Western Medical Care Research Articles

한방의료 이용노인의 노인의료 서비스에 대한 태도분석

The proportion of population over sixty-fiver will be expected to increase from the current level of 7.1% in 13.1% of in 2021. Then health services for them should be extended. And also the utilization of oriental medical care from the elderly has been increased and should be extended. Purpose of this study is to investigate current state of behavioral attitude and satisfaction of the oriental medical services for the elderly of inpatient in the hospital.br/ The four hospitals were selected arbitrarily from Pusan and Masan City, 277 over- sixty five elderly was responded by questionnaire are and analysed with SPSS program. Some major results of the survey are as follows;br/ 1. About half(45.7%) of the respondents is to the age group of 65 to 69. and the low level of income is 28.9% as comparatively very high.br/ 2. Major utihzation of the mpatients is 68.1% m the heart and circulatory system, and the proportion by the case following as first 48.7% second 34.4% cerebral arteriosclerosis and hypermia and stroke. and third 2.9% to of hlghpertenSlon.br/ 3. About half of them( 48. 7%) prefer to onental medical care than western medical carebr/ 4. Major motivation of hopitalization of oriental medical hospital is following as first coperating both oriental and western medical care in the same hospital, next more effective than wetern medical care. third services kindly, firth favorable place, environmental and facility, and five transportion.br/ 5. The differentials of preference to oriental medical care by demographic charactenstics were found out as that of similar to by sex. resident and education but education career of low level to be more preference, while not significant statistics level. Then the elderly of low income IS more prefer to onental medical care. but not signifIcant statistic level among the 3 class of economic levels.br/ 6. The satisfactory status of oriental medical service of them are found out as favorable about more 80% in service of physicians and nurse services. And the differentials of the satisfaction by the demographic characteristics are not significant in general.br/

양.한방 의료서비스 이용환자의 시장 세분화에 관한 연구

The objectives of this study were analysis of patient\`s characteristics and market segmentation in oriental medical care and western medical care. This study focused on medical utilization using Anderson's health utilization model. The source of data was 1998 National Health and Nutrition Survey which Korean Institute For Health and Social Affairs carried out. A stratified multistage probability sampling design was used in this survey. The analysis was conducted using the statistical software package SPSS version 10.0 and Answer Tree 2.1 which is one of data mining methodology. The results were as follows ; 1) 44.9% of respondents reported visiting oriental medical center within recent two weeks. 3.4% of them used oriental medical care. The group of age, kind of disease and medical expenditure are associated with the difference western and oriental medical utilization rate. 2) There were several factors related to utilization of oriental medical care according to decision tree. Especially, important factors that patient chose his medical center were kinds of disease, kinds of common medical use, and expenditure. 3) in the results of CART analysis, market of oriental medical care were classified by seven categories. The major groups who have a preference for oriental medicine were those musculo-skeletal, cerebra-vascular disease, or chronic headache patients, and they had a preference fur oriental medical care in common use. These results show that oriental and western medical market were divided into various areas by market segmentation.

Care seeking during fatal childhood illnesses: Siaya District, Kenya, 1998.

1 of every 5 children in Nyanza Province Kenya dies before reaching 5 years of age. Community health workers in 200 villages were trained by Cooperative for Assistance and Relief Everywhere Kenyas Community Initiatives for Child Survival to treat children with fever cough or difficult breathing and diarrhea; refer seriously ill children; and promote illness prevention behaviors. A year after a study was conducted to investigate care-seeking itineraries during terminal illness to identify opportunities to further reduce childhood mortality. The researchers identified deaths that occurred among children younger than 5 years between May 1 and August 30 1998. Caregivers of 97 children were interviewed about the decreased childrens symptoms and duration of terminal illness the types of health providers consulted and the number chronology and timeliness of visits. In all 46% of the caregivers consulted a health worker at a health facility and 26% consulted a community health worker. 58% of the children were seen by a trained provider of western medical care. The findings point to opportunities for further reducing childhood deaths.

