Social science & medicine
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Social science & medicine · May 2005
Participatory action research: considerations for ethical review.
This paper addresses the distinctive nature of participatory action research (PAR) in relation to ethical review requirements. As a framework for conducting research and reducing health disparities, PAR is gaining increased attention in community and public health research. ⋯ We draw from our community-based experiences in mental health promotion research with immigrant and culturally diverse youth to illustrate the ethical advantages and challenges of applying a PAR approach. We conclude with process suggestions for Research Ethics Boards.
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Social science & medicine · Apr 2005
Comparative StudySelf-reported job insecurity and health in the Whitehall II study: potential explanations of the relationship.
This paper examines the potential of demographic, personal, material and behavioural characteristics, other psychosocial features of the work environment and job satisfaction to explain associations between self-reported job insecurity and health in a longitudinal study of British white-collar civil servants. Strong associations were found between self-reported job insecurity and both poor self-rated health and minor psychiatric morbidity. After adjustment for age, employment grade and health during a prior phase of secure employment, pessimism, heightened vigilance, primary deprivation, financial security, social support and job satisfaction explained 68% of the association between job insecurity and self-rated health in women, and 36% in men. With the addition of job control, these factors explained 60% of the association between job insecurity and minor psychiatric morbidity, and just over 80% of the association with depression in both sexes.
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Social science & medicine · Apr 2005
Autonomy-related behaviors of patient companions and their effect on decision-making activity in geriatric primary care visits.
The objective of this study, undertaken in the USA, was to investigate the consequences of autonomy-related companion behaviors on patient decision-making activity during geriatric primary care visits. Videotapes were analyzed to characterize patient and companion decision-making activity and related companion behaviors. These behaviors were coded throughout the visit using an autonomy-based framework that included both autonomy enhancing (i.e. facilitating patient understanding, patient involvement, and doctor understanding) and detracting behaviors, (i.e. controlling the patient and building alliances with the physician). ⋯ Companions of sicker (compared with less sick) patients were more likely to facilitate patient understanding, p < .05; doctor understanding, p < .01; and patient involvement, p = .06, in care. Patients whose companions facilitated their involvement in the medical visit by asking the patient questions, prompting the patient to talk, and asking for the patient's opinion were more than four times as likely to be active in decision-making as patients whose companions did not assist in this manner (unadjusted OR 3.5, CI 1.4-8.7, p < .01; adjusted OR 4.5, CI 1.6-12.4, p < .01). Companions can play an important role in the visits of geriatric patients by facilitating communication throughout the visit as well as patient activity in decision-making.
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Social science & medicine · Apr 2005
Social and psychological characteristics of Kuwaiti children and adolescents with type 1 diabetes.
Type 1 diabetes mellitus is a chronic disease that may have an impact on children's psychosocial adjustment. This study aimed to investigate the psychosocial characteristics of Kuwaiti children with type 1 diabetes as compared to healthy children without diabetes, and assess the impact of glycaemic control on psychosocial variables. A total of 349 school children aged 6-18 years with type 1 diabetes, and 409 children without diabetes having comparable age, gender, and social class were included in the study. ⋯ In conclusion, the study supported our hypotheses. Children with diabetes had worse psychological adjustment, and distress was related to glycaemic control. Since psychological distress increases the risk for future complications due to its relation with glycaemic control, longitudinal studies are recommended to identify children with diabetes having distress at an early stage when preventive interventions are effective.
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Social science & medicine · Apr 2005
Attitudes toward palliative care, conceptions of euthanasia and opinions about its legalization among French physicians.
We assume that actors of the professionalization process of palliative care make a special effort to demarcate it from euthanasia, and that such an effort has a significant impact on beliefs and attitudes toward euthanasia among the whole medical profession. We investigated concurrently attitudes toward palliative care, conceptions of euthanasia and opinion toward its legalization among a sample of 883 French general practitioners, oncologists and neurologists. ⋯ Attitudes toward palliative care were closely correlated with beliefs about which medical practices should be labelled euthanasia, and these beliefs were in turn strongly associated with opinions toward euthanasia legalization. Our results suggest that the relationship between palliative care and euthanasia mixes semantic and strategic aspects, beyond cognitive and conative ones.