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Closing the rehabilitation utilization gap of New Zealand’s (Aotearoa) Māori people: Multiple case studies 缩小新西兰(Aotearoa) Māori人的康复利用差距:多个案例研究
Pub Date : 2021-12-21 DOI: 10.1017/jrc.2021.10
Ngonidzashe Mpofu, Sasha Anderson, Caroline Brown, Minna Yoo
We aimed to explore personal factors in use of rehabilitation counseling and mental health services by Māori adults. Participants were three Māori adults (females = 2, residing in major urban settings, age range 45–50 years old; male = 1, residing in a rural setting, age range = 25–30 years old). Thematic analysis yielded the following findings: (a) a preference of Māori service providers who understand whānau culture, (b) an understanding of whakapapa or the family structure as an integral source of social support as counselors are planning for treatment, (c) establishing and maintaining trusting relationships within the Māori community by non-Māori counselors, (d) having financial difficulties when attempting to access rehabilitation resources, (e) limited access to health care facilities and services or lack of information about the services available, and (f) a general mistrust of government operated systems. Rehabilitation and mental health services with Māori should address personal cultural and systemic exclusion factors for better service engagement.
我们旨在探讨Māori成人使用康复咨询和心理健康服务的个人因素。参与者为3名Māori成年人(女性= 2名,居住在主要城市环境中,年龄范围为45-50岁;男性= 1名,居住在农村,年龄范围= 25-30岁)。专题分析的结果如下:(a)优先选择了解whānau文化的Māori服务提供者,(b)了解whakapapa或家庭结构是咨询师规划治疗时社会支持的一个不可或缺的来源,(c) non-Māori咨询师在Māori社区内建立和维持信任关系,(d)在试图获得康复资源时遇到经济困难,(e)获得卫生保健设施和服务的机会有限,或缺乏有关现有服务的信息,以及(f)普遍不信任政府运作的系统。Māori的康复和心理健康服务应解决个人文化和系统排斥因素,以更好地参与服务。
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引用次数: 0
Preliminary evidence on combined cognitive behavioral therapy and motivational interviewing intervention efficacy to improve employment motivation for persons with intellectual disability 认知行为疗法与动机访谈联合干预改善智障人士就业动机的初步证据
Pub Date : 2021-12-21 DOI: 10.1017/jrc.2021.8
Abdoulaye Diallo, Lidia Fonseca, D. Holland
This study investigated the efficacy of a combined modified cognitive behavioral therapy (CBT) and motivational interviewing (MI) approach on motivating persons with intellectual disabilities (ID) in obtaining employment. The sample consisted of a total of 52 individuals with ID who were clients of an independent vocational-rehabilitation services provider (females = 42%; males = 58%), ranging in age from 19 to 47. They were randomly assigned to an intervention group (n = 26) and a control group (n = 26). The intervention group received a combined modified CBT and MI intervention and the control group a fact sheet on career-dysfunctional thoughts and lack of motivation to obtain employment. Outcome measures comprised a career-dysfunctional thoughts scale and employment seeking action scale. Results indicated that the intervention group reported higher motivation in obtaining employment than the control. Practitioners seeking to improve employment prospects for persons with ID should consider the use of a combined modified CBT and MI intervention for increasing the chances of employment seeking by people with ID.
