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1.
Mary C. Howell 《Educational gerontology》2013,39(5):439-449
The aging of the population and the widespread prevalence of significant mental and physical disabilities increase the numbers of persons who are vulnerable. This creates ethical dilemmas in providing care, competing alternatives each determined by ethical principles. Such dilemmas are encountered in the Kennedy Aging Project, which teaches health professionals about the problems and care of those who are both mentally retarded and old. Two dilemmas, competency to refuse treatment and recompense for prior mistreatment, are discussed in detail as illustrative. 相似文献
2.
Sexual health topics are not well-covered in US medical schools. Research has not typically asked medical students what sexual health topics they would like addressed and their preferred methods of sexual health education. This study attempted to address this deficit via an online survey of medical students at an institution where little sexual health education is offered. Participants reported receiving the most education in endocrinology and sexually transmitted infections, but they also saw the following topics as important: sexual development, child sexual abuse, healthy sexuality, male sexual dysfunction and female dysfunction. Participants were more confident in talking to adults about sexual health matters than children, and more uncomfortable talking to opposite sex patients. Perceived barriers to sexual health education in medical school included a busy curriculum, other topics being seen as more important, religious influences, discomfort with sexuality and unqualified teaching faculty. Participants favoured training strategies that included panels of experts, panels of patients and role-plays conducted by seasoned professionals in sexual health. To reduce the barriers to sexual health education in US medical schools, educators need to highlight the relevance and importance of sexual health topics to the future work of physicians. 相似文献
3.
OBJECTIVE: This study aims to test the hypothesis of Holmes, Offen, and Waller (1997) that mental health professionals are not asking male patients about histories of sexual abuse. It also aims to investigate general attitudes and practices of mental health professionals to the issue of male sexual abuse. METHOD: One hundred and seventy-nine questionnaires were given to nurses, psychologists, and psychiatrists asking 10 questions about their attitudes and practice towards male sexual abuse. RESULTS: The majority of staff questioned rarely inquire about sexual abuse in male patients; staff are generally using ineffective and unsystematic methods of enquiry when they do ask; knowledge of prevalence rates of male sexual abuse are extremely variable; and 2/3 of staff report having had no specific training in assessment/treatment of sexual abuse and a similar number do not feel sufficiently trained to be able to inquire about sexual abuse in male patients. CONCLUSIONS: The study provides evidence for Holmes and colleagues' (1997) hypothesis that men are not being asked about sexual abuse histories. It also highlights a need for training professionals about male sexual abuse. 相似文献
4.
Health care providers’ knowledge of and attitudes toward sexuality in older adults may have an impact on the overall quality of care they provide to older clients. One place to begin improving the knowledge and attitudes of health care professionals may be health care educators. If educators have accurate knowledge and positive attitudes, they can help their students acquire accurate knowledge and develop positive attitudes. Forty‐two health care educators in a large community college completed a sexuality knowledge and attitude scale. The study attempted to determine the extent of the educators’ knowledge of sexuality in the aged, their attitudes toward it, the relationship between sexual knowledge and attitudes, and the relationship of knowledge and attitudes to certain personal / demographic variables and professional / experiential factors. The results indicated that the health care educators had limited knowledge regarding aged sexuality but held positive attitudes toward it. No significant relationship was found between knowledge and attitudes. Older health care educators and educators who had participated in continuing education related to sexuality possessed more knowledge about aged sexuality. Educators who rated themselves as more religious held more restrictive attitudes. 相似文献
5.
Sandra L. Elvik Carol D. Berkowitz Elisa Nicholas Jenifer Lindley Lipman Stanley H. Inkelis 《Child abuse & neglect》1990,14(4):497-502
Evaluation of developmentally disabled persons for physical signs of sexual abuse presents many challenges to the practitioner. This group is especially vulnerable to all types of abuse. A group of 35 mentally retarded females from a residential treatment facility was examined by the child abuse medical team at Harbor/UCLA Medical Center after one inpatient was found to be pregnant. Patients ranged in age from 13 to 55 years (median, 26 years; mean, 31.3 +/- 13.6 years). All of the women had some degree of disability, with 24 (69%) being categorized as profoundly retarded. No patient was able to provide a history. There were 13 (37%) patients who had genital findings we believe are consistent with prior vaginal penetration. Dilemmas which arose during evaluation included the significance of healed genital lesions in this population and the implications of the findings for the residential facility. While developmentally disabled persons need an advocate in the medical and legal systems, these patients can overwhelm the practitioner. Whenever possible, a team approach is recommended to decrease the work load and frustration and provide collegial support and affirmation of findings. 相似文献
6.
