Academic literature on the topic 'Companionship programme'

Abstract Background Academic physician burnout is concerning. Too little is known about factors associated with residency programme director burnout. Continued uncertainty risks adverse outcomes including graduate medical education leadership turnover and negative impact on recruiting and retaining under-represented minority residency programme directors. Objective This study assessed symptoms of burnout (emotional exhaustion, depersonalization) and depression along with evidence-based individual and environmental risk factors in a U.S. sample of family medicine residency programme directors. Methods The omnibus 2018 Council of Academic Family Medicine Education Research Alliance survey was used to contact programme directors at all Accreditation Council for Graduate Medical Education accredited U.S. family medicine residency programmes via email. Descriptive data included programme director and programme characteristics, Areas of Worklife (workload, values and control), loneliness (lack companionship, feel left out and feel isolated), burnout (emotional exhaustion, depersonalization) and depressive symptoms. Chi-square tests contrasted descriptive variables with burnout and depressive symptoms. Logistic regression (LR) modelled associations between significant descriptive variables and burnout and depressive symptoms. Results The survey response rate was 45.2% (268/590). Programme directors reported: emotional exhaustion (25.0%), depersonalization (10.3%) and depressive symptoms (25.3%). LR models found significant associations with emotional exhaustion (Workload: lacking time and other work-related resources); lack of companionship, depersonalization (North West Central residency region; Workload and lack of companionship) and depressive symptoms (Black/African American ethnicity). Conclusions One-quarter of U.S. programme directors report burnout or depressive symptoms. Future research should consider associated variables as possible intervention targets to reduce programme director distress and turnover.

A sample of 49 ‘elderly graduate’ residents of a hospital designated for closure were surveyed in 1987 and followed up five years later. Twenty-two patients (45%) had died: the mortality rate was much lower than that predicted by the regional health authority and approximated to that of the general population. All but one of the survivors was living in supported accommodation at the time of follow-up. The majority were satisfied with the move and were receiving an appropriate level of care. However there was significant unmet need for structured activities and companionship. During the follow-up period the survivors had declined in functioning.

Background: The Critical Ally and Critical Friend are two models in the early stages of developmental testing as part of a doctoral research programme. Together with the Critical Companionship model, they offer a theoretically coherent framework for developing expertise in the facilitation of learning about practice from within the workplace. The two new models are sequentially related models underpinned by key principles of practice development and critical social theory. Unlike Critical Companionship, the Critical Ally and Critical Friend models are aimed at novice and proficient practice developers respectively; we argue that, because of their design, they can offer stepping stones to Critical Companionship. Together, the three models offer a pathway for practice developers and practitioners to gain, in a systematic way over a longer timescale, a repertoire of facilitation skills and to build expertise. Aims: To describe the two new models and demonstrate their theoretical coherence with Critical Companionship. We also invite other practice developers and facilitators of workplace learning to debate the coherence of the two new models and the overall pathway, and to contribute to testing the models in a range of workplaces. Implications for practice: The two new models, when used in conjunction with the Critical Companionship model, offer a pathway for developing facilitation expertise within practice development The models offer a broad based introduction to learning in and from practice, which could be useful for preceptors, mentors, clinical supervisors and facilitators at all levels from novice to proficient As the three models offer a pathway, they could be useful as part of strategic workforce development, and learning and development planning The models offer a potential new midrange theory that can contribute to developing practice development knowledge

Homesharing programmes bring two or more individuals who are not linked by family bonds to live under the same roof, sharing domestic spaces and daily living activities. Intergenerational cohabitation programmes match an elderly homeowner (or a person with a rental agreement) who needs companionship and some help with a younger one who is looking for affordable accommodation. This article provides an overview of intergenerational homesharing by tracing their arrangements and salient characteristics, besides explaining the typological variety observed. Based on fieldwork carried out mainly by interviewing homesharing programme managers and policymakers over the period 2015-2019, this paper casts light on several dimensions that characterize homesharing programmes as an arrangement potentially capable of relieving loneliness and social isolation issues in old age, and of generating preventive and light forms of care. The study analyses the main critical aspects of homesharing as well as some of their evolution and transformation dynamics in recent years.

