Many elderly patients remain in acute care hospitals while they await transfer to Long Term Care (LTC) facilities. Complex problems, common for this special group of patients, place them at risk for delayed discharge. Discharge planning, for these patients, has become an increasingly critical activity for social workers. / This study examined factors that predict the risks for inappropriate hospitalization for 244 patients waiting for LTC in 1999, and it explored the LTC application process to identify barriers to delayed discharges. / It was found that 63% of the hospitalization of these patients was inappropriate. System related factors, such as the timing of the LTC application, were identified as predictors. Timeline investigations revealed areas for improvement in the discharge process and were discussed with a view to social work implementation, for example, the introduction of a high-risk screening protocol.

The research problem in this qualitative, pilot study explores a child's impressions of hospitalization while in hospital. / Nine children who were in-patients on a pediatric unit of an acute care hospital were interviewed using a semi-structured, self-constructed questionnaire. / The principal finding indicates that these children experienced a neutral emotional response to their hospitalization. Although the subjects were chosen randomly, all children resided in two parent families. This may be a significant factor in enhancing their ability to master hospitalization. Second, their neutral impression of hospitalization may be based on receiving a reasonable level of health care in a child centred environment with support from family.

Munchausen By Proxy Syndrome is a form of child abuse whereby parents induce symptoms of real illness, or falsely report symptoms, to initiate medical treatment for their children. Following a review of the literature with respect to case management, the author presents for study a case followed from initial suspicion to resolution two years later. The management of this case is compared to what the literature would suggest is the ideal practice. Areas of weakness are found to be the average social worker's lack of knowledge about the syndrome, due to its rarity, agency unpreparedness to deal with a case, over-reliance upon medical opinion and a lack of advice as to the long term likelihood of family reunification. Recommendations are made for the field of social work, child protection in particular.

Whether or not there is greater normative tolerance for physical discipline within certain ethno-cultural groups has been hotly debated both within social research and discourse. This descriptive quantitative study examined the characteristics of 72 substantiated physical abuse cases reported to Montreal’s English youth protection over a 2-year period. The findings revealed that 49% of the cases involved visible minority youth. Cross tabulations of 68 variables were compared between two groups: visible minority and Caucasian youth. Factors such as immigration and acculturation stressors and a parent having been subject to physical punishment as a child were more prominent in cases involving visible minority youth while parental mental health problems occurred more frequently in cases involving Caucasian youth. Practice implications regarding the potential benefits of using a varied response model, with an emphasis on culturally competent services, to address the problem of intra-familial violence is also discussed. / Il y a eut maints débats, tant au sein de discussions sociales qu’en recherche, visant à évaluer une potentielle plus grande tolérance pour la discipline physique parmi certains groupe ethnoculturels. Cette étude descriptive a pour but d’examiner les caractéristiques de 72 cas d’abus rapporté au service de protection jeunesse anglais de Montréal sur une période de deux ans. Les résultats révèlent que 49% de ces dits cas impliquaient des enfants provenant de minorités visibles. Deux groupes jeunesses, les minorités visibles et les caucasien furent comparés par l’entremise d’un tri croisé. Certains facteurs tels l’immigration, le stress de l’accommodation culturelle ainsi que l’assujettissement de parents à la correction physique lors de leur enfance furent plus proéminents dans des cas mettant en cause des jeunes de minorités visibles. En contrepartie les cas de problèmes de santé mentale furent plus fréquent dans les cas mettant en cause les jeunes caucasiens.

This descriptive study explores the experience of stress and coping by volunteers working in a cancer support program. Using a model developed by Mary Vachon (1987) who looked at occupational stress of health professionals in critical care areas, methods of content analysis were applied to interviews with six volunteers, three of whom were cancer survivors. Differences in the quality of the stress and in the coping experience were explored. Findings indicate that occupational stress was present for volunteers. The major stressors common to all were issues of relationships with patients and the demands of the role. For volunteers who had had a cancer diagnosis a major stressor distinguishing them was the death of volunteer colleagues. Overall, volunteers utilized a range of coping resources offered by the organization and from within themselves. Key implications include the need to acknowledge not only the strengths of the program and volunteers but the sources of stress, particularly the illness of volunteer colleagues. Maintaining an adequate staff-to-volunteer ratio is essential. Suggestions for volunteer support structures are offered.

