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PubMed2005

Cultural identities and cultural congruency: a new model for evaluating mental distress in immigrants.

OBJECTIVE: Societies and cultures have been described as being individualistic or collectivist (also called ego-centric or socio-centric). Similarly individuals are idiocentric or allocentric. METHOD: Using migration, migrants, ethnic minorities, collectivism and individualism, four databases of Embase, Medline, PsychInfo and Social Sciences abstracts were searched. Other key words included mental disorder, mental distress, psychiatric and psychological disorders. In addition, hand searches were conducted from the relevant books, monographs and secondary references. RESULTS: Migration, cultural identity and mental distress are linked. In addition, social support can provide a buffer against mental illness. Other vulnerability factors in migrants include the type of society they originate from and the type of society they settle in. CONCLUSION: When individuals migrate from one type of culture to another it is likely that depending upon their own personality traits (along with their biopsycho-social vulnerabilities) may develop psychiatric disorders. The cognitions and idioms of distress will be influenced by cultural factors. The clinicians must take into account cultural background when planning any interventions to enable a stronger therapeutic alliance.

Acculturation↗
PubMedDate not supplied

Powerlessness, empowerment, and health: implications for health promotion programs.

PURPOSE AND SCOPE. This article reviews the health and social science research relevant to both the role of powerlessness as a risk factor for disease, and the role of empowerment as a health-enhancing strategy. The research literature surveyed includes studies that address these key concepts from the fields of social epidemiology, occupational health, stress research, social psychology, community psychology, social support and networks, community competence and community organizing. Definitions are provided to operationalize these sometimes loosely-applied terms. IMPORTANT FINDINGS. Powerlessness, or lack of control over destiny, emerges as a broad-based risk factor for disease. Empowerment, though more difficult to evaluate, can also be demonstrated as an important promoter of health. MAJOR CONCLUSIONS. Given the importance and currency of these concepts of powerlessness and empowerment, a model of empowerment education is proposed for health-promotion practitioners. Measurement of empowerment raises issues for researchers on how to test the multiple personal and community changes that may result from an empowering education intervention.

Health Behavior↗
PubMed1997

Human research beyond the medical model: legal and ethical issues.

Advances in medical health depend on non-medical, as well as medical research. When research involves human participants, it raises legal and ethical concerns that have come to be approached by reference to codes of research ethics. Many of these are centered on physician-patient relationships and the pursuit of medical science. This article considers a number of issues that arise from research that follows non-medical models of research, and applications of rules of ethical medical research outside physician-patient settings. In particular, it addresses health research in the social sciences, the exclusion of women as participants in medical research, studies that depend on incomplete disclosure of information to prospective participants and their deception, and public health research based on groups and communities rather than participants as individuals.

Adolescent↗
PubMed2006

The role of theory in the psychophysiology of personality: from Ivan Pavlov to Jeffrey Gray.

Psychophysiological approaches to personality have made significant progress in recent years, partly as a spin-off of technological innovation (e.g., functional neuroimaging) and partly as a result of an emerging theoretical consensus regarding the structure and biology of basic processes. In this field, Jeffrey Gray's influential psychophysiological theory of personality - now widely known as Reinforcement Sensitivity Theory (RST) - owes much to Pavlov, who devoted a large proportion of his later life to personality differences and their implications for psychiatry. In this article, we trace the influence of Pavlov on Hans Eysenck's and Jeffrey Gray's work, and then provide a brief description of RST in order to highlight some of the central problems - as well as some tentative solutions - in the psychophysiology of personality. Specifically, the importance of theory in personality research is stressed by the contrast of Gray's theoretically driven model with less fertile atheoretical (i.e., exploratory-inductive) approaches. The fecundity of RST, which has been in continual development over a period of thirty years, is discussed in the light of Karl Popper's views on the nature of science, especially the formulation of the 'problem situation', which sets up the theoretical and operational conditions under which hypotheses may be challenged and tested to destruction. In this respect, we see the truth of Lewin's [Lewin, K., 1951. Field theory in social science: selected theoretical papers. In: Cartwright, D., (Ed.). Harper & Row, New York] famous phrase, "There is nothing so practical as a good theory".

