Need For Social Services Research Articles

Give and take in major gift relationships

This article investigates the complex phenomenon of major gift giving to charitable institutions. Drawing on empirical evidence from interviews with 16 Australian major donors (who gave a single gift of at least AU$10,000 in 2008 or 2009), we seek to better understand donor expectations and (dis) satisfaction. Given growing need for social services, and the competition among nonprofit organisations (NPOs) to secure sustainable funding, this research is particularly timely. Currently, little is known about major donors' expectations, wants and needs. Equity theory, with the concept of reciprocity at its core, was found to provide a useful framework for understanding these phenomena. A model of equitable major gift relationships was developed from the data, which portrays balanced relationships and identifies potential areas of dissatisfaction for major donors. We conclude by offering suggestions for NPOs seeking to understand the complexities of major gift relationships, with practical implications for meeting donors' needs.

Exploring the community-based service delivery model: Elderly care in China

In response to the rapidly growing need for social services among China’s population, particularly for older people, the government has begun to explore the community-based service delivery model. Using the recent developments in China’s care of older people as a case study example, this article documents the progress of community-based service delivery for the aged living in the community, and explores the community’s evolving role in China’s social service delivery system. China’s model — a horizontal—vertical mixed model — presents a new perspective of defining service delivery and community practice, which has various implications and broadens the view of Western social work practice.

Social services utilization and need among a community sample of persons living with HIV in the rural south

HIV prevalence has increased faster in the southern USA than in other areas, and persons living with HIV (PLWHIV) in the south are often rural, impoverished, or otherwise under-resourced. Studies of urban PLWHIV and those receiving medical care suggest that use of social services can enhance quality of life and some medical outcomes, but little is known about patterns of social service utilization and need among rural southern PLWHIV. The AIDS Alabama needs assessment survey, conducted in 2007, sampled a diverse community cohort of 476 adult PLWHIV representative of the HIV-positive population in Alabama (66% male, 76% Black, and 26% less than high school education). We developed service utilization/need (SUN) scores for each of 14 social services, and used regression models to determine demographic predictors of those most likely to need each service. We then conducted an exploratory factor analysis to determine whether certain services clustered together for the sample. Case management, assistance obtaining medical care, and financial assistance were most commonly used or needed by respondents. Black respondents were more likely to have higher SUN scores for alcohol treatment and for assistance with employment, housing, food, financial, and pharmacy needs; respondents without spousal or partner relationships had higher SUN scores for substance use treatment. Female respondents were more likely to have higher SUN scores for childcare assistance. Black respondents and unemployed respondents were more likely to have SUN scores in the highest quartile of the overall score distribution. Factor analysis yielded three main factors: basic needs, substance use treatment, and legal/medical needs. These data provide important information about rural southern PLWHIV and their needs for ancillary services. They also suggest clusters of service needs that often occur among PLWHIV, which may help case managers and other service providers work proactively to identify important gaps in care.

中山間地で移動販売者が担いうる社会サービスニーズに係る検討

中山間地で移動販売者が担いうる社会サービスニーズに係る検討

From Medical Home to Health Home

To the Editors:—There are numerous ongoing pilot projects evaluating the patient-centered medical home.1 While achieving a designation of “medical home” can be challenging for many providers, the concept is hardly transformative—after all, the medical home model merely describes a higher quality of primary care. Networking individual medical home practices through the sharing of business functions or clinical management resources can lead to greater efficiency in care delivery.2 Even greater potential exists in integrating primary care with other medical services to create organized delivery systems for defined populations.3 Nonetheless, while the likely health improvements attainable through such integrated medical care systems are significant, they are relatively modest. Health behaviors and social environment are also powerful factors. They directly influence health status and indirectly influence patients’ ability to benefit from the availability of health care.4 New models of health care delivery must ensure that patients can access community services that reduce the negative effects of social factors on their health, while maximizing their strengths and resiliency. Medical encounters offer timely and personal opportunities to identify these social influences and to link patients with supportive community services. The need for social services can be identified by reintroducing the long-neglected social history aspect of the medical history. Standardizing this process through the use of structured questionnaires has increased referrals, especially when providers are familiar with resources in their local community.5 When medical care providers have more knowledge of their patients’ social environment, as well as their health and behaviors, medical care takes on a life span approach—considering the whole patient over the course of his or her life. In doing so, physicians are able not only to prevent illness, but also to promote health and well-being. When medical homes promote health and are linked to other community resources to provide truly comprehensive care, they will have achieved a higher level of quality and will become “health homes,” redefining health as a broader term, much like the World Health Organization does. The goal of health care system redesign should be to create high-performing systems of comprehensive, community-oriented care with health homes, not simply medical homes, at their base.

