1
|
Athira VH, Nalini R, Krishna Kumar K. Harnessing Resilience in the Healthy Ageing Discourse: Insights from Attappadi Indigenous Older Adults, Kerala, India. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024:1-26. [PMID: 38739408 DOI: 10.1080/01634372.2024.2351074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 04/30/2024] [Indexed: 05/14/2024]
Abstract
In this "Decade of Healthy Ageing," the integration of resilience into the healthy aging discourse becomes paramount, particularly in the context of indigenous communities grappling with the enduring effects of historical oppression, persistent poverty, and health disparities in their aging journey. Employing a phenomenological lens, this study seeks to derive the resilient characteristics exhibited by the Attappadi indigenous older adults of Kerala, aiming to explore the role of resilience in their pursuit of healthy aging. In-depth phenomenological interviews (n = 34), observation, and document analysis have revealed four key themes: A life course marked by adversities, Embracing the unyielding strength within, Personal resilience catalysts, and Extrinsic resilience catalysts. The participants exhibited a reasonably well-functioning collective, given their persistent adversities in their life course. Narratives illuminated a notable connection between the presence of resilience characteristics and the overall functioning of older adults. From a social work standpoint on resilience, this article underscores the vital interplay between individual agency and environmental factors in addressing adversity. The article advocates culturally sensitive, asset-based strategies to strengthen indigenous older adults' intrinsic and extrinsic resilience to ensure that they are not left behind in the global pursuit of healthy aging.
Collapse
Affiliation(s)
- V H Athira
- Department of Social Work, Pondicherry University, Puducherry, India
| | - R Nalini
- Department of Social Work, Pondicherry University, Puducherry, India
| | - K Krishna Kumar
- Research Officer & Social Worker, Department of Social Work and Community Welfare, Arike Palliative Home Care, Kochi, India
| |
Collapse
|
2
|
Kravić N, Pajević I, Hasanović M, Karahasanović N, Voracek M, Baca-Garcia E, Dervic K. Bosnian Paternal War Orphans: Mental Health in Postwar Time. J Nerv Ment Dis 2023; 211:486-495. [PMID: 36996318 DOI: 10.1097/nmd.0000000000001651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
ABSTRACT More research on the medium- and long-term effects of childhood exposure to war, including orphanhood, is needed. We compared 50 orphans 1 who lost their father during the war in Bosnia and Herzegovina (1992-1995) and 50 age- and sex-matched adolescents from two-parent families during 2011-2012 in terms of sociodemographic characteristics, behavioral/emotional problems, depression, resilience, maternal mental health, and perceived social support. The two groups differed on sociodemographic factors, that is, number of children, family composition, income, school grades, and refugeehood. Paternal war orphans did not differ in terms of adolescent mental health and resilience from their nonorphaned peers, controlling for sociodemographic variables. The mothers of orphans had comparably more posttraumatic psychopathology. As for perceived resources for social support, orphans identified those comparably more often among distant relatives and in the community, that is, religious officials and mental health professionals, and less often among siblings, paternal grandparents, paternal and maternal uncles/aunts, school friends and teachers. Our findings suggest that contextual factors may play an important role in orphans' postwar mental health.
