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Fei C, Zhu Y, Jiang L, Zhou H, Yu H. Social integration, physical and mental health and subjective well-being in the floating population-a moderated mediation analysis. Front Public Health 2023; 11:1167537. [PMID: 37483925 PMCID: PMC10356978 DOI: 10.3389/fpubh.2023.1167537] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 06/14/2023] [Indexed: 07/25/2023] Open
Abstract
Background Individuals of domestic migrant populations in China (specifically, migration that is economically driven) often face difficulties in social integration. They are suffering from discrimination and unfair treatment in work and life, which do harm to their physical/mental health and Subjective Well-Being (SWB). Methods The current study utilized a stratified sampling survey in the Yangtze River Delta region of China, in October and November 2022. Six hundred and eleven useful self-reported questionnaires were collected. Questionnaires include questions about social integration, social capital, physical/mental health, and SWB; Bootstrapping method was used to test the mediating effect of physical health and mental health. Multiple hierarchical regression was used to test the moderating effect of social capital. Results Social integration had positive impact on the SWB (r = 0.523, p < 0.01). Bootstrap analysis showed that physical health and mental health partially mediated the correlation between social integration and SWB of Floating Population with a mediation effect of 0.149 and 0.192. Social capital can positively moderate the relationship between two pair of variables: social integration and SWB (β = 0.152, t = 4.42, p < 0.001), physical health and SWB (β = 0.148, t = 4.39, p < 0.01). However, social capital does not play a significant moderating role in the association between the effect of mental health on SWB (β = 0.032, t = 0.973, p > 0.05). Conclusion This study proved a significant correlation between social integration and SWB of Floating Population, with physical/mental health playing a mediating role. Enhancing the social integration of floating population and keeping healthy physically and mentally are key to improving their SWB.
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Association between Psychological Integration and Permanent Supportive Housing: An Exploratory Study with a Focus on Ethnicity. SOCIAL SCIENCES 2021. [DOI: 10.3390/socsci10120468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There is limited research on the association between Permanent Supportive Housing (PSH) and psychological integration. The purpose of this study was to explore this association among individuals with mental illness and/or substance use disorder (SUD) enrolled in PSH and to identify variables associated with sense of belonging. Given differences in outcomes of PSH by ethnicity, we were interested to determine if an association existed between PSH and psychological integration and whether it was equally observed among Hispanics and non-Hispanics. The target population included individuals who were chronically homeless and diagnosed with a mental illness and/or SUD. Baseline data were collected upon intake (N = 370). Follow-up data were collected at six-months post baseline (N = 286) and discharge (N = 143). Predictor and control variables included demographics, overall health, PTSD symptom severity, interactions with family and friends, and participation in recovery-related groups in the community. Psychological integration scores increased significantly from the baseline to the 6-month follow-up (t = −3.41, p = 0.003) and between the 6-month follow-up and discharge (t = −2.97, p = 0.007). Significant predictors of psychological integration included overall health, interactions with family and/or friends, PTSD symptoms, income, education, and diagnosis. No differences were observed between Hispanics and non-Hispanics. The findings from this exploratory study suggest that future research in this area is warranted.
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Motta-Ochoa R, Leibing A, Bresba P, Williams M, Shaffer S, Julien O, Racine E, Blain-Moraes S. "You're Part of Us and We're Happy to Have You Here": Practices of Social Inclusion for Persons with Dementia. Clin Gerontol 2021; 44:470-481. [PMID: 33662221 DOI: 10.1080/07317115.2021.1891170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: Practices of social inclusion are important for maintaining the relationships of persons with dementia and are associated with positive clinical outcomes. The objective of this study was to explore the in-action practices of social inclusion in the activity center of a community-based organization.Methods: This study applies an ethnographic approach - including participant observation, informal and semi-structured interviews - with persons with dementia (n = 31) and organization staff members (n = 9) to explore the in-action practices of social inclusion.Results: Seven in-action practices of inclusion were identified: ensuring time for individual relationships, building schedules centered around flexibility, empowering decision-making, normalizing dementia-related behaviors, involving family members, soliciting and integrating persons with dementia's feedback, and supporting persons with dementia to practice social inclusion.Conclusions: Care providers of individuals with dementia can effectively facilitate active connections with them by continually soliciting and incorporating their feedback, and by supporting persons with dementia to practice inclusion and care for others.Clinical Implications: Community-based organizations can be effective at supporting the active connection of individuals with dementia with others and should be promoted for individuals with mild to moderate dementia.
