Sociology and Anthropology, Department of

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Family Members' Perceptions Of End-Of-Life Care Across Diverse Locations Of Care

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2013
Abstract: 

Background

The goal of the study was to assess perceived level of satisfaction with end-of-life care, focusing on the last 48 hours of life.

Methods

A previously validated instrument was used in a telephone survey with bereaved family members (n=90) of patients who died within an organization in British Columbia.

Results

Bereaved family members had many unmet needs for information about the patient’s changing condition, the process of dying, how symptoms would be managed and what to do at the time of death. In addition, many bereaved relatives felt that the patient or resident had an unmet need for emotional support and that their own emotional needs were not addressed adequately. The last place of care had the most significant effect on all of these variables, with acute care and residential care having the most unmet needs. Hospice had the fewest unmet needs, followed by the palliative and the intensive care units.

Conclusions

We discuss these findings in relation to overall satisfaction with care, focus on individual, ethno-cultural and diversity issues, information and decision-making, symptom management and attending to the family. We conclude by offering possible practices address the end-of-life needs of patients and family members.

Document type: 
Article
File(s): 

An Average/Deprivation/Inequality (ADI) Analysis of Chronic Disease Outcomes and Risk Factors in Argentina

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2009
Abstract: 

BACKGROUND:Recognition of the global economic and epidemiological burden of chronic non-communicable diseases has increased in recent years. However, much of the research on this issue remains focused on individual-level risk factors and neglects the underlying social patterning of risk factors and disease outcomes.METHODS:Secondary analysis of Argentina's 2005 Encuesta Nacional de Factores de Riesgo (National Risk Factor Survey, N = 41,392) using a novel analytical strategy first proposed by the United Nations Development Programme (UNDP), which we here refer to as the Average/Deprivation/Inequality (ADI) framework. The analysis focuses on two risk factors (unhealthy diet and obesity) and one related disease outcome (diabetes), a notable health concern in Latin America. Logistic regression is used to examine the interplay between socioeconomic and demographic factors. The ADI analysis then uses the results from the logistic regression to identify the most deprived, the best-off, and the difference between the two ideal types.RESULTS:Overall, 19.9% of the sample reported being in poor/fair health, 35.3% reported not eating any fruits or vegetables in five days of the week preceding the interview, 14.7% had a BMI of 30 or greater, and 8.5% indicated that a health professional had told them that they have diabetes or high blood pressure. However, significant variation is hidden by these summary measures. Educational attainment displayed the strongest explanatory power throughout the models, followed by household income, with both factors highlighting the social patterning of risk factors and disease outcomes. As educational attainment and household income increase, the probability of poor health, unhealthy diet, obesity, and diabetes decrease. The analyses also point toward important provincial effects and reinforce the notion that both compositional factors (i.e., characteristics of individuals) and contextual factors (i.e., characteristics of places) are important in understanding the social patterning of chronic diseases.CONCLUSION:The application of the ADI framework enables identification of the regions or groups worst-off for each outcome measure under study. This can be used to highlight the variation embedded within national averages; as such, it encourages a social perspective on population health indicators that is particularly attuned to issues of inequity. The ADI framework is an important tool in the evaluation of policies aiming to prevent or control chronic non-communicable diseases.

Document type: 
Article

Immigration as Pathogenic: A Systematic Review of the Health of Immigrants to Canada

Author: 
Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2010
Abstract: 

This review investigates the health of immigrants to Canada by critically examining differences in health statusbetween immigrants and the native-born population and by tracing how the health of immigrants changes aftersettling in the country. Fifty-one published empirical studies met the inclusion criteria for this review. The analysisfocuses on four inter-related questions: (1) Which health conditions show transition effects and which do not? (2)Do health transitions vary by ethnicity/racialized identity? (3) How are health transitions influenced by socioeconomicstatus? and (4) How do compositional and contextual factors interact to affect the health of immigrants?Theoretical and methodological challenges facing this area of research are discussed and future directions areidentified. This area of research has the potential to develop into a complex, nuanced, and useful account of thesocial determinants of health as experienced by different groups in different places.

Document type: 
Article