Emotional Support Services Research Articles

What Are the Unmet Needs and Care Experiences of Adolescents and Young Adults with Cancer? A Systematic Review.

To assess what is currently known about unmet needs and care experiences of adolescents and young adults (AYAs) with cancer, identify gaps in the research literature, and highlight potential areas for improvement in future research. Medline, PsycINFO, CINAHL, and EMBASE databases were searched to identify relevant studies from 1990 to July 2015. Eligible articles included self-reported care experiences or unmet needs of cancer patients aged between 15 and 30 years in the period between symptom onset and 2 years post-treatment. Qualitative and quantitative designs were included. Forty-five articles from 39 studies (23 qualitative, 12 quantitative, and 4 mixed methods) were rated as "adequate" or "good" quality and reviewed. The majority included any cancer diagnoses and none was longitudinal. There was considerable variation in age ranges and time since diagnosis between studies. Only two studies used standardized survey tools, with both tools validated on adult populations. The most common areas assessed for care experiences and needs were information/communication and fertility. In addition, care experience studies commonly examined clinical expertise and age-appropriate settings, while unmet needs studies reported on emotional support and peer interaction. Findings highlight the need for age-appropriate information and treatment facilities, access to emotional support services, and contact with peers. Fertility information and services are a priority issue for this group. Future research would benefit from a consistent definition of the AYA age range, increased used of standardized scales validated with this population, and longitudinal designs to assess changes over time.

The nature of emotional support and counselling provision for people with sight loss in the United Kingdom

People with sight loss in the United Kingdom are known to have lower levels of emotional well-being and to be at higher risk of depression. Consequently, ‘having someone to talk to’ is an important priority for people with visual impairment. An online survey of the provision of emotional support and counselling for people affected by sight loss across the United Kingdom was undertaken. The survey was distributed widely and received 182 responses. There were more services offering ‘emotional support’, in the form of listening and information and advice giving, than offered ‘counselling’. Services were delivered by providers with differing qualifications in a variety of formats. Waiting times were fairly short and clients presented with a wide range of issues. Funding came from a range of sources, but many felt their funding was vulnerable. Conclusions have been drawn about the need for a national standardised framework for the provision of emotional support and counselling services for blind and partially sighted people in the United Kingdom.

Suicide Communication on Social Media and Its Psychological Mechanisms: An Examination of Chinese Microblog Users.

Background: This study aims to examine the characteristics of people who talk about suicide on Chinese microblogs (referred to as Weibo suicide communication (WSC)), and the psychological antecedents of such behaviors. Methods: An online survey was conducted on Weibo users. Differences in psychological and social demographic characteristics between those who exhibited WSC and those who did not were examined. Three theoretical models were proposed to explain the psychological mechanisms of WSC and their fitness was examined by Structural Equation Modeling (SEM). Results: 12.03% of our respondents exhibited WSC in the past 12 months. The WSC group was significantly younger and less educated, preferred using blogs and online forums for expressing themselves, and reported significantly greater suicide ideation, negative affectivity, and vulnerable personality compared to non-WSC users. SEM examinations found that Weibo users with higher negative affectivity or/and suicidal ideation, who were also using blogs and forums more, exhibited a significantly higher possibility of WSC. Conclusion: Weibo users who are at greater suicide risk are more likely to talk about suicide on Weibo. WSC is a sign of negative affectivity or suicide ideation, and should be responded to with emotional support and suicide prevention services.

Major Burn Trauma Management and Nursing Care

Major burn injury is one of the most serious and often life-threatening forms of trauma. Burn patients not only suffer from the physical, psychological, social and spiritual impacts of their injury but also experience considerable changes in health-related quality of life. This paper presents a review of the literature on the implications of previous research and clinical care guidelines related to major burn injuries in order to help clinical practice nurses use evidence-based care guidelines to respond to initial injury assessments, better manage the complex systemic response to these injuries, and provide specialist wound care, emotional support, and rehabilitation services.

Sexual Assault Response Teams (SARTs)

Multidisciplinary coordinated Sexual Assault Response Teams (SARTs) are a growing model of providing health, legal, and emotional support services to victims of sexual assault. This article conceptualizes SARTs from an organizational perspective and explores three approaches to researching SARTs that have the potential of increasing our understanding of the benefits and challenges of multidisciplinary service delivery. These approaches attend to several levels of organizational behavior, including the organizational response to external legitimacy pressures, the inter-organizational networks of victim services, and the negotiation of power and disciplinary boundaries. Possible applications to organizational research on SARTs are explored.

