There is a growing amount of research showing that a shared social identity and the sense of belonging to a family have a potential effect on health. However, little is known about the effects of severe mental illness on family identity. The authors carried out this thematic synthesis based on a systematic review of literature on family narratives of severe mental illness and family identity. The main findings indicate that in many families (i) their identity—as a shared social identity—undergoes a transformation process by which the identity aspects of being a family are reinforced; (ii) family members often take on a caring role as their main family role; and finally, (iii) a cultural component shapes this transformation process. The authors describe implications for research and application in the mental health field. All in all, family identity is transformed by the experience of severe mental illness. 相似文献
This research examined the sustainability of Canada's At Home/Chez Soi Housing First (HF) programs for homeless persons with mental illness 2 years after the end of the demonstration phase of a large (more than 2000 participants enrolled), five‐site, randomized controlled trial. Qualitative interviews were conducted with 142 participants (key informants, HF staff, and persons with lived experience) to understand sustainability outcomes and factors that influenced those outcomes. Also, a self‐report HF fidelity measure was completed for nine HF programs that continued after the demonstration project. A cross‐site analysis was performed, using the five sites as case studies. The findings revealed that nine of the 12 HF programs (75%) were sustained, and that seven of the nine programs reported a high level of fidelity (achieving an overall score of 3.5 or higher on a 4‐point scale). The sites varied in terms of the level of systems integration and expansion of HF that were achieved. Factors that promoted or impeded sustainability were observed at multiple ecological levels: broad contextual (i.e., dissemination of research evidence, the policy context), community (i.e., partnerships, the presence of HF champions), organizational (i.e., leadership, ongoing training, and technical assistance), and individual (i.e., staff turnover, changes, and capacity). The findings are discussed in terms of the implementation science literature and their implications for how evidence‐based programs like HF can be sustained. 相似文献
This paper describes a developmental psychotherapy undertaken with a physically disabled latency boy, with a background of significant developmental deficits and multiple psychological trauma, diagnosed by CAMHS as being on the autistic spectrum. Using an assessment framework following Anna Freud’s conceptualisation of developmental lines, pathology as a deviation from the norm was formulated. Assessments using standard psychological tests were made at the beginning, in the middle, and at the end of his therapy, in order to study the changes in his personality development. Standard assessment findings were also used to portray the fragmentation of the boy’s psyche in a concrete fashion, in order to facilitate his re-integration. 相似文献
This pilot study attempted to examine the effectiveness of a brief cognitive behavioural therapy (CBT) psychoeducational group for Chinese people with chronic illness in Hong Kong. It adopted a single group design, and 52 participants joined the group. A questionnaire with three outcome measures, measuring general mental health, quality of life and dysfunctional attitudes and beliefs, was administered to participants at pre-test, post-test and six month follow-up. Repeated measures ANOVAs were employed and revealed positive changes in most of the outcome measures across the three time points. Cohen’s d showed a moderate to large effect size for most outcome measures. From a step care perspective, a culturally attuned brief CBT psychoeducational group may serve as an early intervention and a triage to attract suitable people with chronic illness to engage in the treatment process. 相似文献
There has been a dramatic improvement in the survival of children with perinatally-acquired HIV (PHIV) following the introduction of effective treatment in 1990s. The care for children living with PHIV is now focused on more accurately understanding the effects of both HIV and HIV treatment on the developing body and brain. An evaluation of current HIV neuroimaging, and neurocognitive research, when combined with clinical experience in the area of HIV, could help to inform United Kingdom (UK) PHIV service provision. This paper argues that an understanding from a neuropsychological perspective will help these young people to optimize their health, quality of life, and future functioning. The aim of the paper is to bring together research and clinical understanding of HIV and its treatment effects on the developing brain, together with an understanding of other potential neurological risk factors. It is argued here that there is a need for targeted neuropsychology assessment and preventative interventions, supported by clinical and preliminary research on the neurocognitive effects of HIV and its treatments. 相似文献
This paper is a reply to an article by Steven Edwards in a previous issue of Theoretical Medicine and Bioethics. In this paper
Edwards discusses two types of problems which he finds to be inherent in my theory of disability, mainly as presented in my
On the Nature of Health, Kluwer 1995. First, Edwards discerns a tension in my basic definition of health, a tension between
my “subjectivistic” and my “objectivistic” aspirations in the definition. Second, he finds that my theory of disability does
not allow for a distinction between disability due to illness or injury and disability which has no such (at least not immediate)
background. In my answer to Edwards's arguments I claim that his first criticism must be due to a misunderstanding of my intentions.
