Life values,family support and psychosocial adaptation among older people in Taiwan: an institutional and community comparison

The purpose of this study was to investigate the psychosocial adaptation among elderly persons in institutional and community settings, and to explore factors influencing their adaptation. A cross-sectional survey was conducted with a convenience sample of 165 residents of four institutions (two assisted-living facilities and two nursing homes) and 209 community-dwelling elders served by a primary care centre, all located in middle Taiwan. A structured interview questionnaire was used to collect data. Results: community-dwelling elderly had significantly higher adaptation scores than those in institutional settings. Factors related to adaptation differed between institutional and community settings, with more variables influencing adaptation in the community than in the institution. Physical functional status was the major influence on adaptation of the elderly in institutions. Dietary support from family was negatively associated with adaptation in this group. Influencing factors for community-dwelling elders were more complicated, including perceived family emotional and economic support, personal life values and physical functional status. Implications: greater support from government, including economic resources and assistance in community care are needed to achieve the policy goal of ‘aging in place’. Further investigation of the influence of family interaction on elders' adaptation is needed.     

Alcohol Use and Abuse in Old Age:

Alcohol use and abuse among the elderly is a serious problem surrounded by confusion. Traditionally older problem drinkers have been divided into two categories: Type I, individuals who have drunk excessively throughout life yet survived to old age and Type II, individuals whose problem drinking began late in life. An extensive renew of the research produced some paths to late-onset problem drinking but only a weak profile of the Type II alocholic. Popular situational factors purported to be the triggers for late-onsest abuse have mixed support and no clear causal theory has yet been delineated. A number of alternative theories deserve further attention. Current information does not support the usefulness of the Type II classification or traditional definitions of alcoholism for the late-onset abuser. Research and treatment efforts may need to be redirected to include male-female differences, and family conflicts with less emphasis on the disease model of alcoholism.     

Attitudes to prioritization in selected health care activities

The aim of this study was to measure attitudes to health care prioritization in various Finnish population groups. Three study groups were established: 1) the general public (n=4260); 2) politicians (n=1427); and 3) medical and social work professionals (n=1055).
The following background data were obtained: sex, year of birth, marital status, number of children, education, profession, personal income, self-perceived health, and how subjects viewed their own future and whether they were satisfied with their lives. Information on activities involving prioritization of health service was elicited by presenting a list of 16 health care activities. Respondents evaluated these activities as 1) more important than average, 2) of average importance, or 3) less important than average (indicated as numbers 1-3).
The response rate was 59.3%, and 57.2% (n=3858) of the original sample was accepted for analysis. The politicians and profes-sionals showed almost identical attitudes. All groups prioritized treatment of life-threatening diseases among children. The general public prioritized high-tech surgery more highly than professionals or politicians. Alternative medicine and cosmetic surgery were the two least important activities. All groups agreed about prioritization of serious diseases among children, care of dying patients, prevention, surgery which helps people to perform their everyday tasks, and home care for the disabled elderly. Professionals and politicians prioritized mental health more highly than the population. The general public prioritized intensive care for premature babies with a low birth weight (less than 800 g). Professionals prioritized family planning more highly than politicians and the population. The results resemble those obtained in Britain, indicating that attitudes towards priorities in health are similar between Britain and Finland, and that the respondents' professions determine attitudes more strongly than does cultural background.     

CARING CULTURE AND THE POLITICS OF PARENT/PROFESSIONAL RELATIONS

The study on which this paper was based explored parent/ professional relationships where disabled children were involved, and the underlying cultures which influence them. The paper seeks in part to relocate debate about parent/professional relations away from a mere instrumental view to the wider context of advancing understanding of social capital. Interestingly the study highlights some examples of relations consistent with a poststructuralist framework of power which unfolded within broadly patriarchal and capitalist structures more relevant to feminist critiques of human caring and ‘caring’ systems. Overall it shows the unequal structure of power arrangements in parent/professional relations, and indicates the possible benefits for caring and support systems of an approach which is less technically driven and hierarchical and more ‘horizontal’, personal and reciprocally based.     

Lessons Learned from Experiential Group Work Learning

This study evaluated the efficacy of student-led support groups designed to increase students' perceived knowledge of social group work. The student groups described here were based on theories of experiential learning described by Kolb and colleagues. The mixed-method evaluation used Clements' 17-item scale to measure readiness for group practice and narrative journal entries submitted by students about their experiences in the class. This was part of a larger study to determine whether student-led support groups decreased levels of stress among BSW students. Although limited in scope, this research suggests that student-led groups may improve BSW students' knowledge, skills, and readiness for group work practice.     

