不孕症女性污名现象产生原因、影响及对策思考

不孕症女性患者的污名或歧视现象是一个值得关注的话题。在我国,不孕污名的产生具有传统文化背景。不孕污名影响患者的身心健康,造成患者社会隔离,提出相关对策对改善不孕症女性患者及其家属认知与态度、提高不孕女性心理保健水平是有积极意义的。     

污名应对策略的研究现状与展望

应激与应对的理论发展构建了污名应对研究的基本框架。污名应对策略是指被污名者在具体污名情境中为减少压力的消极影响而有目的地采用的情绪、认知和行为反应。目前, 关于被污名者应对污名策略的研究, 特别是艾滋病污名应对策略的研究日趋增多。根据不同的划分标准, 可以区分出问题聚焦性与情绪聚焦性策略、卷入与摆脱策略以及前摄性与反应性策略; 对于可隐藏污名而言, 还涉及到表露/隐藏策略。在研究方法上, 质性研究范式日益发挥重要作用。未来应该注重污名应对策略的情境性, 加强不同污名领域的专题研究, 关注对应对策略的评价并构建污名应对策略的层次模型。     

The Role of Attachment and Stigma in the Relationship Between Stress and Attitudes Toward Counseling in South Korea

Using structural equation modeling, the authors investigated the mediators between stress and attitudes toward seeking professional help among 298 undergraduate students in South Korea. Results indicated that attachment styles (avoidance and anxiety) and stigma (public and self‐stigma) mediated the relationship between stress and attitudes toward seeking help. Furthermore, public and self‐stigma had different paths depending on attachment styles related to help seeking. Regarding previous counseling experience, differences in the relationships between stress, attachment styles, stigma, and attitudes toward seeking help were evident.     

Emotional impacts of participation in an Australian national survey on mental health-related discrimination

Institutional Review Boards have expressed concern that research into sensitive topics such as mental disorder will cause participants undue distress. This study investigated the emotional responses of 5,220 Australians to a survey on mental-health-related discrimination. Participants were interviewed about their mental health and experiences of discrimination across 10 life domains and then the emotional impacts of the survey. Results suggested that a minority experienced a negative reaction (2.8% felt depressed, 5.3% distressed, 9.5% reported intrusion on privacy, 2.5% regretted participation) in contrast to 88% reporting positive experiences. A mental health problem was associated with both negative and positive reactions.     

Cultural Issues in Terrorism and in Response to Terrorism

Summary

Among the multiple causes of terrorism is a clash of cultures. Trauma and the destruction of culture may create fertile ground for violent cultures and future terrorists. Cultural differences are important elements in the prevention, assessment, and treatment of post-terrorism psychological sequelae. Cultural and spiritual practices have been used or adapted to reduce anxiety, enhance recovery, and provide supplemental interventions. Learning within a community and engaging community and religious leaders, community members, and the individual patient in order to be guided by the specific needs of a group or an individual is essential to effective interventions following terrorism.     

Client-Centered and Family-Centered Care: Refinement of the Concepts

Occupational therapy has emphasized the relationship between the therapist and the client. The occupational therapy guidelines for client-centered practice produced in the 1980s by the Canadian Department of National Health and Welfare and the Canadian Association of Occupational Therapists (Task Force on Guidelines for the Practice of Occupational Therapy, 1983) has had variable use over the years. While occupational therapists believe in the principles of client-centered care, the philosophical concepts have been difficult to fully implement and also seem narrow in light of all the external forces and challenges posed by today's clients and their rights, and the ethics of medicine. Other concepts need to be in place to facilitate the true constructs of client-centered care. A historical overview of the medical perspective and the occupational therapy perspectives on client-centered and family-centered care are reviewed. Lessons learned from the various iterations of client-centered and family-centered care are posed for consideration of a newer more inclusive relationship-centered concept for occupational therapy.     

A Role for Occupational Therapy in Foster Care

The purpose of this publication is threefold. First, it is an attempt to document the need for occupational therapy services within the foster care population. Second, it describes methods that can be used by occupational therapists to provide appropriate interventions to people affected by foster care. And third, it highlights the need for and identifies specific assessments that can be used to evaluate individuals affected by foster care and to measure the effectiveness of occupational therapy services delivered to foster care agencies.     

Assessing Mental Health Providers' Perceptions of Consumer-Providers

To gain insight into the challenges of the occupational role of consumer-provider, the authors describe a program evaluation that assessed mental health providers' perceptions of consumer-providers. A qualitative research design was used to assess non-consumer providers' attitudes toward and perceptions of consumer-providers, perceptions of the quality of services consumer-providers deliver, and knowledge and awareness of consumer-providers' education and training background. Four themes emerged, including: (1) service delivery, (2) comparisons between consumer-provided and non-consumer staff provided services, (3) perception and opinion of consumer-providers' education and training background, and (4) power dynamics. Implications of the findings are discussed.     

Community Participation of People with Mental Health Issues within an Urban Environment

Photovoice is an action research methodology in which people create/share photographs with stakeholders to generate personal and community change. In this study, people with mental health issues used photovoice to explore questions about community participation within an urban environment. Identified areas of occupation include spending time with friends, daily living tasks, and managing symptoms. Facilitators to community participation include access to supports, transportation, and making friends. Factors limiting participation include the risks for stigmatization, homelessness, and medication side effects. Implications for occupational therapy intervention include supporting participants’ community participation by developing friendships/supports and addressing the ongoing demands of symptom management.     

First Year Post-Katrina: Changes in Occupational Performance and Emotional Responses

The purpose of this retrospective study was to determine whether Hurricane Katrina affected the occupational performance and emotional states of New Orleans area residents affected by the hurricane over the first year post-Katrina. A purposeful sample of 143 adults who lived in the New Orleans area just prior to Katrina completed a questionnaire one year after Katrina. Participants were asked to rate their satisfaction with their occupational performance and emotional states at four time periods: August 2005, before Katrina; September 2005, one month after Katrina; March 2006, six months post-Katrina; and September 2006, one year post-Katrina. The most notable findings were that both satisfaction with occupational performance and emotional states showed marked declines during the month immediately following Katrina, with some recovery six months post-Katrina, and further recovery a year after Katrina. At one year post-Katrina however, the recovery of satisfaction with occupational performance and emotional states approached, but did not quite reach pre-Katrina baseline responses. Further, women did not fare as well as men post-Katrina, on both variables. Limitations of the study, implications of findings for the theory and practice of occupational therapy in the area of disaster responses, and possible future research are discussed.