本研究探讨了改良认知行为疗法(CBT)与动机性访谈(MI)相结合的方法对激励智障人士就业的效果。样本共包括52名独立职业康复服务提供者的ID个体(女性= 42%;男性占58%),年龄从19岁到47岁不等。他们被随机分为干预组(n = 26)和对照组(n = 26)。干预组接受改良CBT和MI联合干预,对照组接受职业功能失调思想和缺乏就业动机的情况说明书。结果测量包括职业失调思想量表和求职行动量表。结果表明,干预组的就业动机高于对照组。寻求改善ID患者就业前景的从业人员应考虑使用改良CBT和MI联合干预来增加ID患者找工作的机会。
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引用次数: 1
Correlates of vocational outcomes of youth with co-occurring mental illness and substance use disorders: Evidence from a vocational rehabilitation program 青少年职业结果与同时发生的精神疾病和物质使用障碍的相关性:来自职业康复计划的证据
Pub Date : 2021-12-13 DOI: 10.1017/jrc.2021.9
O. Akinola, Euchay Ngozi Horsman, L. Dunkley
Youth with co-occurring mental illness and substance use disorders are at higher risk for vocational rehabilitation exclusion. This study aimed to (a) explore the personal factors associated with vocational outcomes of youth with co-occurring mental illness and substance use disorders and (b) highlight services that have shown the greatest promise for this population in the state-federal rehabilitation program in the United States. Our analytic sample was extracted from the Rehabilitation Services Administration’s Case Service Report data set for 2013, 2014, and 2015 fiscal years. Multiple regression analyses results identified personal factors such as gender, race/ethnicity, level of education, and severity of disability as predictors of the achievement of competitive employment, hours worked, and income. The receipt of vocational rehabilitation services such as job search support, job placement assistance, vocational training, and on-the-job support are significantly associated with the achievement of competitive employment, higher work hours, and income. These finding have implications for vocational rehabilitation practice as they highlight who is at higher risk for poor outcomes, effective services, and additional factors to consider when working with youth with co-occurring mental illness and substance use disorders.
同时患有精神疾病和物质使用障碍的青年被职业康复排斥的风险更高。本研究旨在(a)探索与同时发生精神疾病和物质使用障碍的青少年职业结果相关的个人因素,(b)强调在美国州-联邦康复计划中对这一人群显示出最大希望的服务。我们的分析样本取自康复服务管理局2013、2014和2015财政年度的个案服务报告数据集。多元回归分析结果确定了个人因素,如性别、种族/民族、教育水平和残疾严重程度,作为竞争性就业、工作时间和收入成就的预测因素。接受职业康复服务,如求职支持、就业安置援助、职业培训和在职支持,与实现竞争性就业、提高工作时间和收入显著相关。这些发现对职业康复实践具有启示意义,因为它们强调了谁更容易出现不良结果,有效的服务,以及在与同时出现精神疾病和物质使用障碍的青少年一起工作时需要考虑的其他因素。
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引用次数: 0
Factors influencing workplace accommodations requests among employees with visual impairments 影响视障员工工作场所住宿要求的因素
Pub Date : 2021-12-07 DOI: 10.1017/jrc.2021.6
Shengli Dong, Madison Mullins, I. Ostrowicz
People with visual impairments experience various challenges in the workplace such as under-employment, structural, and attitudinal barriers. Workplace accommodations are instrumental in assisting individuals to complete essential functions of their jobs and to increase job tenure and satisfaction. However, workplace accommodations are under-utilized. The current study examined influences of psychosocial and demographic factors on decisions to request accommodations amongst people with visual impairments. Participants included 116 people with visual impairments (e.g., female = 63.9%, Caucasian = 81%) from agencies and organizations serving people with visual impairments within United States. The results following logistic regression show that increased levels of psychosocial factors (i.e., self-efficacy in requesting accommodations and goal setting, non-personal cost related to accommodation, knowledge related to Americans with Disabilities Act (ADA), and accommodation policies and procedures) predicted participants’ decision to request accommodations. In addition, participants aged 55 or more and those with a high school degree or lower were less likely to request accommodations. Rehabilitation interventions for enhancing work participation self-efficacy in employees with visual impairment, as well as knowledge on ADA and accommodation policies and procedures, would create a more inclusive and accepting work environment for employees with visual impairment.
