Development of a Community-Based Rehabilitation Intervention for People with Schizophrenia in Ethiopia.

BACKGROUND: Community-based rehabilitation (CBR) is a multi-sectoral strategy to improve the functioning and quality of life of people with disabilities. The RISE (Rehabilitation Intervention for people with Schizophrenia in Ethiopia) trial will evaluate the effectiveness of CBR for people with schizophrenia in Ethiopia. Nevertheless, the components of CBR that are both feasible and likely to prove effective in low and middle-income countries such as Ethiopia are unclear. METHODS: In this study intervention development work was undertaken to design a CBR intervention that is acceptable and feasible in the local context. The development work consisted of five phases. 1: Identify potential components of CBR for schizophrenia, 2: Situational analysis, 3: Determine feasibility of CBR (Theory of Change workshops with experts and local stakeholders), 4: Determine acceptability of CBR (16 in-depth interviews and five focus group discussions with people with schizophrenia, caregivers, health workers and community leaders) and 5: Synthesise results to finalise intervention. A Theory of Change map was constructed showing the causal pathway for how we expect CBR to achieve its impact. RESULTS: People with schizophrenia in rural Ethiopia experience family conflict, difficulty participating in work and community life, and stigma. Stakeholders perceived CBR to be acceptable and useful to address these problems. The focus of CBR will be on the individual developing the skills and confidence to perform their previous or desired roles and activities. To ensure feasibility, non-health professionals will be trained to deliver CBR and provide supervision, rather than mental health specialists. Novel components of CBR for schizophrenia included family intervention and dealing with distressing symptoms. Microfinance was excluded due to concerns about stress and exploitation. Community mobilisation was viewed as essential to ensure the effectiveness and sustainability of CBR. CONCLUSION: Extensive formative research using a variety of methods has enabled the design of a culturally appropriate CBR intervention for people with schizophrenia that is acceptable and feasible

A Mental Health Professional Opinion on Family Involvement During the Treatment of Severe Mental Illness: A Multiple Case Study

While severe mental illness (SMI) is extensively studied, less attention focuses on the relationship between people with SMI and their families and the impact this may have on treatment. Bronfenbrenner\u27s (1979) ecological systems theory conceptualized the treatment and recovery of people with SMI and their families. This study proposes that if family members getting social support contribute to a person\u27s treatment plan, the individual\u27s treatment outcome will improve rather than the individual enduring the treatment process individually. By applying ecological systems theory, mental health professionals and policymakers can better grasp the systemic nature of individuals, their family members, and surrounding external circumstances. Future research implications and recommendations aim to increase knowledge and awareness of family involvement during SMI treatment approaches

Roaming Africa:Mobility, Resilience and Social Protection

What happens when digital innovation meets migration? Roaming Africa considers how we understand modern-day mobility in Africa, where age-old routes strengthen the resilience of people roaming the continent for livelihoods and security, assisted by mobile communication. Digital mobility expands connectivity around the world, and also in Africa. In this book, the authors show that mobility, resilience and social protection in the digital age are closely related. Each chapter takes a close look at the migration dynamics in a specific context, using social theory as a lens. This book adopts a critical perspective on approaches in which migration is regarded merely as a hazard. Edited by distinguished scholars from Africa and Europe, this volume, the second in a four-part series Connected and Mobile: Migration and Human Trafficking in Africa, compiles chapters from a diverse group of young and upcoming scholars, making an important contribution to the literature on migration studies, digital science, social protection and governance

Profile of and challenges experienced by stroke patients admitted to Ruhengeri Hospital in Rwanda

Magister Scientiae (Physiotherapy) - MSc(Physio)Stroke is the world's third highest cause of death and a major cause of disability. In order to define optimal management for stroke, reliable data are needed. Although Ruhengeri Hospital in Rwanda receives many stroke patients, no in-depth study has been carried out on stroke patients admitted at the hospital. This study, therefore, identified the profile of stroke patients admitted at Ruhengeri Hospital in Rwanda and explored the challenges that they experienced. A concurrent mixed model design was used to collect data. With a data gathering instrument which was developed by the researcher, a quantitative retrospective approach was used to review existing patients’ records to collect information related to demographic characteristics, documented clinical features and risk factors for stroke, stroke onset-admission interval, length of hospital stay and the process of hysiotherapy for stroke patients. In-depth face-toface interviews were also used to collect data regarding the challenges experienced by stroke patients. The sample for the quantitative phase consisted of medical records of stroke patients admitted at Ruhengeri Hospital from January 1st, 2005 up to December 31st, 2008. In the qualitative phase, a purposive sample of 10 participants was selected.South Afric

