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Community mental health agencies (CMHAs) and consumer-run agencies (CRAs) both provide critically important services to persons with severe psychiatric disabilities. Emerging research has begun to support the effectiveness of the CRA approach, a newer service delivery mechanism. However, collaboration between the two service systems, when it occurs, is often problematic. This article briefly identifies the core features of CRAs, discusses their potential for collaboration with CMHAs, and suggests ways to promote healthy organizational partnerships between the two based upon the model proposed by Gidron and Hasenfeld [(1994) Nonprofit Management & Leadership, 5(2), 159–172]. Salient collaboration theories are reviewed and barriers to collaboration are discussed. Finally, implications for mental health practice and future research directions are identified.John Q. Hodges, Ph.D., is assistant professor of social work at the University of Missouri, Columbia. His research interests include mental health consumer-run services, consumer perspectives on the mental health service system, homelessness, and severe mental illness.Eric R. Hardiman is assistant professor of social welfare at the University at Albany, State University of New York. His research interests include mental health service utilization, consumer-operated services, peer support, and psychiatric recovery. 相似文献
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Collaboration Between the NHS and Social Services in the Provision of Child and Adolescent Mental Health Services: A Personal View 总被引:1,自引:0,他引:1
John B. Pearce 《Child and Adolescent Mental Health》1999,4(4):150-152
The quality of collaborative links between the NHS and Social Services in the field of child mental health is dependent on the culture of co-operation set at the highest level of government. There needs to be an understanding of the different theoretical models that underpin working practices. The importance of personality factors, power struggles and misperceptions is highlighted. Constructive suggestions are made on how to ensure that collaboration works effectively. 相似文献
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Theresa E. Senn Ph.D. Jennifer L. Walsh Ph.D. Michael P. Carey Ph.D. 《Annals of behavioral medicine》2014,48(2):215-224
Background
Objective, subjective, and neighborhood socioeconomic status (SES) are associated with perceived health, morbidity, and mortality.Purpose
We investigated whether perceived stress and health behaviors mediated the relation between the three types of SES and perceived health.Methods
Participants (N?=?508) attending a public clinic completed a computerized survey assessing objective SES (income, education, employment); health behaviors; perceived stress; and perceived health. They also indicated their social standing relative to others (subjective SES) and provided their current address to determine neighborhood SES.Results
In a structural equation model including all three SES types, lower objective and subjective SES were related to poorer perceived health. When mediators were included in the model, there were significant indirect effects of (a) SES on health through stress and (b) SES on health through stress and health-compromising behaviors.Conclusions
Interventions to reduce the impact of stressors could improve the health of socioeconomically disadvantaged individuals. 相似文献5.
Stefano Paolucci Giulia Silvestri Sergio Lubich Luca Pratesi Marco Traballesi Gian Luigi Gigli 《Epilepsia》1997,38(3):266-270
Summary: Purpose: This study was designed to (a) identify the prevalence of poststroke late seizures in a population of patients admitted to rehabilitation of neurologic sequelae of their first stroke, (b) recognize reliable prognostic factors associated with the occurrence of poststroke late seizures, and (c) evaluate the impact of seizures on the results of rehabilitation treatment.
Methods: In a prospective study of 306 consecutive patients admitted to a rehabilitation hospital for sequelae of their first stroke, we assessed the relation among 15 independent variables and the development of seizures by using multiple regression analysis (forward stepwise). In addition, we evaluated the impact of occurrence of poststroke seizures on both efficiency and effectiveness of rehabilitation and length of stay.
