To describe and synthesize client-centered care and service in home care for older persons.
The study was an integrative review using the guidelines for literature reviews by the Joanna Briggs ...Institute. The research process followed the Whittemore and Knafl framework and PRISMA toolkit in the selection of eligible articles. The CINAHL, Medline, Scopus, Web of Science and Social Sciences abstracts were searched for articles published between January 2007 and May 2020 according to previously designed search strategies. In total, 24 articles were deemed relevant for an analysis using a thematic analysis.
The analysis resulted in four themes with sub-themes which revealed that client-centered care and service in home care consist of: 1) Clients' involvement in their own care; self-care, decision-making, satisfactory daily life, 2) Family members' and care partners' participation in care; family members' and care partners' commitment to care, family members' and care partners' competence in care, 3) Communication and co-operation; communication models, empowerment, partnership, and 4) Evidence-based service competence; delivery and organization of services, implementation of services, versatile clinical skills, quality outcomes and personnel wellbeing.
According to the results, achieving client-centered care and service in home care requires the realization of all of the above aspects. The practice of nursing must better identify all dimensions of client-centered care and take these into account in the delivery of home care services.
KEY POINTS
Client-centeredness is a fundamental value and the basis of nursing and care in home care provided for older persons
This paper:
deepens and structures the concept of client-centered care in the context of home care.
assists professionals to understand the factors behind client-centered care within the home care environment.
provides deeper understanding of the roles of the older person, family members, and the service system in developing client-centered services in home care for older persons.
Speech-language pathology graduates are not only expected to be proficient in their area of expertise but to have developed skills that contribute to society as a whole. The purpose of this paper is ...to illuminate the relationship between the Sustainable Development Goals (SDGs), in particular, good health and well-being (SDG 3), quality education (SDG 4), reduced inequalities (SDG 10), sustainable cities and communities (SDG 11), and partnerships for the goals (SDG 17) through the involvement of experts-by-experience in the classroom on a pre-registration speech-language pathology course.
An innovative approach to student-centred learning involved Tom, a person with autism, his family, and his speech-language pathologist (SLP). This commentary is co-written with Tom's mother and advocate, his SLP, and a university educator. Tom's mother's writing was not changed in anyway as agreed in the writing contract.
Co-teaching with experts-by-experience (a parent, and a person with a communication disability) has the potential to strengthen the bonds between communities and universities. Involvement by experts-by-experience promotes equality in teaching and sees the person and the ability behind the disability. SLPs and university educators must collaborate to make this a reality. This commentary paper focusses on SDG 17 to illuminate the relationship between SDG 3, SDG 4, SDG 10, and SDG 11.
Social workers often practice within interprofessional teams, yet few research studies have examined social work students' perceptions of their role on these teams using a visual methodology such as ...illustrations and illustration descriptions. This qualitative study aimed to understand 1) What are social work students' perceptions of their role on interprofessional teams? 2) What are social work students' perceptions of the different members involved in interprofessional teams? 3) What are social work students' perceptions of how interprofessional team members work together? Analysis of the illustrations and illustration descriptions from twenty-six advanced year MSW students from one southeastern university in the United States suggests that many perceived their role as considering the client/family in decision making. In terms of team membership, half of the students depicted clients being involved, and most drew other professionals with a focus on health-related professionals. Students also drew a range of ways team members work together, such as in meetings at tables or in client rooms or talking to each other. Findings from this study have implications for social work education, particularly in relation to interprofessional collaboration, leadership, understanding students' mental models of interprofessional teams, and client-centered care.
Fostering successful interprofessional collaboration remains a challenge in pediatric rehabilitation. A coaching approach can enhance client-centered care and provide a transdisciplinary framework ...for collaboration. The purpose of this longitudinal study was to evaluate the impact of Solution-Focused Coaching in Pediatric Rehabilitation (SFC-peds) training on pediatric rehabilitation practitioners from multiple disciplinary backgrounds. Thirty-seven service providers (SPs) completed surveys at baseline and three follow-ups. Quantitative and qualitative findings both suggested that the training proved an effective way to achieve substantial and sustainable improvements in SFC knowledge, confidence, and use of SFC-peds techniques among participating SPs. The educational intervention also facilitated the integration of a strengths-based, solution-building approach at an individual and team level, providing SPs with a common language and shared framework for client-centered care and optimal collaboration with colleagues. A need for practice opportunities tailored to unique care contexts was identified. Future research should further explore the impacts of a SFC-peds approach on interprofessional teams, as well as on health outcomes of clients.
