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The context in which caring and caregiving takes place is dominated by the cultural conditions and social realities of the time. This ethnographic study explored the perceptions and moral determinants of caregiving from the personal accounts of primary caregivers in 10 Beijing families. Analysis generated themes of labor and routines of caregiving, restricted resources, health, and illness, linked by the sentiment of establishing a connection, family time, personal time, gendered time, and reciprocity. For these Beijing families, caregivers accorded and enacted caregiving based on diffuse sentimental and behavioral as well as cultural guidelines drawing on the nature and quality of the relationship, past patterns of exchange, and a clear sense of who was most able to provide care and why. Implicationsfor the provision of health care tofamilies in China are outlined.

Death is a reality of life. Despite this inevitability, death today remains unwelcome and has been sequestered into the enclaves of medical practice as a means of quelling the rising tide of fear it provokes. Medical practice currently maintains power over the dying individual, actualised through the selective collaboration between medicine and law as a means of subverting the individual who attempts to disrupt the contemporary accepted norms of dying. There is, however, a shift on the horizon as to whether we can make the notion of a true choice become a reality in New Zealand. This serves to offer a compelling movement towards individuals seeking control of their dying trajectory to actualise the notion of individual choice. With this shifting landscape there is an opportunity to be grasped to change how we manage our dying trajectory away from the biomedical patterns of behaviour when dying, in order to balance life decisions. To achieve this prospect, we need to engage with a framework upon which to pin the changes. This paper offers a re-framing and re-presenting approach, using illustrative examples that draw upon British and New Zealand literature, together with over 50 years of professional nursing, and the Ars Moriendi to reflect upon the self-centricity of the contemporary Western individual to access a 'good death' of choice.

Purpose: To clarify sociodemographic and socioeconomic factors associated with mothers' experiences of psychosocial care and communication by midwives during childbirth in Nairobi, Kenya. Design: A descriptive cross-sectional study conducted in a government national referral hospital. Respondents were 109 systematically sampled mothers who delivered in the study hospital. Mothers' experiences of intrapartum care were assessed using three subscales from the Experience of Psychosocial Care and Communication during Childbirth Questionnaire (effective communication; emotional support; and respect, care and dignity). Simple and multivariable logistic regression analyses were used to assess associations between sociodemographic factors, socioeconomic factors and mothers' experiences of intrapartum care. Findings: The majority of respondents were aged 20–24 years (45.9%), married (71.6%), had primary school education (48.6%) and were self-employed (45%). The majority reported positive experiences of communication, respect, dignity and emotional support from their midwives. Being an older mother was significantly associated with a positive experience of intrapartum care (adjusted odds ratio [AOR] 7.32; 95% Confidence Interval (CI): 1.17–45.9). The odds of having a positive intrapartum care experience was significantly lower among women with parity of four or more (AOR 0.09; 95% CI: 0.01–0.56) and tertiary education (AOR 0.11; 95% CI: 0.01–0.91). Conclusion: Attention to the use of respectful language and adherence to clear communication must be an integral part of quality improvement for midwifery care in Kenya.

Abstract Background In mainland China, the motivation behind voluntary blood donation is a relatively new and understudied behavior. In recent times provincial governments in China have implemented various institutional incentive measures. However, little is known regarding the effectiveness of such measures. This qualitative study investigated the nature and outcomes of some identified institutionalized mechanisms, in particular how these were created and distributed in the form of incentives for voluntary blood donation. Methods Participatory observations were conducted at two blood donation stations and four blood collecting vehicles in Changsha city, China. In-depth interviews were conducted with 17 staff and 58 blood donors at the aforementioned venues from May to October 2008 in Changsha. Results Thematic analysis revealed the operation of four primary type incentives: policy-driven, symbolic, information feedback and role models, which constituted the system of institutional incentives. The current blood reimbursement system was not the primary motivation for blood donation; instead this system was a subtheme of future assurance for emergency blood needs. It was evident that symbolic incentives stressed the meaning and value of blood donation. Furthermore, post-donation information services and the inherent mechanisms of communication, enhanced by some public role models, served to draw the public to donate blood. Conclusions At the institutional level, blood donation was not only informed by altruism, but also carried a system of benefit and reward for the donors and their family members. We would recommend that such arrangements, if accommodated effectively into China's health promotion strategies, would increase the likelihood of blood donation.

BACKGROUND: The Four Free and One Care Policy (HIV/AIDS-related free services) has been in place in China since 2004. However, linkage to human immunodeficiency virus (HIV) care is not yet achieved very well among people living with HIV. We conducted a qualitative study to explore individual and contextual factors that may influence a linkage to HIV care from the perspective of young HIV-infected men who have sex with men (MSM) in a highly centralized HIV care context of China. METHODS: Purposive sampling was used to recruit 21 HIV-infected MSM in Shandong Province, with in-depth interviews conducted between March and July 2015. Thematic content analysis was subsequently used for data analysis. RESULTS: Key barriers and facilitators related to a linkage to HIV care emerged from participants' narratives. The barriers included perceived healthy status, low health literacy, and stigma associated with receiving HIV care. The facilitators included an awareness of responsibility, knowledge associated with health literacy, social support, and trusting and relying on services provided by the Center for Disease Control and Prevention (CDC) and the government. These were related to the quality of current HIV counselling and testing, service promotion, and the cost and placement of these HIV services. CONCLUSIONS: In order to improve the MSM linkage to HIV care in China, it is imperative to improve the quality of the current on-going counselling and testing. Further critical linkage support includes increasing supportive services among local CDC systems, designated hospitals and community-based organizations (CBOs), and more financial support for HIV/AIDS related testing, medical checkups and treatments.

In 2020, the government of Aotearoa New Zealand imposed some of the most stringent funerary restrictions in the world as part of its efforts to eliminate COVID-19. This article explores how people experienced this situation, asking why restrictions that some described as precipitating 'the most difficult time of their lives' were described by others as a 'relief', 'blessing', or 'gift'. Much existing literature frames funerary restrictions as a distressing assault upon established ways of grieving to which mourners must try to adapt–and in Aotearoa, both the stringency of the restrictions and the means by which they had been imposed did lead to many people finding them challenging. However, for those with ambivalent pre-existing feelings regarding their funerary traditions–such as many in the Samoan diaspora–COVID-19 restrictions afforded both a reprieve from burdensome practices and a much-welcomed opportunity to reimagine their traditions. Funerary restrictions, though disruptive, are thereby shown to have generative potential.

A new introduction to a timeless dynamic: how the movement of humans affects health everywhere. International migrants compose more than three percent of the world's population, and internal migrants—those migrating within countries—are more than triple that number. Population migration has long been, and remains today, one of the central demographic shifts shaping the world around us. The world's history—and its health—is shaped and colored by stories of migration patterns, the policies and political events that drive these movements, and narratives of individual migrants. Migration and Health offers the most expansive framework to date for understanding and reckoning with human migration's implications for public health and its determinants. It interrogates this complex relationship by considering not only the welfare of migrants, but also that of the source, destination, and ensuing-generation populations. The result is an elevated, interdisciplinary resource for understanding what is known—and the considerable territory of what is not known—at an intersection that promises to grow in importance and influence as the century unfolds