Health & Social Care in the Community最新文献

Background. Many individuals with serious mental illness live in supported accommodation. Decisions regarding type of supported accommodation required and level of support to meet individual’s needs are crucial for continuing rehabilitation and recovery following admission to hospital. This study aimed to identify personal and contextual predictive factors for (1) discharge from hospital to different levels of supported accommodation and (2) self-directed support needs of individuals with serious mental illness once they are in supported accommodation in Scotland. Method. Linked data from the Scottish Morbidity Record-Scottish Mental Health and Inpatient Day Case Section and the Scottish Government Social Care Survey were analysed using multinomial regression and multivariable logistic regression to identify personal and contextual factors associated with accommodation destination at the time of discharge and four self-directed support needs: personal care; domestic care; healthcare; and social, educational, and recreational. Results. Personal factors (age and having a diagnosis of schizophrenia, schizotypal, or delusional disorder) were associated with individuals moving to supported accommodation with higher levels of support. One contextual factor, compulsory detention when admitted to hospital, decreased the likelihood of moving to any type of supported accommodation. The personal and contextual factors associated with identified self-directed support needs varied by need. Support provided by the local authority was associated with all self-directed support needs, with having a diagnosis of schizophrenia, schizotypal, or delusional disorder associated with identifying domestic care, healthcare, and social, educational, and recreational needs, while living in the most deprived areas was associated with identifying healthcare needs. Advancing age and being compulsorily detained decreased the likelihood of identifying social, educational, and recreational needs. Conclusion. The study highlights that older men with a diagnosis of schizophrenia, schizotypal, or delusional disorder require higher levels of support upon discharge from hospital. When living in supported accommodation, having this diagnosis increases the likelihood of identifying support with looking after the home, looking after their health, and social and recreational activities; however, being older decreases the likelihood of identifying support with social and recreational activities.

Objective. This research aimed to validate the Informal Supporter Readiness Inventory (ISRI) for evaluating the preparedness of informal supporters, in an Australian sample, to provide assistance in the context of intimate partner violence (IPV). Method. The ISRI’s four distinct factors were each assessed with separate confirmatory factor analyses (CFA). Reliability was calculated using Cronbach’s alpha values, and test-retest reliability was evaluated using intraclass correlation coefficients. Additionally, the ISRI’s validity was assessed through Pearson’s correlations with both convergent and divergent measures. Results. The CFAs supported the four distinct factors of the ISRI: normative, individual, situational-emotion, and situational-assessment. The measure exhibited good-to-excellent internal consistency across these factors and good test-retest reliability at four weeks. Convergent validity was supported by a strong positive correlation with the Intent to Help Friends Scale, while its weak association with the Generic Job Satisfaction Scale supported divergent validity. Discussion. The ISRI has emerged as a practical instrument with relevance to certain Australian sociocultural dynamics, offering utility in both research and clinical settings. The ISRI supports a network-oriented approach to IPV survivor support, assisting the alliance between formal and informal support mechanisms. Future research should focus on broadening the ISRI’s applicability by assessing its effectiveness across diverse Australian populations.

