Caretaker Attitudes Research Articles

Exploring pet rat care: A comprehensive survey of husbandry, health, behavior, and the associations between caretaker attitudes, attachment, and husbandry practices

Pet rats are still understudied in terms of animal welfare and human-animal interaction research. An extensive online survey targeting German-speaking rat caretakers was conducted (n = 978). One of the study's goals was to investigate husbandry practices, health indicators, rat behaviors that suggest either good or compromised welfare, as well as elements of the human-animal relationship, including interactions between humans and animals, caretaker attitudes, and attachment. The second aim was to explore the associations between caretaker attitudes and attachment, and caretaker behavior, encompassing routine health checks, interactions between humans and animals, as well as the activities and enrichment provided to rats. In some instances, welfare issues were identified: insufficient space (evident in 10.6% of rats), provision of unhealthy snacks (14.6%). The vast majority of rats enjoyed a variety of enrichment objects, e.g., huts/houses (98.4%), nesting material (92.7%), hammocks (91.7%), and tunnels/tubes (83.7%). The average amount of space and time provided for roaming in case of no permanent roaming possibility (13.9 m2 and 2.5 h per day) was positive in terms of welfare. About 79.0% of rats did not suffer from a disease diagnosed by a veterinarian. Repetitive behaviors, which may represent stereotypies, were uncommon (plucking out own fur and cage bar chewing occurred “never” in 99.1% and 81.5%). Indicators of good welfare (e.g., self-grooming, rearing, eye-boggling) were observed several times/day in 89.6%, 46.7%, and 11.6% respectively. Caretakers who formed strong bonds with their rats tended to express positive general attitudes (such as finding rats ‘‘lovable’’ and ‘‘fun’’), while showing little agreement with statements reflecting negative attitudes (like considering rats ‘‘dirty’’). About 84.4% reported stroking their rat, 94.9% reported talking to it, and 70.9% mentioned hand-feeding their rat several times per day. Caretaker attitudes and attachment and human-animal interactions and caretaker behaviors correlated weakly but consistently (P < 0.01): respondents who felt more comfortable during positive interactions, stroked, hand-fed their rats, offered rat-friendly enrichment and performed health checks more often. In contrast, higher agreement to rats being ‘‘dirty’’ related to less frequent health checks and less frequent positive human-animal interactions. The identified relationships between caretaker attitudes and behaviors can help design interventions to promote caretaker behavior that is beneficial for rat welfare.

Hispanic worker attitudes toward pig euthanasia on U.S. farms.

On-farm pig euthanasia considers aspects of animal welfare and industry economics. Guidelines are available about the euthanasia process, but the agricultural workforce is highly diverse and guidelines do not consider cultural barriers. Euthanasia requires the ability to identify compromised pigs, technical skills, and willingness to euthanize pigs. In addition, timely euthanasia is part of the Common Swine Industry Audit (CSIA) and, thus, can lead to failed audits if not performed as required by the audit standards. The United States (US) swine industry employs a high percentage of Latin American workers, some US residents/citizens, and others through non-immigrant North American Free Trade Agreement (NAFTA) visas. These workers vary in their level of education and swine industry experience. Proper training of this workforce and identification of the barriers associated with performing timely euthanasia are critical to promote improved welfare practices. The objectives of this study were to: (1) develop a survey instrument to identify Hispanic caretaker attitudes toward pig euthanasia, (2) assess and describe swine caretakers' attitudes toward pig euthanasia using the developed survey instrument, and (3) determine the demographic and psychological barriers associated with performing pig euthanasia. Participants (n = 163) were surveyed from 16 farms across the State of Iowa. The on-farm survey was administered for two days in a period of 60 min per day. The results for demographics and the swine management survey data indicated that employees with less time working on the farm showed less knowledge of the CSIA, lower perceived ability to identify compromised pigs that needed to be euthanized, lower willingness to pecrform euthanasia on their own, and preferred not to have the responsibility of telling others when to euthanize pigs (p < 0.001). Secondary traumatic stress and transgressions were significantly correlated scales, associated with burnout, betrayals, and worker satisfaction (p = 0.022). Furthermore, individuals identifying as female had higher secondary traumatic stress scores (p = 0.026) and lower compassion satisfaction scores (p = 0.015). This data suggest that there are demographic, psychometric, and training-related factors correlated with Hispanic caretakers' feelings about pig euthanasia. The results of this study could be used to further improve and develop targeted training programs for Hispanic caretakers for early identification of compromised pigs and timely euthanasia, which could benefit human well-being, animal welfare, and the swine industry audit performance.

