Peer workers’ perceptions and experiences of barriers to implementation of peer worker roles in mental health services: A literature review

ObjectivesTo identify peer workers’ perceptions and experiences of barriers to implementation of peer worker roles in mental health services.DesignReview of qualitative and quantitative studies.Data sourcesA comprehensive electronic database search was conducted between October 2014 and December 2015 in PubMed, CINAHL, Web of Science, The Cochrane Library, and PsycARTICLES. Additional articles were identified through handsearch.Review methodsAll articles were assessed on quality. A thematic analysis informed by a multi-level approach was adopted to identify and discuss the main themes in the individual studies. Reporting was in line with the ‘Enhancing transparency in reporting the synthesis of qualitative research’ statement.ResultsEighteen articles met the inclusion criteria. All studies adopted qualitative research methods, of which three studies used additional quantitative methods. Peer workers’ perceptions and experiences cover a range of themes including the lack of credibility of peer worker roles, professionals’ negative attitudes, tensions with service users, struggles with identity construction, cultural impediments, poor organizational arrangements, and inadequate overarching social and mental health policies.ConclusionsThis review can inform policy, practice and research from the unique perspective of peer workers. Mental health professionals and peer workers should enter into an alliance to address barriers in the integration of peer workers and to enhance quality of service delivery. Longitudinal research is needed to determine how to address barriers in the implementation of peer worker roles.     

睢宁县全球基金疟疾项目执行效果

目的 目的 评价睢宁县全球基金疟疾项目执行效果。方法 方法 收集2006-2012年睢宁县疟疾疫情资料, 分析该县全球 基金疟疾项目执行数据, 进行统计分析。结果 结果 2006-2012年睢宁县共报告确诊疟疾病例215例, 其中间日疟213例, 恶性 疟2例。全球基金疟疾项目的实施使疟疾病例从2006年的37例下降至2012年的1例, 发病率从0.28/万下降至0.01/万, 下 降了96.43%。结论 结论 全球基金疟疾项目的执行对睢宁县疟疾疫情的控制发挥了明显的作用。     

效果-实施双轨设计的分类和应用

将证据转化为卫生保健服务,需要经过3个转化过程“临床前研究-临床研究-实施性研究”,耗时漫长且常常出现转化不足。为加快证据转化为日常医疗实践和卫生政策的进程,融合了临床有效性研究和实施性研究的“效果-实施双轨设计”应运而生。本文介绍效果-实施双轨设计的概念、分类及其应用,为研究人员应用此方法开展研究提供参考。     

Local Leaders' Perspectives on Women Veterans’ Health Care: What Would Ideal Look Like?

Background

The Veterans Health Administration (VHA) faces challenges in providing comprehensive, gender-sensitive care for women. National policies have led to important advancements, but local leadership also plays a vital role in implementing changes and operationalizing national priorities. In this article, we explore the notions of ideal women veterans' health care articulated by women's health leaders at local VHA facilities and regional networks, with the goal of identifying elements that could inform practice and policy.

Centralising acute stroke care and moving care to the community in a Danish health region: Challenges in implementing a stroke care reform

In May 2012, one of Denmark's five health care regions mandated a reform of stroke care. The purpose of the reform was to save costs, while at the same time improving quality of care. It included (1) centralisation of acute stroke treatment at specialised hospitals, (2) a reduced length of hospital stay, and (3) a shift from inpatient rehabilitation programmes to community-based rehabilitation programmes. Patients would benefit from a more integrated care pathway between hospital and municipality, being supported by early discharge teams at hospitals.A formal policy tool, consisting of a health care agreement between the region and municipalities, was used to implement the changes. The implementation was carried out in a top-down manner by a committee, in which the hospital sector – organised by regions – was better represented than the primary care sector—organised by municipalities. The idea of centralisation of acute care was supported by all stakeholders, but municipalities opposed the hospital-based early discharge teams as they perceived this to be interfering with their core tasks. Municipalities would have liked more influence on the design of the reform.Preliminary data suggest good quality of acute care. Cost savings have been achieved in the region by means of closure of beds and a reduction of hospital length of stay. The realisation of the objective of achieving integrated rehabilitation care between hospitals and municipalities has been less successful. It is likely that greater involvement of municipalities in the design phase and better representation of health care professionals in all phases would have led to more successful implementation of the reform.     

家庭康复护理对脑瘫患儿的意义及实施要点探析

目的：探讨家庭康复护理对脑瘫患儿的意义以及实施要点。方法选取脑瘫患儿患者80例,随机分为观察组和对照组,各40例。对照组出院后给予患儿家长常规健康宣教,观察组出院后对患儿家长实施专业培训,以确保患儿接受有效的家庭康复护理,并比较2组效果。结果观察组适应行为、大运动行为、精细运动行为、语言行为以及个人-社交行为评分分别为（67.9±5.3）、（70.2±4.6）、（64.3±7.1）、（62.5±4.3）、（60.3±4.7）,对照组分别为（48.6±6.7）、（58.9±5.2）、（41.2±5.3）、（41.6±5.1）、（41.2±5.9）,差异有统计学意义（P<0.05）。结论家庭康复护理在脑瘫患儿护理中的应用效果显著,对提高患儿康复效果具有重要作用,值得推广应用。