Purpose. Maintaining physical activity (PA) has significant implications for health. According to the World Health Organization (WHO), adults aged 18–64 should engage in at least 150 to 300 minutes of moderate-intensity aerobic PA per week. However, urban-rural disparities and economic geography variations in PA levels have not received enough attention. This study aimed to examine these disparities in the likelihood of meeting PA recommendations by using data from the Study of Community Sports in China. Methods. This is a nationwide cross-sectional community-based study. A total of 5,000 participants were randomly selected using a multistage sampling strategy. They were asked to complete a survey including demographics data and PA levels. The data were analyzed using mixed-effects logistic regression to evaluate the association between urban-rural residency, economic geography regions, and the likelihood of meeting PA recommendations. Results. A total of 3,779 participants met the eligible criteria, and only 816 (21.6%) met the PA recommendation. The urban participants were more likely to meet the PA recommendation than their rural peers [OR (95% CI) of 1.72 (1.09, 2.71)]. The association remained significant among those aged ≥30 [OR = 2.53 (1.51, 4.24)] and those with the education of high school and below [OR = 1.88 (1.18, 1.77)], but not in their younger, and more-educated peers (P_interaction = 0.009 and 0.034, respectively). Compared with the east coastal residents, western ones had a greater chance of meeting the recommendation [OR = 2.68 (1.25, 5.74)]. The association was more prominent among the more-educated [OR = 3.89 (1.58, 9.57)] than the less-educated [1.90 (0.83, 4.35)](P_interaction <0.001), but not modified by age. Conclusion. Urban and western residents were more active than their rural and east coastal counterparts. Studies should carefully consider the interactions between age and education level with urbanization and region while evaluating PA levels. Moreover, policymakers should develop policies and programs according to urban-rural disparity and regional variations to shorten the gaps.

If properly used, condoms can serve as an effective family planning method and preventive tool towards sexually transmitted diseases (STDs). Despite its anticipated effectiveness, there are different myths and misconceptions which have been observed as hindrances to both its use and effectiveness. This review examines the myths and misconceptions of condom use among youths and explores challenges in condom usage in sub-Saharan Africa (SSA). A narrative review was employed of which different journal articles were reviewed. The search words/phrases were “condom use in SSA, condom use among youths in SSA, myths and misconceptions on condom use among youths in SSA.” A total of 1074 studies were identified, 93 were relevant to the topic, and only 71 suited the review. The identified myths and misconceptions of condom use include that males were the ones to decide on the use of condoms during sexual intercourse, economic power determines the use of condoms, condom use reduces sexual pleasure, condom use relates to the spread of HIV/AIDS, and condom use is against God’s will. Other identified myths and misconceptions of condom use include that the use of condoms is a sign of lack of trust associated with fornication and adultery, also the use of condoms is only for family planning purposes. The challenges identified were breakage of condom during sexual intercourse, condom slippage, condom leakage, incorrect storage, and reuse of condoms. The identified myths and misconceptions lead to low knowledge of condom use within communities. There is a need for collaboration between governments, researchers, and NGOs to provide education on condom use to communities, particularly youths.

The increased funding provided for Community Health Worker (CHW) hiring and training as part of the COVID-19 pandemic response was to increase their impact in alleviating the effects of negative social determinants of health in the lives of the most vulnerable individuals and communities. This enhanced use of CHW in vulnerable populations can also be used to improve access to such populations for applied research to study ways to improve health outcomes for low-income minority populations. We carried out a feasibility study using the State CHW association as partners to reach CHWs working with low-income minority population. Three hundred and three (303) clients of CHWs were interviewed on various demographic, health access, and employment information and both univariate and multivariate analyses was used to determine factors associated with being unvaccinated against COVID-19 and chi-squared used to determine if employment was associated with having health insurance. About half of the clients self-identified as Black/African American and half as Hispanic. Two-thirds were women and 52.1% were unemployed and 55.1% had no health insurance. There was no association between employment status and having health insurance. Majority (71.6%) had received one dose of a type of COVID-19 vaccine and being younger and being African American were associated with not getting a dose of COVID-19 vaccine, as well as being unemployed and not having health insurance. Most of the clients came to see the CHW about a Health/Healthcare issue of the five social determinants of health (SDOH). There were 38 different job titles provided by the clients and the job titles were mainly blue collar jobs and jobs in health and personal care. Our results indicate that CHWs reach the most vulnerable population who have limited health access and high unemployment and that CHWs can effectively be used for linkage to low-income minority population for applied research. Our analyses found that in this low-income population, being younger, being African American, being unemployed, and not having health insurance are each associated with not getting vaccinated against COVID-19, and employment is not associated with having health insurance. We have shown that partnership with CHWs to access their clients as research subjects leads to elucidating new information on the population that can be used in addressing public health programming.

