Framing the shift to supported employment: Exploring the impacts of a person-centred programme evaluation approach through peer led participatory research.

The purpose of this study was to address the need to improve opportunities for patient participation in their health and health services. This paper reports if and how patients' preferences matched their experiences of participation in treatment for hypertension in primary healthcare and what factors were linked with having had opportunities for participation that matched one's preferences. A total of 949 adult patients treated for hypertension completed the Patient Preferences for Patient Participation (4Ps) tool, with which they ranked their preferences for and experiences of patient participation. Descriptive and comparative analyses of 4Ps data were performed to identify patient characteristics associated with preference-based participation. Approximately half of the participants experienced patient participation to the extent that they preferred. Women were more likely to have had less patient participation than their preference compared with men. Women were also more likely to prefer being more engaged in hypertension care than men. There were also marked associations between age and educational level with the extent of participation preferred and experienced, leaving patients younger than or with lower education than the mean in this study with more insufficient opportunities for patient participation. There is a lack of concurrence between patients' preferences for, and experiences of, patient participation, especially for women. Further efforts to facilitate person-centred engagement are required, along with research on what strategies can overcome human and organizational barriers. ClinicalTrials.gov: NCT03554382.

This study investigated the employment barriers and support needs of people living with psychosis. A purposive community sample of 137 volunteers drawn from six key stakeholder groups were invited to participate in focus groups and semi-structured individual interviews to elicit their perceptions on the employment barriers and support needs of people living with psychosis. The stakeholder groups included in this study were people with lived experience of schizophrenia or bipolar disorder, carers, health professionals, employers, employment service providers, and community members. Data obtained from 14 focus groups and 31 semi-structured individual interviews were transcribed, imported into NVivo 10, and coded for purposes of thematic analysis. The results of this study revealed that the employment barriers and support needs of people living with psychosis were multiple and diverse. The main employment barriers identified were interpersonal in nature, notably stigma and discrimination. Employment assistance, particularly in the area of job seeking, was the most frequently identified employment support need. The findings of this study suggest that a broad-ranging and collaborative approach is needed across multiple sectors to overcome employment barriers and improve employment outcomes for people living with psychosis. This would include increased public awareness, recovery-oriented health services, effective employment services, training across multiple sectors, and removal of disincentives to work.

To describe high-functioning older adults' experiences of participation in daily activities and perceived barriers and facilitators to participation one- and 3-months post-acute hospitalization. Older adults discharged after acute illness hospitalization are at risk for functional decline and adverse health outcomes. Yet, little is known about the subjective experience of resuming participation in meaningful activities beyond the immediate post-discharge period among high-functioning older adults, a mostly overlooked sub-sample. Qualitative descriptive longitudinal study adhering to the COREQ guidelines. Forty two participants ages ≥65 years (mean age 75, SD ± 7.9) were recruited from internal medicine wards. Semi-structured interviews were conducted at participants' homes one-month post-discharge, followed by a telephone interview 3-months after. Data were analyzed using thematic analysis. Participants perceived the hospitalization as a disruption of healthy and meaningful routines. This first key theme had unique expressions over time and included two sub-themes. At one month: (1) reduced life spaces and sedentary routines. At 3months: (2) a matter of quality not quantity - giving up even one meaningful activity can make a difference. The second key theme was described as a combination of physical and psychological barriers to participation over time. These themes demonstrated the profound impact of the hospitalization on behavior (participation) and feelings (e.g., symptoms). The third key theme was described as a dyad of intrinsic and extrinsic facilitators to participation. Acute illness hospitalization may lead to subtle decreases in participation in meaningful health-promoting activities, even among high-functioning older adults. These changes may impact overall well-being and possibly mark the beginning of functional decline. This study highlights the need for a more comprehensive assessment of participation, relevant for high-functioning older adults, to enable person-centered care. Intervention programs should address the modifiable barriers and facilitators identified in this study.

The reintegration of disabled individuals into the workforce presents significant challenges and opportunities for enhancing workplace diversity and inclusivity. This study aims to explore the barriers and supports experienced by disabled workers as they navigate their return to employment, highlighting the complex interplay of personal, societal, and institutional factors that influence their reintegration process. This qualitative study utilized semi-structured interviews with 31 disabled individuals who have attempted to re-enter the workforce. Participants were selected through purposive sampling to capture a diverse range of disabilities, ages, and employment backgrounds. Data were analyzed using thematic analysis facilitated by NVivo software, focusing on reaching theoretical saturation where no new themes emerged from the data. Three main themes were identified: Employment Barriers, Support Systems, and Positive Experiences. Employment Barriers included categories such as Physical Accessibility, Social Attitudes, Workplace Policies, Technology and Tools, and Legal and Institutional barriers. Support Systems highlighted Government Programs, Community and Networks, Employer Support, and Personal Strategies. Positive Experiences encompassed Successful Accommodations, Employer Engagement, Career Development, and Advocacy and Awareness, illustrating facilitative aspects that aid reintegration. The study underscores the necessity of a multi-layered approach to the workforce reintegration of disabled individuals. Effective accommodations, proactive employer engagement, and robust support systems are crucial for overcoming the significant barriers these individuals face. Enhancing these areas can significantly improve employment outcomes for disabled workers, promoting a more inclusive and diverse workforce.

