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1.
Value Health ; 23(11): 1423-1426, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33127011

RESUMEN

It is expected that the coronavirus disease 2019 (COVID-19) pandemic will leave large deficits in the budgets of many jurisdictions. Funding for other treatments, in particular new treatments, may become more constrained than previously expected. Therefore, a robust health technology assessment (HTA) system is vital. Many clinical trials carried out during the pandemic may have been temporarily halted, while others may have had to change their protocols. Even trials that continue as normal may experience external changes as other aspects of the healthcare service may not be available to the patients in the trial, or the patients themselves may contract COVID-19. Consequently, many limitations are likely to arise in the provision of robust HTAs, which could have profound consequences on the availability of new treatments. Therefore, the National Centre for Pharmacoeconomics Review Group wishes to discuss these issues and make recommendations for applicants submitting to HTA agencies, in ample time for these HTAs to be prepared and assessed. We discuss how the pandemic may affect the estimation of the treatment effect, costs, life-years, utilities, discontinuation rates, and methods of evidence synthesis and extrapolation. In particular, we note that trials conducted during the pandemic will be subject to a higher degree of uncertainty than before. It is vital that applicants clearly identify any parameters that may be affected by the pandemic. These parameters will require considerably more scenario and sensitivity analyses to account for this increase in uncertainty.


Asunto(s)
Comités Consultivos , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Evaluación de la Tecnología Biomédica , Betacoronavirus , Presupuestos , Infecciones por Coronavirus/tratamiento farmacológico , Economía Farmacéutica , Humanos , Neumonía Viral/tratamiento farmacológico , Calidad de Vida , Resultado del Tratamiento , Privación de Tratamiento
2.
Child Maltreat ; : 1077559520910806, 2020 Mar 31.
Artículo en Inglés | MEDLINE | ID: mdl-32228189

RESUMEN

Children of parents with cognitive impairment are overrepresented in the child protection system (CPS). The aim of this study was to examine the relationship between primary caregiver cognitive impairment (CCI) and CPS investigation outcomes using the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2008). The CIS-2008 includes process and outcomes data on a national sample of CPS investigations involving a total of 15,980 children under the age of 16 years. This secondary data analysis found that primary CCI was noted in 6.3% of all investigations. When primary CCI was noted, investigations were 3-4 times more likely to result in child removal and court action. The results further suggest that some case characteristics, including case history variables, are weighted differently in decision making depending on whether or not primary CCI is indicated. A systematic, national strategy is needed to build capacity in government and community sectors for the provision of research-informed child and youth protection and family support services for these parents and their children.

4.
Sci Adv ; 3(2): e1600193, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28246629

RESUMEN

We sought to determine whether instructional practices used by undergraduate faculty in the geosciences have shifted from traditional teacher-centered lecture toward student-engaged teaching practices and to evaluate whether the national professional development program On the Cutting Edge (hereinafter Cutting Edge) has been a contributing factor in this change. We surveyed geoscience faculty across the United States in 2004, 2009, and 2012 and asked about teaching practices as well as levels of engagement in education research, scientific research, and professional development related to teaching. We tested these self-reported survey results with direct observations of teaching using the Reformed Teaching Observation Protocol, and we conducted interviews to understand what aspects of Cutting Edge have supported change. Survey data show that teaching strategies involving active learning have become more common, that these practices are concentrated in faculty who invest in learning about teaching, and that faculty investment in learning about teaching has increased. Regression analysis shows that, after controlling for other key influences, faculty who have participated in Cutting Edge programs and who regularly use resources on the Cutting Edge website are statistically more likely to use active learning teaching strategies. Cutting Edge participants also report that learning about teaching, the availability of teaching resources, and interactions with peers have supported changes in their teaching practice. Our data suggest that even one-time participation in a workshop with peers can lead to improved teaching by supporting a combination of affective and cognitive learning outcomes.


Asunto(s)
Enseñanza/normas , Ciencias de la Tierra/educación , Docentes/normas , Humanos , Encuestas y Cuestionarios
5.
J Appl Res Intellect Disabil ; 30(3): 501-510, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28247464

RESUMEN

BACKGROUND: Mothers with intellectual disability are thought to be passive, dependent and in need of protection. This study contributes to a nascent body of research that challenges this schema, revealing how women with intellectual disability who are mothers resist oppression. METHODS: Narrative research methods underpinned by intersectionality theory were used to explore the lives of eight mothers with intellectual disability from various ethnocultural communities in Canada. A total of 33 in-depth interviews were conducted with these eight women over a period of 2 years. RESULTS: The lives of the women who took part in this study were marked by violence. The women resisted. Their resistance strategies addressed two kinds of relationships: their relationships with others and their relationship with themselves. CONCLUSION: The women in this study employed strategies of resistance, sometimes at great personal cost, to provide their children with a better life.


