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Refugees at Work: The Preventative Role of Psychosocial Safety Climate against Workplace Harassment, Discrimination and Psychological Distress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010696. [PMID: 34682442 PMCID: PMC8535317 DOI: 10.3390/ijerph182010696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/03/2021] [Accepted: 10/04/2021] [Indexed: 11/25/2022]
Abstract
It is widely recognised that employment is vital in assisting young refugees’ integration into a new society. Drawing on psychosocial safety climate (PSC) theory, this research investigated the effect of organisational climate on young refugee workers’ mental health (psychological distress) through stressful social relational aspects of work (e.g., harassment, discrimination). Drawing on data from 635 young refugees aged between 15 and 26 in South Australia, 116 refugees with paid work were compared with 519 refugee students without work, and a sample of young workers from Australian Workplace Barometer (AWB) data (n = 290). The results indicated that refugees with paid work had significantly lower psychological distress compared with refugees with no paid work, but more distress than other young Australian workers. With respect to workplace harassment and abuse, young refugee workers reported significantly more harassment due to their ongoing interaction and engagement with mainstream Australian workers compared with unemployed refugees. Harassment played a vital role in affecting psychological health in refugees (particularly) and other young workers. While refugee youth experienced harassment at work, overall, their experiences suggest that their younger age upon arrival enabled them to seek and find positive employment outcomes. Although PSC did not differ significantly between the employed groups, we found that it likely negatively influenced psychological distress through the mediating effects of harassment and abuse. Hence, fostering pathways to successful employment and creating safe work based on high PSC and less harassment are strongly recommended to improve refugees’ mental health and adaptation.
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Bradley C, McGowan J, Michelson D. How Does Homelessness Affect Parenting Behaviour? A Systematic Critical Review and Thematic Synthesis of Qualitative Research. Clin Child Fam Psychol Rev 2019; 21:94-108. [PMID: 28932919 DOI: 10.1007/s10567-017-0244-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The adverse social and physical conditions of homelessness pose significant developmental risks for children, which may be compounded or buffered by the quality of parenting behaviour they are exposed to. There is currently a limited understanding of how parents approach their care-giving role and responsibilities while adjusting to the experience of homelessness. Advancing knowledge in this area is essential for developing acceptable, appropriate and effective interventions to support highly marginalised and vulnerable homeless families. This review explored homeless parents' perceptions of how homelessness affects their parenting behaviour and identified adaptive strategies that parents may use to mitigate the potentially negative impacts of homelessness on the quality of care-giving. A systematic search of four electronic databases (ASSIA, PsycINFO, Web of Science and MEDLINE) identified 13 published qualitative studies, all originating from the USA, which explored parenting behaviour in homeless contexts. The studies were critically appraised using the CASP qualitative assessment tool. Thematic synthesis identified the following determinants of parenting behaviour; negative self-concept in the parental role, parental mental health, material resources, challenges to autonomy and self-efficacy, daily hassles, physical environment and service context, stigma, child characteristics and lack of support. These were synthesised thematically using existing models of parenting determinants and positive parenting. Findings indicate substantive impacts of homelessness on parental mental health, parenting authority, material resources, parenting environments and social support. Parents developed a number of adaptive methods to negotiate the challenges of homeless parenting such as maintaining a positive mindset, cherishing the parental role and developing practical strategies. We conclude with recommendations that service providers should tailor parenting support to resource-constrained circumstances and that further research is required in order to better understand experiences of homeless parents in other international contexts.
