positive experiences in care homes can occur and are important for residents' quality of life. The review supports literature highlighting the need for relationship-centred approaches to care and emphasises the importance of understanding the resident's attitude towards living in care homes.
for people with dementia living in care homes, the QUALIDEM is recommended for measuring QoL. For residents without dementia, we recommend Kane et al.'s Psychosocial Quality of Life Domains questionnaire. Studies of higher methodological quality, assessing a wider range of measurement properties are needed to allow a more fully informed choice of QoL instrument.
QoL is a broad, multidimensional construct for residents with MS. QoL measures for residents with MS should incorporate broad domains, including environmental factors. The conceptual model highlighted several areas for improving QoL of residents with MS, including more involvement of family members, encouraging independence by providing access to rehabilitation and providing support in the transition process.
Scope of review: The paper reports a meta‐review of 15 previous systematic reviews and meta‐analyses of the literature concerning the outcome of counselling and psychotherapy with people at risk of suicide; a meta‐analysis of 67 outcome studies in this area; and a narrative review of 17 studies of the therapeutic process. Publication time span: The literature reviewed was published between 1981 and 2008. Publication origin: The majority of the literature reviewed was by authors from the USA or the UK, but there were also authors from other European countries, Australia, Canada, India, and Sri Lanka. Findings: There is evidence of the effectiveness of dialectical behaviour therapy, cognitive‐behavioural therapy, and problem solving therapy, but also for other forms of therapy. Therapist and client variables, as well as the therapeutic relationship, appear to be related to treatment outcome. Conclusions: People at risk of suicide should have access to psychological interventions, including, but not necessarily limited to, those within the cognitive‐behavioural spectrum. Therapies for which there have been promising findings, but which are under‐researched, should be a research priority.
Scope of review: The paper reports a meta‐synthesis of 13 qualitative studies of counselling and psychotherapy with people at risk of suicide. Publication time span: The studies considered were reported between 1997 and 2006. Publication origin: Seven studies were conducted in the UK, four in the USA, one in Canada, and one in Sweden. Findings: Themes in clients' and therapists' accounts of the process of counselling or psychotherapy were therapist qualities; therapy components; theoretical framework; and therapy techniques. Themes in their accounts of the effectiveness of counselling and psychotherapy were decrease in self‐destructive behaviour, and quality of life. Themes in clients' views of barriers to effective counselling or psychotherapy were therapist characteristics; therapy components; secrecy; and transferring to the real‐life situation. Secrecy was also identified as a barrier by therapists, as were responsibilities of the profession; training; and the nature of suicide and self‐harm. Facilitators of successful counselling and psychotherapy as identified by clients were responsibility; support; and teaching therapy skills to family members, the latter also being identified by therapists.
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