Animals↗
PubMed2007

Video and qualitative research: analysing medical practice and interaction.

CONTEXT: Video has long been recognised as providing an important resource within medical education, particularly, perhaps, for training in primary health care. As a resource for research, and more specifically within qualitative social science studies of medical practice, video has proved less pervasive, despite its obvious advantages. METHODS: In this paper, we sketch an approach to using video to inform the analysis of medical practice and the ways in which health care is accomplished through social interaction and collaboration. Drawing on our own research, we discuss two brief examples: the first involves the use of computing technology in primary health care and the second concerns informal instruction during surgery. The examples illustrate the multimodal character of medical work, how activities are accomplished through the interplay of talk, the visual and the use of material artefacts. They also illustrate the ways in which video provides access to the complex forms of social interaction and collaboration that underpin health care. DISCUSSION: We reflect upon the research opportunities afforded by video and the ways in which video-based studies of interaction can contribute to the practice and practicalities of medicine.

Clinical Medicine↗
PubMed2006

Mapping the literature of maternal-child/gynecologic nursing.

OBJECTIVES: As part of a project to map the literature of nursing, sponsored by the Nursing and Allied Health Resources Section of the Medical Library Association, this study identifies core journals cited in maternal-child/gynecologic nursing and the indexing services that access the cited journals. METHODS: Three source journals were selected and subjected to a citation analysis of articles from 1996 to 1998. RESULTS: Journals were the most frequently cited format (74.1%), followed by books (19.7%), miscellaneous (4.2%), and government documents (1.9%). Bradford's Law of Scattering was applied to the results, ranking cited journal references in descending order. One-third of the citations were found in a core of 14 journal titles; one-third were dispersed among a middle zone of 100 titles; and the remaining third were scattered in a larger zone of 1,194 titles. Indexing coverage for the core titles was most comprehensive in PubMed/MEDLINE, followed by Science Citation Index and CINAHL. CONCLUSION: The core of journals cited in this nursing specialty revealed a large number of medical titles, thus, the biomedical databases provide the best access. The interdisciplinary nature of maternal-child/ gynecologic nursing topics dictates that social sciences databases are an important adjunct. The study results will assist librarians in collection development, provide end users with guidelines for selecting databases, and influence database producers to consider extending coverage to identified titles.

Abstracting and Indexing↗
PubMed1994

[How do daughters experience their elderly mothers move into a nursing home? A pilot study].

A pilot study explored the experiences of three daughters, whose mothers were being admitted to nursing homes. An inductive, qualitative research approach, commonly used in the social sciences, was used. It was assumed that nursing care would be health promoting and would be supportive, not only of patients and clients, but also of the significant others, who had to cope with the crisis. Research on stress has shown that social support positively affects health. The results and the discussion confirm that daughters experience coping with the admission of their mothers to a nursing home as a stressful challenge. Caring for relatives and for patients in crisis situations is very demanding on nursing staff. Recommendations are made for the education of staff concerned with health promotion and with nursing care in the community and in nursing homes.

Adult↗
PubMed2004

Preventing long-term welfare receipt: the theoretical relationship between health and poverty over the early life course.

Largely absent in the congressional debate regarding U.S. welfare reform reauthorization are policy discussions aimed at preventing long-term welfare use for families at risk. This study examines three social science perspectives explaining the relationship between early poverty and health as a means to understand long-term welfare receipt. Using longitudinal data collected for more than 30 years from a cohort of African Americans living in inner-city Chicago, we examined whether a social causation, health selection, or bio-social perspective best characterized the route to long-term welfare receipt. Results indicated that a bio-social perspective provided the best explanation for how early life course factors relate to long-term welfare use later in adulthood. Thus, this theory merits further study as an explanation for the relationship between health status and income. These findings point to the vulnerability of those who are both poor and in ill health, and should direct our policies regarding how to best prevent long term welfare receipt in future generations.