Asunto(s)
Discapacidad Intelectual/psicología , Relaciones Interpersonales , Madres/psicología , Maltrato Conyugal/psicología , Adulto , Alberta , Femenino , Humanos , Discapacidad Intelectual/etnología , Amor , Persona de Mediana Edad , Investigación Cualitativa , Quebec , Resiliencia Psicológica , Maltrato Conyugal/etnología , Adulto Joven
6.
J Appl Res Intellect Disabil ; 30(3): 482-491, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28070932

RESUMEN

BACKGROUND: Little is known about the experience of growing up with a mother with intellectual disability. The aim of this study was to explore this experience from the perspective of adult children. METHOD: In-depth interviews with 23 adult children brought up by mothers with moderate-to-severe intellectual disability. The interview data were analysed using grounded theory methods. RESULTS: The childhood experiences of the interviewees and the role their mothers played in their upbringing varied, depending in part on the involvement of extended family. It was the stigma of maternal intellectual disability, rather than their mother's functional limitations, that posed the greatest challenge. CONCLUSION: Interviewees characterized their mothers and childhoods as different, yet ordinary. Understanding the social context, including but not limited to the availability of informal support, is critical to understanding the experience of children growing up with mothers with intellectual disability.


Asunto(s)
Niños Adultos/psicología , Hijo de Padres Discapacitados/psicología , Discapacidad Intelectual/psicología , Madres/psicología , Adulto , Femenino , Humanos , Masculino , Polonia , Investigación Cualitativa , Adulto Joven
7.
Community Ment Health J ; 52(5): 519-26, 2016 07.
Artículo en Inglés | MEDLINE | ID: mdl-26202547

RESUMEN

This study investigated prevalence and risk factors for suicidal ideation among adults with self-reported disability in Western Canada. The method was secondary data analysis utilising the Canadian Community Health Survey. The odds of 12-month suicidal ideation are 3.5 times greater for adults with self-reported disability compared with non-disabled adults, controlling for age, sex, ethnicity, and psychiatric morbidity. The heightened risk of ideation among adults with self-reported disability is partially explained by social adversity, including food insecurity and low sense of community belonging. Reducing suicide risk among adults with disability requires a broad-spectrum approach, including mental health care, and strategies to ameliorate social and economic hardship.


Asunto(s)
Personas con Discapacidad/psicología , Ideación Suicida , Adolescente , Adulto , Alberta/epidemiología , Colombia Británica/epidemiología , Personas con Discapacidad/estadística & datos numéricos , Femenino , Abastecimiento de Alimentos/estadística & datos numéricos , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Aislamiento Social , Factores Socioeconómicos , Adulto Joven
8.
Community Ment Health J ; 52(8): 944-953, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-26694055

RESUMEN

The purpose of this study was to pilot a flexible, group-based program designed to strengthen the social connections and enhance the psychological well-being of mothers with intellectual impairment. A multi-site, mixed-method, pretest-posttest design was employed. To obtain rich process and outcome data, the evaluation incorporated measures of psychosocial well-being, goal achievement scaling, and interviews with group facilitators and participants. A total of 18 mothers completed the program. Participation was associated with a meaningful reduction in psychological distress with effect sizes ranging from .57 for depression to .71 for anxiety. Participating in the group program gave the mothers something to look forward to each week, opportunities to learn from and support others, and the feeling of "being a part of society". Further research is needed to determine whether these promising results can be replicated, and to evaluate the long-term impact of the program on mothers and their children.