BackgroundSibling sexual abuse (SSA) is a continuum of childhood sexual behaviors that do not fit age-appropriate curiosity. SSA may be the most prevalent, longest lasting form of intrafamilial sexual abuse – and the least reported, studied and treated.ObjectiveThis exploratory qualitative study examined the experience of intervention with SSA survivors from the perspective of mental health professionals, and explored their major therapeutic challenges.Participants and settingThe sample consisted of 20 Jewish Israeli mental health professionals working in private clinics or public social welfare services who had experience with SSA.MethodsSemi-structured interviews focusing on the characteristics of SSA events, perceptions about the effects of abuse, intervention priorities and therapeutic challenges compared to other types of child abuse.ResultsProfessionals working with SSA survivors are preoccupied with the need to provide them with physical and emotional protection, as well as to help them process the abuse narrative. They also find themselves dealing with survivors who do not experience themselves as victims despite external evidence of abuse, or with the need to reconcile their perception of the sexual relationship as mutual, as opposed to the formal requirement to differentiate between “offender” and “victim”. In either case, the reality of these survivors can be just as painful as in other SSA cases.ConclusionsThe complexity of SSA calls for unique intervention skills, including working with survivor narratives that do not fit the victim/offender dichotomy on one hand and that do not minimize the potentially harsh consequences of SSA on the other. 相似文献
7.
Amanda S. Pitceathly James W. Chapman 《International journal for the advancement of counseling》1985,8(3):173-181
Issues relating to sexuality, marriage, and parenthood of mentally retarded people are discussed in the context of normalization. Negative attitudes towards the manifestation of sexuality by mentally retarded people are considered, along with studies which demonstrate that many such individuals are capable of meaning ful sexual behavior, and meaningful interpersonal relationships that may culminate in marriage and child rearing. It is urged that counselors have an important role in assisting mentally retarded individuals attain their rights to sexual activity, marriage, and parenthood. Attention is drawn to teaching techniques for use in sex education programs for mentally retarded people, and examples are presented of programs which deal with psycho-sexual development, marriage, parenthood, and sexual problems and dysfunctions. 相似文献
8.
OBJECTIVE: This study aimed to examine the level of sexual abuse knowledge and self-protection skills in a sample of female Chinese adolescents with mild mental retardation. It was hypothesized that the participants would exhibit impoverished knowledge on sexual abuse and related self-protection strategies. METHOD: A total of 77 female Chinese adolescents aged from 11 to 15 years old who met the inclusion criterion of the study were recruited from four special schools for mental retardation. The Chinese versions of the Personal Safety Questionnaire and the "What If' Situation Test (Wurtele, 1990) were administered orally to the participants during individual interviews. RESULTS: Participants were more able to accurately recognize inappropriate than appropriate touches and sexual requests, and possessed limited information about sexual abuse. They were also inadequate in protecting themselves against sexual abuse, and had the most difficulty in reporting the sexually abusive incident and characteristics of the offender. Regression analyses also showed that their sexual abuse knowledge was the best predictor for self-protection skills. CONCLUSION: The present findings provided strong cross-cultural support to previous Western studies that found females with mild mental retardation of high risk to sexual abuse and in need of specially designed prevention program to enhance their competency against sexual victimization and exploitation. With modification and refinement, measurement scales used in the Western general population could be extended to Chinese adolescents with mental retardation. Suggestions on the design of the sexual abuse prevention programs, limitations of the present study, and recommendations for future studies were also discussed. 相似文献
9.
The increasing rate of child abuse and neglect is a special concern for educators who are legally mandated reporters of suspected maltreatment, are often the first to identify and refer children who have been harmed, are in contact with parents and are aware of the family conditions contributing to child maltreatment, and who must often work closely with other professionals in their efforts to support child victims and prevent further abuse. Moreover, children's emotional or behavioral problems, learning disabilities, or other difficulties often reflect broader problems that are associated with abuse or neglect. Consequently, understanding the causes and consequences of child maltreatment, and contemporary child protection efforts, is essential to educators in their efforts to assist victimized children. This article surveys current research on child maltreatment with particular attention to the challenges of child protection, the multidimensionality of child maltreatment (distinguishing physical abuse, physical neglect, sexual abuse, and psychological maltreatment), and hopeful new avenues for prevention. The implications of this research for educational professionals are emphasized. 相似文献
10.
