Exploring the delivery of community rehabilitation services for older people in an urban Canadian setting: Perspectives of service providers, managers and health system administrators

Author(s):  
Leanne L. Leclair ◽  
Kathleen Zawaly ◽  
Alexandra M. B. Korall ◽  
Jeanette Edwards ◽  
Alan Katz ◽  
...  
2018 ◽  
Author(s):  
Zhe WANG ◽  
Shujuan CHEN ◽  
Junning CHEN ◽  
Chunfeng XU ◽  
Zhikang CHEN ◽  
...  

BACKGROUND Relapse is very common in patients with illicit drug use disorder and contributes to a series of bad consequences that substantially impact their physical and social functions. Due to the limited existence of effective addiction treatment, the majority of patients with drug use disorder could not access help when needing. Mobile health (mHealth) offers a potential solution to improving recovery outcome for patients in community. OBJECTIVE This paper is a protocol for a randomized controlled trial (RCT) of a smart phone application called community-based addiction rehabilitation electronic system (CAREs). This interactive system consists of an APP for clients and a webpage for service providers, with the aim of teaching clients craving and emergency coping skills and helping service providers to improve their work efficiency and effectiveness in community. METHODS A randomized controlled trial (RCT) will be conducted. Sixty drug illicit users who are newly ordered to undergo community rehabilitation will be recruited from the community in Shanghai. Participants will be 1:1 randomly assigned to receive integrated community rehabilitation by using CAREs or only receiving routine community rehabilitation for 6 months. Corresponding anti-drug social workers will provide service and monitor their drug use behavior in accordance with the routine work-flow. Outcomes will be assessed at baseline and in the 6th month. The primary study outcome is the performance on illicit drug urine test which will be carried on regularly twice per week during the study period. Secondary study outcomes include longest duration of sustained abstinence, days that participants interact with anti-drug social workers, and the decrease rate of addiction-related issues severity index. RESULTS Recruitment is currently underway with the aim of recruiting 60 subjects with drug use disorder. Recruitment will continue until the end of 2018. CONCLUSIONS This is the first known trial of a smartphone-based psychotherapy program for improving recovery outcomes in illicit drug users in community. The study provides evidence for the feasibility and effectiveness of the "CAREs" system through comparing the results of the intervention group with the control group. This paper describes the design and methodology of the study. CLINICALTRIAL ClinicalTrials.gov NCT03451344, https://clinicaltrials.gov/ct2/show/NCT03451344


2015 ◽  
Vol 35 (5/6) ◽  
pp. 419-436 ◽  
Author(s):  
Sue Hollinrake ◽  
Will Thomas

Purpose – The purpose of this paper is to understand the nature of support that helps older people continue living in their own homes for as long as they wish to. Design/methodology/approach – The research made use of a participatory approach in which service users, service providers and commissioners were involved in the design of the approach in addition to contributing to the research as participants in their own right. Findings – This paper presents analysis from the research which focuses on the importance of caring relationships for providing a support mechanism. The authors question whether budget cuts and efficiency drives within statutory care providers preclude the notion of caring relationships. Practical implications – The authors suggest, in the light of the evidence presented, that statutory service providers should acknowledge the role that caring relationships play in providing support for older people. Whilst budget cuts make providing support for caring relationships more challenging, the authors suggest that there is scope for delivering services and support in ways which promote the types of interactions which better support older people living independently. Originality/value – The analysis presented here provides a distinctive, timely and thoughtful insight into support for older people at a time when public sector budgets are under increasing pressure.


2006 ◽  
Vol 26 (3) ◽  
pp. 373-391 ◽  
Author(s):  
DEIRDRE HEENAN

Against a background of limited previous research, this paper examines the access to health and social care among older people in the farming communities of County Down, Northern Ireland. In-depth interviews were conducted with 45 people aged 60 or more years living on family farms to collect information about health care needs and service use and adequacy. In addition, interviews with service providers provided information on their perceptions of the farming communities' needs. The findings indicate that there are specific rural dimensions of access to services and that among the respondents there was substantial unmet need. For many farming families, using services is determined by much more than being able to reach them physically. The lack of reliable information, the culture of stoicism and the absence of appropriate services impeded obtaining effective support. Recent health care policies and strategies have stressed the importance of developing local services that are responsive to need in consultation with service users, but there is worryingly little evidence that this has occurred. It is concluded that if effective outcomes are to be achieved, policies must recognise the specific characteristics of rural populations and be sensitive to the needs, attitudes and expectations of farming families. The current lack of understanding about the distinct needs of these communities at present exacerbates the isolation and marginalisation of already vulnerable older people.