6 Validation and Application of a Survey of on-Farm Worker Attitudes Towards Euthanasia

Abstract On-farm euthanasia of pigs considers aspects of welfare and economics, but few comprehensive guidelines are available for swine producers and further, do not consider cultural barriers. The Hispanic workforce largely represents the bulk of agricultural workers. Euthanasia requires the ability to identify compromised pigs, technical skills, and willingness to euthanize pigs. In addition, timely euthanasia is part of the Common Swine Industry Audit (CSIA) and thus, can lead to failed audits. The U.S. swine industry employs a large percentage of Latin American workers through NAFTA visas. These workers vary in their degree of education and pig experience. Proper training of this workforce and identification of the barriers to performing timely euthanasia is critical. The objectives of this study were to: 1) develop and validate surveys (including demographic information, swine management, moral injury events scale, impact of event scale and the professional quality of life scale) in Spanish to determine Hispanic caretaker attitudes towards timely euthanasia and 2) to assess Hispanic caretakers using the validated surveys to determine the barriers associated to timely euthanasia. A total of 163 workers were surveyed and data were analyzed using Chi-Square. The results indicated that employees with less time working in the company presented less CSIA knowledge and a reduced capacity to identify pigs that needed to be euthanizing (P&amp;lt; 0.001). Spearman's rank-order correlations indicated that stress was the most frequently correlated scale, related with burnout, transgressions, betrayals, and worker satisfaction (P=0.022). A Mann-Whitney U test determined that there was a gender difference, presenting a high level of stress and a low level of satisfaction in females and the opposite results in males (P=0.026). It is important to identify the factors that decrease or negatively affect the ability of employees to perform euthanasia in order to provide efficient training that improves good practices in the swine industry.

Caretaker attitudes and animal training are associated with alpaca behaviour towards humans—An online survey

Although alpacas are becoming increasingly popular animals, their behaviour towards humans has received little research interest until now. The purpose of our study was to investigate, for the first time, associations between caretaker attitudes and handling practices (i.e., frequency of different types of contact, and the use of training) and alpaca behaviour in the presence of humans in a large sample of alpaca caretakers. To this end, we conducted an online survey among German-speaking alpaca caretakers. Regarding alpaca behaviour, we were interested in their behaviour towards their caretaker’s approach (assessed as ‘the majority of the alpacas run away’ / ‘keep standing’ / ‘approach the caretaker’), ease of handling in different situations (rated on a 5-point scale), and behavioural problems (spitting, kicking, biting, rising, pushing, or several of these behaviours beyond the normal level) from the caretakers’ point of view. To avoid reactance in participants, we decided against a forced choice answer format, which resulted in varying sample sizes. Questions assessing general attitudes, affective attitudes, behavioural beliefs, frequency of caretaker contact, and questions assessing the animal’s ease of handling were summarised to factors, followed by the performance of confirmatory factor analyses to determine if our hypothesized factor structures fit the observed data. Next, four regression models were calculated with the dependent variables alpacas’ reaction to caretaker approach (n = 142), ease of handling during moving and leading (n = 144), ease of handling during restraint (n = 140), and absence of behavioural problems (n = 139). Predictor variables were eleven attitude factors, four frequency of contact factors, and the use of training by means of the ‘TTeam method / Camelidynamics’. We found associations between caretaker attitudes, handling practices, and animal behaviour. For instance, moving and leading was more difficult in cases of a more negative general attitude (p < 0.05), but easier in cases of training for easier handling (p < 0.05). More talking to alpacas related to easier handling during moving and leading (p < 0.05). Negative general attitudes were associated positively with the occurrence of behavioural problems (p < 0.05). The overall results suggest similar relationships between caretakers’ attitudes and behaviour and the animals’ behaviour, as demonstrated in other species. The fact that training was a highly significant predictor of ease of handling during moving and leading supports findings in other species, that non-aversive training can improve ease of handling.

