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PubMed2005

Depressive symptomatology at age 75 and subsequent use of health and social services.

It is well documented that elderly persons are the largest consumers of many health and social services. Consequently it is of interest to identify characteristics of users of those services. The purpose of this study is to examine whether depressive symptoms among men and women at age 75 are an independent determinant of incident hospitalization and use of home help 5 years later. Four hundred and ten men and women participated in a prospective study in Glostrup, Denmark, when they were 75 and 80 years old. Depressive symptoms were evaluated by the Center for Epidemiologic Studies Depression Scale (CES-D Scale). Use of health and social services was measured by asking the participants whether they had been hospitalized or used home help during the year before follow-up. Among women, depressive symptoms at age 75 were associated with subsequent use of home help at age 80 (odds ratio (OR) = 2.5; 95% confidence interval (CI): 1.2-5.0) and marginally associated with subsequent hospitalization (OR = 1.8; 95% CI: 0.96-3.5). None of these results were seen in men. Preventive services should take into account depressive symptoms among elderly women.

Activities of Daily Living↗
PubMed1993

Alcohol and drug problems among diverse health and social service populations.

OBJECTIVES: This study responds to clinical and research interest in identifying alcohol- and drug-related problems in health and social service agency populations. These problems are associated with a variety of illnesses and social problems, and community agencies serve important screening functions. METHODS: Indicators of problematic alcohol and drug use are compared across representative samples of clients within a county's alcohol, mental health, and drug treatment systems; hospital emergency rooms; primary health clinics; criminal justice and welfare systems; and general population. RESULTS: Agencies followed a consistent rank ordering in the prevalence of substance abuse indicators. Highest prevalences were found in the populations of behavioral health agencies, including alcohol, drug, and mental health treatment facilities and criminal justice, followed by welfare agencies. General medical agencies served populations with the lowest prevalence and problem severity. CONCLUSION: Health and social service agencies provide significant opportunities for the screening and referral of individuals with problematic alcohol and drug use. Although behavioral agencies have higher potential for referral and intervention, general medical services may be more effective in conducting prevention and early case-finding activities.

Adolescent↗
PubMed1963

Social service.

Explore the source record for details and available documents.

Hospital Administration↗
PubMedDate not supplied

An analysis of social services in hospices.

Data were obtained in 34 hospices from social workers, nurses, and volunteers on how frequently they performed 27 social service activities and how much time they spent performing them. Findings revealed that social workers were employed part time and did not play an unique role in service provision. In contrast, nurses were employed full time and provided services commonly associated with social work practice. The authors discuss the study's implications for the future of social workers in hospice settings.

Data Collection↗
PubMed1999

Community care for people with chronic conditions: an analysis of nine studies of health and social service utilization in Ontario.

A series of studies conducted in the same region found that programmatic, community-based health and social service interventions have a positive impact on client well-being. These proactive interventions, designed to address the full range of health and social needs, were usually provided at the same--or even lower--costs as uncoordinated, illness-focused care. The results of this series suggest that across-the-board health care reduction, at least in a system of national health insurance, will produce poorer results, at higher cost, for people with chronic conditions living in the community. Policy planners need more research that concentrates on comparisons of outcomes between and within different models of health and social service delivery. The studies should be designed to help them determine who benefits from different service configurations carried out within a range of policy environments at various costs.

Canada↗
PubMed2006

Levels of death anxiety: a comparison of American and Lithuanian health and social service personnel.

Globalization, coupled with increased attention to issues surrounding death, highlights the need to explore cultural influences on the social, personal, and psychological consequences of death. This study compared the responses of 82 American and 119 Lithuanian health and social service personnel on seven subscales of the Multidimensional Fear of Death Scale. Lithuanian participants were more likely to express fear of the dying process and fear of the unknown and were less likely to fear the dead than were Americans. The findings suggest that different historical and environmental experiences with death may influence anxiety about various dimensions of death. Cultural differences in the dimensions of death anxiety among health and social service providers in the two nations suggest the importance of differential training based on specific cultural knowledge to improve the quality of care.

Anxiety↗
PubMed2001

Social services for the elderly based on the new rurality: the Japanese experience.

