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Selected AbstractsEmphasizing interpersonal factors: an extension of the Witkiewitz and Marlatt relapse modelADDICTION, Issue 8 2009Dorian Hunter-Reel ABSTRACT Aim Recently, Witkiewitz & Marlatt reformulated the Marlatt & Gordon relapse model to account for current research findings. The present paper aims to extend this model further to incorporate social variables more fully. Methods The social-factors and alcohol-relapse literatures were reviewed within the framework of the reformulated relapse model. Results The literature review found that the number of social network members, investment of the individual in the social network, levels of general and alcohol-specific support available within the social network and specific behaviors of network members all predict drinking outcomes. However, little is known about the mechanisms by which these social variables influence outcomes. The authors postulate that social variables influence outcomes by affecting intra-individual factors central to the reformulated relapse prevention model, including processes (e.g. self-efficacy, outcome expectancies, craving, motivation, negative affective states) and behaviors (e.g. coping and substance use). The authors suggest specific hypotheses and discuss methods that can be used to study the impact of social factors on the intra-individual phenomena that contribute to relapse. Conclusion The proposed extension of the relapse model provides testable hypotheses that may guide future alcohol-relapse research. [source] Demands of immigration among nurses from Canada and the PhilippinesINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 2 2008Linda A Victorino Beechinor DNP APRN(BC) The purpose of this study was to describe and compare the demands of immigration on nurses from Canada and those from the Philippines, who immigrate to the USA and work in Hawaii. The findings can assist policy-makers in formulating plans to alleviate the shortage of nurses through effective immigration recruitment practices. Nurse educators can gain support for the recruitment of students from a diverse array of cultures. Managers and nursing leaders can use this information in designing recruitment, orientation, support and retention programmes for nurses that are specific to their cultural needs. The two groups of nurses were sampled from acute care staff nurse populations in Hawaii. Aroian's instrument, the Demands of Immigration scale, was used to measure and compare the distress levels of the nurses. The findings include a higher level of distress experienced by nurses from Canada compared with nurses from the Philippines. This might be attributed to a preponderance of social and collegial support available to the Philippine nurses in Hawaii where one-fourth of the population is derived from their country of origin. [source] Association Between Cognitive Function and Social Support with Glycemic Control in Adults with Diabetes MellitusJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2009Toru Okura MD OBJECTIVES: To examine whether cognitive impairment in adults with diabetes mellitus is associated with worse glycemic control and to assess whether level of social support for diabetes mellitus care modifies this relationship. DESIGN: Cross-sectional analysis. SETTING: The 2003 Health and Retirement Study (HRS) Mail Survey on Diabetes and the 2004 wave of the HRS. PARTICIPANTS: Adults aged 50 and older with diabetes mellitus in the United States (N=1,097, mean age 69.2). MEASUREMENTS: Glycosylated hemoglobin (HbA1c) level; cognitive function, measured with the 35-point HRS cognitive scale (HRS-cog); sociodemographic variables; duration of diabetes mellitus; depressed mood; social support for diabetes mellitus care; self-reported knowledge of diabetes mellitus; treatments for diabetes mellitus; components of the Total Illness Burden Index related to diabetes mellitus; and functional limitations. RESULTS: In an ordered logistic regression model for the three ordinal levels of HbA1c (<7.0, 7.0,7.9, ,8.0 mg/dL), respondents with HRS-cog scores in the lowest quartile had significantly higher HbA1c levels than those in the highest cognitive quartile (adjusted odds ratio=1.80, 95% confidence interval=1.11,2.92). A high level of social support for diabetes mellitus care modified this association; for respondents in the lowest cognitive quartile, those with high levels of support had significantly lower odds of having higher HbA1c than those with low levels of support (1.11 vs 2.87, P=.02). CONCLUSION: Although cognitive impairment was associated with worse glycemic control, higher levels of social support for diabetes mellitus care ameliorated this negative relationship. Identifying the level of social support available to cognitively impaired adults with diabetes mellitus may help to target interventions for better glycemic control. [source] Crossing boundaries, re-defining care: the role of the critical care outreach teamJOURNAL OF CLINICAL NURSING, Issue 3 2002MAUREEN COOMBS BSc MSc PhD RN ,,There is clear indication that both government and professional policy in the United Kingdom supports a radical change in the role of healthcare practitioners, with a move towards a patient-focused service delivered by clinical teams working effectively together. ,,Recent health service imperatives driving the agenda for flexible clinical teams have occurred simultaneously with an increased public and political awareness of deficits in availability of critical care services. ,,Against this policy backdrop, working across professional and organizational boundaries is fundamental to supporting quality service improvements. In the acute care sector, the development of critical care outreach teams is an innovation that seeks to challenge the traditional support available for sick ward patients. ,,Activity data and observations from the first 6-month evaluation of two critical care outreach teams identify the need for clinical support and education offered by critical care practitioners to ward-based teams. ,,The experiences from such flexible clinical teams provides a foundation from which to explore key issues for intradisciplinary and interdisciplinary working across clinical areas and organizational boundaries. ,,Adopting innovative approaches to care delivery, such as critical care outreach teams, can enable clinical teams and NHS trusts to work together to improve the quality of care for acutely ill patients, support clinical practitioners working with this client group, and develop proactive service planning. [source] The contribution of social support to the material well-being of low-income familiesJOURNAL OF MARRIAGE AND FAMILY, Issue 1 2005Julia R. Henly We hypothesize that the social support available from low-income networks serves primarily a coping function, rather than a leverage function. Social support and its relationship to material well-being is assessed in a sample of 632 former and current welfare recipients. Respondents report higher levels of perceived emotional, instrumental, and informational