Health and social care workers (HSCWs) have carried a heavy burden during the COVID-19 crisis and, in the challenge to control the virus, have directly faced its consequences. Supporting their ...psychological wellbeing continues, therefore, to be a priority. This rapid review was carried out to establish whether there are any identifiable risk factors for adverse mental health outcomes amongst HSCWs during the COVID-19 crisis.
We undertook a rapid review of the literature following guidelines by the WHO and the Cochrane Collaboration's recommendations. We searched across 14 databases, executing the search at two different time points. We included published, observational and experimental studies that reported the psychological effects on HSCWs during the COVID-19 pandemic.
The 24 studies included in this review reported data predominantly from China (18 out of 24 included studies) and most sampled urban hospital staff. Our study indicates that COVID-19 has a considerable impact on the psychological wellbeing of front-line hospital staff. Results suggest that nurses may be at higher risk of adverse mental health outcomes during this pandemic, but no studies compare this group with the primary care workforce. Furthermore, no studies investigated the psychological impact of the COVID-19 pandemic on social care staff. Other risk factors identified were underlying organic illness, gender (female), concern about family, fear of infection, lack of personal protective equipment (PPE) and close contact with COVID-19. Systemic support, adequate knowledge and resilience were identified as factors protecting against adverse mental health outcomes.
The evidence to date suggests that female nurses with close contact with COVID-19 patients may have the most to gain from efforts aimed at supporting psychological well-being. However, inconsistencies in findings and a lack of data collected outside of hospital settings, suggest that we should not exclude any groups when addressing psychological well-being in health and social care workers. Whilst psychological interventions aimed at enhancing resilience in the individual may be of benefit, it is evident that to build a resilient workforce, occupational and environmental factors must be addressed. Further research including social care workers and analysis of wider societal structural factors is recommended.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Policy promotes service user engagement in health services design and delivery. Various tools exist to support the engagement of citizens within health services design. We consider community ...engagement within the context of primary care delivery in remote and rural areas of Scotland. We present findings from three years of qualitative work with community members and healthcare professionals within five different remote and rural areas, undergoing primary care service changes. 364 interviews were carried out with community members and healthcare professionals on their experiences of, and feelings towards, the services changes. A key theme to emerge from our thematic analysis of the qualitative data is experiences of community engagement. In this paper we present our analysis of this theme. We identify different types of community engagement discourse within community and healthcare professional interviews. We illustrate these themes and, through consideration of five case study areas, demonstrate how these discourses can co-exist within the same service change process. The paper presents our sub-themes on community engagement relating to discourses of inclusion and exclusion; the role of the General Practitioner (GP); conceptualisations of the organisational role of the NHS; discourses of fear and, finally, community members understandings of what it means to be active “agents of change” (or not) within health services redesign. We argue that context is as important as method when it comes to facilitating a positive community engagement experience for citizens. Our findings have relevance to the emerging social science literature on citizen experience of public sector community engagement activities.
•Citizens and healthcare staff have differing experiences of health services change.•Engagement relates to feelings of inclusion/exclusion, fear and agency.•Expectations can leave citizens feeling consultation is tokenistic.•Citizen dissatisfaction can stem from feelings of being unheard or uninformed.•Context is as important as method in facilitating positive community engagement.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Geographers have highlighted the role of spaces and places in realising or discouraging social integration for marginalised or “dis/abled” citizens. Social enterprises, widely promoted by ...governments, aim to act as unique socio‐commercial spaces that can up‐skill citizens for work through technical and social experiences. Social enterprises have also been proposed to add value by fostering wellbeing realisation, but this has been difficult to measure. Here, we extend extant knowledge linking social enterprises and social integration (an aspect of wellbeing) by providing a “micro‐geography” of how one social enterprise contributes to social integration in an Australian regional city. Visual summaries of integration are built by mixing methods of observation, interviews and go‐along interviews, in a GIS. Our analysis shows that relational features of different workspaces within Work Integration Social Enterprises support integration to realise, but that with other relational features, segregation can occur. Confirming previous qualitative studies, we map and explore how social enterprises help to realise encounters in work and social domains outside the social enterprise and in the community. Micro‐geographies of workspaces and communities show great potential for revealing where social phenomena occur (and do not occur). Most valuably, via layers of mixed data, they help to expose causal factors – an element that has long been elusive in studies of social enterprise. Our study supports work of other geographers showing how places and spaces help social integration of disadvantaged citizens. More broadly, the micro‐geographical analysis affords potential for organisations and communities to understand where and how to generate greater social integration.
