Support For People Research Articles

Social support, self-efficacy, self-esteem, and well-being during COVID-19 lockdown: A two-wave study of Danish students.

Societal lockdown due to the COVID-19 pandemic has transformed everyday life across the globe, including requirements of social distancing that might limit the social support people derive from social interaction. Social support has proven to be a vital resource for well-being (i.e., perceived stress and satisfaction with life) and coping during societal challenges. The present study examined how social support is associated with perceived stress and life satisfaction through self-efficacy and self-esteem among Danish students (N = 204). These psychological constructs were examined both during and after lockdown, assessing the possible aversive psychological effects of the COVID-19 pandemic. Results did not yield any significant changes in either the mean scores of the constructs or the indirect effects model across the two time points. Moreover, the results indicate that social support derived from a significant person, family, and friends - but not student peers - is negatively linked with perceived stress and positively associated with life satisfaction through both self-efficacy and self-esteem. Although societal lockdown did not yield significant psychological impact, the results highlight the importance of social support among students, both during and after lockdown.

"My Autism is Linked with Everything": at the Crossroads of Autism and Diabetes.

Autistic adults experience stark health disparities and difficulties accessing health care. Their realities of managing complex health conditions are unknown. Our research explored the experience of Autistic adults self-managing diabetes. Interviews with Autistic adults with diabetes and their support people were thematically analysed to identify three key themes. The Autistic experience influenced diabetes self-management, including autism-unique challenges and strengths. Participants prioritised avoiding Autistic burnout over diabetes self-management; mitigating the psychosocial pressures of neurotypical systems took precedence. Health professionals often separated autism and diabetes subsequently overlooking key factors impacting diabetes self-management. To better meet the needs of Autistic adults, diabetes care and health management more broadly should be considered within the context of autism, including supports for self-management during Autistic burnout.

Putting Guidelines into Practice: Supporting Young People with Hereditary Angioedema to Live Attack-Free

Putting Guidelines into Practice: Supporting Young People with Hereditary Angioedema to Live Attack-Free

Gaps in the System: Supporting People Living with Dementia

ABSTRACT Persons living with dementia and their caregivers often face challenges in accessing support for their complex needs. This study aims to understand how program administrators, people living with dementia, unpaid caregivers, and decision-makers perceive specific dementia care programs and whether they are adequately meeting the needs of individuals living with dementia. Forty semi-structured interviews were conducted between 2018 and 2020 in five North American jurisdictions. Three main gaps were identified (1) disconnected system infrastructure, (2) lack of comprehensive services to meet diverse needs, and (3) inconsistent understandings of dementia. Despite having programs in place, there remain significant limitations in systems that could be addressed to adequately meet the needs of individuals living with dementia and their caregivers.

Right agent, wrong level of hedonism: How high (vs low) hedonic values in AI-performed tasks lead to decreased perceptions of humanlikeness, warmth, and less consumer support

Reasons of reactions towards artificial intelligence (AI) performing hedonic tasks invites attention. This research argues that the reference of comparison to assess AI's suitability for the task shifts from machine schema to human schema as the hedonic value of the task increases, leading to the decrease in perceived humanlikeness, perceived warmth, and support for the AI, subsequently. Four studies, including a big data study on GitHub and three experiments, have shown that people are less supportive of AI and its creators when AI performs highly (vs low) hedonic tasks. This effect is mediated by the perceived humanlikeness of AI, since it affects AI's perceived warmth in a way that decreasing perceived humanlikeness when AI is assigned to the tasks with high (vs low) hedonic values decreases the perceived warmth of the AI. Decreased perceived warmth, in turn, lowers people's support for the AI and its creators. This serial mediation mechanism remains robust when AI's baseline humanlikeness increases, when the hedonic value of AI's method of performing the task, rather than the task itself is manipulated, and when the perceived competence and fairness are tested as alternative paths in parallel.

The Right to Need-Satisfaction

This article argues that a ‘Right to Need-Satisfaction’ should be the basis of the Scottish Government’s proposed National Care Service. This service will take a ‘human rights-based approach’. The premise of this right is: if people are to participate in society, then they must be given sufficient resources to do so. However, this stance is insufficient unless such resources are accompanied by an awareness of people’s own oppressed situation within society and the support people need from their peer group.

