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Illness Management (illness + management)

Distribution by Scientific Domains
Humanities and Social Sciences60%

Selected Abstracts

Towards a sustainable theory of health-related stigma: lessons from the HIV/AIDS literature

JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 6 2006
Harriet Deacon
Abstract Stigma has been identified as a major barrier to health care and quality of life in illness management. But unfortunately there is no common theoretical perspective on stigma. We need a sustainable theory of health-related stigma. This would start with a coherent definition of stigma that brings together both individual and social dimensions of this complex phenomenon. It would reassesses the existence of ,types' of stigma and explain how stigma relates to disadvantage. A sustainable theory would help researchers to move from theory into practice: to develop a comprehensive measurement tool for stigma and related disadvantage, and inform design, monitoring and evaluation of anti-stigma interventions. This paper draws on two recent literature reviews on HIV/AIDS stigma to introduce several key issues in developing a sustainable theory of stigma. We suggest limiting the definition of stigma to the process of othering, blaming and shaming (often called symbolic stigma). We argue that there is value in analytically separating stigma from discrimination in order to better understand the relationship between them. We also suggest the need to understand discrimination caused by stigma as only one element of stigma-related disadvantage. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Neoliberal Reform and Health Dilemmas

MEDICAL ANTHROPOLOGY QUARTERLY, Issue 3 2008
Social Hierarchy, Therapeutic Decision Making in Senegal
In this article, I trace the links among neoliberalism, regional ecological decline, and the dynamics of therapeutic processes in rural Senegal. By focusing on illness management in a small rural community, the article explores how economic reform is mediated by existing social structures, and how household social organization in turn influences therapeutic decision making. The illness episodes relayed here demonstrate how the acute economic and social crisis facing the Ganjool region becomes written on the bodies of young men, and how the fault lines of gender and generation shape illness experiences. These narratives also illuminate the tremendous discrepancy between the lived realities of sickness and death, and the idealized models of health participation and empowerment envisioned by the state. Rather than "neoliberal subjects" who behave as rational economic actors, men and women coping with illness are social beings embedded in fields of power characterized by highly stratified household social relations. [source]

TRIP: a psycho-educational programme in Hong Kong for people with schizophrenia

OCCUPATIONAL THERAPY INTERNATIONAL, Issue 2 2007
Sunny Ho-Wan Chan
Abstract ,TRIP' (Transforming Relapse and Instilling Prosperity) is a ward-based illness management programme that aims to decrease treatment non-compliance and relapse rate by improving the insight and health of acute psychiatric patients with schizophrenia. Eighty-one stable male acute psychiatric patients with schizophrenia were randomized to receive the TRIP programme (n = 44) or the comparison group of traditional ward occupational therapy (WOT) programme (n = 37). Participants' insights and health were assessed by the Unawareness of Mental Disorder Scale and the Hong Kong version of the Short Form-36 (SF-36) health survey, respectively. Each group was then followed up for a 12-month period. One-way analysis of covariance (ANCOVA) showed that participants in the TRIP programme had significantly better insight and health than a comparison group during post-study measurement. Participants in the TRIP programme had significantly fewer re-admissions in the 12-month follow-up period than those who attended the WOT programme. In summary the TRIP programme, as led by an occupational therapist, was effective in improving insight, awareness of health and in having a lower re-admission rate than a traditional occupational therapy programme. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Maternal depressive symptoms and adherence to therapy in inner-city children with Asthma

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2004
Richard Reading
Maternal depressive symptoms and adherence to therapy in inner-city children with Asthma . Bartlet, S.J., Krishnan, J.A., Riekert, K.A., Butz, A.M., Malveaux, F.J. & Rand, C.S. ( 2004 ) Pediatrics113 , 229 , 237 . Context Little is known about how depressive symptoms in mothers affects illness management in inner-city children with asthma. Objective The goal was to determine how maternal depressive symptoms influence child medication adherence, impact of the child's asthma on the mother, and maternal attitudes and beliefs. Methods Baseline and 6-month surveys were administered to 177 mothers of young minority children with asthma in inner-city Baltimore, MD and Washington, DC. Medication adherence, disruptiveness of asthma, and select attitudes toward illness and asthma therapy were measured. Six-month data (n = 158) were used to prospectively evaluate long-term symptom control and emergency department use. Independent variables included asthma morbidity, age, depressive symptoms and other psychosocial data. Results No difference in child asthma morbidity was observed between mothers high and low in depressive symptoms. However, mothers with high depressive symptoms reported significantly more problems with their child using inhalers properly [odds ratio (OR) 5.0, 95% confidence interval (CI) 1.3,18.9] and forgetting doses (OR 4.2, 95% CI 1.4,12.4). Depressive symptoms were also associated with greater emotional distress and interference with daily activities caused by the child's asthma, along with less confidence in asthma medications, ability to control asthma symptoms and self-efficacy to cope with acute asthma episodes. In addition, depressed mothers reported less understanding about their child's medications and use (OR 7.7, 95% CI 1.7,35.9). Baseline asthma morbidity, maternal depression scores and family income were independently associated with asthma symptoms 6 months later, whereas medication adherence was not predictive of subsequent asthma morbidity or emergency department use. Conclusions Maternal depressive symptoms were not associated with child asthma morbidity but were associated with a constellation of beliefs and attitudes that may significantly influence adherence to asthma medications and illness management. Identifying and addressing poor psychological adjustment in mothers is important when developing a child's asthma treatment and may facilitate parent,provider communication, medication adherence and asthma management among inner-city children. [source]