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1453 results in Nursing

Page 54 of 73

  • 5 - Ethnicity and health

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 83-98

  • Summary

    Overview

  • What does the evidence tell us about ethnic disparities in health on a global basis?

  • What is ‘race’? What does a racist explanation of, or approach to, ethnic disparities in health involve?

  • What does it mean to say that ethnicity and ethnic division are social processes? What role does institutional racism play in these?

  • How does ethnicity work in the production of ethnic disparities in health?

    • New York City, approximately 1890

    The homes of the Hebrew quarter are its workshops also … You are made fully aware of it before you have travelled the length of a single block in any of these East Side streets, by the whir of a thousand sewing-machines, worked at high pressure from earliest dawn till mind and muscle give out together. Every member of the family, from the youngest to the oldest, bears a hand, shut in the qualmy rooms, where meals are cooked and clothing washed and dried besides, the livelong day. It is not unusual to find a dozen persons – men, women, and children – at work in a single small room … Typhus fever and smallpox are bred here … Filthy diseases both, they sprout naturally among the hordes that bring the germs with them from across the sea … The health officers are on constant and sharp lookout for hidden fever-nests. Considering that half of the ready-made clothes that are sold in the big stores, if not a good deal more than half, are made in these tenement rooms, this is not excessive caution. It has happened more than once that a child recovering from small-pox, and in the most contagious stage of the disease, has been found crawling among heaps of half-finished clothing that the next day would be offered for sale on the counter of a Broadway store; or that a typhus fever patient has been discovered in a room whence perhaps a hundred coats had been sent home that week, each one with the wearer’s death-warrant, unseen and unsuspected, basted in the lining (Riis 1890).

  • 8 - Health care and health

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 148-176

  • Summary

    Overview

  • What is the globally dominant form of health care organisation? How does it work?

  • What is the most effective form of health care in terms of advancing the health of most of the world’s peoples? How does it work?

  • What are the major social dynamics responsible for the prevailing patterns of health care both within and between countries globally?

    • Iraq, 1950s

    In the 1950s, archaeologists found a traumatised Neanderthal skeleton in northern Iraq in the Shanidar caves. Their examination of the remains showed that it was the skeleton of a man who had lived between 40 000 and 115 000 years ago and who had begun life with a stunted arm, a large part of it which he had lost some time later. It is likely that without the use of both arms the man had used his mouth for some tasks, such as scraping or cutting – because his teeth were very severely ground down. He had also lost two front teeth, probably in another accident. At some point in this life from thousands of millennia ago, something or somebody had delivered a sharp blow to the top of the man’s head … This was accompanied by another, harder blow that had caused the left side of his face to be shattered, most probably destroying his sight on this side as well. Somehow, he had struggled on long enough to develop severe and crippling arthritis. ‘[A]round his fortieth birthday the roof over his cave hearth collapsed, ending his saga and his troubles.’ (Wood: 1979: 22)

  • 7 - The state and health

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 123-147

  • Summary

    Overview

  • What is ‘the state’?

  • How did rationalised rule and governance differ from their predecessors? What role did they play in the development of democratic states?

  • What is neo-liberalism and what are the main processes by which it is played out in contemporary rule and governance? How do these affect health inequity?

  • What is the relationship between the state and other major processes of social division?

  • How do contemporary rule and governance establish barriers to and opportunities for the advancement of health equity?

    • Timor-Leste (East Timor)

    To the north of Australia lies the 21st century’s first nation state – Timor-Leste, or East Timor. After a period of brutal control by Indonesia, which had taken over the former Portuguese colony in 1975, Timor-Leste formally gained its independence in 2002. Today, Timor-Leste is one of Asia’s poorest countries, with more than 80 per cent of its 1.2 million people resident in rural areas. Yet, it has become one of the fastest-growing countries in the world, with a national budget of over US $1 billion per year. Its newfound wealth derives from vast stores of oil and gas in the Timor Sea that have been used to establish a government fund estimated to be worth close to US $12 billion dollars. Along with this wealth has emerged a major rift about what the government should spend this money on.

