas, selecionados por meio de juízes. Por meio de uma leitura minuciosa dos textos, agrupou-se o conteúdo dos materiais em três eixos. No Eixo 1, foram identificadas três posições a respeito do papel do psicólogo neste contexto; no segundo, evidenciou-se as principais críticas a essa subárea; e o último eixo apresenta as prescrições apontadas pelos autores para a psicologia do trabalho. Desse quadro geral, conclui-se que há dois movimentos centrais na área: um de permanência de certas problemáticas do campo ao longo dos anos, e outro da coexistência de duas perspectivas ideopolíticas. Os resultados indicam a necessidade de que o campo, mais do que se polarizar, deve buscar o diálogo entre as duas posições a fim de avançar em questões nodais.

This paper analyzes features of the profession of psychologist in the area of Organizational and Work Psychology present in the scientific literature. Through a detailed reading, the content of texts were grouped in three axes. The results were arranged in three axes. The first one presents the role of the psychologist in the work context, the second axis brings out the major criticisms of the field, and the last assembles the requirements for improving development of the field. This scenario reveals two central movements in the area: one, the maintenance of certain issues over the years, and the other, the co-existence of two opposite ideopolitical perspectives, towards the organizations or towards the workers. The main conclusion refers to the idea that, rather than polarizing, the field needs to seek dialogue between these two positions in order to move forward on central topics.