The delivery of youth protection services by indigenous social workers in native communities is a fairly recent development in Quebec. This research project is a qualitative study of the practice experience of Inuit community workers located on the Ungava Bay coast of Arctic Quebec. Using participant observation and dialogue as methods of inquiry, an attempt is made to render an account of the workers' day-to-day experience of youth protection work. The findings suggest that their conditions of work encourage a passive subordination to the bureaucratic organization of practice. This tendency emerges in response to the difficulties workers encounter while trying to conform to the requirements of the Youth Protection Act and, at the same time, to the norms and realities of Inuit village life. The resultant tension is central to the Inuit workers' experience and not amenable to any simple resolution. Implications for social work practice, policy and research are examined in light of these findings.

This study explores how experience with a chronically ill or disabled sibling may affect prospective reproductive attitudes and behavior. Eighty-two young adults were interviewed using a structured, written questionnaire, which included the index of Family Relations (IFR) developed by Hudson (1982). Respondents in the main group (n = 41) had siblings with either a single-gene, hereditary illness or a physical/intellectual handicap. A multiple regression analysis examined how different group and subgroup combinations of the sibling factor might predict reproductive attitudes, controlling for sociodemographic, family, and developmental variables. Contrary to expectation, experience with an affected sibling predicted acceptance of potentially affected offspring. The significance of this finding was marginal for the main group, but more favorable when the sibling was intellectually handicapped. Respondents with siblings in genetic categories felt more obliged than others to test their own genetic risk status, but were least likely to favor abortion for medical indication.

Recovery from alcohol problems without treatment is a subject that has received little attention in the addictions literature. This study used media advertising to solicit people who had resolved a drinking problem on their own. The research used a semi-structured interview as a basis for a qualitative analysis of the phenomenon of recovery without treatment. Attention was focused on reasons offered for resolving a problem and factors involved in maintenance of that resolution. Rccovery methods used by these subjects are compared with those commonly recommended by most treatment programs, including Alcoholics Anonymous. The issues of labelling and acceptance are also discussed.

The complexity of information produced since the 1980's on co-occurring severe mental illness and substance misuse makes it difficult for social workers to grasp the current state of the question. This is a new field of study, and much of the information is incomplete or contradictory. This review examines epidemiological studies carried out in North America. We identify the varied semantic and philosophical approaches to the question of dual diagnoses, and provide an overview of etiological theories, as well as of the theory and practice of treatment for these disorders. Emergent concepts of recovery are also discussed. / Major findings. epidemiological data vary, but all point to a widespread problem. The diversity of meaning and of etiological theories appears to be linked to the heterogeneity of this population. An integrated treatment strategy is the current modality of choice, despite outcomes that are only mildly encouraging; finally, there is consensus among consumers that recovery from a disease is possible even in the absence of a complete cure. / Research limitations and knowledge gaps are to be expected in a new field of study. Additional research is necessary to determine the extent and causes of these comorbidities. Social workers must become knowledgeable in this field and remain abreast of new developments in order to engage in evidenced-based practice. Greater education about comorbidities is necessary, as is an overarching policy response from all levels of government. The principal contribution of this master's thesis to the discipline of social work is to provide a general synthesis of knowledge in a domain that is highly medicalized in the literature.

This paper explores the reality of a queer individuals life and the reality of a mother of a queer individual, where the author himself and his mother are the subjects. The paper seeks to explore these person's experiences/realities using both an autoethnographic approach and a life history approach. Coming from a postmodern and feminist position the author delves into such issues as power, oppression, social construction, personal voice, and identity. Personal narratives and academic literature within this paper are going to display queer realities and the broad range of oppression (such as heterosexism, homophobia and gendering) that they face (in educational, familial, and religious settings) and the experiences of a mother who has a queer child (such as emotional reactions, lack of resources/information). / The methodologies used within this paper also seek to explore and expand the use of alternative forms of academic research, focusing on the autoethnographic approach. Personal narratives, emotions and experiences take center stage within the body of this paper and seek to represent the realities of queer youth and their families to the reader, and hopefully, expose the need for more queer awareness, education, and advocacy.