The International Framework for School Health Promotion: Supporting Young People Through and After the COVID-19 Pandemic.

The worldwide COVID-19 government restrictions imposed on young people to limit virus spread have precipitated a growing and long-term educational and health crisis. This novel study used Sen's Capabilities Approach as a theoretical framework to examine the current health and educational impacts of COVID-19 on youth, referencing emerging literature. The objective was to inform the design of an internationally relevant framework for school health promotion to support young people through and after the COVID-19 pandemic. Mapping of existing health resources, internal/external conversion factors and capabilities were used to identify classroom, school and system level strategies that will enable young people to flourish. Four central enablers were identified and used in the design of the International Framework for School Health Promotion (IFSHP). The IFSHP can be used by educational institutions, school leaders and teachers to innovate existing health promotion programs, policies and practices to support young people through and after the COVID-19 pandemic. School systems, schools and teachers are encouraged to utilize the IFSHP to review and innovate existing school health programs to ensure they meet the increased physical and mental health needs of young people.

Co-creation of self-management support during inpatient stroke rehabilitation

ObjectiveThis study aimed to identify priority self-management skills and behaviours in partnership with stroke survivors, and to co-create approaches to support self-management during inpatient stroke rehabilitation. MethodsThree stroke survivors and two communication partners participated in the three-stage Participatory Action Research project with embedded co-design processes after undertaking inpatient rehabilitation at a metropolitan tertiary hospital. ResultsParticipants identified key factors influencing self-management during inpatient rehabilitation including motivation, emotional well-being, and fatigue. Three approaches to support people to self-manage post-stroke were co-created. (1) A health professional concierge and early family meeting. (2) A peer support person. (3) Adapting the hospital environment. ConclusionFindings suggest post-stroke self-management support should commence during inpatient rehabilitation to optimise its research-informed benefits. This support should focus on empowering stroke survivors and their key support people through active involvement in decision-making, and provision of multi-modal individualised education. The impact of hospital environments on emotional-wellbeing and self-management post-stroke also requires further investigation. InnovationThe identification of a health professional concierge as a co-designed solution to the current challenges with self-management support is an innovative recommendation for practice. The findings support changes to the traditional processes of rehabilitation towards a consumer and family-led practices.

Emergency Animal Boarding: A Social Return on Investment.

Companion animals play a central role in many families and are especially valued by those who are socially isolated. Crisis situations such as acute hospitalizations, homelessness, and natural disasters can make it difficult to preserve the human-animal bond and can result in animals being surrendered or euthanized. Social support programs like the RSPCA NSW Emergency Boarding and Homelessness program support people experiencing crisis situations with emergency pet boarding, access to veterinary treatment and individualized case management. This study aimed to estimate the social return on investment (SROI) for this program using the standard SROI methodology. In-depth interviews were conducted with 13 program stakeholders and questionnaire responses were received from 29 program clients. Outcomes were quantified for four stakeholder groups: program clients, client's animals, RSPCA Inspectors, animal pounds, and shelters. Clients and their animals experienced the bulk of the benefit from the program, estimated to have a combined value of over AUD 5 million for the 2020-2021 financial year. The estimated social return on investment was AUD 8.21 for each AUD 1 invested. The study demonstrates that keeping people together with their companion animals or ensuring they are reunited as soon as possible can reduce stressors and improve outcomes for people and animals.

Agreement between questions about physical activity and sitting time, and device-based measures, used in Swedish targeted health dialogues in the context of primary health care