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Affiliation(s)
- Caroline Bradley
- Salomons Centre for Applied Psychology, Canterbury Christ Church University, 1 Meadow Road, Tunbridge Wells, TN1 2YG, Kent, UK. .,The Tavistock Centre, 120 Belsize Lane, London, NW3 5BA, UK.
| | - John McGowan
- Salomons Centre for Applied Psychology, Canterbury Christ Church University, 1 Meadow Road, Tunbridge Wells, TN1 2YG, Kent, UK
| | - Daniel Michelson
- Department of Population Health, Centre for Global Mental Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Riley M. Health needs of a hidden group: child residents of domestic abuse refuges. Br J Gen Pract 2019; 69:138. [PMID: 30819746 PMCID: PMC6400632 DOI: 10.3399/bjgp19x701597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Mark Riley
- Academic Department of Military General Practice, Birmingham
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Dababnah S, Rizo CF, Campion K, Downton KD, Nichols HM. The Relationship Between Children's Exposure to Intimate Partner Violence and Intellectual and Developmental Disabilities: A Systematic Review of the Literature. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2018; 123:529-544. [PMID: 30421974 DOI: 10.1352/1944-7558-123.6.529] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Children exposed to intimate partner violence (IPV) can experience negative social, emotional, behavioral, and academic outcomes. A growing body of research has examined the relationship between intellectual and developmental disabilities (IDD) and IPV exposure. We systematically reviewed the literature for research exploring this relationship and found a limited number of studies meeting inclusion criteria ( N = 11). Over half (64%) identified a significant relationship between IPV and IDD, although the cross-sectional methodologies of the majority of studies (82%) prevented the ability to ascertain directionality. Further, the studies defined and measured IPV and IDD in various ways. Some studies were limited by poor external validity and small sample sizes. More research is needed to understand the intersection between IPV exposure and IDD.
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Affiliation(s)
- Sarah Dababnah
- Sarah Dababnah, University of Maryland, Baltimore; Cynthia Fraga Rizo, University of North Carolina at Chapel Hill; and Karen Campion, Katherine D. Downton, and Helen M. Nichols, University of Maryland, Baltimore
| | - Cynthia Fraga Rizo
- Sarah Dababnah, University of Maryland, Baltimore; Cynthia Fraga Rizo, University of North Carolina at Chapel Hill; and Karen Campion, Katherine D. Downton, and Helen M. Nichols, University of Maryland, Baltimore
| | - Karen Campion
- Sarah Dababnah, University of Maryland, Baltimore; Cynthia Fraga Rizo, University of North Carolina at Chapel Hill; and Karen Campion, Katherine D. Downton, and Helen M. Nichols, University of Maryland, Baltimore
| | - Katherine D Downton
- Sarah Dababnah, University of Maryland, Baltimore; Cynthia Fraga Rizo, University of North Carolina at Chapel Hill; and Karen Campion, Katherine D. Downton, and Helen M. Nichols, University of Maryland, Baltimore
| | - Helen M Nichols
- Sarah Dababnah, University of Maryland, Baltimore; Cynthia Fraga Rizo, University of North Carolina at Chapel Hill; and Karen Campion, Katherine D. Downton, and Helen M. Nichols, University of Maryland, Baltimore
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Abstract
Homeless families are defined as all adults with dependent children who are statutorily accepted by local authorities (housing departments) in the UK, and are usually accommodated for a brief period in voluntary agency, local authority or housing association hostels. This period varies from a few days to several months, although the target for rehousing is usually around 4 to 6 weeks. Some housing departments, particularly in London, also use bed and breakfast accommodation.
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Digital communication between clinician and patient and the impact on marginalised groups: a realist review in general practice. Br J Gen Pract 2016; 65:e813-21. [PMID: 26622034 DOI: 10.3399/bjgp15x687853] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Increasingly, the NHS is embracing the use of digital communication technology for communication between clinicians and patients. Policymakers deem digital clinical communication as presenting a solution to the capacity issues currently faced by general practice. There is some concern that these technologies may exacerbate existing inequalities in accessing health care. It is not known what impact they may have on groups who are already marginalised in their ability to access general practice. AIM To assess the potential impact of the availability of digital clinician-patient communication on marginalised groups' access to general practice in the UK. DESIGN AND SETTING Realist review in general practice. METHOD A four-step realist review process was used: to define the scope of the review; to search for and scrutinise evidence; to extract and synthesise evidence; and to develop a narrative, including hypotheses. RESULTS Digital communication has the potential to overcome the following barriers for marginalised groups: practical access issues, previous negative experiences with healthcare service/staff, and stigmatising reactions from staff and other patients. It may reduce patient-related barriers by offering anonymity and offers advantages to patients who require an interpreter. It does not impact on inability to communicate with healthcare professionals or on a lack of candidacy. It is likely to work best in the context of a pre-existing clinician-patient relationship. CONCLUSION Digital communication technology offers increased opportunities for marginalised groups to access health care. However, it cannot remove all barriers to care for these groups. It is likely that they will remain disadvantaged relative to other population groups after their introduction.