Dental hygienist is the main provider of preventive oral care to promote and improve the oral health of individuals, families, and groups in society. However, the participation of dental hygienists in community outreach and public health programmes in Lithuania is limited, mainly due to the lack of institutional support and the unavailability of positions in public health initiatives, and the country’s population has insufficient access to cost-effective oral health promotion services. This exploratory study aimed to analyse dental hygienists’ perception of their profession–to evaluate the scope of practice and professional challenges faced by dental hygienists in Lithuania, focusing on their provision of preventive dental care and educational roles. This study is one part of a prospective study which was conducted in 2021. By using the qualitative approach, with a semistructured interview, the dental hygienists’ experience, towards understanding their duties and concept of profession, was collected. Interviews were conducted with seven dental hygienists. A thematic analysis of data from the interview was performed. Three themes were extracted from the contents: (1) concept of dental hygienist’s profession, (2) personal qualities, and (3) practical activities carried out by dental hygienists. The study results showed dental hygienists in Lithuania have a broad role focusing on patient care, educational activities, and preventive methods in line with European standards. Key attributes such as communication skills, diligence, and empathy are essential for effective practice, ensuring quality patient care and professional standards. Despite fulfilling nationally defined roles, dental hygienists seek expanded competencies and greater involvement in clinical and preventive care.

Background. Mobile health (mHealth) interventions hold promise in assisting older adults to meet physical activity (PA) guidelines. Yet, little is known about how older adults perceive using smartphones to enhance their PA. This study explored older adults’ experiences with the “My Health Plan” mHealth intervention and examined which person-level factors were associated with adherence. Methods. Forty older adults (52.5% female, mean age: 72.6 years) were instructed to use the My Health Plan application, which provided up to six stretch- and strengthening exercises per day and to wear a Fitbit Charge activity monitor for seven consecutive days. Person-level factors (e.g., gender and age) and psychosocial factors (e.g., intention and motivation) were assessed using a questionnaire. Afterwards, semistructured interviews were conducted to gather participants’ experiences with the application and Fitbit. Deductive thematic analysis (qualitative data) and regression analyses (quantitative data) were conducted. Results. Key themes emerging from the interviews were (1) smartphone notifications (including timing and number) and carrying the smartphone throughout the day, (2) suggested stretch- and strengthening exercises, (3) providing feedback, (4) experiences with Fitbit, and (5) overall suggestions for improving the application and mHealth interventions. Overall, participants reported positive experiences with the application and Fitbit. Being male, having higher baseline PA, lower anxiety, and greater ability to participate in social roles and activities were related to increased engagement with the proposed exercises. Conclusions. This study provides valuable insights to optimize future mHealth interventions tailored to older adults’ specific needs, aligning with their perceptions of the digital transformation in health promotion.

Retail workers contribute to the daily wellbeing of customers, including those living with disabilities or diseases. The relational job design theory suggests that one’s perceived social impact (PSI) of their job contributes to improvements in job satisfaction, turnover intention, and persistence. Confirming such an association could encourage organization managers to commit more to community care for the purpose of improving the work outcomes of their employees. However, how convenience store workers perceive the social contributions of their work and the perception’s impact on their work outcomes remains unclear. Thus, the first objective of this study was to examine the association between retail workers’ PSI and work outcomes (job satisfaction, turnover intention, and hours worked). The second objective was to evaluate the effect of an intervention aimed at increasing the PSI on work outcomes. This study was part of a project to evaluate a dementia-friendly program for convenience store workers. All participants completed a baseline survey after randomization. The intervention group was then required to complete a multicomponent e-learning intervention program within one month. One month later, both groups completed a postintervention survey. The e-learning program included lectures on dementia, virtual contact with people living with dementia, and information on the positive impact of retail store jobs on customers living with dementia. A total of 161 and 145 participants were analyzed in the baseline study and the postintervention survey, respectively. Cross-sectional analysis of baseline data showed that the workers’ PSI was significantly correlated with job satisfaction (β = 0.203, p < 0.001) and turnover intentions (β = −0.305, p = 0.006). However, the e-learning intervention did not change PSI and work outcomes. Interventions that highlight workers’ prosocial contributions more effectively and are successful in changing their PSI may improve their engagement and work outcomes. For retail workers, intervention based on a relational job design framework may be effective; however, designing such interventions remains challenging. This trial is registered with UMIN000043623.