Asunto(s)
Discapacidad Intelectual , Madres/psicología , Adulto , Depresión/prevención & control , Femenino , Humanos , Entrevistas como Asunto , Satisfacción Personal , Investigación Cualitativa , Aislamiento Social , Estrés Psicológico/prevención & control
9.
Disabil Rehabil ; 37(10): 864-72, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25073583

RESUMEN

PURPOSE: The purpose of this study was to investigate parent implementation of home-based therapy regimens, and the relationship between implementation and family-level outcomes. METHOD: A stratified (by child age group) random sample of 538 families raising children with disabilities in Alberta, Canada took part. Participants completed the Family Life Survey, which incorporated child and family measures, and items measuring parent implementation of home-based therapy regimens. RESULTS: Parents are more likely to implement therapeutic regimens when these are "enfolded" into other daily activities and routines. If parents have to "find a slot" in the daily routine to implement therapy, they will sacrifice personal leisure, participation in paid work, and time spent with other family members. Greater parent sacrifices/trade-offs was negatively associated with family well-being. CONCLUSION: As a general rule, children do well when their families do well, and families do well when they have the resources they need to juggle work and family and care demands. Recruiting parents as interventionists can tax family resources. Rehabilitation professionals must weigh up the pros and cons of parent-mediated intervention, and look to enfolding therapy into the everyday family routine.


Asunto(s)
Personas con Discapacidad/rehabilitación , Familia , Padres , Cooperación del Paciente , Adolescente , Adulto , Alberta , Niño , Preescolar , Evaluación de la Discapacidad , Composición Familiar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Relaciones Padres-Hijo , Apoyo Social
10.
OTJR (Thorofare N J) ; 34(2): 81-92, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24651599

RESUMEN

This mixed-methods study examined the impact of professional services on employment and leisure participation of mothers of children with autism. In Phase 1, 139 mothers with a child with autism completed a comprehensive survey addressing their experiences with services and occupational participation. In Phase 2, in-depth interviews, informed by grounded theory methodology, were conducted with a sub-sample of 19 mothers to discuss their experiences with services and the relationship between services, employment, and leisure participation. Findings revealed that discontinuity of services was a significant predictor of disrupted employment and/or leisure. A process of occupational imbalance and sacrifice emerged related to mothers' foregoing participation in personally meaningful occupations to focus time on navigating and participating in professional services for their child. Our findings suggest that many professionals who work with individuals with autism conceptually value family-centered care; yet, actual services often ignore family issues and focus exclusively on the child.


Asunto(s)
Trastorno Autístico/terapia , Servicios de Salud del Niño , Empleo , Actividades Recreativas , Madres , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Entrevistas como Asunto , Persona de Mediana Edad , Encuestas y Cuestionarios , Factores de Tiempo , Adulto Joven
11.
Res Dev Disabil ; 35(4): 833-48, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24491480

RESUMEN

The purpose of this study was to investigate the resilience displayed by families raising children with disabilities and behavior problems. The question is why do some families do well when others, exposed to similar stressors, struggle to keep their family life running? A stratified (by child age group) random sample of 538 families raising children with disabilities in Alberta, Canada took part. Participants completed the Family Life Survey, which incorporated measures of child behavior problems, social-ecological resources and family-level 'outcomes'. Families raising children with disabilities and behavior problems 'do well' under conditions of high social support and low financial hardship. In contrast, families with low levels of social support and high levels of financial hardship typically struggle, even when the number or intensity of child behavior problems is low. The study findings are consistent with the view that 'resilience' has more to do with the availability and accessibility of culturally relevant resources than with intrinsic, individual or family factors. With respect to family-level outcomes, strengthening social relationships and ameliorating financial hardship may be more important than behavior modification.


Asunto(s)
Parálisis Cerebral , Trastornos Generalizados del Desarrollo Infantil , Familia/psicología , Renta , Discapacidad Intelectual , Resiliencia Psicológica , Medio Social , Apoyo Social , Adolescente , Alberta , Niño , Trastornos de la Conducta Infantil , Femenino , Humanos , Masculino , Índice de Severidad de la Enfermedad , Familia de Padres Solteros/psicología , Clase Social
12.
Soc Sci Med ; 96: 138-46, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24034961

