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John E. Zeber PhD Karen J. Coleman PhD Heidi Fischer PhD Tae K. Yoon MS Brian K. Ahmedani PhD LMSW Arne Beck PhD Samuel Hubley PhD Zac E. Imel PhD Rebecca C. Rossom MD MS Susan M. Shortreed PhD Christine Stewart PhD Beth E. Waitzfelder PhD Greg E. Simon MD MPH 《Depression and anxiety》2017,34(12):1157-1163
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This article explores why and how trauma theory and research are currently used in higher education in nonclinical courses such as literature, women's studies, film, education, anthropology, cultural studies, composition, and creative writing. In these contexts, traumatic material is presented not only indirectly in the form of texts and films that depict traumatic events but also directly in the form of what is most commonly referred to in nonclinical disciplines as trauma studies, cultural trauma studies, and critical trauma studies. Within these areas of study, some instructors promote potentially risky pedagogical practices involving trauma exposure or disclosure despite indications that these may be having deleterious effects. After examining the published rationales for such methods, we argue that given the high rates of trauma histories (66%–85%), posttraumatic stress disorder (9%–12%), and other past event–related distress among college students, student risk of retraumatization and secondary traumatization should be decreased rather than increased. To this end, we propose that a trauma-informed approach to pedagogy—one that recognizes these risks and prioritizes student emotional safety in learning—is essential, particularly in classes in which trauma theories or traumatic experiences are taught or disclosed. 相似文献
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Joan Beder DSW Paul Postiglione LCSW-R Jessica Strolin-Goltzman PhD LMSW 《Social work in health care》2013,52(8):661-679
Social workers in the Veterans Administration (VA) hospital system are faced with numerous challenges to best address the ongoing health and mental health needs of those who serve in the military. Social workers in the VA system serve diverse roles on the multidisciplinary medical teams and mental health services and are integral to the VA hospital environment. Most social workers feel positive about their work and their contributions to the care of the military. Despite positive feelings about their work, social workers are also prone to compassion fatigue and burnout as the work, especially with returning veterans from Afghanistan/Iraq, often extracts a toll. This article details the experience of social workers in the VA hospital system; it describes the impact of the work on the social workers, noting levels of compassion satisfaction, compassion fatigue, and burnout. 相似文献
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Faith W. Lucas LMSW PhD 《Social work in health care》2013,52(10):946-962
Past research related to pregnancy outcomes has tended to have a bio-medical focus. More recent research has begun to explore possible social and cultural influences on birth outcomes. Qualitative interviews were conducted with 28 pregnant women of Mexican descent in the Texas/Mexico border region to begin to describe the social and cultural contexts of pregnancy of women of Mexican ancestry. Participants' constructions surrounding pregnancy focused on the mother role. Goodness of fit between constructions of the mother role and women's lives and self-concepts resulted in positive or negative feelings about motherhood. 相似文献
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Mary A. Cavaleri PhD LCSW Kosta Kalogerogiannis LMSW Mary M. Mckay PhD Laura Vitale BA Erika Levi BA Sian Jones MD 《Social work in health care》2013,52(10):934-945
This study is an exploration of engagement in outpatient medical care, medication utilization, and barriers to treatment utilization among 24 predominantly low-income, ethnic minority adults who were admitted to an urban hospital for HIV-related illnesses. A semi-structured interview was administered during the sample's hospital stay to explore patterns of service use and identify barriers to care. The majority of the sample was connected to an outpatient provider and satisfied with the care they received; however, most missed treatment appointments and skipped medication dosages. Health and treatment-related barriers, competing demands, and co-occurring mental health symptoms and illicit substance use were identified as barriers to care. Multiple obstacles indigenous to the individual, their treatment, and the environment prevented consistent treatment use among an economically disadvantaged ethnic minority sample: Implications and future directions in engaging vulnerable populations into health care for HIV are discussed. 相似文献
