Concerned Family Members Research Articles

Development and evaluation of a leaflet for concerned family members and friends: 'It's safe to talk about suicide'.

Objectives:Significant others can play a key role in suicide prevention, but little attention has been given to the resources they may need in order to do so effectively. Based on previous qualitative research and working in partnership with suicide prevention charities, we developed a simple educational leaflet to help family members and friends recognise and respond to a possible suicidal crisis. We disseminated 15,000 copies through a wide range of community agencies within one English local authority. This paper describes the development, distribution and evaluation of the leaflet. The aim of the evaluation was to assess how the distribution strategy was working, whether the leaflet was regarded as useful and acceptable, how it was being used and whether there were any concerns about its content.Design:Interview study.Methods:We conducted two rounds of semi-structured telephone interviews with every agency on the distribution list and in-depth qualitative interviews with a purposefully selected sub-sample.Results:The leaflet was seen as filling an important gap. It was eagerly embraced by staff in frontline agencies, who passed it on to clients, used it for their own personal/professional development and to support clients or colleagues, or used it as a teaching aid. No concerns were raised about its content.Conclusion:Findings reveal a deep-seated fear of talking about suicide among frontline staff. They were using the leaflet in ways we had not anticipated, demonstrating lateral thinking and a real commitment to suicide prevention in agencies that are not typically associated with it.

Helping concerned family members of individuals with substance use and concurrent disorders: An evaluation of a family member-oriented treatment program

There is a growing body of research demonstrating that families of individuals with substance use and concurrent disorders (SUCD) experience a wide range of biopsychosocial problems that significantly impedes their quality of life and health. However, there has been a relative lack of treatment programs primarily focused on improving the well-being and quality of life of these family members. The current study assessed the efficacy of such a program at reducing stress, increasing perceived social support from family and friends, and increasing general, dyadic, and self-rated family functioning within these concerned family members. A sample of 125 family members of individuals with SUCDs was recruited, of which 97 participated in the treatment program and 28 were used as the comparison group. Results indicated that the treatment program significantly reduced stress, increased perceived social support from family and friends, and increased general, dyadic and self-rated family functioning. A perceived personal benefits questionnaire demonstrated that participants had a better understanding of SUCDs, better coping capabilities in regard to emotional difficulties, adopted stronger coping methods, participated in more leisure activities, and improved their relationship with the individual with a SUCD. The results of the current study further demonstrate the need to implement more of these family-member oriented psycho-educational treatment programs.

Sources of Care for Alcohol and Other Drug Problems: The Role of the African American Church.

African Americans experience significant disparities in treatment access, retention, and quality of care for alcohol and drug use (AOD) problems. Religious congregations, often the first point of contact for help with AOD problems, can play an integral role in improving access to treatment. However, little is known about the role of African American churches in addressing AOD problems. We administered a survey to a faith-based collaborative of 169 African American churches in Los Angeles to examine how AOD problems are identified in congregations, the types of support provided, barriers to providing treatment referrals, and factors associated with the provision of treatment referrals. Seventy-one percent of churches reported caring often for individuals with AOD problems. AOD problems came to the attention of congregations most commonly via a concerned family member (55%) and less frequently through individuals with AOD problems directly approaching clergy (30%). In addition to providing spiritual support, a substantial proportion of churches reported linking individuals to AOD services through referrals (62%) and consultation with providers (48%). Barriers to providing treatment referrals included lack of affordable programs (50%), stigma (50%), lack of effective treatments (45%), and insufficient resources or staff (45%). The likelihood of providing treatment referrals was greater among mid-sized versus smaller-size congregations (OR 3.43; p<.05) and among congregations with clergy that had attended seminary (OR 3.93; p<.05). Knowing how to effectively coordinate informal sources of care provided by African American churches with the formal service sector could make a significant impact on AOD treatment disparities.

The pharmacist role in the development and implementation of a naloxone prescription program in Alabama

ObjectiveThe purpose of this report is to describe the development and implementation of a pharmacist-led naloxone-training and prescription service at a county health department. SettingJefferson County Department of Health, Birmingham, Alabama. Practice descriptionThis service was developed in response to the overwhelming heroin and opioid epidemic that is currently affecting the entire nation and which is highly prevalent in the state of Alabama. Because of this epidemic, new state laws have been established regarding prescriptive authority, liability, and possession of naloxone. Practice innovationThrough a collaborative protocol, pharmacists at the Jefferson County Department of Health were responsible for prescribing and educating the public about naloxone. EvaluationBetween 2014 and 2015 the Jefferson County Coroner reported a 131% increase in opioid prescription-related deaths indicating the continued need for the naloxone prescription program. ResultsIn total, 83 clients were trained and 150 naloxone kits were distributed among heroin and opioid users, concerned family members or friends, and those who work closely with users. ConclusionThis service and its extending arms were developed in response to the need for naloxone education among heroin and opioid users, their family members, civil servants who work with users, and family practice physicians who prescribe opioids.

