A qualitative study on advocacy for employment in mental health
Notice bibliographique
Résumé
Advocacy is an expectation in health delivery services including occupational therapy (OT) services. Advocacy in health care has been related to assisting vulnerable individuals in protecting them from social exclusion and accessing opportunities. Employment is one of the most valued roles among individuals diagnosed with depression (IDDs), yet unemployment rates are high. The disparity between unemployment rates and desire for IDDs to be employed makes it imperative to investigate advocacy in ameliorating the barriers to employment. Furthermore, advocacy practices need to be clearly defined as lack of clarity in advocacy roles and processes contribute to challenges with implementing advocacy. This qualitative study explores the perceptions of the advocate role and the advocacy process among IDDs and OTs regarding employment related goals. IDDs were interviewed individually and OTs participated in a focus group to explore their perceptions of the advocate role and how the advocacy process is carried out. The recovery model and Canadian Model of Occupational Performance Model & Engagement (CMOP-E) were used as practice models to inform the topic choice. Study results indicate significant differences in expectations of the advocate role and how the advocacy process is carried out. However, there were some similarities in perception, such as the relationship established the foundation of the advocacy process, the advocate role addresses both health and employment issues, and advocacy processes yields outcomes. IDDs and OTs agreed that the advocacy process facilitated change by considering the dynamic interaction between the person, the occupations the IDDs wished to engage in, and the individual’s environments, which is consistent with core elements of the CMOP-E. OTs’ perception of the advocate role was consistent with the core elements of the recovery model of enhancing individual autonomy, facilitating client empowerment, and increasing client responsibility. On the other hand, IDDs felt that the advocacy process was having the advocate speak to others on their behalf, which is not consistent with the core elements of the recovery model. A number of complex issues contributed to why IDDs relied significantly on their advocates, such as 1) mental health stigma 2) previous negative experiences, 3) poor self-esteem and 4) fears related to disclosure of their depression. This study contributes to the existing body of literature as this study describes the advocacy process and advocate role as perceived by IDDs and OTs. The study is unique in design that it is one of the only studies that explores the concept of advocacy from two different perspectives (health providers and health users). Future research is indicated to establish a consistent definition of advocacy and establish a framework for carrying out the advocacy process. A consistent definition and advocacy framework would provide OTs a frame of reference in implementing the advocacy process. Furthermore, advocacy processes at all levels should be integrated into OT scope of practices to further enhance the practice of advocacy.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,016 | 0,018 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,015 | 0,009 |
| Communication savante | 0,004 | 0,005 |
| Science ouverte | 0,002 | 0,007 |
| Intégrité de la recherche | 0,002 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».