BackgroundIt is important that easy-to-use measures like subjective questions about physical activity (PA) and sedentary behaviour are valid and reliable providing accurate measures, when they are used in health promotion work aiming to support people to improve their lifestyle habits such as PA. The aim of this study was to evaluate the concurrent validity of a structured interview form estimating self-reported PA and a question about sitting time used in Swedish targeted health dialogues in the context of primary health care.MethodThe study was conducted in the southern part of Sweden. To evaluate concurrent validity of the interview form, time spent in moderate-to-vigorous physical activities (MVPA) and energy expenditure related to MVPA estimated by an interview form was compared with the same measures assessed by an ActiGraph GT3X-BT accelerometer. To evaluate a question about sitting time, the Swedish School of Sport and Health Sciences’ single-item question about sitting time (SED-GIH) was compared with measures from an activPAL inclinometer. Statistical analyses included deriving Bland‒Altman plots and calculating Spearman’s rank correlation coefficients.ResultBland‒Altman plots indicated lower absolute variation in the difference between self-reported and device-based PA measures for lower PA levels, both for energy expenditure and time spent in MVPA. No systematic over- or underestimation was observed. The Spearman’s correlation coefficient between self-reported and device-based PA measures was 0.27 (p = 0.014) for time spent in MVPA and 0.26 (p = 0.022) for energy expenditure. The correlation coefficient between the single item question and device-based sitting time measures was 0.31 (p = 0.002). Sitting time was underestimated by 74% of the participants.ConclusionThe PA interview form and the SED-GIH question on sitting time may be of value in targeted health dialogues in primary health care with the intention to support sedentary and insufficiently physically active persons in increasing their physical activity and limiting their sitting time. The questionnaires are easy to use and are more cost effective than device-based measures, especially regarding population-based interventions conducted in primary health care for thousands of participants such as targeted health dialogues.Clinical trial registrationNot applicable.

Exploring specialist nurse clinic appointments: supporting a person with multiple sclerosis to manage spasticity and spasms

Background: Managing clinic appointments effectively and efficiently are a fundamental part of being a multiple sclerosis (MS) specialist nurse (MSSN). Opportunities to practice these skills can be limited, which can be daunting for nurses new into the speciality. Aim: This article explores the management of spasticity and spasms and how a MSSN can effectively use time in a clinic appointment to complete a holistic assessment and support people with MS (PwMS) to manage their spasticity and spasms. Method: Narrative methodology was used to synthesise insights from appointments in a specialist nurse clinic, where individuals with MS needed support to manage spasticity and spasms. The insights were constructed into a reflexive narrative and are presented in this article as one clinic appointment. Findings: Strategies for MSSNs to consider during their clinics and spasticity management practices are suggested. These include clinic preparation, verbal and physical assessments, measuring, timely referral to other multidisciplinary members and educating PwMS, such as educating them on the possible triggers that can exacerbate spasticity and spasms, the importance of exercise and stretching, and monitoring the effectiveness of symptomatic treatments, including drug interventions. Conclusion: MSSNs have a vital role in supporting PwMS to manage their spasticity and spasms throughout the disease trajectory. Developing expertise in effectively using time in clinic appointments will benefit the outcomes for PwMS, the individual nurse and the healthcare organisation.

Supporting Birthing People and Supporting Doulas: The Impact of the COVID-19 Pandemic on a Community-Based Doula Organization in San Francisco.

Beginning in March 2020, health care systems in the United States restricted the number of support people who could be present during pregnancy-related care to reduce the spread of COVID-19. We aimed to describe how SisterWeb, a community-based doula organization that employs Black, Pacific Islander, and Latinx doulas in San Francisco, California, adapted to the COVID-19 pandemic. As part of process and outcome evaluations conducted through an academic-community partnership, we interviewed SisterWeb doulas, mentors, and leaders in 2020, 2021, and 2022 (n=26 interviews). We identified preliminary themes using the Rapid Assessment Process and then conducted thematic analysis of data related to COVID-19. SisterWeb leadership remained committed to safeguarding doulas by shifting to virtual support until doulas were onboarded as benefitted employees. Doulas reported hospital policies impacted clients' pregnancy-related care. Initially, doulas adapted to virtual support by connecting with clients more frequently through phone and text. When permitted to meet in person, doulas adjusted to client preference. Finally, as the pandemic impacted doulas' well-being, they turned to mentors for emotional support. This analysis contributes to a growing body of literature describing doulas' experiences during the pandemic. By shifting to virtual support, SisterWeb leaders prioritized the health, safety, and financial stability of doulas, who were members of communities disproportionately impacted by COVID-19. Our findings suggest that public health guidance, organizational COVID-19 precautions, and hospital policies hindered SisterWeb's goal of ensuring clients receive equitable medical care. In addition, we found that emotional support for doulas is vital to their work.

