Michèle Preyde

The lived experience of students with an invisible disability at a Canadian university

University institutions are required by law to make their services accessible to students with disabilities. Canadian universities have gone a long way to eliminate the physical obstacles that present barriers for students. Many students with disabilities have invisible disabilities that require different types of adjustments. Although some researchers have evaluated the needs of students with disabilities in higher education, the unique needs of students with invisible disabilities have received less attention. The best means of assessing these needs is through direct consultation with students with disabilities. Thus, in-depth interviews were conducted with university students with dyslexia, attention-deficit hyperactivity disorder, and mental illness. Themes were developed that related to the nature of the disability, the accessibility of the university context, the social and organizational barriers, and recommendations for change. This research lends insight into how individuals with invisible disabilities believe that they are perceived within the university context.

Parent–Child Relationships and Family Functioning of Children and Youth Discharged from Residential Mental Health Treatment or a Home-Based Alternative

This report stems from a larger study on the outcomes of children and youth who accessed residential treatment or a home-based alternative. In this report an analysis of family descriptive information, the nature of family relationships, and indicators of family functioning for children and youth who have participated in childrens mental health services are presented. Results suggest that youth accessing residential treatment have very different family experiences than youth accessing the home-based alternative. Furthermore, the functioning of youth at home improved significantly from admission to discharge, and family functioning was considered “healthy” at follow up; however, family relationships remained problematic. In qualitative interviews with a subsample of youth, varied and complex family relationships were described, and many youth revealed aspirations for positive family engagements. Implications for practice and research are presented.

Evidence-based Risk Factors for Adverse Health Outcomes in Older Patients after Discharge Home and Assessment Tools: A Systematic Review

The current health care system is discharging elderly patients “quicker” and “sicker” from acute care facilities. Consequently, hospital readmission is common; however, readmission may be only one aspect of adverse outcomes of importance to social work discharge planners. The early recognition of risk factors might ensure a successful transition from the hospital to the home. A systematic review was conducted to identify factors associated with adverse outcomes in older patients discharged from hospital to home. Using a content analysis, factors were characterized in five domains: demographic factors, patient characteristics, medical and biological factors, social factors, and discharge factors. The most frequently reported risks were depression, poor cognition, comorbidities, length of hospital stay, prior hospital admission, functional status, patient age, multiple medications, and lack of social support. A systematic search identified four discharge assessment tools for use with the general population of elderly patients. Practice and research implications are offered.

Psychosocial Intervention for Adults With Cancer: A Meta-Analysis

Cancer affects a significant number of people and their families. In addition to physical symptoms, people with cancer experience considerable levels of psychosocial distress. Psychosocial oncology has been developed to address this distress. In this meta-analysis, psychosocial interventions for adults with cancer were systematically reviewed. A central finding was the dearth of clinical trials published by social work researchers and clinicians. Small intervention effects were noted for some psychosocial interventions, particularly those in which a focus on stress and coping were included; however, the poor quality of reporting negated conclusive results. The synthesis of research conducted and reported with methodological rigor may inform social work practice, with the ultimate goal of improving the quality of patient care and the quality of patient outcomes. The implications for social work clinicians and researchers are discussed.

Sexual Identity and Sexual Well-Being in Female Heterosexual University Students

Sexual identity has generally been studied with a focus on sexual orientation and has not incorporated a general identity framework. Low levels of identity exploration and commitment have been shown to predict poor well-being in adolescents, but the relationship between sexual identity and sexual well-being has not been examined. The current cross-sectional survey was administered to 293 heterosexual female undergraduate students from a mid-sized university in Ontario, Canada. Participants completed the Measure of Sexual Identity Exploration and Commitment (Worthington, Navarro, Savoy, & Hampton, 2008), as well as several measures to assess sexual well-being. These included the Sexuality Scale (Snell & Papini, 1989), the Sexual Awareness Questionnaire (Snell, Fisher, & Miller, 1991), the Body Esteem Scale for Adolescents and Adults (Mendelson, Mendelson, & White, 2001; Mendelson, White, & Mendelson, 1997), and four individual items assessing sexual satisfaction (Laumann et al., 2006). Confirmatory factor analysis was used to test the measurement models of sexual identity and sexual well-being, and structural equation modeling was used to examine the relationship between sexual identity and sexual well-being. Results indicated that higher levels of sexual identity exploration and commitment predicted sexual well-being. However, other aspects of sexual identity, such as synthesis and sexual orientation identity, were not predictive of sexual well-being. The implications of using an identity framework for measuring sexual identity are discussed.