Research indicates that friendship contributes to wellbeing in later life in various ways: through the provision of companionship in daily life, support during stressful transitions, sustainment of identity under changing circumstances and adaptation to old age. However not all older people have friends available who fulfil these different functions. In order to promote wellbeing and reduce loneliness, an educational programme on friendship enrichment for older women has been developed and implemented in the Netherlands. The friendship programme's main goal is empowerment; it helps women clarify their needs in friendship, analyse their current social network, set goals in friendship and develop strategies to achieve goals. Reduction of loneliness, when present, is also an important goal of the programme. A study that followed 40 participants during the year after the programme demonstrates that a majority succeeded in developing new, or improving existing, friendships and in significantly reducing their loneliness. They also reported changes related to the self and social behaviour. Limitations of the research design, reflection on the feasibility of reducing loneliness through a single type of intervention, and possible applications of the programme's design to other areas, are presented in the discussion.

IntroductionWell-trained, adequately skilled and motivated primary healthcare (PHC) workers are essential for attaining universal health coverage (UHC). While there is abundant literature on the drivers of workforce motivation, published knowledge on the mechanisms of motivation within different contexts is limited, particularly in resource-limited countries. This paper contributes to health workforce literature by reporting on how motivation works among PHC workers in a maternal and child health (MCH) programme in Nigeria.MethodsWe adopted a realist evaluation design combining document review with 56 in-depth interviews of PHC workers, facility managers and policy-makers to assess the impact of the MCH programme in Anambra State, Nigeria. A realist process of theory development, testing and consolidation was used to understand how and under what circumstances the MCH programme impacted on workers’ motivation and which mechanisms explain how motivation works. We drew on Herzberg’s two-factor and Adam’s equity theories to unpack how context shapes worker motivation.ResultsA complex and dynamic interaction between the MCH programme and organisational and wider contexts triggered five mechanisms which explain PHC worker motivation: (1) feeling supported, (2) feeling comfortable with work environment, (3) feeling valued, (4) morale and confidence to perform tasks and (5) companionship. Some mechanisms were mutually reinforcing while others operated in parallel. Other conditions that enabled worker motivation were organisational values of fairness, recognition of workers’ contributions and culture of task-sharing and teamwork.ConclusionsPolicy designs and management strategies for improving workforce performance, particularly in resource-constrained settings should create working environments that foster feelings of being valued and supported while enabling workers to apply their knowledge and skills to improve healthcare delivery and promote UHC. Future research can test the explanatory framework generated by this study and explore differences in motivational mechanisms among different cadres of PHC workers to inform cadre-related motivational interventions.

Background Befriending is a popular way in which to intervene to combat loneliness and social isolation among older people. However, there is a need to improve our understanding about how these interventions work, for whom and in which contexts, to make the best use of the increasing investment in the provision and delivery of befriending services. Methods A realist evaluation was undertaken as it focuses on uncovering causal processes and interactions between mechanisms and contextual characteristics. Five case studies of befriending programmes in Northern Ireland were studied, reflecting variation in contextual variables, service user and provider characteristics. Data was collected via service documentation and semi-structured interviews (n = 46) with stakeholders involved in the delivery and receipt of befriending interventions. Results Eight initial programme theories were generated, which were ‘tested’ in the case study analysis to uncover context-mechanism-outcome relationships. Mechanisms identified included reciprocity, empathy, autonomy, and privacy which were triggered in different contexts to support the alleviation of loneliness and social isolation. Reciprocity was ‘triggered’ in contexts where service users and befrienders shared characteristics, the befriender was a volunteer and befriending took the form of physical companionship. Contexts characterised in terms of shared experiences between befriender and service user triggered empathy. Autonomy was triggered in contexts where befriending relationships were delivered long-term and did not focus on a pre-defined set of priorities. Privacy was triggered in contexts where service users had a cognitive/sensory impairment and received one-to-one delivery. Conclusion This study improves understanding about how and why befriending interventions work. Findings indicate that services should be tailored to the needs of service users and take into consideration characteristics including mobility, impairments e.g. physical, sensory and/or cognitive, as well as the influence of service characteristics including payment for befrienders, fixed/long-term befriending relationship, one-to-one support and the impact of non-verbal communication via face-to-face delivery.

