Health & Social Care in the Community最新文献

Spirituality helps family caregivers (FC) cope with the challenges of home care. FCs use spiritual resources such as hope, faith, or reflection to develop a mindful relationship with themselves, experience meaning, and accept the new life situation, which reduces negative emotions and strengthens their resilience. There is currently a lack of studies investigating how spirituality among FCs changes over time in the care situation. More knowledge about the dynamics of spirituality among FCs is needed to support them appropriately. This longitudinal qualitative study employs an interpretative phenomenological design to describe and understand the spirituality of FCs in the process of home care. In Germany, 24 FCs were interviewed between August 2022 and July 2023, and 11 were interviewed a second time between November 2023 and February 2024. Most FCs cared for cognitively impaired relatives, while the remaining FCs cared for family members with physical or psychosomatic impairments. The resulting data were first evaluated using content analysis, resulting in a category system that was analyzed using a phenomenological approach to get an overall story. The study adheres to COnsolidated criteria for REporting Qualitative research (COREQ). The analysis revealed that FCs use spirituality to experience meaning in care and harmonize it with their meaning in life. To achieve this, FCs experience a spiritual process with five stages: (1) preserving proven values, (2) spiritual trouble, (3) spiritual crisis, (4) reflection on one’s own life, and (5) spiritual development and acceptance. The findings show that the FCs have different spiritual needs and resources in the stages; while the FCs use proven spiritual strategies at the beginning of care, they develop a new form of spirituality over time. This development helps the FCs to cope with and accept their life situation. Healthcare professionals can use the stages as a guide to understand the spiritual needs of FCs and offer them relevant resources.

Self-empowerment (SE) is the process of developing the necessary problem management abilities through interacting with the society. However, there are barriers to SE which may reduce problem management abilities, particularly among individuals with chronic health problems. This study aimed at exploring the barriers to SE among individuals with retinitis pigmentosa (RP). This inductive qualitative study was conducted from February 2019 to September 2020. Participants were nine individuals with RP, one patient family member, and five RP institute staff. They were purposefully and theoretically selected from the RP Institute of Iran, Tehran, Iran. Data were collected through fifteen semistructured interviews with a mean length of seventy minutes and were analyzed through inductive content analysis. The barriers to SE among individuals with RP were grouped into two categories, namely, debilitating effects of RP and sociocultural poverty. The four subcategories of these categories were chronic course of RP, debilitating consequences of RP, inappropriate culture of the society, and limited socioeconomic facilities. These subcategories and categories were grouped into the main theme of combination of an erosive disease and an inappropriate context. There are physical, mental, environmental, and sociocultural barriers to SE among individuals with RP which can threaten their independence. Supportive groups and need-based care plans are essential to reduce these barriers and improve SE among these individuals. Implementing such a program requires the multidisciplinary collaboration of healthcare providers’ team.

Previous evidence suggests an association between social determinants of health and cardiovascular disease. However, evidence for subclinical markers of cardiovascular disease, such as arterial stiffness, is limited. Therefore, the aim of this study was to evaluate the association between social determinants of health (gender, marital status, educational level, and occupation) and arterial stiffness in healthy adults. A cross-sectional study was conducted from the EVasCu study, including 390 healthy participants (42.02 ± 13.15 years). Adjusted and unadjusted differences in arterial stiffness and social determinants of health (gender, marital status, educational level, and occupation) were performed via Student’s t-test and ANCOVA analysis. Our results suggest that males (unadjusted model, p = 0.037; Models 1 and 2, p < 0.001), divorced or widowed (unadjusted, Models 1 and 2, p < 0.001), with primary education (unadjusted model, p = 0.009; Models 1 and 2, p < 0.001), and being unemployed or homemakers (unadjusted, Models 1 and 2, p < 0.001) were associated with higher levels of arterial stiffness. Our findings suggest that males, divorced or widowed individuals, those with a primary educational level, and homemakers or unemployed individuals had higher levels of arterial stiffness. Considering that social determinants of health have been widely associated with the risk of cardiovascular events, adequate control of arterial stiffness could be a clinical strategy to prevent cardiovascular morbidity and mortality. However, due to the cross-sectional design of the study, the results should be interpreted with caution, and longitudinal studies are necessary to establish a causal relationship.

Effective social skills are essential for functional social support, help-seeking, and resource access. Digital social skills training (DSST) plays a key role in empowering individuals to develop social competence, improve access to various support and resources, and enhance locus of control through dynamic media. This scoping review aims to identify and explore existing DSST programs and their mechanisms for access to support and resources, as well as health outcomes among people with and without health conditions. A search across four databases (PubMed, PsycINFO, CINAHL, and Embase) from 2000 to 2023 resulted in the inclusion of 59 papers. Thematic analysis categorized DSST technologies into three levels: (1) passive learning with a low level of interaction, (2) collaborative learning (mutual interactions between individuals for learning and leveraging technological platforms to facilitate the process), and (3) experiential learning (e.g., virtual reality (VR)). DSST programs were beneficial in various health aspects, including physical, mental, and social health, with notable outcomes in social literacy and functional social skills. DSST enhanced cooperative behaviors and well-being and mitigated social stigma, loneliness, stress, and anxiety. Tailoring DSST to specific groups proved beneficial, with collaborative and experiential programs, such as VR, being effective, especially among youth populations because of the high level of interactions. DSST’s capacity to be individualized can significantly improve social perceptions, cognition, and practical social skills, optimizing access to resources.

Safe and ethnic-specific strategies for addressing family violence (FV) remain an underdeveloped area in FV studies about ethnic communities in Aotearoa–New Zealand (ANZ). The limited existing research shows a tension between two perspectives. The first is the culturalization approaches, which tend to overemphasise cultural worldviews as the root of the problem, often concentrating efforts on correcting what they perceive as ‘oppressive’ aspects of victim-survivors’ cultures. The second is an emerging body of scholarship on mobilising rather than erasing culture within strategies for addressing FV. Resolving this tension is beyond the scope of this paper. However, it provides evidence that several challenges intricately linked to their experiences of being ‘migrants’ exist within and outside these communities, affecting how they respond to FV. These issues must be addressed before cultural mobilisation, and ‘culturalization’ approaches can be safely used. The data used were drawn from a narrative inquiry-based study with 10 ethnic women victim-survivors and 10 supporting nonmedical practitioners examining their engagement with the Victims of Family Violence (VFV) Visa policy in ANZ. The issues identified include the small and dispersed size of the communities, which impacts support networks and conditions created by immigration visa status, a critical factor linked to reporting, help-seeking, and support offered to victim-survivors by the community members.