Mounting evidence indicates that emotional maltreatment is at least as harmful as physical and sexual abuse. Notwithstanding their high occurrence among detained adolescents, the link between emotional maltreatment and mental health problems in these youths is not well researched. This study, therefore, was designed to examine the unique link between emotional maltreatment and mental health problems, with particular attention to gender differences. Well validated self-report measures of maltreatment experiences (Childhood Trauma Questionnaire) and mental health problems (Youth Self Report) were completed by 341 detained adolescents (156 boys, 185 girls) aged 12 to 18 years. As expected, girls reported higher levels of maltreatment experiences and internalizing and externalizing mental health problems than boys. Blockwise multiple linear regression analyses indicated that in both genders emotional abuse was uniquely and positively associated with internalizing and externalizing mental health problems, over and above the influence of other types of maltreatment. Furthermore, sexual abuse was uniquely related with internalizing problems in girls only, whereas only in boys this type of abuse was uniquely related with externalizing problems. Detained adolescents who have been the victim of emotional abuse in combination with another type of maltreatment may be the worst subgroup in terms of mental health problems. Therefore, emotional maltreatment experiences in adolescents who offend should receive more research and clinical attention. 相似文献
11.
Retrospective case study analysis was done to determine the number of persons retarded due to child abuse and neglect. Analysis was made of 436 cases of mental retardation diagnosed between 1957 and 1973 by a multiprofessional team in Anchorage, Alaska. Independent analysis was made by the two authors using predetermined criteria of maltreatment and reliability of data. Sixty-five of 436 (14.9) cases had evidence of abuse and neglect prior to identification of their retardation. Higher rates of abuse and neglect were found among native Alaskans (Aleuts, Eskimos, and Indians) than Caucasians. Higher rates of abuse and neglect were found among females than males of the mentally retarded population.Paucity of reported studies of abuse and neglect as causes of mental retardation is discussed. It is concluded that abuse and neglect are preventable, but underappreciated, causes of mental retardation. 相似文献
12.
Jason J. Burrow‐Sanchez William R. Jenson Elaine Clark 《Psychology in the schools》2009,46(3):238-245
Experimentation with substances is typical for many young people, but unfortunately some will go on to develop substance abuse problems that substantially affect their lives. Successfully intervening with students who use or abuse substances is a challenge for school mental health professionals across the nation. There is a need for evidence‐based practices that school professionals can use when working with students who have substance abuse problems. This article provides school professionals in secondary settings with current information on student substance use rates, evidence‐based individual and group interventions, and discussion of the 42 Code of Federal Regulations, Part 2 (42 CFR). © 2008 Wiley Periodicals, Inc. 相似文献
13.
OBJECTIVE: This study aimed to establish the views of a group of mental health professionals from various disciplines working in mental health service in a British hospital about the needs of clients who had experienced childhood sexual abuse. METHOD: Staff members were asked to complete an anonymous survey which asked questions relating to knowledge of sexual abuse and its effects, and the needs of clients and staff in working with this client group. A total of 54 people responded to the survey, 42 were female, 11 male. Most (72%) reported having over 10 years experience working in mental health, working in both in-patient and out-patient settings. RESULTS: While respondents were reasonably knowledgeable about childhood sexual abuse, they were not very comfortable, competent or supported in their work with this client group. There were no differences in responses according to the age or gender of respondents, but less experienced staff were more likely to feel supported. Those that had received training and/or supervision felt significantly more capable in working with this client group. CONCLUSIONS: The study offers some support for the development of specialist training, consultancy and supervision programs for mental health staff in the area of child sexual abuse. 相似文献
14.
Jonathan Willis 《British Journal of Special Education》2018,45(2):172-191
This article examines how the use of restrictive physical interventions (RPIs) for pupils within a social, emotional and mental health (SEMH) special needs primary school relate to teacher professionalism. The dialogue is written from the perspective of the headteacher of such a school. It is a personal response to the suggestion that teachers are sometimes reluctant to identify themselves as professionals, and examines the extent to which RPIs cast them as carers rather than educators. The discussion addresses the question: To what extent does the use of RPIs in a SEMH special needs school constitute an aspect of teacher professionalism, and what shape does this take? The work concludes with the suggestion that the use of RPIs transcends any debate about professionalism, and that those working in the SEMH field need to focus their attention on ensuring these acts are conducted in a manner that meets the needs of the pupils. 相似文献
15.
A total of 295 child protection workers, law enforcement officers, mental health practitioners, and physicians were surveyed to ascertain their uses of the anatomical dolls in child sexual abuse evaluations and their interpretations of young children's interactions with the dolls. The dolls enjoy fairly wide use among all four professional groups although most professionals employing the dolls have had little specific training in their use. Law enforcement officers were significantly less likely than the other professionals to view children's demonstrations of sexual acts with the dolls as convincing evidence of sexual abuse. There was no behavior (e.g., undressing the dolls, touching the dolls' genitals) which all professional groups unanimously agreed would be normal play behavior by young children ages 2-5, who had not been sexually abused. Results highlight the need for training resources and normative research. 相似文献
16.