视障人士在工作场所面临着各种各样的挑战,如就业不足、结构障碍和态度障碍。工作场所的住宿有助于帮助个人完成其工作的基本职能,并增加工作任期和满意度。然而,工作场所的住宿设施没有得到充分利用。目前的研究调查了社会心理和人口因素对视力障碍人士请求住宿的决定的影响。参与者包括来自美国境内为视障人士服务的机构和组织的116名视障人士(例如,女性= 63.9%,高加索人= 81%)。逻辑回归后的结果显示,社会心理因素(即请求住宿和目标设定的自我效能、与住宿相关的非个人成本、与美国残疾人法案(ADA)相关的知识以及住宿政策和程序)水平的提高预测了参与者请求住宿的决定。此外,55岁及以上的参与者和高中或更低学历的参与者不太可能要求住宿。提高视障员工工作参与自我效能感的康复干预措施,以及对《美国残疾人法》和住宿政策和程序的了解,将为视障员工创造一个更包容和接受的工作环境。
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引用次数: 0
Families of veterans with traumatic brain injury in Australia and the United States: implications for rehabilitation counselors 澳大利亚和美国创伤性脑损伤退伍军人家庭:对康复咨询师的启示
Pub Date : 2021-12-01 DOI: 10.1017/jrc.2021.5
C. E. Degeneffe
Starting with World War I, Australia and the United States have been allies in military operations. Since then, both countries have been challenged by meeting the needs of military personnel incurring traumatic brain injury (TBI), especially during recent operations in Iraq and Afghanistan. TBI impacts all members of the veteran’s family. This paper articulates the shared responsibility both countries assume in meeting the support needs faced by families of military veterans with TBI and how TBI in the military is different than in the civilian population. The paper describes how both countries differently address the needs of family caregivers of veterans with TBI and outlines areas for rehabilitation counselor collaborations in research and training.
从第一次世界大战开始,澳大利亚和美国就一直是军事行动的盟友。从那时起,两国都面临着如何满足遭受创伤性脑损伤(TBI)的军事人员的需求的挑战,特别是在最近的伊拉克和阿富汗行动中。创伤性脑损伤影响到退伍军人家庭的所有成员。本文阐述了两国在满足创伤性脑损伤退伍军人家属所面临的支持需求方面所承担的共同责任,以及军人创伤性脑损伤与平民的不同之处。本文描述了两国如何以不同的方式解决创伤性脑损伤退伍军人家庭照顾者的需求,并概述了康复咨询师在研究和培训方面的合作领域。
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引用次数: 1
Physical activity participation among older adults with diabetes: Applying the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) Guidelines 老年糖尿病患者参与体育活动:应用世界卫生组织的国际功能、残疾和健康分类(ICF)指南
Pub Date : 2021-11-18 DOI: 10.1017/jrc.2021.7
Chenchen Yang, E. Mpofu, Xiaoli Li, D. Dorstyn, Qiwei Li, K. Brock
Physical activity (PA) is a known benefit to older adults with diabetes; however, the determinants of PA are less well studied in this population. Applying the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), a well-established biopsychosocial framework, we explored PA participation among older adult with type 2 diabetes. Using data from the Health and Retirement Study and the RAND Center for the Study of Aging (N = 2,016; mean age = 73.19; SD = 6.16), we conducted hierarchical stepwise regression analysis to evaluate the relative contribution of different biopsychosocial predictors to PA – namely, body functions and structure, activity and participation, personal, and environmental factors. Altogether, biopsychosocial factors accounted for 20% of the variance in PA participation. Of the personal factors, high extraversion and low neuroticism explained approximately 54% of the variance in PA among the older adults – beyond sociodemographics. Low body mass index, reduced pain, reduced depression, and higher cognitive functioning also had good explanatory power (25% of explained variance), whereas activity participation and environment did not (10% each). Aligning care with components of the ICF will help to ensure a focus on person-centric practices and, in turn, optimize participation outcomes such as PA.
