Top PDF Community and Mental Health

Community and Mental Health

Community and Mental Health

Moreover, social capital may actually exacerbate the social exclusion of those who are mentally ill in a community. Shaw (2006) drawing on the work of Clark (1992) who explains that “ a sense of security, a sense of significance and a sense of solidarity ” are often seen as ‘ the essentials of community ’ but that these ‘essentials’ may not always be compatible. Shaw explains that “ security for some may be achieved only by the exclusion of others; the ‘belonginess’ associated with solidarity may be constituted through the not- belonging of others; significance may actually signify the reproduction of unequal roles and relations ” (2006; 5). Indeed, activities engaged in promoting better mental well-being in communities can be hampered by the fact that mental illness can carry a stigma; “it tends to be seen as a frightening mystery, coming out of the blue, requiring special treatment, and bringing about a permanent separation between ‘the ill’ and ‘the not ill’” (Cameron, 2003; 8). As such at its worse social capital could contribute to the exclusion of those who suffer mental illness “ social capital is not always ‘a Good Thing’ … it can actively exclude others and not allow new people and different people to become part of a network ” (Kay, 2006; 170).
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Nurses’ Perceptions of Patient Safety in Community Mental Health Settings: A Qualitative Study

Nurses’ Perceptions of Patient Safety in Community Mental Health Settings: A Qualitative Study

In this study, RNs discussed the diversity and complexity of the area of CMHS. They perceived that this could constitute a risk to patient safety by entailing many different actors and possible lapses in professional treatment and communication concerning residents. The RNs perception of this is supported by Hunt et al. [20] saying adverse events and failure of care often depends on lapses in handover practices between staff surround- ing the resident. In this study, it was hard for the RNs to get their voices heard about care quality issues. They felt that they were being left on their own since their sector of care was overshadowed by larger fields of care, i.e. people in CMHS are only a small part of the entire community health care system and that makes it harder to highlight the issues of care quality (patient safety). To work under such conditions has been reported as a threat to patient safety [5] [21] [22]. Another threat to patient safety may be untrained staff; in this study, only half of the RNs had a formal degree in mental health care and the enrolled nurses at the CMHS had nursing training at the upper secondary school level, though not always specialized in mental health care. This also seems to be the case in other countries; a literature review [11] showed that in the USA social workers and staff without mental health qualifications performs similar roles. Key ways to ensure safe mental health care are ongoing training in, for example, psychiatric assessment, breaking down the stigmas surrounding mental ill health, and provision of safe patient care by all involved staff [5].
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Quality of Community Life and Mental Health in Slums

Quality of Community Life and Mental Health in Slums

sense of urgency to build both bonding and bridging capital in the mentally unwell. [5] The main social risk factors for mental ill health are long-term difficulties, negative life events and lack of social support to buffer, or reduce, the effects of such difficulties and events. [6] Further, the relationship between QoL and mental health is a two-way process as studies that describe risk factors affecting resilience of caregivers and their families have noted that the paucity of accessible, available and affordable mental health services can unfavourably alter outcomes. [7] Satisfaction with many community services tend to impact community well-being directly and through satisfaction in various life domains.
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D12 Community Mental Health Forum: Survey of Service Users' Views

D12 Community Mental Health Forum: Survey of Service Users' Views

The Dublin 12 postal district is the locality which marks out the catchment area of the D12CMHF. This geographical area is located on the south side of Dublin City and stretches from a section of the central district of Dublin to where it meets the suburban areas of Dublin at the foothills of the Dublin Mountains. It includes the localities of Drimnagh, Crumlin, Walkinstown, Greenhills, Kimmage and parts of Terenure and Templeogue Limekiln. The Dublin 12 area is served by two sectors within the Health Service Executive Dublin South Central Mental Health Service, namely, The Crumlin Mental Health Service and the Drimnagh Mental Health Service. Within the Dublin 12 area there are a number of premises and centres from which different mental health services and community supports are provided. These include a wide variety of therapeutic, counselling and group support services as well offices of the members of the wider multi-disciplinary mental health team. Within the area are also found Day Hospital services, the Home-Based Treatment service, the Psychiatry of Old Age Team and the Mental Rehabilitation Team. The services are not static but continue to grow and develop.
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Promoting recovery and addressing stigma: mental health awareness through community development in a low-income area

