Social Capital and Depressive Ill-Health—An Evaluative Approach to the Implementation of the Chronic Care Model (CCM)
Author(s)
Anne Lise Holm1*,
Anne Lyberg1,
Ingela Berggren1,2,
Sture Åström1,2,
Elisabeth Severinson1
Affiliation(s)
1 The Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Buskerud & Vestfold University College, Kongsberg, Norway. 2 Department of Nursing, Health and Culture, University West, Trollh?ttan, Sweden .
1 The Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Buskerud & Vestfold University College, Kongsberg, Norway. 2 Department of Nursing, Health and Culture, University West, Trollh?ttan, Sweden .
ABSTRACT
Background: Social capital has been described as a person’s sense of belonging as a result of the number and type of relationships she/he has, in which trust and reciprocity are especially important. Aim: To illuminate older persons’ experiences of social capital and depressive ill-health after implementation of the CCM. Methods: Data were collected from nine participants resident in two districts of Norway by means of individual in-depth interviews. A qualitative hermeneutic analysis was performed. Results: Two overall themes, desire for a guardian and a wish for independence despite being dependent, and two themes emerging from the analysis. The first theme—searching for protection was based on three sub-themes overwhelmed by the emotional pain of other people, a sense of exclusion and worries about the future, while the second theme—the need for a relationship with trustworthy persons comprised two sub-themes, namely, emotional pain was not understood and powerlessness to change the situation. The result of this study highlights the need for greater understanding on the part of healthcare professionals of how older persons manage their social relationships. Healthcare professionals require more knowledge about how negative self-beliefs held by older persons suffering from emotional pain, which can lead to reduced ability to trust other people. Another consequence is that fear of being dependent on other people can result in unwillingness to admit the need for help. Conclusion: This study highlights the lack of social capital in older persons who suffer from depressive ill-health. The implementation of the CCM does not appear to improve the situation. Older persons need to be more aware of their social needs and productive interactions in order to protect themselves and obtain support from their social network.
Background: Social capital has been described as a person’s sense of belonging as a result of the number and type of relationships she/he has, in which trust and reciprocity are especially important. Aim: To illuminate older persons’ experiences of social capital and depressive ill-health after implementation of the CCM. Methods: Data were collected from nine participants resident in two districts of Norway by means of individual in-depth interviews. A qualitative hermeneutic analysis was performed. Results: Two overall themes, desire for a guardian and a wish for independence despite being dependent, and two themes emerging from the analysis. The first theme—searching for protection was based on three sub-themes overwhelmed by the emotional pain of other people, a sense of exclusion and worries about the future, while the second theme—the need for a relationship with trustworthy persons comprised two sub-themes, namely, emotional pain was not understood and powerlessness to change the situation. The result of this study highlights the need for greater understanding on the part of healthcare professionals of how older persons manage their social relationships. Healthcare professionals require more knowledge about how negative self-beliefs held by older persons suffering from emotional pain, which can lead to reduced ability to trust other people. Another consequence is that fear of being dependent on other people can result in unwillingness to admit the need for help. Conclusion: This study highlights the lack of social capital in older persons who suffer from depressive ill-health. The implementation of the CCM does not appear to improve the situation. Older persons need to be more aware of their social needs and productive interactions in order to protect themselves and obtain support from their social network.
Cite this paper
Holm, A. , Lyberg, A. , Berggren, I. , Åström, S. and Severinson, E. (2014) Social Capital and Depressive Ill-Health—An Evaluative Approach to the Implementation of the Chronic Care Model (CCM). Open Journal of Nursing, 4, 683-694. doi: 10.4236/ojn.2014.410073.
Holm, A. , Lyberg, A. , Berggren, I. , Åström, S. and Severinson, E. (2014) Social Capital and Depressive Ill-Health—An Evaluative Approach to the Implementation of the Chronic Care Model (CCM). Open Journal of Nursing, 4, 683-694. doi: 10.4236/ojn.2014.410073.