Collapse
Affiliation(s)
| | | | | | - Nejla Karahasanović
- Department of Neurology, Imaging Based Functional Brain Diagnostics and Therapy, Medical University of Vienna, Vienna, Austria
| | - Martin Voracek
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | | | - Kanita Dervic
- Division of Child Psychosomatics, Department of Pediatrics and Adolescent Medicine/University Hospital, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
3
|
Metzler J, Jonfa M, Savage K, Ager A. Educational, psychosocial, and protection outcomes of child- and youth-focused programming with Somali refugees in Dollo Ado, Ethiopia. DISASTERS 2021; 45:67-85. [PMID: 31322750 DOI: 10.1111/disa.12392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Child- and youth-friendly spaces have become a common feature of emergency humanitarian provision. This study reports on the outcomes of child and youth learning centres (CYLCs) in Ethiopia's Buramino Camp established for those fleeing conflict in Somalia. Eighty-five youths completed baseline assessments shortly after arrival and follow-up assessments three to six months later. Caregivers of 106 younger children completed similar appraisals. 693 children attending the CYLCs completed pre- and post-educational assessments, which indicated major gains-significant at p<0.0001-in both literacy (younger children, t=9.06; youth, t=13.87) and numeracy (younger children, t=13.94; youths, t=17.10). Children's CYLC attendance increased reports of met needs among caregivers (t=2.53, p<0.05) and youths (t=2.57, p<0.05), and, among caregivers but not youths, significantly moderated protection concerns (t=2.39, p<0.05, and t=-1.90, p=0.06, respectively). There was general improvement in psychosocial well-being over time for all children; CYLC attendance predicted greater reductions in reported difficulties only among younger children (t=2.51, p<0.05).
Collapse
Affiliation(s)
- Janna Metzler
- Senior Research Officer, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, United States
| | - Mesfin Jonfa
- Education in Emergency Specialist, World Vision Ethiopia, Ethiopia
| | - Kevin Savage
- Humanitarian Research Director, World Vision International, Geneva, Switzerland
| | - Alastair Ager
- Professor of Population and Family Health, Columbia University, United States
- Now Director of the Institute for Global Health and Development, Queen Margaret University, United Kingdom
| |
Collapse
|
4
|
Kaunda-Khangamwa BN, Kapwata P, Malisita K, Munthali A, Chipeta E, Phiri S, Manderson L. Adolescents living with HIV, complex needs and resilience in Blantyre, Malawi. AIDS Res Ther 2020; 17:35. [PMID: 32571375 PMCID: PMC7310029 DOI: 10.1186/s12981-020-00292-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/11/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Adolescents living with HIV (ALHIV) in Malawi experience multiple challenges associated with their illness and various social, environmental, economic and cultural factors. In exploring their various medical concerns and social vulnerabilities, we consider the role of multiple services in creating a pathway for resilience. METHODS Multiple methods and case studies allowed for triangulation of evidence and provided a holistic understanding of resilience among adolescents with complex needs. The research methods included: (1) a survey to identify examples of young people with complex needs, (2) qualitative interviews and field notes to further explore these needs, (3) patient files and health passports to identify clinical challenges, and (4) ecomapping exercises to personalize cases and identify resilience-enabling resources and supports. We present four case studies to highlight the complex experiences and access to services of ALHIV, and to illustrate their growing power and decision-making capacity over time. RESULTS Adversity experienced by ALHIV varied by gender, family situation, years of schooling, and use of teen-clubs for support. The two female adolescents emphasised their need to be accepted and how this impacted sexuality and reproduction. The two males illustrated how ideas of masculinity influenced their sexual practice and involvement with health services and the correctional justice system. Multiple risks (alcohol use, sexual activities) and complex needs (belonging, having a purpose in life/productive activities, autonomy, desire for offspring) influence pathways to resilience. ALHIV were able to strengthen their own wellbeing by resisting negative behaviours and peer pressure and caregiver interactions through 'strategic silence'. CONCLUSION ALHIV experienced self-transformation as a result of taking ART, with fewer severe episodes of illness and distressing skin conditions. Continuous engagement at the teen-club clinic transformed both productive activities and social relationships among ALHIV as they set life goals, gained a sense of empowerment, requested SRH services, and formed intimate relationships. These transformative opportunities allowed them to learn ways of minimizing risk of reinfection and violence, and of navigating health worker-caregiver-adolescent interactions.
