A review of research specific to the active participation of mental health consumers in mental health research indicates that consumers have little input into mental health services program development or evaluation. Participatory action research, which is strengths-based and action-oriented, offers a process through which people utilizing mental health services and social work researchers can work together to develop evaluation and assessment tools that are both more relevant to program outcomes and empowering to the people whose progress they measure. Congruent with basic social work values of empowerment and social justice, participatory research assists in breaking down long-standing power imbalances between consumers and workers / researchers in the field of mental health. The primary intervention involved the practicum student working collaboratively with a group of mental health consumers to design and complete a research project, where the topic was chosen by the consumer researchers. The student prepared educational sessions so that knowledge of the research process was transferred to the consumer researchers. The consumer researchers progressed through each phase of the project, ultimately completing the project and publishing the research findings. The practicum student learned how to facilitate a participatory action research project, as well as learning the skills associated with working with self-help organizations and their members. Learning goals included increased proficiency in project management skills, research management skills, and research team coordination. Facilitation of a participatory action research project differs from others in its emphasis on shared decision-making and ongoing examination of power relationships. The student’s progress was evaluated by using the following methods: a student supervision form, a post-intervention interview with organizational representatives, and the student’s progress journal. Findings indicated growth in the areas of project management (organizational and facilitation skills), research management (teaching research methodology), and research team coordination (support and accommodation). Areas of continued possible growth were also identified. The practicum intervention was evaluated by using the following methods: A Consumer Constructed Empowerment Scale (CCES) was used to measure pre and post-test indicators of consumer researchers’ empowerment (quantitative), consumer skill logbooks, post-intervention interviews with consumer researchers, and post-intervention interviews with organizational representatives. Empowerment was measured at the individual, group, and organizational levels. Qualitative findings indicated increased perceptions of empowerment at all levels. Findings from the CCES indicated positive trends toward empowerment in one subscale, minimal change in four subscales, and a significant change in the overall empowerment score. / February 2008

A review of research specific to the active participation of mental health consumers in mental health research indicates that consumers have little input into mental health services program development or evaluation. Participatory action research, which is strengths-based and action-oriented, offers a process through which people utilizing mental health services and social work researchers can work together to develop evaluation and assessment tools that are both more relevant to program outcomes and empowering to the people whose progress they measure. Congruent with basic social work values of empowerment and social justice, participatory research assists in breaking down long-standing power imbalances between consumers and workers / researchers in the field of mental health. The primary intervention involved the practicum student working collaboratively with a group of mental health consumers to design and complete a research project, where the topic was chosen by the consumer researchers. The student prepared educational sessions so that knowledge of the research process was transferred to the consumer researchers. The consumer researchers progressed through each phase of the project, ultimately completing the project and publishing the research findings. The practicum student learned how to facilitate a participatory action research project, as well as learning the skills associated with working with self-help organizations and their members. Learning goals included increased proficiency in project management skills, research management skills, and research team coordination. Facilitation of a participatory action research project differs from others in its emphasis on shared decision-making and ongoing examination of power relationships. The student’s progress was evaluated by using the following methods: a student supervision form, a post-intervention interview with organizational representatives, and the student’s progress journal. Findings indicated growth in the areas of project management (organizational and facilitation skills), research management (teaching research methodology), and research team coordination (support and accommodation). Areas of continued possible growth were also identified. The practicum intervention was evaluated by using the following methods: A Consumer Constructed Empowerment Scale (CCES) was used to measure pre and post-test indicators of consumer researchers’ empowerment (quantitative), consumer skill logbooks, post-intervention interviews with consumer researchers, and post-intervention interviews with organizational representatives. Empowerment was measured at the individual, group, and organizational levels. Qualitative findings indicated increased perceptions of empowerment at all levels. Findings from the CCES indicated positive trends toward empowerment in one subscale, minimal change in four subscales, and a significant change in the overall empowerment score.

A review of research specific to the active participation of mental health consumers in mental health research indicates that consumers have little input into mental health services program development or evaluation. Participatory action research, which is strengths-based and action-oriented, offers a process through which people utilizing mental health services and social work researchers can work together to develop evaluation and assessment tools that are both more relevant to program outcomes and empowering to the people whose progress they measure. Congruent with basic social work values of empowerment and social justice, participatory research assists in breaking down long-standing power imbalances between consumers and workers / researchers in the field of mental health. The primary intervention involved the practicum student working collaboratively with a group of mental health consumers to design and complete a research project, where the topic was chosen by the consumer researchers. The student prepared educational sessions so that knowledge of the research process was transferred to the consumer researchers. The consumer researchers progressed through each phase of the project, ultimately completing the project and publishing the research findings. The practicum student learned how to facilitate a participatory action research project, as well as learning the skills associated with working with self-help organizations and their members. Learning goals included increased proficiency in project management skills, research management skills, and research team coordination. Facilitation of a participatory action research project differs from others in its emphasis on shared decision-making and ongoing examination of power relationships. The student’s progress was evaluated by using the following methods: a student supervision form, a post-intervention interview with organizational representatives, and the student’s progress journal. Findings indicated growth in the areas of project management (organizational and facilitation skills), research management (teaching research methodology), and research team coordination (support and accommodation). Areas of continued possible growth were also identified. The practicum intervention was evaluated by using the following methods: A Consumer Constructed Empowerment Scale (CCES) was used to measure pre and post-test indicators of consumer researchers’ empowerment (quantitative), consumer skill logbooks, post-intervention interviews with consumer researchers, and post-intervention interviews with organizational representatives. Empowerment was measured at the individual, group, and organizational levels. Qualitative findings indicated increased perceptions of empowerment at all levels. Findings from the CCES indicated positive trends toward empowerment in one subscale, minimal change in four subscales, and a significant change in the overall empowerment score.

