The study examined the implementation efficacy of a stress-reduction intervention for people living with HIV/AIDS by health care workers in the Eastern Cape Province, South Africa. Informants were 20 health care workers drawn from two health facilities. There were 17 females (85%) and 3 males (15%). Participants engaged in a focus group discussion on their experiences using a theory-based manualised stress-reduction support intervention in primary care settings. Thematic content analysis of the data yielded the following themes characterising costs to faithful implementation: departure from manualised instructions and ad hoc improvisation of theoretical concepts; disruptive power dynamics; lack of grounding in community values; and implementation resource limitations. Manualised intervention implementation efficacy by health workers needs customisation to local culture and health service support services. 相似文献
This study investigated the influence of authentic leadership (AL) on employee organisational commitment (OC) in a South African state hospital. A convenience sample of 222 employees (female = 81%; black = 82%) completed the Authentic Leadership Questionnaire on their perceptions of AL behaviours among their leaders; namely self-awareness, relational transparency, internalised moral perspective, and balanced processing. The employees also completed the Organisational Commitment Questionnaire to self-report on their own OC; namely affective, continuance, and normative commitment. Data were analysed utilising regression analysis to predict employees’ self-reported OC from perceived AL behaviours. Findings suggest AL scores to predict OC scores as well as the OC dimensions of continuance and normative commitment. AL scores did not predict affective commitment. Employees whose leaders apply AL may be able to retain employees through increased OC. 相似文献
Background: Informed by the Gelberg-Andersen behavioral model for vulnerable populations, this study examined the prevalence of and factors associated with not having a family physician among transgender (trans) people in Ontario, Canada.
Methods: Data were drawn from a respondent-driven sampling (RDS) survey of trans Ontarians age 16 and above (n = 433) conducted between 2009 and 2010. All analyses were weighted using RDS II methods. Prevalence ratios were estimated using average marginal predictions from logistic regression models.
Results: An estimated 17.2% (95% CI, 11.0 to 22.9) of trans Ontarians (median age = 28.7, 77.3% White) did not have a regular family physician. In multivariable analyses accounting for other predisposing and need-related factors, transfeminine persons (trans women and non-binary persons assigned a male sex at birth) who were Indigenous and/or persons of color were less likely than other transfeminine persons to have a family doctor. In addition, trans persons who were homeless or had unstable housing were less likely to have a family doctor than those who were adequately housed.
Conclusions: These results provide the first quantitative evidence of health disparities by race and gender within a Canadian transgender population and suggest a social gradient in access to care within Ontario's “universal health insurance” system. 相似文献
Frédérique de Vignemont argues on the basis of several empirical counterexamples that Bain and Klein are wrong about the relationship between pain and bodily care. I argue that the force of the putative counterexamples is weak. Properly understood, the association between pain and care is preserved in a way that is consistent with both de Vignemont's own views and the empirical facts. 相似文献
Disaster pastoral care operates in diverse contexts, which may challenge clergy responders in ecclesiological meaning‐making of their practices of care. This article argues that pastoral care may be imagined as part of a larger “network” of caring acts understood as a collective, multiple care practice. Such practice reflects deep‐rooted movements described in psychoanalytical theory as playing, and the christological idea of communication of properties. Therein, spiritual “safe places” can be seen to emerge, even in the midst of traumatic events. 相似文献
This report describes a secondary analysis of data from a comprehensive intervention project which included training and structural changes in three Baby Homes in St. Petersburg, Russian Federation. Multiple mediator models were tested according to the R.M. Baron and D.A. Kenny ( 1986 ) causal‐steps approach to examine whether caregiver–child interaction quality, number of caregiver transitions, and group size mediated the effects of the intervention on children's attachment behaviors and physical growth. The study utilized a subsample of 163 children from the original Russian Baby Home project, who were between 11 and 19 months at the time of assessment. Results from comparisons of the training and structural changes versus no intervention conditions are presented. Caregiver–child interaction quality and number of caregiver transitions fully mediated the association between intervention condition and attachment behavior. No other mediation was found. Results suggest that the quality of interaction between caregivers and children in institutional care is of primary importance to children's development, but relationship context may play a less direct mediational role, supporting caregiver–child interactions. 相似文献
ABSTRACTPsychotherapy came in for a drubbing by the Women’s Liberation Movement of the 1960s. Indeed, some movement members declared that Feminist Therapy was an oxymoron. Despite the antipathy, feminists in the mental health professions borrowed practices, ethical ideals, principles, and goals from the Women’s Liberation Movement to create innovative models of therapy. This progressive impetus came to an abrupt halt with the sweeping re-medicalization of psychiatry in 1980s and the corporatization of medicine that followed thereafter. As the landscape of psychotherapy changed, so too did the founders’ vision of Feminist Therapy. Drawing on interviews with feminist therapists, I examine some of these changes. I close by asking about the conditions of possibility for feminism in therapy today. 相似文献
In an earlier paper (Carey, T. A. (2005). Can patients specify treatment parameters? A preliminary investigation. Clinical Psychology and Psychotherapy, 12, 326–335) an approach to treatment delivery was examined in which the duration and frequency of the appointments was scheduled by patients. Results of this approach were encouraging but the generalizability of the results was constrained because only one clinician trialed the approach and no standardized assessment measures were used. In the present study there are two clinicians involved and the Depression Anxiety Stress Scale (DASS) was used. The approach was introduced at one GP practice and monitored over a six-month period. Results suggest that this approach might be an effective way of promoting patient access to, and involvement in, service delivery as well as reducing waiting times. 相似文献