Drug adherence, medical pluralism, and psychopharmaceutical selfhood in postreform Vietnam

2019 ◽  
Vol 57 (1) ◽  
pp. 81-93
Author(s):  
Allen L Tran ◽  
Trần Đan Tâm ◽  
Hà Thúc Dũng ◽  
Nguyễn Cúc Trâm
Keyword(s):  
Psychiatric Patients ◽  
Theoretical Models ◽  
The Self ◽  
Medical Pluralism ◽  
Outpatient Basis ◽  
Psychiatric Medication ◽  
Drug Adherence ◽  
Individual Level ◽  
Medical Traditions

This article examines drug adherence in relation to changing patterns of medical pluralism and neoliberal reforms among psychiatric patients in postreform Ho Chi Minh City, Vietnam. We conducted 39 in-depth interviews and 21 follow-up interviews with individuals prescribed psychiatric medication on an outpatient basis in 2016 to identify patterns of nonadherence, which was operationalized as taking medications according to doctors’ prescriptions at the three-month follow-up interval. Patients adapt or reject their medication prescriptions due to (1) concerns about biomedical drugs and adverse drug reactions, (2) local concepts of psychic distress and selfhood, and (3) the social context of medicine taking. The dominant theoretical models of drug adherence focus on individual-level predictors. However, situating drug adherence in its political-economic context highlights the relationship between medicine and neoliberal modernity that underlies adherence. Examining the intersection of multiple medication regimens and political regimes, we argue that nonadherence is rooted in a complex layering of medical traditions and modernist projects of the self. The reception of new biomedical drugs in Vietnam is shaped by not only folk theories of illness but also a changing cultural politics of the self.

The Influence of Videotape Feedback on the Self-Assessments of Psychiatric Patients

1978 ◽  
Vol 133 (2) ◽  
pp. 156-161 ◽  
Author(s):  
R. D. P. Griffiths ◽  
P. Gillingham
Keyword(s):  
Physical Attractiveness ◽  
Psychiatric Patients ◽  
Structured Interview ◽  
The Self ◽  
Response Style ◽  
Partial Replication ◽  
Questionnaire Measure ◽  
Videotape Feedback ◽  
Self Assessments

SummaryThe effects of videotape feedback on patients' self-perception were assessed in a study which was a partial replication of an investigation reported by Griffiths and Hinkson (1973). Subjects were randomly allocated to one of three groups. After a semi-structured interview, they were either (1) shown a videotape of the interview, or (2) shown a videotape of another person being interviewed, or (3) engaged in other activities not involving videotape. Patients' self-ratings indicated that videotape feedback has immediate effects on self-assessments of social ease and physical attractiveness. Feedback produced changes in ratings of social ease, but individuals differed in the direction of the change (i.e. whether social ease was ‘better’ or ‘worse’). The direction of the change was predicted by a questionnaire measure of response style. Feedback also tended to make patients rate themselves as less attractive in the eyes of other people. All changes were, however, temporary and had disappeared at a two-week follow-up.The results are generally consistent with those reported by Griffiths and Hinkson in that they indicate temporary and specific changes in response to videotape feedback. The implications of the results are discussed.

scholarly journals Mixed methods assessment of impact on health awareness in adult childhood cancer survivors after viewing their personalized digital treatment summary and follow-up recommendations

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Helena M. Linge ◽  
Cecilia Follin
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Literacy ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Childhood Cancer Survivors ◽  
The Self ◽  
Health Related ◽  
Treatment Summary

