scholarly journals Social problems, primary care and pathways to help and support: addressing health inequalities at the individual level. Part II: lay perspectives

2007 ◽  
Vol 61 (11) ◽  
pp. 972-977 ◽  
Author(s):  
J. Popay ◽  
U. Kowarzik ◽  
S. Mallinson ◽  
S. Mackian ◽  
J. Barker
Keyword(s):  
Primary Care ◽  
Health Inequalities ◽  
Social Problems ◽  
Individual Level ◽  
Lay Perspectives ◽  
The Individual

scholarly journals A national pilot program for chronic diseases and health inequalities in South Korea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rangkyoung Ha ◽  
Dongjin Kim ◽  
Jihee Choi ◽  
Kyunghee Jung-Choi
Keyword(s):  
Health Insurance ◽  
South Korea ◽  
Chronic Diseases ◽  
Health Inequalities ◽  
Socioeconomic Position ◽  
Prescription Medication ◽  
Socioeconomic Inequalities ◽  
Pilot Program ◽  
Individual Level ◽  
The Individual

Abstract Background To achieve the health equity, it is important to reduce socioeconomic inequalities when managing chronic diseases. In South Korea, a pilot program for chronic diseases was implemented at the national level. This study aimed to examine its effect on socioeconomic inequalities in chronic disease management at the individual and regional levels. Methods Korean National Health Insurance data from September 2016 to October 2017 were used. Study subjects in the national pilot program for chronic diseases included 31,765 participants and 5,741,922 non-participants. The dependent variable was continuity of prescription medication. Socioeconomic position indicators were health insurance contribution level and the area deprivation index. Covariates were gender, age, and the Charlson Comorbidity Index (CCI). A multilevel logistic regression model was used to address the effects at both the individual and regional levels. This is a cross-sectional study. Results Unlike the group of non-participants, the participants showed no inequality in prescription medication continuity according to individual-level socioeconomic position. However, continuity of prescription medication was higher among those in less deprived areas compared to those in more deprived areas in both the participation and non-participation groups. Conclusions This study found that the pilot program for chronic diseases at the least did not contribute to the worsening of health inequalities at the individual level in South Korea. However, there was a trend showing health inequalities based on the socioeconomic level of the area. These findings suggest that additional policy measures are needed to attain equality in the management of chronic diseases regardless of the regional socioeconomic position.

scholarly journals Professional resilience in GPs working in areas of socioeconomic deprivation: a qualitative study in primary care

2018 ◽  
Vol 68 (677) ◽  
pp. e819-e825 ◽  
Author(s):  
Eleanor Eley ◽  
Ben Jackson ◽  
Chris Burton ◽  
Elizabeth Walton
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Personal Characteristic ◽  
Socioeconomic Deprivation ◽  
Individual Level ◽  
Trade Offs ◽  
Increased Risk ◽  
Framework Approach ◽  
Data Saturation ◽  
The Individual

BackgroundGPs working in areas of high socioeconomic deprivation face particular challenges, and are at increased risk of professional burnout. Understanding how GPs working in such areas perceive professional resilience is important in order to recruit and retain a GP workforce in these areas.AimTo understand how GPs working in areas of high socioeconomic deprivation consider professional resilience.Design and settingA qualitative study of GPs practising in deprived areas within one primary care region of England.MethodIn total, 14 individual interviews and one focus group of eight participants were undertaken, with sampling to data saturation. A framework approach was used for data analysis.ResultsParticipants described three key themes relating to resilience. First, resilience was seen as involving flexibility and adaptability. This involved making trade-offs in order to keep going, even if this was imperfect. Second, resilience was enacted through teams rather than through individual strength. Third, resilience required the integration of personal and professional values rather than keeping the two separate. This dynamic adaptive view, with an emphasis on the importance of individuals within teams rather than in isolation, contrasts with the discourse of resilience as a personal characteristic, which should be strengthened at the individual level.ConclusionProfessional resilience is about more than individual strength. Policies to promote professional resilience, particularly in settings such as areas of high socioeconomic deprivation, must recognise the importance of flexibility, adaptability, working as teams, and successful integration between work and personal values.

scholarly journals Resisting psychotropic medicines: a synthesis of qualitative studies of medicine-taking

2010 ◽  
Vol 16 (3) ◽  
pp. 207-218 ◽  
Author(s):  
Nicky Britten ◽  
Ruth Riley ◽  
Myfanwy Morgan
Keyword(s):  
Mental Health Problems ◽  
Active Engagement ◽  
Clinical Environment ◽  
Individual Level ◽  
Psychotropic Medicines ◽  
The Social ◽  
Social Meanings ◽  
Lay Perspectives ◽  
Societal Level ◽  
The Individual

SummaryThis article reports the results of a synthesis of qualitative research articles about lay perspectives on prescribed psychotropic medicines. It updates and elaborates on a model of medicine-taking developed by Pound and colleagues. In this model, the concept of resistance refers to the various ways in which people take prescribed medicines while trying to minimise their intake. The synthesis included 12 papers published since 1992. The findings are presented at the societal level, in terms of the social meanings of mental health problems and medication, and at the individual level; the latter covers active engagement and lay evaluation, as well as the outcomes of evaluation, including the doctor–patient relationship. Although it can be difficult to achieve in the current clinical environment, there is much scope for developing more concordant relationships with patients in relation to prescribing and using psychotropic medicines.