Results: Poststroke late seizures occurred in 46 (15.03%) patients, with a mean interval from stroke of 101.98 ± 37.96 days. In multiple regression analysis, putaminal and lobar hemorrhages showed a significant positive association with the development of seizures (p < 0.005), whereas high scores on the Canadian Neurological Scale (CNS) (indicating less severe strokes) and increasing age were negatively associated (p < 0.01 and p < 0.05, respectively). Patients with putaminal and lobar hemorrhages and patients with severe stroke (CNS score at admission, <7) were at significantly greater relative risk of seizures [relative risk (RR) = 1.99, 95% confidence interval (CI), 1.11–1.39; RR = 3.00, CI, 1.06–1.13; and RR = 2.41, CI, 1.01–1.27, respectively). No significant association was found between poststroke seizures and results of rehabilitation.
Conclusions: Poststroke late seizures occurred mainly in patients with putaminal and lobar hemorrhagic strokes but, if treated, did not affect rehabilitation therapy. 相似文献
Methods: In a prospective study of 306 consecutive patients admitted to a rehabilitation hospital for sequelae of their first stroke, we assessed the relation among 15 independent variables and the development of seizures by using multiple regression analysis (forward stepwise). In addition, we evaluated the impact of occurrence of poststroke seizures on both efficiency and effectiveness of rehabilitation and length of stay.
Results: Poststroke late seizures occurred in 46 (15.03%) patients, with a mean interval from stroke of 101.98 ± 37.96 days. In multiple regression analysis, putaminal and lobar hemorrhages showed a significant positive association with the development of seizures (p < 0.005), whereas high scores on the Canadian Neurological Scale (CNS) (indicating less severe strokes) and increasing age were negatively associated (p < 0.01 and p < 0.05, respectively). Patients with putaminal and lobar hemorrhages and patients with severe stroke (CNS score at admission, <7) were at significantly greater relative risk of seizures [relative risk (RR) = 1.99, 95% confidence interval (CI), 1.11–1.39; RR = 3.00, CI, 1.06–1.13; and RR = 2.41, CI, 1.01–1.27, respectively). No significant association was found between poststroke seizures and results of rehabilitation.
Conclusions: Poststroke late seizures occurred mainly in patients with putaminal and lobar hemorrhagic strokes but, if treated, did not affect rehabilitation therapy. 相似文献
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巫嘉陵 《中国现代神经疾病杂志》2017,(4):241-244
<正>脑卒中是首要病残原因,我国有70%~80%脑卒中患者因残疾不能生活自理[1-2]。我国脑卒中患者病残率较高,与未开展有效的急性期康复治疗有关。尽管关于缺血性卒中和自发性脑出血急性期的时间划分尚未达成共识,但通常认为缺血性卒中急性期指发病2周内[1],自发性脑出血急性期指发病4周内[3]。脑卒中急性期的定义与《中国脑卒中康复治疗指南(2011完全版)》[2]中一级康复开始时 相似文献
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康复医学作为现代医学的重要组成部分, 对功能障碍和心理障碍的患者全面康复、 恢复
社会生活有着重要的作用。 首都医科大学附属北京天坛医院在以脑血管病为重点的康复学科人才梯
队建设方面采用引进学科带头人、 加强人才培训和考核等措施, 极大促进了康复专业的发展并建立了
稳定的人才储备。 本文对天坛医院在康复学科建设方面的经验进行了介绍。 相似文献
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Program Evaluation in Epilepsy Rehabilitation 总被引:15,自引:11,他引:4