This study investigated the possibility that registered nurses, working directly with the patient, may hold attitudes towards consumer rights and nursing independence which are different from those in the literature and those of nurse leaders and activists which are reflected in the resolutions on consumer rights passed at the Annual Meeting of the Registered Nurses' Association of British Columbia in 1976. The Pankratz and Pankratz (1974) Attitude Scale, consisting of 47 statements, divided into three clusters: 1) Nursing Autonomy and Advocacy; 2) Patient Rights; and 3) Rejection of Traditional Role Limitations was administered by mail to a random sample of registered nurses who were members of one of the Districts of the Registered Nurses' Association of British Columbia, Canada. The sample was stratified by educational level and 99.1 percent of 425 subjects were contacted by telephone prior to the delivery of the questionnaire. A total of 392 questionnaires (92.23 percent of the complete sample) was returned. Analysis of variance techniques were used to test the difference between the means when the three clusters in the Attitude Scale (Pankratz and Pankratz 1974) were analyzed by the six independent variables—administrative position, working hours, experience, work setting, age and education. Results indicated that nurses in administrative positions, those with advanced education and those who work in educational or community health settings, are more likely to score highly on the Pankratz and Pankratz (1974) Attitude Scale, than are nurses who have not completed a university degree and who work in a hospital setting as staff nurses. The attitudes expressed suggest that nurses are motivated to accept the patient as a participating member of the health care team but they need support to assume the risks associated with a self-image incorporating professional autonomy and interdependence. Conclusions reached were that the mean of the total sample, on all three clusters, was sufficiently high to encourage nurse leaders to provide assertive leadership on the issues of consumer rights in health care, informed access to information by the consumer and nursing autonomy. Such leadership would develop role models of consumer advocacy with which staff nurses could identify. It is suggested that by increasing, wherever practical, the patient's participation in decision making and in his own care, a more professional and more consumer oriented staff nurse role could evolve. / Applied Science, Faculty of / Nursing, School of / Graduate

Thesis (M.P.H.M. (Primary Health Care Management))-- mahidol University, 2005.

Thesis (M.P.H.M. (Primary Health Care Management)) --Mahidol University, 2006. / LICL has E-Thesis 0011; please contact computer services.

Thesis (M.S.P.H.)--University of Michigan, 1940.

Thesis (M.S.P.H.)--University of Michigan, 1940.

Background: The recognition of growing health disparities globally and, in particular Sub-Saharan’s continued poor health outcomes, has been responded to with a call to revitalise primary health care (PHC) 30 years after the Alma-Ata Declaration. Despite some limitations, and although not the only solution, community health workers (CHWs) have been shown to be able to reduce factors that can act as barriers to accessing care. However, CHW programmes (often provided by non-governmental organisations in South Africa) have historically been poorly regulated and fragmented. The South African government has proposed to address the health inequities through a series of health system reforms. One of these has been a current attempt to strengthen PHC through the use CHWs in order to reach underserved communities. The capacity of CHWs to provide effective outreach services remains unclear. This work examined the experiences of CHWs in their efforts to improve access to care through community participation and outreach services that work across sectors. Aim: The study aimed to examine the implementation of community health worker-provided services through the comparison of three case studies in order to identify enabling and constraining factors. Methodology: A case study method was used to compare three CHW programmes. Qualitative methods such as key informant interviews, participant observations, focus group discussions and network maps, were used to collect data. A thematic content analysis was used to identify a priori and emergent themes. Results: CHWs operate in communities with multifaceted needs (food, transport, health and social welfare services) requiring a comprehensive approach. The experiences of households in this thesis illustrate the various barriers to accessing services. The success and sustainability of CHW programmes depends on the ongoing commitment of resources, including investment in quality training, supervision, mentoring and organizational support. Furthermore, government institutional contexts with poor cross-sectoral integration, conflicting departmental mandates and poor accountability constrain the efforts of CHWs at local level. Operating within a community with strong social cohesion and social capital provided an enabling environment for CHWs to mobilise the community and facilitate community participation, which is crucial for implementation of cross-sectoral outreach activities. Conclusion: The study indicates that CHWs provide services in communities that live in poverty which results in multiple problems that contribute to ill health. The study goes further to illustrate that in order to strengthen outreach services across relevant sectors, the role of central government is crucial. These findings indicate a need for greater understanding about how to strengthen institutional contexts both in government and in non-governmental organisations.

