Social science & medicine
-
Mothers who use crack cocaine are commonly believed to be selfish, uncaring, and neglectful of their children. For this paper, the grounded theory method was used to analyze 68 semi-structured depth interviews with cocaine-using mothers. These women's views of motherhood, the strategies they used to manage mothering on cocaine, and the contextual influences on mothering outcomes were explored. ⋯ When unable to fulfil their maternal responsibilities by other means, some mothers placed their children with family members, and others lost custody involuntarily. When children were forcibly removed, mothers often increased their drug use to cope with the loss. Social and economic conditions influenced the outcomes of mothering on crack.
-
Cesarean section rates have risen dramatically in the U. S. over the past 20 years. Although infant mortality has declined during the same period, there is little evidence that more frequent cesarean surgery is the cause. ⋯ The development of neonatal intensive care, expanded access to prenatal care, and greater availability of abortion and family planning have contributed more to falling infant mortality. It has been estimated that approximately half the cesareans currently performed in the U. S. are medically unnecessary, resulting in considerable avoidable maternal mortality and morbidity, and a cost of over $1 billion each year.
-
Social science & medicine · May 1993
Demographic variables in fetal and child mortality: Hmong in Thailand.
Conventional theories would not predict the 60% decline of infant mortality which has occurred among the Hmong population of Thailand, from 123/1000 in the mid-1960s to 48 in the mid-1980s. The Hmong population in northern Thailand has sustained high fertility and low use of modern health services. Most Hmong live in relatively remote rural villages and earn their living by self-employed farming. ⋯ Sex-specific mortality rates calculated from reproductive histories show no surplus of female deaths in the past, but females have benefitted more from recent mortality declines than males. Ethnographic evidence suggests that Hmong have customs which act to protect the health of mother and child ('chicken soup theory'), and that they are predisposed to accept innovations (including use of modern medicine) which they see as beneficial. This may allow them to respond especially quickly to small opportunities for improving their children's survival, as compared with other ethnic groups.
-
Social science & medicine · Mar 1993
Comparative StudyComparing nurses' and patients' pain evaluations: a study of hospitalized patients in Kuwait.
All eligible patients hospitalized on the general medical, surgical and pediatric wards of a district hospital in Kuwait during the first 2 weeks of April 1990 (N = 199) were interviewed about their pain and the medical care provided. Patients rated their current pain using a 0-10 visual analogue scale (VAS) on which 0 was labelled 'no pain' and 10 'unbearable pain', and also the least and worst levels of pain which they had experienced during the previous 24 hr. Pediatric patients rated their mood at these times using a cartoon faces scale ([1]: McGrath P. ⋯ Also, when specifically questioned, a substantial proportion of patients stated that pain had had a negative impact on their mood and activity. Various explanations for these findings are discussed, and their implications for effective pain management. Some of the special problems facing nurses in Kuwait are considered.
-
Social science & medicine · Mar 1993
ReviewValidity and reliability testing of the FAMCARE Scale: measuring family satisfaction with advanced cancer care.
The purpose of the study was to test the validity and reliability of the FAMCARE Scale which was developed to measure family satisfaction with advanced cancer care. The FAMCARE Scale was developed based upon earlier qualitative research which identified indicators of family care satisfaction and a subsequent Q-sort study that reduced those items to the most salient indicators of satisfaction according to a larger, representative sample (N = 210). ⋯ Cluster analysis of the scale suggested 4 subdimensions. Although the scale requires further testing to establish its reliability and validity, these preliminary results indicate that the scale may be a psychometrically sound instrument useful for measurement of family satisfaction with advanced cancer care.