Social science & medicine
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Social science & medicine · Oct 2005
Alcohol dependence and depression among heavy drinkers in Canada.
This article describes the prevalence of heavy drinking among the Canadian population and the prevalence of alcohol dependence among heavy drinkers aged 18 or older. It also examines the association of depression to alcohol dependence among the latter group and the correlates of depression and alcohol dependence comorbidity. The data are from a national representative sample of the Canadian population in 2000/01. ⋯ When several indicators believed to be risk factors for alcohol dependence including personal characteristics, psychosocial factors, lifestyle behaviours and physical health were included in the logistic regression models, the marked difference in alcohol dependence among depressed and non-depressed heavy drinkers remained. The former had 3.6 times the odds of being classified as alcohol dependent compared to the latter (CI=2.9, 4.3). When the same personal, psychosocial, lifestyle and physical health measures were used to explain comorbidity of depression and alcohol dependence, perceived stress was the only factor that was consistently associated with comorbidity among both men and women.
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Social science & medicine · Oct 2005
Comparative StudyA comparison of attitudes towards end-of-life decisions: survey among the Dutch general public and physicians.
In The Netherlands, there has been a continuing public debate about the acceptability and regulatory system for medical decision-making concerning the end of life. We studied attitudes of the Dutch general public towards different types of end-of-life decisions in various situations and compared them to attitudes of physicians. Questionnaires were mailed to 1777 members of the Dutch general public (response: 78%). ⋯ For the general public, determinants of support for active ending of life were being non-religious, lower education, and having a single household. Acknowledging the observed differences in appreciation of end-of-life decision-making between the general public and physicians is important in doctor-patient communication and in public debate and policymaking. Continued monitoring of practices and informing the general public and policymakers about the clinical and ethical consequences of different types of end-of-life decisions is important.
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Social science & medicine · Oct 2005
Comparative StudyDiscrepancy in the preferences of place of death between terminally ill cancer patients and their primary family caregivers in Taiwan.
There is a worldwide common preference for dying at home. However, death at home does not come without significant challenges and potential consequences for families. Given the interactive nature of decisions regarding the place of death, the family's perspective is important and needs to be investigated. ⋯ There was a moderate association between the two respondents in the preferences of place of death. Results underscore discrepancies between patients and their families in the importance given to cultural concerns, quality of health care, worries of being a burden to others, lack of availability of families, relationships with health care providers, and being surrounded by the home environment. Effective interventions need to be developed which can lighten the caregiving burden and help families retain dying patients at home, avoid unnecessary re-hospitalizations and unfavorable hospital deaths, and improve accordance with the patient's wishes.