RESUMEN

Family-centered care (FCC) has been linked with improved parent and child outcomes, yet its implementation can be challenging due to family, professional, organizational and systemic factors and policies. This study aims to increase knowledge and understanding of how families with children with autism spectrum disorder (ASD) experience FCC in Alberta, Canada. 152 parents with a child with ASD completed the Measure of Processes of Care, separately for each utilized service sector, and 146 professionals working with persons with ASD completed the Measure of Processes of Care - Service Providers. Additionally, in-depth interviews were conducted with a sub-sample of 19 parents, purposefully sampled for diversity in child and family characteristics. Data were collected in 2011. Descriptive and inferential statistics were used to analyze quantitative data. Interview transcripts were analyzed using grounded theory constant comparison methods, yielding a data generated theoretical model depicting families' experiences with FCC over time and across service sectors. There were no statistically significant differences in FCC scores across service sectors, but statistically significant differences in FCC scores between parents' and professionals' were found. Qualitative data revealed positive experiences and perceptions of receiving FCC from professionals "on the ground" across sectors, but negative experiences and perceptions of FCC at the systems level (i.e., administration, funders). These broad experiences emerged as a core theme "System of Exclusion", which integrated the key themes: (1) "The Fight", (2) "Roles and Restrictions of Care", and (3) "Therapeutic Rapport". Professionals and service providers can use findings to ensure that services reflect current conceptualizations of FCC, and decision and policy makers can use findings to recognize systemic barriers to implementing FCC and inform policy change.


Asunto(s)
Actitud del Personal de Salud , Actitud Frente a la Salud , Trastornos Generalizados del Desarrollo Infantil/terapia , Servicios de Salud del Niño/organización & administración , Familia , Padres/psicología , Atención Dirigida al Paciente , Adolescente , Niño , Preescolar , Humanos , Investigación Cualitativa
13.
Res Dev Disabil ; 34(9): 2572-85, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23747943

RESUMEN

This study investigated the experience and perceived outcomes of a behavioural family intervention, standard stepping stones triple P (SSTP), for parents of children with autism. An indepth, prospective, mixed-methods, multiple case-study design was employed. Parent participants and SSTP practitioners took part. Participation in SSTP was consistently associated with improved parental self-efficacy, and was also associated with improved parental psychological well-being and decreased perceived need for behavioural services for some families. Three key themes emerged from the qualitative interview data, reflecting changes attributed to participation in SSTP: (1) changes in the "attribution of cause" of misbehaviour, (2) "Who's the boss?" reflecting a change to parents feeling more in charge of their child's behaviour, daily routines and choices, and (3) "Rewarding is rewarding!" reflecting appreciation of a positive approach to behaviour management. Practitioners discussed their impressions of appropriate participants, timing, structure, and session preferences for SSTP, and implications related to the professional qualifications of practitioners delivering SSTP. Clinical implications for the use of SSTP with families of children with autism are discussed.


Asunto(s)
Trastorno Autístico/psicología , Trastorno Autístico/terapia , Terapia Conductista/métodos , Conducta Infantil/psicología , Responsabilidad Parental/psicología , Ansiedad/psicología , Estudios de Casos y Controles , Niño , Preescolar , Depresión/psicología , Femenino , Humanos , Masculino , Estudios Prospectivos , Autoeficacia , Resultado del Tratamiento
14.
Community Ment Health J ; 48(1): 29-37, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-21243432

RESUMEN

Many mothers with mental health issues are caught up in the child protection system and face the prospect of having their children removed from their care. The aim of this study was to determine prevalence and outcomes for mothers with mental health issues and their children in child maltreatment cases opened for investigation in Canada. The method was secondary analysis of the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003) core data. This CIS-2003 contains process and outcome data on a nationally representative sample of 11,652 child maltreatment investigations. Maternal mental health issues were noted in 2,272 (19.7%) cases opened for investigation. The most common child protection concerns were neglect, emotional maltreatment and exposure to domestic violence. A significant association was found between maternal mental health issues and child maltreatment investigation outcomes, with many potentially confounding variables held constant. Broad spectrum, multi-disciplinary services are needed to support mothers with mental health issues. Effective mental health care is vital but insufficient. Addressing trauma, strengthening social relationships and alleviating poverty are also key. Systemic advocacy is needed to ensure that mothers with mental health issues can access broad spectrum supports.