Caretaker knowledge, attitudes, and practices (KAP) and carriage of extended-spectrum beta-lactamase-producing E. coli (ESBL-EC) in children in Quito, Ecuador

BackgroundThe rapid spread of extended-spectrum beta-lactamase-producing E. coli (ESBL-EC) is an urgent global health threat. We examined child caretaker knowledge, attitudes, and practices (KAP) towards proper antimicrobial agent use and whether certain KAP were associated with ESBL-EC colonization of their children.MethodsChild caretakers living in semi-rural neighborhoods in peri-urban Quito, Ecuador were visited and surveyed about their KAP towards antibiotics. Fecal samples from one child (less than 5 years of age) per household were collected at two time points between July 2018 and May 2019 and screened for ESBL-EC. A repeated measures analysis with logistic regression was used to assess the relationship between KAP levels and child colonization with ESBL-EC.ResultsWe analyzed 740 stool samples from 444 children living in households representing a range of environmental conditions. Of 374 children who provided fecal samples at the first household visit, 44 children were colonized with ESBL-EC (11.8%) and 161 were colonized with multidrug-resistant E. coli (43%). The prevalences of ESBL-EC and multidrug-resistant E. coli were similar at the second visit (11.2% and 41.3%, respectively; N = 366). Only 8% of caretakers knew that antibiotics killed bacteria but not viruses, and over a third reported that they “always” give their children antibiotics when the child’s throat hurts (35%). Few associations were observed between KAP variables and ESBL-EC carriage among children. The odds of ESBL-EC carriage were 2.17 times greater (95% CI: 1.18–3.99) among children whose caregivers incorrectly stated that antibiotics do not kill bacteria compared to children whose caregivers correctly stated that antibiotics kill bacteria. Children from households where the caretaker answered the question “When your child’s throat hurts, do you give them antibiotics?” with “sometimes” had lower odds of ESBL-EC carriage than those with a caretaker response of “never” (OR 0.48, 95% CI 0.27–0.87).ConclusionCaregivers in our study population generally demonstrated low knowledge regarding appropriate use of antibiotics. Our findings suggest that misinformation about the types of infections (i.e. bacterial or viral) antibiotics should be used for may be associated with elevated odds of carriage of ESBL-EC. Understanding that using antibiotics is appropriate to treat infections some of the time may reduce the odds of ESBL-EC carriage. Overall, however, KAP measures of appropriate use of antibiotics were not strongly associated with ESBL-EC carriage. Other individual- and community-level environmental factors may overshadow the effect of KAP on ESBL-EC colonization. Intervention studies are needed to assess the true effect of improving KAP on laboratory-confirmed carriage of antimicrobial resistant bacteria, and should consider community-level studies for more effective management.

PSV-5 Dairy worker perspectives on performing euthanasia as an essential component of their job

Abstract Euthanasia is a critical component of dairy management as it provides a way to alleviate animal suffering. Limited research explores dairy worker perspectives regarding their role in performing euthanasia or the impact of this practice on worker wellbeing. Additionally, training offered to caretakers is inconsistent in content and frequency and lacks cultural congruence. This project aimed to identify how euthanasia methods, procedures, and training affect caretaker attitudes towards performing on-farm euthanasia, job satisfaction and sense of well-being of dairy workers and managers. Focus groups, facilitated by Colorado State University researchers, were conducted at five large Colorado dairies. Thirty-eight animal caretakers (workers, n = 29; managers, n = 8; and veterinarians, n = 1) participated in focus groups according to their job description and language of choice (English or Spanish). Focus groups were recorded for subsequent transcription and translation. Thematic analysis was performed to identify recurring themes in the transcripts. Themes that emerged from the focus groups included: stressors related to physical, work, and social environments; euthanasia techniques, frequency, process, decision making, and who performs this task; the language used when referring to euthanasia; animal welfare; and the effect of the human-animal bond on euthanasia decision-making and performing euthanasia. Preliminary analysis of themes indicated that multiple factors influence how euthanasia is performed and the euthanasia decision-making process. Additionally, euthanasia and job-related tasks were identified as sources of stress for dairy workers. Strength of the human-animal bond and worker compassion towards the animals they care for were evident for all participants. Initial analysis showed a lack of caretaker awareness regarding mental health services available in their community. Training programs on dairy farms should incorporate worker health and safety, particularly as it pertains to performing euthanasia, and address the mental wellbeing of dairy workers. Information regarding mental health services in the community should also be accessible to caretakers.

Examining Caretaker Attitudes Towards Primary Prevention of Pediatric Behavioral Health Problems in Integrated Care.