Family caregivers’ needs predict functional recovery of older care recipients after hip fracture

This paper is a report of a study of the effect of family caregivers' needs on the functional recovery of elders with a hip fracture during the first 6 months after discharge. Family members are closely involved in the postdischarge care of older Chinese patients. However, the influence of family caregiving-related variables, such as caregiver's needs, on recovery after hip fracture has not been explored. Data were collected between 2002 and 2005 with elders with hip fracture and their family caregivers at a medical centre in Taiwan. Data were collected at 1, 3 and 6 months after discharge, and 120 people completed all follow-ups. The effect of caregiver needs on elders' recovery was analysed using the generalized estimating equations approach. Elders whose caregivers reported a need for information on caregiving and related health care were more likely (odds ratio = 1·93, confidence interval = 1·08-3·46) to recover their walking ability than those whose caregivers did not report such need. However, elders whose caregivers reported a need for social services were less likely to recover their walking ability (odds ratio = 0·38, confidence interval = 0·18-0·78), and activities of daily living (odds ratio = 0·40, confidence interval = 0·17-0·94) than those whose caregivers did not report such need. Healthcare providers should include caregivers' needs in their clinical assessment of Chinese elders after surgery for hip fracture. Given the rapidly increasing population of Asian elders in Western countries, the results of this study may be applicable to other countries with Chinese populations.

Psychiatric evaluation of sexual abuse cases: A clinical representative sample from Turkey

Objective This study investigated the characteristics of forensic childhood sexual abuse cases referred for psychiatric evaluation in a university hospital. Material and methods The files of childhood sexual abuse cases referred from the Court to the Child and Adolescent Psychiatry Clinic between January 2006 and January 2010 were examined retrospectively. The information about demographic variables and characteristics of sexual abuse, as well as diagnostic and treatment processes was reviewed. Results A total of 83 sexual abuse cases were evaluated. The majority of them (69%) were girls. The mean age of the children and adolescents was 11.01 ± 3.9 years. The majority (73.5%) of the suspected perpetrators were familiar people, intrafamilial cases constituting 31.1%. The most common type of sexual abuse encountered was genital contact without penetration, representing 44.6% of the cases. All of the strangers were reported to legal authorities within 3 months whereas the ratio was 77% when offenders were familiar people ( p < 0.05). Forty percent of the cases involving family members as offenders needed additional evaluation by social services, in contrast to 11.3% of cases with offenders who were not family members ( p < 0.05). Anxiety Disorders and Adjustment Disorder were the most common psychiatric diagnoses. Family counseling for possible risk factors, child protection, and prevention of further abuse was provided for all cases. About 45% of the patients required additional medical treatment. Conclusion The data, in many respects, share properties with western studies, such as greater number of girls, familiarity of the assaulters, delayed disclosure, increased need for social services especially for intrafamilial cases, and preponderance of anxiety disorders. Since abuse, whether sexual or physical, has a highly significant impact on the victim, publishing these data and emphasizing the topic of child sexual abuse should serve to facilitate recognition and management of such cases.

