ABSTRACT
The demand for healthcare services internationally continues to increase, exacerbated by patient backlogs resulting from the COVID-19 pandemic and the difficulties in recruiting and retaining healthcare staff. These difficulties have led to increased interest in workforce redesign, and the upskilling of existing staff in all areas of healthcare, including within the Allied Health Professions (AHP). Clinical support staff are a key component of workforce redesign, yet little has been documented on the utilization of this workforce across the wide range of professions that collectively form the AHP workforce. Existing research is also unclear due to the variety of titles used to describe them (eg, allied health assistants, therapy assistants, etc). This study aimed to review how Support Workers and Assistant Practitioners (SWAPs) are utilized within the AHP professions. Electronic databases (MEDLINE, CINAHL complete, Scopus, and Google Scholar) were searched to find English Language primary research articles that explored the deployment of clinical support staff within Allied Health. Following the scoping review methodology, data from each study were analyzed in terms of design, key findings, and implications. A quality assessment was also completed. Thirty-nine articles met the eligibility criteria. Studies were undertaken in Australia, UK, and USA, and covered a range of AHPs and methodological approaches. Most articles employed qualitative methods, with highly variable research quality identified. Key findings were that cost-effectiveness of this workforce has not been formally evaluated in any setting or AHP discipline, and that support workers are a largely underutilized staff group potentially due to inconsistencies in their deployment and scope of practice, and the lack of a clear career pathway. Rigorous, quantitative, and mixed methods research into the deployment and impact of this staff group is needed in order to gain a clearer understanding of how they are optimally utilized across the different AHP disciplines.
ABSTRACT
PURPOSE: The present study explored whether people with psoriasis display an attentional bias towards disease-related threat words and whether this bias occurs relatively early during the phase of stimulus disengagement, or during a later maintained attention phase dominated by controlled strategic processes. We also explored the degree to which attentional bias is dependent on the emotional valence of control words. METHODS: Individuals with psoriasis and matched controls took part in 4 online experiments. Participants completed a spatial cueing paradigm using disease-related threat words and control words as cues, in order to obtain reaction time estimates of attentional bias. RESULTS: We did not observe evidence for attentional bias when control words were matched with threat words for emotional valence, regardless of whether processing time for the cues was limited (Experiment 1: SOA = 250 ms) or extended (Experiment 2: SOA = 1050 ms). We also did not observe evidence for attentional bias when control words of positive valence were used, but processing time was limited (Experiment 3). An attentional bias was only observed (p = .012, Cohen's d = .37) when sufficient processing time was available and positively-valanced control words were used (Experiment 4). CONCLUSION: Rather than showing large and generalized AB effects as predicted by previous accounts, our results tentatively suggest that AB in psoriasis is restricted to situations where participants have ample processing time and threat words are easily distinguishable from control words on the basis of emotional valence. The pattern of results suggests that attentional bias in psoriasis is best characterized as a relatively slow strategic process.
ABSTRACT
Attention is known to modulate itch intensity. In contrast, the reverse relationship, i.e. the degree to which the presence of an acute itch affects attention, is currently not well understood. The aims of this study were to investigate whether acute itch induces an attentional bias towards or away from visual itch-related stimuli, and if so, whether it occurs in the early or later stages of processing. A volunteer sample of 60 healthy individuals were subjected to a skin prick (either histamine or placebo), followed by completion of a spatial cueing paradigm using itch-related and neutral words as cues, in order to obtain reaction time estimates of attentional bias. The results suggest that experience of acute itch induces attentional avoidance of visual itch threats. This attentional avoidance occurs at a later processing stage in the form of facilitated disengagement of attention from itch and/or delayed disengagement from neutral information.
