Increasing support staff fluency with the content of behaviour support plans : an application of precision teaching

Background: Behaviour Support Plans (BSPs) are at the core of Positive Behavioural Support for challenging behaviour, but non-adherence to BSPs is common. Generally, non-fluent component knowledge prevents learners achieving fluent application and retention of information and we hypothesised that this may apply to staff learning BSPs. Method: We compared the effectiveness of fluency training (FT) and precision teaching on staff learning of BSPs with staff receiving consultation as usual (CAU), comprising standard support for learning BSPs. All staff completed pre- and post-intervention tests measuring frequency of component skill recall and application of component knowledge (composite skills). Results: The FT group made and maintained greater gains in component skill recall and achieved higher composite test scores, suggesting greater application of component skills. These effects were associated with moderate effect sizes. Conclusions: This study offers initial support for the application of fluency training and precision teaching for staff learning BSP content

Coping with psychological distress during COVID-19: a cautionary note of self-criticalness and personal resilience among healthcare workers

PURPOSE: The COVID-19 pandemic resulted in immense pressure on healthcare workers (HCWs) and healthcare systems worldwide. The current multi-centre evaluation sought to explore the association between coping behaviours and levels of psychological distress among HCWs working during the initial onset of COVID-19. DESIGN/METHODOLOGY/APPROACH: Between April and July 2020 HCWs at three urban hospitals in England were invited to complete an online survey measuring personal and professional characteristics, psychological distress and coping. A principal component analysis (PCA) identified components of coping and structural equation modelling (SEM) was used to test the relationship between components of coping and psychological distress. FINDINGS: A total of 2,254 HCWs participated (77% female, 67% white, 66% in clinical roles). Three components for coping were retained in the PCA analysis: external strategies, internal strategies and self-criticalness/substance use. SEM indicated that internally based coping was associated with lower levels of psychological distress, whereas externally based coping and self-criticalness were associated with greater psychological distress. The final model accounted for 35% of the variance in psychological distress. ORIGINALITY/VALUE: This multi-centre evaluation provides unique insight into the level of psychological distress among HCWs during the initial onset of the COVID-19 pandemic (2020) and associated coping strategies. Addressing self-criticalness and supporting cognitive-based internal coping strategies among HCWs may protect against prolonged exposure to psychological distress. Findings highlight the importance of developing a culture of professional resilience among this vital workforce as a whole rather than placing pressure on an individual's personal resilience

Severe Mental Illness and Pregnancy Outcomes in Australia. A Population-Based Study of 595 792 Singleton Births 2009-2016

BackgroundWomen with Severe Mental Illness (SMI) may have more complex pregnancies and pregnancy outcomes that require different care and management, but this has not been extensively studied. The aim of this study was to explore associations between SMI and adverse maternal and infant outcomes in the state of Victoria, Australia.MethodsOur sample included all reported live singleton births in Victoria 2009–2016 (N = 595 792). Associations between SMI and adverse pregnancy outcomes were explored using Odds Ratios (OR), adjusted for sociodemographic and lifestyle factors, and co-morbidities, including any other mental illness.ResultsOf all singleton births, 2046 (0.34%) were to a mother diagnosed with a SMI. We found evidence of an association between SMI and a range of adverse maternal and infant outcomes. Compared to women without SMI, women with a SMI had higher adjusted odds of being admitted to a High Dependency Unit or Intensive Care Unit (aOR 1.83, 1.37–2.43), having gestational diabetes mellitus (1.57, 1.34–1.84), undergoing an unplanned caesarean section (1.17, 1.02–1.33), induction of labour (1.17, 1.05–1.30) and postpartum haemorrhage (1.15, 1.03–1.29). Newborns of women with SMI had higher adjusted odds of being admitted to Special Care Nursery (aOR 1.61, 1.43–1.80), a low Apgar score at 5 minutes (1.50, 1.19–1.90), preterm birth (1.40, 1.20–1.63), and low birthweight (1.26, 1.06–1.49).ConclusionWomen with SMI are at higher risk for a range of adverse maternal and infant outcomes and are a population that may benefit from targeted early identification and enhanced antenatal care