For example, because different etiologies require corresponding therapeutic designs and mechanisms (Spector, 2000; Steefel, 2002), specific support group makeup must consider the need to develop different strategies and methodologies for the following types of patients at a minimum if support groups are to provide equal benefit to all patients:
Elderly Patients and Lifelong Laborers - This group typically presents with psychological issues in the realm of a direct link between their sense of purpose and self-worth and their ability to continue to function productively in their community. Their need for acute medical and ancillary services, particularly in the Longview/East Texas community are often precipitated by chronic physical deterioration from a lifetime of relatively hard labor. Therefore, support group rehabilitation services must address the issues of self-esteem as a function of vocational productivity and lifestyle changes necessitated by medical conditions.
Prime-of-Life Victims of Traumatic Injury - This group typically presents with psychological issues in the realm of life-changing loss of physical function and a direct link between their emotional outlook and the life changes that correspond to their injuries. Whether their need for acute medical and ancillary services, are precipitated by combat wounds received overseas or traumatic injuries associated with vehicular or vocational accidents or sports injuries, their psychological needs, and therefore the design of appropriate support group services differ tremendously from other groups of patients (Clark & Robinson, 2000; Spector, 2000).
Pediatric Patients - This group typically presents with psychological issues in the realm of those associated with all pediatric areas of medical practice including the increased involvement of primary caretakers and extended family. While pediatric support groups require their own methodologies, it is anticipated that some area of direct overlap emphasizing direct interaction between their group support systems and those provided to prime-of-life patients might benefit both groups substantially.
Drug Abusers - This group typically presents with severe psychological, social, and physiological issues...
Their support group needs require very specialized counselors and different methodologies from other patients.
Targeted Population, Eligibility Criteria, and Social Welfare Policy and Legislation:
The targeted population of this project includes the entire spectrum of patients receiving acute medical care and rehabilitation services in connection with the conditions and procedures identified above. In that regard, each category of patient represents its own range of patient profiles by virtue of the specific etiology of disease and physical disability necessitating acute medical services and rehabilitation. Therefore, the approach recommended by this project incorporates an understanding that the structure and processes of support groups may differ substantially even among patients of similar (even identical) underlying pathologies (Steefel, 2002).
Current concerns in the area of social welfare policy and related legislation arise in connection with the ineligibility of rehabilitation services for Medicaid reimbursement, program eligibility criteria that exclude patients with acute medical needs that they cannot afford, and the stringent eligibility and payment policies of the Medicare program. Since the failure of the 75% compliance-to-25% noncompliance proposal of qualified patients with regard to inpatient rehab, current regulations still reflect the 60% compliance-to-40% non-compliance rate that potentially undermines the ability of the institution to provide services to all patients who would benefit from them. It is hoped that the healthcare policies of the new Presidential administration will help rectify this unfortunate limitation.
References
Clark, C., Robinson, T. (2000). "Multiculturalism as a Concept in Nursing" Journal of the Black Nurses Association, 11(2), 39-43.
Spector, R. (2000). Cultural Diversity in Health and Illness (5th ed.). New Jersey: Prentice Hall.
Stanhope, M., Lancaster, J. (2004). Community and Public Health Nursing (6th ed.)
St. Louis: Mosby.
Steefel, L. (2002). "Treat Pain in Any Culture" Nursing Spectrum, 6(5), 8-9.