Emotional Support Animals, Service Animals, and Pets on Campus

For decades, universities have been accommodating physically disabled students who require guide dogs and other types of service animals. Within the past several years, however, mentally disabled students have increasingly petitioned colleges with no-pet policies to permit them to bring their animals on campus because they need a companion or emotional support animal to make college life easier and to reduce their stress, loneliness, depression, and/or anxiety. Institutions that unlawfully reject such requests are finding themselves in court and charged with disability discrimination. Schools are understandably confused about their obligation, if any, to waive their no-pet rules under these circumstances. This article discusses pets on campus and provides administrators guidance with respect to this increasingly contentious issue and to keep their organizations “out of the legal dog house.”

Does marriage affect survival among the elderly in China?

Q. HUANG, G. CHEN. Does marriage affect survival among the elderly in China? Gerontechnology 2014; 13(2):214; doi:10.4017/gt.2014.13.02.329.00 Purpose Marriage provides key social ties that can offer both economic and social advantages and thus protect people against poor health outcomes1. However, research related to the link between marriage and mortality are not as rigorous as other research topics due to limitations in research such as selection bias and limited sampling, when compared with the links between marriage and other health outcomes2,3. This paper attempts to present more rigorous evidence by using the Cox Model to analyze the relationship with longitudinal data and provide some insight on this issue. Method Five sets of data collected in 1998, 2000, 2002, 2005 and 2008 are derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and 8,589 subjects were included after deleting samples with missing data. To enhance the statistical power, missing data was input using the values of the same variable in the former or latter survey. Current marital status is divided into two categories including ‘married’ and ‘unmarried’, and the quality of previous marriages were measured by the total evaluation scores of all relationship histories with former spouses. Basic survival function curves and correlative methods (log-rank tests) were used to explore associations between socio-demographic factors together with dynamics of current marriages, marital history status and changes in survival time. Cox’s semi-parametric regression model was used to explore the marital effects on survival time. Results & Discussion Of people analyzed in this study, 37%, 33.1%, 49.7%, 45.8% of the subjects died in 1998–2000, 2000– 2002, 2002–2005 and 2005–2008, respectively. The total time at risk was 341,311 person-months; average survival time was 39.7 months. Those who were married were more likely to survive longer than unmarried people (Figure 1) and the survival rate between married and unmarried people were significantly different throughout the log-rank tests. The hazard ratio of death of married people is 23% lower than those who are unmarried (p=0.000) and those who have a better evaluation of marriage history are likely to survive longer than unmarried people (p=0.057) after controlling for other covariates. For the elderly, marriage can protect health by providing emotional support and care services; thus married people live longer than those who are not married. This result is consistent with other studies4. Social initiatives, such as designing specific marriage markets as well as social networking and communication tools that help elderly get remarried, or entertainment robots to reduce loneliness for singles or widows should be launched to reduce the negative effects of being unmarried in order to improve the longevity of the elderly.

Access to Medical and Supportive Care for Rural and Remote Cancer Survivors in Northern British Columbia

Rural cancer survivors (RCS) potentially have unique medical and supportive care experiences when they return to their communities posttreatment because of the availability and accessibility of health services. However, there is a limited understanding of cancer survivorship in rural communities. The purpose of this study is to describe RCS experiences accessing medical and supportive care postcancer treatment. Interviews and focus groups were conducted with 52 RCS residing in northern British Columbia, Canada. The data were analyzed using qualitative content analysis methods. General Population RCS and First Nations RCS experienced challenges accessing timely medical care close to home, resulting in unmet medical needs. Emotional support services were rarely available, and, if they did exist, were difficult to access or not tailored to cancer survivors. Travel and distance were barriers to medical and psychological support and services, not only in terms of the cost of travel, but also the toll this took on family members. Many of the RCS lacked access to trusted and useful information. Financial assistance, for follow-up care and rehabilitation services, was rarely available, as was appropriate employment assistance. Medical and supportive care can be inaccessible, unavailable, and unaffordable for cancer survivors living in rural northern communities.

