Patient influence in home-based reablement for older persons: qualitative research

Abstract Background Reablement services are rehabilitation for older people living at home, being person-centered in information, mapping and the goal-setting conversation. The purpose of this study was to gain knowledge about conversation processes and patient influence in formulating the patients’ goals. There are two research questions: How do conversation theme, structure and processes appear in interactions aiming to decide goals of home-based reablement rehabilitation for the elderly? How professionals’ communication skills do influence on patients' participation in conversation about everyday life and goals of home-based reablement? Methods A qualitative field study explored eight cases of naturally occurring conversations between patients and healthcare professionals in a rehabilitation team. Patients were aged 67–90 years old. The reablement team consisted of an occupational therapist, physiotherapist, nurse and care workers. Data was collected by audio recording the conversations. Transcribed text was analyzed for conversational theme and communication patterns as they emerged within main themes. Results Patient participation differed with various professional leadership and communication in the information, mapping and goalsetting process. In the data material in its entirety, conversations consisted mainly of three parts where each part dealt with one of the three main topics. The first part was “Introduction to the program.” The main part of the talk was about mapping (“Varying patient participation when discussing everyday life”), while the last part was about goal setting (“Goals of rehabilitation”). Conclusions Home-based reablement requires communication skills to encourage user participation, and mapping of resources and needs, leading to the formulation of objectives. Professional health workers must master integrating two intentions: goal-oriented and person-centered communication that requires communication skills and leadership ability in communication, promoting patient influence and goal-setting. Quality of such conversations is complex, and requires the ability to apply integrated knowledge, skills and attitudes appropriate to communication situations

Not just bi the bi: the relationship between essentialist beliefs and attitudes about bisexuality

In the literature about bisexuality few studies consider bisexual people’s beliefs about bisexuality and none examine essentialist beliefs about bisexuality. In the present study 244 participants (bisexual n = 58, lesbian/gay n = 54 and heterosexual n = 132) from the UK were asked via online questionnaire about their attitudes towards bisexuality, homosexuality and heterosexuality, and how stable they perceived bisexuality, homosexuality and heterosexuality to be. They were also asked about their essentialist beliefs towards bisexuality. Bisexual respondents viewed bisexuality as significantly more stable than lesbian, gay and heterosexual respondents. Analysis also showed that less belief in the discreetness of bisexuality predicted more positive attitudes towards bisexuality, as did positive beliefs towards homosexuality and heterosexuality. Belief in the immutability of bisexuality did not, however, predict attitudes towards bisexuality. Therefore, discreteness appears to be an especially problematic essentialist belief about all sexual minorities, as it is consistently associated with negative attitudes. However, beliefs about the immutability of sexuality are not consistently associated with negative attitudes for all sexual minorities

Challenges in Meeting the Mental Health and Wellbeing Needs of Refugee Children and Young People in England: Evaluation and Critique of Policy and Guidance

In this chapter the foci for examination and discussion are some of challenges in meeting the mental health and wellbeing needs of refugee children and young people in England. While much health policy applies across the UK, we address these issues within the English context. Our work and our writing is informed by a children and young peoples’ rights perspective - United Nations Convention on the Rights of the Child (1989, hereafter UNCRC); Ruck et al (2017), and by the understanding that refugee children and young people are children and young people first (Crawley, 2006)