Background Reablement is an intensive, time-limited intervention for people at risk of needing social care or an increased intensity of care. Differing from home care, it seeks to restore functioning and self-care skills. In England, it is a core element of intermediate care. The existing evidence base is limited. Objectives To describe reablement services in England and develop a service model typology; to conduct a mixed-methods comparative evaluation of service models investigating outcomes, factors that have an impact on outcomes, costs and cost-effectiveness, and user and practitioner experiences; and to investigate specialist reablement services/practices for people with dementia. Methods Work package (WP) 1, which took place in 2015, surveyed reablement services in England. Data were collected on organisational characteristics, service delivery and practice, and service costs and caseload. WP2 was an observational study of three reablement services, each representing a different service model. Data were collected on health (EuroQol-5 Dimensions, five-level version) and social care related (Adult Social Care Outcomes Toolkit – self-completed) quality of life, practitioner (Barthel Index of Activities of Daily Living) and self-reported (Nottingham Extended Activities of Daily Living scale) functioning, individual and service characteristics, and resource use. They were collected on entry into reablement (n = 186), at discharge (n = 128) and, for those reaching the point on the study timeline, at 6 months post discharge (n = 64). Interviews with staff and service users explored experiences of delivering or receiving reablement and its perceived impacts. In WP3, staff in eight reablement services were interviewed to investigate their experiences of reabling people with dementia. Results A total of 201 services in 139 local authorities took part in the survey. Services varied in their organisational base, their relationship with other intermediate care services, their use of outsourced providers, their skill mix and the scope of their reablement input. These characteristics influenced aspects of service delivery and practice. The average cost per case was £1728. Lower than expected sample sizes meant that a comparison of service models in WP2 was not possible. The findings are preliminary. At discharge (T1), significant improvements in mean score on outcome measures, except self-reported functioning, were observed. Further improvements were observed at 6 months post discharge (T2), but these were significant for self-reported functioning only. There was some evidence that individual (e.g. engagement, mental health) and service (e.g. service structure) characteristics were associated with outcomes and resource use at T1. Staff’s views on factors affecting outcomes typically aligned with, or offered possible explanations for, these associations. However, it was not possible to establish the significance of these findings in terms of practice or commissioning decisions. Service users expressed satisfaction with reablement and identified two core impacts: regained independence and, during reablement, companionship. Staff participating in WP3 believed that people with dementia can benefit from reablement, but objectives may differ and expectations for regained independence may be inappropriate. Furthermore, staff believed that flexibility in practice (e.g. duration of home visits) should be incorporated into delivery models and adequate provision made for specialist training of staff. Conclusions The study contributes to our understanding of reablement, and what the impacts are on outcomes and costs. Staff believe that reablement can be appropriate for people with dementia. Findings will be of interest to commissioners and service managers. Future research should further investigate the factors that have an impact on outcomes, and reabling people with dementia. Funding The National Institute for Health Research Health Services and Delivery Research programme.

Sociability refers to the extent to which animals seek social companionship. Individual differences in social behaviour exist between animals. It is important to measure individual social motivation in order to develop suitable temperament scores that can be used in future breeding programmes or as part of welfare assessment schemes. Runway tests have been shown as reliable methods of measuring sociability in animals (Birds Mills & Faure, 1991; Sheep Sibbald et al., 2005). The aim was to develop a suitable test that could be used to measure sociability of cows in a commercial situation. The following questions were addressed i) How repeatable is the runway test when carried out on dairy cattle, ii) Does a cow’s performance in a runway test correlate with social behaviour within a group house setting?

While the production of real-life sex robots is currently only at prototype stage, sexualized female artificial intelligences have long been a trope in popular media. By critically analysing a selection of science fiction films and television programmes, we explore the narrative of fictional representations of eroticized female robots and the ways in which their reception feeds real-life expectation. While these media representations are, at times, surprisingly nuanced, they persist in giving their female AIs stable gender identities, even when the AIs are disembodied. Fictional and factual fembots each reflect the same regressive male fantasies: sexual outlets and the promise of emotional validation and companionship. Underpinning this are masculine anxieties regarding powerful women, as well as the fear of technology exceeding our capacities and escaping our control.

The fifth chapter examines how “Deobandi” tradition is mediated through scholarly and pedagogical networks in theory and practice. The first part of the chapter focuses on Qari Muhammad Tayyib, rector of the Dar al-`Ulum Deoband for half a century and the foremost theorist of Deobandi identity, arguing that mid-twentieth century Deobandis like Tayyib developed the concept of the maslak (“path” or “way”) as a means of lending ideological and affective coherence to a rapidly expanding global network. Tayyib theorized the maslak as a “middle path” between ideological extremes—as, for instance, between those who indulge in “excessive” Sufi devotions and those who dispense with Sufism altogether—and as an embodied discourse one learns to inhabit through the companionship of those who already do. The second part of the chapter, shifting from theory to practice, traces the rise of the Tablighi Jama`at, a Deobandi revivalist movement that sought to make individual Muslims mobile “embodiments” of the seminary and the Sufi lodge, effectively translating Thanvi’s project of public reform into an actual program, one explicitly based on internalizing the teachings of Ashraf `Ali Thanvi’s Urdu primers for lay Muslims, on shunning public debate of controversial legal issues, and on the replication of a set of reformed affects in others—hence the Tablighi Jama`at’s role, by mid-century, in propelling Deobandi tradition across the globe.