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PubMed2006

The personal and vocational impact of training and employing people with psychiatric disabilities as providers.

OBJECTIVE: This study examined the feasibility of a structured peer provider training program and its effect on peer providers with respect to their own personal and vocational recovery. METHODS: Sixty-six individuals participated in an evaluation of a 60-hour, 5-week long peer training program. Participants were assessed prior to and after the training on scales to measure recovery, empowerment and self-concept. Analyses of variance were used to examine subjective changes in these measures. Job acquisition and retention data were also examined at posttest. RESULTS: Participants experienced gains in perceived empowerment, attitudes toward recovery and self-concept. Trainees went on to obtain peer provider positions within the mental health agency in which they received the training and 89% of those trained retained employment at 12 months. Twenty-nine percent of the initial jobs into which the peer providers were placed were full-time; 52% were part-time and 19% were hourly. CONCLUSIONS: Findings suggest that a standardized program designed to provide peer training was used successfully and participants' recovery and employability were improved. Further studies are recommended to rigorously test peer providers' impact on their clients and to examine the advantages that accrue to the agency when mental health recipients are employed as peer providers.

Community Participation↗
PubMed1981

Counselor training as a treatment method for alcohol and drug abuse.

Based on the "helper-therapy" principle, a group of predominantly chronic alcohol- and drug-dependent individuals were trained for new careers in alcohol-drug counseling. A 2-month preinternship in alcohol or drug treatment centers served as a screening procedure for motivation and sobriety. Prior to training, measures of personality and self-concept were taken as well as demographic information. A 4-month training course covered broad educational and technical areas, including counseling procedures with participation, and physical conditioning. The 13% who dropped out were compared to the completers and found to differ only in extent of past antisocial history and less certainty about social drinking and abstinence. The pre-post measures of the completers indicated significant improvement in all areas of self-concept and on most of the MMPI scales. A 1-year post follow-up self-report questionnaire revealed that 74% of the respondents were employed, 59% in counseling or related areas. Less than 10% reported moderate regular use of drugs of alcohol, less than 2% heavy usage or addiction. Overall the program appears to have had sustained positive effects.

Alcoholism↗
PubMed2000

Structure of outcome beliefs in condom use. The Project RESPECT Study Group.

To study the structure of beliefs about condom use outcomes, the authors derived and tested 4 psychosocial hypothetical models: (a) a 2-factor model of the personal and social outcomes of condom use; (b) a 2-factor model of the pros and cons of the behavior; (c) a 3-factor model (i.e., physical, self-evaluative, and social) of outcome expectancies; and (d) a thematic 4-factor model of the protection, self-concept, pleasure, and interaction implications of the behavior. All 4 models were studied with a confirmatory factor analysis approach in a multisite study of 4,638 participants, and the thematic solution was consistently the most plausible. Self-concept and pleasure were most strongly associated with attitudes toward using condoms, intentions to use condoms, and actual condom use, whereas protection and interaction generally had little influence.

Adult↗
PubMed1996

Predicting self-esteem from perceptions of actual and ideal ratings of body fatness: is there only one ideal "supermodel"?

Silhouette ratings of actual and ideal body fat (N = 258 high school students) were related to 4 self-concept scales (Body Fat, Physical Appearance, General Physical, Esteem) and objective body composition measures in order to test predictions from actual-ideal discrepancy models. Actual-ideal discrepancy scores were more strongly related to self-concept than actual scores alone, thus supporting the traditional discrepancy model. However, multiple regression analyses demonstrated that more sophisticated actual-ideal discrepancy models that considered discrepancies in either direction (feeling too fat or too thin) did significantly better. Because the traditional discrepancy model is a special case of this more general discrepancy model, the more general model should have broad applicability. Important aspects of this task were (a) that discrepancies were evaluated along a continuum in which the ideal was not one of the endpoints of the continuum, (b) that there was reasonable variation in ideal ratings, and (c) that positive and negative discrepancies were reported.

Adipose Tissue↗
PubMed2005

Do daily stress processes account for socioeconomic health disparities?