References
[1] World Health Organization (2012) Depression Is a Common Illness and People Suffering from Depression Need Support and Treatment.
http://www.who.int/mediacentre/news/notes/2012/mental_health_day_20121009/en/ [2] Feely, M. and Long, A. (2009) Depression: A Psychiatric Nursing Theory of Connectivity. Journal of Psychiatric and Mental Health Nursing, 16, 725-737.
http://dx.doi.org/10.1111/j.1365-2850.2009.01452.x [3] Feely, M., Sines, D. and Long, A. (2007) Naming of Depression: Nursing, Social and Personal Descriptors. Journal of Psychiatric and Mental Health Nursing, 14, 21-32.
http://dx.doi.org/10.1111/j.1365-2850.2007.01035.x [4] Chapman, D.P. and Perry, G.S. (2008) Depression as a Major Component of Public Health for Older Adults. Preventing Chronic Disease, 5, 1-9.
http://www.cdc.gov/pcd/issues/2008/jan/07_0150.htm [5] World Health Organization (WHO) (2004) Global Burden of Disease.
http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf [6] Blazer, D.G. (2003) Depression in Late Life: Review and Commentary. The Journal of Gerontology: Series A, 58, 249-265. [7] Brown, E.L., Kaiser R.M.O. and Gellis, Z.D. (2007) Screening and Assessment of Late Life Depression in Home Healthcare: Issues and challenges. Annals of Long Term Care, 15, 27-32. [8] Gellis, Z.D. (2010) Depression Screening in Medically Ill Homecare Elderly. Best Practices in Mental Health, 6, 1-16. [9] Putnam R.D. (2000) Bowling Alone: The Collapse and Revival of American Community. Simon & Schuster, New York. [10] Torche, F. and Valenzuela, E. (2011) Trust and Reciprocity: A Theoretical Distinction of the Sources of Social Capital. European Journal of Social Theory, 14, 181-198.
http://dx.doi.org/10.1177/1368431011403461 [11] Lindström, M. (2008) Social Capital and Health-Related Behaviour. In: Kawachi, I., Subramanian, S.V. and Kim, D., Eds., Social Capital and Health, Springer, New York, 215-238.
http://dx.doi.org/10.1007/978-0-387-71311-3_10 [12] Holm, A.L., Lyberg, A., Lassenius, E., Berggren, I. and Severinsson, E. (2013) Older Persons’ Lived Experiences of Depression and Self-Management. Issues in Mental Health Nursing, 34, 757-764.
http://dx.doi.org/10.3109/01612840.2013.809829 [13] Forsman, A. (2012) The Importance of Social Capital in Later Life. Mental Health Promotion and Mental Disorder Prevention among Older Adults. Dissertation, Nordic School of Public Health NHV, Gothenburg. [14] De Silva, M., McKenzie, K., Haprpham, T. and Huttly, S.R.A. (2005) Social Capital and Mental Illness: A Systematic Review. Journal of Epidemiology and Community Health, 59, 619-627.
http://dx.doi.org/10.1136/jech.2004.029678 [15] Nyqvist, F., Finnäs, F., Jakobsson, G. and Koskinen, S. (2008) The Effect of Social Capital on Health: The Case of Two Language Groups in Finland. Health Place, 14, 347-360.
http://dx.doi.org/10.1016/j.healthplace.2007.09.001 [16] Lyberg, A., Holm, A.L., Lassenius, E., Berggren, I. and Severinsson, E. (2013) Older Persons’ Experiences of Depressive Ill-Health and Family Support. Nursing Research and Practice, 2013, Article ID: 837529.
http://dx.doi.org/10.1155/2013/837529 [17] Nasser, E.H. and Overholser, J.C. (2005) Recovery from Major Depression: The Role of Support from Family, Friends and Spiritual Beliefs. Acta Psychiatrica Scandinavia, 11, 125-132.
http://dx.doi.org/10.1111/j.1600-0447.2004.00423.x [18] Bowen, G.A. (2009) Social Capital, Social Funds and Poor Communities: An Exploratory Analysis. Social Policy and Administration, 43, 245-269.
http://dx.doi.org/10.1111/j.1467-9515.2009.00660.x [19] Kay, A. (2006) Social Capital, the Social Economy and Community Development. Community Development Journal, 41, 160-173.
http://dx.doi.org/10.1093/cdj/bsi045 [20] Castle, E.N. (2002) Social Capital: An Interdisciplinary Concept. Rural Sociology, 67, 331-349.
http://dx.doi.org/10.1111/j.1549-0831.2002.tb00107.x [21] Holm, A.L. and Severinsson, E. (2013) Interdisciplinary Team Collaboration during Discharge of Depressed Older Persons—A Norwegian Qualitative Implementation Study. Nursing Research and Practice, 2013, Article ID: 794743.
http://dx.doi.org/10.1155/2013/794743 [22] Holm, A.L. and Severinsson, E. (2013) Reflections on the Ethical Dilemmas Involved in Promoting Self-Management. Nursing Ethics, 21, 402-413.