Social enterprises aim to up‐skill citizens for work through technical and social experiences as well as foster wellbeing realisation, but this has been difficult to measure. Here, we extend extant knowledge linking social enterprises and social integration (an aspect of wellbeing) by providing a mapped, “micro‐geography” of how one social enterprise contributes to realising social integration. This innovative mixed methodology affords potential for organisations and communities to understand where and how to generate greater social integration.
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BFBNIB, DOBA, FSPLJ, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UILJ, UKNU, UL, UM, UPUK
There is a lack of research into green exercise which investigates and compares motivational drivers between the different types of outdoor activities. The current paper addressed this gap by ...classifying and comparing three types of green exercise: (i) Recreational physical activity, (ii) competitive sport, and (iii) outdoor adventure sport. Using a mixed methodological approach, the present study investigated the motivations for adhering to green exercise and directly compared the differences between these three forms of green exercise. Online questionnaires and face-to-face interviews were used to collect data. The results demonstrated that within all types of green exercise, enjoyment was the greatest motivator. Based on analysis of the qualitative materials, extrinsic motivators such as the environment, family, and friends were highlighted as key factors in beginning and continuing their activity. However, intrinsic motivators were also emphasised as more important in adherence to green exercise. Furthermore, as seen in other research, numerous psychological benefits were reported over time. The results of the study may act as a starting point in understanding how we may increase public engagement in green exercise by prompting participants to select a form of green exercise that best suits them based on their motivational profile.
Green exercise studies have tended to use walking as a modality of exercise to establish benefits to mental health. Whether green exercise benefits translate into different forms of green exercise ...has been deemed an important research gap. A mixed-methods study design was used to compare psychological responses between two forms of green exercise; golf and walking. A total of 20 participants (10 in each group), with a range of ages and experience were recruited to take part in the study. Participants in the walking condition exhibited significantly greater levels of dissociative cognitions than golf condition participants. Consequently, only the walking condition significantly improved in a directed attention test. Results from the Exercise-Induced Feeling Inventory questionnaire found the walking condition demonstrated increases in all four subscales, whereas the golf condition showed no significant improvements. Based on the findings from the qualitative analysis, distinct differences were seen with regards to the perception of the environment. Participants in the golf condition noted natural elements as obstacles to effective performance, whereas the walking group noted natural stimuli as evoking positive feelings. In agreement with the Attention Restoration Theory, the current study demonstrates that the benefits of green exercise are somewhat reduced when greater levels of directed attention towards the activity are exhibited during green exercise.
Social isolation and loneliness are known to be associated with increased morbidity and mortality. Therefore, reducing social isolation and loneliness may improve such outcomes. In relation to men's ...health, “Men's Sheds” have been shown as one mechanism to achieve this. Studies in Australia and England have shown social, health and personal benefits; however, this remains an area that has not yet been researched in Scotland. This study, therefore, aimed to assess the characteristics of attendees, self‐reported motivations for and the values and benefits of attending the Shed from the views of the attendees themselves. The participants of the study were the members of a Men's Shed in the North of Scotland, which was initially set‐up by a small number of core Shedders. A convenience sample was recruited by opportunistic interviewing of participants when they attended the Shed using a mixed methods approach from 1 to 15 November 2016. In the absence of a validated questionnaire, a bespoke questionnaire was developed in several iterative stages. The answers to the questionnaire were transferred to an electronic database and analysed by frequency and thematic analysis. The participants (n = 31) had a mean age (SD) of 69.7 ± 9.5 with 96.8% being retired, thus the majority of the Shed users were older and retired. The results suggest that there were several benefits from attending the Shed, with an overwhelming majority of the sample reporting personal, social and health benefits—however, more research is needed to determine the magnitude of these. This study has also shown that the men attending the Shed frequently discussed health, which could potentially have a beneficial effect. The Shed therefore, as a community project, has the potential to have a positive impact on health welfare by focusing on the social aspects of life.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
This article explores what happened, over the longer term, after a community participation exercise to design future rural service delivery models, and considers perceptions of why more follow-up ...actions did or did not happen. The study, which took place in 2014, revisits three Scottish communities that engaged in a community participation research method (2008–2010) intended to design rural health services. Interviews were conducted with 22 citizens, healthcare practitioners, managers and policymakers all of whom were involved in, or knew about, the original project. Only one direct sustained service change was found – introduction of a volunteer first responder scheme in one community. Sustained changes in knowledge were found. The Health Authority that part-funded development of the community participation method, through the original project, had not adopted the new method. Community members tended to attribute lack of further impact to low participation and methods insufficiently attuned to the social nuances of very small rural communities. Managers tended to blame insufficient embedding in the healthcare system and issues around power over service change and budgets. In the absence of convincing formal community governance mechanisms for health issues, rural health practitioners tended to act as conduits between citizens and the Health Authority. The study provides new knowledge about what happens after community participation and highlights a need for more exploration.