体力活动(PA)对老年糖尿病患者是一种已知的益处;然而,在这一人群中,PA的决定因素研究得较少。应用世界卫生组织的国际功能、残疾和健康分类(ICF),一个完善的生物心理社会框架,我们探讨了老年2型糖尿病患者的PA参与情况。使用来自健康与退休研究和兰德老龄化研究中心的数据(N = 2016;平均年龄73.19岁;SD = 6.16),我们进行了分层逐步回归分析,以评估不同的生物心理社会预测因素对PA的相对贡献-即身体功能和结构,活动和参与,个人和环境因素。总的来说,生物心理社会因素占了PA参与差异的20%。在个人因素中,高外向性和低神经质解释了老年人中大约54%的PA差异——超越了社会人口统计学。低体重指数、减轻疼痛、减轻抑郁和较高的认知功能也具有良好的解释力(解释方差的25%),而活动参与和环境则没有(各占10%)。使护理与ICF的组成部分保持一致,将有助于确保关注以人为本的实践,进而优化参与成果,如PA。
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引用次数: 1
Men with adult-onset epilepsy: Their experiences of health care provider relationship qualities following neurosurgery 男性成人癫痫:他们的经验,卫生保健提供者的关系质量后,神经手术
Pub Date : 2020-12-01 DOI: 10.1017/jrc.2020.19
M. Raffaele, Charity Tinofirei
Abstract The success of a lobectomy procedure for adult-onset epileptic seizure (AOES) would depend on the quality of the patient’s relationship with the health care provider. This ethnographic multiple case study explored patient and health professional relationship contexts following surgery for seizure activity reduction treatment. We interviewed five Australian men (aged 34–59) with a history of AOES and neurosurgery regarding the quality of their relationship with health care providers. Interpretive phenomenological analysis (IPA) of the data yielded three interrelated relationship themes of Timeliness (promptness of necessary care), Support (availability, understanding, and empathy), and Responsibility (adaptive communication, self-care, and decision-making ownership). Self-directed relationship resourcing enhanced subjective well-being in the patients.
成人癫痫发作(AOES)的肺叶切除手术的成功与否取决于患者与医疗保健提供者的关系。本人种学多例研究探讨了患者和卫生专业人员的关系背景手术后癫痫活动减少治疗。我们采访了5名澳大利亚男性(34-59岁),他们有AOES和神经外科病史,了解他们与卫生保健提供者的关系质量。数据的解释现象学分析(IPA)产生了三个相互关联的关系主题:及时性(必要护理的及时性),支持(可用性,理解和移情)和责任(适应性沟通,自我保健和决策所有权)。自我导向的关系资源增加了患者的主观幸福感。
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引用次数: 0
State-level differences in public vocational rehabilitation closures among transition-aged youth with traumatic brain injury 外伤性脑损伤过渡年龄青年公共职业康复关闭的国家级差异
Pub Date : 2020-11-23 DOI: 10.1017/jrc.2020.18
C. E. Degeneffe, M. Tucker, Z. J. Ahonle
Abstract This study aimed to understand state-level variation in participation in the State/Federal Vocational Rehabilitation (State VR) System in the United States among transition-aged youth (persons under the age of 22 years at application for State VR services) with traumatic brain injury (TBI) in Federal Fiscal Year 2016. A weighted least squares regression analysis was conducted to determine the relationship of state-level population size, unemployment rate, and per-capita income to the number of State VR closures in each state for transition-aged youth with TBI. Population size and per-capita income significantly predicted closures, while there was no relationship between closures and unemployment rate. Research is needed that further explores and explains state-level disparities in participation among transition-aged youth with TBI.
摘要本研究旨在了解2016年联邦财政年度美国创伤性脑损伤(TBI)过渡年龄青年(申请州VR服务时年龄在22岁以下的人)参与州/联邦职业康复(State VR)系统的州级差异。采用加权最小二乘回归分析来确定各州人口规模、失业率和人均收入与各州为TBI过渡年龄青年关闭的州VR数量之间的关系。人口规模和人均收入显著预测关闭,而关闭与失业率没有关系。需要进一步的研究来探索和解释州一级在过渡性脑损伤青年参与方面的差异。
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引用次数: 1
Personal factors classification revisited: A proposal in the light of the biopsychosocial model of the World Health Organization (WHO) 重新审视个人因素分类:参照世界卫生组织(世卫组织)生物心理社会模型的建议
Pub Date : 2020-11-19 DOI: 10.1017/jrc.2020.14
S. Grotkamp, W. Cibis, S. Brüggemann, M. Coenen, H. Gmünder, K. Keller, E. Nüchtern, Urban Schwegler, W. Seger, S. Staubli, Bia von Raison, R. Weißmann, A. Bahemann, H. Fuchs, M. Rink, M. Schian, K. Schmitt
Abstract In 2010, we proposed a personal factor classification which was published in this journal. Since then, the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization (WHO) and the biopsychosocial model were increasingly incorporated into the German Social Law Code for participation and rehabilitation, implying that personal factors are indispensable for individual assessments. For the present study, we aimed to come up with an updated version of the personal factors classification based on current research. To achieve this goal, we employed a qualitative approach to re-examine the basic structure, consistency, and selection of categories in the classification from our 2010 study, to amend and supplement the categories to reflect best practice personal factor classifications. Our findings indicate that the basic structure remained largely unchanged, with relatively minor changes, including the deletion of 5 categories from our 2010 classification, 10 categories revised in format or content, and 13 new categories. We believe our revised classification to be useful for supporting users in systematically, comprehensively, and transparently reporting influences on specific aspects of individuals’ life and living background on their functioning and participation, thus facilitating an equitable allocation of disability benefits.