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Affiliation(s)
- Rossio Motta-Ochoa
- School of Physical & Occupational Therapy, McGill University, Montreal, Canada.,Biosignal Interaction and Personhood Technology (BIAPT) Lab, Montreal General Hospital, Montreal, Canada
| | - Annette Leibing
- Faculté Des Sciences Infirmières, Université De Montréal, Montreal, Canada
| | | | | | | | | | - Eric Racine
- Pragmatic Health Ethics, Institut De Recherche Cliniques De Montréal, Montreal, Canada
| | - Stefanie Blain-Moraes
- School of Physical & Occupational Therapy, McGill University, Montreal, Canada.,Biosignal Interaction and Personhood Technology (BIAPT) Lab, Montreal General Hospital, Montreal, Canada
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Community Integration of Persons with Mental Disorders Compared with the General Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051596. [PMID: 32121636 PMCID: PMC7084303 DOI: 10.3390/ijerph17051596] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 11/17/2022]
Abstract
Aims: Community integration is the catalyst for recovery that is provided by mental health services to persons with mental disorders. This study explores the impact of socio-demographic variables on the level of community integration in persons with mental disorders compared to the general population living in the same communities and the difference in community integration level between the two groups. Methods: A total of 224 persons with mental disorders (M age = 45.0, SD = 12.84, male 51.8%, female 48.2%) in communities and 247 individuals (M age = 44.6, SD = 11.41, male 50.6%, female 49.4%) of the general population in the same communities participated in the evaluation of levels of physical, psychological, and social integration. The effects of socio-demographic variables on the three types of community integration on both groups were evaluated using multiple regression analyses. Differences in the three types of community integration between the two groups were tested using multivariate analysis of covariance (MANCOVA) by controlling for socio-demographic variables as covariates. Results: The effects of socio-demographic variables on the three types of community integration differed between the two groups. In addition, the two groups differed significantly in terms of social rather than physical or psychological integration when the level of community integration was compared while controlling socio-demographic variables. The results also show that persons with mental disorders had smaller social networks and fewer social contacts than the general population. Conclusions: Based on the findings, we recommended that service providers provide incentives for consumers to strengthen social relationships and social skills training in order to maintain relationships.
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Chinchilla M, Gabrielian S, Hellemann G, Glasmeier A, Green M. Determinants of Community Integration Among Formerly Homeless Veterans Who Received Supportive Housing. Front Psychiatry 2019; 10:472. [PMID: 31297070 PMCID: PMC6607471 DOI: 10.3389/fpsyt.2019.00472] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 06/13/2019] [Indexed: 11/24/2022] Open
Abstract
Community integration is recognized as a meaningful goal that is highly relevant to the long-term success of supportive housing programs. Research to date highlights concerns that some individuals in permanent supportive housing remain socially isolated and have limited success in other domains of community integration. However, we know little about what factors impact formerly homeless veterans' ability to achieve community integration. To identify factors associated with community integration among homeless veterans housed through the Department of Veterans Affairs' (VA's) Supportive Housing program (HUD-VASH), we performed secondary database analyses of Veterans (n = 560) housed via HUD-VASH in the VA Greater Los Angeles Healthcare System from 10/1/14-9/30/15. We conducted ordinal and logit regressions to examine associations between baseline HUD-VASH participant characteristics, supportive housing voucher type, health service utilization in the year post-housing, and three types of community integration outcomes (i.e., change in community adjustment, status of housing stability, and change in employment). Data were obtained from HOMES (VA's homeless registry) and Corporate Data Warehouse (CDW) (VA's a national administrative dataset of VA inpatient and outpatient care). Mental health service utilization was negatively associated with community adjustment, housing stability, and employment. Employment at baseline was positively associated with housing stability and employment. Also, substance use disorder visits was positively associated with employment, and combined medical and substance use disorder diagnoses was positively associated with change in community adjustment. We considered 29 variables and found relatively few were associated with community integration. Consistent with previous research, our study highlights the importance of mental health needs, and suggests that utilization of mental health services is an important indicator of improvements in community adjustment, housing stability, and employment.