•Explores what happens after a rural health community participation exercise.•Includes multiple stakeholders, juxtaposing citizen and management perspectives.•Highlights health practitioner role as a conduit for communication and change.•Reveals a deficit in formal community governance around health issues.•Shows that citizen can be ‘responsibilised’ to coproduce rural services.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Social enterprises are promoted as a method of welfare reform, to transition people out of disadvantage by addressing poverty, unfulfilled capabilities and social exclusion. This study explores how ...three Work Integration Social Enterprises (WISEs) in Australia help to realise wellbeing for their employees by mapping their micro-geographical experience of wellbeing. By mapping the sites within a social enterprise where wellbeing is realised, we provide a practical, empirical and replicable methodology that is useful for gaining insights into where and how wellbeing realisation occurs. This situates wellbeing as an upstream place-based resource likely to influence downstream health outcomes.
•Social enterprises are spaces of wellbeing, but wellbeing is unevenly distributed across the sites.•Mapping situates wellbeing as an empirical and upstream place-based resource.•Micro-geography of wellbeing can aid social enterprises design for wellbeing outcomes.•Work supporting wellbeing is not simply allocating people to one job, in one location.•Mobility through tasks in relation to personal aptitudes helps wellbeing to realise.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
This article considers whether, and if so how, rural communities can be supported, through a facilitated process, to create social enterprises within the field of health and care. Using results from ...the thematic analysis of four community case studies involved in a facilitated actionresearch process, the article identifies community capabilities and entrepreneurial skills needed to create such rural community-based service providers. The identification of similarities and differences in how the development process took place in four communities allows us to present a development model of our facilitated process. The article contributes to understanding about rural community social enterprises for service provision and the processes associated with their creation.
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BFBNIB, NUK, ODKLJ, PNG, UL, UM, UPUK
Interventions need to be developed in a timely and relatively low-cost manner in order to respond to, and quickly address, major public health concerns. We aimed to quickly develop an intervention to ...support people with severe mental ill-health, that is systematic, well founded both in theory and evidence, without the support of significant funding or resource. In this article we aim to open and elucidate the contents of the 'black box' of intervention development.
A multidisciplinary team of seven academics and health practitioners, together with service user input, developed an intervention in 2018 by scoping the literature, face-to-face meetings, email and telephone. Researcher fieldnotes were analysed to describe how the intervention was developed in four iterative steps.
In step 1 and 2, scoping the literature showed that, a) people with severe mental illness have high mortality risk in part due to high levels of sedentary behaviour and low levels of exercise; b) barriers to being active include mood, stress, body weight, money, lack of programmes and facilities and stigma c) 'nature walks' has potential as an intervention to address the problem. In Step 3, the team agreed what needed to be included in the intervention so it addressed the "five ways to mental wellbeing" i.e., help people to connect, be active, take notice, keep learning and give. The intervention was mapped to key behavioural change concepts such as, personal relevance, relapse prevention, self-efficacy. In Step 4, the team worked out how best to implement the intervention. The intervention would be delivered over 12 weeks by members of the hospital team and community walk volunteers. Participants would receive a nature walks booklet and text messages.
We developed a theoretically-informed, evidence-based nature walks programme in a timely and relatively low-cost manner relevant in an era of growing mental illness and funding austerity. Further research is required to test if the intervention is effective and if this approach to intervention development works.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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