Exploring Acceptability of Employment Interventions to Support People Living With Cancer: Qualitative Study of Cancer Survivors, Health Care Providers, and Employers.

Employment contributes to cancer survivors' quality of life, but this population faces a variety of challenges when working during and after treatment. Factors associated with work outcomes among cancer survivors include disease and treatment status, work environment, and social support. While effective employment interventions have been developed in other clinical contexts, existing interventions have demonstrated inconsistent effectiveness in supporting cancer survivors at work. We conducted this study as a preliminary step toward program development for employment support among survivors at a rural comprehensive cancer center. We aimed (1) to identify supports and resources that stakeholders (cancer survivors, health care providers, and employers) suggest may help cancer survivors to maintain employment and (2) to describe stakeholders' views on the advantages and disadvantages of intervention delivery models that incorporate those supports and resources. We conducted a descriptive study collecting qualitative data from individual interviews and focus groups. Participants included adult cancer survivors, health care providers, and employers living or working in the Vermont-New Hampshire catchment area of the Dartmouth Cancer Center in Lebanon, New Hampshire. We grouped interview participants' recommended supports and resources into 4 intervention delivery models, which ranged on a continuum from less to more intensive to deliver. We then asked focus group participants to discuss the advantages and disadvantages of each of the 4 delivery models. Interview participants (n=45) included 23 cancer survivors, 17 health care providers, and 5 employers. Focus group participants (n=12) included 6 cancer survivors, 4 health care providers, and 2 employers. The four delivery models were (1) provision of educational materials, (2) individual consultation with cancer survivors, (3) joint consultation with both cancer survivors and their employers, and (4) peer support or advisory groups. Each participant type acknowledged the value of providing educational materials, which could be crafted to improve accommodation-related interactions between survivors and employers. Participants saw usefulness in individual consultation but expressed concern about the costs of program delivery and potential mismatches between consultant recommendations and the limits of what employers can provide. For joint consultation, employers liked being part of the solution and the possibility of enhanced communication. Potential drawbacks included additional logistical burden and its perceived generalizability to all types of workers and workplaces. Survivors and health care providers viewed the efficiency and potency of peer support as benefits of a peer advisory group but acknowledged the sensitivity of financial topics as a possible disadvantage of addressing work challenges in a group setting. The 3 participant groups identified both common and unique advantages and disadvantages of the 4 delivery models, reflecting varied barriers and facilitators to their potential implementation in practice. Theory-driven strategies to address implementation barriers should play a central role in further intervention development.

The experiences of people with intellectual disabilities living in Ukraine during the first months of the Russian invasion: A lack of fulfilment of basic necessities and support and uncertainty towards reforms

The present study aimed to explore the situation of people with intellectual disabilities and their families during the first three months of the Russian invasion in Ukraine. Utilising a snowball sampling procedure, five participants were recruited to participate in this descriptive qualitative study. Thematic analysis was used to analyse the interviews. Five overarching themes emerged from the data: 1) The physical and mental well-being of people with intellectual disabilities was threatened due to a lack of fulfilment of basic needs; 2) People with intellectual disabilities experienced difficulties in finding safety within air-raid shelters; 3) People with intellectual disabilities and their families could only flee the country with help and support; 4) Creative solutions were developed to help keep in touch with and support people with intellectual disabilities and their families; and 5) Fear regarding the quality of life of and support for people with intellectual disabilities in the near future.

Increased psychological distress among young people before and during the fifth wave of COVID-19 after two years of pandemic in Hong Kong: a 6-month longitudinal study