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Affiliation(s)
- Melissa Chinchilla
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation, & Policy, Los Angeles, CA, United States
| | - Sonya Gabrielian
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation, & Policy, Los Angeles, CA, United States
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Amy Glasmeier
- Department of Urban Studies and Planning Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Michael Green
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
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6
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Tong B, Sung C, Sánchez J. Using the biopsychosocial model to predict sense of community for persons with serious mental illness. J Ment Health 2019; 30:366-374. [DOI: 10.1080/09638237.2019.1581330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Boyang Tong
- Resource Center for Persons with Disabilities, Michigan State University, East Lansing, MI, USA
| | - Connie Sung
- Department of Counseling, Educational Psychology and Special Education, Michigan State University, East Lansing, MI, USA
| | - Jennifer Sánchez
- Department of Rehabilitation and Counselor Education, The University of Iowa, Iowa City, IA, USA
- Iowa Consortium for Substance Abuse Research and Evaluation, The University of Iowa, Iowa City, IA, USA
- I-SERVE (Iowa-Support, Education, and Resources for Veterans and Enlisted), The University of Iowa, Iowa City, IA, USA
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Terry R, Townley G, Brusilovskiy E, Salzer MS. The influence of sense of community on the relationship between community participation and mental health for individuals with serious mental illnesses. JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 47:163-175. [PMID: 30506935 DOI: 10.1002/jcop.22115] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/14/2018] [Accepted: 06/20/2018] [Indexed: 06/09/2023]
Abstract
The goal of the current study is to better understand the association between community participation and mental health by investigating sense of community as a potential mediating factor between community participation, psychological distress, and mental health functioning. A survey was administered to 300 adults with serious mental illnesses using community mental health services in the United States in a cross-sectional design. Hayes PROCESS macro (model 4, version 2.16; Hayes, 2013) was employed to test all of the hypotheses. Results indicate that sense of community partially mediated the association between community participation and psychological distress, as well as mental health functioning. Implications include contributing to the current knowledge base about the influence of community factors on mental health and informing future interventions aimed at promoting community participation of adults with serious mental illnesses.
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Sánchez J, Muller V, Chan F, Brooks JM, Iwanaga K, Tu WM, Umucu E, Crespo-Jones M. Personal and environmental contextual factors as mediators between functional disability and quality of life in adults with serious mental illness: a cross-sectional analysis. Qual Life Res 2018; 28:441-450. [PMID: 30244361 DOI: 10.1007/s11136-018-2006-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine personal and environmental contextual factors as mediators of functional disability on quality of life (QOL) in a sample of individuals with serious mental illness (SMI). METHODS A cross-sectional analysis of 194 individuals with SMI (major depressive disorder = 38.1%; bipolar disorder = 35.6%; schizophrenia spectrum disorder = 25.8%) recruited from four psychosocial rehabilitation clubhouses was undertaken to test a multiple regression model assuming that personal (i.e., resilience, social competence, and disability acceptance) contextual factors and environmental (i.e., family support, support from friends, and support from significant others) contextual factors would mediate the relationship of functional disability on QOL. The bootstrap test for multiple mediators was then used to test for the significance of the indirect effects functional disability on QOL through the mediators. RESULTS In the simple regression model, functional disability had a strong relationship with QOL; however, after introducing the potential mediators, its effect was significantly reduced indicating partial mediation effects. The final regression model yielded a large effect, accounting for 44% of the variance in QOL. Controlling for all other potential mediating factors, social competence, disability acceptance, family support, and support from friends were found to partially mediate the relationship between functional disability and QOL. Bias-corrected bootstrap procedure results further supported the mediation model. CONCLUSIONS The findings from the study provide good support for the inclusion of person-environment contextual factors in conceptualizing the relationship between functional disability and QOL for individuals with SMI.
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Affiliation(s)
- Jennifer Sánchez
- Department of Rehabilitation and Counselor Education, The University of Iowa, N346 Lindquist Center, Iowa City, IA, 52242, USA. .,Iowa Consortium for Substance Abuse Research and Evaluation, The University of Iowa, 2662 Crosspark Road, Coralville, IA, 52241, USA. .,I-SERVE (Iowa-Support, Education, and Resources for Veterans and Enlisted), The University of Iowa, N122 Lindquist Center, Iowa City, IA, 52242, USA.