A Feeling for the Language

The author proposes that animal experimentation is one part of a master narrative involving presumptions about Western medical care, knowledge acquisition, and the object status of nonhuman animals. Drawing on Cohn’s analysis of the language of nuclear defense, the author applies her insights to Dunayer’s path-breaking work on speciesist language. She identifies profound connections between Cohn’s and Dunayer’s analyses, specifically “take the high ground and hold it,”“the disappearance of the victim,” and “squeeze out all available space for feeling.” The author sketches some of these connections and concludes by suggesting some of the ecofeminist implications of Dunayer’s work, specifically ecofeminism’s critique of dualistic cultural constructions that, for instance, oppose emotion to rationality. Coining the term pathophobia —the refusal to feel and thus the refusal to engage with the suffering of animals—the author suggests why master narratives will always be pathophobic.

Asian versus western differences in satisfaction with western medical care: The mediational effects of illness attributions

This study examined Asian versus Western students' satisfaction with Western medical care. and the extent to which differences in satisfaction are mediated by culture-specific “illness models”. Seventy-nine Westem (largely Canadian-born; 27 males, 53 females) and 63 Asian (first and second generation immigrants; 31 males. 32 females) undergraduates completed measures assessing satisfaction with Western medical care and views about causes of illness. Results were consistent with predictions. Asian participants were less satisfied with the health care they had resaved in Canada, and believed more strongly in non–biological causes of illness (i.e., “balance” and supernatural and interpersonal influences) than did Western participants. Moreover. illness beliefs Partly mediated the group differences in satisfaction with Western medical care.

Child health promotion in developing countries: the case for integration of environmental and social interventions?

In spite of improving epidemiological knowledge in relation to child health, the challenge of promoting the survival and quality of life of infants and children in most parts of the developing world remains an abiding public health problem, for both the countries and the international agencies involved. Current infant and child health programmes largely reflect western style medical care, with emphasis placed on reducing mortality, and the preventive aspects confined mainly to immunisation, improved nutrition, provision of micronutrients, promotion of breast-feeding and birth spacing. In contrast, environmental and social factors which underpin the proliferation of disease agents are receiving minimal attention. This paper presents a critical review of current strategies for promoting child health in developing countries, and examines the environmental, social, and political factors that influence child health. Presenting a specific example of infant and childhood diarrhoea, the authors argue that in order for a real reduction in mortality, and improvements in quality of life to be sustained, attention needs to be focused equally on the environmental and social factors that underlie much of the childhood diseases in the developing world. This will involve the adoption of a broader strategy aimed at reducing childhood diarrhoea, using the hazard analysis critical control point (HACCP) system in combination with other methods.

Multilevel healing pursuits of Cambodian refugees.

The difficult adjustment of Cambodian refugees to life in the United States is no more evident than in their use of the biomedical health care system. When forced by circumstances to seek Western medical care, they often perceive the cause of their symptoms to be untreatable by this technological modality of healing. This attitude is understandable because the lengthy and destructive civil war they survived also extinguished their medical system. Many of the refugees had no contact with Western-style health care until they reached the camps in Thailand. As a result, the Cambodians have had to develop ways to integrate centuries-old indigenous and self-care practices, that they know well, with the modern health care services and technologies, that are new to them. In San Diego they have sought what is for them a new kind of provider, Vietnamese physicians who practice medicine that is culturally appropriate and convenient. Although these multiple systems satisfy them in many ways, a significant number of Cambodians are still not getting well. The constant pursuit of healing is time-intensive and expensive, and ignores the emotional effects of refugee status on physical health.

Cancer incidence in the Hmong of Central California, United States, 1987-94.