Since the 1920s, Japan has changed from being a relatively youthful society, with an average age of about 26, to an elderly society with an average age of over 40 (Fordyce, 1999). The number of elderly is rising and the number of births is falling. Concurrently, the health and infrastructure needs of many of the retired elderly are increasing while, for the same retirees, their contribution to productivity and revenue is diminishing (Fordyce, 1999). As the population ages, inevitably the burdens of taxes, pensions, public medical insurance and social services have been rapidly increasing. To meet the challenges of these changes in population structure, Japan has established policies such as the Gold Plan and the Public Long-term Care Insurance Program and it has expanded social services into rural agricultural areas. This article examines those policies and the care services and productive aging programs that have developed due to population aging and new rural patterns in Japan.

Aged↗
PubMed1992

Predicting the volume of health and social services: integrating cognitive impairment into the modified Andersen framework.

This investigation examined cognitive impairment as a predictor of the volume of community services used by older adults. Predictors of service volume were selected according to the modified Andersen framework and tested with 97 health care and 246 social service clients of a large multiservice agency. Results for health care clients showed that the effects of four predictors differ depending on clients' level of cognitive impairment; living arrangement, presence of secondary caregivers, client depression and task burden of the primary caregiver. No differences in predictor of social service use were observed for cognitively impaired and lucid clients.

Aged↗
PubMedDate not supplied

Social service and case management needs of HIV-infected persons upon release from prison/jail.

This study sought to identify social service needs of HIV-infected persons at the time of release from prison/jail and to describe their case management experiences after release from prison/jail. Sixteen men and women who were infected with HIV, each with a history of incarceration, participated in one of three focus group sessions. Study participants consisted of 11 men and five women. The majority of the participants were African-American (81%), single (50%), and currently unemployed (69%). Qualitative analysis of the focus group transcripts revealed a total of 483 comments regarding a need for social or health services. These comments were further grouped into 13 categories of services or service-related issues that represented the range of the responses. Although participants described positive experiences with specific case managers, their overall evaluation of case management was negative. Identified social services needs and the descriptions of their experiences with case management provides insight as to how case management services can be improved for this population.

Adult↗
PubMedDate not supplied

Predictors of social service staff involvement in selected palliative care tasks in nursing homes: an exploratory model.

Little research has been conducted on nursing home social service staff and end-of-life care in nursing homes. To address this gap, a cross-sectional study on end-of-life issues for people with dementia in nursing homes was conducted in New York State, in which 138 nursing home social service staff participated. This exploratory study examined issues such as perceived confidence, perceived influence, and demographic variables in relation to self-reported frequency of tasks related to palliative care of nursing home residents with dementia. Results showed that participants in this survey who discussed specific treatment issues during advance directive discussions perceived themselves to have higher degrees of influence in their respective facilities, were directors or managers of their departments, and were more likely to engage in tasks related to palliative care.

Adult↗
PubMed2002

Implementing assertive community care for patients with schizophrenia. A case study of co-operation and collaboration between mental health care and social services.

The aim of this study was to describe the personal experiences of collaboration and co-operation between staff from the community mental health and social services programmes in their daily work with schizophrenic patients. An additional aim was to generate the first step in a theory of how staff in the field of health care and social services manages to integrate their efforts on an individual and organizational level. The study group consisted of five members of a multidisciplinary team who had been working for 2 years with assertive outreach intensive clinical case management. Verbatim-transcribed thematic interviews were analysed according to the comparative method for grounded theory. The analysis was focused on quality of interpersonal interaction between practitioners, representing different professions in community-based mental health care, as well as the professional relationship to the patients/clients and their relatives. In the light of an individual and organizational perspective, different typologies of interpersonal interactions appeared. Three main variables were identified: collaborative relationship, co-operative partnership and professional-amateurism. Our findings on these qualitative differences in interpersonal relations should be taken into account in the continuing reorganization of the community health care services. This knowledge can also help in overcoming barriers between patients, professionals and organizations in the mental health services.

Adult↗
PubMedDate not supplied

[Release on trust in social service as an alternative to imprisonment: criminological problems].

The Authors, after synthetic outline of the new regulations concerning "the release on trust in social service", an alternative measure to that of imprisonment according to law no. 354 of 26 July 1975, take into consideration some of the problems and difficulties which have emerged in the first months of application of this law. This examination is followed by a review of the results of criminological research on the period of probation and of the present aims emerging with regard to this measure, in the countries where it has been tested for some time. The Authors conclude with a critical evaluation of the present regulations and a series of proposals aimed at improving the application of the probation system in social service.

