Health & Social Care in the Community

During the COVID-19 pandemic, the well-being of older adults has been highlighted as a significant public health concern. In this study, we investigated the role of psychological resilience in mediating the relationship between positive self-perceptions of aging (SPA) and the subjective well-being (SWB) of community-dwelling older adults in Taiwan during the pandemic. We collected data through face-to-face interviews conducted from October 2021 to February 2022, involving 1,095 participants aged 50 years or above residing in a southern city in Taiwan. More than half of the study participants were female, aged 65 or older, and had less than a high school education. More than two thirds were married and/or living with partners. More than a third had two or more noncommunicable diseases. We calculated scores for SWB, positive SPA, and psychological resilience and examined correlations among the outcome and predictor variables. Our findings indicated that higher positive SPA was significantly associated with better SWB among community-dwelling older adults in Taiwan and that this association was mediated by psychological resilience. Specifically, after controlling for covariates, structural equation modeling (SEM) analysis revealed a significant main effect of positive SPA on SWB (b = 0.412, β = 0187, and ), while bootstrap mediation analysis showed a statistically significant indirect mediating effect from positive SPA on SWB via psychological resilience (0.597, 95% bootstrap CIs = [0.445, 0.749], and ). These findings highlight the potential importance of cultivating positive self-perceptions of aging and implementing resilience-centered interventions to promote well-being among Chinese older adults in the community.

Background. There is a high prevalence of homeless people with psychotic disorders and supported housing is often required. However, there is little evidence about supported housing services, especially in low-middle income countries. This rapid review synthesizes evidence about the experiences of users and providers of community-based accommodation services for people living with serious mental illness internationally to understand priorities for policy and practice. Methods. PubMed, PsycINFO, Google Scholar, and reference lists were searched to identify 1344 studies. The inclusion criteria specified qualitative studies about users’ and/or providers’ views of the accommodation services for adults aged 18+ years with serious mental illness. Title, abstract, and full-text screening were conducted in duplicate, and quality appraisal was conducted using the standard for reporting qualitative research tool. Data extraction was conducted using both Excel and Word documents, and we used thematic analysis to report findings. Results. Only 43 studies were identified for inclusion. Service users’ and providers’ experiences of accommodation services from high income countries and low-middle income countries were similar. Both the service providers and users appreciated housing, and service providers mentioned it was not a sufficient step towards independent living. Shortage of resources in low-middle income countries made it challenging for some service providers to provide care because they had to choose between buying medicine or food. While service users needed greater availability of service providers, providers were at risk of burnout. Although some service providers were trained to respond to stigmatizing events, some users continued to experience stigma from their family members, society, and service providers. Conclusions. People living with serious mental illness and service providers value the housing provision but globally their experience of this provision is relatively poor compared to mainstream society, suggesting people living with serious mental illness remain disadvantaged. Further research should explore low-cost housing options that will provide quality person-centered care for people living with serious mental illness.

Income support programs (ISPs) are important social policy measures to reduce the risk of poverty among older adults. Over the years, developing countries including South Asian countries have introduced various ISPs to support the older population. This scoping review will provide information on ISPs for older adults in South Asia and will map the evidence available on the impact of these programs. This scoping review uses the Joanna Briggs Institute’s (JBI) methodology. Older adults living in South Asia were included, and ISPs were considered as the “concept.” Eight electronic databases and organizational/governmental websites were searched for English language publications from January 2000 to May 2021. Four authors independently screened and extracted the data and analyzed it by descriptive statistics. A total of 115 studies provided information on ISPs for older adults and 25 on the impact of these programs. The identified studies covered all types of ISPs; however, government-sponsored or pillar 0 (ISP classification) programs were the most common. They also covered a vast spectrum of all types of study designs. The most common schemes are social pensions that work towards sustainable development goals (Goal 1.3) of social protection for all. Future research should focus on studying the impact of ISPs and expanding the ISPs for older adults in low-coverage countries.

Public services have increasingly sought to use lay assessors (often known as “experts by experience”) as members of inspection teams in health, social care, and education settings. This involvement has been credited as giving more influence to users over how services ought to run. Yet, little is known about the process or outcome of engaging with lay assessors. We conducted a systematic review to understand the benefits and challenges of involving lay assessors in the inspection of public services. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the literature in English using five bibliographic databases with the date of publication limited to 2000 onward. Across 27 eligible studies, results suggest that including diverse views and perspectives is a strength, yet little consideration is given to issues of “representativeness” of lay assessors or the power differentials within mixed groups that can shape which perspectives gain dominance. Despite a frequent rehearsal of the many benefits of involving lay assessors in inspections as a potential force to drive up the quality of inspections and inspected services, the impact of including lay assessors in inspections in terms of improving services was hard to determine. When designing training for lay assessors, services needed to carefully consider the tension between maintaining the assessor’s “naive eye” versus becoming “professionalised.” It was also apparent that expectations are often not clearly shared over how lay perspectives could be included in final inspection reports, thus risking disengagement. Involving lay assessors is still a fairly novel, yet rich and meaningful way to improve services, yet a lack of clear expectations, and typical exclusion of lay assessors in setting standards for regulation, can still act as barriers to meaningful involvement, preventing lay views from being heard and acted upon.

Contemporary healthcare for those experiencing mental illness requires healthcare practitioners (HCPs) to effectively incorporate the prescription of exercise in their treatment, in accordance with clinical guidelines. However, there has been a lack of effective implementation of such recommendations. The purpose of this review was to identify barriers to exercise prescription in the treatment of people diagnosed with mental illness as perceived by HCPs. APA PsycINFO, CINAHL, MEDLINE, and PubMed electronic databases were searched for relevant articles published in the period from January 2005 to September 2023. A total of 18 papers were included for thematic synthesis. Four key themes were identified across the qualitative (8), quantitative (6), and mixed method (4) papers, including a lack of knowledge and confidence of HCPs in prescribing exercise; role and responsibility; HCPs’ misconceptions of client barriers; and systemic issues impacting exercise prescription practices. A lack of knowledge or confidence was the most common barrier. Some HCPs indicated a desire to develop their skills in exercise prescription, while others indicated a preference for an exercise professional to take responsibility for this aspect of treatment. Systemic barriers were spread across a range of issues, with lack of time, excessive workload, and difficulties accessing qualified staff most commonly cited. This review provides further insight into the barriers to exercise prescription faced by HCPs and makes recommendations regarding how to address these barriers in order to better implement clinical guidelines and thus improve the quality of treatment provided to people diagnosed with a mental illness.

The COVID-19 pandemic has affected all aspects of professional disciplines including occupational therapy; however, little is known about how much of an impact the COVID-19 pandemic affected occupational therapy practice in Ghana. This study examined the impacts, coping strategies, and COVID-19 pandemic lessons for occupational therapy practices in the future. A descriptive qualitative design was employed with a purposive and convenience sampling methods to recruit occupational therapists from four practice settings in Ghana. Semi-structured interviews were conducted with seven participants. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Four major themes were identified from the analysis enlightening stakeholders on the impact and preparation for minimizing the impact of future pandemics on the workloads of an occupational therapist. The major themes are (1) impacts of the COVID-19 on occupational therapy practice and practitioners; (2) aspects or domains of work significantly affected by the pandemic; (3) the existing strategies employed to handle the challenges; and (4) strategies to minimize these challenges in the future. The current study has enlightened stakeholders on the need to make alternate preparations including telehealth, continuous support for telehealth infrastructures, training of practitioners, and research to adapt intervention strategies effectively.