Background: Relational continuity of care (RCC), which is characterised by an ongoing therapeutic relationship between patients and their primary care providers, is critical for ensuring high-quality care in general practice. Despite its importance, challenges such as staffing shortages, policy shifts, and evolving patient needs often impede its consistent delivery. With the new GP contract in England highlighting the need for primary care providers to monitor and deliver relational continuity, it is more than ever crucial to understand how best to achieve it.
View Article and Find Full Text PDFThere is a great need for more high-quality rehabilitation and delirium research and the National Health Service (NHS) should be well placed to deliver such research. This commentary discusses the challenges we faced in delivering a feasibility trial of a rehabilitation intervention aimed at supporting recovery from delirium. We found a number of challenges including identifying therapy teams, delays in study set up, difficulty in identification and recruitment of participants, staff capacity to undertake the research and site selection.
View Article and Find Full Text PDFBackground: Evidence and Gap Maps (EGMs) are a visual representation of the available evidence relevant to a specific research question or topic area. They are produced using similar methods to systematic reviews, however, there is little guidance on which databases to search and how many. Information Specialists need to make decisions on which resources to search, often for a range of study designs within a broad topic area to ensure comprehensiveness.
View Article and Find Full Text PDFHealth Soc Care Deliv Res
March 2025
Background: In health care, errors could have serious consequences for patients and staff. High-risk industries, such as aviation, have improved safety by taking a systems approach, known as safety management systems. Safety management systems are generally considered to have four key components: leadership commitment and safety policy; safety risk management; safety assurance; and safety culture.
View Article and Find Full Text PDFBackground: Sharing data about patients between health and social care organisations and professionals, such as details of their medication, is essential to provide co-ordinated and person-centred care. While professionals can share data in a number of ways - for example, through shared electronic record systems or multidisciplinary team meetings - there are many factors that make sharing data across the health and social care boundary difficult. These include professional hierarchies, inaccessible electronic systems and concerns around confidentiality.
View Article and Find Full Text PDFObjective: Describe families' experiences of interventions to improve continence in children and young people with neurodisability, and health professionals' and school and social care staff's perspectives regarding factors affecting intervention use.
Design: Four online surveys were developed and advertised to parent carers, young people with neurodisability, health professionals and school and social care staff, via societies, charities, professional contacts, schools, local authorities, and national parent carer and family forums, who shared invitations with their networks. Survey questions explored: difficulties helping children and young people use interventions; acceptability of interventions and waiting times; ease of use and availability of interventions, and facilitators and barriers to improving continence.
Health Soc Care Deliv Res
November 2023
Background: Remote monitoring involves the measurement of an aspect of a patient's health without that person being seen face to face. It could benefit the individual and aid the efficient provision of health services. However, remote monitoring can be used to monitor different aspects of health in different ways.
View Article and Find Full Text PDFPilot Feasibility Stud
September 2023
Background: The CanMEDS physician competency framework will be updated in 2025. The revision occurs during a time of disruption and transformation to society, healthcare, and medical education caused by the COVID-19 pandemic and growing acknowledgement of the impacts of colonialism, systemic discrimination, climate change, and emerging technologies on healthcare and training. To inform this revision, we sought to identify emerging concepts in the literature related to physician competencies.
View Article and Find Full Text PDFBackground: Peer support interventions involve people drawing on shared personal experience to help one another improve their physical or mental health, or reduce social isolation. If effective, they may also lessen the demand on health and social care services, reducing costs. However, the design and delivery of peer support varies greatly, from the targeted problem or need, the setting and mode of delivery, to the number and content of sessions.
View Article and Find Full Text PDFDementia (London)
November 2022
Background: Research has highlighted a need for more theoretical work in arts interventions, including the role of the dyad. This study aimed to test theories from a literature review on the impact of including carers in museum programmes for people with dementia, and develop a model which can be used in other programmes to consider the impact of including carers more broadly.
Methods: Using a realist evaluation approach, theory was developed through interviews and participant-observation at six museums in the UK.
Background: Many male prisoners have significant mental health problems, including anxiety and depression. High proportions struggle with homelessness and substance misuse.
Aims: This study aims to evaluate whether the Engager intervention improves mental health outcomes following release.
Background: 'Engager' is an innovative 'through-the-gate' complex care intervention for male prison-leavers with common mental health problems. In parallel to the randomised-controlled trial of Engager (Trial registration number: ISRCTN11707331), a set of process evaluation analyses were undertaken. This paper reports on the depth multiple case study analysis part of the process evaluation, exploring how a sub-sample of prison-leavers engaged and responded to the intervention offer of one-to-one support during their re-integration into the community.
View Article and Find Full Text PDFHealth Technol Assess
November 2021
Background: Children and young people with neurodisability often need help to achieve socially acceptable bladder and bowel control. Approaches vary depending on whether or not the impairment results from spinal cord pathology that impairs motor control and sensation of the bladder and bowel. Currently, there is uncertainty about which interventions are effective.
View Article and Find Full Text PDFUnlabelled: Policy Points The 2018 Declaration of Astana reemphasized the importance of primary health care and its role in achieving universal health coverage. While there is a large amount of literature on the economic aspects of delivering primary care services, there is a need for more comprehensive overviews of this evidence. In this article, we offer such an overview.
View Article and Find Full Text PDFBackground: People in prison experience a range of physical and mental health problems. Evaluating the effectiveness and efficiency of prison-based interventions presents a number of methodological challenges. We present a case study of an economic evaluation of a prison-based intervention ("Engager") to address common mental health problems.
View Article and Find Full Text PDFArts Health
February 2021
: "In the moment" museum programmes for people with dementia (PwD) are an increasingly popular way of supporting people to live well. Most programmes include carers, though it is not well understood what effects, if any, their inclusion has. This review aimed to understand how including carers in museum programmes impacts the PwD, the carer, and the relationship between them.
View Article and Find Full Text PDFThe short time frame associated with rapid reviews can be challenging for researchers conducting qualitative evidence synthesis. In these circumstances a Best-Fit Framework Synthesis, drawing upon existing theory and/or research, may be conducted to rapidly make sense of qualitative evidence. This article discusses a "Rapid Best-Fit" approach to conducting Framework Synthesis within an 6-week rapid systematic review of qualitative evidence.
View Article and Find Full Text PDFPerioper Med (Lond)
September 2020
Multicomponent peri-operative interventions offer to accelerate patient recovery and improve cost-effectiveness. The recent National Institute of Health Research-commissioned evidence synthesis review by Nunns et al. considers the effectiveness and cost-effectiveness of all types of multicomponent interventions for older adults undergoing elective inpatient surgery.
View Article and Find Full Text PDFAging Ment Health
October 2021
Objectives: Persistent delirium is associated with poor outcomes in older adults but little is known about how to support longer-term recovery from delirium. The aim of this review was to identify and synthesise literature to understand mechanisms of recovery from delirium as a basis for designing an intervention that enables more effective recovery.
Methods: A systematic search of literature relevant to the research question was conducted in two phases.