How a concerned family member, friend or member of the public can help someone with gambling problems: a Delphi consensus study.

BackgroundGambling is an enjoyable recreational pursuit for many people. However, for some it can lead to significant harms. The Delphi expert consensus method was used to develop guidelines for how a concerned family member, friend or member of the public can recognise the signs of gambling problems and support a person to change their gambling.MethodsA systematic review of websites, books and journal articles was conducted to develop a questionnaire containing items about the knowledge, skills and actions needed for supporting a person with gambling problems. These items were rated over three rounds by two international expert panels comprising people with a lived experience of gambling problems and professionals who treat people with gambling problems or research gambling problems.ResultsA total of 66 experts (34 with lived experience and 32 professionals) rated 412 helping statements according to whether they thought the statements should be included in these guidelines. There were 234 helping statements that were endorsed by at least 80 % of members of both of the expert panels. These endorsed statements were used to develop the guidelines.ConclusionTwo groups of experts were able to reach substantial consensus on how someone can recognise the signs of gambling problems and support a person to change.Electronic supplementary materialThe online version of this article (doi:10.1186/s40359-016-0110-y) contains supplementary material, which is available to authorized users.

Quantitative study of oncology nurses' knowledge and attitudes towards pain management in Saudi Arabian hospitals

Pain is an unpleasant human experience, often associated with underlying medical conditions, and a key reason for individuals experiencing pain to seek medical advice. However, the pain experience is unique and subjective, and affects people's quality of life, as well as impacting on their concerned family members. Optimal pain management requires adequate knowledge, a positive attitude, and competent pain assessment measures. It has been reported that oncology nurses in the Kingdom of Saudi Arabia (KSA) have inadequate knowledge, assessment skills and management of pain. ObjectiveThis paper aims to examine nurses' knowledge and attitudes regarding pain management in Saudi Arabian hospitals (SA). MethodA cross-sectional survey was administered to 320 nurses exhibiting considerable racial, cultural, religious and professional diversity, working in oncology units at five hospitals in the KSA. Self-completed survey questionnaires were distributed using the ‘Knowledge and Attitudes Survey Regarding Pain’ (KASRP) tool. ResultsThe nurses exhibited a relatively poor overall knowledge of pain management (mean score = 45.1%; 95% CI = 43.9%, 46.2%). The mean KASRP scores varied significantly at α = 0.05 with respect to the nurses' nationality, whether they had attended pain-related courses, and whether they had participated in research. ConclusionThe results indicate the urgency needed to reform pain management education for oncology nurses in the KSA.

Congressional Statement of Reid K. Weisbord Regarding Social Security Representative Payee Misuse to United States House Ways and Means Committee (June 5, 2013)

Hearing before the House Ways and Means Committee Subcommittee on Social Security Wednesday, June 5, 2013. “How Social Security Protects the Benefits of Those Who Cannot Protect Themselves.” Statement of Reid Kress Weisbord, Submitted June 5, 2013, on Social Security Representative Payee Misuse.Representative payee misuse adversely affects the most vulnerable beneficiaries within the Social Security program and is exceptionally difficult to detect under current agency protocols. Additionally, when the Social Security Administration’s failure to monitor a representative payee results in benefit misuse, SSA is statutorily required to reimburse certain beneficiaries for all misused funds. To reduce the incidence of benefit misuse (and, by extension, to reduce government reimbursement of misused funds), this statement proposes a "family representative" system whereby a concerned family member or friend would be carefully vetted and appointed with authority to monitor the representative payee’s performance. A family representative with first-hand observation of the beneficiary would be in a better position to detect and report benefit misuse than a governmental agency lacking personal contact. This proposal would be essentially cost-free, protect vulnerable beneficiaries, and reduce government spending on benefit misuse reimbursements.

Bladder cancer discussed on the internet: a systematic analysis of gender differences of initial posters on an online discussion board

ObjectivesTo evaluate gender differences of initial posters in threads dealing with bladder cancer on an online discussion board.Method529 threads opened between 09/2005 and 03/2012 were screened on the largest German speaking bladder cancer online discussion board. 366 threads fulfilled the requirements for this study. Gender, age, number, status of concern and oncological situation of initiating posters as well as their motives and language style were analyzed following a standardized protocol.ResultsThreads were initiated in 45% (164/366) by men and in 55% (202/366) by women. Mean age of male initiating posters was 50 years and of female posters 44 years (p < 0.001). Of males 80% (132/164) were concerned patients and 20% (32/164) relatives or friends. Of females they were 39% (78/202) and 61% (124/202), respectively (p < 0.001). In general motives for initial posting were focused on medical information and did not differ between both genders. 81% of the posters asked for medical information or therapeutic recommendations regarding diagnosis, treatment and prognosis. However, women significantly more often expressed their wish for emotional support (p = 0.034) and in tendency wanted to share their experiences with others (p = 0.057). Language analysis revealed that women significantly more often used a tentative language style than men (p = 0.003).ConclusionEven though women are less often affected by bladder cancer, they are more active –especially for their concerned family members - on the evaluated discussion board than men. Whereas both genders equally often ask for medical information, women more often want to share their experiences and look for emotional support.

