Modeling Relationships Involving Perceived Recovery Orientation of Mental Health Teams Among Quebec Mental Health Professionals

The Journal of Behavioral Health Services & Research - While mental health (MH) services are expected to support client recovery, very little is known about services provided by MH teams in...     

The values and qualities of being a good helper: a qualitative study of adult foster home caregivers for persons with serious mental illness

BACKGROUND: Canadian foster homes for adults with serious mental illness are operated by non-professional caregivers, usually women, whose mandate is to support residents and reintegrate them into the community. While mental health professionals recognize that adult foster homes are an important service for this population, there is little understanding of how caregivers impact on the lives of their residents. AIMS AND OBJECTIVES: This article draws on the findings of a larger study which examined both caregiver and resident perspectives on the helping relationship in adult foster homes. Caregiver perspectives on the values and qualities required to help people living in foster homes are reported. DESIGN AND METHODS: With no pre-set theoretical framework, this qualitative study employed an inductive approach within a naturalistic paradigm. Semi-structured interviews were conducted with 20 caregivers. Data analysis was an ongoing, 2-year process, involving the identification of categories and themes through several distinct stages. SETTING: The study included Montreal adult foster homes (n=242) for persons with serious mental illness, supervised by two university-affiliated psychiatric hospitals. PARTICIPANTS: Twenty caregivers, selected according to years of experience and number of residents in the home, were diverse in terms of age, cultural background, family composition, education and occupational background. RESULTS: Caregivers possess a clearly articulated value system, and 21 specific qualities which reflect the attributes of both professional and informal helpers. These values and qualities provide caregivers with a "professional" or "vocational" orientation. CONCLUSIONS: A deeply held system of values and qualities is critically important to caregiver effectiveness and job satisfaction. Findings suggest that caregivers are highly motivated, and should be recognized as full participants in the mental health system at both policy and practice levels.     

Eventual error caused by dehydration with pachometry

Among the possible variables responsible for systemic errors in the acquisition of pachometric measurements, the corneal hydration condition plays a determinant role. In the present study, the authors have investigated the importance of this condition with two different pachometers (Storz Corneoscan II and Allergan Humphrey), reproducing an experimental dehydrated condition. The main datum arising from the comparison of the measurements obtained is represented by the different time course of the value of the measurement in the two groups. In fact, confronting the medium initial superimposed thickness value in the two tables (521 vs. 520 microm) there is a substantial difference in the final examination. For the first group of 60 corneas, the thickness values appear almost identical in the different intervals of time (medium initial thickness 521 vs. 512 microm final thickness). For the group examined with the solid-point machine, a decreasing thickness equal to 7% was evidenced (520 vs. 482 microm) with a significant decrease in the corneal thickness after only 45 s.     

Promoting health through breast cancer screening.

Health promotion and preventive medicine are popular topics today due to the rising cost of medical care. The use of mammography has been shown to significantly reduce the mortality rate of women with breast cancer, and breast cancer treatment is less costly when it is done in the early stages of the disease. However, screening mammography is not being utilized as much as it should be because of conflicting guidelines established by the medical community. The purpose of this paper is to discuss the role mammography should play in promoting health, and to determine who should be responsible for establishing a universal set of guidelines.     

Photorefractive keratectomy and laser in situ keratomileusis in refractive accommodative esotropia

PURPOSE: To evaluate the efficacy of excimer laser refractive surgery as an alternative for optical correction in patients affected by fully refractive accommodative strabismus. SETTING: Eye Clinic, University of L'Aquila, L'Aquila, Italy. METHODS: After a simulation of the cycloplegic correction with contact lenses over a 30-day period, 18 patients (6 men, 12 women, mean age 32.4 years +/- 9.4 [SD]) affected by fully refractive accommodative esotropia had refractive surgery using an excimer laser; 8 patients had photorefractive keratectomy (PRK), and 10 patients had laser in situ keratomileusis (LASIK). RESULTS: The correction of the refractive error with excimer laser allowed a reduction of the angle of deviation in all but 1 patient, who presented with a regression of refractive error and of the angle of deviation 2 years posttreatment. The 2-year follow-up showed that the mean angle of deviation in PRK was 2(Delta) esophoria at near and 0.4(Delta) esophoria at distance (P<.06); in LASIK, it was 1.7(Delta) esophoria at near and 0.2(Delta) esophoria at distance (P<.06). The difference between the 2 groups was not statistically significant at near (P = .56), at distance (P = .74), or for spherical equivalent (P = .16). CONCLUSION: Excimer laser refractive surgery seems to be useful in the correction of fully refractive accommodative esotropia.     

Recovery in Canada: toward social equality

This article reviews evolution of the recovery paradigm in Canadian mental health. We first trace the origins and development of the recovery concept through the literature, followed by an examination of how the recovery concept has been implemented in national and provincial mental health policy since publication of the 2006 Kirby Commission Report. Based on consultations with Canadian policymakers, and an examination of available policy documents, we explore how the dual theme of 'recovery' and 'well-being', adopted by the Mental Health Commission of Canada in its 2009 strategy: Toward Recovery and Well-being - A Framework For a Mental Health Strategy has subsequently played out in mental health policymaking at the provincial level. Findings reveal mixed support for recovery as a guiding principle for mental health reform in Canada. While policies in some provinces reflect widespread support for recovery, and strong identification with the aspirations of the consumer movement; other provinces have shifted to population-based, wellness paradigms that privilege evidence-based services and professional expertise. The recognition of social equality for people who experience mental illness emerges as an important value in Canadian mental health policy, cutting across the conceptual divide between recovery and well-being.     