Being holistic is often used by occupational therapists to describe their practice and philosophy worldwide. This study explores the perspectives of 33 occupational therapists, working in 13 ...different countries, on their understanding of holistic epistemology and practice and how they seek to incorporate holism in their work. On the basis of a qualitative study design, individual interviews were conducted with the participants by 18 Norwegian undergraduate occupational therapy students, supported by their supervisors. The authors subsequently analyzed the transcribed data, using a thematic analysis approach. Three principal themes emerged: (1) holism as a broad and narrow concept, (2) being holistic spans from treating body parts to teaching marginalized children, and (3) being holistic is a lot to ask. When talking about holism and holistic practice, participants described their holistic practices in various ways, and their accounts reflected different understandings and cultural contexts. Participants characterized a holistic approach as one emphasizing the importance of occupations and activities and helping patients regain independence in their everyday lives. However, they also highlighted the specific challenges they faced, including cultural factors and inadequate resources. Significantly, participants from both Western and non-Western contexts emphasized the importance of holistic practice, suggesting that a dichotomous understanding of Eastern versus Western philosophical approaches does not necessarily make sense in occupational therapy interventions. Therapists’ degree of commitment to client-centered practice appears of greater relevance. With its international perspective, our study sheds light on important areas of contemporary occupational therapy practice, including the difficulties occupational therapists face when seeking to cover “everything” in an effort to be more holistic.
More than 1 billion people globally are immigrants, refugees, and migrants. Newcomers experience uncertainty regarding work, housing, social isolation, concerns for family members back home, trauma, ...and economic hardships. Language and literacy issues add to the daily stress. The nurse practitioner (NP) approach to client-centered care and integration of social determinants of health into comprehensive care lends itself well to the needs of a refugee population. This article provides an overview of some of the common health problems faced by refugees and how the NP can address them.
•In 2022, the number of refugees admitted to the United States more than doubled from 2021, rising from 11,454 refugees in 2021 to 25,465 in 2022.•Providing refugee care to newly arrived immigrants and their families (newcomers) presents challenges for the health care team.•The nurse practitioner (NP) approach to client-centered care and integration of social determinants of health into comprehensive care lends itself well to the needs of a refugee population.•Newcomers should receive culturally informed, timely and language appropriate health care in accordance with the Centers for Disease Control Refugee Health Screening Guidelines within the first 90 days of arrival.
Background: The Canadian Occupational Performance Measure (COPM) is a recognized assessment tool within Danish occupational therapy (OT), and translated versions of the COPM have been implemented in ...Danish OT practice. However, a rigorous translation and cross-cultural validation process has not been applied to these versions.
Aims: To produce a new Danish translation of the COPM evaluating its semantic, conceptual, operational and item equivalence while addressing its face and content validity.
Methods: An iterative, multistage translation process was undertaken with (1) forward translation involving professional translators and bilingual OTs, (2) pilot testing and cognitive debriefing interviews with 15 OTs and 37 clients which were analyzed quantitatively and qualitatively, and (3) finalization with adaptations, back translation and approval.
Results: Content validity of COPM in terms of appropriateness, acceptability, intelligibility and comprehensiveness was found in 78-100% of the cases, and its ability to ensure a client-centred focus in the assessment process was confirmed. However, issues concerning the administration and content of the COPM were identified. Subsequently, two recommendations regarding the administration of the COPM were added to the Danish version.
Conclusion: Semantic, conceptual, operational and aspects of item equivalence of the COPM into Danish were achieved and supported by face and content validity.
Introduction
The aim of this retrospective cross-sectional study is to examine the routine use proportion and factors determining the use of the Canadian Occupational Performance Measure in the ...real-world subacute rehabilitation setting.