BackgroundDespite over two years of COVID-19 worldwide, the outbreak of the Omicron variant has given rise to an unprecedented surge of infection with diverse lockdown measures implemented globally. Whether the emergence of a new wave of COVID-19 could further affect mental health in the population after nearly two years of the pandemic remains to be addressed. Furthermore, whether changes in smartphone overuse behaviours and physical activity – both of which are particularly relevant to young people – would together contribute to changes in distress symptoms during this wave of COVID-19 was also examined.MethodsA total of 248 young people from an ongoing household-based epidemiological study in Hong Kong who completed their baseline assessments prior to the Omicron variant outbreak, i.e., fifth wave of COVID-19 (July–November 2021), were invited for a 6-month follow-up study during this wave of infection (January–April 2022) (mean age = 19.7 years, SD = 2.7; 58.9% females). At both time points, levels of global distress symptoms, perceived stress, smartphone overuse, frequency of engagement in vigorous physical activity, and other potential risk and protective factors were assessed.ResultsThe proportion of young people presenting moderate-to-severe distress (6-item Kessler Psychological Distress Scale ≥ 5) significantly increased from 45.6 to 54.4% during the fifth wave of COVID-19 (p < 0.010). Significantly increased levels of smartphone overuse and reduced days of vigorous physical activity were also observed during the fifth wave. Notably, increased smartphone overuse and reduced physical activity both additively and interactively contributed to elevated distress at 6 months, even after accounting for demographic characteristics, psychiatric history, childhood adversity, as well as baseline distress symptoms, resilience, and recent personal stressors.ConclusionsThe findings suggest that the emergence of a new wave of COVID-19, specifically the Omicron outbreak, can further aggravate mental distress even after a protracted period of the pandemic. Awareness of the dynamic nature of COVID-19 is necessitated to address the pressing mental health needs of populations. Supporting young people in healthier patterns of smartphone use and physical activity can be helpful.

Indigenous biocultural rights and the Blue Mountains: Local and international policy challenges

AbstractIndigenous knowledges play a critical role in addressing the environmental crisis, and the United Nations system has adopted a suite of international treaties to protect and strengthen Indigenous peoples’ rights, which are often described as biocultural rights. Because World Heritage Areas are nominated and monitored by UNESCO, an initial hypothesis in this study was that such areas would be subject to higher than normal standards in regard to Indigenous people’s biocultural rights. By reference to the Greater Blue Mountains World Heritage Area, Australia, this research examined how the international legislative framework influences conservation practices. We held semi‐structured interviews with conservation and Indigenous local experts and compared park management practices in the Area against those used in an Indigenous Protected Area. Findings align with the literature and suggest that Indigenous and scientific knowledge systems can generate new insights for the Area and other sites. Yet, Indigenous knowledges are only marginally applied in practice. Some barriers to full participation of Indigenous people are specific to the colonial history of the area. Yet, findings point to a lack of action by Australian governments and UNESCO, and that needs to be redressed. The study calls attention to the need to support and resource Indigenous people to enable collaborative partnerships to yield significant benefits for biodiversity and protection of Country.

Perceived national wealth increases support for structural climate policies

Climate change cannot be successfully mitigated solely through individual-level actions. Structural change is urgently needed. While wealthy countries have the greatest capacity to implement structural change, the question remains to what extent perceived country wealth is associated with support for structural climate policies over individual-level behaviour change policies. We found in Australian (Study 1) and UK (Study 2) samples (N = 967) that perceived national wealth positively predicts people's support for structural (vs. individual-level behaviour) change policies. In an experimental (Study 3, N = 401) and a quasi-experimental study (Study 4, N = 400; comparing South African and UK participants), we found that people in both wealthy and poor countries more strongly prefer wealthy (vs. poor) countries to implement structural (vs. individual-level behaviour) change policies. There was some evidence that these effects are mediated by perceiving wealthy countries to have a moral obligation to contribute to the solution of global issues. The findings suggest that there is considerable public support for wealthy countries to spearhead structural transformations to limit climate change. These insights can help environmental organisations and policymakers to gain public support for climate policies by emphasising their countries' moral obligation to implement change and by countering blame-deflecting narratives.

“It’s Not a One-Time Conversation”: Australian Parental Views on Supporting Young People in Relation to Pornography Exposure

While pornography provides opportunities for sexual exploration for young people, early and easy access also has possible negative implications for young people’s behavioural and sexual development. Parental responsibilities concerning their children’s consumption of pornography are largely misunderstood. This study explored parental experiences and beliefs about pornography education for young people using a qualitative study (n = 8, 6 females, 2 males). Interview data were analysed using a reflexive thematic approach. Results indicated that parents have concerns about the ease of access to pornography and the unmediated ideas it presents. Additionally, parents believe they have a responsibility to educate young people about pornography through having open and honest conversations and providing supervision. Further, parents believe that schools should be doing more to educate young people about pornography. This study extends upon current literature by suggesting that although parents feel well-equipped to communicate with and educate young people about pornography consumption, they lack confidence in their capacities to do this.