Job evaluation model of major public hospitals in China

The current economic climate has contributed to an increasingly competitive environment among organizations. In order to ensure competitive advantage, they must be able to promote high levels of professional performance. This research is part of this theme and aims to analyze how the job characteristics, professional knowledge, skills, competencies, training and work engagement influence the job evaluation and, consequently, the performance of employees of six public hospitals, China. The sample consists of 546 subjects aged between 21 and 58 years (M = 37.9; SD = 8.73), with the majority being females (55.5%). For the collection of data, such scales were used as the Job Diagnostic Survey (JDS), the Knowledge, Skills, Abilities, and Other Personal Characteristics Scale (KSAOS), the Competencies and Training Scale (CTS) and the Utrecht Work Engagement Scale (UWES). The results obtained show that the job characteristics, the professional knowledge, the skills, the training and the work engagement influence the job evaluation. It was also found that the male respondents, those belonging to the older age group, those with higher academic qualifications and those with higher positions present higher average performance in all dimensions under study. It was also possible to verify that Autonomy is the JDS variable with greater effect on the Job evaluation and the bigger the Autonomy, Skill variety and Feedback given to the employees, the more positive their perception of Job evaluation. Data analysis also reveals that KSAO moderate the relations between job characteristics and job evaluation and the dimension with the most effect on Job evaluation is Professional Ethics and Health Law. On the other hand, the higher the competencies and professional training in the area of Organization and finance, the greater the Job evaluation. Finally, it was verified that Vigor is the only variable with significant effect on Job evaluation. It is hoped that these results may inspire further research that contributes to a better understanding of these relationships; and at the practical level, it is intended to alert the justified investment by the organizations in the implementation of a performance evaluation model. Taking into account the current competitiveness at the organizational level, it is considered that the analysis of the relationships between these dimensions is crucial to an organization. In this way, this project is intended to build a new process of performance evaluation in public hospitals in China, based on the competencies identified for each job.Atualmente, o clima económico contribuiu para um ambiente cada vez mais competitivo entre as organizações e para garantir a vantagem competitiva, as organizações devem ser capazes de promover altos níveis de desempenho profissional. Esta investigação insere-se nesta temática e tem como objetivo estudar como as características da função, o conhecimento profissional, as habilidades, as competências e o envolvimento no trabalho influenciam a avaliação do trabalho e, consequentemente, o desempenho dos funcionários de seis hospitais públicos . China. A amostra é composta por 546 sujeitos com idades compreendidas entre os 21 e os 58 anos (M = 37.9; DP = 8.73), sendo a maioria do sexo feminino (55.5%). Os dados foram recolhidos através das seguintes escalas: Job Diagnostic Survey (JDS), Escala de Conhecimento, Habilidades, Aptidões e Outras Escalas Pessoais (KSAOS), Escala de Competências e Formação (CTS) e Escala de Envolvimento no Trabalho de Utrecht ( UWES). Os resultados obtidos mostram que as características da função, o conhecimento profissional, as habilidades, a formação e o envolvimento no trabalho influenciam a avaliação do trabalho. Constatou-se também que os entrevistados do sexo masculino, os que pertencem à faixa etária mais avançada, os que possuem maior qualificação académica e que ocupam posições hierárquicas mais elevadas, apresentam um desempenho médio superior em todas as dimensões em estudo. Também foi possível verificar que a Autonomia é a variável do JDS com maior efeito na avaliação do trabalho e que quanto maior é a Autonomia, a variedade de competências e o feedback dado aos funcionários, mais positiva é a sua perceção da avaliação do trabalho. A análise dos dados também revelou que o KSAO modera a relação existente entre as características da função e a avaliação do trabalho e que a variável com maior efeito na avaliação do trabalho é a Ética Profissional e a Lei da Saúde. Por outro lado, quanto maiores são as competências e a formação profissional na área de Organização e Finanças, melhor é a avaliação do trabalho. Por último, verificou-se que o Vigor é a única dimensão do envolvimento no trabalho com efeito significativo na avaliação do mesmo. Espera-se que esses resultados possam inspirar pesquisas futuras e que possam contribuir para uma melhor compreensão dessas relações; a nível prático pretende-se alertar os gestores para a implementação de um modelo de avaliação de desempenho. Considerando a atual competitividade a nível organizacional, considera-se que a análise da relação entre estas dimensões é crucial para qualquer organização. Esta investigação pretende assim construir um novo processo de avaliação do trabalho nos hospitais públicos na China, com base nas competências identificadas para cada função