Correlates of community rehabilitation service utilization among persons with psychiatric disabilities.

BACKGROUND: The use community psychiatric rehabilitation (CPR) service could facilitate community tenure, autonomy, and recovery among persons with psychiatric disabilities. Nevertheless, based on existing scientific evidence, the conformance rate with the treatment recommendations was modest and the existing services are underutilized in Taiwan. AIMS: This study examined the correlates of CPR service utilization based on the Behavioral Model of Health Service Utilization. Especially, the effects of enabling factors were explored. METHODS: Five hundred and ninety-two participants from 32 community psychiatric rehabilitation centers in Taiwan completed the questionnaire. There were three groups of independent variables: predisposing, enabling, and need factors. Multiple regression analysis with a hierarchical method of entry was performed. RESULTS: The hypothesized model was significant. Eight independent variables in the model explained 29.3% of the variances in the service utilization. Three enabling factors were significant after controlling for the effects of other factors. The most important correlate was professional relationships followed by family support and welfare subsidy. CONCLUSIONS: The findings support that factors associated with CPR service utilization need to be examined separately from general mental health service. CPR program design and service delivery should consider the three most important enabling factors and the extent of service utilization could be enhanced.

A validation study on the Recovery-Promoting Relationship Scale (RPRS) in a Chinese population.

OBJECTIVE: This study examined the psychometric properties of a Chinese language version of the Recovery-Promoting Relationship Scale (RPRS) scale in a sample of persons with severe mental illness in Taiwan. METHOD: Five hundred ninety-two participants from 32 community psychiatric rehabilitation centers in Taiwan agreed to participate in this study. Principal component factor analysis with oblique rotation was performed. Internal consistency and external construct validity were also examined. RESULTS: The results revealed a 2-factor solution that differed from the structure of the original RPRS. The first factor (F1) comprised 7 items in the Core Relationship Index and 7 items in the Recovery-Promotion Strategies Index of the original RPRS. The second factor (F2) comprised 8 items in the Recovery-Promotion Strategies Index and 1 item (I5) in the Core Relationship Index of the original RPRS. The reliability of F1 and F2 was 0.961 and 0.941, respectively. The entire scale and subscales all had a significant and moderate correlation with recovery and service use. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This study provides initial psychometric support for a Chinese language version of the RPRS. Additionally, the use of core interpersonal skills was correlated with recovery-promoting strategies. The findings support the use of the RPRS as a guide to promote recovery-oriented services in Taiwan. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Predictors of personal recovery for persons with psychiatric disabilities: An examination of the Unity Model of Recovery.

This study examined a comprehensive set of potential correlates of recovery based on the Unity Model of Recovery. Thirty-two community psychiatric rehabilitation centers in Taiwan agreed to participate in this study. A sample of 592 participants were administered the questionnaires. Five groups of independent variables were included in the model: socio-demographic variables, illness variables, resilience, informal support, and formal support. The results of regression analysis provided support for the validity of the Unity Model of Recovery. The independent variables explained 53.5% of the variance in recovery for the full sample, and 55.5% for the subsample of the consumers who have been ever employed. The significance of the three cornerstones (resilience, family support, and symptoms) for recovery was confirmed. Other critical support variables, including the extent of rehabilitation service use, professional relationship, and professional support were also found to be significant factors. Among all the significant correlates, resilience, family support, and extent of rehabilitation service use ranked in the top three. The findings could shed light on paths to recovery. Implications for psychiatric services were discussed and suggested.

Service utilization, perceived changes of self, and life satisfaction among women who experienced intimate partner abuse: the mediation effect of empowerment.

This study explored the growth experiences of women abused by their intimate partner, specifically focusing on the associations between social services and empowerment, perceived changes of self, and life satisfaction. The potential effects of demographic variables, social support, coping, and experience of partner abuse were also explored. A survey study was conducted through the collaboration of social workers in the Centers of Prevention and Intervention for Domestic Violence and private sectors in Taiwan. Through contact by their social workers, 191 participants completed the questionnaires. The results revealed that the participants had growth mainly in their psychological and interpersonal domains. The independent variables in the regression model explained 45.3% (adjusted) variance in perceived changes of self. In addition to empowerment and negative impact of violence, intensity of contact and professional relationship were two important service variables that directly and significantly correlated with perceived changes of self. A significant amount of variance (adjusted R² = .556) in life satisfaction could be explained by the independent variables. Social support and empowerment directly correlated with life satisfaction. The findings also supported the mediation effect of empowerment. Seven variables (e.g., social support, coping method, and professional relationship) indirectly associated with perceived changes of self and life satisfaction through empowerment.

[Effects of climate change on photosynthesis of Diospyros kaki under different soil moisture conditions].

Taking two-year-old Diospyros kaki as test material, this paper studied the effects of high CO2 concentration (700 micromol x mol(-1)), high temperature (5 degrees C higher than the mean daily temperature); and their combination on the net photosynthesis rate (Pn), evapotranspiration (Tr), stomatal conductance (Gs), water use efficiency (WUE), chlorophyll content, Fv/Fm, and Fv/Fo under different soil moisture conditions, with the ambient air temperature and CO2 concentration (380 micromol x mol(-1)) as the control. Under all test soil moisture conditions, the combination of high CO2 concentration and high temperature decreased the Tr and Gs, but increased the WUE. This combination increased the Pn when the soil moisture content was 75%-85% and 55%-65% of field capacity, but decreased the Pn when the soil moisture content was 35%-45%. High CO2 concentration increased the Pn and WUE but decreased the Gs and Tr under all test soil moisture conditions. The effects of high temperature and its combination with high CO2 concentration on the WUE depended on soil moisture condition, with the WUE increased with increasing soil moisture content. Comparing with the control, high CO2 concentration also increased the leaf Chla, Chlb, Chl (a + b), and Car concentrations and the Fv/Fm and Fv/Fo values, relieved the water stress, and increased the stress-resistance of D. kaki.

