ABSTRACT
BACKGROUND: We hypothesised that a key factor determining the quality of active support was 'practice leadership' - provided by the first-line manager to focus staff attention and develop staff skills in providing direct support to enable people with intellectual disabilities to have a good quality of life. This exploratory study focused on what levels of practice leadership were found and its role in explaining variation in active support. METHOD: Relevant aspects of management, including practice leadership, were assessed by questionnaires administered to staff in residential settings alongside observational measures of active support and resident engagement in meaningful activity. Relationships between these variables were explored using regression and post hoc group comparisons. RESULTS: There was wide variation, with average levels of practice leadership being low, though improving over the period studied. Practice leadership had a significant impact on active support, but was fully mediated by the effect of quality of management. When the quality of management was higher better practice leadership did produce a significant difference in active support. However, higher quality of management on its own did not produce better active support. CONCLUSIONS: A number of limitations are acknowledged and further research is required. Practice leadership appears to be an important factor in enabling staff to provide active support but as part of generally good management. Given the rather low levels found, attention needs to be given to the training, career development and support of practice leaders and also to how to protect their time from their many other responsibilities.
Subject(s)
Intellectual Disability/rehabilitation , Leadership , Patient Care Management/standards , Professional-Patient Relations , Social Support , Adult , Attitude of Health Personnel , Humans , Male , Pilot Projects , Quality of Life , Residential Facilities/standardsSubject(s)
Folic Acid/administration & dosage , Food, Fortified/standards , Neural Tube Defects/prevention & control , Pregnancy , Bread , Female , Folic Acid/metabolism , Humans , Neural Tube Defects/epidemiology , Neural Tube Defects/etiology , Nutrition Policy , Nutritional Physiological Phenomena , Nutritional Requirements , Pregnancy/metabolism , Public Health Practice , Risk Factors , United Kingdom/epidemiologySubject(s)
Delivery, Obstetric/methods , Hydrotherapy/standards , Midwifery/methods , Nurse Midwives/standards , Attitude of Health Personnel , Attitude to Health , Delivery, Obstetric/nursing , Delivery, Obstetric/psychology , Delivery, Obstetric/standards , Evidence-Based Medicine , Female , Humans , Hydrotherapy/nursing , Hydrotherapy/psychology , Midwifery/standards , Pregnancy , Pregnancy OutcomeSubject(s)
Labor, Obstetric/physiology , Labor, Obstetric/psychology , Mothers/education , Mothers/psychology , Oxytocin/physiology , Patient Education as Topic/methods , Affect , Attitude to Health , Brain Chemistry , Female , Humans , Nurse Midwives/organization & administration , Nurse's Role , Obstetric Labor Complications/physiopathology , Obstetric Labor Complications/prevention & control , Obstetric Labor Complications/psychology , Pregnancy , Stress, Psychological/physiopathology , Stress, Psychological/prevention & control , Stress, Psychological/psychologySubject(s)
Postnatal Care/methods , Postpartum Period/psychology , Rest , Social Support , Adaptation, Psychological , Female , Humans , Infant, Newborn , Length of Stay , Male , Maternal Health Services/standards , Parenting/psychology , Postnatal Care/psychology , Pregnancy , United Kingdom , United StatesABSTRACT
Nuchal screening has the following advantages: Non invasive. First trimester procedure. Results are obtained quickly. 80-90% detection rate for Down's Syndrome.