Latin Justice

Latin Justice

Impact of Family Expressed Emotion upon Schizophrenic Patients

Objectives: To describe the demographic characteristics of the patients. Describe the samples demographic profile by gender. Estimate the relationship between patient's socio-demographic (age, gender, education, marital status, kinship, income, employment, and the families expressed emotions. Methodology: The study carried out on a purposive "non probability" sample of (100) schizophrenic patient were selected of Psychiatric Hospital in Baghdad City. A questionnaire is constructed for the purpose of the present study, which is distributed across 4 main parts. Part one is a covering letter to obtain the agreement of patients and their family members to participate in the present study, part tow included the demographic characteristics of the sample, and part three included the demographic characteristics of the sample concerned family members who provide care and for schizophrenic patients, part four the level of expressed emotion scale. The overall items, which were included in the questionnaire, are 42 items. Validity and reliability of the questionnaire were determined through the review of a panel of experts and the pilot study. Data were collected through the period of September 11th 2011 to October 11th 2011. It was analyzed through the descriptive statistics (frequency, percentage, and mean of score) and inferential statistics. Results: the results shows that The findings of the present study show that (46%) of the subjects are in the age group of 30-39, years. (62.8%) of the women reported that their income was inadequate compared to 33.3% of the men. Conclusion: The results revealed that were a significant relationship was found in family expressed emotion with schizophrenic patient regarding to their Compliance with medication, family size, and patient income. Recommendation: Collaboration between family members and mental health professional in the treatment of schizophrenic patient. Family Educational programs about how to deal with schizophrenic patient's behavior should be implemented to increase their knowledge about schizophrenia and accepting to schizophrenic patients.

의료에서 덕과 실천의 매개로서 서사(narrative)*

Every human being is a “narrative being” in the sense that he or she has a life story. It is not advisable, or even technicall possible, for a physician to separate a patient’s life history when making medical decisions. The best medical decision-making involves the patient, the physician, and concerned family members who come together to mediate conflicts that may arise through the patient’s life stories, rather than merely relying on regulations and principles. The ability to understand the meaning and importance of a patient’s life story is an important one for physicians to have. Physicians with this ability form stronger bonds with patients. This article examines some of the problems caused by scientific medicine and emphasizes the importance of patients’ life experiences and physicians’ willingness to listen to and understand patients’ life-narratives.

Prevalence and frequency of problems of concerned family members with a substance-using loved one

Background: Limited research has examined the prevalence and frequency of specific problems of concerned family members and significant others (CSOs) of alcohol- or substance-using individuals (SUIs). Objectives: We surveyed CSOs of SUIs to determine the prevalence and frequency of their problems and explored whether relationship to the SUI, gender of the CSO, or living arrangements altered problem prevalence and frequency. Methods: Non-substance-using CSOs (n = 110) completed the Significant Other Survey, which asks about problems in seven domains (emotional; family; relationship; financial; health; violence; legal). Problem outcomes were compared based on the CSO's relationship to the SUI (partner or spouse vs. parent), gender of the CSO (male vs. female), and living arrangements of the CSO and the SUI (residing together vs. residing apart). Results: Problems were prevalent with at least two-thirds of the participants endorsing one or more problems in all but the legal domain. They also occurred frequently, with CSOs reporting problems on one-third to one-half of the past 30 days, in all but the violence and legal domains. Problems tended to be greater for CSOs who were partners, females, or living with the SUI. Conclusion: CSOs experience frequent problems in a wide range of life domains and the types of difficulties they experience appear to differ based on type of relationship, gender, and their living arrangement relative to the SUI. Scientific Significance: This investigation expands our understanding of the specific problems that CSOs face. The findings have important implications for treatment and health policy regarding these individuals.

Web-based 5-Step Method for affected family members

Though affected others probably outnumber those actually misusing alcohol and drugs, the services that are available to them are marginal and do not adequately meet the needs of this growing population of concerned family members (FMs). Evidence available suggests that the 5-Step Method is effective in supporting FMs who are concerned about their relatives’ drinking or drug misuse. However, not all evidence-based treatments are being used by health care practitioners. The challenge of the 5-Step Method would thus be making it available to the FMs in need. This article looks at the development and experience of providing this intervention in a format that can be accessed on the internet by FMs. Preliminary results show that the internet is viable for the dissemination of the 5-Step intervention with the potential of reaching many affected FMs. FMs reported this online version as straight forward, easy to use and helpful. Ways in which the delivery of the programme might be improved for the increased benefit of FMs are discussed.