The Hmong are an ethnic minority in China, some of whom migrated to the mountainous areas of North Vietnam, Laos, and Thailand in the 19th and 20th centuries. Because of their support for the United States during the Vietnam war, many Laotian Hmong fled to Thailand and eventually were re-settled in the US after the end of that conflict. Approximately 100,000 Hmong currently live in the US, of whom about half reside in the Central Valley of California. The purpose of this study was to measure cancer incidence in this unique new immigrant population. Using the resources of the Cancer Registry of Central California (CRCC), a population-based cancer registry, cancer incidence in the Hmong was evaluated by calculating age-adjusted incidence rates as well as by calculating proportional incidence ratios. Compared with all races combined, elevated rates of cancer in the Hmong were observed for the following sites: nasopharynx, stomach, liver, pancreas, leukemia, and non-Hodgkin's lymphoma. Cervical cancer incidence overall was elevated, but more noteworthy, invasive cervix cancer rates were much higher than expected. Lower cancer rates were found for breast, prostate, and colorectal cancer. Hmong also experienced advanced stage and grade of disease at diagnosis for many cancer sites in addition to cervical cancer, which may be explained by cultural factors, including avoidance of Western medical care and low rates of participation in screening programs. This population should be followed closely and monitored for patterns of cancer incidence in the future since it provides a natural laboratory for studies of cancer etiology as this population gradually becomes acculturated to the Western lifestyle.

Health care access and preventive care among Vietnamese immigrants: Do traditional beliefs and practices pose barriers?

Some have speculated that underutilization of Western health services among non-Western populations can be explained by traditional health beliefs and practices rooted deep within cultures. These beliefs and practices may act as barriers to access to and utilization of services. Among Vietnamese, in particular, a number of traditional health beliefs and practices have been identified which are said to pose barriers to Western medical care. No studies to date, however, have examined this hypothesis empirically. To examine this hypothesis, we measured traditional health beliefs and practices among Vietnamese in the San Francisco Bay area and analyzed the relationships between these factors and access to health care and use of preventive health services. The results of this study show clearly that many Vietnamese possess traditional health beliefs and practices which differ from those of the general U.S. population. Yet, the data do not support the hypothesis that these traditional beliefs and practices act as barriers to access to Western medical care or to utilization of preventive services. Being married and poverty status were the most consistent predictors of health care access. Furthermore, the components of access to health care (having some form of health insurance or having a regular doctor, for example) were the strongest predictors of preventive health care services utilization. Importantly, the cultural attributes of individuals did not explain either lack of health care access or underutilization of preventive health care services.

License to Practice? A View from the Rain Forest

The practice of rendering medical aid to people with whom anthropologists live and work is widespread. This article describes how two investigators were drawn into medical caregiving activities in an area that supports both indigenous shamanic practices and modern western medical care delivery. Activities that began on an incidental, interpersonal level gradually expanded into a larger, systematic program. The discussion examines the medical care-giving experiences with regard to ethical considerations of intrusion, dependency, autonomy and control. [Ecuador, Canelos Quichua, medical care delivery program, indigenous collaborators, ceramics] Peggy Golde writes that she received her first request for medical aid within ten days of moving into her house in a Mexican pottery-making village (1970: 72). She had returned to Mexico to study art style in cultural context; her research was inspired by strikingly decorated pottery she first saw in 1956. Her dispersal of medicine, usually in return for eggs, became a regular part of her daily routine. She recognized that the exchange of one valued item for another, in this case medicines for information, became the most important part of the reciprocity upon which her fieldwork depended. This situation is quite similar to the reciprocal system discussed in this article. While Golde acknowl

Assessment of medical technology and the challenge for health reform in Africa.

Introduces an African perspective to existing research and scholarship on the relationship between western medical technology and health care planning in Africa. Examining the broader issues of development and underdevelopment, contends that the present health care system, fashioned after western medical systems (focusing on hospital and curative care), has failed to make significant impact by reducing mortality rates in Africa. Describes the already precarious health conditions in Africa and argues that, while Africa can benefit from the application of western medical technology, the irrelevance of current strategies to people's needs and the widespread abuse of medical resources have rendered western technology ineffective in Africa. Concludes by calling for the creation of a council of technological assessment in Africa to review requirements and recommend to African governments appropriate and efficient medical technologies to meet the health needs of Africans.

