Wellness in Chronic Care (WCC) families, illness & disability: an integrative clinical intervention model.

This paper describes the Wellness in Chronic Care (WCC) model, an innovative integrative clinical intervention method aimed at helping social workers manage the care of patients living with chronic illnesses and their families. The goal is to propose appropriate clinical responses to the changing reality of the health system. This new reality poses new challenges that require caregivers (social work practitioners and family members) to develop suitable skills and expertise. The intervention method we developed offers a new paradigm that entails partnership and the need to assume responsibility in decision-making while coping with the illness over time. The intervention provides practical tools and methods for coping and managing the illness. These factors have contributed to building a specifically tailored intervention program for patient and family care to achieve an effective and meaningful wellbeing. An assessment of the training program of the intervention model and its implementation is presented. The model was found to be essential yet some found it difficult to make the needed changes.

Breaking through the silence: the experience of living with HIV-positive serostatus, and its implications on disclosure.

AIDS has reached pandemic proportions and despite advances in medical treatment both the medical and social consequences of HIV-positive serostatus continue to be of concern throughout the world. In countries with greater access to antiretroviral therapy (ARV), HIV/AIDS it is no longer defined as fatal, but rather a chronic disease, thereby this study seeks to understand the experience of individuals living with HIV-positive serostatus, a multifaceted disease, from the time the infection is diagnosed through the four post-diagnosis years, and in particular its implications on the issue of disclosure. A qualitative analysis was conducted, based on 13 in-depth interviews with participants who are HIV-positive and the data was analyzed by inductive content analysis. The results identify six themes, four central elements that compose the experience of living with HIV: the emotional experience, the stigma attached to HIV, the inner dialogue, and disclosure. A three-phase coping process and personality differences were found, all of which will be discussed. The issue of disclosure was found to be cardinal and problematic in its impact on the patient's wellbeing.

The relationship between sense of coherence and attribution of responsibility for problems and their solutions, and cessation of substance abuse over time.

The present study deals with personal and psychological characteristics of addicts coping with abstinence from drugs in various stages of recovery. The study focuses primarily on two personal variables: attribution of responsibility for the problem and its solution, and the sense of coherence. Additional factors that were examined in the study are demographic variables, which include those related to drug addiction. The sample included 128 short-term abstinent patients in the early stages of recovery after detoxification, and 40 long-term abstinent former addicts, who have abstained from the use of drugs for two to eight years. The results indicate a higher level of sense of coherence among the long-term abstinent subjects relating to their inner resources. On the other hand, much similarity was found between the groups in relation to the attribution of responsibility variable. In both groups, the majority reports that they attribute responsibility for the solution of the problem to themselves. The findings underscored the significant link between personality variables and coping with the processes of recovery, while an analysis of demographic and addiction variables did not show a significant distinction between the group of long-term abstinent subjects and the short-term abstinent subjects.