Quality of life in the evaluation of community support systems

As a result of the authors' experience in conducting an evaluation of the community support system (CSS) program in New York State, they have identified five reasons for focusing on quality of life (QOL) as a desired outcome for programs for the chronically ill. These reasons are presented and problems in QOL evaluative research are discussed. Psychological indicators are distinguished from social indicators of QOL, and two methods of operationalizing perceived QOL, the psychological well-being and life domains methods, are examined. A conceptual model is presented and the results of an exploratory study of the QOL of 118 chronic psychiatric patients receiving CSS services are presented.     

Inpatient psychiatric treatment of the difficult child: Common practices and their ethical implications

This article reviews and discusses the available research literature pertaining to the prevalence of seclusion and restraint procedures in inpatient psychiatric treatment facilities for children and adolescence. The rationales for use, potential effects, and factors found to influence the application of these more extreme clinical interventions are considered. The author suggests that the supposed therapeutic function of these types of practices has not been substantiated and their implementation can vary widely from one setting to another. Results from several studies suggest that clearly defined criteria for use and more observational studies of prevalence and precipitant factors could considerably refine these procedures and reduce potential abuses. The psychopharmacologic approach to the treatment of difficult children is examined as a sophisticated counteraggression strategy which has yet to demonstrate therapeutic efficacy. These clinical procedures, which are utilized in scores of inpatient settings, generate serious ethical questions for the health professional concerned with the legal rights of those minors labeled as deviant members of families or the society at large.     

The protestant work ethic,human values and attitudes towards taxation

The literature on demographic determinants of attitudes towards taxation was briefly reviewed. Whereas most previous concerned the relationship between such things as income, vote etc. and tax attitudes, this study examined the relationship between Protestant Work Ethic beliefs, social value systems and attitudes toward taxation. It was demonstrated that subjects who strongly endorsed the Protestant Work Ethic were more opposed to taxation than those who did not strongly endorse these beliefs. Further many of the instrumental and terminal value systems of subjects who were pro-taxation were significantly different from those who were anti-taxation. The results are discussed in terms of the psychology of lay-economic beliefs and implications for social change were noted.     

The subjective well-being of mental patients in nursing homes.

This article reports a survey of self-reports of well-being by chronic mental patients in nursing homes. Patients reported lower levels of well-being than the general population, but not lower than other socially disadvantaged groups including urban renewal blacks. Nursing home mental patients reported levels of well-being that were generally similar to mental patients in other settings, including day hospital patients, participants in an innovative community care program, and patients receiving traditional hospital and follow-up care. These reports were mostly unrelated to levels of symptomatology or social integration, but were strongly related to patient perceptions of the quality of the environment. Results have important implications concerning the justifications for community care goals like noninstitutional care, reduction of symptomatology, and the fostering of social integration.     

The dysfunctional side effects of quantitative indicator production: illustration from mental health care (a message from Chicken Little)

In the current context of economic conservation, accountability and retrenchment from social programs, justification is required in order to maintain human service capacity. In this effort, evaluation is a key component. Yet desire to base action upon information resulting from evaluation must be tempered by increased attention to the effects of the evaluation process. All too often premature application of quantitative indicators formerly used for individual assessment and research to bureaucratic decision making produces side effects that are dysfunctional in nature. Frequently these side effects influence service delivery directly. More insidious, because they are less easily discerned, are distortions introduced into the data by evaluation pressure. These not only delay effects on service but also impair understanding of the very process they are meant to illuminate. In order to illustrate this phenomenon, the author reviews a general literature and utilized examples from mental health care. Common themes are identified and a tentative theory of side effect generation proposed.     

The conduct of program evaluation reviews in the general accounting office

Professional behavior during the General Accounting Office's (GAO's) present era of oversight can best be understood by reviewing the audit types that populate village life in the GAO and the repertoire the office uses in conducting program evaluation audits. Four types of auditors are present, each of which has a role to play in the audit repertoire. This repertoire focuses on finding faults in government programs in order to catch or sustain congressional interest in GAO's work. The “audit trail” of each report may last up to 3 years and involves considerable organizational strife and conflict with outside groups. To sustain themselves through this arduous auditing process, auditors have developed a creed through which they conceptualize themselves as an elite with a mission to insure good government.     

The use of the psychosocial maturity inventory in evaluations of youth conservation corps programs

Although work experience has been widely recommended as beneficial to adolescent development, there is little empirical support for this recommendation. The Youth Conservation Corps (YCC), combining as it does some of the best features of both paid work and unpaid community service, offers an opportunity to explore the developmental impact of work experience. However, the need to pay as much attention to the problems of measurement as to the programs themselves dictates simultaneous evaluation of both programs and measures.     

The influence of acculturation level and family relationships on quality of life among U.S. Chinese older adults

ABSTRACT

The present study examined the influence of acculturation level and family relationships (i.e., positive family support and negative family strain) on quality of life (QOL), using the data from the Population Study of ChINese Elderly (PINE) in Chicago (N = 3159). Controlling for sociodemographic variables and health status, it was found that individuals’ acculturation level and positive family support were positively related to QOL, whereas negative family strain was negatively associated with QOL. More importantly, higher acculturation levels were associated with increased protective effects of positive family support and reduced risk effects of negative family strain on QOL among U.S. Chinese older adults.     

The impact of general accounting office program evaluations on government

General Accounting Office (GAO) audit reports have an impact on government operations by encouraging growth in the size and scope of the state and by encouraging the Congress and executive agencies to attend to the auditor's dominant values of economy, efficiency, and effectiveness in government. Through its financial, management, and program audits, the GAO program evaluators seek to rationalize agency management and programs so that more resources are required. The GAO's program evaluation efforts also serve Congress by providing for oversight of public policy, a bludgeon to coax agencies into pursuing activities preferred by congressmen, and a tool for electoral activities. In the end, the evaluation auditors are doomed to frustration in achieving their ideals for effective democratic government. This is so because “practical business policy” is irrelevant to government operations and inconsistent with the core values of a democratic state.     

The operation was a success but the patient died: A critique of “the implementation and evaluation of a problem-solving training program for adolescents”

This critique examines George S. Tellado's account of his evaluation of a problem-solving program for adolescents in a public junior high school in Pennsylvania. The program was apparently successful (i.e., it was shown by the evaluation to improve students' problem-solving capacities), and the evaluation was, for the most part, technically sound, but the program did not survive. This critique suggests that by examining the problem-solving program as an organizational change intervention, several problems can be uncovered regarding the program's design, implementation, evaluation, and institutionalization. In particular, it appears that the school system's staff did not have sufficient ownership of the program to understand it or to wish to carry it on after the program's originator and evaluator were no longer present. This article addresses these problems in detail and recommends techniques from the field of organizational change consultation to increase the likelihood that such programs will live on into the future.