How Do U.S. Chinese Older Adults View Elder Mistreatment? Findings From a Community-Based Participatory Research Study

This study examines the perception, knowledge, and help-seeking tendency toward elder mistreatment among Chinese older adults. A community-based participatory research approach was implemented to partner with the Chicago's Chinese community. A total of 39 Chinese older adults (age 60+) participated in focus group interviews. Data analysis is based on grounded theory framework. Chinese older adults mostly characterized elder mistreatment in terms of caregiver neglect and identified psychological mistreatment as the most serious form of mistreatment. Other forms included financial exploitation, physical mistreatment, and abandonment. Chinese older adults have limited knowledge of help-seeking resources other than seeking assistance from local community service centers. This study has important practical implications for health care professionals, social service agencies, and concerned family members. Our results underscore the need for research and educational initiatives as well as community awareness programs that highlight the pervasive public health issue of elder mistreatment.

Out of a Cell into This Darkened Space

Out of a Cell into This Darkened Space

Bringing order to chaos: How RFID can deliver business intelligence to hurricane evacuations and enhance public safety in the process

In the wake of Hurricane Katrina and subsequent major hurricanes, evacuation planning and execution have taken-on a heightened level of interest from both public officials and the general public. In this article, the authors examine how radio frequency identification (RFID) can be utilized to not just facilitate mass evacuations due to hurricanes, but yield far-better, real-time information to public officials, emergency managers, and concerned family members as well. The authors begin with an overview of RFID technology. Then, the authors explore how two leading areas—the State of Texas and the City of New Orleans—have worked with private sector partners to develop, test, and actually utilize RFID-based tracking systems to be used ondemand for hurricane evacuation events. The authors then analyze the benefits of such systems for use in hurricanes and other potential mass evacuations. The authors pinpoint the public safety, operational, and business intelligence advantages of employing this new identification technology in these crisis situations.

Au-delà du diagnostic d’une maladie génétique, la question de l’information de la parentèle

The examination of a person's genetic characteristics is not a classic diagnostic. It concerns the gene pool of an entire family. It is valid in the present and may affect some part of the future. The diseases that it reveals, sometime very serious ones, may or may not be treated. But genetic advice allows sometimes to preventing some of these diseases. The 2004 Bioethics Law makes the provision that in case a serious genetic anomaly is diagnosed during the examination of a person's genetic characteristics, the medical doctor informs the person or its legal representative of the risks that his silence could cause to the potentially concerned family members as long as prevention measures or care can be offered to them. For these reasons, besides the specificity of the diagnostic for the person directly concerned, there is also the question of the right of other people, like family members, to be informed of the diagnostic. As such, there is an ethical conflict between medical confidentiality owed to each patient and the duty of information. The pharmacist must know the medical confidentiality rules that frame this information. He must also know the different patient attitudes and must be able to encourage him to inform his family because the future if not the life of others may depend on this information.

Life: A Circle With Challenges at Both Ends

Life: A Circle With Challenges at Both Ends

Working with Family Members to Engage Treatment-Refusing Drinkers: The CRAFT Program

SUMMARY Community Reinforcement and Family Training (CRAFT) is an empirically-supported program based on behavioral reinforcement that engages treatment-refusing alcohol-other drug abusers into treatment by working with their concerned family members. These concerned significant others (CSOs) are taught how to rearrange contingencies in the drinker's environment such that sober behavior is supported and drinking behavior is discouraged. CSOs receive behavioral skills training in order to acquire the tools to successfully influence the drinker to enter treatment, and to enhance their own happiness as well. This review describes the outgrowth of CRAFT from the original Community Reinforcement Approach (CRA) program, summarizes the research foundation, and presents the basic CRAFT procedures with illustrative examples.

Introduction to Infectious Wildlife Diseases

In the last 10 years, wildlife diseases that were once discussed only on the pages of a microbiology textbook are making their way into the common vernacular. Emerging infectious diseases have been increasingly reported as causes of death in wild animals. These diseases are a particular threat to wildlife species whose population, habitat, or range has been diminished or artificially manipulated to promote species survival (e.g., captive breeding, translocation, and release programs) (Lyles and Dobson 1993). Sometimes the newfound fame of these diseases is the result of sensationalism, yet other times they have garnered rightful attention. How do you make the distinction? Inevitably, you, as a wildlife rehabilitator, will most likely field questions from the public visiting your facility or a concerned neighbor or family member. It is important to disseminate accurate information without either fomenting undue panic or understating danger.