A positive, nonjudgmental, and informed approach to sexual health during pregnancy promotes acceptance of the normal functioning of women's bodies. It also encourages the development of close and supportive relationships that are so essential during pregnancy and birth. Common concerns do not need to become problems. Concerns include issues of libido, positioning, and preterm labor or fetal health, as well as myths and cultural attitudes. Childbirth educators can use tools such as the PLISSIT model to approach the topic of sexuality during pregnancy. In addition, opportunities are available in every childbirth class to acknowledge or ignore sexual issues. Perinatal educators who take responsibility for addressing this often-taboo topic can enhance women's feelings of safety and their confidence in normal birth. 相似文献
17.
18.
This article compares multiple types of child maltreatment among Puerto Rican youth. We seek to expand the limited knowledge of the effects of multiple types of maltreatment on depressive symptoms in a specific Latino population as emerging studies indicate that children who are exposed to one type of maltreatment are often exposed to other types. This study examines the predictive strength of different and multiple types of lifetime child maltreatment (i.e., physical, sexual, and emotional abuse; and neglect), and the effect of youth support from parents, youth coping, youth self-esteem, and place of residence on depressive symptoms among Puerto Rican youth. Secondary data analyses were performed using three annual waves (2000–2004) of data from the Boricua Youth Study. The analytic sample consists of 1041 10–13 year old Puerto Rican youth living in New York and Puerto Rico. Results indicate that: (1) youth who experienced ‘sexual abuse only’, ‘multiple maltreatment’ (2 or more types of maltreatment), ‘physical abuse only’ have a significant increase in depressive symptoms (75.1%, 61.6%, and 40.5% respectively) compared to those without maltreatment; and (2) place of residence, exposure to violence, and mental disorders were significant risk factors. When developing psychosocial interventions, professionals should particularly focus on youth who report past lifetime experience with child maltreatment. Particular attention should be given to children living in the Bronx, New York and similar urban low-income areas who report past lifetime experience with multiple types of child maltreatment and who present symptoms or a diagnosis of co-occurring mental health problems. 相似文献
19.
The 2005–2008 Australian National Sexually Transmissible Infections Strategy identifies young people as a key target group in need of sexual health education, screening and management. For young people who are in contact with the New South Wales (NSW) juvenile justice system, a dire need for remedial sexual health education exists. NSW young offenders indicate initiation of sexual activity at a younger age than their peers, higher numbers of sexual partners, infrequent condom use and higher rates of sexually transmitted infections. They also report family instability, poor accessing of health services, and low school attendance: all factors that result in poor sexual knowledge and health outcomes. An examination into the cognitive profile of these young offenders indicates remedial education for this group may require a dual approach in order to redress their specific circumstances and needs. The first approach should target young offenders who simply missed out on stages of sexual health information in the school curriculum. The second approach requires a tailored teaching methodology more appropriate for a group with atypical cognitive profiles. Both approaches need to engage an educative model that acknowledges that these disadvantaged young people are already sexual active; and that many did not have the benefit of an informed or consensual decision making processes. More importantly, the tailoring of a sexual health education program to these young people needs to resonate with teaching to a cognitively distinctive population who have experienced higher than usual rates of alcohol and other drugs abuse, and higher than usual episodes of physical and emotional abuse and neglect. 相似文献
20.
School professionals have a unique vantage point for identifying child maltreatment and they are a frequent source of referral to child protective services. Disturbingly, past studies have found that maltreatment concerns reported by educators go unsubstantiated by child protective services at much higher rates than suspected maltreatment reported by other professionals. This study explores whether there are systematic differences in the characteristics of cases reported by educators as compared to other professionals and examines whether such variation might account for differences in investigation outcome. Analyses were based on 7,725 cases of suspected maltreatment referred by professionals to child protective services from the Canadian Incidence Study of Reported Child Abuse and Neglect – 2003 a national database on the characteristics of children and families investigated by child protective services. School professionals were responsible for 35.8% of professional referrals. Reports by educators were much more likely to be unsubstantiated (45.3%) than those by other professionals (28.4%) in subsequent child protective investigation. Cases reported by educators were found to contain significantly more child risk factors (e.g., child emotional and behavioural problems) and fewer caregiver and family risk factors (e.g., caregiver mental health problem, single parent family) than cases reported by other professionals. Even controlling for these differences, educator-reported concerns were still 1.84, 95% CI [1.41, 2.40] times as likely to be unsubstantiated as reports from other professionals. Contrary to the notion that educators are mostly reporting non-severe cases, suspected/substantiated cases reported by school professionals were more likely to be judged as chronic and more likely to involve families with a previous child protection history. Results are concerning for the capacity of the education and child protection systems to work together to meet their shared goal of promoting healthy child development. Additional research is needed on the way in which child risks and problems influence child protective service, particularly in the context of chronic abuse and neglect and lack of availability of child and family mental health interventions. Potential problems with credibility of school professionals as reporters of child maltreatment concerns also warrant further investigation. 相似文献