Conflict-related sexual violence (CRSV) can severely impair survivors’ mental health and prompt their need for mental health care. Male survivors face gender-related barriers to disclosing experiences of sexual violence, yet the understanding of factors impeding or promoting disclosure is limited. This knowledge gap is even more pronounced regarding male disclosure in refugee settings. The high prevalence of CRSV experiences in male refugees in European host countries points to the urgency of understanding male disclosure processes along with its barriers and facilitators, in order to provide for adequate mental health care. 10 clinical experts working with male survivors of CRSV in Germany were interviewed adopting an explorative phenomenological approach and using the Problem-Centered Interview. Qualitative content analysis yielded five themes describing male disclosure of CRSV: 1. Experiences of CRSV commonly remain nonverbalized, 2. Disclosure of CRSV is a dialogical and iterative process, 3. The process of (non-)disclosure is a negotiation of agency, 4. Disclosure of CRSV affects the survivor’s psychoemotional state, and 5. Disclosure and recovery are interdependent processes. Additionally, seven categories describing barriers to and facilitators of male disclosure were extracted: 1. trauma characteristics, 2. survivor variables, 3. clinician variables, 4. interpreter variables, 5. interpersonal variables, 6. contextual variables, and 7. sociocultural variables. Clinical experts emphasize the effectivity of a gender-specific communicative taboo for male refugee survivors that intersect with socio-cultural norms. Variables characterizing survivors who are at risk of not disclosing CRSV are identified. A discussion of clinical approaches to address the taboo surrounding CRSV and to support male refugee survivors in agentic disclosure and recovery is provided.

Aims. To understand what domains of acculturation are experienced by Chinese immigrants with cardiovascular disease (CVD) in Australia and how these domains of acculturation influence their CVD self-care behaviours. Design. A qualitative descriptive design. Methods. Individual phone interviews were conducted among Chinese immigrants with CVD in Sydney, recruited from Chinese Community associations and social media. Inductive and deductive thematic analysis was employed, guided by the Middle-Range Theory of Self-Care of Chronic Illness and the conceptual model of acculturation. Results. Twenty participants, mean age 69.9 years, were interviewed. The domains of acculturation in relation to CVD self-care behaviours encompassed cultural practices, cultural values, healthcare system navigation, and new living environment. Retaining their Chinese culture and integrating into Australian culture regarding dietary practices, social networks, traditional values and family relationships served as both enablers and barriers of self-care maintenance through factors such as heart-healthy diets, physical activity, stress management and medication adherence. Many participants denied encountering difficulties to utilize primary care services, but language barriers deterred them from accessing acute services and heart-health information from mainstream sources. Some preserved beliefs and practices in Traditional Chinese Medicine may complicate their self-care maintenance (medication adherence) and self-care management (responding to acute angina episodes). Conclusion. The influence of acculturation on CVD self-care behaviours among Chinese immigrants is multifaceted and individualized. Clinicians and community health workers should assess patients’ acculturation experiences to enable culturally sensitive practices. The lack of culturally and linguistically appropriate heart health information in the community should be addressed urgently to mitigate the cardiac health disparity. Collaboration with Chinese community associations offers an opportunity for co-design and dissemination of information about Australian healthcare systems and heart health education to upskill CVD self-care practices and mitigate the health inequities experienced by Chinese immigrants.