Promoting recovery and addressing stigma: mental health awareness through community development in a low-income area

There is a clear argument that mental health service users should lead the work, challenging stigma and dispelling stereotypes through their personal knowledge and experi- ence. The evidence suggests that the best campaigners against discrimination are those who can challenge it per- sonally and directly. Link et al (1989) found that people with mental health problems working collectively to address stigma were more likely to be effective. In addi- tion, a study by Penn and Martin (1998) demonstrates that the most effective methods for reducing stigma involve promoting contact between the community and people with mental illness. The involvement of service users in the delivery of anti-stigma training programmes is one way of promoting positive contact.
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Mental Health Outreach at Community Behavior Health Centers

Mental Health Outreach at Community Behavior Health Centers

Background: Major Depressive Disorder (MDD) is considered to be one of the most common inca- pacitating psychiatric diseases. A pharmacist interacting with patients has the potential to en- hance compliance, ensure proper medication use, and monitor adverse effects that will ultimately improve patients’ quality of care. Methods: The primary objectives of this study were to 1) assess individuals’ knowledge of depression before and after a 30-minute educational intervention and 2) measure satisfaction with the program. The pre- and post-test consisted of 11 identical questions that assessed individuals’ knowledge regarding depression. The survey consisted of four ques- tions that rated program satisfaction. Results: Although 82 individuals participated in some aspect of the program, 56 individuals completed the program requirements and were included in the da- ta analysis. Four hundred and eighty six of the total 616 (56 participants × 11 questions) pre-test questions (79%) were answered correctly at the beginning of the program. A total of 556 post-test questions (90%) were answered correctly at the conclusion of the program, with an overall in- crease of 70 (p ≤ 0.001) more correct answers. Correct responses to five questions were statisti- cally significant for improved post-test scores: Over-the-counter or herbal medications will inter- fere with your medication (p = 0.01); certain foods can interfere with medications that affect mood (p = 0.01); it is safe to use multiple pharmacies to get your medications (p = 0.001); the main chemical of the brain that is not balanced in depression (p ≤ 0.001); and the most common type of medication for depression (p ≤ 0.001). Overall, 95% of participants would recommend the pro- gram to a friend or family member. Conclusion: The data from this program supports that phar- macists can have a positive impact in the mental health field and satisfaction with such services in the community.
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Integrated mental health care in a multidisciplinary maternal and child health service in the community: the findings from the Suzaka trial

Integrated mental health care in a multidisciplinary maternal and child health service in the community: the findings from the Suzaka trial

had any other psychosocial problems using the psycho- social screening questionnaire, with the aim of develop- ing a relationship between the Suzaka City public health service and the pregnant women and making it easier for them to utilize the public health services if they had any concerns about the pregnancy and child care. The psychosocial assessment sheet included the Japanese ver- sion of the Edinburgh Postnatal Depression Scale [14, 15], as well as the risk factors of postnatal depression identified by a Japanese epidemiological study [16]. The public health nurses carefully followed up the women based on the results of the interviews. The intervention program, developed by two psychiatrists (YT and NK) and two pub- lic health nurses (CA and HT) from Suzaka City [16], pro- gram aimed to provide continuous support to the mother and child from the start of pregnancy and after childbirth. In keeping with the NICE guidelines [17], it consisted of a multidisciplinary clinical network which had the following four features: a) it provided multidisciplinary perinatal ser- vices, including consultation and advice from maternity, mental health and community services; b) pregnant women and breast-feeding women could access advice on the risks and benefits of consuming psychotropic medica- tion during the perinatal periods from psychiatrists and obstetricians; c) it had clear referral and management
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Community mental health in India: A rethink