PERCEPTION OF SENIOR CENTERS BY THE BLACK ELDERLY

This study explored the impact of the neighborhood senior center on the black elderly by determining their perception of senior centers. Three groups of black elderly were interviewed: attenders of a neighborhood senior center (n = 46), non-attenders in the same community (n = 33), and non-attenders in a comparable community without a neighborhood senior center (n = 27). A 29-item interview schedule was conducted that determined awareness of senior center activities and services. Significant differences were found among the three groups with the attenders and non-attenders in the same community having the highest level of awareness of senior center activities and services. Age, sex and marital status were not found to influence perception of senior centers. The findings suggest that the neighborhood senior center needs to be further examined as a model for serving minority elderly.     

SOCIAL WORK WITH GROUPS IN THE GENERIC BASE OF SOCIAL WORK PRACTICE

Social work with groups in generic practice requires more integration of group process theory and group work methodology in relation to two questions: What is important for all social workers to know about groups and group work and when is the group the most appropriate method-of-choice in generic practice? Important premises and knowledge for this practice are the relationship of the individual to the group; the small group as a microcostic social system; and especially, the stages of group development. This knowledge base and the understanding of the "curative factors" or "change mechanisms" in groups is suggestive of the selective use of groups for providing services in generic social work practice.     

THE USE OF SOCIAL SERVICES BY BLACK AND WHITE ELDERLY

Little is known about the roles of the family, kin, and non-kin support networks in determining the use of social services by the elderly. The purpose of this study was to examine the role of the formal and informal support systems in explaining social service utilization by Black and White elderly. Path analytic procedures are used to test an explanatory model of utilization by a national area probability sample of 3.996 non-institutionalized elderly. The findings indicate that informal family support was more important for Black elderly than White elderly. In addition, family aid was found to be supplementary rather than an alternative support system. In the planning, designing, and delivery of social services to the elderly, it is imperative that racial and cultural differences become explicit input factors. Additionally, future researchers have a responsibility to employ research procedures capable of simultaneously dealing with a comprehensive range of variables in investigating this rather complex phenomenon.     

They're Cool: Social Status and Peer Group Supports for Aggressive Boys and Girls

This study examined who among the 526 fourth to sixth graders are nominated as among the coolest kids in their class. There were two questions: (1) Are popular‐aggressive (tough) children nominated as cool by a broad spectrum of their peers, or only by a select few? (2) Does variability in children’s cool nominations more closely follow their individual characteristics or group affiliations? Three‐level hierarchical linear modeling (nominators in groups in classrooms) tested the study hypotheses. The main finding was that children in aggressive groups nominated tough peers as cool and children in nonaggressive groups nominated popular‐nonaggressive (model) peers, regardless of nominators’ individual characteristics or the prominence of their groups across diverse classroom contexts. Girls were proportionately more likely to nominate tough than model boys, but only a minority (less than 25 percent) of relatively aggressive girls nominated any boys as cool. Findings indicate that normative boy and girl peer cultures give broad reputational support to some aggressive children.     

STUDENT POVERTY AT THE UNIVERSITY OF BALLARAT

This article draws together the findings of two recent studies at the University of Ballarat which suggest that poverty is experienced among a considerable minority of students. In a pilot study of 54 students and a phenomenological study of 17 students, different ways of measuring poverty were considered: the Poverty Line, dependence on a government allowance, cultural criteria and self‐perception. It was found that undertaking part‐time work failed to protect students from poverty, with significant indebtedness affecting all. Those under the Poverty Line were more likely to be young and male and less likely to be living in a family. Poor students saw their well‐being and self‐worth affected by poverty as they struggled to escape a cycle of indebtedness and risked academic standards by working longer hours.     

THE GROPE FOR GROUP

There has been an apparent increase in the use of social work groups for clinical purposes. This trend has neglected the more traditional and important use of groups for community change goals. Even when working with clinical groups, community goals can be impacted. This article suggests a specific methodology for integrating group treatment goals with community action. It suggests that group workers view their role as instigators in broadening community support and action around clinical group work issues; that agencies need to make time to do this; that how group workers connect group work to community action needs to be empirically demonstrated with each service act.     

Group leaders’ experiences in heterogenous grief support groups

Group processes in social work are complex. In this article, the authors examine how Norwegian leaders experience these processes during their grief support group work. The authors take a qualitative approach, specifically semistructured interviews. Seven group leaders participated. Using qualitative content analysis, the authors found new and supporting information as presented in two inter-related themes: (1) Achieving cohesion is a challenging balance and (2) Facilitating the group activity is linked to group leaders’ engagement and competence. The authors suggest that group work is enhanced by well-qualified leaders paying attention and understanding toward the ongoing group processes, homogenous groups, prescreening, individual timing, and group cohesion.     

A Different Kind of Holding Environment: A Case Study of Group Work with Pediatric Staff

ABSTRACT

This paper reports a nearly two-year intervention with staff at a major urban pediatric facility. The authors worked as trainers and consultants for two groups–the Emergency Department (ED) and Chronic Care units (CC). Following two days of training about grief and loss, highlighting skill building for work with traumatized and grieving children and parents, the consultants worked to develop teams which could provide a Winnicottian holding environment for staff. The efficacy of this staff training is analyzed and support needs of staff members are identified. Findings include varied willingness to make use of group support. Chronic care participants are more likely to express willingness to engage in on-going support for one another, while ED staff members seem to prefer structured, educational training and episodic support. The holding environment of the processing groups must be adapted to fit the needs of the medical sub-culture.     