OBJECTIVES: The present study examined the extent to which daily stressor severity and appraisals of the stressors accounted for socioeconomic disparities in health. METHODS: Data from the National Study of Daily Experiences and the Midlife in the United States Survey were combined for the current analyses, resulting in 1,031 respondents who reported on 7,229 days. RESULTS: Respondents without a high school degree experienced more severe stressors and appraised stressors as posing greater risk to their financial situation and to their self-concept than respondents with a high school or college degree. Differences in severity and stressor appraisal accounted for education differences in psychological distress and physical health symptoms. DISCUSSION: Findings suggest the importance of considering variation across stressors, particularly implications for self-concept, in understanding sources of differential stressor vulnerability.

Adult↗
PubMed1978

Drug abuses in the military: correlates of successful rehabilitation.

Investigated the relationships among motivation for drug abuse, successful rehabilitation, and personality/demographic variables. The Ss, 20 airmen who had completed successfully a local USAF Drug Abuse Rehabilitation Program, were administered the 16PF Qestionnaire, the Tennessee Self-Concept Scale, and the Sensation Seeking Scale. Multivariate correlative analyses showed that those Ss who progressed most rapidly through the rehabilitation program could be best identified by their scores on the Sensation Seeking Scale, while specific subscales of the Tennessee Self-Concept Scale and the 16PF contributed somewhat to the predictive value. It was concluded the the SSS has potential value in predicting successful rehabilitation of military drug abusers.

Adolescent↗
PubMed1991

The whys of patient education.

The rationale for patient education is that patients and families have the right to be informed; that professional standards describe appropriate patient education; that health care organizations and the law require patient education; and patients, health care organizations, and that society benefit from the process. Patients with cancer benefit in terms of knowledge acquisition, enhanced self-care, reduced anxiety, enhanced self-concept and self-esteem, increased satisfaction with care, improved pain control, improved oral status, and reduced disruption in daily functioning. Health care organizations benefit in terms of quality services, reduced costs, and reduction in malpractice suits. Society benefits as patients with knowledge and skills maintain or resume functional status and return to school, work, or service activities. Nurses are key professionals in the coordination and delivery of patient education programs. They too have the opportunity to benefit from patient education through therapeutic alliances with patients and families that foster both personal and professional satisfaction.

Economics, Hospital↗
PubMed1989

[Results of 108 exenteration operations in advanced gynecologic cancers].

We can now say that in our opinion exenteration is not an operation that is dangerous to life, if the conditions that will be described below are observed and if the indication is interpreted sufficiently narrowly, although during the first few years results had been moderate indeed. Exenteration has since developed so positively that it is now increasingly possible to consider the aspect of preserving the function of the adjacent organs, so that the disadvantages resulting for the patient's own body image and her self-concept and self-appraisal are now relatively acceptable compared to what had been possible previously. Indication for exenteration results from the situation, the ideas and the motivation of the patient, mainly, however, against the background of the characteristic features of the operation described here. Today we can say that even these extensive operations are firmly established in gynaecological oncology if there are extended carcinomas and recurring carcinomas. Hence, I believe it is advisable--at least in central recurring carcinomas--to refer such patients to competent surgical oncological centres before attempting to irradiate (or to irradiate again) the recurring tumour.

Colostomy↗
PubMed2003

Self-esteem scores among deaf college students: an examination of gender and parents' hearing status and signing ability.

Overall, research studies of self-esteem and deafness yield inconsistent findings. Some studies indicate a higher incidence of low self-esteem among deaf individuals than among hearing individuals (Bat-Chava, 1994; Mulcahy, 1998; Schlesinger, 2000). Other findings suggest that one must examine this complex phenomenon more closely to understand how deafness influences self-concept and self-esteem (Bat-Chava, 2000; Emerton, 1998; Foster, 1998; Munoz-Baell & Ruiz, 2000; Stone, 1998). This study asked whether self-esteem scores are significantly different among deaf college students compared across groups based on gender and parents' hearing status and signing ability. The construct of self-esteem was measured by the Rosenberg Self-Esteem Scale, administered using an American Sign Language-translated videotape. Results revealed that gender, age, and the interaction of parent by gender were nonsignificant. However, respondents who had at least one deaf parent and signed scored significantly higher than those with hearing parents who could not sign and those with hearing parents who could sign. Overall, self-esteem scores for all respondents were high. Implications for further study are discussed.

Journal Article↗
PubMed1997

Reflective capacity and its significance to the attachment concept of the self.