support than perceived financial support, and received financial aid is particularly uncommon. Multivariate findings demonstrate that perceived support is unrelated to employment quality, but it reduces the likelihood of living in poverty and is associated with three different measures of coping. These findings generally support the contention that informal aid is important for the everyday survival of low-income families, but is less able to assist with economic mobility. [source] Providing support to siblings of hospitalised childrenJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2010Amanda S Newton Abstract The purpose of this study was to describe child life services provided to siblings of hospitalised children and the resources associated with these services in major paediatric hospitals throughout the United States (U.S.) and Canada. Cross-sectional data on sibling support services and resources needed for capacity building were collected via a web-based survey from administrative and clinical practice leads in identified Child Life Departments. The 34-item survey targeted three domains: Facility Demography, Sibling Support Resources, and Capacity Building and Funding. Surveys were sent to 217 leads and 109 responded (50% response rate). Of the 109 respondents, 48% indicated their facilities provided sibling support including grief or palliative support (90% of facilities) and therapeutic play (94% of facilities). More than 50% indicated that these services were not evaluated for improved family or sibling outcomes. Twenty-six percent of the respondents indicated having monies earmarked for sibling support from the following sources: hospital budget (34%), private donation (25%), foundation (22%), other (14%) and government (4%). There was a significant relationship between respondents who indicated sibling support services and funding (,2= 0.0001). Resources identified included staff availability and funding as needed for sibling support capacity building. Given the limited sibling support available in major paediatric hospitals across the U.S. and Canada, hospitals with existing resources should act as exemplars and evaluate the impact of their services with clear dissemination to other facilities. In addition to defining service effectiveness, this evaluation can help to determine the most fiscally responsible ways to deliver sibling support in their established facilities and others. [source] An educational evaluation of supervisor and mentor experiences when supporting Primary Care Graduate Mental Health WorkersJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2009N. HARRISON ma pgdip cogth pgdip pc couns pgdip ed ba(hons) dpsn rgn rmn This paper reports on the findings of a postal survey used to enhance understanding into the backgrounds, experiences and support offered to supervisors and mentors of Primary Care Graduate Mental Health Workers (PCGMHWs). A postal questionnaire was sent to the total population of supervisors and mentors who had supported PCGMHW students from three universities in the Northwest of England, during the period of their introduction 2004,2006. Most supervisors and mentors had previous experience of supervision and mentorship with other types of students but not PCGMHWs. Data suggest that there were difficulties due limited understanding of the role of PCGMHWs and how it was to be operationalized. Respondents reported staff shortages, time constraints and competing commitments, which limited support available to students. The lack of organizational readiness and infrastructure to support the role was widely reported. However, the role has developed and is generally well received. The implications for future development of the PCGMHW and the preparation and support of supervisors and mentors are discussed. [source] Living with severe osteoarthritis while awaiting hip and knee joint replacement surgeryMUSCULOSKELETAL CARE, Issue 2 2009Cert HSM, Gail Elizabeth Parsons MSc Abstract Objectives:,To explore the lived experiences of patients with severe osteoarthritis (OA) of the hip or knee joint while awaiting joint replacement surgery. Methods:,An exploratory qualitative approach using phenomenology was adopted for the purpose of the study. Unstructured interviews were carried out on a sample of six patients who had been referred to the National Health Service waiting list for a primary hip or knee replacement. The participants were invited to share their experiences and concerns relating to how they were coping with end-stage OA of their hip or knee joint. Interviews were digitally recorded and transcribed verbatim. Narrative data were analysed using Giorgi's (1985) procedural steps to reveal themes which recurred in the participants' stories. Results:,Six themes emerged from the data, central to the experience of living with severe OA. They were: coping and living with pain; not being able to walk; coping with everyday activities; body image; advice and support available; and the effect of their disease upon family, friends and helpers. There were also a number of sub-themes associated with each major theme. Conclusions:,This study suggests that there is an absence of generic support, guidance and information relating to the management of symptoms of OA for individuals awaiting hip and knee replacement surgery. Patients awaiting hip and knee joint replacement surgery often have difficulty in managing their symptoms. Support in general appears to be dependent on the availability of resources in the primary care setting. Potential patients who are fortunate to know or meet someone who has undergone a similar procedure learn from the experience of exchanging information between themselves, along with coping strategies in the management of their symptoms. Copyright © 2008 John Wiley & Sons, Ltd. [source] The Edinburgh Principles with accompanying guidelines and recommendationsJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 3 2002H. Wilkinson Abstract A panel of experts attending a 3-day meeting held in Edinburgh, UK, in February 2001 was charged with producing a set of principles outlining the rights and needs of people with intellectual disability (ID) and dementia, and defining service practices which would enhance the supports available to them. The Edinburgh Principles, seven statements identifying a foundation for the design and support of services to people with ID affected by dementia, and their carers, were the outcome of this meeting. The accompanying guidelines and recommendations document provides an elaboration of the key points associated with the Principles and is structured toward a four-point approach: (1) adopting a workable philosophy of care; (2) adapting practices at the point of service delivery; (3) working out the coordination of diverse systems; and (4) promoting relevant research. It is expected that the Principles will be adopted by service organizations world-wide, and that the accompanying document will provide a useful and detailed baseline from which further discussions, research efforts and practice development can progress. [source] | ||||||||||