| | - Veronica Muller
- Department of Educational Foundations and Counseling, Hunter College, City University of New York, 695 Park Avenue, Room W1123, New York, NY, 10065, USA
| | - Fong Chan
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, 431 Education Building, 1000 Bascom Mall, Madison, WI, 53706, USA
| | - Jessica M Brooks
- Department of Rehabilitation and Health Services, University of North Texas, 218 Chilton Hall, 410 Avenue C, Denton, TX, 76203, USA
| | - Kanako Iwanaga
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin-Madison, 431 Education Building, 1000 Bascom Mall, Madison, WI, 53706, USA
| | - Wei-Mo Tu
- Department of Rehabilitation and Health Services, University of North Texas, 218 Chilton Hall, 410 Avenue C, Denton, TX, 76203, USA
| | - Emre Umucu
- Department of Rehabilitation Sciences, The University of Texas at El Paso, 101 Campbell Building, 500 West University Avenue, El Paso, TX, 79968, USA
| | - Mileidy Crespo-Jones
- Department of Rehabilitation and Counselor Education, The University of Iowa, N346 Lindquist Center, Iowa City, IA, 52242, USA
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9
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Abstract
As different facets of community integration as well as psychological and social integration are important dimensions of recovery for individuals with serious mental illness (SMI). The primary aim of the study was to explore psychological integration for individuals with SMI into the mental health and mainstream (i.e., non-mental health) communities and its association with their social integration into both communities. The study used self-report and egocentric social network data from 60 individuals with SMI receiving community-based mental health services. The primary findings indicated that social integration connected to service providers was associated with psychological integration in both mental health and mainstream communities. Our data suggest that in addition to providing services, providers are doing something meaningful to impact their clients' lives well beyond mental health services. The study supports a bifurcated conceptualization of psychological integration and provides a more complex understanding of the community integration concept.
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Sheridan A, O'Keeffe D, Coughlan B, Frazer K, Drennan J, Kemple M. Friendship and money: A qualitative study of service users' experiences of participating in a supported socialisation programme. Int J Soc Psychiatry 2018. [PMID: 29536792 DOI: 10.1177/0020764018763692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Social opportunities can be limited in the lives of people with enduring mental illness (EMI) due to psychiatric stigma, restricted home environments and employment barriers. Supported socialisation programmes have the potential to redress the impact of social isolation. AIM To explore the experiences of service users with EMI taking part in a supported socialisation programme, using written diary entries. METHODS This article reports on the qualitative component of a randomised controlled trial of supported socialisation for people with EMI (published previously in this journal). Trial participation involved (1) being matched with a volunteer partner and engaging in social/leisure activities while receiving a stipend of €20 or (2) receiving this stipend only and engaging in self-driven socialisation. Participants completed written diaries documenting their perspectives on their experiences of supported socialisation. Data were analysed using Thematic Analysis. RESULTS Experiences of participation were characterised by involvement 'normalising' life, fostering a sense of connectedness, improving physical health, and facilitating engagement with culture. Taking part helped participants integrate socialising into their identity, enhanced their perceived capacity to be social, and cemented/expanded social networks. Participants also experienced significant obstacles to socialisation. CONCLUSION Supported socialisation can increase confidence, social competence and self-agency; buffer against psychiatric stigma; build social capital; and afford opportunities to enhance social integration, inclusion and belonging.
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Affiliation(s)
- Ann Sheridan
- 1 UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Donal O'Keeffe
- 2 DETECT Early Intervention Psychosis Services, Cluain Mhuire Community Mental Health Services, Dublin, Ireland
| | - Barbara Coughlan
- 1 UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Kate Frazer
- 1 UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Johnathan Drennan
- 3 School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Mary Kemple
- 1 UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Palis H, Marchand K, Oviedo-Joekes E. The relationship between sense of community belonging and self-rated mental health among Canadians with mental or substance use disorders. J Ment Health 2018; 29:168-175. [DOI: 10.1080/09638237.2018.1437602] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Heather Palis
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada, and
- Providence Health Care, Centre for Health Evaluation & Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada
| | - Kirsten Marchand
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada, and
- Providence Health Care, Centre for Health Evaluation & Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada
| | - Eugenia Oviedo-Joekes
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada, and
- Providence Health Care, Centre for Health Evaluation & Outcome Sciences, St. Paul's Hospital, Vancouver, BC, Canada
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12
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Milbourn B, McNamara B, Buchanan A. A qualitative study of occupational well-being for people with severe mental illness. Scand J Occup Ther 2016; 24:269-280. [PMID: 27734712 DOI: 10.1080/11038128.2016.1241824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND/AIM People with severe mental illness (SMI) do not receive adequate attention in research or clinical practice. They are considered hard to reach and difficult to engage. Information is needed to help provide support for this vulnerable population. This paper aims to investigate the well-being of adults diagnosed with SMI and receiving Assertive Community Treatment (ACT) by applying the occupational well-being framework to the everyday activities of this vulnerable group of people. MATERIALS AND METHODS Eleven adults diagnosed with an SMI, living in the community, participated in semi-structured interviews over a 12-month period. A longitudinal design was used to collect data through using field notes and audio recordings. For this paper, secondary analysis was conducted by coding the data deductively thereby investigating the participants' experiences in relation to the seven Occupational Well-being framework descriptors (accomplishment, affirmation, agency, coherence, companionship, pleasure and renewal). RESULTS Participants' everyday activities and occupational well-being appeared severely restricted and largely determined by the type of care they received. There was minimal evidence of the well-being descriptors, though all the participants reported experiencing some form of pleasure, even though some of the pleasurable experiences negatively impacted their health. CONCLUSION/SIGNIFICANCE The episodic nature of SMI means that people living with an SMI require continuity in key relationships and support to achieve Occupational Well-being. Occupational therapists working with mental health consumers need to facilitate the types of activities that foster well-being through accomplishment, affirmation, agency and companionship, and that derive pleasure in healthy and positive ways.
