A qualitative analysis of trainer/coach experiences of changing care home practice in the Well-being and Health in Dementia (WHELD) randomised control trial

This is the author accepted manuscript. The final version is available from SAGE Publications via the DOI in this recordObjectives This study explored the experiences of a range of health and social care professionals employed in the role of trainer/coaches to support care home staff to implement a psychosocial intervention for residents living with dementia. It aimed to identify the factors which are pertinent to these roles, in the context of a cascade model of training. Method A focus group was convened involving dementia trainer/coaches and supervisors who had worked on Well-being and Health for people with Dementia randomised control trial. Twelve participants explored their preparedness for and experiences of their role as 'Well-being and Health for people with Dementia therapists'. They reflected on their perceptions of the resources and support required. The data were transcribed verbatim and subjected to inductive thematic analysis. Results Three main themes emerged from the data. Within the theme of 'skills in relationship building' were two subthemes of developing trust and getting to know individual staff and each care home. In the second main theme of 'making use of tangible resources' two subthemes relating to using the Well-being and Health for people with Dementia manuals and the supervision of the therapists arose. The third theme, 'being an agent for change' contained three subthemes: effective training methods, creating opportunities for Dementia Champions to reflect and therapists' perceived rewards of their role. Conclusion The findings provide new insights into the trainer/coach role applicable to the practices of services recruiting, training and providing ongoing professional support to practitioners in-reaching into care homes.National Institute for Health Research (NIHR

Investigation of the lived experiences and illness perceptions of adults with sudden onset neurological conditions

Purpose: The systematic review summarised the literature on the impact of patient illness perceptions on health outcomes and coping after an acute neurological event, guided by Leventhal’s Self-Regulatory Model (SRM). The empirical study investigated individuals’ lived experiences of emotionalism, a sudden onset neurological disorder characterised by involuntary laughter and crying. A further aim was to develop a questionnaire measuring beliefs about emotionalism based on patients’ perspectives. Method: The review identified seventeen articles through database searches using predefined inclusion criteria. In the empirical paper, eighteen individuals took part in a qualitative study to explore their experiences of emotionalism. Results: Findings provided support for the SRM in acute neurological populations. Negative illness perceptions were associated with a range of poor health outcomes and unhelpful coping behaviours. The empirical paper provided rich individual accounts of the social and personal impact of emotionalism. Four themes were identified and used to develop a questionnaire measuring beliefs about emotionalism. Conclusions: Both chapters emphasise the value of eliciting patient beliefs about their neurological condition and of providing support at the early stages of recovery. The clinical implications and directions for future research were discussed as was the need for further validation of the questionnaire

The mediating role of early maladaptive schemas in the relationship between childhood traumatic events and complex posttraumatic stress disorder symptoms in older adults (>64 years)

The current study investigated the mediating role of Early Maladaptive Schemas (EMS) in the association between childhood trauma and Complex PTSD (CPTSD) symptom severity in a clinical sample of 42 older adults (>64 years). It was found that EMS total score mediated the relationship between childhood trauma and CPTSD symptom severity. Two second order schema factors (Disconnection; Impaired Autonomy) also had a mediating role in this relationship. Results provide preliminary support for the utility of interventions targeting EMS, particularly in the domains of Disconnection and Impaired Autonomy, in order to alleviate CPTSD symptoms. Future research is required to replicate these results within larger samples and to examine the efficacy of schema and cognitive interventions within trauma exposed older adults

Interpersonal Light Touch Assists Balance in the Elderly

Previous researchers have shown that light touch contact with a fixed object reduces body sway, whereas light touch with a moving object entrains and increases sway. Given the importance of interpersonal touch and, for example, its use in care for the elderly, it is interesting to ask whether light touch contact between two people reduces or increases sway? The authors measured ground reaction forces and trunk movements in 5 pairs of older participants (M age = 65.1 years, SD = 4.2 years) during quiet standing, when contacting another person using light touch at the index finger and during light touch with a fixed object. Postural sway was reduced in both light touch conditions, by 13% with interpersonal light touch and by 31% with the fixed object. A small but significant positive correlation in sway with near 0 phase lag during interpersonal light touch may reflect the role of anticipation in maintaining light touch. The authors conclude interpersonal light touch affords an interesting new paradigm for the study of balance