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Rees P, Edwards A, Powell C, Evans HP, Carter B, Hibbert P, Makeham M, Sheikh A, Donaldson L, Carson-Stevens A. Pediatric immunization-related safety incidents in primary care: A mixed methods analysis of a national database. Vaccine 2015; 33:3873-80. [PMID: 26122580 PMCID: PMC4518472 DOI: 10.1016/j.vaccine.2015.06.068] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 05/21/2015] [Accepted: 06/15/2015] [Indexed: 11/28/2022]
Abstract
Background Children are scheduled to receive 18–20 immunizations before their 18th birthday in England and Wales; this approximates to 13 million vaccines administered per annum. Each immunization represents a potential opportunity for immunization-related error and effective immunization is imperative to maintain the public health benefit from immunization. Using data from a national reporting system, this study aimed to characterize pediatric immunization-related safety incident reports from primary care in England and Wales between 2002 and 2013. Methods A cross-sectional mixed methods study was undertaken. This comprised reading the free-text of incident reports and applying codes to describe incident type, potential contributory factors, harm severity, and incident outcomes. A subsequent thematic analysis was undertaken to interpret the most commonly occurring codes, such as those describing the incident, events leading up to it and reported contributory factors, within the contexts they were described. Results We identified 1745 reports and most (n = 1077, 61.7%) described harm outcomes including three deaths, 67 reports of moderate harm and 1007 reports of low harm. Failure of timely vaccination was the potential cause of three child deaths from meningitis and pneumonia, and described in a further 113 reports. Vaccine administration incidents included the wrong number of doses (n = 476, 27.3%), wrong timing (n = 294, 16.8%), and wrong vaccine (n = 249, 14.3%). Documentation failures were frequently implicated. Socially and medically vulnerable children were commonly described. Conclusion This is the largest examination of reported contributory factors for immunization-related patient safety incidents in children. Our findings suggest investments in IT infrastructure to support data linkage and identification of risk predictors, development of consultation models that promote the role of parents in mitigating safety incidents, and improvement efforts to adapt and adopt best practices from elsewhere, are needed to mitigate future immunization-related patient safety incidents. These priorities are particularly pressing for vulnerable patient groups.
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Affiliation(s)
- Philippa Rees
- Primary Care Patient Safety (PISA) Research Group, Division of Population Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK.
| | - Adrian Edwards
- Primary Care Patient Safety (PISA) Research Group, Division of Population Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK.
| | - Colin Powell
- Primary Care Patient Safety (PISA) Research Group, Division of Population Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK.
| | - Huw Prosser Evans
- Primary Care Patient Safety (PISA) Research Group, Division of Population Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK.
| | - Ben Carter
- Primary Care Patient Safety (PISA) Research Group, Division of Population Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK.
| | - Peter Hibbert
- Australian Institute for Healthcare Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney 2109, NSW, Australia.
| | - Meredith Makeham
- Australian Institute for Healthcare Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney 2109, NSW, Australia.
| | - Aziz Sheikh
- Centre for Medical Informatics, The University of Edinburgh, Medical School, Teviot Place, Edinburgh EH8 9AG, UK; Harvard Medical School, Harvard University, Department of Medicine, 1620 Tremont St, Boston, MA 02120, USA.