Methods
This study retrospectively collected data from all inpatients and occupational therapists at a single Japanese subacute rehabilitation ward during 2017, including Functional Independence Measure motor/cognitive scores, years of experience, and rate of Canadian Occupational Performance Measure administration (that is, Canadian Occupational Performance Measure proportion). Multiple logistic regression analyses were used to identify the determining factors of daily routine Canadian Occupational Performance Measure use/non-use, after which cut-off values were calculated.
Results
Of the 619 included clients, the Canadian Occupational Performance Measure was applied in 232 cases (37%). A multiple logistic regression analysis revealed two significant determining factors of its use: Canadian Occupational Performance Measure proportion (odds ratio, 1.06) and Functional Independence Measure cognitive item (odds ratio, 1.22). The cut-off value, sensitivity, and specificity, respectively, were 35.4%, 0.73, and 0.36 (p < 0.0001) for the Canadian Occupational Performance Measure proportion and 25.5, 0.84, and 0.45 (p < 0.0001) for the Functional Independence Measure cognitive score.
Conclusion
The client’s high-level cognitive skill and occupational therapist’s attitude may determine the use of the Canadian Occupational Performance Measure.
This article examines how Community Health Workers (CHWs) build trust with low-income women of color who have a historical distrust of the healthcare system, and are at risk for maternal-child health ...disparities. This qualitative study used a grounded theory methodology guided by Charmaz's inductive social constructivist approach. Data were collected using open-ended semi-structured interviews and focus groups with CHWs who worked in community-based and hospital-based programs in California, Oregon, Illinois, Texas, South Carolina, New York, and Maine. Thirty-two CHWs participated, with 95% of participants being of Latinx and African American ethnicity. They served women from Latinx, African American, and Migrant communities. The CHW communication strategies represent aspects of respect and client-centered care and are applied in the development of a theoretical framework. CHWs were able to build and sustain trust at the initial encounter through these specific strategies: 1) addressing immediate needs related to social determinants of health; 2) embodying mannerisms and dress; 3) speaking appropriately to the client's age, culture, and knowledge; 4) easing client's fears through locus of control, and 5) allowing for time flexibility. These findings have implications for practice through interventions to train healthcare providers to build trust with low-income women of color who have a historical distrust of the healthcare system and who are at risk for maternal-child health disparities. Future research is recommended to explore how the communication trust-building constructs also benefit all other groups at similar risk, including those with mental health disorders and infectious diseases. The findings indicate specific communication strategies through which trust can be built, beginning at the initial encounter with low-income women at risk for maternal-child health disparities and who have a historical distrust of the healthcare system.
Introduction
There are few culturally informed, theory-driven evidence-based strategies to support PrEP use among Black MSM. This paper describes the theoretical foundation and conceptual development ...of C4™ to support the prevention of HIV and other STIs.
Methods
C4™ integrates self-determination theory with comprehensive risk counseling and services using an integrative anti-racism lens. C4™ was implemented in a 52-week HIV prevention demonstration project to facilitate PrEP use and adherence among Black MSM (
N
= 226) in three US cities from 2014 to 2017.
Results
PrEP use was 79%, with 91% of PrEP users starting within 30 days. Twelve-month retention in C4™ was 92%. Care coordination encounters focused primarily on clients’ needs related to PrEP adherence (43%) and sexual health (19%). Over the 12-month period, a substantial proportion of the men made progress towards their PrEP adherence goals at the 8-week (83%), 26-week (75%), and 52-week (81%) study visits.
Conclusions
C4™ is a multi-level, multi-component intervention that dually targets individual-level motivations and capacities of Black MSM and the healthcare facility-level attitudes, behaviors and processes that characterize the climates where Black MSM receive services.
Policy Implications.
Public health policy efforts to scale-up PrEP may consider C4™ as a tool to optimize the use of PrEP and PrEP program retention with Black MSM. C4™ is also a tool for healthcare facilities to transform their models of service delivery towards improving the implementation PrEP services, including ensuring racial equity in the prevention impact of novel PrEP formulations such as long-acting injectable and potential future long-acting oral regimens.
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