http://dx.doi.org/10.1177/0969733013500806 [23] Wagner, E.H., Glasgow, R.E., Davis, C., et al. (2001) Quality Improvement in Chronic Illness Care: A Collaborative Approach. Journal of Quality Improvement, 27, 63-79. [24] Gadamer, H.G. (2004) Truth and Method. Interactive Sciences Ltd., Gloucester. [25] Polit, D.F. and Beck, C.T. (2010) Essentials of Nursing Research: Appraising Evidence for Nursing Practice. Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia. [26] Lincoln, Y.S. and Guba, E.G. (l985) Naturalistic Inquiry. Sage Publications Inc., London. [27] Northern Nurses’ Federation (2003) Ethical Guidelines for Nursing Research in the Nordic Countries.
http://www.sykepleien.no/ikbViewer/Content/337889/SSNs%20etiske%20retningslinjer.pdf [28] Liamputtong, P. (2007) Researching the Vulnerable: A Guide to Sensitive Research Methods. Sage, London. [29] Hedelin, B. and Jonsson, I. (2003) Mutuality as Background Music in Women’s Lived Experience of Mental Health and Depression. Journal of Psychiatric and Mental Health Nursing, 10, 317-322.
http://dx.doi.org/10.1111/1540-5885.310001-i1 [30] Ahlström, B.H., Skärsäter, I. and Danielsson, E. (2009) Living with Major Depression: Experiences from Families’ Perspectives. Scandinavian Journal of Caring Sciences, 23, 309-316.
http://dx.doi.org/10.1111/j.1471-6712.2008.00624.x [31] Hogan, B.E. (2002) Social Support Interventions: Do They Work? Clinical Psychological Review, 22, 383-442.
http://dx.doi.org/10.1016/S0272-7358(01)00102-7 [32] Eysenbach, G. (2004) Peer-Review and Publication of Research Protocols and Proposals: A Role for Open Access Journals. Journal of Medical Internet Research, 6, e37.
http://dx.doi.org/10.2196/jmir.6.3.e37 [33] Levinas, E. (1994) Ethics and Infinity. Conversations with Philippe Nemo. Duquesne University Press, Pittsburgh. [34] Holm, A.L. (2009) The Meaning of Emotional Pain. Analytic Interpretative Research on Women’s Experiences of Mental Health Problems. Doctoral Thesis, University of Stavanger, Stavanger. [35] World Health Organization and World Psychiatric Association (2002) Reducing Stigma and Discrimination against Older people with Mental Disorders. WHO, Geneva. [36] De Mendonca Lima, C.A. (2004) The Reduction of Stigma and Discrimination against Older People with Mental Disorders: A Challenge for the Future. Archives of Gerontology and Geriatrics, 38, 109-120.
http://dx.doi.org/10.1016/j.archger.2004.04.018 [37] Jorm, A.F. and Reavley, N. (2013) Depression and Stigma: From Attitudes to Discrimination. The Lancet, 381, 10-11.
http://dx.doi.org/10.1016/S0140-6736(12)61457-3 [38] Griffiths, K.M., Christensen, H. and Jorm, A.F. (2008) Predictors of Depression Stigma. BMC Psychiatry, 8, 25-37.
http://dx.doi.org/10.1186/1471-244X-8-25 [39] Jorm, A.F. and Oh, E. (2009) Desire for Social Distance from People with Mental Disorders. The Australian and New Zealand Journal of Psychiatry, 43, 183-200.
http://dx.doi.org/10.1080/00048670802653349 [40] Lasalvia, A., Zoppei, S., Van Bortel, T., et al. (2012) Global Pattern of Experienced and Anticipated Discrimination Reported by People with Major Depressive Disorder: A Cross-Sectional Survey. The Lancet, 381, 55-62.
http://dx.doi.org/10.1016/SO140-6736(12)61379-8 [41] Jeon, H.-S., Dunkle, R. and Roberts, B.L. (2006) Worries of the Oldest-Old. Health & Social Work, 31, 256-265.
http://dx.doi.org/10.1093/hsw/31.4.256 [42] Lee, I. and Dunkle, R.E. (2010) Worries, Psychosocial Resources and Depressive Symptoms among the South Korean Oldest Old. Aging and Mental Health, 14, 57-63.
http://dx.doi.org/10.1080/13607860903420997 [43] Rizzo Parse, R. (2010) Human Dignity: A Human-Becoming Ethical Phenomenon. Nursing Science Quarterly, 23, 257-262.