Asunto(s)
Maltrato a los Niños/estadística & datos numéricos , Bienestar del Niño/estadística & datos numéricos , Salud Mental , Madres/psicología , Canadá/epidemiología , Niño , Maltrato a los Niños/psicología , Bienestar del Niño/psicología , Preescolar , Análisis por Conglomerados , Víctimas de Crimen/psicología , Víctimas de Crimen/estadística & datos numéricos , Femenino , Humanos , Modelos Logísticos , Masculino , Responsabilidad Parental , Prevalencia , Política Pública , Factores Socioeconómicos
15.
Child Abuse Negl ; 35(8): 621-32, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-21862126

RESUMEN

OBJECTIVES: The aim of this study was to determine the prevalence of parental cognitive impairment in cases opened for child maltreatment investigation in Canada, and to examine the relationship between parental cognitive impairment and maltreatment investigation outcomes including substantiation, case disposition and court application. METHODS: The method was secondary analysis of the Canadian Incidence Study of Child Abuse and Neglect (CIS-2003) core-data, which is derived from a multi-stage stratified cluster sample of 11,562 child maltreatment investigations. RESULTS: Parental cognitive impairment was noted in 10.1% of sampled cases that were opened for child maltreatment investigation in 2003, and in 27.3% of sampled cases that resulted in child welfare court application. Neglect was the most common cause of concern. With child and case characteristics held constant, parental cognitive impairment predicted investigation outcomes. The data further suggest that the relationship between parental cognitive impairment and investigation outcomes was partially mediated by perceived parent non-cooperation, mental health issues and low social support. CONCLUSIONS: The number of children who are living with a parent with cognitive impairment and who are referred for protective services is thought to be increasing. Building systems capacity to support parents with cognitive impairment and promote child wellbeing is therefore essential to containing the human and economic costs of maltreatment and out-of-home care. PRACTICE IMPLICATIONS: A broad-spectrum approach is needed to support parents with cognitive impairment and their children. Equipping services with the knowledge, skills, and mandate they need to deliver evidence-based parent training is vital. However, strategies are also needed to tackle discrimination, alleviate family poverty, strengthen the social ties of parents with cognitive impairment and in turn, improve the life chances of their children.


Asunto(s)
Maltrato a los Niños , Hijo de Padres Discapacitados/psicología , Trastornos del Conocimiento , Padres/psicología , Adolescente , Canadá , Niño , Maltrato a los Niños/estadística & datos numéricos , Bienestar del Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Incidencia , Lactante , Masculino , Factores de Riesgo
16.
Prev Sci ; 12(4): 411-22, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-21750943

RESUMEN

The purpose of this paper is to present a case study of "evidence-based" program uptake and implementation. The process of integrating Triple P (levels 2 and 3) into existing family support centers in Alberta, Canada, was examined. We conducted ten individual interviews with directors, and ten group interviews, involving a total of 62 practitioners across ten Triple P pilot sites. Key findings show that there was variability in the approach and extent to which Triple P was integrated into family support centers. Five key factors impacting the integration process emerged from the interviews. These were: (1) the level of development of pre-existing support services; (2) the degree of "fit" between the Triple P program approach and existing agency practice, including the perceived suitability/unsuitability for some client groups; (3) practitioner perceptions of the adaptability of the program; (4) rules about who can and who cannot use Triple P resources; and (5) training and sustainability issues. In addition to identifying specific factors, this study was able to provide some insight as to why and how these factors were significant, thereby adding to the literature on knowledge/program dissemination processes.


Asunto(s)
Familia , Padres/educación , Alberta , Humanos , Desarrollo de Programa
17.
Child Maltreat ; 16(1): 21-32, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-21131633

RESUMEN

The authors examined decision making and service referral in child maltreatment investigations involving children of parents with cognitive impairments using the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003) core-data. The CIS-2003 includes process and outcome data on a total of 1,243 child investigations (n = 1,170 weighted) in which parental cognitive impairment was noted. Employing binary logistic regression analyses, the authors found that perceived parent noncooperation was the most potent predictor of court application. Alternative dispute resolution was rarely utilized. The findings from this study highlight the need for development and utilization of alternative dispute resolution strategies, worker training, dissemination of evidence-based parent training programs, and implementation of strategies to alleviate poverty and strengthen the social relationships of parents with cognitive impairments and promote a healthy start to life for their children.