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Affiliation(s)
- Benjamin Milbourn
- a School of Occupational Therapy and Social Work , Curtin University , Perth , Australia
| | - Beverley McNamara
- a School of Occupational Therapy and Social Work , Curtin University , Perth , Australia
| | - Angus Buchanan
- a School of Occupational Therapy and Social Work , Curtin University , Perth , Australia
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Emmerink PMJ, Roeg DPK. Predictors of quality of life of people receiving intensive community-based care. Qual Life Res 2016; 25:457-464. [PMID: 26319948 PMCID: PMC4722070 DOI: 10.1007/s11136-015-1093-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE Intensive community-based care (ICBC) is a home-treatment approach aiming to support people 'living in the community' with severe psychiatric and addiction problems. Although subjective quality of life (SQOL) is an increasingly important outcome measure in health care, little is known on ICBC clients' SQOL. METHODS Clients of three ICBC teams (N = 523) participated in the study. Upon intake, clients filled out a SQOL measure and indicated whether they had a good friend, partner, and children, as well as their experiences with crime. Professional caregivers filled in a measure on problem severity. RESULTS Regression was used to examine to what extent the included variables contributed to explaining variance in ICBC clients' SQOL. Determinants in the model significantly predicted client SQOL and explained 37 % of the variance. 'Symptomatology' (depressive symptoms) and 'social problems' (living conditions) negatively influenced the SQOL, while having a partner, a good friend, and an overall lower problem severity positively influenced SQOL. CONCLUSIONS SQOL among ICBC clients is related to psychopathology, in contrast to previous knowledge. It is dependent upon symptom specificity, living conditions, and social circumstances and therefore presumably on program characteristics. This study provides insight into well-being among ICBC clients and is therefore relevant to involved healthcare professionals.
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Affiliation(s)
- P. M. J. Emmerink
- Tranzo Department, Tilburg University, Warandelaan 2, 5000 LE Tilburg, The Netherlands
| | - D. P. K. Roeg
- Tranzo Department, Tilburg University, Warandelaan 2, 5000 LE Tilburg, The Netherlands
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14
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Townley G. “It Helps You Not Feel So Bad—Feel Like You Again”: The Importance of Community for Individuals with Psychiatric Disabilities. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s40737-015-0036-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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SoYoung Min. The Moderating Effect of Community Cohesion on the Relationship between Neighborhood Disorder and Community Integration among Persons with Mental Illnesses. ACTA ACUST UNITED AC 2015. [DOI: 10.20970/kasw.2015.67.3.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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16
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Eklund M. Exploring quality of life as an intervention outcome among women with stress-related disorders participating in work rehabilitation. PATIENT-RELATED OUTCOME MEASURES 2015; 6:1-7. [PMID: 25610009 PMCID: PMC4298298 DOI: 10.2147/prom.s74498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Findings from quality of life studies are often inconclusive for reasons such as: i) estimates may address different aspects of quality of life and thus produce different outcomes; ii) quality of life is largely determined by self-factors; and iii) people with a long-term condition rate their quality of life better than those who have had their condition for a short duration. This makes quality of life a complex phenomenon to measure. Aims The above explanations served as hypotheses for this methodologically oriented paper, based on a longitudinal study on women with stress-related disorders receiving work rehabilitation. Methods Eighty-four women participating in a lifestyle intervention or care as usual were compared. Self-ratings of “general quality of life” and a summarized “satisfaction with different life domains” index (according to Manchester Short Assessment of Quality of Life) and two self-factors (self-esteem and self-mastery) were administered at admission and a 6-month follow-up. Participant age and amount of months on sick leave prior to rehabilitation were used as two proxies of duration of the condition. Results General quality of life distinguished between the groups, whereas satisfaction with life domains did not. Self-esteem and self-mastery were related to both quality of life aspects. Age was related to both estimates of quality of life, whereas duration of sick leave was unrelated to both. Conclusion General quality of life and satisfaction with life domains produced different results. Outcome studies should apply more than one operationalization of quality of life and self-factors should be considered as important determinants of quality of life. Duration of the condition needs to be acknowledged as well when interpreting levels of quality of life, although the current study could not present any clear-cut findings in this respect.
