Adaptation to Chronic Dialysis

While dialysis is a medical advance that enables people to live who would otherwise die, it is often experienced as an ordeal by those who must live with it. Patients and staff experience difficulties in their adaptation to chronic dialysis. A program that excepts all patients, regardless of motivation and stability, carries with it the responsibility of offering care in a way the patient can tolerate and of providing a regimen within the context of his personality structure and social adaptation.     

The Mental Health Status and Long Term Care Needs of the Chinese Elderly in Hong Kong

ABSTRACT

This paper examines the mental health status of 945 Chinese older people who are in need of long term care services in Hong Kong. It was found that for those aged respondents who are already waiting for admission to infirmary, over 59.3% were already living in private aged homes, and only as few as 17.8% of these applicants were still living in their own homes. Besides, it was found that the mean SPMSQ score was lowest amongst those living in medical infirmary (1.52) and highest for those living in their own residences (5.99). Analysis of the relationship between GDS scores and residential types reveals that there were higher proportion of respondents residing in their own residences that fell into the highly depressed category. There is a need for the overall revamp of the planning, provision and financing for long term care and psychogeriatric services for Chinese older people in Hong Kong.     

From a Social Issue to Policy

Summary

This paper outlines a 22 year campaign to introduce openness into the arena of donor conception in the UK. It identifies key aspects of the development of an advocacy based approach to such work and argues that social work values and principles can prove key to identifying structural inequalities which are not necessarily based in socio-economic disadvantage. Donor conceived people may find themselves in families which enjoy material privilege but whose exposure to a legislative framework and dominant professional cultures within the treatment centres encourages secrecy around genetic origins. Social workers' experience of adoption and family work leads them to recognise the danger of such secrets within families. Turning such social issues into policy changes requires vision, strategic long term advocacy and partnership with those directly affected.     

Postmodern Social Work in Interdisciplinary Contexts

Abstract

This paper describes a university-based, maternal child health, interdisciplinary training project designed to assist health professionals in working with neurodevelopmentally at-risk children and their families. It discusses a role for social work educators and practitioners that brings to the table varied, conceptual questions that are intertwined with more traditional social work intervention in a postmodern approach to interdisciplinary teaming. A case example illustrates the integration of these two approaches and the inquiries that social work can initiate to facilitate “making space” both between the team and family and between members of the team in a dynamic, postmodern, interdisciplinary context.     

Clinical Social Work

Master's level students, new workers and agency and academic faculty are challenged to maintain social work practice standards and retain traditional values and identifications in a climate of diminishing resources for social work services. Pressure for third party reimbursement, accelerated demands for self-directed and autonomous clinical social work practice in new systems of care characterize this climate. This paper addresses issues and dilemmas attendant to these changes for which we seek solutions. Some suggestions are offered. Some issues are posed as questions since answers are evolving and outcomes are uncertain.     

CLINICAL CONTRIBUTIONS TO ADMINISTRATIVE PRACTICE

No abstract available for this article.     

Realizing or Relinquishing Rights? Homeless Youth,Their Life on the Streets and Their Knowledge and Experience of Health and Social Services in Hillbrow,South Africa

Poverty and youth unemployment are critical issues in South Africa with homeless persons begging at traffic light intersections in all major cities. Support services represent one way of empowering homeless youth. The study therefore examined the experiences of 10 homeless young adult males in Hillbrow, Johannesburg and whether they were aware of local health and social services. Qualitative interviews revealed that participants experienced poor health, addiction, physical violence, psychological trauma, and public hostility. Despite limited education, they were aware of and utilized local health and social services. Findings are discussed in terms of their implications for social work.     

Hunger

Patients at a New York City municipal hospital were surveyed in 1985 and 1989 to ascertain the extent of hunger and its possible correlates. Twenty-two percent (22%) of the 382 subjects in 1985 and 23% of the 332 subjects in 1989 experienced hunger. Hunger was related significantly to homelessness, social isolation and the physical inability to buy and/or prepare food. Between 1985 and 1989, there was a large increase in the use of institutional resources for food; a decline in reliance on Food Stamps; and an increase in household density. Inpatients were found to be poorer than outpatients, and to rely more heavily upon soup kitchens. Practice, policy and research implications are noted.     

Social network influences on smoking,drinking and drug use in secondary school: centrifugal and centripetal forces

We explore how school experiences and social networks structure young people’s substance use in different institutional contexts. The concepts of ‘selection’ and ‘influence’ are situated within the context of bounded agency, counter‐school cultures and Bourdieusian notions of capital. We employed individual and group interviews, network‐mapping, and observations at two contrasting English secondary schools. Both schools were characterised by extended social network structures that appeared to influence patterns of substance use, although the mechanisms via which this occurred varied according to school context. At Grange House school (suburban context) a minority of students from disadvantaged families were alienated by the attainment‐focused regime, marginalised by a strong peer‐led centrifugal force pushing them outwards, and substance use was an alternative source of bonding and identity for these students. In contrast, at North Street a centripetal force operated whereby the majority of students were pulled towards highly‐visible, normative markers of ‘safe’, ‘road culture’, such as cannabis use and gang‐involvement, as they attempted to fit in and survive in an inner‐city school environment. We conclude that health inequalities may be reproduced through these distinctive centrifugal and centripetal forces in different institutional contexts, and this should be the focus of quantitative examination in the UK and elsewhere.