Abstract Background The survival rate after childhood cancer has improved to 80%. The majority of childhood cancer survivors (CCS) will experience late complications which require follow up care, including access to their individual cancer treatment summary. The need to understand CCS needs and preferences in terms of ways to receive information e.g. digitally, becomes important. This study aims to through a mixed methods approach a) examine how CCS’ health awareness was impacted by viewing their personalized digital treatment summary and follow-up recommendations, b) explore E health literacy, and c) determine self-reported survivorship experiences and health care usage. Methods Survivors with a recent visit to the Late effects clinic were eligible for the study (n = 70). A representative sample of primary diagnoses were invited (n = 28). 16 CCS were enrolled. Recent medical visits, e health literacy and impressions of the digital treatment summary were assessed by a survey in conjunction with viewing their digital treatment summary on a computer screen. Their experience of reading and understanding their digital treatment summary in the context of their health related survivorship experiences were assessed in focus groups. The transcribed data was analyzed with conventional qualitative content analysis. Results The self-reported medical problems largely reflected that, only 6,3% reported no cancer-related reasons for seeking medical attention. Of the medical specialists, the primary care physician was the most frequently visited specialist (68.8%). High E health literacy was not associated with treatment features but with educational level (p = 0.003, CI: 3.9–14.6) and sex (p = 0.022, CI: − 13.6- -1.3). All survivors graded the digital treatment summary above average in terms of being valuable, agreeable and comprehensive. The focus group interviews identified three themes: 1) The significance of information, 2) The impact of awareness; and 3) Empowerment. Conclusions Reading the treatment summaries furthered the survivors understanding of their health situation and consequently aided empowerment. A digital treatment summary, provided by knowledgeable health care professionals, may increase the self-managed care and adherence to follow-up recommendations. Further insights into e health literacy in larger samples of CCS may determine to what extent health-related information can be communicated via digital resources to this at risk population.

Manual occupations with high all-cause mortality: The contribution of socioeconomic and occupational characteristics

2020 ◽  
pp. 140349482096065
Author(s):  
Hanna Rinne ◽  
Mikko Laaksonen
Keyword(s):  
High Mortality ◽  
Excess Mortality ◽  
Proportional Hazard ◽  
Individual Level ◽  
Cox Proportional Hazard ◽  
Occupational Characteristics ◽  
Study Population ◽  
Cox Proportional Hazard Regression ◽  
Year 2000

Aims: Most high mortality-risk occupations are manual occupations. We examined to what extent high mortality of such occupations could be explained by education, income, unemployment or industry and whether there were differences in these effects among different manual occupations. Methods: We used longitudinal individual-level register-based data, the study population consisting of employees aged 30–64 at the end of the year 2000 with the follow-up period 2001–2015. We used Cox proportional hazard regression models in 31 male and 11 female occupations with high mortality. Results: There were considerable differences between manual occupations in how much adjusting for education, income, unemployment and industry explained the excess mortality. The variation was especially large among men: controlling for these variables explained over 50% of the excess mortality in 23 occupations. However, in some occupations the excess mortality even increased in relation to unadjusted mortality. Among women, these variables explained a varying proportion of the excess mortality in every occupation. After adjustment of all variables, mortality was no more statistically significantly higher than average in 14 occupations among men and 2 occupations among women. Conclusions: The high mortality in manual occupations was mainly explained by education, income, unemployment and industry. However, the degree of explanation varied widely between occupations, and considerable variation in mortality existed between manual occupations after controlling for these variables. More research is needed on other determinants of mortality in specific high-risk occupations.

Four-Year Follow-Up of a Meditation-Based Program for the Self-Regulation of Chronic Pain

1986 ◽  
Vol 2 (3) ◽  
pp. 159-774 ◽  
Author(s):  
J. Kabat-Zinn ◽  
L. Lipworth ◽  
R. Burncy ◽  
W. Sellers
Keyword(s):  
Chronic Pain ◽  
Self Regulation ◽  
The Self

Mortality among Psychiatric Patients

1970 ◽  
Vol 15 (4) ◽  
pp. 143-148 ◽  
Author(s):  
G. Innes ◽  
W. M. Millar
Keyword(s):  
Causes Of Death ◽  
Psychiatric Patients ◽  
Psychiatric Services ◽  
Social Classes ◽  
First Year ◽  
Organic Psychosis ◽  
Physical Symptomatology ◽  
Regional Board ◽  
Excessive Number

A 5-year follow-up study was carried out of all referrals to the psychiatric services in a Regional Board area. The death registers of the Registrar General for Scotland were searched for all patients who were not known to be alive at the end of the study. Of the 2103 patients included in the original study, 343 were found to have died. This represents 15.9 per cent of males and 16.7 per cent of females referred. Most of the deaths (41%) occurred in the first year of follow-up, 20 per cent in the first 3 months. The overall death rate was approximately twice the expectation based on death rates in the general population of the area. The excess was greatest in those aged under 55 years. All areas of residence, occupations and social classes had increased mortality. Those patients diagnosed as organic psychosis had highest mortality (70%) but all diagnoses had an excessive number of deaths when standardised for age. Of the initial referrals, 1.4 per cent committed suicide during the follow-up period. Apart from neoplasms where deaths were close to expectation, all other broad categories of causes of death were equally involved in the increase. This survey of a total psychiatric referral group (in-patients, out-patients and domiciliary visits and private patients) supports previously reported studies, mainly of in-patients, in their finding of an association between high mortality rates and psychiatric illness. It is possible that this association may result from selective referral to the psychiatric services of those psychiatrically ill patients who exhibit physical symptomatology.