Collapse
|
5
|
Powers JJ, Duys D. Toward Trauma‐Informed Career Counseling. THE CAREER DEVELOPMENT QUARTERLY 2020. [DOI: 10.1002/cdq.12221] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Janis J. Powers
- Department of Rehabilitation Counseling and EducationUniversity of Iowa
| | - David Duys
- Department of Rehabilitation Counseling and EducationUniversity of Iowa
| |
Collapse
|
6
|
Hughes N, Ungar M, Fagan A, Murray J, Atilola O, Nichols K, Garcia J, Kinner S. Health determinants of adolescent criminalisation. THE LANCET CHILD & ADOLESCENT HEALTH 2020; 4:151-162. [PMID: 31956016 DOI: 10.1016/s2352-4642(19)30347-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/24/2019] [Accepted: 10/15/2019] [Indexed: 12/18/2022]
Abstract
Several conditions related to health and development in adolescence can increase the risk that a young person will be exposed to the criminal justice system. Such determinants include neurodevelopmental disability, poor mental health, trauma, and experiences of maltreatment. Furthermore, the risk of exposure to the criminal justice system seems to be amplified by social marginalisation and inequality, such that young people are made susceptible to criminal behaviour and criminalisation by a combination of health difficulties and social disadvantages. This Review presents evidence on the health determinants of criminalisation among adolescents, providing a persuasive case for policy and practice reform, including for investment in approaches to prevent criminalisation on the basis of health and developmental difficulties, and to better address related needs once within a criminal justice system.
Collapse
Affiliation(s)
- Nathan Hughes
- Department of Sociological Studies, University of Sheffield, Sheffield, UK; Murdoch Children's Research Institute, Melbourne, VIC, Australia.
| | - Michael Ungar
- School of Social Work, Dalhousie University, Halifax, NS, Canada
| | - Abigail Fagan
- Department of Sociology and Criminology and Law, University of Florida, Gainesville, FL, USA
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Olayinka Atilola
- College of Medicine, Lagos State University, Yaba, Lagos, Nigeria
| | - Kitty Nichols
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Joana Garcia
- School of Social Work, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Stuart Kinner
- Murdoch Children's Research Institute, Melbourne, VIC, Australia; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
7
|
Martel R, Reihana-Tait H, Lawrence A, Shepherd M, Wihongi T, Goodyear-Smith F. Reaching out to reduce health inequities for Māori youth. Int Nurs Rev 2020; 67:275-281. [PMID: 31898328 DOI: 10.1111/inr.12565] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/30/2019] [Accepted: 10/01/2019] [Indexed: 01/25/2023]
Abstract
AIM This paper describes an initiative facilitating comprehensive assessment and delivery of brief interventions for Māori youth in Northland, New Zealand. BACKGROUND The population in Northland is predominantly Māori and is one of New Zealand's most deprived populations. Māori youth have the highest youth suicide rate in the developed world and elevated numbers of youth displaying mental health issues and/or risk behaviours are of grave national concern. Like Indigenous peoples worldwide, inequities persist for Māori youth accessing and engaging with healthcare services. DESCRIPTION Taking services out to Māori youth in remote and isolated areas, Northland's youth specialist nurses are reducing some barriers to accessing health care. The youth version of the Case-finding and Help Assessment Tool is a New Zealand-developed, e-screening tool for youth psychosocial issues, facilitating comprehensive assessment and brief intervention delivery. DISCUSSION Early detection of, and timely intervention for, mental health and risk behaviours can significantly improve health outcomes in youth. However, for this to happen barriers preventing youth from accessing appropriate care need to be overcome. CONCLUSION Youth specialist nurses could improve access to care for youth from ethnic minorities, rural and isolated regions, and areas of high deprivation without overwhelming the medical profession. IMPLICATIONS FOR NURSING POLICY Specialist nurses are trained and empowered to practice at the top of their scope. With general practitioner oversight and standing order sign off specialist nurses can work autonomously to improve access to health services, without increasing the workload of doctors. IMPLICATIONS FOR NURSING PRACTICE Encouraging continuous self-reflection of the nurse's effectiveness in meeting patient needs, holistically and culturally, facilitates the provision of accessible care that is patient-centred and culturally safe.