Community mental health in India: A rethink

Background: Community care of the chronic mentally ill has always been prevalent in India, largely due to family involvement and unavailability of institutions. In the 80s, a few mental health clinics became operational in some parts of the country. The Schizophrenia Research Foundation (SCARF), an NGO in Chennai had established a community clinic in 1989 in Thiruporur, which was functional till 1999. During this period various programmes such as training of the primary health center staff, setting up a referral system, setting up of a Citizen's Group, and self-employment schemes were initiated. It was decided to begin a follow up in 2005 to determine the present status of the schemes as well as the current status of the patients registered at the clinic. This we believed would lead to pointers to help evolve future community based programmes.
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Perception of community pharmacists in Malaysia about mental healthcare and barriers to providing pharmaceutical care services to patients with mental disorders

Perception of community pharmacists in Malaysia about mental healthcare and barriers to providing pharmaceutical care services to patients with mental disorders

The aim of this study was to assess community pharmacists’ (CPs) perceptions toward mental healthcare, and the barriers faced in providing pharmaceutical care (PC) services to these patients. A 40-item survey was posted to CPs. Ninety-six phar- macists participated. The majority (84.2%) agreed there is a role for CPs to play in mental health care, while approximately 60% agreed it is their responsibility to provide PC to these patients. The biggest barrier to providing this service is the lack of knowledge, cited by close to 50% of respondents. This corresponds with the revelation that close to 60% believe that they have a poor or fair understanding of mental disorders. About 30% of respondents said they do not stock psychotropic drugs at all, mainly due to medico-legal reasons, and low prescription requests. Our findings highlight the need for more training of CPs in managing patients with mental disorders.
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Mental Health in Museums :  Exploring the reactions of visitors and community groups to mental health exhibitions

Mental Health in Museums : Exploring the reactions of visitors and community groups to mental health exhibitions

However, it is argued that self-reflexive processes and a willingness to secede power to communities do not ensure effective collaboration with mental health communities. Museums may also benefit from taking into account the range of specific emotional needs of the mental health community participants they engage. These can include an acknowledgement, and active decision by museum staff, to accommodate for the fact that community participants may require flexible working hours that do not match institutional standards. Likewise, participants may need extra formal support while working on projects about their mental illnesses, or have specific requirements about where the collaboration occurs. Museum work with mental health participants that does not take sufficient stock of these needs, and which does not actively pledge to allow participants to discuss the topic of mental health openly and honestly, runs the risk of re-entrenching the stigmatised outcomes that collaboration was designed to remedy; a point taken up further in Chapter Five. It is for this reason that museums might wish to commit to working through the difficult emotions that inevitably arise when working on a topic that involves elements of abuse and immense suffering. The sensitivity and resolve that such an approach demands from museum staff is difficult to achieve. This almost inherently requires an ethical belief by museum staff that community work is a core function of taxpayer-funded museums and that museums possess an ethical obligation to be relevant to the communities that they purport to serve. This does not suggest that curators must cede away their curatorial control. It does mean, as shown in Chapter Five, that curators who are willing to think outside of traditional ways of curating are more likely to develop mutually beneficial ways of creating exhibitions. These, in turn, must satisfy the desire of certain community groups to express their views on mental health and illnesses, including its unpleasant and difficult aspects, in an open and honest manner.
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Training community mental health staff in Guangzhou, China: evaluation of the effect of a new training model

Training community mental health staff in Guangzhou, China: evaluation of the effect of a new training model

As the provincial capital of Guangdong Province, Guangzhou’s community mental health services have a history of more than half a century. To improve the mental health service status in Guangzhou, Guangzhou Brain Hospital has been in charge of training commu- nity mental health staff for a decade and held more than 10 training courses [15]. However, for the commu- nity mental health staff, the traditional training curricu- lum was based on an individual approach, while the public heath approach was lacking. Thus we could not develop effective community mental health services in real situations. Among them, from public health’s point of view, the clinical approach could not offer appropri- ate training courses for community mental health staff [16]. In order to better deliver mental health services, we are now developing the “Guangzhou model” in the field of community mental health (which also named “PTSA”: Policy, Training, Services and Assessment).
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Community based mental health treatments for survivors of torture and militant attacks in Southern Iraq: a randomized control trial

