Nursing, Midwifery & Health Systems Research Collection
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- PublicationExpanding health technology assessment towards broader value: Ireland as a case study(Cambridge University Press, 2023-05-02)Healthcare innovations often represent important improvements in population welfare, but at what cost, and to whom? Health technology assessment (HTA) is a multidisciplinary process to inform resource allocation. HTA is conventionally anchored on health maximization as the only relevant output of health services. If we accept the proposition that health technologies can generate value outside the healthcare system, resource allocation decisions could be suboptimal from a societal perspective. Incorporating broader value in HTA as derived from social values and patient experience could provide a richer evaluative space for informing resource allocation decisions. This article considers how HTA is practiced and what its current context implies for adopting broader value to evaluating health technologies. Methodological challenges are highlighted, as is a future research agenda. Ireland serves as an example of a healthcare system that both has an explicit role for HTA and is evolving under a current program of reform to offer universal, single-tier access to public services. There are various ways in which HTA processes could move beyond health, including considering the processes of care delivery and/or expanding the evaluative space to some broader concept of well-being. Methods to facilitate the latter exist, but their adaptation to HTA is still emerging. We recommend a multi-stakeholder working group to develop and advance an international agenda for HTA that captures welfare/benefit beyond health.
23Scopus© Citations 1 - PublicationA Scoping Review to Map the Evidence on Family Carers Who Combine Work with Care(Ubiquity Press, 2022-11-04)Introduction: Family carers provide a wide range and significant amount of assistance to relatives, friends and neighbours who are ill or disabled. Statistical data from the Organisation for Economic Co-operation and Development (OECD) indicates that at least 1 in 10 adults is involved in informal, and most often unpaid care. About half of the proportion of those who participate in a caring role combine this with paid employment and balancing both roles can be a challenge. Consequently, there is increased demand for the introduction of measures to reconcile paid work and care-provision. Unfortunately, much remains unknown about the lives of family carers who balance work with care. Aim: The present work endeavours to illuminate this topic by scoping the extent, range and nature of available evidence on ‘family carers who are in paid employment’. Methods: Steps followed when carrying out the scoping review included: i) Clarifying the research purpose and question; ii) Identifying relevant research studies from various electronic databases, reference lists of identified studies, and grey or unpublished literature; iii) Selection of studies by two independent reviewers; iv) Collating data using an excel data sheet; and v) Analysing and summarising data using qualitative thematic analysis. Results: Two-hundred-and-sixty-three publications were incorporated, and these comprised a variety of research study designs, which were based in different countries. Six themes were emergent from the scoping review findings. The first was the compound carer’s experience who is a working family carer; subthemes relevant to this group were coping, health outcomes and employment outcomes. A subsequent theme was health outcomes for working family carers; health outcomes were subdivided into mental health, physical health, and health behaviour outcomes. The theme on the profile of characteristics for working family carers comprised of subthemes indicative that caring was largely a gendered activity, with age as another important variant — caring increasing at older ages. The economic impact of caring on working family carers was an eminent theme with a clear personal economic impact and national economic impact. A significant finding was the theme on conflicting priorities among working family carers; subthemes related to this were either work-to-family conflict or family-to-work conflict. The most important theme in the present work was that on employment outcomes among working family carers with subthemes characterised by employment participation, employment-related disadvantages, work-place provisions in place for this group and positive employment impacts. Finally, it was clear that there were support services for working family carers and thus this was an apparent theme; subthemes related to this were the formal services and social support services. Conclusions: Evidence on working family cares is vast and covers a wide range of topics such as compound caring, health, demographic profile, conflicting priorities, finances, employment, and support services. Working family carers face the difficult task of balancing work with care which could lead to negative outcomes related to employment, finances, and health. Implications for applicability: The pressures associated with the dual responsibility can be alleviated via the introduction of support services and policies to support working carers.
26 - PublicationThe role of line managers and co-workers in mediating informal flexibility for working family carers(2023-08-25)Purpose: Our paper identifies the enabling mechanisms through which carer-friendly informal flexibility is enacted in the workplace and explores whether these enabling mechanisms help working carers remain in the workforce and avoid taking leave from employment. Methodology: Twenty-six working carers in Ireland were interviewed. Interviews were semi-structured, and questions were formulated around three broad themes: participants’ caregiving role; their employment situation; and the services and supports available to them. Findings: The findings highlight three mechanisms through which carer-friendly informal flexibility is enacted: reassurance and pre-emptive support; carer advocacy; and idiosyncratic deal making (i-deals). In the absence of informal flexibility, disruption to working arrangements is likely in the form of intermittent periods of leave from the workplace. Research limitations/implications: Greater diversity in the profile of our study participants could be helpful, particularly the inclusion of more male carers and those working in the private sector. Practical implications: A greater emphasis on informal, locally negotiated, flexible working arrangements would facilitate carers to remain in employment. Originality/value: Our research explores the enabling mechanisms through which carer-friendly informal flexibility is enacted. Our study uncovered the pivotal mediating role played by line managers and co-workers in supporting carers to secure access to these informal flexible working arrangements.
49 - PublicationAn exploration of young carers' experiences in secondary school and their perceptions regarding their future career: a scoping review(International Journal of Care and Caring, 2023-03-22)Compared with their peers, young carers are at a higher risk of being not in education, employment or training. Using Arksey and O’Malley’s framework, this review aims to map out the literature on young carers’ experiences of caring while attending school and their future career perceptions. The key themes that emerged from the literature include: the impact of the caring role on education and future aspirations; school awareness and multiagency support; and the positives gained from caring. Greater support in secondary school, along with multiagency collaboration, are highlighted as key influences on the likelihood of young carers maximising their career opportunities.
67Scopus© Citations 1 - PublicationEvaluation of a formative peer assessment in research methods teaching using an online platform: A mixed methods pre-post study(Elsevier, 2022-01)Background: In higher education settings, there are increasing calls to shift away from traditional summative assessment practices, such end of term written tests, to explore methods of assessing learning in alternative ways. Peer assessment has been advocated as a means of formative assessment to enhance student engagement, empowering students to take responsibility for their own learning. While there is accumulating evidence for the value of peer assessment in higher education, one cannot assume peer feedback will translate appropriately to all settings and educational contexts. Objectives: This study evaluated the implementation of formative online peer assessment in a nursing and midwifery research methods module. We explored students' expectations, experiences, and ultimately the acceptability of this approach. Design: A quantitative descriptive study. Setting: Ireland. Methods: An online survey to collate expectations and experiences of engagement in peer assessment. Scales were drawn from previous research and non-parametric tests explored changes in perceptions over time. Qualitative content analysis explored patterns evident in open-text responses. Results: The response rate was 28% (n = 74) at baseline and 31% at follow-up (n = 81). Peer assessment was a new experience for 95% of respondents. Students initially expressed apprehension, perceiving the task as daunting, and doubting their ability to provide feedback to peers. However, through providing instruction and tools to support students in the activity, high levels of satisfaction with the process and the experience were reported. Significant differences in perceptions of peer assessment were evident over time, including an enhanced belief that respondents had the requisite skills to appraise the work of their peers. Conclusions: In sum, nursing and midwifery students agreed that peer assessment was a valuable learning experience as part of research methods training and critical skills development.
71Scopus© Citations 13