Evaluation of an Emotional Support Service for the Visually Impaired

To evaluate the impact of a facilitated peer group emotional support service on visual quality of life (VQoL). Consecutive participants in an emotional support service delivered to groups of up to six and facilitated by trained counselors were recruited (n = 29). The VCM1 (Vision Quality-of-life Core Measure) instrument was administered to participants at the start of the service, at the end of the service, and 6 months after completion of the service. For the group as a whole, VQoL significantly improved between the beginning of the service and the end (F(1,23) = 16.43, p = 0.000) but was no better than at the start 6 months later (F(1,23) = 3.60, p = 0.07). However, those with poorer initial VQoL showed significantly greater improvements after 6 months (1.74 ± 2.21 logits) than those with higher initial VQoL (-0.12 ± 0.71 logits) (t23 = 2.89, p = 0.008). The effect size of the intervention for those with poor initial VQoL was 1.10 at the end of service and 0.92 after 6 months. The items that became and remained easier were "feeling lonely or isolated due to eyesight," "feeling sad or low due to eyesight," and "feeling worried about general safety outside the home." This facilitated peer group emotional support service significantly improves VQoL as assessed with the VCM1 over at least 6 months for those with poorer initial VQoL. Different interventions may be needed for those with initially good VQoL and to improve other aspects of QoL not influenced by the service.

Configuring the caller in ambiguous encounters: Volunteer handling of calls to Samaritans emotional support services

This paper discusses volunteer strategies for handling and assessing calls to Samaritans emotional support services for the suicidal and despairing. It presents findings from the qualitative components of a two-year mixed methods study based on an online caller survey, branch observations and interviews with volunteers and callers throughout the U.K. A thematic analysis of the qualitative data analysis was undertaken using the principle of constant comparison. Many calls fell beyond the primary remit of a crisis service, and called for rapid attribution and assessment. Uncertainty about identifying 'good' calls and recognizing those which were not caused difficulty, frustration and negative attribution towards some callers. This paper presents our analysis of volunteers' accounts of how they configure the caller in intrinsically uncertain and ambiguous encounters, and how such strategies relate to the formal principles of unconditional support and non-judgemental active listening espoused by the organization.

Creating safe places: an exploratory evaluation of a school-based emotional support service

School-based interventions for young people with emotional/mental health problems are often provided by external practitioners and their relationship with host schools is a key influence on implementation. Poor integration within school systems, schools’ tendency to define interventions around pupils’ behaviour and teachers’ control over access, may undermine therapeutic relationships. This study examines how one school-based intervention—Bounceback—addressed these challenges. Methods comprised interviews with programme staff, school staff and service users. Bounceback sought to develop therapeutic relationships through creating a safe, welcoming place and maximising pupils’ choice about how they engaged with it. To ensure Bounceback was delivered as intended, staff developed five conditions which schools were asked to meet: adhering to referral criteria, ensuring that attendance was voluntary, appropriate completion of referral forms, mechanisms for contacting pupils and private accommodation to maintain confidentiality. Pupils reported high levels of acceptability and described relationships of trust with Bounceback staff. Although pupils had choice about most aspects of Bounceback, teachers controlled access to it, partly in order to manage demand. The study highlights the need for external agencies to communicate their aims and needs clearly to schools and the importance of peripatetic practitioners being well integrated within their parent organisations.

Exploring the role of an emotional support and counselling service for people with visual impairments

There is growing evidence of the need for services to address the emotional support needs of people with visual impairments. This article presents findings from a mixed methods evaluation of an emotional support and counselling (ESaC) service delivered within an integrated low vision service, focusing primarily on the qualitative findings. Data collected using a standardised measure of psychological well-being (Clinical Outcomes in Routine Evaluation–Outcome Measure; CORE-OM) show an improvement in the psychological well-being of clients of the service between baseline and follow-up assessment. Qualitative findings from interviews with service users and service providers help to illustrate and explain the experiences underlying the quantitative findings. The ESaC services are shown to be helpful to service users in two particular ways: helping them to normalise their experiences by talking to an impartial listener and helping them to accept and adapt to the physical, emotional and social changes in their lives resulting from their visual impairment.

Emotional support and counselling for people with visual impairment: Quantitative findings from a mixed methods pilot study

AbstractAims: This paper reports on mainly quantitative findings from a mixed methods evaluation of a new model of emotional support and counselling for people with moderate visual impairment. Method: The CORE Outcome Measure was completed with service users at baseline and post‐intervention to assess the impact of the new service on psychological wellbeing and social functioning. Their perceived needs and expectations of the service were also explored. Results: Of the 35 individuals providing data at each assessment time, mean item scores on the CORE fell significantly (p<.001), taking the sample from within a clinical population before therapy, to a mean score below this following therapy. A more positive outlook accompanied this improvement in functioning. Discussion: Findings from the study augment the growing evidence that emotional support and counselling services can play an important role alongside and within related vision services. Implications for practice: The study indicates that therapeutic input for the visually impaired client group may need to target both wellbeing (feelings about oneself and the future) and problems (depression, anxiety, physical health, and trauma). Conclusions: Our findings suggest that a dual model of emotional support and counselling offers considerable benefit for people with visual impairment.

