Health & Social Care in the Community最新文献

In an evolving global labor market, the expansion of informal employment presents profound implications for workers’ health and social welfare, especially among women. Using data from the China Family Panel Studies (CFPS) in 2016, 2018, and 2020, this study employs logistic regression models to investigate gender disparities in health status among informal workers. The findings reveal that women in informal employment have significantly lower health levels than men, and these health disparities vary across different ages and educational levels. The study results indicate that within informal employment, women’s health levels are significantly lower than those of men. This disparity is not only related to economic income and educational levels but also closely associated with social support. In the informal employment sector, although women are more active in informal social support networks such as family, friends, and community, they are influenced by a variety of factors and significantly lag behind men in obtaining formal social support, such as government subsidies and social security. Policymakers should pay more attention to the informal employment sector and consider implementing targeted health interventions and policies to enhance the health levels and social welfare of women in informal employment.

Background: With the rapidly aging global population, family caregivers face increased burdens when caring for disabled older adults; however, comprehensive understanding of the determinants remains limited.

Objective: To systematically analyze the factors affecting caregiver burden among family caregivers of disabled older adults within the stress process model framework.

Methods: In accordance with PRISMA guidelines, six electronic databases were searched up to September 2024. The methodological quality was assessed via the JBI critical appraisal tool. Twenty-eight studies meeting the inclusion criteria were analyzed.

Results: Analysis of 28 studies revealed that caregiver burden results from a complex stress process involving distinct patterns of stressors and moderators. Primary stressors included care recipients’ functional limitations in activities of daily living (ADLs), behavioral problems, and cognitive impairments, with functional dependency and behavioral problems showing consistent positive correlations with burden. The secondary stressors included caregivers’ psychological factors (depression and anxiety) and socioeconomic circumstances, with caregiving time, depressive symptoms, and financial difficulties demonstrating strong positive associations with burden. Conversely, caregiver health status and cohabitation were negatively correlated with burden. Moderating factors—particularly social support, service utilization, and psychological resources such as resilience and coping strategies—consistently demonstrated significant protective effects against caregiver burden.

Conclusion: The stress process model effectively frames the multifaceted nature of caregiver burden, highlighting the interaction between primary and secondary stressors. Future interventions should adopt a dual-focus approach, addressing both primary care-related stressors and secondary psychosocial factors while strengthening moderating resources to enhance caregivers’ quality of life.

Despite the health and social problems resulting from a severe mental illness, there are cases of people diagnosed who manage to live a satisfactory life. This study focuses precisely on people who undergo positive and consolidated recovery processes over time. The objective is to understand the mechanisms that enable this achievement. To do so, a sample of 16 subjects aged between 33 and 63 years, who met this condition, was set up. Sample recruitment was carried out via the intermediation of professionals at mental health social care services in Catalonia (Spain). A qualitative research approach was employed, based on in-depth interviewing. The results highlight the importance of identity reconstruction in the recovery process. Three relevant factors that emerged during the course of the interviews associated with this reconstruction are identified and described as follows: a) the participants’ ability to provide a biographical meaning to the experience arising from the disorder; b) the presence of a discursive ability, manifested through the use of metaphors, that provides them with greater control over their identity narrative; and c) the establishment of group and collective identification relationships that allow them to overcome the negative self-perception associated with stigma. The findings reveal that identity reconstruction processes do not involve a return to “normality” prior to the onset of the disorder. Likewise, recovery itineraries develop through social dimensions and spaces that go beyond the context of healthcare. The appropriateness of continuing to conduct holistic and comprehensive research that allows delving into the richness and complexity of positive recovery experiences in the first person is brought to the fore.

Community organizations supporting people with disabilities (PWD) initiated or increased their online services to maintain their support during the COVID-19 pandemic. The objective of this study is to report on the collaborative development of solutions to improve access to online community services for PWD. This study followed a multiple-case design to report on the co-creation process engaged by four community organizations. A four-step methodology for co-creation was applied and documented by field notes. Cases were analyzed separately, and then, cross-case analyses were performed. Eighteen members and employees of community organizations participated in co-creation workshops (3 per organization). Co-created solutions to accessibility of online services were developed in each case, and three out of the four organizations chose to implement them. The co-created solutions are expected to improve access to online services and satisfaction among PWD. A similar approach of co-creation could benefit the development of other online community services for PWD.

This study utilized data from the 2011–2018 China Health and Retirement Longitudinal Study (CHARLS) to explore the effects of various types and frequencies of social activities on the health outcomes of middle-aged and elderly adults. A total of 5800 participants aged 45–80 years at baseline were included in the analysis. The results indicated that participating in activities such as playing mahjong, chess, and cards was notably linked to enhanced physical health for both genders. However, this correlation was only statistically significant for psychological and cognitive health among men. Conversely, regular involvement in dancing, practicing qigong, and performing other exercises in the park was significantly associated with improved physical and psychological health exclusively among women. No significant disparities were observed in the effects of socializing with friends on the health of both genders. These findings underscore the significance of acknowledging gender differences and the specific characteristics of social activities when devising interventions aimed at fostering healthy aging.