The reintegration of disabled individuals into the workforce presents significant challenges and opportunities for enhancing workplace diversity and inclusivity. This study aims to explore the barriers and supports experienced by disabled workers as they navigate their return to employment, highlighting the complex interplay of personal, societal, and institutional factors that influence their reintegration process. This qualitative study utilized semi-structured interviews with 31 disabled individuals who have attempted to re-enter the workforce. Participants were selected through purposive sampling to capture a diverse range of disabilities, ages, and employment backgrounds. Data were analyzed using thematic analysis facilitated by NVivo software, focusing on reaching theoretical saturation where no new themes emerged from the data. Three main themes were identified: Employment Barriers, Support Systems, and Positive Experiences. Employment Barriers included categories such as Physical Accessibility, Social Attitudes, Workplace Policies, Technology and Tools, and Legal and Institutional barriers. Support Systems highlighted Government Programs, Community and Networks, Employer Support, and Personal Strategies. Positive Experiences encompassed Successful Accommodations, Employer Engagement, Career Development, and Advocacy and Awareness, illustrating facilitative aspects that aid reintegration. The study underscores the necessity of a multi-layered approach to the workforce reintegration of disabled individuals. Effective accommodations, proactive employer engagement, and robust support systems are crucial for overcoming the significant barriers these individuals face. Enhancing these areas can significantly improve employment outcomes for disabled workers, promoting a more inclusive and diverse workforce.

N08 What patients expect and perceive in terms of their participation in their health and healthcare, while living with inflammatory bowel disease

BackgroundThere are an estimated 50 million adults living with dementia worldwide, a number that is projected to triple by 2050 (Patterson, 2018). Because there is no cure for Alzheimer’s disease and other dementias, maintaining and supporting quality life are among the most important care targets. Engagement in meaningful and purposeful activities is a cornerstone of quality of life, however opportunities for participation in meaningful activities can be limited for people with dementia (Wenborn et al., 2008). Although social media has the potential to be a source of engagement and connectivity for people with dementia, there is little known about the impacts of social media use on engagement‐related outcomes in people with dementia.MethodTwo databases (PubMed and PsychINFO) were searched from 2000 through November 12st, 2021 for English‐language articles with search terms relating to dementia and social media in the title. The search returned 23 articles after removal of duplicates with 7 selected for inclusion into the review.ResultAlthough there has been an increase in the scholarly exploration of using social media as a tool or raising awareness about dementia and providing a space for connection for carers, there is little research examining social media use in people with dementia. The research that does exist has primarily explored Twitter use and people with early‐onset dementia. Themes that emerged from the articles reviewed included 1) social media use as a tool to counter loss of identity, 2) social media as a forum for support following a diagnosis, 3) a need for greater accessibility, 4) the presence and lack of consideration regarding safety and privacy risks, and 5) dementia activism as a source of engagement and purpose.ConclusionThe potential for social media to be a tool for social engagement for people living with dementia is relatively unexplored as are the considerations for safety and privacy. There is a need to more broadly understand the patterns and context of social media use among people with dementia. There are also opportunities for interventions using social media as a pathway to intergenerational and social connection, meaningful engagement, and cognitive stimulation.

The purpose of this study is to explore the relationship between emotional independence and economic independence among young adults receiving livelihood support in South Korea. Emotional independence is a concept composed of hope and barriers related to labor and employment, involving a process of increasing hope and overcoming obstacles. This research conceptualizes economic independence as transitioning from livelihood support to regular employment and examines the relationships between employment barriers, employment hope, labor in regular jobs, and the transition from livelihood support using structural equation modeling with a sample of 417 young adults receiving livelihood support. The results indicate that hope serves as a mediator between employment barriers and the transition from livelihood support. The findings highlight the importance of overcoming practical and psychological employment barriers and fostering employment-related hope, including recognizing one's own worth and abilities, being motivated by future prospects, setting goals related to work, and utilizing skills and resources to achieve these goals, for low-income young adults to achieve economic independence through the transition from livelihood support. The study's results extend the understanding of independence by revealing the importance of enhancing emotional capacities in the process of economic independence for low-income young adults. Furthermore, it is expected that these findings will stimulate related research and contribute to the development of a more multidimensional and integrated support system in South Korea's youth-related policies, moving beyond a focus on support for employment, housing, and education to support various aspects of young adults' lives, including entrepreneurship.