| | - Liam Donaldson
- Imperial College London, 1090a, Queen Elizabeth the Queen Mother Wing (QEQM), St Mary's Campus, Norfolk Place, London W2 1PG, UK.
| | - Andrew Carson-Stevens
- Primary Care Patient Safety (PISA) Research Group, Division of Population Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS, UK; Australian Institute for Healthcare Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney 2109, NSW, Australia; Centre for Medical Informatics, The University of Edinburgh, Medical School, Teviot Place, Edinburgh EH8 9AG, UK; Department of Family Practice, University of British Columbia, 3rd Floor, 5950 University Boulevard, Vancouver, BC, Canada V6 T 1Z3.
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Sleed M, James J, Baradon T, Newbery J, Fonagy P. A psychotherapeutic baby clinic in a hostel for homeless families: practice and evaluation. Psychol Psychother 2013; 86:1-18. [PMID: 23386552 DOI: 10.1111/j.2044-8341.2011.02050.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES A pilot baby clinic in a hostel for homeless families has been established to address the specific attachment and developmental needs of infants living in temporary accommodation. The aim of this study was to assess whether this clinic model was associated with more positive outcomes than mainstream community services in terms of infant development and parent-infant interactions. DESIGN Parent-infant psychotherapy and health visiting services collaborated to develop a new model of baby clinic, which reconfigured the traditional clinic to give priority to infants' affective experiences in a therapeutic group setting. Outcomes for parent-infant dyads in a homeless hostel where this service model was applied were compared with outcomes for parents and infants in hostels, which did not have such a service. METHODS Fifty-nine mother-baby dyads participated in evaluation, 30 in the intervention hostel group and 29 living in comparison hostels. Infant mental and motor development was assessed using the Bayley Scales of Infant Development. Interactions between the parents and infants were video-recorded and coded on the Coding Interactive Behaviour Scales. RESULTS The indices of mental and motor development of infants in the intervention hostel were significantly improved over time in relation to infants in the comparison hostels. No significant differences were found in the quality of parent-infant interaction between the two groups over time. CONCLUSIONS The findings indicate that the service model may have positive benefits for infant development. The findings, study limitations, and clinical implications are discussed. PRACTITIONER POINTS Parents and infants living in temporary accommodation represent a high-risk and hard-to-reach population. A new model of intervention, which combines universal infant health services with a therapeutic parent-infant group may be an effective means of supporting the emotional needs of hard-to-reach parents and infants.
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Affiliation(s)
- Michelle Sleed
- The Anna Freud Centre, London, UK University College London, London, UK
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Racicot K, Fortin A, Dagenais C. Réduire les conséquences de l'exposition de l'enfant à la violence conjugale : pourquoi miser sur la relation mère-enfant ? ACTA ACUST UNITED AC 2010. [DOI: 10.3917/cips.086.0321] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Karim K, Tischler V, Gregory P, Vostanis P. Homeless children and parents: short-term mental health outcome. Int J Soc Psychiatry 2006; 52:447-58. [PMID: 17278346 DOI: 10.1177/0020764006066830] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Homeless families are an increasing but marginalised part of society. They have diverse and complex needs that have often not been addressed by the available services. There is some evidence that psychosocial factors continue to be detrimental to the mental health of these families even after rehousing. METHOD Thirty-five homeless families were assessed on their mental health (Hospital Anxiety and Depression Scale, Eyberg Child Behaviour Inventory Scale, Health of the Nation Outcome Scales for Children and Adolescents), parenting problems (Parenting Daily Hassles Scale), and service satisfaction (semi-structured interview) following admission to two homeless hostels, and four months later, when most families (69%) had been rehoused in the community. RESULTS Children and their mothers continued to experience high rates of mental health problems whilst resident in the hostels and after rehousing. However, a proportion of parents expressed a subjective improvement, which was often associated with their housing and social circumstances. A diverse range of further needs was described. CONCLUSIONS There is a need to address the complex problems experienced by these families, with housing only forming one aspect of this provision. Interagency strategy, commissioning and services are required to meet the needs of this vulnerable group of parents and children.