  • 3 - Class and health

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 33-59

  • Summary

    Overview

  • What is the social gradient in health? What are some of the key indicators of socio-economic status (SES) used to identify it?

  • What is the relationship between SES and social resources? What kinds of health disparities can it explain?

  • What is specific to class as a domain of social practice? What does it seek to explain in relation to health?

  • What is the division of labour and what role does it play in producing class?

  • How does the ownership and control of the resources needed for producing and distributing goods and services generate class?

  • What are representational practices and discourses? What role do they play in class dynamics?

  • How does class get into peoples’ bodies as health and illness?

    • California, United States, 2013

    As one of this year’s memorable episodes of the television program ‘Keeping Up With the Kardashians’ showed, Kim Kardashian’s pregnancy and baby appeared to be in crisis. Less than a week later, Kardashian and partner Kanye West had their first child, delivering a very happy ending to the medical drama.

    On a l ight during which Kardashian experienced unexpected distress, the reality star reported that she had ‘never experienced pain like this in her life’, and was rushed to her doctor. ‘The episode offered a behind-the-scenes look at her personal anxieties and fears for what has been a very public pregnancy’.

  • 4 - Gender and health

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 60-82

  • Summary

    Overview

  • What distinguishes gender from other processes of social division? What does it mean to say that gender dynamics are historically and socially variable?

  • How does a sex-differences approach to health characterise the health of men and women? What are the limitations of this approach?

  • What is a gender order and what does it mean to say that it is patriarchal?

  • What evidence is there to say that gender inequality prevails on a global scale?

  • What is gendered health? What are examples of gender dynamics involved in it?

  • What is the relationship between gender dynamics, intersectionality and health disparity?

  • How are gender inequality and patriarchy evident in health disparity?

    • China 1911

    ‘My grandmother’s feet had been bound when she was two years old. Her mother … first wound a piece of white cloth about twenty feet long round her feet, bending all the toes except the big toe inward and under the sole. Then she placed a large stone on top to crush the arch’ (Chang 1991:31). As Jung Chang (1991: 31–2) recounts in her acclaimed personal history about her life in China, the pain from footbinding had been so agonising that her grandmother had screamed in agony, fainting over and over. The procedure had been repeated over several years, with the feet bound day and night to stop them from recovering. Though there had been no reprieve from the pain throughout the process and Jung’s grandmother had pleaded with her mother to stop, the mother could only weep, telling her daughter her life would be ruined without bound feet and that her future happiness depended on it. As Jung explains, such a practice had prevailed in China for about a thousand years. It was only in bed at night that the binding could be relaxed – rarely ever removed and rarely ever witnessed by men. Removal of the binding usually revealed rotting, stinking flesh.

  • 2 - Understanding the social

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 16-32

  • Summary

    Overview

  • What does it mean to say that the individual is a ‘modern’ invention?

  • In what ways were modernist ideas about the individual central to the development of 18th and 19th-century European thinking about the social?

  • What is ‘social structure’ and what contribution does it make to understanding human being and action?

    • The Atlantic Ocean, somewhere between West Africa and South Carolina, 1756

    The contractions began rolling hard and long and often, and I left it to Fanta (a slave woman) to decide when to push …

    She pushed for a long time, and then she lay back and rested . . . ‘Now,’ Fanta said. She pushed three more times. I saw hairs on a head starting to part her, but the baby wouldn’t come yet. She pushed once more, and the head came all the way out, blue and purplish and light coloured and specked with bits of whiteness and blood. Fanta pushed again, and out came the shoulders. The rest slid out quickly . . . I . . . slice[d] the cord, then I wrapped the baby and gave him to Fanta. The baby cried, and Fanta let it howl good and long before allowing it to root for her nipple. She was not a proud mother, but an angry one. I tried to settle Fanta comfortably on the bed, but she pushed me away. (Hill 2007 : 86–7)

  • 1 - The social determinants of health approach

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 1-15

  • Summary

    Overview

  • What are health inequities according to a social determinants of health (SDOH) approach?

  • What causes health inequities and how can they be abolished using this approach?

  • What are the limitations of the SDOH approach in addressing and redressing health inequities?