Barriers to health care access and utilization among vietnamese Americans in Southern California

The objective of this study was to collect data on barriers to health care utilization and access among Vietnamese residents of southern California, and to assess the current influence of acculturation on acquisition of health care. A survey was administered anonymously in Vietnamese to 532 randomly selected respondents in their Orange County, California homes. Acculturation was assessed using a score and index. Eighty-five percent of respondents used a Western-trained physician and 70% had a regular physician. On language facility, 78% could speak with medical personnel and 86% could complete medical forms in English. Seven percent were unable to obtain medical care in the prior 12 months, 40% believed that they could not be admitted to hospital when needed, and 24% had no health insurance. Women reported more difficulty on most items. Seventy-seven percent of all respondents reported that they were satisfied with their health care, and health-related behavior change to reduce individual risk of disease was identified as their most important health need. Low income was the most important health concern. Respondents were largely bicultural, and acculturation was not associated with use of and satisfaction with Western medicine or ability to access it, but was associated with perceived obstructions to health care. Traditional health care beliefs and practices were not obstructions to using Western medical care. While substantial barriers to improving health care utilization remain, acculturation to the US health care system appears to have occurred in this community. English language facility is a barrier largely for women, and strategies to improve access and utilization for both genders should focus on increasing regular access to a physician, and on reducing logistical and financial barriers.

Asian Pacific Elders: Implications for Health Care Providers

Asian Pacific Islanders are a diverse group that include recent immigrants as well as long-term residents. They may be isolated or unsettled in their relationships with their own families and unfamiliar with Western medical care and thought. Medical care should take into consideration unique features of their traditional health benefits, traditional medications, prevalence of medical problems, pharmacokinetics and pharmacodynamics, diet, health risks, and health promotion. Although they cannot be homogenized into one tidy bundle, certain commonalities apply, and are addressed.

Medical careers and health care for Indian women: patterns of control

Abstract In the 1880s reform-minded men and women in Great Britain had joined the missionaries and a number of Indian reformers in demanding that Western medical care be extended to Indian women. The subjects of their concern were high-status Indian women who observed the norms of seclusion. British women, at this time entering the medical profession, supported this initiative because it legitimized their professional goals and promised employment. This paper explores the introduction of medical care for Indian women with reference to the life of Dr Haimavati Sen (c. 1867-1932), ‘lady doctor’ in charge of an exclusively women's hospital in Hughli district of Bengal. The paper explores two issues: the ways in which imperialism, feminism, and racism worked to marginalize Indian women in professional medical roles and the impact of this process upon women as patients and clients.

Medical careers and health care for indian women: patterns of control

Abstract In the 1880s reform-minded men and women in Great Britain had joined the missionaries and a number of Indian reformers in demanding that Western medical care be extended to Indian women. The subjects of their concern were high-status Indian women who observed the norms of seclusion. British women, at this time entering the medical profession, supported this initiative because it legitimized their professional goals and promised employment. This paper explores the introduction of medical care for Indian women with reference to the life of Dr Haimavati Sen (c. 1867-1932), ‘lady doctor’ in charge of an exclusively women's hospital in Hughli district of Bengal. The paper explores two issues: the ways in which imperialism, feminism, and racism worked to marginalize Indian women in professional medical roles and the impact of this process upon women as patients and clients.