Asunto(s)
Maltrato a los Niños/estadística & datos numéricos , Bienestar del Niño/estadística & datos numéricos , Hijo de Padres Discapacitados/estadística & datos numéricos , Trastornos del Conocimiento/epidemiología , Tamizaje Masivo/estadística & datos numéricos , Relaciones Padres-Hijo , Adulto , Canadá/epidemiología , Niño , Trastornos del Conocimiento/psicología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Padres/educación , Factores de Riesgo , Adulto Joven
18.
Aust Occup Ther J ; 57(3): 167-73, 2010 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-20854585

RESUMEN

AIM: To investigate family caregiver perceptions of allied health professional processes of care and support in hospital following stroke, and to test an adapted version of the Measure of Processes of Care (MPOC) for its suitability of use in the stroke care setting. METHODS: The first stage involved the adaptation and refinement of the MPOC, designed to measure caregiver perceptions of processes of professional care and support across five care dimensions. The second stage involved mailing out of questionnaires to primary caregivers of stroke survivors. A total of 107 completed questionnaires were included in the analysis. The reliability of the adapted questionnaire was assessed and summary statistics were computed. RESULTS: The reliability of the adapted MPOC was found to be high, with good internal consistency of items within each subscale. Mean scores indicated that caregivers were most likely to report negative perceptions of the way allied health professionals engaged with and supported them, particularly in the area of information provision. CONCLUSION: The number of families being affected by stroke is predicted to rise substantially in the near future. Allied health professionals have a significant role to play in supporting family caregivers. Results highlight caregiver-identified areas of weakness in current clinical practice.


Asunto(s)
Técnicos Medios en Salud , Cuidadores/psicología , Servicios de Atención a Domicilio Provisto por Hospital/organización & administración , Terapia Ocupacional , Percepción , Rehabilitación de Accidente Cerebrovascular , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nueva Gales del Sur , Atención Primaria de Salud , Quebec , Reproducibilidad de los Resultados , Factores de Tiempo , Resultado del Tratamiento
19.
Res Dev Disabil ; 31(6): 1176-86, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20850268

RESUMEN

BACKGROUND: Older parent-carers in Australia are the subject of increasing policy and practice attention due to concerns about their ongoing ability to care in the light of their own ageing and the ageing of their adult son or daughter. This paper examines health status and the coping strategies of a group of older Australian parents caring for an adult son or daughter with intellectual disabilities. METHOD: Health status using the SF-12 (Ware, Snow, Kosinski, & Gandek, 1993), caring stress using the CADI (Nolan, Grant, & Keady, 1998), and coping strategies using the CAMI (Nolan et al., 1998) were assessed in 64 older parent-carers of adults with intellectual disabilities. RESULTS: The self-reported health status of this sample of older parent-carers did not differ significantly from Australian population norms, with one exception. That is, the younger parent-carers in the sample (55-64 years) reported significantly poorer mental health. Better health was associated with having a partner, a larger and close support network of family, friends and neighbours, and a lower care-load. Overall, the study participants identified both satisfaction as well as stress associated with caring, a finding that runs counter to the common perception that being a carer is overwhelmingly burdensome. Common sources of stress were feeling helpless or not in control, and poor professional support. Analysis of older parent-carers coping strategies suggests that self-reliance, whether by choice or necessity, was the norm. CONCLUSIONS: The health status of older parent-carers may present less cause for concern than anecdotal reports suggest. That said, the strong self-reliance particularly of the older carers presents a challenge to service providers seeking to engage those whose situation appears to warrant support from the service system.


Asunto(s)
Adaptación Psicológica , Cuidadores/psicología , Estado de Salud , Discapacidad Intelectual/psicología , Padres/psicología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Australia , Personas con Discapacidad/psicología , Salud de la Familia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión , Autoeficacia , Factores Sexuales , Apoyo Social
20.
Psychiatr Rehabil J ; 33(3): 228-31, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20061259

RESUMEN

OBJECTIVE: The aim of this exploratory study was to investigate the process of transition to independent accommodation for people with schizophrenia. METHOD: The study employed a grounded theory approach. Multiple semi-structured and responsive e-mails and interviews were conducted with a total of seven participants currently living in independent accommodation. Through constant-comparative analysis of interview and e-mail data, three central processes were identified. RESULTS: The three processes are developing a sense of control; establishing a relationship between illness and place; and attaining a sense of belonging. CONCLUSION: By attending to each of these three processes, mental health professionals may better assist people with schizophrenia to make a successful transition to independent accommodation, and in turn, to living well in the community.


Asunto(s)
Vida Independiente/psicología , Esquizofrenia/rehabilitación , Psicología del Esquizofrénico , Adolescente , Adulto , Deluciones/psicología , Deluciones/rehabilitación , Femenino , Humanos , Control Interno-Externo , Masculino , Persona de Mediana Edad , Nueva Gales del Sur , Ajuste Social , Medio Social , Identificación Social , Adulto Joven
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