조손가정 청소년의 생활경험에 관한 연구: 학습정서지원 서비스 이용 경험을 중심으로

The purpose of the study shall be to achieve an understanding of learning and emotional support services for adolescents being raised by their grandparents. In-depth interview and qualitative methodology were used to find changes in the service experiences of 10 adolescents being raised by their grandparents by analyzing their experiences at a health family support center. 1 agency in the Chungnam area was selected as a model for its program for adolescents being raised by their grandparents. Ultimately, 78 items as sub-concepts, 44 items as sub-categories, and 4 items as subjects were identified. Specifically, these included school achievement, peer group relationship, family relationship and significant others. In conclusion, they were found to experience slower physical and emotional development and tend to withdraw in social situations. They were also found to have experienced difficulties in communicating with other people and with school achievement. However, it was shown that these adolescents have made positive changes after participating in a program involving a family coach who supports and provides services for them. Also, they were found to have experienced psychologically changes, and improved in their school achievement and personal relationships. Consequently, we will require more effort to provide emotional support, adult role models, counseling intervention, and social support for them.

Callers' experiences of contacting a national suicide prevention helpline: report of an online survey.

Background: Helplines are a significant phenomenon in the mixed economy of health and social care. Given the often anonymous and fleeting nature of caller contact, it is difficult to obtain data about their impact and how users perceive their value. This paper reports findings from an online survey of callers contacting Samaritans emotional support services. Aims: To explore the (self-reported) characteristics of callers using a national suicide prevention helpline and their reasons given for contacting the service, and to present the users’ evaluations of the service they received. Methods: Online survey of a self-selected sample of callers. Results: 1,309 responses were received between May 2008 and May 2009. There were high incidences of expressed suicidality and mental health issues. Regular and ongoing use of the service was common. Respondents used the service for complex and varied reasons and often as part of a network of support. Conclusions: Respondents reported high levels of satisfaction with the service and perceived contact to be helpful. Although Samaritans aims to provide a crisis service, many callers do not access this in isolation or as a last resort, instead contacting the organization selectively and often in tandem with other types of support.

Psychosocial service use and unmet need among recently diagnosed adolescent and young adult cancer patients

Adolescents and young adults (AYAs) with cancer demonstrate biomedical risks and psychosocial issues distinct from those of children or older adults. In this study, the authors examined and compared the extent to which AYAs treated in pediatric or adult oncology settings reported use of, and unmet need for, psychosocial support services. Within 4 months of initial cancer diagnosis, 215 AYAs ages 14 to 39 years (99 from pediatric care settings and 116 from adult care settings; 75% response rate) were assessed for reporting use of information resources, emotional support services, and practical support services. Statistical analyses derived odds ratios and 95% confidence intervals for service use and unmet needs after controlling for race, employment/school status, sex, relationship status, severity of cancer, treatment, and treatment-related side effects. AYAs ages 20 to 29 years were significantly less likely than teens and older patients ages 30 to 39 years to report using professional mental health services and were significantly more likely to report an unmet need with regard to cancer information, infertility information, and diet/nutrition information. Compared with teens who were treated in pediatric facilities, AYAs who were treated in adult facilities were more likely to report an unmet need for age-appropriate Internet sites, professional mental health services, camp/retreats programs, transportation assistance, and complementary and alternative health services. Substantial proportions of AYAs are not getting their psychosocial care needs met. Bolstering psychosocial support staff and patient referral to community-based social service agencies and reputable Internet resources may enhance care and improve quality of life for AYAs.

“The Anticipation Alone could Kill You”: Past and Potential Clients' Perspectives on HIV Testing in Non-Health Care Settings

HIV testing in non-health care settings is an effective strategy for increasing the proportion of persons aware of their infection. We conducted 21 focus groups with 186 past and potential clients in five U.S. cities to explore attitudes and experiences related to HIV counseling and testing in non-health care settings. Qualitative analysis yielded several key themes. HIV-related stigma and fear emerged as a main theme throughout the discussions. Knowing one's HIV status quickly and accurately was of primary importance; HIV prevention counseling was secondary. Participants prioritized a supportive, nonjudgmental environment with adequate privacy and confidentiality. Provision of immediate emotional support, medical information, and linkage services to HIV-infected clients were considered essential. Staff with HIV-specific skills to address clients' emotional and informational needs was considered a strength of non-health care testing programs. Frequently, however, participants compared non-health care settings unfavorably to health care settings regarding privacy, competency, confidentiality, and test accuracy. Recommendations for enhancing counseling and testing services in non-health care settings are discussed.

