Health of Carers of Young People with Early Psychosis: A Biopsychosocial Approach

Despite widespread recognition of the usefulness of a biopsychosocial approach in social work, there are limited studies exploring how social workers can use this approach to support the health and wellbeing of carers of young people with first episode psychosis (FEP). Validated questionnaires and anthropometric measures were used to assess the physical health and wellbeing of 42 carers of young people with FEP. Carers had moderate levels of negative caregiving consequences, quality of life, and health status. More than half (52.4%) of carers were experiencing social isolation. Many carers were overweight (78.6%), had a high risk for type 2 diabetes (39.0%), and had hypertension (33.3%). Practical implications of a biopsychosocial approach to social work that supports both clients and their carers are discussed.     

“The only equality is the pain”: An exploration of the Irish policy sphere's approach to “access” and “entitlement” in health care

This paper critically analyses how overarching policy goals and practices surrounding access and entitlement to health care (HC) have been dominated by a conflicting system of libertarian and equity-based principles. We examine how this mixed-motives system originated and the importance of policy legacies inherited from the Poor Laws era in shaping modern conceptions of access and entitlement to HC. We also considered how these determined the scope of state intervention in this policy domain. Drawing on empirical evidence and interviews with key stakeholders in Irish health policy, we explored the appetite to engage in meaningful HC reforms that address the growing gaps of inequity between higher and lower socio-economic groups in society. Rather than emulating European counterpartsapos; emphasis on universal coverage within an egalitarian paradigm, Irish policy actors have sought to instill a spirit of fairness in HC delivery. Under the guise of equality of opportunity and equity, the policy focus has centred on directing publicly funded HC towards lower-income groups and the most vulnerable in Irish society. However, we argue that the operation of the mixed-motives structure has also created conflict and policy ambiguity surrounding overarching goals which frame the governance and consumption of HC in Ireland. This is evidenced by the dysfunction and complexity of the two-tier system of public-versus-private access to HC services. Ultimately, we argue that the policy aspirations of equality that underpin the HC structures surrounding access and entitlement should be revisited to achieve greater health outcomes and create a more equal society.     

Preference for caesarean and attitudes toward birth in a Chilean sample of young adults

BackgroundLittle empirical research exists about what motivates birth mode preferences, and even less about this topic in Latin America, where obstetric interventions and caesareans are some of the highest worldwide.AimTo identify factors associated with caesarean preference among Chilean men and women who plan to have children and to inform childbirth education and informed consent procedures.MethodsAn online cross-sectional survey measuring attitudes toward birth was administered to graduate students at a large public university in Chile. Eligible students were under the age of 40 and had no children but intended to have children. Logistic regression modelling was used to determine which sociodemographic factors, knowledge and beliefs were associated with caesarean preference.FindingsAmong eligible students, 730 responded and 664 provided complete answers to the variables of interest. Respondents had a mean age of 28.8; 38% were male and 62% female. Positive attitude toward technological intervention (Odds Ratio 7.4, 95% Confidence Interval 3.9–14.0), high risk perception of vaginal birth (Odds Ratio 1.8, 95% Confidence Interval 1.1–2.8), family history of caesarean (Odds Ratio 1.9, 95% Confidence Interval 1.0–3.8) and high fear of birth (Odds Ratio 3.7, 95% Confidence Interval 2.0–6.8) were associated with caesarean preference.DiscussionPreference for caesarean birth was highly associated with positive attitudes toward technological intervention and may be related to a lack of knowledge about the realities of caesarean and vaginal birth.ConclusionsPatient-centered education on the relative benefits and risks of birth modes has the potential to influence preferences toward vaginal birth.     

“I wish someone would explain why I am in care”: The impact of children and young people's lack of understanding of why they are in out‐of‐home care on their well‐being and felt security

Having a good understanding of one's origins and history is known to be significant in identity development. Drawing on a large‐scale online survey of looked after children's subjective well‐being, this paper demonstrates that a significant number of children and young people (age 4–18 years) did not fully understand the reasons for their entry to care. The paper explores the effect of this lack of knowledge on children's well‐being and on their feelings of being settled in their current placement. The study reiterates the need for professionals to be honest and open with children in out‐of‐home care and the need to specifically address, perhaps repeatedly, why a child is not living with their birth family.     

Stillbirth in Australia 6: The future of stillbirth research and education

The first five papers in the Stillbirths in Australia series have described the current state of stillbirth research and education in Australia, as well as the national approach being adopted to prevention. This final paper in the series asks ‘where to from here?’. What does the next 5–10 years hold for those of us working in this field and how much more can be achieved? There are signs that we are moving in the right direction with a national prevention program about to rollout to add to the gains of the last two decades, and evidence of a more consistent approach to bereavement care. However, we must sharpen our equity lens and ensure that all groups are included in these efforts.     

Examining collaboration across organizations in an age-friendly community

ABSTRACT

Collaboration among organizations is fundamental to promoting age-friendly environments. This study questions: To what extent do organizations collaborate with other organizations in age-friendly communities to provide services to older adults? This study draws on 48 semi-structured qualitative interviews with representatives of organizations that provide services to older adults in an age-friendly community. Findings demonstrated that organizations can engage in collaboration and cooperation across multiple sectors of service delivery and across multiple types of organizations. Nevertheless, some organizations were not collaborating; older adults receiving services at these organizations may miss opportunities to connect to complementary services that can meet their holistic needs.     

The dual contingencies of ethnoraciality: Status-context disparities in health information sources among sexual minorities

Researchers often explore health (care) beliefs as a function of individual characteristics; yet, few consider the role of context in shaping both beliefs and the behaviors that are informed by them. As a sociopolitical construct, ethnoraciality provides a concerning source of bias in studies of health (care) beliefs because it inhabits both individual and contextual forms. This study examines whether the ethnoracial context of the residential area where sexual minorities live is associated with a particular health (care) belief – sources of trustworthy health information – and considers how ethnoracial group membership status differentiates these ecological associations drawing on mediation and moderation models. Using data from the 2010 Social Justice Sexuality Project, our analysis shows that sexual minorities who live with high concentrations of Latinos and Whites are less likely to rely exclusively on medical professionals for trustworthy health information than those who live with high concentrations of Blacks. Moreover, exclusive reliance on medical professionals for health information among Black and Latino sexual minorities is stronger in co-ethnic communities (predominately Black and Latino areas, respectively). The analysis also documents status and contextual differentials and status-context contingencies of reliance on the Internet, social networks, and multiple agents (“triangulation”) as sources of health information. Findings suggest that place-based co-ethnic networks may facilitate disease prevention among Black and Latino sexual minorities by improving the quality of their relationships with sick role gatekeepers and breaking down the silos of the medical complex. The study concludes by considering the value of a place-based approach to alleviating health disparities among sexual minorities vis-à-vis the health care system.