2010年,我们提出了一种个人因素分类方法,并发表在该杂志上。此后,世界卫生组织(世卫组织)的国际功能、残疾和健康分类(ICF)和生物心理社会模式越来越多地纳入德国社会法典,用于参与和康复,这意味着个人因素对于个人评估是不可或缺的。在本研究中,我们的目标是在现有研究的基础上提出一个更新版本的个人因素分类。为了实现这一目标,我们采用定性方法重新审视2010年研究中分类的基本结构、一致性和类别选择,并对类别进行修正和补充,以反映最佳实践的个人因素分类。我们的研究结果表明,基本结构基本保持不变,只有相对较小的变化,包括从2010年的分类中删除了5个类别,修改了10个类别的格式或内容,以及13个新类别。我们认为,修订后的分类有助于支持用户系统、全面和透明地报告个人生活和生活背景对其功能和参与的具体方面的影响,从而促进公平分配残疾福利。
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引用次数: 10
Information and resources important to the quality of life of people living with multiple sclerosis 对多发性硬化症患者生活质量重要的信息和资源
Pub Date : 2020-11-09 DOI: 10.1017/jrc.2020.17
M. Bishop, Stuart P. Rumrill, Bradley McDaniels, Jian Li, R. Fraser, P. Rumrill, M. Bhattarai, Mirang Park
Abstract Multiple sclerosis (MS) is a chronic, typically progressive immune-mediated disease characterized by inflammation and demyelination in the central nervous system (CNS), and is associated with a wide range of neurological, physical, and psychosocial effects. For people living with MS, access to relevant, timely, and accessible health information and resources may contribute to effective illness management, psychosocial health, and quality of life (QOL). In this study, we sought to increase understanding of the specific types of information most wanted by people with MS, as well as the sources and effects of this information. Specifically, we surveyed 748 adults with MS about (a) the sources from which they obtain information about MS, (b) the type of information that is most important in terms of improving their QOL, and (c) specific topics about which they would like to have more information, services, or resources. Content analysis of the qualitative results demonstrated the diversity of information sources accessed by people with MS and the importance of providing information through different formats and media. The participants prioritized information related to new MS medications and treatments, physical and mental health and wellness, and local opportunities for support. Implications for practicing rehabilitation counselors are discussed.
多发性硬化症(MS)是一种慢性、典型的进行性免疫介导疾病,以中枢神经系统(CNS)炎症和脱髓鞘为特征,并与广泛的神经、身体和社会心理效应相关。对于多发性硬化症患者,获得相关的、及时的、可获取的健康信息和资源可能有助于有效的疾病管理、心理健康和生活质量(QOL)。在这项研究中,我们试图增加对MS患者最想要的特定类型信息的理解,以及这些信息的来源和影响。具体来说,我们调查了748名患有多发性硬化症的成年人(a)他们获得多发性硬化症信息的来源,(b)在改善他们的生活质量方面最重要的信息类型,以及(c)他们希望获得更多信息、服务或资源的具体主题。定性结果的内容分析显示了多发性硬化症患者获取信息来源的多样性,以及通过不同格式和媒介提供信息的重要性。参与者优先考虑与新的MS药物和治疗,身心健康和健康以及当地支持机会相关的信息。对实践康复辅导员的影响进行了讨论。
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引用次数: 2
期刊
The Australian Journal of Rehabilitation Counselling
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