Care-seeking for fatal illnesses in young children in Indramayu, West Java, Indonesia

To examine patterns of seeking care for gravely ill infants and children, we studied all deaths in children under 5 in 10 000 households in Indramayu, West Java, Indonesia, between July 1, 1991, and Dec 31, 1992. 141 deaths were identified (mortality rate 80·7 per 1000), of which 139 were due to causes other than trauma. No treatment of any kind was sought outside the home for 30 (22%) of the children who died from natural causes, and for 59 (42%) others only a traditional healer or other source of non-western medical advice was consulted. Whether or not a mother sought western medical care was strongly associated with the age of the child, the duration of the terminal illness, the previous attendance of the mother at a community-based maternal-and-child-health facility, and the mother's response to a prospectively asked question about what care should be sought for a hypothetical 1-month-old baby with signs of severe pneumonia. Household income, maternal age, and education, and distance between home and government health post were not associated with whether or not western medical care was sought.

Epilepsy in Indonesia: Notes from Development

Based on interviews with neurologists and medical personnel throughout Indonesia, the paper reports on the medical and cultural situation of epilepsy in a developing country. After briefly reviewing the context of Indonesian medical care, the paper examines the indigenous perspectives of epilepsy with particular attention the “underutilization” of western medical care. Contributing factors discussed include cultural beliefs, perception of stigma, and cost and accessibility of medical care. This is followed by a discussion of two grassroots initiatives to modify the image and treatment of epilepsy.

Political violence and Eritrean health care

In both colonial and post-colonial eras, the creation of nation states has often been accompanied by conflict and violence in Third World countries, particularly if such attempts have ignored previously existing cultural, religious and/or ethical differences. The illegitimacy of national state construction becomes even more apparent when the attempt is associated with conflicting geopolitical interests of the ‘super-powers’, as is in the case of the Horn of Africa. The 27 years of armed struggle of Eritrea to free itself from Ethiopian domination is a consequence of previous and continuing attempts to create a nation state serve the interests of the ex-colonialists and ‘super-powers’ at the expense of the needs and desires of the people. Throughout the 27 years of strugglewith its inevitable disruption ofcivilian life and service provisions, Eritrea has continued to develop a needs-based health care system. The Eritrean People's Liberation Front (EPLF) has developed a health care system which directly involves the people themselves. Through careful selection of priorities and a national allocation system for the distribution of scarce resources, it has provided remarkably effective emergency services, primary care and preventive health services. Such an approach has avoided the errors committed by many other Third World countries who, through copying modern western medical care systems, developed secondary and tertiary medical care facilities which were irrelevant to the health care needs of the vast majority of their populations.

The effect of child fostering on feeding practices and access to health services in rural Sierra Leone

In Sierra Leone, where infant and child mortality rates are quite high, a large proportion of small children from 1 to 5 yr are fostered: living away from their mothers. This paper examines the relationships between fosterage and child feeding practices and children's access to Western medical care. Ethnographic data from field studies in Sierra Leone are combined with quantitative data from Serabu Hospital, which show that fostered children are underrepresented in hospital admissions and that young fosters present more problems of malnutrition. (Fostered girls appear to be at more risk in both these categories than boys.) Unlike young fosters, however, older ones do not appear to be at more risk than children with mothers. We draw connections between these results and patterns of intrahousehold discrimination in food allocation and access to medical treatment for young fostered children: especially those sent to elderly rural caretakers. Finally, we examine the implications of the findings for applied issues, arguing that fostered children may slip through the cracks of maternal-child health care programs.

Teamwork in Sri Lankan general practice.

This paper reports part of a study to investigate the organization of general practice in Sri Lanka with particular reference to teamwork. Questionnaires were sent to 347 members of the two bodies representing general practitioners and to a further 43 doctors who were identified as providing either traditional or Western primary medical care in a defined population. A response rate of 74.2% was obtained. All practitioners of traditional (Ayurvedic) medicine were single-handed and 54.4% of members of the College of General Practitioners in Sri Lanka also worked on their own. All ancillary staff were employed by the practitioner and the mean number of staff was 3.1. Multifactor comparison was undertaken. More staff were employed by practitioners who were under 45 years old, who lived within five miles of a hospital, and who had in-patient facilities. Questions are posed concerning the development of team care in Sri Lanka.