Attachment writing about the self systematically regards the working model of the self as a social product. At the same time, reflective self-capacity is regarded as a particularly salient aspect of the individual's current state of mind with respect to attachment. Additionally, evidence has accumulated that some individuals have been able to create a coherent working model of the self despite a history of negative attachment experiences. This paper proposes that in these circumstances it is necessary to conceive of a private self through which the history of attachment experiences may be creatively transformed.

Humans↗
PubMed2004

Using music as a therapy tool to motivate troubled adolescents.

Children and adolescents with emotional disorders may often be characterized by having problems in peer and adult relations and in display of inappropriate behaviours. These include suicide attempts, anger, withdrawal from family, social isolation from peers, aggression, school failure, running away, and alcohol and/or drug abuse. A lack of self-concept and self-esteem is often central to these difficulties. Traditional treatment methods with young people usually includes cognitive- behavioural approaches with psychotherapy. Unfortunately these children often lack a solid communication base, creating a block to successful treatment. In my private clinical practice, I have endeavoured to break through these communication barriers by using music as a therapy tool. This paper describes and discusses my use of music as a therapy tool with troubled adolescents. Pre- and post-testing of the effectiveness of this intervention technique by using the Psychosocial Functioning Inventory for Primary School Children (PFI-PSC) has yielded positive initial results, lending support to its continued use. Music has often been successful in helping these adolescents engage in the therapeutic process with minimised resistance as they relate to the music and the therapist becomes a safe and trusted adult. Various techniques such as song discussion, listening, writing lyrics, composing music, and performing music.

Adolescent↗
PubMed2004

Impact of a national rural youth health and safety initiative: results from a randomized controlled trial.

OBJECTIVES: We conducted a comprehensive evaluation of a rural youth health and safety initiative implemented in 4000 National FFA (formerly Future Farmers of America) chapters across the United States. METHODS: Data were collected from high school students and their FFA advisers at 3 time intervals (preintervention, immediate postintervention, and 1 year postintervention) with a 3-group (standard, enhanced, and control), cluster-randomized, controlled trial design. RESULTS: Matched data from 3081 students and 81 advisers revealed no significant effect of this initiative on agricultural health and safety knowledge, safety attitudes, leadership, self-concept, and self-reported injuries of project participants. Data from 30 public health nurses following the intervention confirmed the program's failure to develop sustainable community partnerships. CONCLUSIONS: This nationally coordinated initiative was funded with more than $1 million donated by agribusinesses. Program implementation was inconsistent, and desired outcomes were not achieved. Future efforts should better guide effective use of private sector resources aimed at reducing agricultural disease and injury among rural youths.

Accident Prevention↗
PubMed1999

Weighing risks and taking chances: adolescents' experiences of the regimen after renal transplantation.

The purpose of this study, which used a descriptive qualitative design, was to describe adolescents' experiences of the treatment regimen that follows renal transplantation in order to gain a better understanding of their experience. Five adolescents each participated in one in-depth, semistructured interview. Participants were asked to speak about the requirements of the recommended regimen related to medications, blood pressure and fluid monitoring, and diet and activity restrictions. The interviews were analyzed using Giorgi's data analysis method. The following overarching theme was identified: Weighing risks and taking chances. The consequences of the regimen and adhering or nonadhering to it were evident in the physiological, social, and psychological domains. Following the initial period, the adolescents were more selective in their adherence to the regimen, based on their perceptions of the risks involved in modifying the regimen. The modifications made to the posttransplantation regimen, which at times placed the adolescents' health at risk, were influenced by how the regimen interfered with their daily routines, such as school, leisure activities, and peer reactions as well as changes in their self-concept and self-image.

Adolescent↗
PubMed2006

Overprotection and lowered expectations of persons with disabilities: the unforeseen consequences.

Lowered expectations and overprotection of the individual with a disability can cause lowered self esteem which can result in a life time of underachievement and failure to reach their full potential. Both lowered expectations and overprotection are forms of discrimination. Internalization of discrimination causes the person with a disability to believe that they are less capable than a person without a disability. Parents and care providers of children with disabilities may overprotect the child to shield them from harm; however this can actually cause more damage. Successful parenting skills are required to help children and adolescents develop a positive self concept and high self esteem. Guidelines have been developed to assist parents, educators and other professionals regarding the effects of overprotection and lowered expectations.

Adolescent↗