Self-reported mental health problems and post-traumatic growth among children in Pakistan care homes

ABSTRACT

Children in care experience multiple risk factors, particularly in low-income countries such as Pakistan. The aim was to establish rates of mental health problems and their relationship with posttraumatic growth, as reported by 132 children aged 9–19 years, living in three care homes in Pakistan. Children reported high rates of posttraumatic stress (70.45%) and common mental health symptoms (43.94%) within the clinical range, but also high levels of posttraumatic growth. These findings highlight the high levels of mental health needs among children in residential care, as well as the importance of understanding factors that promote their posttraumatic growth and resilience.     

“It’s a Dignity Thing”: Nursing Home Care Workers’ Use of Emotions1

This article examines how nursing home care workers use emotions to construct dignity at work. Previous scholarship has shown how the financial and organizational characteristics of nursing homes shape and constrain emotion work among staff. Using evidence gathered during 18 months of participant observation in two nursing homes and 65 interviews with staff, this article analyzes how, despite obstacles, nursing home care workers generated authentic emotional attachments to residents. Surprisingly, some staff members said they particularly appreciated working with residents difficult to control. They felt accomplished when such residents successfully transitioned from life at home to life in institutional care. Emotions created dignity for staff and induced compliance among residents. Emotions are not only generated by organizations and imposed on workers; staff themselves produced emotions—sometimes in ways consistent with organizational demands, and sometimes not—and they consistently found in their emotions a resource to manage the strains of their work lives.     

PERSPECTIVES: THE EDITORS' VIEW

No abstract available for this article.     

Therapeutic alliance between youth and staff in residential group care: Psychometrics of the therapeutic alliance quality scale

Therapeutic alliance has been frequently studied in individual counseling sessions; however, research on therapeutic alliance in residential settings for youth with mental health diagnoses has been limited. This may be due, in part, to the presence of multiple service providers often in caregiving roles. The purpose of this study was to examine the psychometric quality of a widely utilized measure of therapeutic alliance used in psychotherapy with youth in residential care where the treatment is provided by a trained married couple. We also compared the relationship between youth ratings of their male and female service providers, as well as examined correlations in ratings between youth and staff on therapeutic alliance. Finally, we investigated the direction, magnitude, and trajectory of change in therapeutic alliance over a 12-month period following admission into residential care. The method was a longitudinal assessment of 135 youth and 124 staff regarding therapeutic alliance over the course of 12 months or discharge from services. Results indicated strong psychometric properties and high correlations for youth ratings of both their male and female service providers. However, the correlation was low between youth and service provider ratings of alliance. Longitudinal analyses indicated that rates of therapeutic alliance changed over time.     

Nursing Home Deficiency Citations for Safety

Deficiency citations for safety violations in U.S. nursing homes from 2000 to 2007 are examined (representing a panel of 119,472 observations). Internal (i.e., operating characteristics of the facility), organizational factors (i.e., characteristics of the facility itself), and external factors (i.e., characteristics outside of the influence of the organization) associated with these deficiency citations are examined. The findings show that nursing homes increasingly receive deficiency citations for resident safety issues. Low staffing levels, poor quality of care, and an unfavorable Medicaid mix (occupancy and reimbursement) are associated with the likelihood of receiving deficiency citations for safety violations. In many cases, this likely influences the quality of life and quality of care of residents.     

Every Object Tells a Story

ABSTRACT

The article considers objects and stories within the homes of Pakistani Heritage families who came from Pakistan to the UK in the 1950s and 1960s. The research team particularly explored the relationship between objects and family stories and timescales. Part of the research process involved an ethnographic inquiry exploring the stories told by the families. An exhibition was constructed from these stories and a website. The experience of migration, of the resettling of people and objects produced new kinds of stories in relation to objects, as families moved across national and transnational spaces. I highlight how a nuanced understanding of timescales can help illuminate studies of home cultures of migrant families. Notions of place and space are disrupted when possessions are left behind, and language is all there is left to recreate lost objects in old spaces. Longer timescales can be attached to objects that appear valueless when actual objects are lost or in transit. By making the timescales a focus for discussion, actual stories and experiences of families making that transition can be more readily heard. Home cultures can be understood in this context as “traveling” and subject to transformation and disruption.     