Community based mental health treatments for survivors of torture and militant attacks in Southern Iraq: a randomized control trial

Among the mental health therapies for adult survivors of systematic violence that have been evaluated and in- cluded in review articles, most assessed PTS as the pri- mary outcome [11–15]. Cognitive behavioral therapy (CBT), narrative exposure therapy (NET), testimony ther- apy (TT), and/or exposure therapy have been the most frequently studied interventions. One review of treatment for refugees and asylum-seekers found support for the ef- fectiveness of CBT and NET [11]. Another found support only for trauma-focused treatments [12], and a third con- cluded that exposure-based and CBT-based treatments both showed effectiveness [13]. Prominent across all these reviews were cautions in interpretation due to methodo- logical limitations in the studies reviewed, such as non- random allocation to treatment, lack of controls, and small sample sizes. Given the comorbidity documented among survivors of systematic violence, a recent review of interventions expanded its search beyond participants with just PTS to include a broader population of adults with histories of trauma and/or torture [15]. Of the mul- tiple types of research designs reviewed by McFarlane et al., the authors reported only 11 randomized control trials (RCTs) which examined individual psychotherapies specif- ically targeting PTS symptoms (NET, CBT, TT and expos- ure therapy) or healing workshops (1 study) among resettled refugees (5 studies), asylum seekers (1 study), displaced persons (2 studies), and survivors residing within their country of origin (3 studies) [15]. Overall, the RCT-evaluated therapies were effective in reducing PTS symptoms but less consistent in reducing depression or other trauma-related symptoms. This review also highlighted a need to address symptoms beyond PTS and for more rigorous research studies of treatments for tor- ture survivors.
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Maternal mental health priorities, help seeking behaviors, and resources in post conflict settings: a qualitative study in eastern Uganda

Maternal mental health priorities, help seeking behaviors, and resources in post conflict settings: a qualitative study in eastern Uganda

We then conducted a second round of key informant interviews with a subset of the community and primary health workers who participated in the free listing inter- views and traditional healers who participated in the initial key informant interviews. Health workers and healers were selected if they provided rich information about the mental health needs in their sub-counties. We also con- ducted key informant interviews with two older (more ex- perienced) perinatal women from each sub-county. These women were recruited by health care workers and selected based on their ability to read and their experience with the antenatal care system, as determined by their age and number of previous births. Because free listing resulted in several terms that seemed closely related, we added a pile sorting activity to these key informant interviews. Pile sorting was intended to increase our understanding of how participants would classify various symptoms. Partici- pants were provided with notecards with names of symptoms (in both Ateso and English) derived from de- scriptions of the three prioritized maternal mental health problems. Participants were asked to sort the cards into piles that made sense for them, in as many or few groups as they preferred, and to name to each pile. These key informant interviews subsequently focused on different idioms of distress used to describe the three prioritized maternal mental health problems; symptoms belonging to these problems; and groups of women particularly affected by them. Finally, participants were asked about the causes of the top three problems and possible solutions for each
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Celebrating our Cultures: Guidelines for Mental Health Promotion with Black and Minority Communities

Celebrating our Cultures: Guidelines for Mental Health Promotion with Black and Minority Communities

To offer a culturally appropriate and supportive space to ethnic minority women, including women of mixed parentage, experiencing any form of mental illness or emotional distress. Project description: The Women of Colour Project meets one day a week, providing a woman only space and free and confidential support and information, at present available in English, Urdu and Punjabi. Women do not need a referral or a specific diagnosis – the group is for anyone who is feeling lonely, isolated, depressed or who wants some support in a welcoming, culturally aware environment. Lunch is prepared by members of the group and is available at minimum cost. A number of activities are planned, including art and creativity, day trips, cooking together. One group member is planning to write and present a play around women’s experiences in the African Caribbean community. Support with child care costs is available. For women unable to leave their home, the project also provides an outreach service, visiting women at home. Project workers go into local colleges to work with young people and let staff know about the service, and also visit hospital wards and link up with ward staff so that women hear about the project before they are discharged. Consultation: Consultation took place with statutory organisations and with the local community to identify need.
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Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN)