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Affiliation(s)
- Mona Eklund
- Department of Health Sciences, Lund University, Lund, Sweden
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17
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Nieminen I, Ramon S, Dawson I, Flores P, Leahy E, Pedersen ML, Kaunonen M. Experiences of Social Inclusion and Employment of Mental Health Service Users in a European Union Project. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2014. [DOI: 10.2753/imh0020-7411410401] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Irja Nieminen
- a School of Health Sciences, University of Tampere, Tampere, Finland
| | - Shulamit Ramon
- b Faculty of Health and Social Care, Anglia Ruskin University, Cambridge, United Kingdom
| | - Ian Dawson
- c Salten District Psychiatric Centre, Nordland Hospital, Bodø, Norway
| | - Paz Flores
- d Day Psychiatric Hospital, Centre Forum-Hospital del Mar, Barcelona, Spain
| | - Eithne Leahy
- e Biomedical Research Institute, Barcelona, Spain
| | | | - Marja Kaunonen
- g School of Health Sciences/Pirkanmaa Hospital District, Science Center, University of Tampere, Tampere, Finland
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18
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Chan DV, Helfrich CA, Hursh NC, Sally Rogers E, Gopal S. Measuring community integration using Geographic Information Systems (GIS) and participatory mapping for people who were once homeless. Health Place 2014; 27:92-101. [PMID: 24589632 DOI: 10.1016/j.healthplace.2013.12.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 11/14/2013] [Accepted: 12/15/2013] [Indexed: 10/25/2022]
Abstract
Measures of community integration rely on self-report assessments that often quantify physical or social participation, but fail to capture the individual׳s spatial presence in the community. The current study documents the activity space, or area of daily experiences, of 37 individuals who were once homeless through participatory mapping and Geographic Information Systems (GIS). Contrary to expectations, there was no significant relationship between activity space size and community integration measures, except a negative association with physical integration. Further analysis revealed, however, that continued use of homeless services, geographically spread throughout the city, was associated with larger activity space size, but may be counterproductive to social and psychological integration efforts. Analysis of the types of locations identified revealed high importance given to leisure locations and ongoing involvement with medical and mental health locations. Finally, community integration outcomes did not differ significantly by demographics or housing type, but rather degree of family involvement and feeling like home, factors that may have more potential for change.
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Affiliation(s)
- Dara V Chan
- Rehabilitation Counseling and Psychology, The University of North Carolina at Chapel Hill, 4102 Bondurant Hall, Campus Box 7205, Chapel Hill, NC 27599-7205, USA.
| | | | | | - E Sally Rogers
- Occupational Therapy, Boston University, Boston, USA; Center for Psychiatric Rehabilitation, Boston, USA
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Townley G, Miller H, Kloos B. A little goes a long way: the impact of distal social support on community integration and recovery of individuals with psychiatric disabilities. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2013; 52:84-96. [PMID: 23689965 DOI: 10.1007/s10464-013-9578-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Although an extensive body of literature highlights the important role of social support for individuals with psychiatric disabilities, definitions of support tend to be restricted-focusing on intimate relationships such as friend and family networks and ignoring the role of casual relationships existing naturally in the community. This mixed-methods study of 300 consumers of mental health services in the Southeastern US aims to better understand the impact of community supports, termed distal supports, on community integration and recovery from mental illness. Qualitative content analysis, tests of group mean differences, and hierarchical linear regression analyses revealed the following: (1) participants primarily reported receiving tangible support (e.g., free medication/discounted goods) from distal supports rather than emotional support (e.g., displays of warmth/affection) or informational support (e.g., provision of advice); (2) women and older participants reported more distal supports than men or younger participants; and (3) distal supports played a unique role in predicting community integration and recovery even after accounting for the influence of traditional support networks. Results highlight the importance of considering diverse types of social support in naturally occurring settings when designing treatment plans and interventions aimed at encouraging community participation and adaptive functioning for individuals with psychiatric disabilities.