Understanding caretaker attitudes towards the prevention of pediatric behavioral disorders is important for the effective delivery of prevention services. Caretakers of children ages 0-18 (N = 385) read a description of pediatric prevention services in an integrated primary care setting. Attitudes towards these services were assessed. The majority of participants (80%) agreed that prevention is important, 87% reported interest in learning their child's risk for a behavioral disorder, 84% were interested in learning the results of a screen for behavioral disorders, and 88% were interested in learning parenting strategies. Participants endorsed similarly positive attitudes towards prevention in integrated care. Perceived risks outweighing perceived benefits, younger caregiver age, and identifying as non-Hispanic Whitepredicted less favorable attitudes towards prevention. Other socio-demographic characteristics (e.g., caretaker education) were associated with disorder-specific beliefs about the importance of prevention, but not general attitudes. Findings suggest generally positive attitudes towards preventing behavioral disorders in an integrated care setting.

Alpaca and llama behaviour during handling and its associations with caretaker attitudes and human-animal contact

The behaviour of new world camelids towards humans has received little research attention so far. Our aims were to assess the response of alpacas and llamas to handling, and to investigate its associations with caretaker attitudes and handling practices (i.e., the reported amount of contact to the animals at different ages). Reactions of 116 alpacas and llamas during handling by a familiar person and during a physical examination by a veterinarian were observed on 20 animal holdings. The 20 main caretakers completed or partially completed a questionnaire on their attitudes and their amount of contact to their animals. Data were analysed at farm level by means of Spearman rank correlations. Animals were generally very easy to lead by a familiar person, but a higher proportion showed fear and stress related behaviour, predominantly freezing, during the physical examinations. Associations between caretaker attitudes, amount of contact, and animal behaviour were found. For instance, if the caretakers found tactile contact more pleasant, a lower percentage of animals attempted to flee during leading (rs = -0.51, p < 0.05, n = 18). Likewise, a higher percentage of animals showed no rising or freezing during the physical examination, if the caretakers rated talking to the animals as more important (rs = 0.57 / 0.49, p < 0.05, n = 17), and a higher percentage of animals did not scream and / or squeal, if caretakers rated training as more pleasant (rs = 0.77, p < 0.001, n = 18). Out of the 12 participants rearing young animals, those stroking their animals more frequently in early life had a higher percentage of non-balking animals during leading (rs = 0.64, p < 0.05, n = 12). A higher percentage of animals with handling difficulties and /or attempts to flee was associated with lower frequencies of touching in later life (rs = -0.80, p < 0.01, n = 11). The overall results suggest similar sequential relationships between caretaker attitudes, amount of gentle contact with the animals and the animals’ behaviour, as in other species.

Residents’ Management of, and Attitudes Towards, the Dog Population on Two Mariana Islands

ABSTRACTThis study reports the level of care dogs received from their caretakers and the attitudes of caretakers and non-caretakers toward dogs on the islands of Guam and Saipan. Surveys were collected from residents of Guam and Saipan (274 and 275, respectively) and analyzed using chi-squared tests. Dogs were the most popular companion animal (Guam 66.4%; Saipan 72% ownership) with a strong preference toward pedigree, male puppies (Guam 45.4%; Saipan 62.4%). The more preferred dogs were housed inside and fed dog food, while the less preferred local mixed-breed dogs were free-roaming and fed table scraps. Fifty-nine per cent of caretakers in Saipan and 22.8% of caretakers in Guam had never provided veterinary care to their dog. Generally, caretakers on both islands did not sterilize their dogs, which may result in the potential for unplanned litters and a growth in the dog population. Residents of both islands reported witnessing abusive acts toward dogs, despite dogs being reported as having an important role on the island. This paper aims to identify challenges in dog welfare and management options for the stray population.

Caretaker attitudes toward swine euthanasia.

