Social science & medicine
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Despite the ethical codes guiding bereavement research, few studies have been conducted to evaluate the perceived stress experienced by the bereaved, and to explore which methodologies cause least distress. This article investigates how bereaved and traumatised populations experience research participation, and they voice their recommendations for future research. The data are from a nationwide three-phase study in Norway among parents who had lost their child by suicide, SIDS, and accidents between July 1, 1997 and December 31, 1998. ⋯ However, three-quarters of the interviewees reported that it was to a greater or lesser degree painful to talk about the traumatic loss. Regression analysis showed that being a woman and high levels of psychic distress were the most important predictors of a painful interview experience. In order to protect bereaved and vulnerable populations from harm, already existing ethical codes must be strictly applied, and the researchers must listen respectfully to recommendations from bereaved parents.
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Social science & medicine · Dec 2003
Randomized Controlled Trial Clinical TrialThe continuum of patient satisfaction--from satisfied to very satisfied.
In a move towards a more informed understanding of the concept of satisfaction, this paper aims to explore how 30 dermatology patients describe what it meant to them to be either satisfied or very satisfied with their healthcare. This was undertaken using in-depth interviews and the findings suggest that participants clearly differentiated between being satisfied or very satisfied with healthcare. ⋯ This observation of a 'continuum of satisfaction' has specific and important implications for the future analysis and presentation of patient satisfaction surveys. It is suggested that attention to the differences between the two constructs provides a useful means to highlighting areas of patient concern and that researchers reporting the results of patient satisfaction surveys should cease to collapse them.
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Social science & medicine · Nov 2003
Pain management and symptoms of substance dependence among patients with sickle cell disease.
Concerns about dependence on prescribed analgesia may compromise pain management, but there was previously little reliable evidence about substance dependence among patients with sickle cell disease (SCD). We conducted in-depth, semi-structured interviews with SCD patients in London, UK, to assess DSM-IV symptoms of substance dependence and abuse. Criteria were applied to differentiate between pain-related symptoms, which corresponded to the DSM-IV symptoms but involved analgesics used to control pain, and non-pain-related symptoms, which involved analgesic use beyond pain management. ⋯ Psychological disturbance was a theme associated with non-pain-related symptoms. The implications are for more responsive treatment of pain in SCD and greater awareness of how patients' pain coping may be perceived as analgesic dependence. Further research could examine ways that pain-related and non-pain-related symptoms of dependence may be associated with other pain coping strategies and with the outcomes of treatment for painful episodes in hospital.
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Social science & medicine · Nov 2003
The impact of the national polio immunization campaign on levels and equity in immunization coverage: evidence from rural North India.
Few studies have investigated the impact of immunization campaigns conducted under the global polio eradication program on sustainability of polio vaccination coverage, on coverage of non-polio vaccines (administered under Expanded Program on Immunization (EPI)), and on changes in social inequities in immunization coverage. This study proposes to fill the gaps in the evidence by investigating the impact of a polio immunization campaign launched in India in 1995. The study uses a before-and-after study design using representative samples from rural areas of four North Indian states. ⋯ Significant dropouts between first and third dose of polio raise concerns of sustainability of immunization coverage under a campaign approach. Similarly, little evidence to support synergy between polio campaign and non-polio EPI vaccinations raises questions about the effects of polio campaign on routine health system's functions. However, moderate success of the polio campaign in reducing social inequities in polio coverage may offer valuable insights into the routine health systems for addressing persistent social inequities in access to health care.
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Social science & medicine · Nov 2003
Comparative StudySomatization and mental health: a comparative study of the idiom of distress hypothesis.
Somatization is the expression of physical symptoms in the absence of medically explained physical illness. As a disproportionate response to psychosocial distress, somatization is usually correlated with depression. According to the idiom of distress hypothesis, the association of somatization and mental health is mitigated when somatizing indirectly expresses, and is understood by others as, emotional distress. ⋯ Bivariate and multivariate analyses revealed that the relationship of somatization with mental health depends on culture. Also, the disparity in mental health was greatest and favored the U. S. adults at low levels of somatization, but the disparity in mental health between countries disappeared as somatization increased.