Challenging the perceptions of cancer service provision for the disadvantaged: evaluating utilisation of cancer support services in Western Australia

The main aim of the study was to evaluate the distributive utilisation of services provided by the Cancer Council of Western Australia according to age, social disadvantage and geographic location. Results were used to determine if social justice principles in terms of service provision were upheld. Cross-sectional study design to evaluate utilisation of cancer support services over a 12-week period in 2007 using administrative records. Service utilisation incidence rates (population information obtained from de-identified cancer registry data) and incidence rate ratios were calculated by gender, age group, cancer type, socioeconomic status and location. The Information services (52%, n = 4,932) were the most popular Cancer Council of Western Australia (CCWA) services followed by Emotional Support services (21%, n = 2,045). All CCWA services were more likely to be accessed by those with a lower socioeconomic status, except for Clinical Services. The rate of utilisation for patients with cancer in the 65+ years age group was found to be under-serviced relative to the 40-64 years age group. Overall, the study has shown that CCWA services are not provided uniformly (horizontal equity) across strata of socio-economic status. Given that the prevalence of cancer generally increases with socio-economic advantage, the findings were notable in regard to one particular outcome. Results for age indicate that there may be some underlying accessibility issues for the aged population. The findings are consistent with current literature highlighting issues of disadvantage in regard to the ability of elderly persons with cancer to access services and support.

‘I wanted to learn how to heal my heart’: Family carer experiences of receiving an emotional support service in the Well Ways programme

Family carers of people with mental illness provide an immense contribution to society in caring for mental health consumers. However, carers can experience substantial burdens and poor health outcomes themselves. Recognition of their needs for education and support has led to the development of a range of family education programmes. Throughout Australia, the Mental Illness Fellowship Australia offers the Well Ways programme, a group-based, family-to-family, education programme that provides information and aims to increase carers' capacity to care effectively for themselves, their families, and the mental health consumers. This paper describes a qualitative evaluation of an emotional support service piloted in a Well Ways programme in rural Queensland, Australia. The pilot service comprised individual emotional support offered to family carers attending the weekly Well Ways group education programme. Six of eight family carers who received the emotional support engaged in semistructured interviews exploring their experience of receiving the support. Three themes emerged from their experience: dealing with difficult times, connecting through shared experience, and exploring different options. Family carers found the emotional support beneficial, and reported that it enhanced their capacity to manage their own well-being, as well as their caregiving roles.

Quality assurance of HIV counselling and testing for the prevention of mother-to-child transmission of HIV in Rivers State, Nigeria

As the HIV/AIDS pandemic continues especially in the developing countries, the evaluation of quality and effectiveness of interventions aimed at its control remains very critical. A descriptive, cross-sectional study was carried out among HIV/AIDS counsellors providing counselling services to pregnant women attending antenatal clinics in all the 34 secondary health care facilities in Rivers State between September and December 2009 to assess the quality of HIV counselling services offered by these counsellors. A semi-structured, self-administered questionnaire was used to elicit relevant information on counsellors' performances and extent of compliance with the national guidelines on pre-and post test counselling for PMTCT. Data was analyzed using the Epi-Info version 6.04d statistical software package. Confidence limit of 95% was set at a significance level at P=0.05. The average duration of counseling was twenty minutes, with only one or two counsellors in attendance. Most of the counsellors, 228 (59.4%) out of the 384 (95%CI=53.0-65.8) said they were only supervised occasionally. Majority of the counsellors 369(96.1%) did not have access to copies of the national guidelines for VCT counselling for PMTCT and the checklist for providing counselling services. Similarly, other resources for counselling such as television and video sets, posters and banners were in short supply. Important issues in post-test counselling such as information about assessing ongoing emotional and social support services, making plans for the future and future fertility, information on delivery options, nutrition and the need for follow up and adherence counselling were often left out. Counsellors' motivation and the institutionalization of supportive supervision are advocated to enhance the quality of HIV counselling at PMTCT centres in Rivers StateKey words: HIV/AIDS, counselling quality assurance, PMTCT services, Rivers State Nigeria.