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Hurwitz EJH, Gupta J, Liu R, Silverman JG, Raj A. Intimate partner violence associated with poor health outcomes in U.S. South Asian women. J Immigr Minor Health 2006. [PMID: 16791535 DOI: 10.1007/s/10903-006-9330-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
To assess the associations between Intimate Partner Violence (IPV) victimization and health outcomes of South Asian women in Greater Boston. To explore the nature of the health experiences of victimized women in this population. Cross-sectional surveys with a community-based sample of women in relationships with males (n = 208) assessed demographics, IPV history, and health. In-depth interviews were conducted with a separate sample of women with a history of IPV (n = 23). Quantitative data were assessed by logistic regression, qualitative data by a grounded theory approach. Twenty-one percent of the quantitative sample reported IPV in the current relationship. Abused women were significantly more likely than those with no history of IPV in their current relationship to report poor physical health (95% CI = 1.3-12.0), depression (95% CI = 1.8-9.3), anxiety (95% CI = 1.3-6.4), and suicidal ideation (95% CI = 1.9-25.1). Qualitative subjects described how victimization resulted in injury and chronic health concerns and how IPV-induced depression and anxiety affected their sleep, appetite, energy, and wellbeing. Experiences of IPV are related to increased poor health among South Asian women. This elevated risk demands intervention. Healthcare providers should be trained to screen and refer South Asian patients for partner violence.
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Hurwitz EJH, Gupta J, Liu R, Silverman JG, Raj A. Intimate Partner Violence Associated With Poor Health Outcomes in U.S. South Asian Women. J Immigr Minor Health 2006; 8:251-61. [PMID: 16791535 DOI: 10.1007/s10903-006-9330-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To assess the associations between Intimate Partner Violence (IPV) victimization and health outcomes of South Asian women in Greater Boston. To explore the nature of the health experiences of victimized women in this population. Cross-sectional surveys with a community-based sample of women in relationships with males (n = 208) assessed demographics, IPV history, and health. In-depth interviews were conducted with a separate sample of women with a history of IPV (n = 23). Quantitative data were assessed by logistic regression, qualitative data by a grounded theory approach. Twenty-one percent of the quantitative sample reported IPV in the current relationship. Abused women were significantly more likely than those with no history of IPV in their current relationship to report poor physical health (95% CI = 1.3-12.0), depression (95% CI = 1.8-9.3), anxiety (95% CI = 1.3-6.4), and suicidal ideation (95% CI = 1.9-25.1). Qualitative subjects described how victimization resulted in injury and chronic health concerns and how IPV-induced depression and anxiety affected their sleep, appetite, energy, and wellbeing. Experiences of IPV are related to increased poor health among South Asian women. This elevated risk demands intervention. Healthcare providers should be trained to screen and refer South Asian patients for partner violence.
