scholarly journals Care dependence in old age: preferences, practices and implications in two Indonesian communities

2012 ◽  
Vol 34 (3) ◽  
pp. 361-387 ◽  
Author(s):  
ELISABETH SCHRÖDER-BUTTERFILL ◽  
TENGKU SYAWILA FITHRY

ABSTRACTThe provision of physical care is a sensitive matter in all cultures and is circumscribed by moral injunctions and personal preferences. Research on Western cultures has shown care networks to be narrow subsets of people's wider networks and revealed dependence to be deeply undermining of full personhood. In non-Western societies these issues have received little attention, although it is sometimes assumed that care provision and dependence are much less problematic. This paper uses longitudinal ethnographic data from two ethnic groups in rural Indonesia to compare care preferences and practices in old age and to examine the implications of care dependence. The groups manifest varying degrees of daughter preference in care and differ in the extent to which notions of shame and avoidance prohibit cross-gender intimate care and care by ‘non-blood’ relatives. Demographic and social constraints often necessitate compromises in actual care arrangements (e.g. dependence on in-laws, neighbours or paid carers), not all of which are compatible with quality care and a valued identity. We argue that by probing the norms and practices surrounding care provision in different socio-cultural settings, it becomes possible to arrive at a deeper understanding of kinship, personhood and sociality. These insights are not only of sociological interest but have implications for people's vulnerability to poor quality care in old age.

2010 ◽  
Vol 15 (4) ◽  
pp. 497-509 ◽  
Author(s):  
Helen Minnis ◽  
Graham Bryce ◽  
Louise Phin ◽  
Phil Wilson

Children in care have higher rates of mental health problems than the general population and placement instability contributes to this. Children are both most vulnerable to the effects of poor quality care and most responsive to treatment in the early weeks and months of life yet, in the UK, permanency decisions are generally not in place until around the age of four. We aimed to understand the components of an innovative system for assessing and intervening with maltreated children and their families developed in New Orleans and to consider how it might be implemented in Glasgow, UK. During and after a visit to New Orleans by a team of Glasgow practitioners, eight key interviews and meetings with New Orleans and Glasgow staff were audio-recorded. Qualitative analysis of verbatim transcripts identified key themes. Themes highlighted shared aspects of the context and attitudes of the two teams, identified gaps in the Glasgow service and steps that would be needed to implement a version of the New Orleans model in Glasgow. Our discussions with the New Orleans team have highlighted concrete steps we can take, in Glasgow, to make better decision-making for vulnerable children a reality.


2010 ◽  
Vol 4 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Melanie R. Krause ◽  
Janice L. Palmer ◽  
Barbara J. Bowers ◽  
Kathleen C. Buckwalter

BMJ ◽  
2009 ◽  
Vol 339 (sep01 2) ◽  
pp. b3549-b3549
Author(s):  
M. Pownall

Author(s):  
Sheila Leatherman ◽  
Linda Tawfik ◽  
Dilshad Jaff ◽  
Grace Jaworski ◽  
Matthew Neilson ◽  
...  

Abstract Quality problem or issue There are record-setting numbers of people living in settings of extreme adversity and they continue to increase each year. Initial assessment There is a paucity of validated data on quality and safety across settings of extreme adversity. Choice of solution This paper argues for an action framework to address the unique challenges of providing quality in extreme adversity. Implementation We describe a preliminary Quality in Extreme Adversity framework which has been informed by—and will continue to be validated through—literature, data collection, WHO expert consultations and through working in settings of extreme adversity with national authorities and NGOs. Lessons learned Poor quality care costs lives, livelihoods and trust in health services. The recommended framework, based on evidence and experiential lessons, intends to address the WHO goal for 2019–2023 of ‘one billion people better protected from health emergencies’ (9).


Author(s):  
Daniela A. Pimentel Maldonado ◽  
April Moreno ◽  
Mitzi J. Williams ◽  
Lilyana Amezcua ◽  
Shawn Feliciano ◽  
...  

Abstract Background: For unclear reasons, minorities have been historically underrepresented in multiple sclerosis (MS) clinical trials. We hypothesized that different perceptions and preferences about research participation among racial and ethnic groups contribute to this imbalance. Methods: Members of the MS Minority Research Engagement Partnership Network developed a Web-based survey in English and Spanish on research impressions, concerns, and preferences regarding study attributes among people with MS. Invitations to take the survey were distributed by network members and partner organizations. Results: We included 2599 participants with MS (2111 White, 215 African American; 188 Hispanic). Consistently disliked study attributes included potential harms to health and confusing study information. Compared with White and non-Hispanic participants, respectively, African American (odds ratio [OR] = 2.05, P ≤ .001) and Hispanic (OR = 1.79, P = .003) participants were more concerned about being used by the research team. Hispanic participants were more concerned about research participation carrying risks to their legal status (OR = 1.70, P = .001). Hispanic (OR = 3.18, P ≤ .001) and African American (OR = 5.51, P ≤ .001) participants were more likely to prefer for the study to benefit their own racial/ethnic group. A top concern across all groups was not being fully informed about the research. Conclusions: We found strong support for research across racial and ethnic groups; however, minority groups have specific concerns regarding mistrust, receiving poor-quality care, unemployment, health insurance, and legal status. Investigators wanting to recruit a diverse study population are advised to show how they have addressed these concerns and to communicate how the research will advance the science and literature and result in better care and/or other benefits to underrepresented communities.


2017 ◽  
Vol 25 (1) ◽  
pp. 121-141 ◽  
Author(s):  
Patti Hamilton ◽  
Eileen Willis ◽  
Terry Jones ◽  
Rhonda McKelvie ◽  
Ian Blackman ◽  
...  

Background and Purpose: Current measures of missed nursing care employ inventories of tasks which are rated for the frequency with which each is missed. These lists have shortcomings for research and clinical evaluation. There is a need for measures with less response burden, wider generalizability, and greater sensitivity and specificity for identifying poor quality care. Methods: We tested a single-item, global, measure using data from a large study of missed care in Australia. We employed traditional and innovative analysis techniques such as receiver operating characteristic curve and item response theory. Results: The single-item measure had adequate concurrent and convergent validity when compared to one list-format measure of missed care and strong sensitivity and specificity for identifying poor quality care. Conclusions: A well-crafted single-item measure, such as the one tested, can be useful for measuring missed nursing care.


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