Background: Poor mental health among children and young people (CYP) is a global issue, with one in seven affected. In the United Kingdom (UK) and abroad, social prescribing is emerging as a community-based, non-clinical method to address health inequalities. Link workers (LWs) play a pivotal role in this approach, and more research about the factors influencing their recruitment, retention, and job satisfaction is required.

Aim: This study explores the experiences of LWs working with CYP, focusing on service delivery, job satisfaction, career development, and retention, addressing a critical gap in research on LW roles and their influence on CYP care.

Method: This qualitative study employed semistructured, one-to-one interviews with 17 LWs and managers. These interviews were conducted between April 2023 and February 2024. Data were analysed using Braun and Clarke’s thematic analysis framework, identifying key themes related to LW experiences and job satisfaction.

Findings: The findings highlight how a transformational leadership approach contributed to LW job satisfaction and retention, characterised by supportive leadership that promoted flexibility and autonomy, and continuous professional development (CPD) that enabled career progression.

Conclusion: Findings from this study established a unique conceptual model of LW job satisfaction and retention, which illustrates how transformational leadership fosters a creative, collaborative environment that supports flexibility, continuous development, and meaningful impact for LWs. This approach creates the conditions for sustainable services by promoting job satisfaction and retention, ensuring that LWs can consistently provide person-centred care to CYP and their families.

Palliative care is undergoing shifts to identify and respond to social and structural inequities. Caregiving in a palliative context is steeped in assumptions that those who provide care are biologically or legally (biolegal) related, well-resourced, and able to balance the many demands of work and life with caregiving. As families in the Western world change, people are increasingly looking outside their biolegal families for care. This is common among people experiencing homelessness, but little is known about how this translates at the end of life. To address this knowledge gap, we undertook an ethnographic study informed by critical perspectives, integrating social justice and health equity approaches. Over a period of 27 months, approximately 300 h of observation and 44 interviews were conducted with service providers, clients, and caregivers in three Canadian cities. We found that caregiving in contexts of inequity challenges dominant understandings of palliative caregiving. Rather than a biolegal family, people with life-limiting conditions were found to be accessing care from a constellation of formal and informal caregivers (e.g., friends, neighbors, and spouses). For this analysis, we focus on exploring the experiences of unrelated, informal caregivers, with thematic findings illustrating three main aspects: (1) Relationships and roles in informal caregiving, (2) identifying and perceiving informal caregivers, and (3) biolegal privileging and exclusion of unrelated caregivers. For palliative care to improve the quality of life of people who face inequities and their caregivers, there is a need to better identify, engage, and support all of those who participate in care at the end of life regardless of whether they are biologically or legally related.

Interprofessional collaboration among health professionals is widely recognised as best practice in the assessment and support of autistic children and their families. Nevertheless, limited empirical research has considered the extent to which health professionals actually collaborate in practice. This study aimed to explore how health professionals from diverse disciplines experience interprofessional collaboration when supporting autistic children and their families in Australia. An exploratory qualitative study was undertaken using semistructured interviews with 15 health professionals from various disciplines including occupational therapy, paediatric medicine, physiotherapy, psychology, social work and speech therapy, who work with autistic children in Australia. Interview data were analysed using inductive reflexive thematic analysis. Five distinct yet interrelated themes were developed from the data that summarised the health professionals’ experiences of interprofessional collaboration in supporting autistic children and their families. These were as follows: interprofessional collaboration is recognised as best practice, differences in attitudes and understandings create conflict, professional networks are a foundation for interprofessional collaboration, concerns about leadership roles and responsibilities and interprofessional collaboration is influenced by broader social systems. Findings have practical implications for individual health professionals and the policy makers and organisations who oversee the delivery of support services to autistic children and their families. Systems should be reorganised and interprofessional education programs expanded to better enable health professionals and those from other sectors to collaborate effectively when supporting autistic children and their families. These findings also highlight a need for further research of the conflict caused by different approaches to autism support.

Gay and bisexual men face disproportionately higher rates of adverse mental health conditions compared to their heterosexual counterparts. Grounded in the minority stress theory and set within the China’s stigmatized cultural context, this study probes deeply into the mediating roles of proximal minority stressors (including rejection sensitivity and internalized homophobia) and individual coping process (i.e., self-efficacy) in the relationship between enacted stigma and adverse mental health among Chinese gay and bisexual men. Furthermore, it examines the moderating roles of outness to the family on the interrelationships among enacted stigma, proximal minority stressors, and adverse mental health. A total of 728 participants, comprising 334 gay men and 394 bisexual men, completed measures of sociodemographics, enacted stigma, rejection sensitivity, internalized homophobia, self-efficacy, outness to the family, and adverse mental health. Results indicated that enacted stigma was positively associated with adverse mental health, with both rejection sensitivity and internalized homophobia acting as partial mediators. Furthermore, the sequential mediation role via proximal minority stressors and self-efficacy was statistically significant. Notably, the degree of outness to the family moderated not only the relationship between enacted stigma and internalized homophobia but also its indirect link on adverse mental health. These findings provide compelling cross-cultural evidence in support of the minority stress theory and spotlight pivotal intervention pathways aimed at addressing adverse mental health prevalent among Chinese gay and bisexual men.