Collapse
Affiliation(s)
- R Martel
- Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand
| | - H Reihana-Tait
- Te Tai Tokerau Primary Health Organisation, Kerikeri, New Zealand
| | - A Lawrence
- Te Tai Tokerau Primary Health Organisation, Kerikeri, New Zealand.,Manaia Health Primary Health Organisation, Whangarei, New Zealand
| | - M Shepherd
- School of Psychology, Massey University, Auckland, New Zealand
| | - T Wihongi
- Northland District Health Board, Whangarei, New Zealand
| | - F Goodyear-Smith
- Department of General Practice & Primary Health Care, University of Auckland, Auckland, New Zealand
| |
Collapse
|
8
|
Martel RM, Darragh ML, Lawrence AJ, Shepherd MJ, Wihongi T, Goodyear-Smith FA. YouthCHAT as a Primary Care E-Screening Tool for Mental Health Issues Among Te Tai Tokerau Youth: Protocol for a Co-Design Study. JMIR Res Protoc 2019; 8:e12108. [PMID: 30626568 PMCID: PMC6329425 DOI: 10.2196/12108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 01/13/2023] Open
Abstract
Background In New Zealand (NZ), 1 in 4 adolescents is affected by mental health issues (eg, depression and anxiety) and engages in risk behaviors (eg, harmful drinking and substance abuse), with rates among Māori youth being significantly higher. The majority of NZ secondary school students visit their local primary health care providers (PHPs) at least annually, yet most do not seek help for mental health and risk behavior (MHB) concerns. While youth think it acceptable to discuss sensitive issues during a consultation with their PHPs, unless problems are severe, such conversations are not initiated by PHPs. Early intervention for MHB concerns can prevent long-term health and well-being issues. However, this relies on the early identification of developing problems and youth being offered and accepting help. YouthCHAT is an electronic, multi-item screening tool developed in 2016 to assess MHB concerns among youth. YouthCHAT is completed before a consultation with the PHP, who can access a summary report straight away. A help question allows young people to identify issues that need addressing. A resource pack uses stepped care pathways to guide providers to use appropriate brief interventions. Objective This study aimed to explore the utility, feasibility, and acceptability of YouthCHAT when tailored for use with youth in primary care settings with large Māori populations. Objectives of the study are to evaluate the implementation of YouthCHAT in nurse-led youth clinics, school-based clinics, and general practice in Te Tai Tokerau (Northland, NZ); to develop a framework for the scaling up of YouthCHAT across further settings; to assess health provider and youth acceptability of the tool; to improve screening rates for mental health and help-seeking behavior; to enable early identification of emerging problems; and to improve brief intervention delivery. Methods Using a bicultural mixed-methods co-design approach, 3 phases over a 3-year period will provide an iterative evaluation of the utility, feasibility, and acceptability of YouthCHAT, aiming to create a framework for wider-scale rollout and implementation. Results Recruitment for the first phase began in September 2018. YouthCHAT was implemented at the first site in October 2018 and is expected to be at a further two sites in late January to early February 2019. The study is due for completion at the end of 2021. Conclusions YouthCHAT has potential as a user-friendly, time efficient, and culturally safe screening tool for early detection of MHB issues in NZ youth. The resource pack assists the clinician to provide appropriate interventions for emerging and developed youth mental health and lifestyle issues. Involving input from community providers, users, and stakeholders will ensure that modifiable elements of YouthCHAT are tailored to meet the health needs specific to each context and will have a positive influence on future mental, physical, and social outcomes for NZ youth. International Registered Report Identifier (IRRID) PRR1-10.2196/12108
Collapse
Affiliation(s)
- Rhiannon Mary Martel
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Margot Louise Darragh
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Aniva Joanne Lawrence
- Manaia Health Primary Health Organisation, Whangarei, New Zealand.,Te Tai Tokerau Primary Health Organisation, Kerikeri, New Zealand
| | - Matthew John Shepherd
- Faculty of Education and Social Work, Department of Counselling, Human Services and Social Work, The University of Auckland, Auckland, New Zealand
| | | | - Felicity Anne Goodyear-Smith
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
9
|