Depression in primary care: part 2—management

BMJ ◽  
2019 ◽  
pp. l835 ◽  
Author(s):  
Parashar Ramanuj ◽  
Erin K Ferenchick ◽  
Harold Alan Pincus
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Primary Care Providers ◽  
Organizational Level ◽  
Psychological Interventions ◽  
Care Providers ◽  
Individual Level ◽  
Treatment Of Depression ◽  
The Individual

AbstractDepression is a common and heterogeneous condition with a chronic and recurrent natural course that is frequently seen in the primary care setting. Primary care providers play a central role in managing depression and concurrent physical comorbidities, and they face challenges in diagnosing and treating the condition. In this two part series, we review the evidence available to help to guide primary care providers and practices to recognize and manage depression. The first review outlined an approach to screening and diagnosing depression in primary care. This second review presents an evidence based approach to the treatment of depression in primary care, detailing the recommended lifestyle, drug, and psychological interventions at the individual level. It also highlights strategies that are being adopted at an organizational level to manage depression more effectively in primary care.

Depression in primary care: part 1—screening and diagnosis

BMJ ◽  
2019 ◽  
pp. l794 ◽  
Author(s):  
Erin K Ferenchick ◽  
Parashar Ramanuj ◽  
Harold Alan Pincus
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Organizational Level ◽  
Current Evidence ◽  
Evidence Based ◽  
Care Providers ◽  
Individual Level ◽  
Treatment Of Depression ◽  
The Individual ◽  
Evidence Based Guidelines

AbstractDepression is a common and heterogeneous condition with a chronic and recurrent natural course that is frequently seen in the primary care setting. Primary care providers play a central role in managing depression and concurrent physical comorbidities, and they face challenges in diagnosing and treating the condition. In this two part series, we review the evidence available to help to guide primary care providers and practices to recognize and manage depression. In this first of two reviews, we outline an approach to screening and diagnosing depression in primary care that evaluates current evidence based guidelines and applies the recommendations to clinical practice. The second review presents an evidence based approach to the treatment of depression in primary care, detailing the recommended lifestyle, drug, and psychological interventions at the individual level. It also highlights strategies that are being adopted at an organizational level to manage depression more effectively in primary care.

scholarly journals Income-Related Health Inequalities in Korea

2009 ◽  
Vol 22 (1) ◽  
pp. 32-41 ◽  
Author(s):  
Byung Chul Ahn ◽  
Katrin Engelhardt ◽  
Hyojee Joung
Keyword(s):  
Health Inequalities ◽  
Household Income ◽  
The United States ◽  
Grouped Data ◽  
Lower Income ◽  
Individual Level ◽  
Health And Nutrition ◽  
The United Kingdom ◽  
Western Germany ◽  
The Individual

Data from the 2001 Korean National Health and Nutrition Examination Survey and the ill health concentration index (CI) were used to examine income-related health inequalities among Koreans. Participants (>19 years old) were requested to provide information regarding monthly household income, expenditures, subjective living conditions, and health status. Ill health was determined both subjectively through self-rated health (SRH) scores and objectively through the number of diseases (ND). At the individual level, the CIs for SRH and ND were -0.147 and -0.093, respectively; age—gender adjusted CIs were -0.065 and -0.071, respectively. These values remained unchanged when estimating CI for grouped data. These results indicate that ill health was more pronounced among lower income groups in Korea. However, avoidable health inequality in Korea was smaller than in the United Kingdom and the United States, larger than in Sweden, Eastern Germany, Finland, and Western Germany, and roughly equal to the Netherlands, Spain, and Switzerland.

Differential Effects of Competence and Morality on Self-Esteem at the Individual and the Collective Level

2020 ◽  
Vol 51 (3) ◽  
pp. 183-198
Author(s):  
Wiktor Soral ◽  
Mirosław Kofta
Keyword(s):  
Self Esteem ◽  
Differential Effects ◽  
Individual Level ◽  
The Subject ◽  
The Individual

Abstract. The importance of various trait dimensions explaining positive global self-esteem has been the subject of numerous studies. While some have provided support for the importance of agency, others have highlighted the importance of communion. This discrepancy can be explained, if one takes into account that people define and value their self both in individual and in collective terms. Two studies ( N = 367 and N = 263) examined the extent to which competence (an aspect of agency), morality, and sociability (the aspects of communion) promote high self-esteem at the individual and the collective level. In both studies, competence was the strongest predictor of self-esteem at the individual level, whereas morality was the strongest predictor of self-esteem at the collective level.

Metonymy in Dance: Ballet Bunheads Take a Cognitive Turn

2019 ◽  
Vol 37 (1) ◽  
pp. 18-34
Author(s):  
Edward C. Warburton
Keyword(s):  
Identity Formation ◽  
Cognitive Science ◽  
Artistic Development ◽  
Individual Level ◽  
Figures Of Speech ◽  
Self Image ◽  
Level I ◽  
Dance Educators ◽  
The Individual ◽  
Metaphor And Metonymy

This essay considers metonymy in dance from the perspective of cognitive science. My goal is to unpack the roles of metaphor and metonymy in dance thought and action: how do they arise, how are they understood, how are they to be explained, and in what ways do they determine a person's doing of dance? The premise of this essay is that language matters at the cultural level and can be determinative at the individual level. I contend that some figures of speech, especially metonymic labels like ‘bunhead’, can not only discourage but dehumanize young dancers, treating them not as subjects who dance but as objects to be danced. The use of metonymy to sort young dancers may undermine the development of healthy self-image, impede strong identity formation, and retard creative-artistic development. The paper concludes with a discussion of the influence of metonymy in dance and implications for dance educators.

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