Caregiver Support Service Needs for Patients With Mild Cognitive Impairment and Alzheimer Disease

Little is known about the service needs for persons caring for individuals with mild cognitive impairment (MCI). In this study, the level of support service need for caregivers of individuals diagnosed with Alzheimer disease (AD; N=55) and MCI (N=25) was compared with normal controls (N=44). Study partners (ie, caregivers) completed questionnaires about their service needs and participants' neurobehavioral symptoms, functional abilities, and frailty. Total, social, and mental health service needs were significantly different among the 3 groups (P<0.0001), with MCI and AD caregivers reporting more need for services as compared with the normal control group. There was no significant difference between MCI and AD groups for total and social service need. In the MCI group, caregiver's service need was related to neurobehavioral symptoms and frailty, whereas service need among the AD caregivers was related to functional disability and frailty. Caregivers of individuals with MCI are already experiencing a need for increased services comparable to that of individuals caring for AD patients, though the pattern of patient-related factors is different between the 2 patient groups. These findings suggest possible areas of intervention that could be considered at the earliest stages of memory loss.

“Every Man His Specialty”

I: To decompose is to live, too In Bending Over Backwards Lennard Davis coins the term to describe the ways that disability challenges ideas of liberal autonomy and able-bodied normalcy that underwrite contemporary identity politics. As a social model, dismodernism shares with theories of postmodernism a skepticism toward grand narratives of Subjecthood and historical teleology, but Davis faults much postmodern theory for maintaining a social constructionist view of identity on the one hand while retaining a politics of multiculturalism and core group identity on the other. Reprising recent scientific discoveries in the field of genetics that disprove the biological basis of race, sexuality or ethnicity, he asks how does it make sense to say there is a social construction of it. (1) Discourses of race, gender, and sexuality are products of late nineteenth-century medical science--as is disability--but unlike these other areas, disability crosses all such categories and is the one identity position that all of us, if we live long enough, may inhabit. Its pervasiveness and instability permit Davis to see disability as a kind of ur-identity constructed within the technologies of bio-power a subject position bound by specific genetic, economic, or racial markers. The dismodernist ideal aims to create a new category based on the partial, incomplete subject whose realization is autonomy and independence but dependency and interdependence. (2) Although Davis conflates a postmodern philosophical stance toward performativity with a historical, post-civil rights cultural politics, he does point to a key limitation of rights claims that presume a healthy, independent (probably white, probably heterosexual, male) ideal to the exclusion of those deemed defective or unable to make rational choices. In this respect he joins a number of recent theorists--Albert Memmi, Martha Nussbaum, Michael Berube, Eva Kittay, and Alasdaire MacIntyre--for whom a consideration of dependency challenges the social contract as it has been conceived from Rousseau and Hume to Rawls and asks whether contractarian ideals can stand the test of differently abled bodies? (3) Stated succinctly by Eva Kittay, dependency critique asserts that the idea of society as an association of equals masks inequitable dependencies, those of infancy and childhood, old age, illness and disability. While we are dependent, we are well positioned to enter a competition for the goods of social cooperation on (4) Although liberal theories of social justice imply access to the public sphere, they do account for individuals who, because of cognitive impairment or physical disability, cannot cooperate on equal and independent terms. Nor are dependent relations validated in the common weal. Citizens who need special are often stigmatized as narcissists, whiners, and drains on public funds. Their requests for reasonable accommodations under the ADA have led to a series of court cases that have been, for the most part, decided against the plaintiffs. The need for interpreters, care-givers, therapists, and social services places persons with disabilities in conflict with liberal ideals of independence and self-reliance. (5) Can a model of independent living--the basis of the disability rights movement--coincide with what Alasdair MacIntyre calls the virtues of acknowledged dependence that implicate all of us? (6) Martha Nussbaum's Frontiers of Justice answers these questions with a resounding not yet and in particular charges John Rawls' Theory of Justice with bracketing the rights of persons with disabilities, poor persons, and nonhuman animals as constituencies that cannot be included in Rawls original position--those normal conditions under which human cooperation is both possible and necessary. (7) Against contract models of human rights that stress cooperation for mutual benefit, Nussbaum argues for a rights discourse from the standpoint of what she calls, adapting Amatyra Sen, capabilities--what people are actually able to do and to be in a way informed by an intuitive idea of a life that is worthy of the dignity of the human being. …