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Timothy W. Farrell MD AGSF William W. Hung MD MPH Kathleen T. Unroe MD MHA AGSF Teneille R. Brown JD Christian D. Furman MD MSPH AGSF Jane Jih MD MPH MAS Reena Karani MD MHPE Paul Mulhausen MD MHS Anna María Nápoles PhD MPH Joseph O. Nnodim MD PhD FACP AGSF Gina Upchurch RPh MPH Chanel F. Whittaker PharmD BCGP FASCP Anna Kim LMSW Nancy E. Lundebjerg MPA Ramona L. Rhodes MD MPH MSCS AGSF 《Journal of the American Geriatrics Society》2022,70(12):C1-C1
The American Geriatrics Society (AGS) has consistently advocated for a healthcare system that meets the needs of older adults, including addressing impacts of ageism in healthcare. The intersection of structural racism and ageism compounds the disadvantage experienced by historically marginalized communities. Structural racism and ageism have long been ingrained in all aspects of US society, including healthcare. This intersection exacerbates disparities in social determinants of health, including poor access to healthcare and poor outcomes. These deeply rooted societal injustices have been brought to the forefront of the collective public consciousness at different points throughout history. The COVID-19 pandemic laid bare and exacerbated existing inequities inflicted on historically marginalized communities. Ageist rhetoric and policies during the COVID-19 pandemic further marginalized older adults. Although the detrimental impact of structural racism on health has been well-documented in the literature, generative research on the intersection of structural racism and ageism is limited. The AGS is working to identify and dismantle the healthcare structures that create and perpetuate these combined injustices and, in so doing, create a more just US healthcare system. This paper is intended to provide an overview of important frameworks and guide future efforts to both identify and eliminate bias within healthcare delivery systems and health professions training with a particular focus on the intersection of structural racism and ageism. 相似文献
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Wenbo Wu PhD Kaes J. Holkeboer Temidun O. Kolawole Lorrie Carbone LMSW Elham Mahmoudi PhD 《Health services research》2023,58(6):1292-1302
Objective
To develop a natural language processing (NLP) algorithm that identifies social determinants of health (SDoH), including housing, transportation, food, and medication insecurities, social isolation, abuse, neglect, or exploitation, and financial difficulties for patients with Alzheimer's disease and related dementias (ADRD) from unstructured electronic health records (EHRs).Data Sources and Study Setting
We leveraged 1000 medical notes randomly selected from 7401 emergency department and inpatient social worker notes generated between 2015 and 2019 for 231 unique patients diagnosed with ADRD at Michigan Medicine.Study Design
We developed a rule-based NLP algorithm for the identification of seven domains of SDoH noted above. We also compared the rule-based algorithm with deep learning and regularized logistic regression approaches. These models were compared using accuracy, sensitivity, specificity, F1 score, and the area under the receiver operating characteristic curve (AUC). All notes were split into 700 notes for training NLP algorithms, and 300 notes for validation.Data Collection/Extraction Methods
Social worker notes used in this study were extracted from the Michigan Medicine EHR database.Principal Findings
Of the 700 notes for training, F1 and AUC for the rule-based algorithm were at least 0.94 and 0.95, respectively, for all SDoH categories. Of the 300 notes for validation, F1 and AUC were at least 0.80 and 0.97, respectively, for all SDoH except housing and medication insecurities. The deep learning and regularized logistic regression algorithms had unsatisfactory performance.Conclusions
The rule-based algorithm can accurately extract SDoH information in all seven domains of SDoH except housing and medication insecurities. Findings from the algorithm can be used by clinicians and social workers to proactively address social needs of patients with ADRD and other vulnerable patient populations. 相似文献50.
Associations between nursing home performance and hospital 30‐day readmissions for acute myocardial infarction,heart failure and pneumonia at the healthcare community level in the United States
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Michelle M. Pandolfi LMSW MBA LNHA Yun Wang PhD Ann Spenard RN‐BC MSN Florence Johnson RN MSN MHA Alice Bonner PhD RN FAAN Shih‐Yieh Ho PhD MPH Timothy Elwell MBA PhD Anila Bakullari BS Deron Galusha MS Erica Leifheit‐Limson PhD Judith H. Lichtman PhD MPH Harlan M. Krumholz MD SM 《International journal of older people nursing》2017,12(4)