Survivor of Suicide Loss Support Group Facilitators: Do Peers and Professionals Differ?

ABSTRACT

Suicide is a major public health issue affecting countless people each year worldwide. Support groups are one of the few resources available to survivors of suicide loss to aid the healing journey. This study examined differences among support group facilitators based on status as a peer, professional, or peer/professional. Differences emerged among the facilitator types, particularly on attitudes of group effectiveness, the role of sharing stories in the group, when loss survivors should attend, and who should facilitate groups. The results provide important insights about group facilitation differences, though further research is necessary to understand effective approaches. A degree in social work was the most common educational background for facilitators who identified as professionals. As social workers often facilitate groups or work alongside peers in the provision of support groups across a variety of areas, the findings provide insights regarding facilitation differences to which social workers may need to attend.     

A different kind of holding environment: a case study of group work with pediatric staff

This paper reports a nearly two-year intervention with staff at a major urban pediatric facility. The authors worked as trainers and consultants for two groups-the Emergency Department (ED) and Chronic Care units (CC). Following two days of training about grief and loss, highlighting skill building for work with traumatized and grieving children and parents, the consultants worked to develop teams which could provide a Winnicottian holding environment for staff. The efficacy of this staff training is analyzed and support needs of staff members are identified. Findings include varied willingness to make use of group support. Chronic care participants are more likely to express willingness to engage in on-going support for one another, while ED staff members seem to prefer structured, educational training and episodic support. The holding environment of the processing groups must be adapted to fit the needs of the medical sub-culture.     

FRIENDSHIP SKILLS

Children who are not adjusting to their environment because of poor peer relationship skills are well suited to group therapy. We have designed a short-term group treatment model for children with the limited focus of learning friendship skills. Each group consists of eight children (coed), between the ages of 9 and 11 working with two therapists for ten 1 1/2hr-sessions, twice a week for five weeks. The sessions are highly structured periods moving from less threatening, structured exercises/games to activities that require more personal interaction and trust. Following each activity the group verbally processes what happened.     

Towards Accountability in Social Work: Long Term Social Work in an Area Office

Summary This article reports the results of monitoring the social workof two long term teams in an area office throughout one yearwith the help of a computerized Case Review System. It describesthe characteristics of some 1,400 long-term cases of whom 61%were disabled, visually handicapped and/or elderly and 22% presentedproblems related to children and families. One of the outstanding features was the concentration on surveillanceand review visiting which was reported for nearly three quartersof these cases and was considered the most important socialworker activity in two fifths of them. In over half of theselong term situations no change was expected and nearly threequarters of the cases were to remain open indefinitely. Another striking feature was the somewhat uneven distributionof social work resources among the different problem groups.Although the physically disabled and/or elderly outnumberedthe child/family problems by two to one, they made up only 20%of the cases allocated to individual social workers, while almostall the child and family problems were allocated amounting to35% of all individual caseloads. But the disabled and elderlyreceived far more domiciliary services and aids to daily living. This exercise has brought into sharp focus the question of howto ensure continuous support and surveillance for the very frailelderly, as the occasional social work visit did not appearto be the appropriate means of support, rarely anticipatingor averting crises. The data highlight the challenge which chronically disorganizedand disturbed families present to social work skills. The outcomescast doubt on the wisdom of closing, within the intake stageas low priority, relatively early family problems, and on thesharp division into intake and long term teams. The general issue emerging is the need to formulate more precisesocial service strategies for those who require long term careby others to some extent—the very old and frail, the chronicallyphysically and mentally disabled and children in long term care—andwhat specific contributions social workers can usefully maketo this enterprise.     

Social Support and its Correlation with Loneliness and Subjective Well-being: A Cross-cultural Study of Older Nepalese Adults

Population aging in Nepal is a recent phenomenon, due more to demographic changes than to socio-economic development. The study had three goals: to analyze the social support exchange among elderly men and women; to discover the main sources of support in loneliness and subjective well-being in the elderly; and to study the cross-cultural differences in support among elderly Chhetri ( N  = 137, mean age = 69.1 [7.2] years) and Newar people ( N  = 195, mean age = 68.8 [7.7] years) in one ward in Kathmandu. The data were collected using face-to-face interviews. The dependent variables were loneliness and subjective well-being (SWB). The results for both ethnic Chhetri and Newar respondents show that their major support comes from their children living in the same household and their spouses. I conclude that the sources of social support and social support exchange are similar between the two castes/ethnicities and that there are no cross-cultural differences between them in terms of support for loneliness and SWB-life stability, although there are cross-cultural differences in their SWB-life satisfaction. Providing social support to friends and neighbors appears to be related to less loneliness and increased SWB in both castes/ethnicities.