Estimating future numbers of adults with profound multiple learning disabilities in England

This article summarises recent work, commissioned by the Department of Health, which estimated the future need for health and social care services for adults with profound multiple learning disabilities (PMLD) in England. This estimation process involved four stages: identifying children with SEN associated with PMLD; adjusting for the effects of child mortality; estimating the number of adults with PMLD in England; and estimating net changes in the number of adults with PMLD in England. The overall findings suggest sustained and accelerating growth in the number of adults with PMLD in England over the time period 2009‐2026 and hence the need and demand for health and social care services for adults with PMLD.

Social Problems and Service Needs in a Korean-American Community: Perceptions of Community Residents and Community Key Informants

The aim of this study was to investigate the similarities and differences between Korean residents' and community key informants' perceptions of problems and needs in the areas of immigration, health, social services, emotional/behavioral concerns, and family issues. Both survey and key informant approaches were employed, and a total of 127 residents and 25 community key informants participated. Findings show fairly good agreement between residents and community key informants regarding their respective perceptions of social problems; and significant group differences regarding what services were actually needed. This study serves as a rationale for developing strategies to solve community problems, promote the awareness of social services, and highlight community integration within the Korean community.

The need of the elderly for nursing and social services in the community of Kaunas district

The aim of this study was to evaluate the need of the elderly for outpatient nursing and social services in Kaunas district. The object of the study was elderly people (aged 65 years and more) living in Kaunas district. A questionnaire was used for interviewing. The sample was randomly selected from the lists of people registered at the primary health care centers (including outpatient departments and medical aid centers). A total of 390 inhabitants were investigated who represent all the elderly of Kaunas district. The independence of the respondents was evaluated by the standard tests (the Barthel Index and Mini-Mental State Examination). The respondents reported that 71.3% of them needed nursing and 58.2% social services. The need for the services was higher in older age group. The rural elderly reported higher need for social services (64.3%) than the urban elderly (49.6%). Less than half (45.9%) of respondents referred having problems visiting the general practitioner. Majority of the respondents (86.4%) pointed out that those who took care of them had no special medical training. Totally or almost totally dependent respondents (groups by Barthel Index) needed social (88.0%) and nursing (96.0%) services. Majority of respondents (79.2%) preferred to be cared at home. More than half of the elderly needed both nursing and social services. The need for social services differently from nursing services was influenced by the living place of the respondents; the rural elderly needed services more than the urban elderly.

Differentiating the Social Service Needs of Homeless Sexual Minority Youths from those of Non-homeless Sexual Minority Youths

While homeless youths and sexual minority youths are at greater risk for negative life experiences, and homeless sexual minority youths are at greater risk than homeless heterosexual youths, little is known about the differential risks for homeless sexual minority youths compared to non-homeless sexual minority youths. Using a sample of 187 sexual minority youths from a community-based social service agency in Denver, Colorado, the findings of this study suggest that homeless sexual minority youths are at greater risk for victimization, mental health issues, substance abuse, and illegal or dangerous activities than their non-homeless counterparts. Implications for social work practice and social service provision are discussed.

Commentary

Gilbert's article underlines the need for social and mental health services to recognise spirituality as part of the ‘whole person’. To do this effectively in our multi‐cultural, multi‐faith society will require dismantling of stereotypes and sensitivity to the needs of BME communities.