2021 ◽  
Author(s):  
Julia Getchell

Sexual violence is a relevant topic in the Canadian mental health system. However, the dominant bio-medical understanding of mental health can be harmful to survivors. This study is focused on analyzing how sexual violence is discussed within the bio-medical mental health system. The bio-medical understanding of mental health is one that conceptualizes “mental illness” is brain disease and emphasizes pharmacological treatment. Sexual violence is a broad term that describes any violence, physical or psychological, carried out through sexual means or by targeting sexuality. Critical Discourse Analysis is used in this study to find and analyze discourses in the bio-medical mental health system found in three interviews with mental health service providers. The discourses that emerged were as follows: 1. people were “boiled down” to their diagnoses or experiences of sexual violence; 2. professionalism; 3. being funneled into “streams of care”; 4. what makes someone credible; and 5. who “gets it”. The MRP concludes with a discussion of implications of these findings for social work.


2020 ◽  
Vol 20 (1) ◽  
pp. 48-54
Author(s):  
Md Mizanur Rahman ◽  
Zabidah binti Putit ◽  
Norliza binti Suut ◽  
Mohamad Taha Arif ◽  
Asri bin Said ◽  
...  

Caring for stroke survivors is inevitably a burden to caregivers. It is not uncommon for stroke survivors who are discharged from the hospital and found themselves at home without any help and care from the supposed caregivers. However, in instances where there are available and willing caregivers, a sudden and unpredictable task of caring for stroke survivors require the stroke caregivers to apply their coping strategies due to the demanding nature of looking after a survivor. This study aimed to determine coping strategies undertaken by stroke caregivers in caring for stroke survivors. This was an exploratory qualitative study and data was collected from the caregivers of stroke survivor using a semi-structured guided questionnaire. A total of 18 caregivers were included in the study. The data were collected from November 2015 until June 2016 at a selected community rehabilitation centre in Kuching, Sarawak. The qualitative data analysis revealed that the coping strategies undertaken by stroke caregivers include change of role in life, self-motivation, sharing with other people, crying, trying to forget things that happen, hoping survivors will get better, emotion suppression and self-blame. The study highlighted the experiences by the caregivers for caring for stroke patients and focused on the coping strategies undertaken by the caregivers. Better ununderstanding of these experiences does help the service providers to provide better support and resources for caregivers in caring for stroke survivors.


2021 ◽  
Vol 19 (1) ◽  
pp. 13-22
Author(s):  
Mahta Alsadat Aarabi ◽  
◽  
Kianoush Abdi ◽  
Mohammad Saeed Khanjani ◽  
◽  
...  

Objectives: One of the most essential needs of children with Autism Spectrum Disorder (ASD) is using rehabilitation services. However, these services are associated with numerous challenges. The present study aimed to identify the perceptions of the parents of children with ASD and rehabilitation service providers about the challenges of using rehabilitation services in Iran. Methods: This was a qualitative study. In total, 27 participants were selected from the parents of children with ASD and rehabilitation service providers to these children, based on purposive sampling method; we considered maximum variation and sampling continued until data saturation. The necessary data were collected by semi-structured and in-depth interviews. The interviews lasted from July to December 2020 and MAXQDA was used for data analysis. Results: The challenges of children with ASD in accessing and using rehabilitation services were identified and categorized into 6 main classes, as follows: the lack of a systematic support system; the lack of commitment to observing professional ethics; neglecting the structure and policy of rehabilitation; the lack of comprehensive ASD diagnostic and rehabilitation protocols; inadequate knowledge and attitude, and the lack of feasible access to services. Discussion: Policymakers, service providers, and managers must be aware of the challenges of rehabilitation services for ASD; subsequently, they are expected to pay special attention to this issue. This study provided evidence for the above-mentioned groups for accessing and using rehabilitation services among ASD. Besides, the obtained data could help to improve the services they receive and their living conditions; ultimately, they help improve their quality of life.


2002 ◽  
Vol 25 (4) ◽  
pp. 169 ◽  
Author(s):  
Robyn Smith ◽  
Susan Quine ◽  
Julie Anderson ◽  
Kirsten Black

A qualitative study was conducted in Victoria to explore factors affecting the acceptability and use of assistive devices by older people. Four focus groups and fifteen home-based interviews were conducted with older people (mean age 77 years) who had been issued with 2 or more assistive devices. Analysis of the data indicated that almost all participants were content to be advised by professionals on suitable equipment. Most considered the equipment and home modifications safe and easy to use, and appreciated the benefits for mobility, confidence and independence. Reasons for non-use were commonly related to changes in functional ability. Cost was a major deterrent for a small number who opted to 'make do'. Recommendations are made for improvements to the existing system of equipment provision and use, including: review and development of consistency of provision and payment policy among service providers; flexibility of payment options; adequate education and follow-up support for clients.


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