Health & Social Care in the Community最新文献

Children with disabilities in out-of-home care (OOHC) are an overrepresented group in Australia, yet little is known about their circumstances, needs, and experiences within OOHC. Utilising a systematic scoping review methodology, we explored the state of knowledge about the experiences of children and young people with a disability in out-of-home care in Australia. Findings in this review speak to the unmet needs and challanges that children with disabilities face in child welfare systems and how systemic failures can lead to institutional pipelines of further maltreatment, adversity, and marginalisation. The review discusses the key themes in the literature, including (i) compounding trauma and placement failures, (ii) concerns of safety, stability, and neglect, (iii) limited control and choice, and (iv) disability and multisystem involvement.

The COVID-19 pandemic significantly endangers the development of at-risk young adults across various life domains, with potential enduring consequences. Despite prior reporting on the pandemic’s adverse effects on these individuals, there is a lack of the empirical literature regarding their resilience. Building upon the stress process model (Pearlin, 1978), we explored the challenges of 20 at-risk young adults (aged 18–25 years) and the strategies and resources they employed to cope with these challenges during this period. Thematic analysis revealed that these young adults struggled with worsened family relationships, loneliness, mental health issues, and setbacks in their quest for independence and autonomy. However, resources and character strengths that facilitated coping strategies during this period also emerged, specifically the motivation to become a role model within their family, personal abilities, and the use of formal and informal support. Theoretical and practical implications are discussed.

Internationally, community healthcare is provided by personal health budgets or personalised schemes as part of a consumer-directed care emphasis. Although the introduction of a personalised scheme in Australia has improved the lives of many, people with psychosocial disability (PSD) and their families have experienced many challenges with service integration. Six focus groups with 17 National Disability Insurance Scheme (NDIS) support workers were conducted between June and November 2022. Participants were asked semistructured questions about their engagement with emergency department (ED) clinicians when presenting with a person with PSD and NDIS plan. They were also asked how they contribute to service integration to improve communication practices between the two services. A qualitative, descriptive thematic analysis approach was used. Results indicate there is a need for improved service integration pathways between the ED and NDIS services. The thematic analyses identified five main themes: the ED is harmful and not safe, but nowhere else to go; make the ED safe; further training for ED staff; improving communication across services; and alternatives to the ED. This study reports NDIS support worker’s experience when supporting a person they are caring for in the ED. NDIS support workers have an understanding of the needs of the people they care for;their wisdom can contribute greatly to ED clinical responses in crisis care. Recommendations are offered to assist with service integration between the two systems.

Moving into a nursing home is a significant transition for older people which can be emotional and stressful. The literature on the decision to move and subsequent residential stress focuses on the time after admission; however, there is less understanding of older people’s management of the process. To fully understand and possibly reduce negative consequences and health-related risks, the aim of this article is to explore how older people manage the transition from home to nursing home. The study is based on 21 longitudinal interviews with seven older people during the process of moving. Following Dorothy Smith’s theory of work, the analysis finds three types of work—practical, relational, and emotional—that older people engage in during the transition process. The results highlight the importance of considering the entire transition process, not only experiences before or after, if we are to reduce the negative, stress-related consequences of relocations of this kind. The findings have practical implications for professionals in health and social care and point to the need to develop practical, relational, and emotional support for older people throughout the transition process.

Purpose. This study aims to elucidate the gender gaps in the strategies for maintaining the social participation and interaction of older adults with people in a local community. Methods. The subjects were 130 older adults aged 65 years or older and independently living in their homes in Saitama, Saitama Prefecture, Japan. The authors conducted an anonymous questionnaire survey on paper and performed multiple regression analysis for men and women separately using the Lubben Social Network Scale-6 (LSNS-6) as the dependent variable. Results. Among the independent variables used for the analysis, those that significantly influenced LSNS-6 in men were social activities related to the daily life satisfaction of the elderly (SARDS). The independent variables that significantly influenced LSNS-6 in women were SARDS, sense of coherence-13 (SOC-13), and the number of family members living with the subjects. Discussion. Health promotion is not associated with interaction with people in men compared with women.

