Secret-Keeping Behaviors in Black and White Children as a Function of Interviewer Race,Racial Identity,and Risk for Abuse

Summary

The tendency for children to keep the secret of child abuse is an important practical impediment to adequate research, prevention, assessment, and treatment. While some studies have established that children will readily keep adult secrets, few have investigated the predictors of ease of disclosure. In this research, race of the interviewer requesting the secret strongly affected disclosure, with Black children particularly showing an unwillingness to disclose a negative secret to a different race interviewer. Children at high risk for sexual abuse (as assessed by the Finkelhor checklist) also were more likely to keep the secret.     

Residents' Attitudes About On-Site Religious Activities: A Comparison of Continuing Care Retirement Communities in Two States

ABSTRACT

Twelve older adults were interviewed in two continuing care retirement communities (CCRCs), one in Florida and the other in Wisconsin. Only the residents in Wisconsin maintained contact with local congregations, probably because most had always lived in communities not far from the CCRC. On-site religious activities such as worship and study groups were important because of the ways they ordered the week and the opportunities they offered for social interaction. In both locations, Protestant residents appreciated the opportunity to worship in ecumenical services conducted by clergy of different Protestant faith traditions. Catholic services were also available in both locations. Suggestions are offered about ways that faith communities can nourish the spiritual lives of persons living in CCRCs by working with chaplains and by conducting small prayer and study groups.     

A Palliative Approach to Spirituality in Residential Aged Care

SUMMARY

This paper describes how a palliative approach to care is relevant in the context of residential aged care, with specific focus on the spiritual needs of residents. Three issues are described that make attention to spirituality in residential aged care particularly challenging: effects of cognitive changes, potential threats to dignity, and uncertainties about how to provide bereavement support to the range of people who experience loss in this care context. Reflections on how residential aged care staff might better assess the spiritual needs of residents are offered with suggestions from the literature about how to sensitively respond to these needs.     

Reducing obstacles to the provision of quality diabetic care

Abstract

High quality diabetic care is seen as influenced by the organisation of care, health care workers' involvement in diabetes-specific areas, co-operation among staff members, the availability of resources, and the competence of medical staff (including both physicians and nurses). In a prospective study we have tested a programme for improvements of the quality of diabetes services which combined organisational development and continuing medical education (CME) measures. The study involved 34 primary health care centres over an 18 month period and was based on the responses to questionnaires answered by 123 general practitioners and 247 registered nurses at the 34 PHCCs.

The combined programme had a considerable influence on inter-group co-operation, staff members' perceptions of resources available, and nurses' involvement in diabetic care (54 versus 30% seeing diabetic patients for regular check-ups).

The results show that, in order to diminish obstacles to high quality care, organisation of care as well as care workers' theoretical knowledge has to be focused.     

Counselling in primary care: A study of the psychological impact and cost benefits for four chronic conditions

Primary care counselling services have expanded rapidly over the last twenty years. Their principal focus has been to manage the demands placed on general practitioners by high service users, such as frequent attenders and patients with mental health problems. To date, very little research has been conducted to ascertain the impact of counselling for other patient groups in terms either of psychological outcomes or of cost-benefits. This study looked at the effect of short-term counselling on both the uptake of health services and the psychological states of four patient groups – frequent attenders and patients with diabetes, hypertension and asthma. All patients on the chronic disease register for these conditions and all patients who had made at least eight GP appointments over the previous twelve months were invited to take part in the study. The participants received eight 90-minute small-group counselling sessions, conducted by trained counsellors. The counselling followed a cognitive behavioural therapy (CBT) approach, with an emphasis on developing personal responsibility. Psychological outcomes were assessed using three proprietary measures (SF 36, HADS and CORE) immediately following counselling and at six months post-intervention. Health service uptake was assessed for each group over the twelve months post-intervention, using number of GP consultations, home visits, hospital referrals and test/investigations requested as outcome indicators. These data were compared with those for comparable control groups for each condition. The results suggested that, overall, all patient groups showed a significant improvement in psychological well-being, and that these gains were maintained for the six-month study period. The intervention groups also significantly reduced their uptake of primary and secondary care services, by comparison with their comparable control groups. The results suggest that the psychological and fiscal benefits of counselling provision within a primary care setting can extend to other patient categories.     

Women,Mental Health,and Managed Care

Abstract

Managed care has changed the way that mental health care is provided. These insurers manage such factors as length and type of therapy made available, access to therapy, and level of payment for therapy. Women, as the majority of those insured by managed care and as consumers of mental healthcare, are differentially affected by these changes.     

Women and Mental Health

No abstract available for this article.     

Preventing Family Violence: An Educational Model

This article gives an example of cross-cultural teaching between the United States and Korea using Bible study, lecture, and psychodrama by Korean students on the topic of domestic violence. In the process, basic education on domestic violence is presented in a culturally sensitive way.

The significance of the concept of sin for bioethics.

After a period during which the theological categories of sin and forgiveness were ignored or trivialized, presently these notions are being rediscovered. What could their impact be on bioethics, either in the narrow sense of medical ethics, or in the more encompassing sense of the ethics of the life sciences? This essay begins with describing the processes of transcending and ethitization, which gave rise to the biblical notion of sin. It portrays the theological foundation of sin in terms of a twofold refusal of proper relations to God and other humans. Through the practise of confession in the face of God (coram deo), sin is placed into a horizon of hope for forgiveness and reconciliation. The heuristic and hermeneutical significance of these categories results from their introducing a "surplus value," which transcends biological and ethical considerations. This additional dimension is illustrated in view of care (cura) for the injured, and in view of individual as well as collective willingness to forgive.