The Vocational Services Program of the University of Washington Regional Epilepsy Center is described, and data relating to the first 106 clients who entered the program are examined. A major emphasis of the study was characteristic differences between those clients later competitively employed and program dropouts. Other study purposes related to examining client satisfaction ratings of different aspects of services and establishing whether a relationship existed between seizure occurrences and job loss. Stepwise discriminant function analysis indicated that "months employed in the last 24" appeared to be the stable discriminator between the employed and dropout groups. The group later employed averaged 12 of the prior 24 months in employment, whereas dropouts approximated 7. Associated psychiatric/addictions treatment was initially a key outcome discriminator, but it did not hold up on cross-validation. Subjects were more satisfied with individualized client services (e.g., counseling sessions) than with group activities (e.g., Job Club). As opposed to seizures, emotional/attitudinal difficulties with this rehabilitation population appeared to be the primary reason for job loss. A work adjustment or job station program can be critical for these individuals and others with neurological impairments. The importance of counselor follow-up after the initial job placement is also underscored. This program, with about half of its clients entering unsubsidized jobs, basically replicated the results of other community-oriented epilepsy rehabilitation programs. 相似文献
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The unifying theme for the papers in this volume is that event‐predictive representations play an important role in cognitive processes, and they are a particularly fruitful object of study for cognitive scientists. In this paper, we present our own model of event representations that draws together several disparate strands of research into event representations, relating to event perception, event encodings in working memory and their role in prediction, and events as they are reported in language. Our main claim is that the notion of deictic routines originally developed by Ballard et al. (1997) is of great use in explaining how these different types of event representation interface with one another. 相似文献
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目的 对比开放病房管理与封闭病房管理对精神分裂患者康复的疗效.方法 对以阴性症状为主要临床相的80例精神分裂症患者,进行为期1年的院内康复治疗训练.采用住院精神病患者康复疗效评定量表(IPROS)进行治疗3,6,9,12个月后对疗效评定及分析.结果 开放病房与封闭病房比较,康复疗效差异有统计学意义.开放病房治疗从6个月开始,社会功能、卫生能力、生活能力提高及社交能力均有改善.结论 开放病房治疗对慢性分裂症患者的社会功能的改善有明显的促进. 相似文献
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早期综合康复治疗对脑卒中患者认知功能的影响 总被引:2,自引:0,他引:2
目的探讨早期综合康复治疗对脑卒中患者认知功能的影响。方法将入选的114例脑卒中患者随机分为两组:早期康复组(n=56例)和对照组(n=58例)。康复组患者在常规治疗的同时进行正规综合康复训练,对照组患者仅给于常规治疗,分别对两组患者治疗前后进行欧洲卒中评分(ESS)、日常生活活动(ADL)及简易智能状态检查(MMSE)评分,并对评分结果进行对比分析。结果治疗后早期综合康复组较对照组患者功能改善明显:(1)两组患者1个月的ADL、ESS及MMSE评分间差别均有显著性意义(P<0.05);(2)两组患者3个月后ADL、ESS及MMSE评分间差别仍有显著性意义(P<0.05)。结论早期综合康复治疗能有效改善患者的认知功能。 相似文献
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Karen A. Myors Virginia Schmied Maree Johnson Michelle Cleary 《Child and Adolescent Mental Health》2013,18(1):1-10
Background: An integrative review was undertaken to synthesise the research related to professionals’ perceptions and experiences of working in collaborative and integrated models of perinatal care for women with mental health problems. Method: A search of the databases CINAHL, Medline, PubMed, Psychinfo and Scopus was conducted. Studies were limited to English language papers published from 2000 to 2010. Fourteen papers were included in the review. Results: The overarching theme identified in the review related to the process of ‘making it happen’. Eight key elements were identified as central components of this process: funding and