Health and Social Service Needs of Transgender People in Chicago

SUMMARY

A needs assessment of transgender people was conducted in Chicago in 2001 to assess their HIV risks, health and social service needs, and barriers to care. One hundred and eleven transgender individuals, 78 male-to-females (MTFs) and 33 female-to-males (FTMs), participated in the study. Fourteen percent of respondents reported being HIV-positive; they were all male-to-female and the majority was of color. Risk factors for HIV included unprotected sex and willingness to have high-risk sex in the future. Respondents experienced high levels of violence. Two-thirds of respondents had thought of attempting suicide. Respondents reported a high need for health and social services, particularly MTFs and people of color.     

Trauma Survivors' Emotional Distress and Barriers to Early Psychological Intervention in an Inner-City Acute Surgical Trauma Service

Fifty-five predominantly low-income ethnic minority patients were interviewed and screened for early signs of psychological distress following traumatic injury. A free, brief intervention and transportation were offered to patients who evidenced psychiatric symptoms. Over half of participants reported psychiatric symptoms, but none accepted the free intervention. This study examined reasons participants remained reluctant to engage in services despite elimination of common barriers. Results highlight the importance of perceptual barriers over structural barriers in engaging patients in psychological interventions following a traumatic event.     

Barriers to Treatment in an Ethnically Diverse Sample of Families Enrolled in a Community-Based Domestic Violence Intervention

Using quantitative and qualitative data, we examined the association between barriers to treatment, motivating factors, treatment attendance, and outcome in a sample of 63 mothers (most of Asian or Pacific Islander descent) enrolled in a family-based domestic violence treatment program. A high number of perceived barriers was associated with lower attendance and lower scores on assessment of parenting practices at posttreatment. Mothers reported relying on their own motivation, observations of children's improvement, and the quality of their relationships with staff and group members to overcome barriers. A larger number of motivating factors was associated with positive parenting practices at posttreatment. Discussion includes the benefits of a mixed-method approach to measuring barriers and its clinical application to increase treatment participation.     

Redefining dementia care barriers for ethnic minorities: the religion–culture distinction

Barriers to healthcare services experienced by black and minority ethnic (BME) persons with dementia are labelled as “cultural” in existing research. This is a promising shift from an ethno-centric approach to dementia care provision, yet very little research is dedicated to specifically how religion – as distinct from culture – influences healthcare practice. Further consideration of the religion–culture distinction is required; religion and culture are two distinct entities, which inevitably interlink. Cultural themes such as “God's will”, “Religious Ritual” and “Religious Duty”, warrant re-categorisation as “religious”. Sensitivity to the nuances between cultural and religious themes will provide clearer knowledge of how and why BME persons with dementia experience barriers to accessing care services. Further research is needed with regard to the role of religion specifically on dementia care access for BME persons to aim to improve care provision for this underrepresented demographic.     

Finding Voice: The Photovoice Method of Data Collection in HIV and AIDS-Related Research

This study examined the efficacy of photovoice as a research technique to explore the lives of children and families living in the context of HIV and AIDS. Participants were volunteers at a Day Care and Support Centre (n=18), and members of a community support group consisting of People Living with AIDS (n=5). The findings revealed that the photovoice method is particularly useful for dealing with the ‘unspoken’ lived experience of children and families.     

Factors Impacting on Career Choices of Technikon Students From Previously Disadvantaged High Schools

Career development is a socially constructed process involving complex interactions among different structures, forces, and systems all constituting spheres of influence. The purpose of this study was to investigate factors that influence career decisions. Eighty respondents (40 males and 40 females with mean age of 22 years) participated in the study. Results revealed that family variables of parental high expectations of children and appropriate communications within the family, as well as factors such as prestige statuses of some occupations, school curricular subjects, academic performance, teacher influences, and peer pressure had strong positive influences on career choices. Barriers to career choices identified included finance, lack of appropriate information, poor academic performance, and unsatisfactory career counseling services. Results suggest need for a better approach to career education in schools and counseling services that are adaptive to social, economic, and cultural contexts.     

Women in the National Guard: Coping and Barriers to Care

This study involved interviews with 42 women from the National Guard about their experiences of coping during reintegration into civilian life. Data were analyzed using techniques of conventional content analysis. The 1st theme that emerged regarded barriers to seeking and accessing care (institutional barriers, personal barriers, and stigma). The 2nd theme, coping strategies, consisted of 4 categories (seeking or gaining professional help, seeking social support, using routine activities, and using aspects of religion/spirituality). Implications for clinical work with returning female soldiers are discussed.     

放弃治疗后，以护理为主导的医学服务和人文关怀

剖析放弃治疗后死亡病案508例,分析放弃治疗的原因、疾病和形式,放弃治疗后护理工作存在的问题。提出在放弃治疗后,临床护理决策：对于护理工作发生的变化,应该提高认识,培养护理人员人文素质和法律意识,应该加强护理管理和规范,放弃治疗后,护理应该承担医学服务和人文关怀的主导作用。     

Parent Motivation to Participate in Treatment: Assessment and Prediction of Subsequent Participation

Treatment motivation is required for virtually all psychosocial treatments because clients must participate actively in the treatment process. In child and family treatments, it is the parent who must be motivated to manage treatment participation; however, no measures are currently available for evaluating parent motivation for treatment. The authors developed and evaluated a brief rating scale, the Parent Motivation Inventory (PMI), to measure parent motivation to participate in treatment. Results supported a uni-dimensional measure with strong internal consistency and test-retest reliability. Increases in parent motivation predicted the perception of fewer barriers to treatment participation, which was significantly associated with greater treatment attendance. The PMI provides a reliable and valid method of assessing parents’ motivation to participate in treatment and has implications for the prediction and potential modification of barriers to treatment and treatment participation.