Goodyear-Smith F, Martel R, Darragh M, Warren J, Thabrew H, Clark TC. Screening for risky behaviour and mental health in young people: the YouthCHAT programme. Public Health Rev 2017; 38:20. [PMID: 29450092 PMCID: PMC5810064 DOI: 10.1186/s40985-017-0068-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 08/23/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The prevalence of mental health concerns and risky health behaviours among young people is of global concern. A large proportion of young people in New Zealand (NZ) are affected by depression, suicidal ideation and other mental health concerns, but the majority do not access help. For NZ indigenous Māori, the burden of morbidity and mortality associated with mental health is considerably higher. Targeted screening for risky behaviours and mental health concerns among youth in primary care settings can lead to early detection and intervention for emerging or current mental health and psychosocial issues. Opportunistic screening for youth in primary care settings is not routinely undertaken due to competing time demands, lack of context-specific screening tools and insufficient knowledge about suitable interventions. Strategies are required to improve screening that are acceptable and appropriate for the primary care environment. This article outlines the development, utilisation and ongoing evaluation and implementation strategies for YouthCHAT. YOUTHCHAT YouthCHAT is a rapid, electronic, self-report screening tool that assesses risky health-related behaviours and mental health concerns, with a 'help question' that enables youth to prioritise areas they want help with. The young person can complete YouthCHAT in the waiting room prior to consultation, and after completion, the clinician can immediately access a summary report which includes algorithms for stepped-care interventions using a strength-based approach. A project to scale up the implementation is about to commence, using a co-design participatory research approach to assess acceptability and feasibility with successive roll-out to clinics. In addition, a counter-balanced randomised trial of YouthCHAT versus clinician-administered assessment is underway at a NZ high school. CONCLUSION Opportunistic screening for mental health concerns and other risky health behaviours during adolescence can yield significant health gains and prevent unnecessary morbidity and mortality. The systematic approaches to screening and provision of algorithms for stepped-care intervention will assist in delivering time efficient, early, more comprehensive interventions for youth with mental health concerns and other health compromising behaviours. The early detection of concerns and facilitation to evidence-based interventions has the potential to lead to improved health outcomes, particularly for under-served indigenous populations.
Collapse
Affiliation(s)
- Felicity Goodyear-Smith
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Rhiannon Martel
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Margot Darragh
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Jim Warren
- Department of Computer Science, Faculty of Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Hiran Thabrew
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Terryann C. Clark
- School of Nursing, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
| |
Collapse
|
10
|
van Rensburg AC, Theron LC, Rothmann S. Adolescent perceptions of resiliencepromoting resources: the South African Pathways to Resilience Study. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2017. [DOI: 10.1177/0081246317700757] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Resilience, or being well-adjusted despite facing adversity that predicts negative life outcomes, is a process that is scaffolded by resilience-enabling supports. How well resilience-enabling resources support positive adjustment depends, in part, on adolescents’ perceptions of the availability and usefulness of such resources. Currently, there is limited quantitative, generalisable evidence of the aforementioned. Accordingly, the purpose of this study was to document how two groups of Sesotho-speaking adolescents perceived available social-ecological resources and how significantly varied perceptions related to these adolescents’ use of formal supports. The advisory panel to the Pathways to Resilience Study clustered participating adolescents into a resilient group ( n = 221) and vulnerable, or service-using, group ( n = 186). In comparison with the service-using adolescents, resilient adolescents reported significantly higher perceptions of physical and psychological caregiving. Analyses of variance revealed that higher perceptions of caregiving were associated with higher voluntary and lower mandatory service usage. We concluded that relationship-building was a crucial resilience mechanism and would, therefore, encourage psychologists to both prioritise and facilitate caregiving.
Collapse
Affiliation(s)
| | - Linda C Theron
- Optentia Research Focus Area, North-West University, South Africa
- Department of Educational Psychology, Faculty of Education, University of Pretoria, South Africa
| | | |
Collapse
|