Social science & medicine
-
Social science & medicine · Jul 2010
Help seeking for cardiac symptoms: beyond the masculine-feminine binary.
Empirical and theoretical literature suggests that stereotypical gender roles shape men's and women's health help-seeking behavior, and plays an important role in the treatment seeking delays of cardiac patients. We were interested in exploring the ways in which gender informs the experiences and help-seeking behavior of men and women who experienced the symptoms associated with acute cardiac events. We undertook 20 in-depth interviews between October 2007 and July 2008 with 11 men and 9 women recently diagnosed with an acute coronary syndrome in British Columbia, Canada. ⋯ However, men's and women's experiences of seeking health care were not easily parsed into distinct binary gender patterns. Behavior that might stereotypically be considered to be 'masculine' or 'feminine' gender practice was shared by both male and female participants. Our findings undermine simple binary distinctions about gendered help-seeking prevalent in the literature, and contribute towards setting the direction of the future health policy and research agenda addressing the issue of gender and health help-seeking behavior.
-
Social science & medicine · Jul 2010
Is wealthier always healthier? The impact of national income level, inequality, and poverty on public health in Latin America.
Despite findings indicating that both national income level and income inequality are each determinants of public health, few have studied how national income level, poverty and inequality interact with each other to influence public health outcomes. We analyzed the relationship between gross domestic product (GDP) per capita in purchasing power parity, extreme poverty rates, the gini coefficient for personal income and three common measures of public health: life expectancy, infant mortality rates, and tuberculosis (TB) mortality rates. Introducing poverty and inequality as modifying factors, we then assessed whether the relationship between GDP and health differed during times of increasing, decreasing, and decreasing or constant poverty and inequality. ⋯ In sharp contrast, during times of decreasing or constant poverty and inequality, there was a very strong relationship between increasing GDP and higher life expectancy and lower TB and infant mortality rates. Finally, inequality and poverty were found to exert independent, substantial effects on the relationship between national income level and health. Wealthier is indeed healthier, but how much healthier depends on how increases in wealth are distributed.
-
Social science & medicine · Jul 2010
Randomized Controlled Trial Comparative StudyEffectiveness of a knowledge-contact program in improving nursing students' attitudes and emotional competence in serving people living with HIV/AIDS.
This study compared the effectiveness of an AIDS knowledge-only program (knowledge) with a combined program of AIDS knowledge and contact with people having HIV/AIDS (PHA) (knowledge-contact) in reducing nursing students' stigma and discrimination towards PHA and in enhancing their emotional competence to serve PHA. Eighty-nine nursing students from two universities in Hong Kong were randomly assigned to either the knowledge or the knowledge-contact condition. All participants completed measures of AIDS knowledge, stigmatizing attitudes, fear of contagion, willingness to treat, positive affect, and negative affect at pre-test, post-test, and six-week follow-up. ⋯ No significant difference between the two groups was found at follow-up. Findings showed the short-term effect of contact in improving nursing students' attitudes and emotional competence in serving PHA. Implications for research and training of nursing staff were discussed.
-
Social science & medicine · Jul 2010
Race and shared decision-making: perspectives of African-Americans with diabetes.
Shared decision-making (SDM) is an important component of patient-centered healthcare and is positively associated with improved health outcomes (e.g. diabetes and hypertension control). In shared decision-making, patients and physicians engage in bidirectional dialogue about patients' symptoms and treatment options, and select treatment plans that address patient preferences. Existing research shows that African-Americans experience SDM less often than whites, a fact which may contribute to racial disparities in diabetes outcomes. ⋯ They identified mistrust of white physicians, negative attitudes and internalized racism as patient-related issues that may influence African-American patients' SDM behaviors (e.g. less forthcoming with physicians about health information, more deference to physicians, less likely to adhere to treatment regimens). This study suggests that race-related patient and physician-related barriers may serve as significant barriers to shared decision-making between African-American patients and their physicians. Finding innovative ways to address such communication barriers is an important area of future research.
-
Social science & medicine · Jul 2010
Interpersonal conflict and depression among Japanese workers with high or low socioeconomic status: findings from the Japan Work Stress and Health Cohort Study.
Research that focuses on the relationship between interpersonal conflict at work (i.e., intragroup conflict and intergroup conflict) and depression that also considers differences in socioeconomic status (SES) is limited. The purpose of the current study is to investigate the relationship between interpersonal conflict at work and depression at different levels of SES. A cross-sectional study was conducted with a total of 17,390 males and 2923 females employed in nine factories located in several regions of Japan. ⋯ More specifically, the association of intergroup conflict with depression was significantly greater among males of a high SES than males of a low SES. However, this pattern was not observed in females. The current study suggests that males of a higher SES are more vulnerable to interpersonal conflict at work in terms of developing depression than males of a lower SES.