Comparison of Self-reported to Observational Agitation Scales

2017 ◽  
Vol 41 (S1) ◽  
pp. S151-S151
Author(s):  
L. Zun ◽  
L. Downey
Keyword(s):  
Psychiatric Patients ◽  
Likert Scale ◽  
The Self ◽  
Assessment Tools ◽  
Self Assessment ◽  
Convenience Sample ◽  
Ed Visits ◽  
Competing Interest ◽  
A Prospective Study ◽  
Age Range

BackgroundIncreasingly, psychiatric patients are presenting to the emergency department (ED) with agitation. ED staff rarely, if ever, use scale to assess agitation or use any self-assessment tools to determine a patient's level of agitation.ObjectivesTo evaluate the relationship between a patient's self-reported level of agitation and other validated agitation assessment tools.MethodsThis is a prospective study using a convenience sample of patients presenting to the ED with a psychiatric complaint. This study was conducted in an urban, inner-city trauma level 1 center with 55,000 ED visits a year. After obtaining consent, a research fellow administered observational tools, PANSS-EC and ACES and BAM and Likert scale self assessment tools on arrival to the ED. SPSS version 24 was used. The study was IRB approved.ResultsA total of 139 patients were enrolled. The most common ED diagnoses were depression, schizophrenia, or bipolar. Majority of patients were African-American (59%), falling in the 25–44 year old age range (56%) 52% male. Self-reported agitation was rated as moderate to high in 72.4% of these patients on the Likert scale and 76.3% on the BAM. There was a significant correlation between the self-reported score versus the BAM (F = 11.2, P = 0.00). However, the self-reported scores were significantly different from the scores assessed by observational tools (P < 0.05).ConclusionsED providers should assess a patient's self-reported level of agitation because a patient could be feeling markedly agitated without expressing outward signs detected by observational tools.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The Chronic Patient in the Community A Two-Year Follow Up of 338 Chronic Patients

1968 ◽  
Vol 13 (3) ◽  
pp. 231-236 ◽  
Author(s):  
M. Herjanic ◽  
A. Stewart ◽  
R. C. Hales
Keyword(s):  
Social Worker ◽  
Living Arrangements ◽  
Community Care ◽  
Psychiatric Patients ◽  
Chronic Patient ◽  
Chronic Patients ◽  
Chronic Psychiatric Patients

Three hundred and thirty-eight chronic psychiatric patients were followed up for two years after their discharge. Information was available on all but four patients. During the twenty-four month follow-up period, 11% had died and 25% required readmission. The source of support and living arrangements for the whole group were discussed, and the opinions about the outcome by the informant, psychiatrist, and social worker, were compared, The opinions correlated remarkably well. Characteristics of community care deemed important by the investigators were discussed briefly.

Bayesian Prediction in Hybrid Conjoint Analysis

2002 ◽  
Vol 39 (2) ◽  
pp. 253-261 ◽  
Author(s):  
Frenkel Ter Hofstede ◽  
Youngchan Kim ◽  
Michel Wedel
Keyword(s):  
Prior Information ◽  
Current Model ◽  
The Self ◽  
Attribute Importance ◽  
Individual Level ◽  
Special Cases ◽  
Full Profile ◽  
Credible Intervals ◽  
Competing Models ◽  
The Individual

The authors propose a general model that includes the effects of discrete and continuous heterogeneity as well as self-stated and derived attribute importance in hybrid conjoint studies. Rather than use the self-stated importances as prior information, as has been done in several previous approaches, the authors consider them data and therefore include them in the formulation of the likelihood, which helps investigate the relationship of self-stated and derived importances at the individual level. The authors formulate several special cases of the model and estimate them using the Gibbs sampler. The authors reanalyze Srinivasan and Park's (1997) data and show that the current model predicts real choices better than competing models do. The posterior credible intervals of the predictions of models with the different heterogeneity specifications overlap, so there is no clear superior specification of heterogeneity. However, when different sources of data are used—that is, full profile evaluations, self-stated importances, or both—clear differences arise in the accuracy of predictions. Moreover, the authors find that including the self-stated importances in the likelihood leads to much better predictions than does considering them prior information.

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