Psychosocial rehabilitation after disfiguring injury or disease: investigating the training needs of specialist nurses

AIM OF THIS STUDY: To investigate the training needs of specialist nurses working with patients who have disfiguring conditions. BACKGROUND: As the psychosocial impact of disfiguring illness and disease becomes more widely recognized and understood, there are increasing issues about who can provide this kind of input. Whilst nurses have been identified as the health professionals who are often the most appropriate to fulfil this role, there is less evidence that they feel confident in their skills to provide it. The volume of requests from health professionals, particularly nurses, to a lay-led organization specializing in facial disfigurement suggested both an acknowledgement of the importance of providing psychosocial support to this population, together with a perceived lack of skill in this area. DESIGN/METHOD, STUDY 1: This study used a cross-section design. Two groups of nurses working either in burns or in head and neck cancer were surveyed by questionnaire. RESULTS, STUDY 1: Both the burns group and head and neck group rated their skills in the social rehabilitation of their patient group as significantly lower than their skills in physical rehabilitation. DESIGN/METHOD, STUDY 2: Using a multiple baseline design, a pilot intervention consisting of a specifically focused resource pack and 1-day training course was delivered to eight head and neck cancer nurses. RESULTS, STUDY 2: Postintervention, only the targeted skills (those concerned with social rehabilitation) were rated as significantly improved. Research continues to establish the extent to which these skills are implemented by nurses in the clinical setting and passed on to patients. CONCLUSIONS: These findings suggest that although nurses do not feel as skilled in delivering psychosocial support to patients as they do in delivering more traditional aspects of physical nursing care, they can very easily take on this role when given simple training and access to appropriate resources. This training can be provided by a lay-led organization.     

The Development and Psychometric Evaluation of the Ethical Issues Scale

Purpose: To describe the Ethical Issues Scale (EIS), its conceptual development and psychometric evaluation, and its uses in determining how frequently nurses experience ethical issues in practice.
Design: The EIS was validated with a sample (N=2,090) of New England registered nurses (RNs) currently in practice. The sample was randomly split into two approximately equal samples. The calibration sample was used to derive the underlying components; the validation sample was used to confirm the component structure.
Methods: Psychometric analysis of the 35-item EIS included: (a) item analysis, (b) confirmatory principal components analysis (PCA), and (c) internal consistency reliability using Cronbach's alpha.
Results: Three components (end-of-life-treatment issues, patient care issues, and human rights issues) were demonstrated, confirming the original conceptually-derived structure. The calibration sample accounted for 42.4% of initially extracted common variance; the validation sample accounted for 41.5% of initially extracted common variance.
Conclusions: The three EIS subscales had satisfactory internal consistency reliability and factorial validity for use as independent scales in future studies.     

Increasingly distant from life: problem setting in the organization of home care

Abstract The analysis undertaken in this paper explores the significance of a central finding from a recent field study of home care case management practice: a notable feature of case management work is the preparation of an orderly, ordered space where care may be offered. However, out of their encounters with an almost endless variety of situations, out of people's diverse narratives of need, case managers seem able to pick out only limited range of recognized needs to which to respond and demonstrate a series of responses themselves equally limited. Though this observation suggests a kind of efficiency that is currently highly valued within healthcare systems, it also underlines the system's inability to engage difference and variability in a meaningful way. This inability or limitation in effectively engaging difference is conceptualized here as, in some sense, a problem, and the nature of this problem is explored through the rhetorical process of problem setting. The central question becomes how might we develop and deploy an orderly and coherent system of care without essentializing people's experiences, without treating these experiences reductively, without, in a Foucaultian frame of reference, allowing what can be understood as similarity or resemblance among clients and situations to be folded back into sameness? As we encounter complexity, variability and difference in practice, how should we treat it?     

网络心理咨询业的开展与伦理困境

目前网络心理咨询业正处于高速发展期,而在其发展过程中,却存在一些问题。本文主要分析网络心理咨询业的发展现状、存在问题,并对网络心理咨询业的职业伦理规则进行了探讨。     

Critical Issues for Substance Abuse Prevention Targeting American Indian Youth

This paper examines prevention programs targeting alcohol and other drug use among American Indian youth. We start with a review of what is known about substance use by this population. We provide consideration of specific prevention programs for Indian youth within these frameworks: Cognitive/Information Dissemination, Affective Education, Social Influence, and Personal and Social Skills Training. A particular focus is on the manner in which issues of culture are incorporated into prevention programs. A detailed overview of the diversity of the American Indian population is presented and its implications for prevention work with Indian youth are discussed. A major conclusion is that there is not one type of prevention program that is likely to work with American Indian youth since there is no such thing as a typical American Indian.     

Developing pathways to assist parents to exit the child protection system in Australia

The prevalence of child abuse and neglect is an international concern that justifies the existence of child protection systems. An important first principle for all such statutory child protection systems is to ensure that the system itself does no further harm. It can be argued that there are specific circumstances within which well‐meaning services have the potential to do harm: specifically, processes and actions that disempower parents by reducing their autonomy and capacity for positive action. Exploring the circumstances in which reduced parental autonomy impacts negatively on families is an important first step in developing procedures for working with families that not only avoid harm but are orientated to produce meaningful change. Two evidence‐based programs are described that together have the potential to assist child protection practitioners to develop a collaborative helping partnership with families, clarify goals for change and support parents to achieve meaningful improvement in their family functioning. The programs described are both manualised and have empirical support for their effectiveness. The potential benefits for both families and practitioners working within child protection agencies in the two programs are described.