Occupational Therapy in the Rehabilitation of the Patient with Anorexia Nervosa

The first part of this paper develops an ecological and rehabilitative stance for the occupational therapist in relation to the anorexic patient. Maximizing the individual's level of psychosocial functioning is regarded as the primary aim of treatment. A model for approaching the anorexic patient is described which examines environmental factors, and the importance of assessment and follow up. The cognitive behavioral approach is discussed and suggestions are made for adapting it to the occupational therapist's orientation towards practical activity. In the second part of the paper concrete suggestions for therapy are made.     

Typical Development of Roles and the Impact of Schizophrenia on the Development of Adult Social Roles

Abstract

This chapter is a literature review that explores the nature of interaction between parents and children with emotional disorders, issues between parents and professionals when children are psychiatrically hospitalized, and the nature of parent involvement in child psychiatric settings.     

Psychological wellbeing and quality of life in amyotrophic lateral sclerosis: A review

Amyotrophic lateral sclerosis is a fatal neurodegenerative disease with a progressive and rapid course that, so far, cannot be stopped or reversed. The psychological impact of the disease is huge, on both patients and caregivers. This review summarizes studies that have investigated quality of life, depression, anxiety, pain, spiritual and existential issues, hope, and hopelessness in the ALS field, with attention to both patients and their caregivers. Psychological support and the possible role of psychologists in the ALS field are also discussed.     

Service User Perception of and Satisfaction with Programs Having Higher Education and Employment Goals for People Diagnosed with Mental Illness

This study examined quantitative and qualitative outcomes of service users’ perceptions of and satisfaction with a program having higher education and employment goals. In a one-group post-test design, 48 participants with various mental health diagnoses completed a quantitative questionnaire and 29 of those participated in qualitative focus groups. Participants identified positive and negative aspects of the program and provided recommendations for change. Results indicated that service users with higher education and employment goals benefit from a multi-faceted program that includes person-centered individualized care, concrete, goal-directed activities, practitioners who are compassionate and knowledgeable, and plans addressing setbacks and obstacles.     

Deception,Catholicism, and Hope: Understanding Problems in the Communication of Unfavorable Prognoses in Traditionally-Catholic Countries

The doctor's use of deception in appropriate circumstances has commonly been considered a necessity of the medical art. Resistance to full and frank communication is typical of many traditionally Catholic countries, and particularly of Italy, a western country where Catholicism remains particularly influential. The Catholic teaching on truth and lies, and the problem of telling the truth to a severely ill patient is discussed. It is suggested that the contemporary Catholic model of gradually telling a terminal patient the truth, which looks reasonable and feasible in theory, is rarely followed in practice, as in the majority of cases the truth is not told tout court. Problems stem from the way in which medicine is currently practiced in Italy; from the synergism between Catholicism and the medical tradition's grounded paternalism; and from the ambiguity of the term ‘hope’. Catholic ethics in fact recommends that the truth must be told without destroying hope, but the Catholic meaning of ‘hope’ is very different from its meaning in current language.     

Spiritual Inquiry and Well-Being in Life-Limiting Illness

ABSTRACT

Introduction: End of life, as a developmental phase, is accompanied by inner resources as well as losses. Spirituality is a potential inner resource for integrating illness that often occurs during this time. Despite the increase in spirituality research, how spiritual perspectives are used in life-limiting illness remains under-investigated. Better knowledge about this process may be useful for health care providers, family caregivers and patients themselves to enhance well-being at end of life. This study describes the process of how patients and family care-givers use their spiritual resources to facilitate well-being at the end of life.

Method: A qualitative study was designed, based upon the grounded theory method, that entails theoretical sampling of concepts (not sampling of people as in quantitative designs), and the analytic technique of constant comparison of the data until conceptual categories are saturated with supporting data and a theory can be identified. The sample consisted of 12 respondents: 6 dyads of elderly patients with a life-limiting illness and family caregivers. Interviews occurred over a 2-year period.

Results: Data analysis generated a theory about a process called “transcending life-limiting illness,” which derived from two related themes: spiritual inquiry and end-of-life dimensions.

Conclusion: The results expand existing knowledge about how people, either as patients or as family caregivers of persons facing end of life, live with life-limiting illness. The process of transcending life-limiting illness goes beyond merely coping to tap resources for well-being. This resource is expressed through an ongoing dialectic process of spiritual inquiry about life and death as supported by six critical life dimensions.     

心理疾病污名内隐测评的类别标签初探

采用单一类型内隐联想测验,考察以往研究中常用的概括化心理疾病词和具体心理疾病词作为心理疾病内隐污名间接测量概念词或类别标签的有效性。结果发现,相较于与积极词配对的任务,两类概念词与消极词（心理疾病态度词）配对的任务反应时更快,正确率更高。研究表明概括化概念和具体疾病与反映人们对心理疾病患者真实态度的消极词存在更紧密的自动联结,是人们头脑中表征心理疾病的概念词或类别标签,可作为内隐测量中的心理疾病概念词用于污名评估。     

The effect of personal and group discrimination on the subjective well-being of people with mental illness: the role of internalized stigma and collective action intention

The goal of this study is to test a model in which personal discrimination predicts internalized stigma, while group discrimination predicts a greater willingness to engage in collective action. Internalized stigma and collective action, in turn, are associated to positive and negative affect. A cross-sectional study with 213 people with mental illness was conducted. The model was tested using path analysis. Although the data supported the model, its fit was not sufficiently good. A respecified model, in which a direct path from collective action to internalized stigma was added, showed a good fit. Personal and group discrimination appear to impact subjective well-being through two different paths: the internalization of stigma and collective action intentions, respectively. These two paths, however, are not completely independent, as collective action predicts a lower internalization of stigma. Thus, collective action appears as an important tool to reduce internalized stigma and improve subjective well-being. Future interventions to reduce the impact of stigma should fight the internalization of stigma and promote collective action are suggested.     

Perceptions of mental healthcare consumers regarding their conditions

Distress is experienced, understood and communicated differently across various cultures. The aim of the study was to investigate the role of culture, religion and spirituality in patients’ understanding of and coping with mental problems. A quantitative survey was done at a psychiatric institution. A questionnaire was designed to explore patients’ cultural and religious beliefs about mental illness, and how these beliefs and perceptions influenced their actions in search for recovery. Questionnaires were completed by 94 patients. The majority of participants were Christian (79.8%), followed by African traditionalists (17.0%). Seventy-two per cent believed that faith in God, and 34.4% that help from religious leaders, could contribute to mental wellness. Approximately a third (29.0%) believed that by keeping their ancestors happy, they would be protected from sickness and bad luck. Mental healthcare providers’ sensitivity to cultural and religious beliefs will translate into a more comprehensive management plan, ensuring a satisfying therapeutic relationship.