Outcomes of Children Participating in Mental Health Residential and Intensive Family Services: Preliminary Findings

It has been estimated that approximately 20% of children experience some form of mental health problem, with 14% in the clinical range. Residential mental health treatment is often reserved for those with the most severe presentation of disorder, and intensive home-based alternatives have been developed to cope with increasing demand. The purpose of this study was to examine the long-term developmental trajectories, personal functioning, and life circumstances of the children and youth who accessed residential mental health treatment or the home-based alternative along a number of domains (e.g., clinical outcomes, school personal well-being), and determine if differences between the groups exist.

Psychosocial Profile of Elderly Patients Discharged from a Community Hospital

Abstract Social workers have historically been an advocate for vulnerable groups. One such vulnerable group is elderly patients who have been shown to have multiple, chronic health problems. The current fiscal environment favors shortened lengths of stay, potentially leaving these vulnerable patients at risk for adverse outcomes upon discharge, especially for those discharged home as opposed to institutional settings. The purpose of the study was to characterize the biopsychosocial risks for adverse outcomes in the elderly patients discharged home from Guelph General Hospital (Ontario, Canada). The objectives were to (1) estimate the number of elderly people who indicate biopsychosocial risk for adverse outcomes, (2) determine the specific risks and their severity, and (3) estimate the number of readmissions to hospital within three months after discharge. Standardized, self-reported scales were used to measure risks in elderly patients at discharge from acute care medical and surgical units. The sample included 62 patients with a mean age of 79 years. At discharge almost 40% of the patients were considered at risk for adverse outcomes, 11% indicated depression, 45% indicated psychological distress, 13% showed cognitive impairment, and 62.5% (35/56) had at least one nutritional concern. Over the three-month follow-up period, there were 23 readmissions, 8 ED visits (not mutually exclusive), and 7 outpatient visits. The mortality rate over the three-month period was 5% (3/62). Many elderly patients who were discharged from hospital to home experienced several challenges medically, psychologically and some also experienced social adversities. The implication is that these patients may benefit from a more comprehensive discharge plan than is currently practiced that addresses their challenges.

Community Adaptation of Youth Accessing Residential Programs or a Home-Based Alternative: Contact With the Law and Delinquent Activities

This article presents the findings from a longitudinal investigation of the prevalence of negative contact with the law for a sample of youth 12–18 months after graduating from residential and intensive childrens mental health programming. Results of this study suggest serious community adaptation difficulties face many youth graduating from these childrens mental health programs. This study suggests that delinquency outcomes may be particularly problematic for older males who are transitioning out of treatment programs, as well as for youth with prior contact with the law, and greater challenges adapting to school at program admission.

Intervention Fidelity in Psychosocial Oncology

Intervention fidelity refers to strategies that practitioners and researchers use to monitor, enhance, or evaluate the accuracy and consistency of the delivery of an intervention to ensure that it is implemented according to how it was planned. The purpose of the authors in this article was to evaluate intervention fidelity in the psychosocial oncology intervention effectiveness research. Twenty-eight studies located in a previous systematic review on psychosocial oncology intervention effectiveness comprised the sample for this research. A treatment fidelity checklist was applied to each study independently by each author (MP & PB). Percent agreement between raters ranged from 68% to 100% (M = 89%). Overall, the mean proportion of adherence was 0.57 (SD 0.12), which may be considered to be moderate fidelity. Critical examination and applicability of the checklist in examining and assessing intervention fidelity were highlighted and discussed. Overall, intervention fidelity was adequately addressed in the psychosocial oncology intervention effectiveness research, and integrity was confirmed in the majority of studies reviewed. Suggestions for future psychosocial oncology effectiveness research were made.

Exploratory survey of patients' needs and perceptions of psychosocial oncology.

Cancer is a major health issue that affects a significant proportion of the population. Advancements in oncology treatment have reduced mortality, creating an ever-greater need for psychosocial oncology. Patients with cancer at Grand River Regional Cancer Centre (GRRCC) have access to some psychosocial intervention (e.g., wellness workshops, social work intervention); however, the extent to which these efforts meet patients’ current needs is not known. The purpose of the exploratory survey was to assess patients’ psychosocial needs and psychosocial oncology service needs. Patients receiving treatment for cancer at GRRCC were asked to participate in the anonymous survey. Two research assistants from the University of Guelph obtained informed consent, then with assistance from volunteers from the GRRCC, collected all data. The two screening tools, and standardized, self-report measures of depression and social support (Perceived Social Support Scale) were administered. Patients rated the psychosocial oncology services as very helpful, though 100% indicated the presence of distress. The main source of distress concerned not knowing what their personal outcomes will be. Implications for practice and research are discussed.