http://dx.doi.org/10.1177/0894318410371841 [44] Beauchamp, T. and Childress J. (2001) Principles of Biomedical Ethics. 5th Edition, Oxford University Press, Oxford. [45] Erikson, K. (1997) Understanding the World of the Patient, the Suffering Human Being: The New Clinical Paradigm from Nursing to Caring. Advanced Practice Nursing Quarterly, 3, 8-13. [46] Tillich, P. (1970) The Courage to Be. Collings Clear-Type Press, Lon-don. [47] Hillcoat-Nalléamby, S. (2014) The Meaning of “Independence” for Older People in Different Residential Settings. Journals of Gerontology: Series B, 69, 419-430.
http://dx.doi.org/10.1093/geronb/gbu008 [48] Erikson, K. (2006) The Suffering Human Being. Nordic Studies Press, Chicago. [49] Erikson, E.H. (1980) Identity and the Life Cycle. W.W. Norton & Company, London. [50] Stickley, T. and Freshwater, D. (2006) The Art of Listening in the Therapeutic Relationship. Mental Health Practice, 9, 12-17.
http://dx.doi.org/10.7748/mhp2006.02.9.5.12.c1899 [51] Eisenberger, N.I., Lieberman, M.D. and Williams, K.D. (2003) Does Rejection Hurt? An fMRI Study of Social Exclusion. Science, 302, 290-292.
http://dx.doi.org/10.1126/science.1089134 [52] Hassan, E. (2005) Recall Bias Can Be a Threat to Retrospective and Prospective Research Designs. The Internet Journal of Epidemiology, 3, No. 2.
http://ispub.com/IJE/3/2/13060 [53] Joachim, G. and Acorn, S. (2000) Stigma of Visible and Invisible Chronic Conditions. Journal of Advanced Nursing, 32, 243-248.
http://dx.doi.org/10.1046/j.1365-2648.2000.01466.x
[1] World Health Organization (2012) Depression Is a Common Illness and People Suffering from Depression Need Support and Treatment.
http://www.who.int/mediacentre/news/notes/2012/mental_health_day_20121009/en/ [2] Feely, M. and Long, A. (2009) Depression: A Psychiatric Nursing Theory of Connectivity. Journal of Psychiatric and Mental Health Nursing, 16, 725-737.
http://dx.doi.org/10.1111/j.1365-2850.2009.01452.x [3] Feely, M., Sines, D. and Long, A. (2007) Naming of Depression: Nursing, Social and Personal Descriptors. Journal of Psychiatric and Mental Health Nursing, 14, 21-32.
http://dx.doi.org/10.1111/j.1365-2850.2007.01035.x [4] Chapman, D.P. and Perry, G.S. (2008) Depression as a Major Component of Public Health for Older Adults. Preventing Chronic Disease, 5, 1-9.
http://www.cdc.gov/pcd/issues/2008/jan/07_0150.htm [5] World Health Organization (WHO) (2004) Global Burden of Disease.
http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf [6] Blazer, D.G. (2003) Depression in Late Life: Review and Commentary. The Journal of Gerontology: Series A, 58, 249-265. [7] Brown, E.L., Kaiser R.M.O. and Gellis, Z.D. (2007) Screening and Assessment of Late Life Depression in Home Healthcare: Issues and challenges. Annals of Long Term Care, 15, 27-32. [8] Gellis, Z.D. (2010) Depression Screening in Medically Ill Homecare Elderly. Best Practices in Mental Health, 6, 1-16. [9] Putnam R.D. (2000) Bowling Alone: The Collapse and Revival of American Community. Simon & Schuster, New York. [10] Torche, F. and Valenzuela, E. (2011) Trust and Reciprocity: A Theoretical Distinction of the Sources of Social Capital. European Journal of Social Theory, 14, 181-198.
http://dx.doi.org/10.1177/1368431011403461 [11] Lindström, M. (2008) Social Capital and Health-Related Behaviour. In: Kawachi, I., Subramanian, S.V. and Kim, D., Eds., Social Capital and Health, Springer, New York, 215-238.
http://dx.doi.org/10.1007/978-0-387-71311-3_10 [12] Holm, A.L., Lyberg, A., Lassenius, E., Berggren, I. and Severinsson, E. (2013) Older Persons’ Lived Experiences of Depression and Self-Management. Issues in Mental Health Nursing, 34, 757-764.