Timely euthanasia is a fundamental part of safeguarding swine welfare by reducing suffering when compromised pigs are unable to recover. The quality and appropriateness of timely euthanasia rely mainly on the knowledge and experience of the individual caretaker but may also be affected by caretaker attitudes toward euthanasia. However, literature on caretaker attitudes toward swine euthanasia is lacking. This study investigated caretaker attitudes, perceived knowledge, and confidence in performing on-farm timely euthanasia. A total of 84 caretakers from eight swine farms (ranging in size from 1,300 to 7,000 sows) participated in a survey designed to investigate attitudes toward swine and swine euthanasia. Caretaker’s ages ranged from 18 to 59 yr with an average work experience of 8.5 yr. The majority of participants worked in either farrowing or breeding units. Survey questions were designed to assess caretakers’ attitudes and attributes (empathy affect, empathy attribution, attitudes toward pigs, feeling bad about euthanizing pigs, and assumptions about pigs’ emotional capabilities), decision-making skills (confidence in identifying compromised pigs or relying on coworkers to make decisions), and euthanasia skillset (confidence in performing euthanasia, training, and perceived level of knowledge). Using cluster analysis to analyze survey answers, three distinct groups of caretakers were identified: 1) confident and empathetic; 2) Confident, knowledgeable, and detached; and 3) unconfident and lacking knowledge. The survey results showed that empathy attribution was strongly correlated with empathy affect (r = 0.571, P < 0.01) and that empathy affect and empathy attribution were higher in female caretakers compared with male caretakers (P < 0.05). A risk analysis that included previously identified clusters showed that females were more likely to be grouped among caretakers that were confident and empathetic (P = 0.04), and caretakers with more than 2 yr of swine experience were more likely to be grouped as confident and skilled (P = 0.01), while the unconfident and empathetic were more likely to have had less than 2 yr of experience (P = 0.04). This study provides important information about variability in caretaker experience as well as their attitudes toward pigs and timely euthanasia. Increased knowledge about swine caretaker attitudes may be used to implement training and euthanasia protocols to increase both human and pig welfare on farm.

Is there a relationship between attitudes of shelter staff to cats and the cats’ approach behaviour?

One aspect of welfare that is measured in protocols used for the assessment of farm animal welfare is the human-animal relationship. The aim of the present study was to develop a ‘human approach test’ to measure the human-animal relationship in shelter cats and to investigate aspects of feasibility, reliability and validity of this test in a surveillance setting.Cat behaviour towards humans was assessed using a standardized approach in their home pens. Cats were categorized as ‘no contact possible’ when they withdrew, ‘froze’ or showed signs of aggression. ‘Contact possible’ was assigned to cats that stayed near and investigated the experimenter. In total, 725 cats in 30 shelters were tested and it was possible to initiate contact with 59±21% (Mean±S.D.) of the cats per shelter. To evaluate test-retest reliability of the approach test at shelter level, ten shelters were visited twice (mean number of days between visits: 58). Spearman rank correlation of the proportion of cats per shelter showing contact behaviour resulted in rs=0.68, P=0.032. No significant difference was found between visit 1 and visit 2 (P=0.799). Between-experimenter repeatability was tested at pen level in 8 shelters on a total of 221 cats in 36 housing units. The ratings of the first rater and the three second raters resulted in rs=0.99, p<0.001. We attempted to assess the validity of the approach test by investigating relationships with attitudes of staff and frequency of daily care reported by the shelter manager. To assess attitudes to cats, 127 members of shelter staff completed a questionnaire. Overall, shelter staff had a quite positive attitude to cats (e.g. positive characteristics of cats: 5.6±0.9 on a scale from one to seven). Negative quality of interactions was seldom reported (coercive handling: 1.8±1). Relationships between cat behaviour and the attitude of several subsamples of shelter staff (based on measures of time spent working with cats) were analysed at shelter level. Of 60 correlations, only two in different subsamples were significant. However, more frequent provision of fresh water (rs=0.38, p=0.044, N=28) and more frequent cleaning of food bowls (rs=0.38, p=0.036, N=30) were related to an increased proportion of cats showing contact behaviour.Overall, the test was feasible and showed very good to moderate reliability, but cat behaviour did not reflect caretaker attitudes in the shelters we visited. To develop valid animal-based measures of the human-shelter cat relationship further studies are needed.

Gay Men and the Health Care System

Because of the homophobia manifested by health care providers, gay men have had to exercise extra prudence in the selection of their physician to avoid "second class" medical care. The persistence of negative attitudes of caretakers towards gay men is evident in the interaction between the physician and her/his gay male patient. These negative attitudes are manifested in a range of behaviors, from overt rejection to benign neglect. To avoid this deleterious experience, some gay men will withold pertinent information which subsequently interferes with the physician's ability to make an appropriate diagnosis. The AIDS epidemic has led to a confrontation of the health system by gay activists and AIDS service organizations, ushering in the start of more positive attitudes and behaviors towards gay men with HIV or AIDS. Possible solutions to these shameful occurrences with the health system are discussed.

