In this study, we examine British Columbia’s Hospital Association conference records (1918–31) to understand how place, gender, and profession shaped debates about hospital standardization during the interwar period. The conference records reveal that hospital standardization was conceptualized as the conformity of smaller, peripheral hospitals to larger metropolitan ones. Arguments about how to best address the gaps in small hospitals were often directed to elite nursing leaders, who suggested improved nursing education as a solution. Hospital affiliation was recommended to ensure adequate training for rural nurses by moving trainee nurses from rural to urban hospitals during the last year of their education. Yet the way that affiliation was conceived was more aligned with the professional goals of the nursing elite, rather than the needs of rank-and-file nurses in small hospitals. These ideas ultimately worked to support the goals of standardization, but obscured the divergent needs of small community hospitals.
Aims To appraise the empirical literature on the needs of Indigenous informal caregivers caring for people living with dementia in Indigenous communities. Design Whittemore and Knafl's updated approach to integrative reviews, PRISMA guidelines, and CASP checklists for narrative analysis were followed. Data sources A systematic search of published empirical literature from January 2010 to August 2020 was undertaken in six databases. Review methods Fifty‐one studies met the research question and the inclusion criteria. Results Five themes describe the findings: Decolonizing Western perspectives on dementia, the centrality of cultural safety, caregivers’ experiences, pre‐dementia community education and family and community‐centred care emerged from the thematic analysis. Most of the studies used quantitative methodologies, and few studies were conducted using community‐based approaches. Conclusion This review shows that Indigenous caregiving represents an emerging field in nursing and health sciences in a context of a global crisis. Researchers need to focus on Indigenous values and voices to adapt care and support informal caregivers. Our review emphasizes that working with Indigenous communities will likely translate into new care delivery models, policies and practices to support Indigenous informal caregivers and address the specific social determinants impacting caregivers’ roles and tasks. Impact This review highlights the necessity of having community and family‐based discussions on enhancing the delivery of dementia care for Indigenous peoples in Canada and worldwide. Decolonizing Western perspectives of dementia translate into culturally safe approaches that aim to integrate Indigenous cultural perspectives of holism, reciprocity, wisdom, respect of older people and relationality into nursing practice. The support of Indigenous informal caregivers requires future studies to address the stigmatizing Western views of dementia.
Aims To synthesize research findings about Indigenous perspectives on cognitive impairment and dementia. Design Whittemore and Knafl's updated approach to integrative review and PRISMA guidelines for narrative analysis was followed. Data Sources A systematic search of the published literature from 2010–June 2020 was undertaken in four databases and complemented by supplementary searches. Review Methods Thirty‐four studies met the research question and inclusion criteria. Results Four themes describe the findings. Most of the studies were conducted by non‐Indigenous researchers and may reflect Western perspectives on dementia rather than Indigenous views. A majority of the studies report epidemiological data or the testing of clinical tools. Conclusion The review indicates a dearth of knowledge about Indigenous perspectives on ageing and understanding of cognitive impairment and dementia. Researchers need to draw on Indigenous traditional knowledge, culture, and traditions through a meaningful engagement with Indigenous communities and Elders to indigenize and decolonize dementia care. Impact This integrative review highlights the need for community‐led discussions and community engagement around Indigenous perspectives, needs, and understandings of ageing, cognitive impairment, and dementia care.
Empirically supported risk factors are predictive of sexual re-offense regardless of whether individuals suffer from a major mental illness. A small subgroup of individuals with major mental illness may be more likely to demonstrate acute psychotic symptoms at the time of their sexual offending behavior (Smith & Taylor, 1999). This study reviewed archival data from a high-risk sample to identify 55 individuals with major mental illness who had committed a total of 176 sex offenses. The relationship between acute psychiatric symptoms and criminogenic needs was explored. Most sex offenses were not temporally related to acute psychiatric symptoms. The apparent effect of mental health symptoms on criminogenic factors over the individual’s life was rated. Where acute symptoms were associated with worsened criminogenic factors, this most often involved Grievance Thinking, Poor Emotional Control, and Poor Problem-Solving. Typologies emerged based on the pattern of criminogenic needs along with demographic and offense characteristics. Assessment and treatment implications are discussed.
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