Crime↗
PubMed2006

The development of a Local Index of Need (LIN) and its use to explain variations in social services expenditure on mental health care in England.

Wide variations in deprivation exist across England and it is likely that these variations translate into differences in the need for mental health care. Social Services Departments in England account for a substantial proportion of mental health expenditure. It is important that the distribution of expenditure reflects mental health needs. This paper's aims are to (1) describe the development of a new indicator of mental health needs, (2) use the index to explain variations in social services expenditure on mental health, and (3) compare the index with other established measures of need. A principal components analysis of sociodemographic variables considered to be indicators of need was used to produce four distinct factors for 148 Local Authority areas in England. A weighted sum of these factors was used to produce a single index. (Weights were the proportion of variance explained by each factor.) The index was used in a regression model to explain variations in spending on mental health care and was compared with (1) a model containing the four individual factors, (2) the current method of allocating resources, (3) the index used to allocate resources to primary care trusts, (4) the Mental Illness Needs Index (MINI), (5) four indices of deprivation produced by the Office of the Deputy Prime Minister, and (6) the average of the above four indices. The new index could explain 54% of variation, compared with 56% using the current method. The four-factor model could explain 66%, whilst the other models could explain between 37% and 20%. This new index has the advantage that it is not based on previous levels of utilisation or expenditure and yet still explains a comparable amount of variation as the current method. However, a disaggregated model containing individual factors may be preferable.

Adolescent↗
PubMed2005

Social services day care and health services day care in mental health: do they differ?

BACKGROUND: The difference between the services provided by day hospitals and day centres is far from clear. The supposition that day hospitals would provide an acute service, while day centres would offer social support for a more chronic population has been contentious and there is little evidence of how they are currently used. AIMS: We aimed to ascertain the differences between day hospitals (partial hospitalisation) and social service day centres in functions and roles, as perceived by staff, service users and referrers. METHODS: The views of service users and staff at two day hospitals and four day centres were ascertained through questionnaires and interviews, along with those of staff of eight Community Mental Health Teams, who constitute the sole pathway to the two services. RESULTS: Day hospitals were perceived by both referrers and clients to offer short-term, more intensive 'treatment' to more acutely ill people in need of mental health monitoring. Day centres were perceived to offer longer-term support, particularly social support, to people more likely to have longer-term and psychotic illnesses. CONCLUSION: There is currently a clear distinction between day centres and day hospitals, in key features of their services and client groups. It would be unwise to treat them as interchangeable.

Ambulatory Care↗
PubMed2003

Violence prevention in the ED: linkage of the ED to a social service agency.

Interpersonal violence continues to be a problem in the United States, most prominent in the inner-city minority young persons population. The medical approach of "treat 'em and street 'em" philosophy has led to foregoing the psychosocial needs of injured young persons. This study describes a program to link young persons who are victims of interpersonal violence to a healthcare system and a social service agency in an effort to meet their psychosocial needs. An unvalidated screening tool was developed by a team consisting of an EP, social worker, and public health scientist to determine the young victims' psychosocial needs. Patients aged 10 to 24 years who were victims of interpersonal violence (excluding child abuse, sexual assault, and domestic violence) were randomly assigned in the study. The control group was given a list of services and the treatment group received an assessment, case management, and referral to appropriate resources. The study site was a community, teaching level 1 trauma center. The study was approved by the institutional review board. Numbers of referrals in both groups were counted and compared using SPSS (version 10, Chicago, IL). One hundred eighty-eight victims of interpersonal violence were enrolled. A total of 82.5% were male, 65.4% were African American and 31.4% were Hispanic. At the end of 6 months, 78 of the 96 young persons (81.3%) in the treatment group made one or more contacts with their case manager and made use of social service, healthcare, and other referrals. Education (21.6%), job readiness (19.1%), and mental health (11.9%) were the most frequently used services. Nine of the 92 (9.8%) in the control group used services; most of these referrals were for social services (7 of 9 respondents) and the others were healthcare-related. The difference in utilization of services between the treatment and the control groups were found to be significant different (95% confidence interval, 1.41-1.55, significance =.00), and there was a strong positive correlation of using services and case management (Pearson coefficient = 0.728, significance =.00). The referral of young victims of violence from the ED to psychosocial services could be successful using a case management model and an alliance between a healthcare system and a social service agency.