Adolescent↗
PubMed2001

Modernization, globalization and the welfare state: a comparative analysis of old and new convergence of social insurance since 1930.

Convergence of policies and institutions across countries has been a recurrent theme within social sciences. 'Old' and 'new' convergence hypotheses have been associated with changing concepts and catchwords, such as modernization, logic of industrialism, post-industrialism, post-Fordism and globalization, but share some underlying theoretical perspectives. The purpose of this paper is to analyse tendencies towards convergence of social insurance systems in 18 OECD countries between 1930 and 1990, a period which has seen our sample of countries develop from predominantly agricultural societies to industrial or post-industrial market democracies. Data from the Social Citizenship Indicator Program (SCIP) are used to examine the development of institutional variables within the various national social insurance systems. Sub-samples of larger and smaller countries are examined separately, in order to test the open-economy hypothesis that smaller countries, being more exposed to international pressures than larger ones, could be expected to show higher degrees of social protection and also more convergence. Hypotheses on differentiated institutional barriers against pressures from the processes of transnationalization of the economy, as well as possible convergence effects of the supra-national policy making within the European Union, are discussed in the last section.

Developed Countries↗
PubMed1994

Professionalization--theoretical analysis of the implications for nursing practice.

The aim of the present paper is to examine ideas of professionalization, and to explore in what way they might give directions for the development of nursing practice. An examination of the literature on professionalization in social science reveals that the existing ideas of professionalization may be divided into two paradigms, denominated naïve paradigm and cynical paradigm. Both paradigms have been criticized on the grounds of being idealistic and ahistoric. A contemporary view has developed from this criticism, oriented towards the historical and social contexts of professions. The implications for nursing practice of this view brings into focus the development of nursing practice in relation to the public and the tradition of nursing. This view of professionalization contributes to a contemporary view of nursing practice, and an expanded idea of professionalization is discussed.

Humans↗
PubMedDate not supplied

Filial therapy for children's behavioral and emotional problems in mainland China.

TOPIC: Filial therapy as a therapeutic intervention to promote parent-child interaction and improve child's behavior across culture. PURPOSE: To review the state of the science of filial therapy and explore whether filial therapy would be an effective parenting program in China. SOURCES: Four research articles related to the impact of filial therapy, used with Chinese immigrants, Koreans, and Native Americans, were located in a search of nursing, medical, psychological, and social science literature. CONCLUSIONS: The findings indicated that filial therapy is a culturally sensitive and effective intervention. The overall limitations, some recommendations for future research, and the discussion of efficacy of filial therapy in China were provided.

Affective Symptoms↗
PubMed2005

Land-use and land-cover change in montane mainland southeast Asia.

This paper summarizes land-cover and land-use change at eight sites in Thailand, Yunnan (China), Vietnam, Cambodia, and Laos over the last 50 years. Project methodology included incorporating information collected from a combination of semiformal, key informant, and formal household interviews with the development of spatial databases based on aerial photographs, satellite images, topographic maps, and GPS data. Results suggest that land use (e.g. swidden cultivation) and land cover (e.g. secondary vegetation) have remained stable and the minor amount of land-use change that has occurred has been a change from swidden to monocultural cash crops. Results suggest that two forces will increasingly determine land-use systems in this region. First, national land tenure policies-the nationalization of forest lands and efforts to increase control over upland resources by central governments-will provide a push factor making it increasingly difficult for farmers to maintain their traditional swidden land-use practices. Second, market pressures-the commercialization of subsistence resources and the substitution of commercial crops for subsistence crops-will provide a pull factor encouraging farmers to engage in new and different forms of commercial agriculture. These results appear to be robust as they come from eight studies conducted over the last decade. But important questions remain in terms of what research protocols are needed, if any, when linking social science data with remotely sensed data for understanding human-environment interactions.

Agriculture↗
PubMed2000

Place, social exchange and health: proposed sociological framework.