Health Trends in the Elderly Population: Getting Better and Getting Worse

Health trends in the fastest growing sector of the population, the oldest old, have received much attention during the past decade because of the rising costs of medical and long-term care. Many studies have suggested a compression of morbidity in this sector, implying that the future care needs of elderly people will not follow the demographic prognoses. Most of these studies have used health indicators based on disability, a concept that is contextually embedded. We have taken a closer look at health-trend surveys with a focus on the health indicator used. Our findings reveal that although disability measures often show improvement, there is a simultaneous increase in chronic disease and functional impairments-health components that require care resources. That is, an expansion of other health problems may accompany a compression of disability. Therefore, a concept of general morbidity is not sufficient when discussing health trends and the need for care services in the elderly population. Because different indicators do not show the same trends over time, we suggest a more refined discussion that distinguishes between different health components. In addition, different components have different implications for the amount and kind of care resources needed. If the current positive trends in disability continue, future need for social services and long-term care may not parallel demographic projections. Trends in disease and functional limitations seem to have taken a different direction, suggesting a parallel or increased need for resources in medical care, rehabilitation, and compensatory interventions such as assistive technology.

Domestic Violence and Risk Factors among Korean Immigrant Women in the United States

Domestic Violence is a serious problem among Korean immigrant women in the United States. However, little is known about the incidence of domestic violence as well as risk factors predicting violence experienced in intimate relationships. The purpose of this study is to describe domestic violence among Korean immigrant women, including type and frequency of violence and predictive factors of domestic violence experienced by Korean immigrant women. One hundred and thirty-six Korean women completed questionnaires developed in this study. Results indicate that domestic violence is a major family problem for Korean immigrant women. Implications are discussed in terms of the need of social services for Korean immigrant women.

Chronic Posttraumatic Stress Disorder After Facial Injury: A 1-year Prospective Cohort Study

This study examined the prevalence, severity, and predictors of persistent traumatic stress symptoms in socioeconomically disadvantaged adults after orofacial injury. A 1-year prospective study of 336 socioeconomically disadvantaged adults treated for orofacial injury at a Level I trauma center was conducted. Univariate analyses were performed on early measures of injury characteristics, prior trauma exposure, coping resources, and psychosocial functioning to select potential predictors of 1-year posttraumatic stress disorder (PTSD) scores; independence of variable contribution was then evaluated in multiple regression analyses. A substantial number of patients (23%) continued to experience significant PTSD symptomatology at 12 months. Predictors of PTSD symptoms at 12 months included current and lifetime mental health and social service needs, lifetime social service use, prior trauma exposure, sum of stressful life events in the year preceding injury, patient report of pain severity and inadequate social support at 10 days postdischarge, and PTSD scores at 1 month. One-month PTSD symptoms, unmet social service need, and need for more instrumental and emotional support were independent predictors of 12-month PTSD outcomes. Limitations include loss to follow up, use of self-report measures, and the possibility of additional traumatization in the follow-up year influencing symptom levels. Many socioeconomically disadvantaged adults manifest negative psychological outcomes even 1 year after an orofacial injury. Poor social support and unmet social service needs immediately after the injury, as well as high PTSD symptoms at 1 month postinjury, are strongly associated with the risk of developing chronic PTSD. The surgical management of orofacial injuries in disadvantaged individuals should integrate case management that addresses psychosocial sequelae and patient service needs.