哪些老年人更倾向于入住养老院？--基于江苏农村地区的实证调查数据

在城市化加速发展、家庭结构迅速小型化及人口老龄化加剧的社会形势下,农村老年人对养老院的入住意愿正在发生变化。以江苏省为例,运用 Logistic 模型对农村老年人养老院入住意愿进行回归分析。研究结果表明,农村老年人对养老院的入住意愿主要受文化程度、个人月收入、健康状况、存活女儿数、共同生活人数以及晚年生活满意度等因素的影响。政策含义在于,尊重农村老年人对养老院的入住意愿,推动农村地区养老服务事业发展;充分考虑农村地区经济发展水平,对农村养老机构的层次和规模进行战略规划;从农村地区实际出发,对农村养老院功能定位进行适当的引导。     

Racial and Gender Differences in Pressure Ulcer Development Among Nursing Home Residents in the Southeastern United States

Objective: To determine whether there is a difference in the incidence of pressure ulcers (PU) between African American (AA) and White nursing home (NH) residents in the Southeastern United States. Methods: Data from the Centers for Medicare and Medicaid Services Minimum Data Set were examined for 113,869 residents who were free of PU at NH admission during 1999–2002. Facility and neighborhood characteristics were abstracted from the Online Survey Certification and Reporting database and the 2000 U.S. Census respectively. Results: The incidence of PU in NH among AAs and Whites was 4.7% (95% CI: 4.4–5.0) and 3.4 % (95% CI: 3.3–3.5) respectively. The association between race and PU development varied between males and females. Differences were noted between AA and White males who were dependent in mobility and between AA and White females who were bedfast and resided in facilities with less than 200 beds. Unlike for females, facility and neighborhood characteristics were not significant confounders in risk for PU incidence among males. Conclusion: PU occurred more frequently in AAs than in Whites. Results suggest that racial differences are marked among males and females with specific characteristics. Interventions for reducing this disparity should target these at-risk groups.     

Long-Term Services and Supports for Older Adults: A Review of Home and Community-Based Services Versus Institutional Care

Despite a shift from institutional services toward more home and community-based services (HCBS) for older adults who need long-term services and supports (LTSS), the effects of HCBS have yet to be adequately synthesized in the literature. This review of literature from 1995 to 2012 compares the outcome trajectories of older adults served through HCBS (including assisted living [AL]) and in nursing homes (NHs) for physical function, cognition, mental health, mortality, use of acute care, and associated harms (e.g., accidents, abuse, and neglect) and costs. NH and AL residents did not differ in physical function, cognition, mental health, and mortality outcomes. The differences in harms between HCBS recipients and NH residents were mixed. Evidence was insufficient for cost comparisons. More and better research is needed to draw robust conclusions about how the service setting influences the outcomes and costs of LTSS for older adults. Future research should address the numerous methodological challenges present in this field of research and should emphasize studies evaluating the effectiveness of HCBS.     

Reading the Queer Domestic Aesthetic Discourse

Abstract

The stereotype of the gay man as arbiter of domestic style and design is widely recognized. Robin Williams humorously referenced this in a joke: “We had gay burglars the other night,” he notes, “They broke in and rearranged the furniture.” What remains unclear is the ways in which stereotypes relate to the lives of ordinary people and the homes they inhabit. This article brings together the idiosyncrasies of queer design that circulate at a number of levels in a mainly transatlantic discourse—thanks to the help of mass media, television programs, and a niche of scholarly literature—with a study of ordinary homes belonging to lesbian, gay, bisexual, transgender, and queer (LGBTQ) lives in a global city. It is argued that this wider queer aesthetic penetrates everyday space and shapes homes in complicated ways; there is a tension between these two domains. The empirical research draws from in-depth semi-structured interviews with Londoners gathered as part of a larger project on sexual minority identity at home in London, UK. Looking to these domestic case studies allows for a spatialized reading that challenges celebrated and exclusive interiors. Offering a timely and distinct architectural approach looking to the everyday users of ordinary domestic space aims to modestly move in another direction towards a model of diversity, opening up queer domesticity and sexual minority identity to multiple representations.