http://dx.doi.org/10.3109/01612840.2013.809829 [13] Forsman, A. (2012) The Importance of Social Capital in Later Life. Mental Health Promotion and Mental Disorder Prevention among Older Adults. Dissertation, Nordic School of Public Health NHV, Gothenburg. [14] De Silva, M., McKenzie, K., Haprpham, T. and Huttly, S.R.A. (2005) Social Capital and Mental Illness: A Systematic Review. Journal of Epidemiology and Community Health, 59, 619-627.
http://dx.doi.org/10.1136/jech.2004.029678 [15] Nyqvist, F., Finnäs, F., Jakobsson, G. and Koskinen, S. (2008) The Effect of Social Capital on Health: The Case of Two Language Groups in Finland. Health Place, 14, 347-360.
http://dx.doi.org/10.1016/j.healthplace.2007.09.001 [16] Lyberg, A., Holm, A.L., Lassenius, E., Berggren, I. and Severinsson, E. (2013) Older Persons’ Experiences of Depressive Ill-Health and Family Support. Nursing Research and Practice, 2013, Article ID: 837529.
http://dx.doi.org/10.1155/2013/837529 [17] Nasser, E.H. and Overholser, J.C. (2005) Recovery from Major Depression: The Role of Support from Family, Friends and Spiritual Beliefs. Acta Psychiatrica Scandinavia, 11, 125-132.
http://dx.doi.org/10.1111/j.1600-0447.2004.00423.x [18] Bowen, G.A. (2009) Social Capital, Social Funds and Poor Communities: An Exploratory Analysis. Social Policy and Administration, 43, 245-269.
http://dx.doi.org/10.1111/j.1467-9515.2009.00660.x [19] Kay, A. (2006) Social Capital, the Social Economy and Community Development. Community Development Journal, 41, 160-173.
http://dx.doi.org/10.1093/cdj/bsi045 [20] Castle, E.N. (2002) Social Capital: An Interdisciplinary Concept. Rural Sociology, 67, 331-349.
http://dx.doi.org/10.1111/j.1549-0831.2002.tb00107.x [21] Holm, A.L. and Severinsson, E. (2013) Interdisciplinary Team Collaboration during Discharge of Depressed Older Persons—A Norwegian Qualitative Implementation Study. Nursing Research and Practice, 2013, Article ID: 794743.
http://dx.doi.org/10.1155/2013/794743 [22] Holm, A.L. and Severinsson, E. (2013) Reflections on the Ethical Dilemmas Involved in Promoting Self-Management. Nursing Ethics, 21, 402-413.
http://dx.doi.org/10.1177/0969733013500806 [23] Wagner, E.H., Glasgow, R.E., Davis, C., et al. (2001) Quality Improvement in Chronic Illness Care: A Collaborative Approach. Journal of Quality Improvement, 27, 63-79. [24] Gadamer, H.G. (2004) Truth and Method. Interactive Sciences Ltd., Gloucester. [25] Polit, D.F. and Beck, C.T. (2010) Essentials of Nursing Research: Appraising Evidence for Nursing Practice. Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia. [26] Lincoln, Y.S. and Guba, E.G. (l985) Naturalistic Inquiry. Sage Publications Inc., London. [27] Northern Nurses’ Federation (2003) Ethical Guidelines for Nursing Research in the Nordic Countries.
http://www.sykepleien.no/ikbViewer/Content/337889/SSNs%20etiske%20retningslinjer.pdf [28] Liamputtong, P. (2007) Researching the Vulnerable: A Guide to Sensitive Research Methods. Sage, London. [29] Hedelin, B. and Jonsson, I. (2003) Mutuality as Background Music in Women’s Lived Experience of Mental Health and Depression. Journal of Psychiatric and Mental Health Nursing, 10, 317-322.
http://dx.doi.org/10.1111/1540-5885.310001-i1 [30] Ahlström, B.H., Skärsäter, I. and Danielsson, E. (2009) Living with Major Depression: Experiences from Families’ Perspectives. Scandinavian Journal of Caring Sciences, 23, 309-316.
http://dx.doi.org/10.1111/j.1471-6712.2008.00624.x [31] Hogan, B.E. (2002) Social Support Interventions: Do They Work? Clinical Psychological Review, 22, 383-442.
http://dx.doi.org/10.1016/S0272-7358(01)00102-7 [32] Eysenbach, G. (2004) Peer-Review and Publication of Research Protocols and Proposals: A Role for Open Access Journals. Journal of Medical Internet Research, 6, e37.