Assessment of Social and Health Service Needs in Senior Population

P-401 Introduction: The long term demographical changes (decreasing natality and concurrent aging of population) became a problem in the Czech Republic alike in other European countries. Aging of population is a complex of problems consisting of demographical, economical, social, health a psychical dimension. The goal of the presented study was to bring the analysis of health and social needs of the elderly in the region as a background for development of appropriate services. Methods: Randomly selected 3.300 elderly people in the North Moravia region were invited to participate in a questionnaire study. The double-entry data was analyzed by χ2-test and logistic regression using the statistical software STATA, v.9. Results: The total number of analyzed questionnaires was 2,385 (response rate 72.3%). More women (64.8%) than men participated in the study; the average age of the sample was 72 years. About half of them lived in a marriage or with a friend, the other lived alone. Only 10% of respondents declared good subjective health, about half of them evaluated their health status as adequate to age and more than one third (37.6%) reported serious illness. The most frequently reported illness was hypertension, arthrosis and cardiovascular diseases. The self-sufficiency was declared in 78.3% of respondents; 15.6% of them were partly limited in self-sufficiency and 6.1% were completely disabled. The obtained health care was evaluated as good, but the positive perception became adverse in association with the decreasing self-sufficiency. The social services were used in 18.1% of the elderly and home nurse services in 6.4% of respondents. The services were mostly provided by local government institutions (93.0%). Further need of help was perceived in 10.2% of respondents, mostly in people with partly limited self-sufficiency. People in need of help of other people or institutions preferred among other suggestions more often to stay at home with help of home nurse services (OR 4.57; 95%CI =2.90–7.19). The request of social and health services were reported more in men, women perceived more need of help with house-keeping. Respondents being in care of a family surprisingly missed the social contacts and help with transportation to a physician. The other seniors in care of institutions or persons outside family missed help with house-keeping. The need of help of other person was significantly higher in women (OR 1.32; 95%CI =1.04–1.67), in people living alone (OR 1.26; 95%CI =1.17–1.36) and was higher in more old people, in people who felt the insufficient care of their family (OR 2.65; 95%CI =2.03–3.45) or an institution (OR 12.4; 95%CI =9.2–16.65). The plans where to spend their old age (at own home, with family, in pensioners home) in the elderly dependent on help of other people did not differ by sex, age and family status. Discussion and Conclusions: The results of the study indicated the target groups for social and health service distribution. The services should be focused on the groups of old people with partly limited self-sufficiency. The most requested of social and health services were home nurse services and help with house-keeping and transport to a physician.

Physical activity, body composition and healthy ageing

Aims To apprehend the interest of a lifestyle adapted in order to minimize the effects of ageing. Current knowledge During the last century life expectancy increased rapidly in Europe as well in other affluent societies in the world. Combined with the decline in birth rates, Europe faces an increasingly ageing population. Since ageing is associated with an increasing risk for chronic diseases, disability and cognitive decline, a sharp rise in the need for medical and social services and associated costs is to be expected. Physical activity and nutrition are both modifiable risk factors for many chronic diseases and evidence accumulates suggesting that an active lifestyle and a proper diet can also prevent the functional limitations associated with advancing age. However, data from surveys show that physical activity levels decline with ageing. In Europe approximately 80% of the persons 65 years and older do not engage in strenuous physical activity and 55% of them report not to engage in moderate activity. If the declined level of physical activity is not matched with a reduced energy intake, weight gain, particularly in the trunk is expected to occur. Abdominal obesity, also in the elderly is associated with cardiovascular disease, diabetes mellitus type 2 and cancer morbidity. On the other hand, if reduced physical activity is matched with a reduced food intake, the intake of micronutrients may become inadequate and will endanger the nutritional status of the elderly. Apart from inadequate intake also drug use and co-morbidity may lead to multiple micronutrient deficiencies. Therefore particularly for the elderly population a proper balanced diet is essential. Prospects Public health programs should focus on the adoption of a healthy lifestyle in elderly people. There is a need for systematically planned approaches addressing both food consumption patterns and physical activity. The program should be tailored to the elderly population and make use of suitable and realistic strategies.

Cross-national variations in behavioral profiles among homeless youth.

Cross-national comparisons of homeless youth in Melbourne, Australia, and Los Angeles, CA, United States were conducted. Newly (n = 427) and experienced (n = 864) homeless youth were recruited from each site. Compared to Australia, homeless youth in the United States were younger, more likely to be in school or jail, demonstrated fewer sexual and substance use risk acts, fewer suicidal acts, and reported less need for social services. Across sites, experienced homeless youth were more likely to be older, male, engage in sexual and substance use, report greater need for social services, and make greater use of work, substance use, and health-related services. Homeless youth have different behavioral profiles in Australia and the United States, reflecting differences in the effectiveness of service systems in the two countries in keeping youth with fewer problems out of homelessness.