The work experiences of staff in a MfOP service impacted directly on patient care experience. Poor ward and patient care climates often lead staff to seek job satisfaction through caring for 'poppets', leaving less favoured - and often more complex patients - to receive less personalised care. Implications for practice. Investment in staff well-being and ward climate is essential for the consistent delivery of high-quality care for older people in acute settings.

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ObjectivesTo first, validate in English hospitals the internal structure of the ‘Patient Evaluation of Emotional Care during Hospitalisation’ (PEECH) survey tool which was developed in Australia and, second, to examine how it may deepen the understanding of patient experience through comparison with results from the Picker Patient Experience Questionnaire (PPE-15).DesignA 48-item survey questionnaire comprising both PEECH and PPE-15 was fielded. We performed exploratory factor analysis and then confirmatory factor analysis using a number of established fit indices. The external validity of the PEECH factor scores was compared across four participating services and at the patient level, factor scores were correlated with the PPE-15.SettingFour hospital services (an Emergency Admissions Unit; a maternity service; a Medicine for the Elderly department and a Haemato-oncology service) that contrasted in terms of the reported patient experience performance.ParticipantsSelection of these acute service settings was based on achieving variation of the following factors: teaching hospital/district general hospital, urban/rural locality and high-performing/low-performing organisations (using results of annual national staff and patient surveys). A total of 423 surveys were completed by patients (26% response rate).ResultsA different internal structure to the PEECH instrument emerged in English hospitals. However, both the existing and new factor models were similar in terms of fit. The correlations between the new PEECH factors and the PPE-15 were all in the expected direction, but two of the new factors (personal interactions and feeling valued) were more strongly associated with the PPE-15 than the remaining two factors (feeling informed and treated as an individual).ConclusionsPEECH can help to build an understanding of complex interpersonal aspects of quality of care, alongside the more transactional and functional aspects typically captured by PPE-15. Further testing of the combined instrument should be undertaken in a wider range of healthcare settings.

This article draws from sociological and socio-legal studies of dispute between patients and doctors to examine how healthcare professionals made sense of patients’ complaints about healthcare. We analyse 41 discursive interviews with professional healthcare staff working in eight different English National Health Service settings to explore how they made sense of events of complaint and of patients’ (including families’) motives for complaining. We find that for our interviewees, events of patients’ complaining about care were perceived as a breach in fundamental relationships involving patients’ trust or patients’ recognition of their work efforts. We find that interviewees rationalised patients’ motives for complaining in ways that marginalised the content of their concerns. Complaints were most often discussed as coming from patients who were inexpert, distressed or advantage-seeking; accordingly, care professionals hearing their concerns about care positioned themselves as informed decision-makers, empathic listeners or service gate-keepers. We find differences in our interviewees’ rationalisation of patients’ complaining about care to be related to local service contingences rather than to fixed professional differences. We note that it was rare for interviewees to describe complaints raised by patients as grounds for improving the quality of care. Our findings indicate that recent health policy directives promoting a view of complaints as learning opportunities from critical patient/consumers must account for sociological factors that inform both how the agency of patients is envisaged and how professionalism exercised contemporary healthcare work.

Treatment interventions for female sexual abuse survivors was explored through a pilot study examining the relationship between group treatment and adolescent self-image. Self-image was defined as body image, self-reliance, self-control, and impulse-control. An experimental pre-post design was utilized. Participants were 13 female adolescent high school drop-outs with a history of sexual abuse who participated in the National Guard Youth Challenge Program at Camp Shelby in Mississippi. Participants completed the Offer Self- Image Questionnaire for Adolescents. The hypothesis that group therapy was an effective intervention for sexual abuse survivors was not supported; however, this is likely due to the small sample size. Because this was a pilot study, mean trends were observed to see directional changes that may assist future researchers. Observation of mean trends revealed that participants who received group therapy increased in levels of impulse control while the group that did not receive group therapy remained the same. Mean trends also revealed that the experimental group had a decrease in self-reliance whereas the control group maintained their levels of self-reliance.