Adolescent↗
PubMed2003

Schizophrenia and contact with health and social services: a Nordic multi-centre study.

BACKGROUND: In a Nordic multi-centre study investigating the life and care situation of persons with schizophrenia living in the community, factors explaining use of health and social services were examined. METHOD: Four hundred and eighteen individuals with schizophrenia from 10 sites were interviewed about their contact with different services (support functions within and outside the mental health services, general practitioners (GPs), physicians in the mental health, psychotherapy, day-care and inpatient treatment), psychopathology, social network and needs for care. RESULTS: Physicians and support contacts within the mental health system were most used and GPs and psychotherapy least. Three groups of variables were stabile predictors of contact: rural-urban differences, diagnoses (hebephrenic schizophrenia associated with less contact with physicians in the mental services and more with GPs) and health needs as experienced by the patients. No differences between the centres with regard to total service use were found, but the patterns of contact reflected urban-rural variance. A low number of health needs predicted contact with physicians within the mental health services, whereas a high number of such needs was related to contact with GPs and support functions within the mental health services. Social relations exhibited the highest number of unmet needs. CONCLUSIONS: Contact with physicians working in the mental health services was much more common than contact with GPs. Based on a broad spectre of demographic, clinical and network variables, it was not possible to find models that explained substantial parts of the variance of service use. Patterns of contact were different in rural, town and city-surroundings, and with the exception of psychotherapy, the rural pattern was characterized by use of less specialized services. The importance of health needs and diagnosis as predictors of contact illustrate the profound and lasting effects on health of having a diagnosis of schizophrenia.

Adult↗
PubMed2002

[Health status, functional prospects and use of medical and social services by the elderly living in St. Petersburg].

The sharp increase of absolute number and share of the aged population in St. Petersburg requires changes in the medico-social service provision for the elderly. IPSE survey study was realized in 2000 in St. Petersburg under support of the Tacis Bistro Facility of the European Commission (The findings, conclusions and interpretations expressed in the article are those of authors and should not be taken to reflect the policies or opinions of the Europian Commission). The aim of the survey was to analyse health status, functional ability and use of medical and social services by the 60-89 aged elderly of the city and to identify the groups of elderly population in the most need of help. According to the results of the IPSE survey study, there is a significant number of elderly people who are not able to live independently at home without other people's help (approximately 97,000 elderly people in St. Petersburg who need assistance in daily living). The group of elderly people with considerably declined functional abilities should be a priority in planning the elder care services. For this group intervention programmes need to be developed. Providing the elderly with sufficient home help services fosters their independent living and allows the elderly to live longer at own home. To live at home is often the best choice for both the elderly and also the service system due to lower costs.

Activities of Daily Living↗
PubMed1998

Evaluation of an innovative program to address the health and social service needs of drug-using women with or at risk for HIV infection.

Drug-using women with or at risk for HIV infection have many competing unmet needs, especially for social services, drug treatment, and medical care. High-risk drug-using women were recruited through street outreach, at needle exchange sites, a prison, and local community based organizations in New Haven, Connecticut for a study of the service needs of out-of-treatment drug users and the ability of an interactive case management intervention (ICM) to address those needs. These women were administered baseline and follow-up interviews to identify their health and social service needs and the degree to which these needs were resolved. The women who chose to enroll in the interactive case management intervention (n = 38) did not differ demographically nor in their HIV risk behaviors from those not receiving case management (n = 73). Provision of ICM was most successful in meeting needs for supportive mental health counseling, basic services, and long term housing. The impact of interactive case management was less evident for the acquisition of medical and dental services, which were accessed comparably by women not receiving the intervention. Overall, the women who enrolled in the ICM intervention showed a significant decrease in the number of unmet service needs as compared to those who did not enroll. Multiple contacts were required by the case manager to establish trust and to resolve the unmet service needs of these high-risk women. Women with or at risk for HIV infection can be effectively engaged in an ICM intervention in order to meet their multiple unmet service needs, although such interventions are time-and-labor intensive.

Adult↗