I find his second criticism to be more to the point. It raises important issues in the theory of health which partly concern
our interpretation of the notion of illness. Edwards introduces the notion of capacity in order to separate between disability
due to illness or injury and disability without such a background. In the last part of my paper I argue that this distinction,
however, will not fulfil its purpose.
This revised version was published online in August 2006 with corrections to the Cover Date. 相似文献
An experiment, designed to overcome shortcomings in previous work, was conducted to investigate the potential symptomatic benefits of relaxation training in the treatment of asthma in children. Fourteen chronic, severely asthmatic children received three sessions in which they rested quietly, followed by five sessions of relaxation training, and finally three sessions of relaxing as trained previously. Pulmonary function was assessed, in a manner far more definitive than in previous studies, before and after each session, and three additional times at 30-minute intervals thereafter. Tension in the frontales muscles, heart and respiration rates, and skin temperature and conductance were also monitored. Heart rate and to some extent muscle tension results tended to confirm the attainment of relaxed states. However, the lung function results failed to substantiate the previous, preliminary findings of a clinically meaningful change in pulmonary function following relaxation. The status of relaxation in the treatment of asthma was discussed. 相似文献
Objectives: Previous research suggested that illness perceptions provide the basis for illness risk perceptions through an inductive reasoning process. This study aimed to assess the direction of relationships between illness and recurrence risk perceptions over time, among cardiac patients.
Design: A longitudinal study was conducted among 138 patients undergoing coronary angioplasty. Self-report questionnaires measured perceived recurrence risk and illness perceptions one day and one month after catheterisation.
Results: Cross-lagged Panel Model Analyses revealed that higher perceptions of timeline, consequences and emotional representations of illness at hospitalisation were associated with higher recurrence risk perceptions one month later. Perceived personal control was the only illness perception with bi-directional associations: higher perceived personal control at hospitalisation was associated with higher recurrence risk perceptions one month later; and higher recurrence risk perceptions at hospitalisation was associated with lower personal control one month later.
Conclusions: The findings suggest that the associations between recurrence risk and illness perceptions can only partly be explained by inductive reasoning. Halo effects and defensive processes are suggested as complementary explanations for the observed associations between risk and illness perceptions. 相似文献
Objective: Diabetes mellitus (DM) is the commonest cause of end stage renal disease (ESRD). Despite increasing DM-ESRD prevalence and high dependency on care, there is a lack of literature on DM-ESRD caregivers. We sought to explore the perspectives and experiences of caregivers of patients with DM undergoing haemodialysis in Singapore.
Design: This study employed an exploratory, qualitative design comprising in-depth interviews with caregivers of DM-ESRD patients.
Methods: Semi-structured interviews were conducted with a sample of 20 family caregivers (54.2 ± 12.6 years; 75% female) of DM-ESRD patients. Data were analysed using Thematic Analysis.
Results: Key caregiving challenges identified were managing diet, care recipients’ emotions and mobility dependence. Patients’ emotional reactions caused interpersonal conflicts and hindered treatment management. Difficulties in dietary management were linked to patients’ erratic appetite, caregivers’ lack/poor understanding of the dietary guidelines and caregivers’ low perceived competence. Limited resources in terms of social support and finances were also noted. Physical and psychological well-being and employment were adversely affected by caregiving role.
Conclusion: This study highlights distinctive aspects of the DM-ESRD caregiving experience, which impact on caregivers’ health and challenge care. Disease management programmes should be expanded to support caregivers in dealing with multimorbidity. 相似文献