resources for collaboration; shared vision, aims and goals; pathways and guidelines; continuity of care; building relationships and trust; role clarity; training and education of staff and support to work in new ways. Conclusion: Perinatal mental health is an emerging field that is particularly challenging as it requires professionals to work across disciplines and timeframes, where there is a risk of dichotomising care, compounding existing barriers to service uptake. Professionals need resources and to feel supported to change clinical practice and work in more collaborative ways. The voices of women and families are missing in the literature. 相似文献
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三城市社区卒中患者康复治疗现状调查 总被引:2,自引:0,他引:2
【摘要】
目的 了解我国城市社区卒中患者康复知识知晓和接受康复治疗状况,为制订适宜的康复知识教育
和康复治疗计划提供依据。
方法 在北京、上海和成都3个城市社区,以问卷调查形式对964例卒中患者康复知识知晓、接受康
复治疗情况以及康复需求的现况进行调查。
结果 在被调查的964例卒中患者中,325例(33.7%)社区卒中患者表示接受过康复知识教育,仅
有100例(10.4%)表示对康复治疗比较了解和很了解。714例(74.1%)患病后进行了住院治疗,294例
(30.4%)住院期间接受过康复治疗,其中198例(20.5%)只接受过针灸治疗和按摩、推拿治疗,178例
(18.5%)接受过运动疗法治疗。出院后,仅有250例患者继续接受康复治疗。不接受康复治疗的原因中,
“从来就不知道康复治疗”是最主要的原因,占65.2%。74.3%的患者表示如果社区医院能够提供康复
治疗服务,愿意在社区接受康复治疗。现实中却只有8.3%的患者出院后在社区接受继续康复治疗。
结论 我国城市社区卒中患者出院后康复治疗的状况总体较差。在社区人群中建立康复宣传措施以
及康复治疗计划非常必要。 相似文献
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Joanna Ho Adrienne Epps Louise Parry Miriam Poole 《Neuropsychological rehabilitation》2013,23(2):183-207
Memory problems that interfere with everyday living are frequently reported in children who have sustained acquired brain injury (ABI), but their nature and rehabilitation is under-researched. This study aimed to (1) determine neuropsychological correlates of everyday memory deficits in children with ABI, and (2) investigate the effectiveness of a newly developed programme for their rehabilitation. We assessed everyday memory, verbal memory, attention and behaviour in 15 children with ABI. The children attended the everyday memory rehabilitation programme: six weekly sessions that involved diary training, self-instruction training and case examples. At the onset we found that everyday memory problems were related to impaired attention and behavioural difficulties. On completion of the programme there was a significant increase in children's abilities to perform daily routines that demanded recall of information and events. In addition, children used diaries more frequently. Moreover, significant secondary gains were found in attention and mood (anxiety and depression). In conclusion, the results provided preliminary evidence that our six week programme could be effective in reducing everyday memory difficulties and improving psychological well-being in children with ABI. 相似文献
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目的 调查了解北京市丰台区社区居民对卒中康复相关知识的认知情况以及社区康复现状。方法 在北京市丰台区两个社区内采用随机抽样方法随机抽样198名卒中患者,194名卒中患者看护人,填写自行设计的调查表。结果 调查显示约9.7%的患者及9.3%的看护人表示对康复治疗很了解或比较了解。约65.2%的患者和63.0%的看护人希望能够在社区进行康复。但只有34.4%的患者和42%的看护人曾经进行过社区康复。结论 北京市丰台区两社区居民对卒中康复治疗的相关知识仍比较缺乏,社区康复开展率较低,但是对康复的需求量仍较大。需要进一步加强康复治疗相关知识的宣传,同时进一步普及社区康复。 相似文献
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气管切开是临床抢救重症卒中患者的一种重要手段,但长期气管切开套管留置易造成多
种并发症,及早康复介入可促进患者早期拔管。本文从呼吸功能康复、吞咽康复、说话瓣膜的使用、
气道及套管的循证护理管理和一般支持治疗方面对促进卒中气管切开患者拔管的康复治疗进展进
行了归纳总结,为提高临床卒中患者拔管率提供参考。气道廓清技术、呼吸肌训练、运动训练和体位
管理可改善患者呼吸功能;直接与间接吞咽功能训练、唾液的管理和咽腔电刺激可改善患者吞咽功
能;说话瓣膜的合理使用可促进患者早日拔管;对气道进行气道湿化、气囊管理和吸痰护理,对套管
进行合理的固定与清洁消毒等,可减少并发症,防止感染;稳定患者病情,给予良好的营养支持和心
理康复等一般支持治疗,可提高拔管成功率。虽然目前对卒中气管切开患者拔管的康复治疗并无统一
标准,但是多学科合作的综合性康复治疗可提高患者拔管率,促进患者早日康复。 相似文献