Achievements in mental health outcome measurement in Australia: Reflections on progress made by the Australian Mental Health Outcomes and Classification Network (AMHOCN)

Our efforts to equip the mental health workforce to col- lect and use outcome data began with the development of basic training materials that described the administra- tion of the MH-NOCC suite of measures. These materi- als built on a range of pre-existing documents, including manuals [23-25], glossaries [26], policy documents and technical reports [27-29]. We aimed to make the new materials nationally consistent, but this presented chal- lenges. Although there was a national data collection protocol, there was no agreement as to which con- sumer-rated measure should be used and the protocol had been modified in some states/territories (e.g., NSW had elected to collect the Kessler-10 ( K-10) in inpatient settings, despite the national protocol only requiring col- lection in community settings) [15]. Our solution was to develop a core set of training materials (structured around age group and service setting) that could be modified to meet local needs.
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Policing and street triage

Policing and street triage

The policy of deinstitutionalisation -i.e. the closure of the large asylums and their replacement by community based mental health services - has been followed across Europe and North America (Cummins, 2011). The failure to develop adequate community mental health services and the impact on individuals is well documented (Moon, 2000, Kelly, 2005 and Wolff, 2005). One impact of these failings has been for the police and CJS to become de facto providers of mental health care (Lamb et al 2002). This is the case across a number of jurisdictions. Wood et al (2011, 6) show US police have become “front-line workers who often come into contact with persons with mental illness and must respond to their needs with whatever tools lie at hand (emphasis added)” This is reflected in the Australian context. Godfreson et al (2011) concluded that responding to mental health related incidents was a significant part of the working week for most officers. It is an area that police officers feel unprepared for by the current training (Cummins and Jones, 2010). The IPCC role in investigations of serious incidents and deaths in custody means that officers can feel very exposed. The impact on individual officers who are involved in such cases is not to be underestimated. This is a reflection of wider organizational cultures. As Pollitt and Bouckaert (2011) suggests the audit culture with an emphasis on risk and risk management that the new style of public
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“Always paracetamol, they give them paracetamol for everything”: a qualitative study examining Eastern European migrants’ experiences of the UK health service

“Always paracetamol, they give them paracetamol for everything”: a qualitative study examining Eastern European migrants’ experiences of the UK health service

This difference in ethos and approach to healthcare is causing distrust between the Eastern European population and their GP thus creating barriers to primary care, which could also deter patients from accessing other healthcare services. Sime et al. [29] found a similar experience when talking to health professionals and recent Eastern Euro- pean migrants in Scotland; differences in provision had led to disappointment for migrants when they could not self-refer to a specialist or had a long waiting time for an appointment. Similar findings have been found with asy- lum seekers in the UK [22]. This new model of care with the GP as gatekeeper could lead to inappropriate service use with some participants reporting bypassing their GP and attending A&E. If patients feel dismissed and not lis- tened to by their GP they are unlikely to approach their GP for support for issues such as mental health, alcohol or smoking cessation which is particularly pertinent as knowledge of other community based health services was low. There was also evidence in this study of overreliance on the GP with very few participants using pharmacy ser- vices. This has important wider public health implications as the GP may represent not only the main source of clin- ical care, but also the sole source of public health advice and intervention for the majority of participants.
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Examining the validity and reliability of the Activities Specific Balance Confidence Scale 6 (ABC 6) in a diverse group of older adults

Examining the validity and reliability of the Activities Specific Balance Confidence Scale 6 (ABC 6) in a diverse group of older adults