From the real frontline: the unique contributions of mental health caregivers in Canadian foster homes

This article reports the findings of a qualitative study on the contribution of foster home caregivers for people with serious mental illness. Traditionally, social workers have played a key role in the supervision of foster homes. Little is known about how the help caregivers provide is similar to, or different from, that provided by mental health professionals. Twenty semistructured interviews were conducted with caregivers operating foster homes in Montreal, Canada.With no preset theoretical framework, data analysis was inductive and ongoing, involving the identification of categories and themes. Overall findings revealed that caregivers consider themselves the real frontline workers.They claim to be available 24 hours a day, seven days a week to combine egalitarian and affective relationships with their residents and to provide them with personalized care. Caregivers are well positioned to respond immediately to crises. Caregivers also believe that their intimate and thorough familiarity with their residents allows them to assess residents differently than could social workers. These findings have implications for mental health professionals. The combined skills and expertise of nonprofessional caregivers and social workers are essential in promoting the residents' reintegration into the community.     

Relationship between mandibular deviation and ocular convergence

Recent studies have confirmed the relationship between head posture, mandibular position and visual focusing. A case-controlled study was conducted to assess the occurrence of ocular convergence defects between subjects with functional mandibular latero-deviation and healthy subjects in pediatric age. Sixty subjects (the study group) presented mandibular latero-deviation classified as functional according to the use of a clinical examination and frontal and basal tele-radiography. Sixty subjects without functional mandibular laterodeviation (control group) were selected randomly from all subjects seeking pediatric dental care and matched by gender and age to study group. All one hundred and twenty subjects were submitted to orthoptic tests performed by the same operator. These results seemed to confirm that in mandibular latero-deviation subjects ocular convergence defects occurred in greater frequency than in controls underlining the importance of role of pediatric dentistry among interdisciplinary cooperation.     

Supported housing for adults with psychiatric disabilities: How tenants confront the problem of loneliness

The objective of this study was to examine the experience of loneliness among people with psychiatric disabilities after moving from custodial housing, including group homes, boarding homes, and family‐type residences to independent, supported apartments in the community. Qualitative research methods guided by a naturalistic/constructivist framework were used. Data collection occurred between May 2014 and July 2015 and consisted of individual semi‐structured interviews with 24 tenants residing in five supported housing sites across three Canadian provinces; interviews were also conducted with a designated family member for each tenant and with their service providers. Group interviews were conducted with housing workers in the five housing sites. The interviews were transcribed verbatim, codes generated and a thematic analysis undertaken using a constructivist approach. Results showed that for most tenants living in independent apartments with support loneliness was not a serious problem or was an issue that could be overcome. Most study participants viewed supported housing as preferable to custodial housing and as a normalising experience that facilitated community integration. While housing conditions, particularly those associated with congregate housing, sometimes helped attenuate loneliness among tenants, managing loneliness was primarily contingent on the ability of individuals to develop and maintain social connections, as well as on family involvement.     

Convergence defects in patients with temporomandibular disorders

The aim of this study is to show the presence of a correlation between ocular convergence defects (OCD) and temporomandibular disorders (TMD) among a group of adult subjects. The group studied was made up of 48 subjects (12 males and 36 females). The average age was 35 with a range of 19-45 years of age. The subjects presented with TMD and muscular pain and/or dysfunction. Forty-eight subjects with TMD for the case study were matched by gender and age to 48 control subjects seeking routine dental care (control group). All the subjects were examined by the same orthoptist who classified the ocular convergence degree using two tests. The first test evaluated the distances (in centimeters) of the convergence near point (3-4 cm: normal; 5-7 cm: sufficient; > 7 cm: insufficient). The second test assessed the fusional convergence using a Berens prism test (> 25 diopters: normal; between 18-25: sufficient; < 18 diopters: insufficient). In the TMD group, 36 subjects (75%) showed a compromise of convergence: 13 (36%) were classified in the 5-7 degree range and 23 (48%) in the > 7 cm degree range. The Berens test showed ten subjects (28%) in the group < 18D and 26 (72%) in the group 18-25D. The control-group presented ten (21%) subjects with compromise of convergence: three classified in the group < 18D and seven in the group 18-25D. The TMD subjects presented a higher statistical percentage (p < 0.0001) of ocular convergence defects. The TMD patients also reported a strong association referred to specific signs and symptoms, i.e., limited maximal opening or myofascial pain. There were some subjective reports also of headaches and torcicollis (neck stiffness) which appeared significantly more frequently in subjects with a compromise of convergence. The study showed a much higher prevalence of ocular convergence defects in patients with head, neck, and shoulder pain.