http://dx.doi.org/10.2196/jmir.6.3.e37 [33] Levinas, E. (1994) Ethics and Infinity. Conversations with Philippe Nemo. Duquesne University Press, Pittsburgh. [34] Holm, A.L. (2009) The Meaning of Emotional Pain. Analytic Interpretative Research on Women’s Experiences of Mental Health Problems. Doctoral Thesis, University of Stavanger, Stavanger. [35] World Health Organization and World Psychiatric Association (2002) Reducing Stigma and Discrimination against Older people with Mental Disorders. WHO, Geneva. [36] De Mendonca Lima, C.A. (2004) The Reduction of Stigma and Discrimination against Older People with Mental Disorders: A Challenge for the Future. Archives of Gerontology and Geriatrics, 38, 109-120.
http://dx.doi.org/10.1016/j.archger.2004.04.018 [37] Jorm, A.F. and Reavley, N. (2013) Depression and Stigma: From Attitudes to Discrimination. The Lancet, 381, 10-11.
http://dx.doi.org/10.1016/S0140-6736(12)61457-3 [38] Griffiths, K.M., Christensen, H. and Jorm, A.F. (2008) Predictors of Depression Stigma. BMC Psychiatry, 8, 25-37.
http://dx.doi.org/10.1186/1471-244X-8-25 [39] Jorm, A.F. and Oh, E. (2009) Desire for Social Distance from People with Mental Disorders. The Australian and New Zealand Journal of Psychiatry, 43, 183-200.
http://dx.doi.org/10.1080/00048670802653349 [40] Lasalvia, A., Zoppei, S., Van Bortel, T., et al. (2012) Global Pattern of Experienced and Anticipated Discrimination Reported by People with Major Depressive Disorder: A Cross-Sectional Survey. The Lancet, 381, 55-62.
http://dx.doi.org/10.1016/SO140-6736(12)61379-8 [41] Jeon, H.-S., Dunkle, R. and Roberts, B.L. (2006) Worries of the Oldest-Old. Health & Social Work, 31, 256-265.
http://dx.doi.org/10.1093/hsw/31.4.256 [42] Lee, I. and Dunkle, R.E. (2010) Worries, Psychosocial Resources and Depressive Symptoms among the South Korean Oldest Old. Aging and Mental Health, 14, 57-63.
http://dx.doi.org/10.1080/13607860903420997 [43] Rizzo Parse, R. (2010) Human Dignity: A Human-Becoming Ethical Phenomenon. Nursing Science Quarterly, 23, 257-262.
http://dx.doi.org/10.1177/0894318410371841 [44] Beauchamp, T. and Childress J. (2001) Principles of Biomedical Ethics. 5th Edition, Oxford University Press, Oxford. [45] Erikson, K. (1997) Understanding the World of the Patient, the Suffering Human Being: The New Clinical Paradigm from Nursing to Caring. Advanced Practice Nursing Quarterly, 3, 8-13. [46] Tillich, P. (1970) The Courage to Be. Collings Clear-Type Press, Lon-don. [47] Hillcoat-Nalléamby, S. (2014) The Meaning of “Independence” for Older People in Different Residential Settings. Journals of Gerontology: Series B, 69, 419-430.
http://dx.doi.org/10.1093/geronb/gbu008 [48] Erikson, K. (2006) The Suffering Human Being. Nordic Studies Press, Chicago. [49] Erikson, E.H. (1980) Identity and the Life Cycle. W.W. Norton & Company, London. [50] Stickley, T. and Freshwater, D. (2006) The Art of Listening in the Therapeutic Relationship. Mental Health Practice, 9, 12-17.
http://dx.doi.org/10.7748/mhp2006.02.9.5.12.c1899 [51] Eisenberger, N.I., Lieberman, M.D. and Williams, K.D. (2003) Does Rejection Hurt? An fMRI Study of Social Exclusion. Science, 302, 290-292.
http://dx.doi.org/10.1126/science.1089134 [52] Hassan, E. (2005) Recall Bias Can Be a Threat to Retrospective and Prospective Research Designs. The Internet Journal of Epidemiology, 3, No. 2.
http://ispub.com/IJE/3/2/13060 [53] Joachim, G. and Acorn, S. (2000) Stigma of Visible and Invisible Chronic Conditions. Journal of Advanced Nursing, 32, 243-248.
http://dx.doi.org/10.1046/j.1365-2648.2000.01466.x