Integrated Supported Employment for People With Schizophrenia in Mainland China: A Randomized Controlled Trial.

OBJECTIVE: In this randomized controlled trial, we investigated the effectiveness of integrated supported employment (ISE) compared with individual placement and support (IPS) and traditional vocational rehabilitation (TVR) for people with schizophrenia in mainland China. METHOD: One hundred and sixty-two participants with schizophrenia were randomly assigned to ISE (n = 54), IPS (n = 54), or TVR (n = 54). Blinded assessments of employment status, job tenure, and psychological outcomes were conducted at admission; completion of the 3-mo program; and follow-up at 7, 11, and 15 mo. RESULTS: Significantly higher employment rate and longer job tenure were found in the ISE group (63.0%, 29.56 wk) compared with the IPS group (50.0%, 25.47 wk) and TVR group (33.3%, 9.91 wk). The ISE group also attained the most positive psychological outcomes. CONCLUSION: Work-related social skills training embedded in ISE with generalization strategies can enhance vocational and nonvocational outcomes for people with schizophrenia in mainland China.

A randomized trial comparing Tai Chi with and without cognitive-behavioral intervention (CBI) to reduce fear of falling in community-dwelling elderly people.

The aim of this randomized trial was to compare the effects of Tai Chi with and without CBI on a primary outcome of reducing the fear of falling, and on secondary outcomes including encouraging better social engagement, improving self-perceived personal wellbeing, and achieving better mobility among elderly people with fear of falling. One hundred and twenty-two community-dwelling elderly people aged ≥ 65 were randomly assigned to either a Tai Chi or a Tai Chi plus CBI group. Participants' level of fear of falling, physical mobility, self-perceived personal wellbeing and social participation were compared before and after completing the 8-week intervention and then at a 2-month follow-up. The findings showed that Tai Chi both with and without CBI had a similar effect on reducing elderly people's fear of falling, but only Tai Chi plus CBI had a positive effect on participants' self-perceived personal wellbeing. Tai Chi both with and without CBI had no effect on participants' self-perceived social participation and mobility. Apart from a slight improvement in participants' self-perceived personal wellbeing, other outcome effects were similar for Tai Chi with and without CBI. This finding raises a question about the additive effects of combined intervention over Tai Chi alone in reducing elderly people's fear of falling. In view of the higher demand for resources and manpower to implement a combined intervention, further study is still required to confirm the potential additional benefits of this combined intervention prior to recommending it to community services.

Student nurses' perception and understanding of elder abuse.

AIM: The aim of this study is to investigate student nurses' perception, knowledge and awareness of elder abuse. BACKGROUND: It is evidential that elder abuse tends to be unrecognized and is often hidden from public awareness. Nurses who work with older people are expected to be knowledgeable of the causes and detection of elder abuse. DESIGN: A quantitative approach using a questionnaire was used to collect data from 245 student nurses from year 1 and 3 of a 4-year bachelor's degree programme. METHOD: Convenience sampling was used to recruit participants from the two cohorts of the nursing programme. A 25-item questionnaire was used to investigate participants' perception and awareness of elder abuse. RESULTS: Some 47.8% (n=86) year 1 students and 76.9% (n=50) year 3 students perceived that they were not well trained in identifying or handling elder abuse. Year 1 and 3 students ranked the top three most common abuses differently. In addition, 38% of year 3 students thought that it was largely the responsibility of social workers rather than nurses, to deal with cases of elder abuse. CONCLUSIONS: The study reveals that nurses-to-be, who are generally expected to be part of the joint force to protect older people against abuse, did not find themselves adequately prepared to fulfil this responsibility. RELEVANCE TO CLINICAL PRACTICE: The findings provide useful information from which more comprehensive content about elder abuse can be developed in the gerontological nursing curriculum, to better prepare future nurses by increasing their basic understanding of elder abuse.