Rationale. Recent studies have highlighted organizational issues, work stressors, and moral distress as prevalent problems among staff working within care services for older people, but factors influencing regulatory compliance in care services for older people are currently uncharted. Aims and Objectives. The aim of this exploratory study was to investigate how organizational factors, the clinical characteristics of the clients, and perceived organizational factors are associated with staff regulation noncompliance within home care services and service housing facilities. Methods. A self-report survey was sent to practical and registered nurses working in home care services and service housing in Finland in October 2021. The sample consisted of 352 home care and 555 service housing staff members. Separate models were calculated for home care services and service housing facilities. The data were analyzed using logistic regression models. CROSS reporting guidelines were followed. Results. The results show that in service housing facilities, higher numbers of disruptions, lower team autonomy, and working for a private employer increased the odds of regulation noncompliance. In home care services, higher numbers of visits during a day, higher numbers of disruptions, and lower team autonomy increased the odds of regulation noncompliance, while attending to clients requiring less resources decreased the odds of regulation noncompliance. Perceived lack of time and resources were influential factors in both contexts. Conclusion. Allocating more time to attend to tasks, ensuring adequate staffing, as well as supporting team autonomy, may increase regulation compliance within care services for older people.

Purpose. The aim of the study was to examine the relationships of early maladaptive schemas, overcompensation, and avoidant behaviors with sociodemographic, psychological, legal, and substance use status of individuals under probation due to illicit substance use. Methods. The data of this cross-sectional study were collected from adults under probation through self-report. The dependent variables were early maladaptive schemas, overcompensation, and avoidant behaviors. Sociodemographic, legal, and psychological characteristics and characteristics related to illicit substance use were the independent variables of the study. Student-t test and ANOVA or Mann–Whitney-U and Kruskal–Wallis tests were used in bivariate analyses. Multiple linear regression analysis was used in multivariate analyses. Results. A total of 300 adult individuals under probation participated in the study, and the inclusion rate was 93.5%. The mean age of the study group was 27.96 ± 6.40 years. The amount of smoking (B = 0.65 (95% CI: 0.04–1.27), p = 0.038), frequency of illicit substance use (B = 12.15 (95% CI: 2.04–22.25), p = 0.019), and childhood violence (B = 29.24 (95% CI: 16.92–41.56), p < 0.001) were explanatory for schema scores (R²: 0.240). Frequency of illicit substance use (B = 7.06 (95% CI: 0.58–13.54), p = 0.033) and childhood violence (B = 9.18 (95% CI: 1.36–17.00), p = 0.022) were explanatory for compensation scores (R²: 0.083). The amount of smoking (B = 0.49 (95% CI: 0.22–0.76), p = 0.001), frequency of illicit substance use (B = 5.16 (95% CI: 0.67–9.65), p = 0.025), being treated for substance use disorder (B = 6.74 (95% CI: 0.30–13.17), p = 0.040), and experiencing violence in childhood (B = 6.02 (95% CI: 0.59–11.45), p = 0.030) were explanatory for avoidant scores (R²:0.169). Conclusion. Childhood violence and frequency of illicit substance use were associated with early maladaptive schemas, overcompensation, and avoidance. Smoking appears to be a behavioral way of coping with both early maladaptive schemas and schemas through avoidance.

Providing formal care and support in the home has many benefits. Applying a human rights-based approach places the person and their human rights at the centre of all that a health and social care service does. There is a paucity of evidence on how to apply a human rights-based approach in practice when providing homecare. Increasing knowledge and understanding of human rights will empower health and social care practitioners to protect and promote human rights in formal homecare. The aim of this narrative review was to identify and describe human rights-based approaches in homecare, in order to promote awareness and understanding of a human rights-based approach. Five bibliographic databases were searched. Primary research studies pertaining to the delivery of formal homecare that included a human rights-based approach were eligible for inclusion. Sixteen articles were identified for inclusion. Quality appraisal and data extraction were conducted on included studies. A deductive framework analysis was used and concepts of a human rights-based approach that emerged from the literature as relevant to homecare were as follows: dignity and respect, autonomy, equality, participation, and communication. We found that homecare planning and delivery requires the integration of human rights, using approaches, such as person-centred care, partnerships in decision-making, supporting independence, and acknowledging a person’s beliefs and cultures, in everyday practice. Findings from this review can support and enable service providers to apply human rights in everyday practice, ultimately for the benefit of people using homecare services.