Social science & medicine
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Social science & medicine · Apr 2010
Socioeconomic inequalities in suicidal ideation, parasuicides, and completed suicides in South Korea.
As a result of unprecedented increase in suicides over the last decade, Korea now ranks at the top of OECD countries in suicide statistics (26.1 deaths per 100,000 population in 2005). Our study sought to document socioeconomic inequalities in self-destructive behaviors including suicidal ideation, parasuicide, and completed suicide. For prevalence of suicidal ideation and parasuicide, we used four waves of data from the Korea National Health and Nutrition Examination Survey (1995, 1998, 2001, and 2005). ⋯ Both absolute as well as relative inequalities in suicide by socioeconomic position widened over time. Our findings suggest that the current suicide epidemic in Korea has social origins. In addition to clinical approaches targeted to the prevention of suicides in high risk individuals, social policies are needed to protect disadvantaged populations at risk of self-destructive behaviors.
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Social science & medicine · Apr 2010
Which carers of family members at the end of life need more support from health services and why?
With end of life care a national priority in many countries, and the main place of care the family home, informal family carers are now considered the frontline of primary care. Yet we are insufficiently informed about the needs of carers, both during the time of caring and during bereavement. This study identifies which carers believed they did not get enough support from health services when caring for a terminally ill family member, what factors influenced perceptions of support, and whether inadequate support influenced the carer's health following the death of a family member. ⋯ Additionally, carers were more likely to be not coping if they were aged 60 years or less, female, had lost a spouse/partner and the deceased family member did not die in the carer's preferred place. By identifying which carers are more vulnerable than others, carer education and practical support can be targeted to specific groups. Ideally resources for bereavement support should be extended into the months following the relative's death.
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Social science & medicine · Apr 2010
End of life care policies: do they make a difference in practice?
Although institutional policies related to care at the end of life (EOL) are a common feature of hospitals, there has been little examination of the ways in which these policies shape the focus and provision of care. The question asked in this study was "What effect do institutional policies relating to care at the EOL have on practice?" Data were drawn from health record reviews of 310 adults who had died in 3 acute care facilities in a major urban centre of a Western Canadian health region. ⋯ Relatively few providers, however, followed policy directives regarding use of care plans, terminology or documentation of discussions with patients and families about treatment plans. The findings of this study demonstrate a significant gap between institutional EOL care policies and practice in this health region, challenging institutional decision makers and front-line providers to collaborate more effectively to devise clinically relevant policies that enhance patient care at a particularly vulnerable time of life.
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Social science & medicine · Apr 2010
Conflict between the work and family domains and exhaustion among vocationally active men and women.
Exhaustion is consistently found to be more prevalent in women than in men. Women suffer from job strain more often, which may constitute a partial explanation for this phenomenon, but experienced shortcomings in combining work and family demands may also contribute to ill health. The aim of this study was to investigate, and analyse by gender, how work-related and family-related factors, as well as the interface between them, i.e. work-to-family conflict (WFC) and family-to-work conflict (FWC), are related to exhaustion. ⋯ While WFC was more prevalent among men, it was more strongly associated with exhaustion in women than in men. In women, WFC and FWC contributed to a larger part of the explanatory power of the model, which amounted to 22% of the variance in women and 14% in men. The results imply that the concept of 'work stress' should be regarded in a wider context in order to understand gender related issues of exhaustion among vocationally active individuals.