Influence of patient caregivers on course of patient illness: "expressed emotion" and alternative measures.

The influence of the quality of care that patients receive during the course of their illness has been the subject of special scrutiny in the area of mental health. The concept of "expressed emotion" (EE) evolved in an effort to understand the impact of family and social environment on the vulnerability to relapse of schizophrenic patients. A semistructured interview, the Camberwell Family Interview, was developed to assess expressed emotion. This article examines the historical context, generalizability, methodological strengths and limitations of the construct of EE and the Camberwell Family Interview, as well as the nature and effects of treatment intervention programs designed to neutralize adverse effects of patient caretaker attitudes.

The impact of temperament in a school setting: an epidemiological study.

The authors present the results of an epidemiological study on a large non-clinical population-based sample of French speaking seven year-old children (N = 596) whose aim was to verify if a relation exists between temperament and outward-type or inward-type behavior problems in school. The Thomas and Chess' Parent Temperament Questionnaire, filled out twice by the parents over a four-week interval, was used to determine temperament. The Conners Teacher Questionnaire, filled out twice by the teachers over a four-week interval, was used to determine behavior problems in school. Five points emerge from this study. First, "difficult" temperament 'per se' is not associated either with outward-type or inward-type behavior problems in school. Second, a temperamental pattern of high activity and high approach with new stimuli predisposes boys to present outward-type behavior problems in school. Third, the temperamental traits of low adaptability or withdrawal with new stimuli predisposes girls to inward-type behavior problems in school. Fourth, the study demonstrates the importance of verifying if the associations between temperament and behavior problems are stable since, in the comparisons between results of the test with those of the retest, several of the associations found in one occasion failed to be replicated at the other. Fifth, the different influences of temperament according to sex emphasize the need to study boys and girls separately. Future studies should take into account interactions between parents/teachers and child temperament since these sex-related different influences of temperament could be related to the sex-related different attitudes of caretakers.

A population-based study of nonfatal childhood injuries

A random-digit-dialing telephone survey was used to assess the frequency and associated characteristics of childhood poisoning, burns, and head injuries in 1.213 San Diego County households having at least one child 14 years of age or younger at the time of the telephone interview in 1980. The survey population was representative of the general San Diego County population with regard to socioeconomic status and geographic distribution. The frequency of injuries judged to be serious enough to require medical care and the median ages for each injury were head injury, 4.2% and 5.5 years: burns, 4.0% and 2 years: and poisonings, 3.4% and 2 years. Forty-four percent of all poisonings were related to drugs. of which aspirin was the single most common medication. Hot liquids or hot surfaces were responsible for 52% of burns. The majority of head injuries (65%) were caused by falls, usually outside the home. Education was positively associated with poisonings. and income was negatively associated with burns. Children of caretakers working outside the home did not have higher injury rates than those whose caretakers were not so employed. Differences in caretaker attitudes were few, and may reflect the experience of having an injury, rather than factors preceding it. The advantages and limitations of this method of assessing childhood injury in populations are discussed.

Geriatric team dynamics: E he dietitian’s role

In 1980, a geriatric consultation team was formed at Massachusetts General Hospital to meet the complex medical, psychological, rehabilitative, nutritional, and social needs of geriatric patients. This team strives to provide elderly patients with the comprehensive care necessary to potentiate return to maximum independent functioning and to change attitudes of primary caretakers toward care of geriatric patients through increased recognition of the elderly as a heterogeneous group. The team consults on patients with changes in mental status, need for physical rehabilitation, "failure to thrive," or need for definitive planning for posthospital disposition. The dietitian conducts nutritional screening of each patient, is a nutrition resource for team members, and promotes collaboration in nutrition care planning. When the dietitian communicates nutrition concerns, goals, and care plans for patients to other health professionals, they use the information to reinforce her recommendations and integrate nutrition components into their care plans. A multidisciplinary approach has resulted in earlier identification and evaluation of functional ability, more comprehensive individualized care planning, and a reduced percentage of readmissions.

Demythologizing the attitudes of family caretakers about “mental illness”

Demythologizing the attitudes of family caretakers about “mental illness”