ABSTRACT
@#Quality care is a basic human right and a core foundation for a patient's health, recovery, and well-being. In the current Philippine context, gay and lesbian older persons face gender-care disparities in the caring dynamism. Until now, their care needs are not articulated in the country's basic nursing curriculum. Consequently, the care approach is incongruent, biased, and risky. In response to this gender-care disparity, participatory action research (PAR) was used to identify this cohort's care needs and their meaning by developing a nursing care hub called the ‘Gay Care Center’ for older gays and lesbians. This paper focuses on describing: (a) the current situation of nursing care among the gay and lesbian older persons; (b) the meaning of care needs from their perspective; and (c) the Gay Care Center's tailored approach and services to meet their care needs. Multiple sources were utilized to collect data: focus group discussions, in-depth interviews, and observations. Data were then analyzed using Mayring's qualitative content analysis. Findings revealed that caring practices for older gays and lesbians could only be effective, satisfying, and holistic when the meaning of their individual needs are sensitively listened to, understood, and met. This led to the coined term HUMANistic caring, a new approach that emerged as their preferred mode of care. It is recommended that extensive gender-care training be conducted among gerontological nurses, and this be incorporated in the nursing curriculum to ensure that the provision of care is safe, respectful, humane, and just.
ABSTRACT
@#Spinocerebellar ataxia (SCA) is a rare neurodegenerative disease with progressive course and poor expected outcomes. Therefore, rehabilitation remains the principal form of management especially in advanced disease. Impairment-based rehabilitation through multidisciplinary care approach has proven benefits for functional improvement in individuals with advancing SCA. This concept is based on comprehensive assessments of individualised impairments and functional limitations while exploring contributing environmental and personal factors affecting the person as a whole. From this assessment, individualised rehabilitation goals can be formulated through a multidisciplinary care approach. Neurologists, rehabilitation physicians, physiotherapists, occupational therapists and speech and language pathologists are key individuals involved in the multidisciplinary care for individuals with SCA rehabilitation. Two cases of individuals at different stages of SCA are presented to highlight the rehabilitation approach in providing focused interventions based on individualised impairments through multidisciplinary care. These cases emphasise the importance of understanding the needs of each individuals with SCA so that the rehabilitative therapies prescribed can be tailored to the functional achievements desired.
ABSTRACT
Recent National Mental Health Survey (2015-16) reported a prevalence of 13.7% for any mental disorders excluding tobacco use disorders in India. Translating it into real numbers, nearly 150 million people need active mental health interventions, disproportionately more in rural areas. Major challenges in delivering comprehensive mental health services in rural India are: a) lack of a well-defined strategy; and b) lack of trained mental health manpower. To fill this gap, the global mental health community has increasingly realized the importance of Community Health Workers (CHWs) and role of stepped care approach in mental health service delivery. We propose a model of stepped care approach to fulfil the need of rural India, utilizing the existing health system components for improving mental health knowledge, reducing social stigma for mental disorders, screening for priority mental disorders at community level, ensuring compliance to treatment, timely follow-up, and community-based rehabilitation by mobilising community support for diagnosed cases. This stepped care approach will integrate mental health into Ayushman Bharat’s Health and Wellness Centres (HWCs) for the provision of comprehensive primary health care. Integration of new age technologies such as telepsychiatry, e-health, and mHealth into the proposed model will make it feasible and costefficient for inaccessible parts of the country.