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Affiliation(s)
- Greg Townley
- Department of Psychology, Portland State University, P.O. Box 751, Portland, OR 97207-0751, USA.
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Kloos B, Townley G. Investigating the relationship between neighborhood experiences and psychiatric distress for individuals with serious mental illness. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2010; 38:105-16. [PMID: 20680675 DOI: 10.1007/s10488-010-0307-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The present study examined the relationships between how research participants experienced their neighborhood, their neighborhood social climate, and psychological well-being. Participants (n = 525) were residents of supported housing programs who used mental health services at one of 17 community mental health centers in South Carolina. Hierarchical regression and mediation analyses were employed to answer research questions. Results suggest that neighbor relations, perceptions of neighborhood safety, and neighborhood satisfaction were significantly associated with perceptions of neighborhood social climate; and neighborhood social climate accounted for a significant amount of the variance in psychiatric distress. Of particular interest, perceptions of neighborhood social climate fully mediated the relationship between the specific reported neighborhood experiences and psychiatric distress. These findings have implications for interventions and policy aimed at promoting integration of individuals with serious mental illness into community settings.
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Affiliation(s)
- Bret Kloos
- Department of Psychology, University of South Carolina, 1512 Pendleton Street, Columbia, SC 29208, USA.
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Eklund M, Ostman M. Belonging and doing: important factors for satisfaction with sexual relations as perceived by people with persistent mental illness. Int J Soc Psychiatry 2010; 56:336-47. [PMID: 19617283 DOI: 10.1177/0020764008101635] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND It is increasingly acknowledged that satisfaction with sexual relations forms an important aspect of people's lives, but little is known of factors associated with this phenomenon among people with mental illness. AIM This study aimed to investigate how demographic, social, clinical, and health-related factors were related to satisfaction with sexual relations. METHODS Patients with persistent mental illness (N = 103), recruited from an outpatient unit, were assessed regarding the target variables. RESULTS No clinical variable, and only one demographic factor, namely being a cohabitant, was found to be important to satisfaction with sexual relations. Several social factors, pertaining to how everyday occupations were valued and how the social network was perceived, were shown to be of importance. General quality of life, but not self-rated health or interviewer-assessed psychopathology, was also important for satisfaction with sexual relations. A multivariate analysis showed that the most significant factor for satisfaction with sexual relations was how everyday activities were valued, and being a cohabitant explained some additional variation. CONCLUSION Previous research indicates that the mental health care services largely neglect sexual problems among people with mental illness, and the findings may provide additional knowledge that may be used in the support of this target group.
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Affiliation(s)
- Mona Eklund
- Faculty of Health and Society, Malmö University SE-20506, Malmö, Sweden.
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Abstract
Social inclusion is a leading concept in mental health practice. Multiple definitions exist and it is often assumed that full participation is required to achieve full inclusion. Challenging this assumption is the notion of ‘middle-ground’, a personally defined position where an individual feels socially included regardless of his or her physical involvement in the community. Occupational therapists can address this area of inquiry by recognising an alternative to the polar extremes of social inclusion. A practical tool is provided, which views social inclusion as a multidimensional system and promotes reflection on what it really means to be socially included.
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Affiliation(s)
- Clair Le Boutillier
- Institute of Psychiatry, King's College London, London; Formerly South London and Maudsley NHS Foundation Trust, London
| | - Anna Croucher
- South London and Maudsley NHS Foundation Trust, London
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Yanos PT, Felton BJ, Tsemberis S, Frye VA. Exploring the role of housing type, neighborhood characteristics, and lifestyle factors in the community integration of formerly homeless persons diagnosed with mental illness. J Ment Health 2009. [DOI: 10.1080/09638230701496378] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Townley G, Kloos B. Development of a measure of sense of community for individuals with serious mental illness residing in community settings. JOURNAL OF COMMUNITY PSYCHOLOGY 2009; 37:362-380. [PMID: 19305637 PMCID: PMC2658753 DOI: 10.1002/jcop.20301] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The psychological sense of community is one of the most commonly investigated constructs in community psychology. Sense of community may be particularly important for individuals with serious mental illness (SMI) because they often face societal barriers to participation in community living, including stigma and discrimination. To date, no published studies have investigated the psychometric qualities of sense of community measures among individuals with SMI. The current study tested a series of confirmatory factor analyses using the Brief Sense of Community Index (BSCI, Long & Perkins, 2003) in a sample of 416 persons with SMI living in community settings to suggest a model of sense of community for individuals with SMI and other disabilities. The resulting scale, the Brief Sense of Community Index- Disability (BSCI-D), demonstrated good model fit and construct validity. Implications are discussed for how this scale may be used in research investigating community integration and adaptive functioning in community settings.