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Bair-Merritt MH, Blackstone M, Feudtner C. Physical health outcomes of childhood exposure to intimate partner violence: a systematic review. Pediatrics 2006; 117:e278-90. [PMID: 16452335 DOI: 10.1542/peds.2005-1473] [Citation(s) in RCA: 171] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Children exposed to intimate partner violence (IPV) are at increased risk for adverse mental and behavioral health sequelae, as has been documented by both systematic reviews and meta-analyses. Studies addressing the physical health impact of childhood IPV exposure, however, have not been summarized in a manner that might facilitate additional hypothesis-driven research and accelerate the development of targeted interventions. METHODS To identify a comprehensive set of articles examining the association between childhood IPV exposure and physical health, we searched online bibliographic databases including Medline, CINAHL, PsychInfo, and Sociological Abstracts using the keywords "domestic" or "intimate partner violence" and "infant," "child," or "pediatric." From >2000 articles retrieved in the initial search, we used online abstract and bibliographic information to identify 94 articles potentially meeting the inclusion criteria of studies that (1) examined a postnatal physical health outcome related to IPV exposure and (2) had a contemporaneous control group. Thorough review of these 94 published studies yielded 22 that met these inclusion criteria. The data then were abstracted independently by 2 of the authors, and differences were settled with the assistance of a third author. RESULTS Childhood exposure to IPV increases the likelihood of risk-taking behaviors during adolescence and adulthood and is likely associated with underimmunization. Minimal data and study limitations preclude establishing a clear connection between IPV exposure and general health and use of health services, breastfeeding, or weight gain. CONCLUSIONS The impact on physical health from exposure to IPV during childhood is still uncertain. Future studies should be grounded in a theoretical model that specifies how IPV exposure can affect child health, should adjust for confounders adequately, should include a community-based sample, and should be of larger scale.
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Affiliation(s)
- Megan H Bair-Merritt
- Pediatric Generalist Research Group, Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
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Cherniak D, Grant L, Mason R, Moore B, Pellizzari R. Intimate partner violence consensus statement. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2005; 27:365-418. [PMID: 15999433 DOI: 10.1016/s1701-2163(16)30465-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Archivée: Déclaration de consensus sur la violence exercée par le partenaire intime. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2005. [DOI: 10.1016/s1701-2163(16)30466-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
BACKGROUND Children living in special circumstances, defined as those who are at risk of achieving poorer outcomes than their peers, have a particular need of good quality, accessible services to promote their health and well-being, yet may be least likely to receive them. AIMS This review considers the evidence for effective services to support children living in five kinds of special circumstances: (1) those at risk of offending; (2) teenage parents; (3) children whose parents have drug, alcohol or mental health problems; (4) children living with domestic violence; and (5) children who have been abused or neglected. In practice, there is often considerable overlap between these groups, and many children face multiple disadvantage. The review also aims to identify effective strategies for making support services more accessible to hard-to-reach groups. METHODS Relevant literature was identified through searches of databases and websites, and consultation with experts. Given the broad scope of the topic, the aim was to provide an overview of best evidence rather than to undertake a systematic review. RESULTS Similar themes underpin the most promising approaches to supporting children in special circumstances. These include: (1) a holistic, multi-agency approach addressing the needs of the whole child rather than compartmentalising children's social, educational, health and care needs; (2) the importance of links between adults' and children's services so that children who are in need because of their parents' circumstances can be identified and supported; and (3) the value of providing children in special circumstances with intensive, targeted support within a framework of universal provision. CONCLUSIONS Overall, there is a lack of well-designed evaluations of the effectiveness of UK services and programmes for children in special circumstances. The existing evidence base would be strengthened by the development of better outcome measures, by exploring the characteristics of effective services from the perspective of different stakeholders (including children and young people themselves) and by extending the current problem-oriented approach to consider the factors that promote resilience and coping.
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Affiliation(s)
- J Statham
- Thomas Coram Research Unit, Institute of Education, University of London, London, UK.
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Affiliation(s)
- E Webb
- University of Wales College of Medicine, Cardiff, Wales, UK.
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Tischler V, Karim K, Rustall S, Gregory P, Vostanis P. A family support service for homeless children and parents: users' perspectives and characteristics. HEALTH & SOCIAL CARE IN THE COMMUNITY 2004; 12:327-335. [PMID: 15272888 DOI: 10.1111/j.1365-2524.2004.00502.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The objective of the present study was to establish the psychosocial characteristics and perspectives of 49 consecutive homeless families who received input from a new designated family support worker (FSW) post at a large statutory hostel for homeless parents and children. The FSW provided: assessment of social, educational and health needs; support and parent training; and liaison with and referral to specialist services. Measures included quantitative questionnaires (i.e. the Hospital Anxiety and Depression Scale, the Parenting Daily Hassles Scale, the Eyberg Child Behaviour Inventory, and the Health of the Nation Outcome Scales for Children and Adolescents), and a qualitative (semistructured) interview on service experiences and satisfaction. The psychosocial measures indicated high rates of parenting difficulties, mental health and related needs among children and their parents. Parenting difficulties were associated with child behaviour problems. Parents expressed satisfaction with the service whilst they were residents at the hostel, but they were often not clear about the objectives of agencies and interventions. Family support interventions have a key role in service provision for homeless and other vulnerable families by providing direct parenting interventions and ensuring that specialist agencies are appropriately involved. Family support worker involvement needs to continue when families are re-housed in the community.