A sociological framework is proposed to better understand how spatial characteristics translate into people's physical and psychosocial conditions that are relevant to their health. In particular, high susceptibility to poor health among specific adult population groups is analyzed in terms of exclusion from or inadequate participation in a society's structure of opportunities. Acquisition of, and agency through, core social roles, such as the work role, the family and marital role, and civic roles, are essential prerequisites for successful personal self-regulation in adult life, strengthening a sense of self-esteem, self-efficacy, and belonging (self-integration). It is argued that exclusion from, or loss of core social roles, threats to their continuity and confinement to non-reciprocal exchange impair personal self-regulation and trigger a state of 'social reward deficiency'. This state, in turn, elicits prolonged stressful experience, and it may reinforce a person's craving for stress-relieving, potentially addictive health-damaging behavior. This framework is applied to the explanation of the life expectancy gap between Western and Central/Eastern European countries. Although most of the epidemiological evidence reviewed in support of this approach originates from investigations that were conducted in western countries several results reported in the collection of articles published in this Special Issue of Social Science and Medicine are in line with the proposed framework.

Adult↗
PubMedDate not supplied

[Why do we need clinical epidemiology?].

Epidemiology as a tool of objective reasoning in health science is more evident. Its application in medical care is called clinical epidemiology; nevertheless, this term has been controversial through time as it has increased its application in both research and clinical care. The field covers issues of health services research, medical economics, clinical decisions analysis and medical social sciences; moreover, the proper epidemiology issues. We propose the role that this discipline should have in medical care practice and in clinical investigation, and we describe the usefulness of its applications.

Epidemiology↗
PubMed2006

Welfare state matters: a typological multilevel analysis of wealthy countries.

Building on the social science literature, we hypothesized that population health indicators in wealthy industrialized countries are 'clustered' around welfare state regime types. We tested this hypothesis during a period of welfare state expansion from 1960 to 1994. We categorized data from 19 wealthy countries into 4 different types of welfare state regimes (Social Democratic, Christian Democratic, Liberal and Wage Earner Welfare States). Outcome variables were the infant mortality rate (IMR) and the low birth weight rate (LBW), obtained from the Organization of Economic Co-operation and Development (OECD) Health Data 2000 and from the United Nations Common Statistical Database (UNCSD). A two-level multilevel model was constructed, and fixed effects of welfare state were tested. Through the 39 years analyzed, Social Democratic countries exhibited a significantly better population health status, i.e., lower infant mortality rate and low birth weight rate, compared to other countries. Twenty percent of the difference in infant mortality rate among countries could be explained by the type of welfare state, and about 10% for low birth weight rate. The gap between Social Democracies and other countries widened over the 1990s. Our results confirm that countries exhibit distinctive levels of population health by welfare regime types even when adjusted by the level of economic development (GDP per capita) and intra-country correlations. It implies that countries, as groups, adopt similar policies or through any other ways, achieve similar level of health status. Proposed mechanisms of such process and suggestions for future research directions are presented in the discussion.

Asia↗
PubMed2003

The determinants of health: structure, context and agency.

The concept of social structure is one of the main building blocks of the social sciences, but it lacks any precise technical definition within general sociological theory. This paper reviews the way in which the concept has been deployed within medical sociology, arguing that in recent times it has been used primarily as a frame for the sociological interpretation of health inequalities and their social determinants. It goes on to examine the contribution that medical sociologists have made to the debate over health inequalities, giving particular attention to contributions to Sociology of Health and Illness. These have often provided a focus for discussions outside or critical of the mainstream debates that have been driven primarily by epidemiologists. The paper reviews some of the main points of criticism of epidemiological approaches, focusing in particular on the methodological constraints that limit the capacity of epidemiologists to develop more theoretically satisfactory accounts of the inter-relationships of social structure, context and agency in their impact on health and well being. Some recent examples from the Journal of more theoretically innovative and analytically fine-grained approaches to understanding the impact of social structure on health are then explored. The paper concludes with an argument for a more historically-informed analysis of the relationships between social structure and health, using the knowledgeable narratives of people in places as a window onto those relationships.

Epidemiology↗