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Townley G, Kloos B, Wright PA. Understanding the experience of place: expanding methods to conceptualize and measure community integration of persons with serious mental illness. Health Place 2008; 15:520-531. [PMID: 19062326 DOI: 10.1016/j.healthplace.2008.08.011] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2008] [Revised: 07/23/2008] [Accepted: 08/27/2008] [Indexed: 11/24/2022]
Abstract
Community integration research explores community contexts and factors that encourage or hinder individuals with serious mental illness (SMI) from actively participating in community life. This research agenda can be advanced by using mixed-methods that better document the relationships between contextual factors and individual experience. Two such methods were applied to a mixed-methods study of 40 adults with SMI living in independent housing in the Southeastern United States. Their contextualized experiences of community integration were measured by applying innovative participatory mapping and Geographic Information Systems (GIS) mapping techniques. Use of these methods in conjunction with one another facilitated the creation of activity spaces, which can measure geographic accessibility and help to represent an individual's experience of place and degree of mobility. The utility of these newly applied methods for better understanding community integration for persons with SMI is explored and implications for using these measures in research and practice are discussed.
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Affiliation(s)
- Greg Townley
- Department of Psychology, University of South Carolina, 224 Barnwell College, 1512 Pendleton Street, Columbia, SC 29208, USA.
| | - Bret Kloos
- Department of Psychology, University of South Carolina, 224 Barnwell College, 1512 Pendleton Street, Columbia, SC 29208, USA
| | - Patricia A Wright
- Department of Psychology, University of South Carolina, 224 Barnwell College, 1512 Pendleton Street, Columbia, SC 29208, USA
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Eklund M, Hansson L. Social network among people with persistent mental illness: associations with sociodemographic, clinical and health-related factors. Int J Soc Psychiatry 2007; 53:293-305. [PMID: 17703645 DOI: 10.1177/0020764006074540] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Social interaction is crucial for whether a person will successfully accomplish important life tasks. AIM AND METHOD This study investigated the importance of sociodemographic, clinical and self-perceived health-related factors for social interaction among 103 individuals with persistent mental illness, mainly psychoses, visiting an outpatient unit. RESULTS Bivariate analyses pointed to several relationships, especially between the health-related variables and both quantitative and qualitative aspects of the social network. In multivariate analyses, higher levels of quality of life, self-esteem, being a cohabitant, and living in a house were related to higher ratings on different aspects of the social network. Older age was associated with fewer close relationships but more adequate social integration. CONCLUSIONS The social network appeared to be a function of both self-perceptions and sociodemographic influences. The influence is probably dynamic and, for example, just as a better quality of life may lead to more social interaction, a more developed social network probably promotes better quality of life. Therefore, interventions in mental health care that target social interaction constitute a powerful resource and should be part of the support for people with severe and persistent mental illness.
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Affiliation(s)
- Mona Eklund
- Department of Health Sciences, Division of Occupational Therapy, Lund, Sweden.
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Jivanjee P, Kruzich J, Gordon LJ. Community Integration of Transition-Age Individuals: Views of Young with Mental Health Disorders. J Behav Health Serv Res 2007; 35:402-18. [PMID: 17464569 DOI: 10.1007/s11414-007-9062-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2006] [Accepted: 03/25/2007] [Indexed: 11/29/2022]
Abstract
This qualitative study examines the perceptions of young adults with mental health disorders of community integration. Fifty-nine young men and women participated in 12 focus groups whose aim was to gain understanding of what community integration means to them. Focus group questions also explored barriers and supports for their community integration, as well as their goals for the future and advice to others facing similar challenges. Themes that emerged were reported within the multiple domains that participants used to describe their experiences of community integration (or the lack thereof). This study highlights the desires of these young people to achieve goals in education and employment and to have friendships. Participants identified a pervasive lack of understanding of mental health and prevalent stigmatizing attitudes as resulting in challenges to their community integration. Implications of the study discuss roles for behavioral health services in encouraging empowerment, choices, and connections so that young people with mental health disorders may achieve their preferred levels of community integration.
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Affiliation(s)
- Pauline Jivanjee
- Research and Training Center on Family Support and Children's Mental Health, Portland State University, P.O. Box 751, Portland, Oregon 97207-0751, USA.
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