BackgroundQuality cancer care necessitates opportunities for patient participation, supposedly recognizing the individual's preferences and experiences for being involved in their health and healthcare issues. Previous research shows that surgical cancer patients wish to be more involved, requiring professionals to be sensitive of patients' needs.AimsTo explore preference‐based patient participation in surgical cancer care.MethodsA cross‐sectional study was conducted. The Patient Preferences for Patient Participation tool (4Ps) was used, which includes 12 attributes of preferences for and experiences of patient participation. Data were analyzed with descriptive and comparative statistical methods.ResultsThe results are based on a total of 101 questionnaires. Having reciprocal communication and being listened to by healthcare staff were commonly deemed crucial for patient participation. While 60% of the patients suggested that taking part in planning was crucial for their participation, they had experienced this only to some extent. Learning to manage symptoms and phrasing personal goals were items most often representing insufficient conditions for preference‐based patient participation.Linking Evidence to ActionTo support person‐centered surgical care, further efforts to suffice preference‐based participation are needed, including opportunities for patients to share their experiences and engage in the planning of healthcare activities.

Internationally, youth organisations, including mental health organisations, have been creating opportunities for youth participation in service design and delivery. Jigsaw1 – The National Centre for Youth Mental Health is one such organisation. Jigsaw was founded in 2006 and provides free, confidential, brief mental health support for young people aged 12-25. Jigsaw's services have been designed in partnership with a group of young people, who are members of the organisation's Youth Advisory Panel (YAP). Our research, conducted over the summer of 2015, sought to explore members of the YAP's experiences of participation in the organisation. The project adopted a qualitative approach. Data collection involved semi-structured interviews with ten members of the YAP. We adopted a thematic approach to data analysis. Our key findings relate to participants' understanding of their role, factors enabling participation and the benefits of participation, as well as what participants experienced as barriers and the downsides of participation.

The intense historical transformations in Portugal during the last 30 years have had a profound impact on the educational system and on its role in citizenship education. During this period, Portugal experienced dictatorship, the last socialist revolution in Europe (1974) (Barreto, 2002), the end of colonial empire and of colonial wars, the stabilization of a democratic regime and the entrance in the European Economic Community later to be transformed into the European Union. Such deep social and political transformation had strong implications in education and its mission in promoting democratic citizenship has been intensively discussed, with fears of ideological inculcation and a tension between conservative vs. emancipatory goals underpinning the curricular decisions in the field. This paper considers these transformations and articulates them with the perspective of adolescents in basic and secondary education regarding citizenship, politics and civic engagement and the actual opportunities for participation they feel they have in the family, the school, and the community. The bases for this discussion are two studies with Portuguese adolescents: the IEA Civic Education Study (CivEd 2000-2001) that involves three national representative samples of students from grade 8, 9 and 11; and a longitudinal study (2005-07) with adolescents from grades 9, 10 and 11. Results from both studies show a tendency for a dissatisfaction/distrust that young people have in relation to key-institutions of democracy (government, political parties) but, at the same time, the valuing of active citizenship and the emergence of new forms of participation. That oxymoron appears as a challenge to both researchers and teachers that might take advantage in being more aware of the quality of youngsters’ participation experiences in their various life contexts.

Children and young people's mental health and well-being has seen a dramatic decline. In the UK, this has been exacerbated by service retrenchment associated with austerity, with evidence of increasing health inequalities. Service innovation that is grounded in practice, has ongoing learning, and is co-designed with children and young people is required now. This can provide creative solutions within the local context and contribute to the fledgling evidence base that explores complex mechanisms of impact. This methodological reflection describes a co-design process of a bespoke, group-based ecotherapy programme: from early piloting using appreciative enquiry before COVID-19 by the mental health, public health, and Street Services team in the port city of Plymouth, to further developing an evaluation framework through an innovative, matched-funded academia-practice partnership. The findings showcase the benefits of a systems-based approach to public, multi-agency and academic collaboration, facilitated by peer and practitioner researchers and embedded researchers-in-residence. They highlight the need to consider nuances of specific (connecting with self, others, animals, nature) and non-specific active ingredients of the emerging and constantly adapting service (therapeutic relationship with practitioners/carers; nature as therapist, and group dynamics), as well as the value of pragmatic and participatory evaluation methods (distance-travelled, goal-based measures; and ethnographic, qualitative observation), to provide rapid, continuous, and real-time learning and improvement.