CACREP accredits 540 masters programs. Of those, 32 are Clinical Mental Health, 156 are Community Counseling, and 55 are Mental Health Counseling programs (CACREP, 2012). These programs train professional counselors who may work with adults and/or children and adolescents in non-school settings. Given the importance of CACREP to the field of counseling and its role in helping programs produce counselors who work with children and adolescents in non-school settings, it is important to note that the 2009 CACREP Standards section which details the requirements of Clinical Mental Health Counseling programs and graduates contains no mention of children or adolescents. The common core curricular section of the 2009 CACREP standards require human growth and development “studies that provide an understanding of the nature and needs of persons at all developmental levels and in multicultural contexts…” (CACREP, 2009, p. 11). Only briefly do the most current Clinical Mental Health Counseling standards address developmental levels of clients when it states that graduates should have the skills to differentiate “between diagnosis and developmentally appropriate reactions during crises, disasters, and other trauma-causing events” (CACREP, 2009, p. 35). Although the 2009 CACREP standards stress the importance of human growth and development coursework, there is no requirement that courses specifically discuss how to counsel children and adolescents. Graduates of CACREP Clinical Mental Health (2009 CACREP standards), Community Counseling and Mental Health Counseling programs (2001 CACREP standards) who work with children and adolescents in non-school settings are not required to demonstrate skills to effectively
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Mental Health Nurses’ Experiences of the Use of Psychosocial Interventions in Ireland: A Multiple Case Study

Mental Health Nurses’ Experiences of the Use of Psychosocial Interventions in Ireland: A Multiple Case Study

In contrast, a study conducted by MacNeela et al. (2010) identified PSI in mental health nursing that were relevant to routine care by exploring their content and patterns. This study comprised 37 MHNs who were recruited from the community (n=22) and acute hospital settings (n=15). A think-aloud task performance design (Ericsson & Simon 1993), and data were collected by using four case simulations. For example, in line with the think-aloud approach, for each case simulation, focused tasks were devised in which participants were invited to describe the current situation of the client in the presented case and recommend next steps in the nursing care of the client. In other words, nurses’ judgments about a client were introduced first, followed by the PSI upon which they drew. The identified psychosocial care themes were dialogue, reassurance, encouragement and structured engagement. The data described that more experienced nurses were more likely to recommend PSI, while some other nurses described their role as being minimal in developing collaborative relationships with clients. One explanation for why the more experienced nurses recommended PSI could be that they had more time to develop the skills and were therefore more confident, while less experienced nurses delivered care in a directive and authoritative way rather than focusing on specific PSI activities with clients. This finding is similar to that of Jackson & Stevenson (2000) and Deady (2005), who also found that the staff approached clients with a ‘mother figure’ attitude rather than working collaboratively with their clients. Nonetheless, the findings of MacNeela et al. (2010) describe recent mental health nursing care within an Irish context. The researchers did acknowledge that the observations of actual nurse-client interactions are required to confirm whether nurses have a different approach in practice. Hence, this present study has built on this current research by using observations that focus on nurse-client interactions and their PSI activities.
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Mediumship and mental health: tensions from ethnopsychiatry/ethnopsychology

Mediumship and mental health: tensions from ethnopsychiatry/ethnopsychology

Religious experiences as promoters of practices considered therapeutic have been suggested by a relevant literature with studies on candomblé, umbanda and spiritism 26,42 , both in the national and international contexts. What these studies suggest is that, often, religious spaces can function as places of emotional reception, a welcome that is not always possible in formal health equipment that may not be prepared to receive users/patients/clientswith religious and spiritualities that are dissonant in relation to the standard or, in other words, to the existing hegemonic Christian context in Brazil. Obviously, it is not a matter of listing religious spaces as spaces of formal care, but rather of spheres in which the subject can be more widely accepted, accepted and respected in his identity and in his belonging, which often embraces the notion addressed by R/S. So, mediumship can and should be understood in the interim, representing a movement that seeks to know and respect the subject based on their anchorage, their ancestry, the knowledge conveyed in their community of reference, in their identity, in their belonging. It is within this interface that recent R/S studies can and should develop strategies and repertoires, enhancing not only R/S consideration in health care, but in what way different religiosities and spiritualities, especially non-hegemonic ones, can compose a range of references for the promotion of health and well-being.
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