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Taft A, Broom DH, Legge D. General practitioner management of intimate partner abuse and the whole family: qualitative study. BMJ 2004; 328:618. [PMID: 14766719 PMCID: PMC381135 DOI: 10.1136/bmj.38014.627535.0b] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2003] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To explore management by general practitioners of victimised female patients, male partners who abuse, and children in the family. DESIGN Triangulated qualitative study comparing doctors' reported management with current recommendations in the literature. PARTICIPANTS 28 general practitioners attending continuing medical education about management of domestic violence. RESULTS Doctors perceived partner abuse in diverse ways. Their gender, perceptions, and attitudes could all affect identification and management of this difficult problem. A few doctors practised in recommended ways, but many showed stress and aversion, difficulties in resolving the tensions involved in managing all family members, and neglect of the risks to children. Some doctors used contraindicated practices, such as breaking confidentiality and undertaking or referring for couple counselling. Doctors who were not familiar with community based agencies were reluctant to use them. A lack of expertise and support could have a negative impact on doctors themselves. CONCLUSIONS General practitioners managing partner abuse need to be more familiar with and apply the central principles of confidentiality and safety of women and children. Recommended guidelines for managing the whole family should be developed. Doctors should consider referring one partner elsewhere and avoid couple counselling; always ask about and act on the children's welfare; refer to specialist family violence agencies; and seek training, supervision, and support for the inherent stress. Medical education and administration should ensure comprehensive training and support for doctors undertaking this difficult work.
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Affiliation(s)
- Angela Taft
- Centre for the Study of Mothers' and Children's Health, La Trobe University, 251 Faraday Street, Carlton, Vic 3053, Australia.
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Tischler V, Vostanis P, Bellerby T, Cumella S. Evaluation of a mental health outreach service for homeless families. Arch Dis Child 2002; 86:158-63. [PMID: 11861229 PMCID: PMC1719131 DOI: 10.1136/adc.86.3.158] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To describe the characteristics of homeless children and families seen by the mental health outreach service (MHOS), to evaluate the impact of this service on the short term psychosocial functioning of children and parents, and to establish perceptions of, and satisfaction with, the service. METHODS Twenty seven children from 23 families who were in receipt of the MHOS and 27 children from 23 families residing in other hostels where no such service was available were studied. The MHOS was delivered by a clinical nurse specialist with expertise in child mental health, who offered the following interventions: assessment and brief treatment of mental health disorders in children; liaison with agencies; and training of homeless centre staff. RESULTS Children in the experimental group had a significantly higher decrease in Strengths and Difficulties Questionnaire (SDQ) total scores. Having received the intervention was the strongest predictor of improvement in SDQ total scores. There was no significant impact on parental mental health (General Health Questionnaire) scores. Homeless families and staff expressed high satisfaction with the MHOS. CONCLUSION This MHOS for homeless families is an innovative intervention which meets the complex and multiple needs of a vulnerable population unable to access mainstream mental health services. The primary objective of the service was to improve child mental health problems; however, the service developed in a responsive way by meeting social and practical needs of families in addition to its clinical role.
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Affiliation(s)
- V Tischler
- Greenwood Institute of Child Health, University of Leicester, Westcotes House, Westcotes Drive, Leicester LE1 0QU, UK
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