Exploring the experiences of people living with dementia in Dementia Friendly Communities (DFCs) in Northern Ireland: a realist evaluation protocol

BackgroundThe aim of this study is to 1) explore the experiences of people living with dementia interacting with DFCs and 2) identify factors that influence empower and support people living with dementia to live successfully in DFCs. The main elements of a DFC are related to people; communities; organisations and partnerships. There are over 200 organisations recognised as dementia-friendly in Northern Ireland (NI). This realist evaluation is to understand how DFCs work for people living with dementia, how positive outcomes are achieved, for whom and in what contexts do DFCs work best.MethodsA realist evaluation using case study methodology. The process evaluation includes a realist review of the literature, non-participant observation of people living with dementia in their local communities, semi-structured interviews to explore the facilitators and barriers to living well in DFCs and focus groups comprised of people living with dementia, family caregivers and people working in DFCs to support Context- Mechanisms and Outcomes (CMOs). This four-stage realist assessment cycle is used, including iterative rounds of theory development, data gathering, and theory testing. In the end, analysis will reveal context mechanisms that influence how dementia-friendly communities operate and present an initial theory of how people think, which, if adopted, may be able to alter current contexts so that "key" mechanisms are activated to generate desired outcomes.DiscussionTo give confidence in moving from hypothetical constructions about how DFCs could function to explanations of possible or observable causal mechanisms, the realist evaluation of a complex intervention incorporates a variety of evidence and perspectives. Despite playing a significant role in a person with dementia's everyday life, it appears that little is known about how communities function to achieve intended results. Even though there has been a lot of work to pinpoint the fundamentals and crucial phases of building DFCs, it is still unclear how people living with dementia benefit the most from these communities. This study intends to advance our understanding of how outcomes are produced for people living with dementia by contributing to the underlying theory of DFCs as well as addressing the primary research objectives.

EPH113 Healthcare Utilization Remains Elevated Among People Living with Post-COVID-19 Condition More Than One Year after Acute COVID-19 Illness

Healthcare systems require comprehensive data for long-term resource allocation planning to support people living with post-COVID-19 condition (PCC). Limited information is available on long-term PCC-associated healthcare utilization patterns. In this study, we assess healthcare utilization rates six and 12-18 months following acute COVID-19 illness among COVID-19 survivors in British Columbia (BC), Canada by PCC status. We used difference-in-difference analysis to assess healthcare utilization by all adult COVID-19 survivors in BC diagnosed with COVID-19 on/before November 18, 2021 during three time periods: (i) 26 weeks after the first 4 weeks of COVID-19 illness, and that exact period (ii) one or two years prior (baseline), and (iii) one year afterwards. PCC/non-PCC patients were matched 1:2 on age, sex, region, comorbidities, vaccination status, and COVID-19 index date ±14 days. The total number of daily healthcare encounters (medical visit, emergency department visit, hospitalization) per person was calculated. Rate ratios (RR) for PCC-associated healthcare utilization were estimated using weighted Poisson regression. The matched cohort (n= 7,092) included 2,364 PCC patients (54.9% female; mean age 39.8 [SD, 13.4] years). Healthcare utilization rates were comparable between the PCC and non-PCC groups at baseline (average: 39.3 vs. 32.7 visits per 1000 patients, respectively), but rose two-fold for the PCC group during the 26-week period post-acute illness (76.1 vs. 33.5). One year later, PCC-associated healthcare utilization rates declined but remained elevated relative to baseline rates (54.6 vs. 34.4). In multivariable Poisson regression models, PCC was associated with a 103% increase in healthcare utilization over 26 weeks post-acute illness (aRR: 2.03, 95% CI 1.71-2.41) and a 24% increase the next year (aRR: 1.24, 95% CI 1.03-1.48). The increased healthcare utilization rates noted among PCC patients one year following acute COVID-19 illness highlights the need for adequate planning to provide optimal support for people living with PCC.