• The effectiveness of social group work with head trauma rehabilitation patients

      Futeral, Susan Todd; Ephross, Paul H. (1993)
      This study investigated the relationship between the use of social group work methods and self-esteem of closed-head injured adolescents and young adults. Head injury is damage to the brain as a result of traumatic injury. There are approximately 3 million head injuries each year, resulting in 30,000 deaths. Head injuries are often caused by vehicular accidents, falling objects, gunshot wounds, sharp instruments, or projectiles. The lengthy psychosocial rehabilitation period of head injured persons is often complicated by the combined effects of the pre-injury history as well as the post-trauma physical and psychological changes. The study was conceptualized as action research. The design of this study was a pre-test/post-test design using multiple group comparisons. Trained social workers collected data in group interviews, and patients completed self-report questionnaires. The instruments used were the Rosenberg Self-Esteem Scale, the Piers-Harris Self-Concept Scale, and an exit interview. The sample size was 25 outpatients and 25 community persons, which had sustained head injuries. The theoretical frameworks are symbolic interactionism and social group work theory. The study sought to develop findings which may contribute to clinical social work practice, theory, group work, and related fields. The goal of the study was to add to the present body of knowledge about effective treatment of head trauma patients. The experimental and comparison group members were matched on demographic variables of age, race, gender, residence, etc. One of the most significant differences of the demographic variables studied was the level of education, specifically that the participants in the comparison group completed more years of formal education than the participants in the experimental group. Both groups were matched similarly in their pre-test scores on the Piers-Harris and Rosenberg scales and both groups showed improvement in the desired direction over time. Using T tests to compare the pre-test to post-test scores, the following differences were statistically significant: the total Piers-Harris score, three subscales of the Piers-Harris (the Behavior, Intelligence and Anxiety subscales), and the Rosenberg scale. Overall the hypothesis that group work enhances self-esteem was supported by this study. In conclusion, this author advocates the use of group work for head trauma recoveries as an effective therapeutic intervention to increase group members' self-esteem. This study has implications for future research for inpatient and outpatient settings.
    • Healthcare Provider Communication with Young Adults: Patient-Centered Communication, Patient Satisfaction, Patient Trust, Social Support, Self-Care Skills, and Emotional Well-Being

      Nichols, Helen M.; Sacco, Paul; 0000-0002-6782-0869 (2018)
      Patient-centered communication is critical to the delivery of quality healthcare services. Although numerous health outcomes have been connected to patient-provider communication, there is limited research that has explored the processes and pathways between communication and health. Research among young adults (ages 26-39 years) is even more scarce, despite findings that health communication does vary with age. This study used data from the 2014 Health Interview National Trends Survey to (1) test a scale of seven items measuring patient-centered communication among young adults age 26 to 39 and (2) explore the relationship between patient-centered communication, patient trust, patient satisfaction, social support, self-care skills, and emotional well-being among young adults age 26 to 39. Exploratory and confirmatory factor analyses were conducted and results showed that a one-factor model of patient-centered communication among young adults fit the data well. In the final regression model, income, history of depression diagnosis, patient-centered communication, patient trust, social support, and patient self-efficacy (self-care skills) were all significantly related to emotional well-being. Post-hoc analyses showed that self-efficacy and patient trust modify the association between general health and emotional well-being. Among respondents who reported poor overall health, increases in self-efficacy and trust in their provider are associated with corresponding improvement in their predicted emotional well-being. This is in contrast to respondents who reported excellent overall health, for whom an improvements in self-efficacy and trust did not have the same effect on predicted emotional well-being. There was a significant interaction between depression and self-efficacy, as respondents who reported being diagnosed with depression showed a stronger relationship between self-efficacy and greater predicted well-being. Post-hoc analyses also showed significant interactions between patient-centered communication, satisfaction, and social support. Respondents who reported lower levels of PCC, showed decreased predicted emotional well-being as their satisfaction and perceived social support increased. These findings suggest the need to explore the means through which communication can impact emotional well-being, specifically among young adults who are in poor health or have a history of depression. Future research should also include longitudinal studies, in order to determine causality and directionality among constructs.