BACKGROUND: Before 1993, vocational rehabilitation services in Hong Kong mainly adopted a prevocational training approach at the outset, before placing people with disabilities in competitive employment. In order to improve outcomes, particularly the rates of employment and job retention, supported employment (SE) was introduced and later endorsed by the Rehabilitation Development Coordinating Committee in 1995. OBJECTIVE: SE is a vocational rehabilitation method based on the Individual Placement and Support (IPS) model. It promotes high levels of integration with the clinical team to help people with disabilities obtain and maintain community-based competitive employment in their chosen occupation. METHODS: This paper presents a review of literature on supported employment services for people with mental disabilities in Hong Kong and the growth since its development. RESULTS: Results of local studies provide evidence that SE, although originally developed in the United States, is generalizable to Hong Kong. CONCLUSION: This article describes the development of SE in Hong Kong and the challenges of implementing it in a local context. Finally, it presents ideas for the future direction of SE in Hong Kong.

The aim of the study was to analyse how the development of activation and employment sup­ port services for long term unemployed and for persons with disabilities has affected social work practices in the municipalities in Finland. The data consists of interviews and training materials collected in 2003-2004 in the Helsinki region. The theoretical framework of the study relies on the conceptual discussion on empowerment, social work, and rehabilitation in Finland in the beginning of the 2000's. The social work practice descriptions and evaluations of the interviewed are compared to the good practices of activation and social work described in the literature and in the relevant research and development projects. The implications and stipulations on customer-oriented practices in the municipalities of the new workfare paradigm of social policy are being evaluated, as well. As a member of a multidisciplinary team, social worker brings comprehensiveness and larger societal views to the problems of employment and disability. Social worker's views and practices concentrate on the barriers of employment and aim at overcoming them. Assessment of the life situations of the clients, case management, counselling of long processes, and securing the rights of the clients is the core content of empowering social work practices. Empowering social work practices in the municipality social welfare services were previ­ ously coincidental. The change has been rapid and thorough in the beginning of 2000's, and it has brought new perspectives to the aims and practices of the client work, and the network of cooperation has broadened and become closer. The multisectoral cooperation in activation, em­ ployment and vocational rehabilitation services is considered to be primarily well functioning and effective. However, the encounter of varying work cultures, practices, values, and service models has brought about contradictions, as well. At the present moment there is a continuous re-organizing process of client work and work organizations in the municipalities. During the last two years numerous joint employment service centres have been established, primarily in urban areas, in co-operation with employment, social welfare, health care, and social insurance authorities. This development is changing the local service cultures from sectoral approach towards close partnership and comprehensiveness in cli­ ent work. Various stipulations and mechanisms are endangering the establishment of empowering social work practices in the municipal social welfare services. The high turnover of workers, recruit­ ment problems, case load, and introduction of new tasks and responsibilities also hamper the establishment of the new practices. The conditions of social work have become unstable.

Emotional regulation is a fundamental aspect of human psychology, influencing mental health, interpersonal relationships, and overall well-being. This book offers a comprehensive exploration of emotional regulation, integrating insights from biological, psychological, and social perspectives. It begins by unraveling the science of emotions, examining the biological and psychological foundations and how emotions are processed in the brain. The book delves into the concept of emotional intelligence, discussing its components—self-awareness, self-regulation, motivation, empathy, and social skills—and their interrelationship with emotional regulation. The spectrum of emotional regulation strategies is thoroughly examined, distinguishing between adaptive and maladaptive approaches. Cognitive strategies such as cognitive restructuring, mindfulness, and Acceptance and Commitment Therapy (ACT) principles are detailed, offering readers practical methods to alter their thought patterns and enhance emotional management. Behavioral strategies, including engagement in pleasant activities, problem-solving, and exercise, are presented as effective ways to influence emotions through actions. Physiological strategies like deep breathing, progressive muscle relaxation, and sleep hygiene are also explored, highlighting their role in regulating emotional states. Special focus is given to the challenges in emotional regulation faced by individuals with PTSD, addiction, and muscle dysmorphia. These conditions are discussed in-depth, emphasizing the unique emotional regulation difficulties they present and proposing tailored therapeutic interventions. The book provides real-life case studies and practical applications, illustrating how individuals successfully manage their emotions in various contexts, including professional settings and across different cultures and spiritual practices. Techniques and practices for enhancing emotional regulation are provided, including cognitive approaches, behavioral techniques, and the use of technological aids and applications. The book also addresses the importance of tailoring strategies for special populations, such as children, adolescents, the elderly, and those with specific psychological or physical health challenges. The concluding sections of the book focus on integrating emotional regulation into daily life, offering practical tips for making it a habitual practice and strategies for overcoming setbacks. Emerging research areas and potential technological advancements in emotional health are discussed, providing a forward-looking perspective on the future of emotional regulation. This book is designed to be a valuable resource for anyone interested in mastering emotional regulation—whether they are struggling with emotional dysregulation, professionals seeking to expand their toolkit, or curious minds interested in the intricacies of human emotions. By combining scientific insights with practical advice, it aims to equip readers with the tools needed to enhance their emotional regulation skills, improve their mental health, and lead more fulfilling lives.