Family Caregiver Communication in the ICU: Toward a Relational View of Health Literacy

We interviewed 18 family caregivers about their communication experiences in the ICUs at an urban hospital. Analysis of their narratives suggests health literacy is important in family caregiver/healthcare provider communication, especially as complicated illnesses move the caregiver deeper into decision making. Using the domains of Yuen et al.’s conceptual model of caregiver health literacy (2015), we identified three themes within the context of ICU communication: agency, coordinated communication, and caregiver’s evolving role. We saw family caregivers negotiating domains of health literacy as they built upon knowledge of the patient’s needs, their rights as family caregivers, and the hierarchy of the professional staff. We found that these narratives represent co-created, or relational communication, rather than individual health literacy skills. Conceptualized in the transaction of relationship, health literacy is enacted; it is socially constructed and is the scaffolding upon which family caregivers make decisions, care for their loved one, and care for themselves.     

The Development of a Reliable Change Index and Cutoff for the Revised Dyadic Adjustment Scale

The Revised Dyadic Adjustment Scale (RDAS; Busby, Crane, Larson, & Christensen, 1995) is a measure of couple relationship adjustment that is often used to differentiate between distressed and non‐distressed couples. While the measure currently allows for a determination of whether group mean scores change significantly across administrations, it lacks the ability to determine whether an individual's change in dyadic adjustment is clinically significant. This study addresses this limitation by establishing a cutoff of 47.31 and reliable change index of 11.58 for the RDAS by pooling data across multiple community and clinical samples. An individual whose score on the RDAS moves across the cutoff changes by 12 or more points can be classified as experiencing clinically significant change.     

Developing an undue influence screening tool for Adult Protective Services

The study purpose was to develop and pilot an undue influence screening tool for California’s Adult Protective Services (APS) personnel based on the definition of undue influence enacted into California law January 1, 2014. Methods included four focus groups with APS providers (n = 33), piloting the preliminary tool by APS personnel (n = 15), and interviews with four elder abuse experts and two APS administrators. Social service literature—including existing undue influence models—was reviewed, as were existing screening and assessment tools. Using the information from these various sources, the California Undue Influence Screening Tool (CUIST) was developed. It can be applied to APS cases and potentially adapted for use by other professionals and for use in other states. Implementation of the tool into APS practice, policy, procedures, and training of personnel will depend on the initiative of APS management. Future work will need to address the reliability and validity of CUIST.     

Gaining by giving? Peer research into service user and carer perceptions of inclusivity in Higher Education

Abstract

Service users and carers (SUAC) have made significant contributions to professional training in social work courses in Higher Education (HE) over the past decade in the UK. Such participation has been championed by government, academics and SUAC groups from a range of theoretical and political perspectives. Most research into the effectiveness of SUAC involvement at HE has come from the perspectives of academics and very little SUAC-led research exists. This qualitative peer research was led by two members of the University of Worcester’s SUAC group. Findings were that SUAC perceived their involvement brought benefits to students, staff, the University and the local community. Significant personal benefits such as finding a new support network, increased self-development and greater confidence to manage their own care were identified in ways that suggested that the benefits that can flow from SUAC involvement at HE are perhaps more far-reaching than previously recognised. Barriers to inclusion were less than previously reported in the literature and the humanising effects of SUAC involvement are presented as a partial antidote to an increasingly marketised HE culture.     

The Love Ethic: A Radical Theory for Social Work Practice

Love is marginalised in professional social work codes of ethics in Australia and internationally. Yet, reflecting the emancipatory imperative of social work, feminist bell hooks promotes love as a political process to transform systems of injustice such as capitalism, patriarchy, and racism. Analysing the works of hooks and other relevant literature, this article discusses “the love ethic”, a model of relationship-oriented activism encompassing dialogue, nonviolence, interconnectedness between people and between people and nature, reflexivity, shared power, and solidarity. It provides some practical suggestions for love-based social work practice, such as self-forgiveness, pursuing gender-equal relationships, upholding fair workplace conditions, honouring Indigenous peoples, supporting oppressed people to assert their rights, connecting local and global action, nurturing symbiotic relationships with nature, and supporting empowering spiritualities. The love ethic supports radical social workers to engage in activism, and necessitates further exploration within academia and practice.     

Relationships between Economics,Welfare, Social Network Factors,and Net Migration in the United States

By using economics, welfare and social network factors as frames of reference, this study aims to explore the relationship between these three factors and net migration to various US states. Adopting related variables collected from official aggregate data, this study first utilizes Logit Regression analysis to draw out seven variables that best explain net migration to the various states, then employs these variables in LISREL analyses to build a model explaining the factors influencing net migration to the various US states. Concretely, this research obtained the following findings: (1) the seven variables ‐‐ the average rate of net migrants of 2002–2005, Medicaid, federal aid, employment rate, non‐poverty population rate, and SSI subsidy ‐‐ all significantly affected (p < 0.01 or p < 0.05) net migration in 2006; (2) the main influences on net migration for the various states are, from highest to lowest, social network, economic, and welfare factors. More specifically, a better explanation is that, through the social network factor, economic and welfare factors exert an increased influence on the net number of migrants; and (3) as for the influence of social network factors on the number of net migrants, the social network factor for the previous year was found to best explain domestic migration flows, while the social network factor for the previous three‐to‐four years best explained international migration flows.     

Lesbian Identity Management at Various Stages of the Coming Out Process: A Qualitative Study

This qualitative study is designed to explore how women at various stages of lesbian identity development make decisions about managing their identities. Management of identity was studied in terms of how women came out or stayed hidden and how they made decisions both to disclose and to conceal. The Cass (1984) Stage Allocation Measure was used as a means to categorize women at various stages of lesbian identity development. Twenty-five adult women were individually interviewed using a semi-structured interview schedule. A journal was kept by each woman for one month. The major findings indicated that women at different stages of lesbian identity development use both disparate and similar identity-management and decision-making strategies. Underlying and connecting lesbian identity management and development was the need to maintain self-esteem and safety.     

Managing urban wetlands for multiple use: research,restoration, and recreation

Conservation of urban wetland habitat is challenging, because multiple uses must coexist. We use examples from California and Wisconsin to describe potential synergies among recreation, restoration and research activities (the 3 R's). Allowing passive recreation is often essential to garner public support for habitat protection, restoration, and research. In turn, restoration activities can improve the appearance of degraded sites, and designing the work as a research experiment can serve the scientific community. Two projects at Tijuana Estuary support the 3 R's. (1) Oneonta Tidal Linkage is a 0.7-ha tidal channel and salt marsh that was excavated from disturbed upland to bring wetland habitat closer to the Visitor Center (thereby reducing visitor intrusion into natural marsh habitat, where endangered species would be disturbed). It supports an ambitious field experiment that is testing the importance of species diversity in restoration; it also includes a bridge that serves the interpretive program, and it adds 0.7 ha of wetland habitat that helps restore regional biodiversity. (2) A larger excavation (8 ha) of former tidal wetland will soon add wetland habitat, while testing the importance of tidal creek networks in ecosystem functioning and offering views and interpretive opportunities. A third situation, at the 485-ha University of Wisconsin–Madison Arboretum, concerns restored wet prairies, which provide habitat for native species and serve many hikers. Urban stormwater flows into and degrades the Henry Greene Prairie, allowing aggressive plants to invade. Research and restoration efforts are planned to sustain the habitat and recreation functions. These three models suggest that recreation, restoration, and research are compatible uses of urban wetland habitats.