Social science & medicine. Part A, Medical sociology最新文献

The effect on the chief carer in 97 patients with fresh stroke has been observed for 4 years and compared with 19 stroke patients without identifiable chief carer—84% lived together and a further 5% saw each other daily. The largest group of chief carers were women, aged less than 60, and over one quarter of them had responsibility for other people. Deterioration in the chief carer's health was common during the first year and 14% of those in employment gave up their jobs because of the patient's stroke. By the end of one year post-stroke 27% of the patients they were looking after in the community were totally dependent (including personal care). The main problems they found were in relation to behaviour and the need for constant supervision. It is concluded that the vast majority of stroke survivors are living in the community and that their chief carers could be afforded more support by mobile “stroke teams” at an early stage, more involvement of relatives in rehabilitation and the continued development of stroke clubs.

The history of the formerly colonised countries is influenced by the former metropolitan countries. So is the history of modern health institutions. This paper explores the implications of the continuing trend toward the provision of curative health care. It is argued that the trend is at the expense of the rural populations; the hospital-based care is expensive, and is bound to be inefficient and largely ineffective. In addition, the development of hospital-based care coupled by an inevitable degree of specialisation, will contribute to existing inequality of distribution and accessibility. The paper argues that the health policy formulators and implementors are bound partly by their own values, partly by the values of the intended clients and least by ethical or moral considerations. The dilemma exists between what is politically desirable and what is morally binding.

A group of 61 male and 90 female non-selected Finnish cancer patients were interviewed forthe use of unproven cancer remedies. About 50 remedies were known to these patients and 23 of these were actually in use. The most popular remedy was extract of birch ash, but health beverages, with or without ascorbic acid and iodine, butterbur and beetroot were also commonly used.

55.6% of the females and 29.5% of the males had used unproven cancer remedies and 38.9% and 37.7%respectively had confidence in such remedies. Those with a higher educational level more often had confidence in these remedies than did those with only a basic education, but the actual use of the remedies was similar in both groups. The most common argument behind their use was that the remedy was health-restoring, and confidence was grounded in reports of its beneficial results. The majority of users had learned the remedy from their friends and relatives and used it in conjunction with cancer therapy or afterwards. Only a few had felt any positive effects on their cancer, however. The majority of patients had not discussed such remedies with the medical staff.

Many studies have demonstrated the importance of health perceptions in predicting and illness behavior, especially the use of health services. Despite the theoretical importance of this concept, the critical determinants of health perceptions have not yet been identified. This study analyses the relative importance of professionally defined oral health status and demographic factors in detesmir ing patients' perceptions of their oral health status. The sample consisted of 1350 patients who had submitted a dental insurance claim. For each patient, data was obtained on their oral health, demographic background and perceived oral health status.

The findings indicate that the number of missing teeth is the most important variable explaining oralhealth perceptions. However, the association is weak, and even at extreme levels of clinical morbidity many patients still consider themselves to be in good oral health. Sociodemographic factors had only a minor effect on oral health perceptions, although older, male patients in the upper socioeconomic class tended to have a more positive view of their oral health.

Japan has experienced a dramatic increase in psychiatric beds from a level of 32.4 per 100,000population in 1953 to 254.1 in 1977. The number of inpatients has always paralleled this increase as the bed occupancy rate has remained above 100% during these years. The age specific resident patient rates of psychiatric patients were initially higher for the younger age groups but have gradually shifted to the middle age groups. Geriatric psychiatric patients over 65 years of age have had low rates and constitute only about 8.5% of the total at present. The increase in psychiatric beds has resulted in large part from the establishment of private hospitals each having about 200 beds. While the number of personnel per bed in psychiatric hospitals has slightly increased, the basic composition has remained the same for 20 years. The proportion of medical care cost devoted to psychiatric care has been estimated to have grown from 5.8% of the total in 1963 to 7.2% in 1976. However, the burden of inpatient psychiatric care has been obscured by the general increase in medical care costs. A futher increase in psychiatric beds would become necessary if the psychiatric sector is to play a major role in geriatric care.

This research describes the extent of use of antipsychotic drugs in sheltered-care and examines the effect of these drugs by dosage, age group and psychopathology on rehospitalization and social integration.

Data were collected from a large sample of former mental patientsmentally ill between 18 and 65 a living in community based

Findings suggest that antipsychotic drugs, when used with limited medical supervision, have detrimentaleffects on the social functioning of the least disturbed. While antipsychotics may short circuit the psychotic process and thereby reduce mental hospital readmissions, social programming is necessary to promote better social functioning.