Factors, process and outcomes of recovery from psychiatric disability: the unity model.

BACKGROUND: Despite the fruitful findings on related issues of recovery in the West, some researchers have called for more studies on the factors that facilitate recovery and international literature on recovery to be made available. Moreover, to date, a united model that integrates outcome, component process and contextual factors of recovery has not yet been developed. Thus, this study explored the recovery experiences of persons with psychiatric disabilities (hereinafter called consumers) in Taiwan and extracted the key facilitators for developing a preliminary unity theory of recovery. MATERIAL: In-depth qualitative interviews of 15 consumers in recovery and their caregivers were held. Over a research period of two years, consumers were interviewed twice. The dialogue of each interview was transcribed into text and a narrative summary of the storyline for each participant was also prepared. DISCUSSION: For most consumers, the journey of recovery was an incremental process of progress, yet few of them mentioned a turning point and its significant change on their life. Regaining social roles seemed to be a necessary but not sufficient outcome indicator for recovery. While symptom remission, mental strength and parental support were the cornerstones for recovery, the treatment model and professionals got the credit for it too. CONCLUSION: The recovery process occurs within a complex context of various stages and multi-facilitators. The forces of three cornerstones, essential components and contextual facilitators all influx into the river of recovery and emerge as one united mechanism that supports the consumer's spiral progress through the journey of striving for autonomy.

The attitudes towards and enactment of psychosocial rehabilitation principles: discrepancies and correlates.

BACKGROUND: Previous literature suggests that attitudes have critical effects on recovery outcomes. Yet mental health professionals' attitudes towards psychiatric rehabilitation principles (PRP) have not been fully addressed. Whether the professionals could act in accordance with attitudes has also not been examined. AIMS: This study explored how hospital professionals in Taiwan perceived PRP, and whether there were discrepancies between attitudes towards and enactment of PRP. Also, the correlates of attitudes and enactment were examined. METHODS: Survey questionnaires were sent to hospitals in Taiwan, and yielded a valid sample of 743 subjects, with a 23.48% return rate. The potential correlates included five groups of variables: demographic, professional background, training experience, and external and internal structure of hospital. RESULTS: The factor analyses revealed nine factors of PRP, which partly confirmed Cnaan et al.'s findings (1990), and added recovery components. Hospital professionals held favorable attitudes toward and enacted more on recovery and strengths perspectives, yet less on social change, commitment from staff, and using environmental resources. The discrepancies between attitudes and enactment were mainly on macro related principles. Attitudes and hospital emphasis on psychiatric rehabilitation (PR) in discharge plans were the two most important correlates of enactment. CONCLUSIONS: Doctors are the training target group for enhancing favorable attitudes and enactment. Continuous advocacies on structural changes for increasing PR resources, and hospital emphasis on PR in treatment approach are needed.

Measuring social capital of persons residing in a long-term psychiatric institution.

BACKGROUND: Most studies support the association between social capital and health. However, none of the studies to date has focused on persons with psychiatric disability, and these past studies have drawbacks in conceptual development and the use of operational variables of social capital. AIMS: This study develops measures and examines patterns of social capital for persons with psychiatric disability. METHODS: Subjects (n = 273) were selected from a long-term psychiatric institution in Taiwan, based on their level of functioning. The measures of social capital were designed at the individual level, and included social networks, reciprocal help (engagement) and level of seeking help (trust and mobilization). Data were collected through face-to-face interviews. RESULTS: Factor analyses revealed a three-factor structure of social capital with 14 measures: bonding and reciprocity in the hospital, bonding and reciprocity within the ward, and network resources. Through cluster analyses, five patterns of social capital emerged among the consumers: large network and strong bonding, strong network and high bonding, ward network and bonding, ward network and low bonding, and low social capital. Based on the profile of each cluster, younger age, a history of drug abuse, shorter hospitalization and better social functioning seem to correlate with higher social capital. CONCLUSION: The results support the idea that social capital is a metaconstruct, and reveal that consumers have the ability to establish social capital. The measurement and level of social capital as well as its implications for the rehabilitation of consumers into community living are discussed.

Community attitudes towards the mentally ill: the results of a national survey of the Taiwanese population.

BACKGROUND: In Taiwan, to strengthen the psychiatric rehabilitation system has been one of the primary goals of the Department of Health since 1985. Unfortunately, this endeavor has not been successful and it is believed that one of the barriers is social stigma towards the mentally ill. However, to date no national survey has been conducted for Chinese population on the focal topic using a random sample. AIMS: In this study we explored the attitudes of the general population towards the mentally ill in Taiwan. Specifically, we examined the effect of contact on one's attitudes after controlling for demographic variables. METHODS: A national survey was conducted on 1,203 subjects drawn through a stratified proportional random sampling. Data were collected using the Computer-Assisted Telephone Interview System. We conducted MANOVA and multiple regression analyses to explore the correlates of the attitudes. RESULTS: The results revealed that the general population held relatively higher levels of benevolence, tolerance on rehabilitation in the community, and nonsocial restrictiveness. However, they held relatively less positive attitudes on non-authoritarianism and normalization. Overall, direct contact and age were the two most important correlates of community attitudes. Education and occupation were also significant. CONCLUSIONS: Benevolent thoughts do not necessarily guarantee the acceptance of rehabilitation in the community or treating the mentally ill as a person like anyone else. However, the benevolent thought could be transformed into compassion and acceptance of another human being if people are given the opportunity to have direct contact with mentally ill persons. The results also indicated that community education should specifically target laborers of all age groups.