Este estudo pretendeu discutir a experiência da implantação de um grupo de convivência para adultos com deficiências, na comunidade, como uma das estratégias de reabilitação no âmbito territorial, realizadas a partir de uma unidade básica de saúde. Os objetivos foram: compreender o processo de grupalização de adultos com deficiências e identificar as transformações ocorridas no âmbito individual e coletivo; conhecer os modos de vida e as demandas dessas pessoas e como um grupo de convivência pode contribuir para responder a tais demandas.Para o estudo de caso, utilizou-se a entrevista semi estruturada e o registro/diário de campo das atividades realizadas e acompanhadas pela pesquisadora.Participaram do grupo 10 adultos com deficiências que vivenciavam situação de pobreza e isolamento social, sendo: seis mulheres e quatro homens. Cinco apresentavam deficiência mental, três deficiência física e duas deficiências múltiplas. As entrevistas foram realizadas com 05 participantes do grupo, que o representavam em termos de idade, sexo e tipo de deficiência e tratavam de assuntos como: atividades cotidianas, experiências em saúde e reabilitação, educação, trabalho e participação comunitária.Foram registrados 34 encontros, durante 8 meses, de março a dezembro de 2006, uma vez por semana, encontros que duravam aproximadamente duas horas. A realização do grupo em um centro comunitário tornou visíveis para a comunidade os problemas enfrentados pelas pessoas com deficiências e promoveu a discussão sobre os direitos sociais. Tanto nas entrevistas quanto nas observações, ficou evidente a falta de autonomia e iniciativa das pessoas para participar das atividades do grupo, assim como para discutir as situações do cotidiano. Estes temas foram tratados no desenvolvimento da rotina do grupo (participação no planejamento das atividades, compra do material, confecção e venda). Participar do grupo promoveu trocas afetivas, a descoberta de habilidades manuais e criativas, o acolhimento, a melhora da auto-estima e da comunicação entre os participantes. Observou-se a organização de um modo de vida peculiar, centrada nas dimensões do habitar e comer (urgências respondidas no dia a dia). Para três dos entrevistados a aquisição da deficiência interrompeu a vida produtiva e a vinculação ao trabalho. Outros aspectos da vida cotidiana como conversar e passear foram demandas importantes na vida dos entrevistados. Estudar, realizar tratamento em reabilitação, ter uma moradia digna e aconchegante, ter alimento, trabalho, benefício previdenciário, locomover-se, passear e conversar foram as principais demandas apresentadas pelos sujeitos. A realização de um grupo de convivência na comunidade foi uma experiência de participação comunitária, de trocas interpessoais e aumento da rede de apoio social das pessoas com deficiências, em contraposição a situação de isolamento social. Grupos de convivência podem ser uma estratégia alternativa para o acompanhamento de pessoas com deficiências na comunidade. / This study was aimed at discussing the experience of implementing a co-existence group for adults with disabilities in the community as one of the territorial rehabilitation strategies, carried out by a Basic Health Unit. The goals were to: comprehend the process of group formation by adults with disabilities and identify the transformations that occur in both the individual and collective ambit; to understand the way of life and the demands of these people and assess how a co-existence group can help to address such demands. For the case study we used the semi-structured interview and a field diary to record the activities accompanied by the researcher. Ten adults with disabilities and who experience poverty and social isolation participated in the group, six of them women and four men. Among the adults surveyed, five have mental disabilities, three have physical disability and two have multiple disabilities. Interviews were conducted with five of the group participants, who represented the group in terms of age, sex and type of disability. The interviews dealt with issues such as daily activities, experiences in health and rehabilitation, education, work and community participation. 34 two-hour meetings were recorded, once a week, during 8 months, from March to December 2006. The undertaking of the group activity in the Community Center allowed the difficulties faced by people with disabilities to be seen by the community and led to the discussion of social rights issues. Through the interviews and observations, the lack of autonomy and initiative of people to participate in the activities of the group, as well as to discuss the situation of their daily life, became evident. These issues were addressed during the development of the group routine (participation in planning the activities, purchasing the material, manufacturing and sale). Participating in the group resulted in affective exchanges, the discovery of manual and creative skills, the sense of holding, improved self-esteem and improved communication amongst the participants. The organization of a peculiar way of life, focusing on the dimensions of living and eating (emergencies dealt with daily) was observed. For three of the interviewees the acquisition of a disability interrupted their productive life and their link to work. Other aspects of everyday life, such as dialoguing and going for walks, were important demands in the life of the interviewees. Studying, treatment in rehabilitation, having decent and comfortable housing, food, work, pension benefits, getting around, taking trips and talking were the main demands made by the subjects. The achievement of a co-existence group in the community was an experience of community participation, interpersonal exchanges and increasing network of social support for people with disabilities, which opposed the situation of social isolation. Coexistence groups can be an alternative assistance strategy for people with disabilities in the community.