Understanding the importance of therapeutic relationships in the development of self-management behaviours during cancer rehabilitation: a qualitative research protocol

Cancer survival rates are rising and the long-term needs of cancer survivors are of growing importance. Cancer rehabilitation aims to address the physical or psychosocial decline in ability to engage in daily activities. Incorporating strategies for self-management development into rehabilitation can prepare individuals for cancer survivorship and healthcare professionals will need to adjust their therapeutic interactions accordingly.This qualitative study aims to understand cancer rehabilitation participants’ beliefs regarding the importance of therapeutic relationships in developing self-management behaviours. A sample representative of a local cancer rehabilitation cohort will be asked to complete a semistructured interview to identify their perspectives on the importance of therapeutic relationships in cancer rehabilitation. Data will be entered into a Delphi questionnaire for circulation to a local cancer rehabilitation population to determine if the views expressed by the interviewees are supported by group consensus

Informal Mindfulness Practices: A New Approach to the Prevention and Treatment of Parental Burnout

The present study assessed the effectiveness of informal mindfulness practice among parents in terms of parental burnout prevention and treatment. The objective was to test the new approach of informal mindfulness practice, the FOVEA program, implemented in daily activities rather than based on formal meditations. Traditional mindfulness programs (e.g., mindfulness-based cognitive therapy, MBSR) require a 45-min daily meditation practice which can be difficult to include in parents’ tight schedules, and even more for the parents suffering from or at risk of parental burnout. In contrast, the FOVEA program was designed to enhance the awareness of the present moment in ecological context mainly using the five senses and awareness of breath and body sensations. We tested the hypothesis that compared to the waitlist control group parents participating in the program would present a greater reduction of parental burnout scores following the intervention. The results revealed a statistically significant large effect of FOVEA intervention on parental burnout severity. There was a statistically significant decrease in parental burnout symptoms between T1 and T2 within the intervention group and no statistically significant difference in parental burnout within the waitlist control group. Thus, informal mindfulness practice seems to effectively prevent and reduce parental burnout

Eat Well Keep Active: Qualitative findings from a feasibility and acceptability study of a brief midwife led intervention to facilitate healthful dietary and physical activity behaviours in pregnant women

Pregnant women often find it difficult to follow recommendations for a healthy lifestyle and some women refer back to pregnancy as being the start of their problems with obesity. This paper reports the findings of a study designed to test the feasibility and acceptability of a brief, novel, midwifery led intervention to encourage healthy lifestyle in pregnancy. The intervention was theoretically driven, based on Self Determination Theory and utilised Motivational Interviewing to facilitate motivation to pursue a healthy lifestyle. This paper reports the qualitative finding from semi-structured interviews with a sample of 20 pregnant women. The findings suggest that the three psychological needs of Self Determination Theory are supported, the intervention was received well by participants who also reported positive change in lifestyle behaviours. Theoretically driven interventions for pregnant women, such as the novel intervention reported here are scarce. The Eat Well Keep Active has the potential to make a difference to women before, during and after pregnancy in motivating healthy lifestyle behaviour

The development of a collaborative framework for commissioning health and social care

Background: Integrating health and social care is a national priority. This paper presents an evaluation of an approach for collaborative commissioning designed to improve quality and experience and reduce cost within integrated health and social care. The approach, termed CAREMORE®, provides an acronym for the seven components considered essential for effective planning and commissioning of services. Methods: We used a multi-method approach using qualitative interviews, documentary analysis and non-participant observation. The data gathered are explored using thematic analysis, combining deductive and inductive analysis methods. Findings: Our study provides evidence that CAREMORE® has the means to effectively facilitate a collaborative approach to developing services through its requirement for key stakeholders with relevant knowledge to come together in the co-production of a legally binding Framework Agreement for the commissioning health and social care services. Beyond offering an assessment of the relative success or otherwise of CAREMORE, we also draw out general lessons relevant to the wider implementation of this commissioning method within NHS Wales. Conclusions: This research presents an innovative method for collaborative commissioning and reveals activities that appear to contribute to more effective commissioning processes. The findings suggest that CAREMORE® provides a suitable framework for the collaborative commissioning of integrated health and social care, and that further research is now needed to provide a definitive evaluation of its’ value outside of Wales

Involving the headteacher in the development of school-based health interventions: A mixed-methods outcome and process evaluation using the RE-AIM framework

Although interventions delivered in school settings have the potential to improve children’s health and well-being, the implementation of effective interventions in schools presents challenges. Previous research suggests facilitating greater autonomy for schools to select interventions aligned to their needs could improve implementation and maintenance. The aim of this mixed-methods outcome and process evaluation was to explore whether involving headteachers in the developmental stages of health interventions influenced adoption, effectiveness (e.g. pupil fitness and physical activity, assessed quantitatively), implementation and maintenance (assessed quantitatively and qualitatively). Three UK primary schools were provided with a choice of five evidence-based physical activity interventions: Playground scrapstore, daily classroom refreshers, alternative afterschool clubs, parent and child afterschool activities and an ‘In the Zone’ playground intervention. To evaluate the impact of this autonomous approach, semi-structured interviews with headteachers (n=3), teachers (n=3), and a private coach, and focus groups with pupils aged 9-11 (n=6, 31 pupils, 15 boys), were undertaken. This was alongside an outcome and process evaluation, guided by the RE-AIM framework. This study assessed the impacts on adoption, implementation and maintenance of the autonomous approach and the effect on physical activity (seven day accelerometry – GENEActiv) and aerobic fitness (20m shuttle run). All three schools adopted different intervention components; alternative afterschool clubs, parent and child afterschool activities and daily classroom refreshers. Headteachers welcomed greater autonomy in developing school-based interventions and appreciated the more collaborative approach. Mixed results were reported for the effectiveness, implementation and maintenance of the interventions adopted. Allowing pupils choice and promoting a positive school environment were key factors for enhancing engagement. Moreover, promoting inclusive physical activity projects with a consideration of existing curriculum pressures aided implementation. This mixed-methods study provides valuable insights about autonomous approaches to inform further development, implementation and maintenance for future interventions