    • Nigeria, around 1970

    Jonathan Iwegbu counted himself extraordinarily lucky. ‘Happy survival!’ meant so much more to him than a current fashion of greeting old friends in the first hazy days of peace … He had come out of the war with five inestimable blessings – his head, his wife Maria’s head and the heads of three out of their four children. As a bonus he also had his old bicycle – a miracle too but naturally not to be compared to the safety of five human heads …

    … [Jonathan] made the journey to Enugu and found another miracle waiting for him. It was unbelievable . . . This newest miracle was his little house in Ogui Overside . . . Only two houses away a huge concrete edifice some wealthy contractor had put up just before the war was a mountain of rubble. And here was Jonathan’s little zinc house of no regrets built with mud blocks quite intact! Of course the doors and windows were missing and five sheets off the roof. But what was that? And anyhow he had returned to Enugu early enough to pick up bits of old zinc and wood and soggy sheets of cardboard lying around the neighbourhood before thousands more came out of their forest holes looking for the same thing. He got a destitute carpenter with one old hammer, a blunt plane and a few bent and rusty nails in his tool bag to turn this assortment of wood, paper and metal into door and window shutters for five Nigerian shillings . . .

  • Foreword

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp v-vi

  • Summary

    ‘To good health!’ we say when sharing a drink. Sadly, all too often that good health is not shared. Many people do not enjoy the conditions needed to live healthy lives.

    Health authorities around the world now recognise the social determinants of health as a major concern. That is an important advance. Recognising a problem, however, and understanding it, are different things. And doing something effective about it is another matter again.

    In this book Toni Schoi eld and her colleagues move us towards understanding and action. They give the facts about health and society, mapping the realities of class, gender, ethnicity, indigeneity, the state and health care. The facts are tough. There is grim evidence here about violence, abuse and exclusion; and about the less-dramatic, grinding effects of poverty and stress.

    The book does much more. It takes us beyond describing the social dimensions of health to the ‘causes of the causes’ – the social dynamics of health. The chapters consider carefully the major structures of inequality in contemporary societies, explaining how they operate and how they have changed. They place health in the context of economic change, colonisation, migration and changing reproductive practices.

    How do social inequalities get under the skin and become health effects? That’s a key question, and in this book we see the multiple answers. They range from socially caused malnutrition, to social pathways of viral infection, to physical injury in the workplace, to genetic damage and environmental pollution. All are bound up in the operations of social power. All have an impact on bodies, but unequally so.

  • Epilogue

  • Toni Schofield, University of Sydney
  • Book:
    A Sociological Approach to Health Determinants
    Published online:
    06 August 2018
    Print publication:
    03 February 2015, pp 177-182

  • Summary

    A common response to sociology is: ‘What do I do with this?’ (Russell and Schofield 1986 : 203). Physical scientists’ research can often be taken up for ‘practical’ purposes, such as providing cures and treatments for disease and injury. A sociological approach offers no comparable technical solution – no ‘magic bullet’. Not that sociology has a singular mission. In its comparatively short history, it has had many purposes. In this book, its ‘project’ has been inspired and shaped by international policy and research development in health: the social determinants of health. As Chapter 1 explained, the ‘social determinants of health’ has become a globally inl uential approach to understanding and responding to social inequalities and health disparities, both within countries and globally. Pioneered by the WHO, it has entered the lexicon of health policy makers, health practitioners, researchers and social movements. It has generated a seismic shift in global awareness of the inter-connectedness of the differentiated health fates of the planet’s peoples, and of the injustices that accompany them. Its central ‘take-home’ message is that health disparities are of our making and, therefore, can be un-made. What’s more, the problem does not lie with insufi cient global resources. Rather, the problem and its solution are located squarely within the realm of human society; in particular, ‘social factors’ associated with how we live, work and grow.

A Sociological Approach to Health Determinants
  • Toni Schofield
  • Published online:
    06 August 2018
    Print publication:
    03 February 2015
  • A Sociological Approach to Health Determinants investigates how 'the social' works in determining health and health inequity. Taking a global perspective, the book shines a light on how experiences of health, illness and health care are shaped by a variety of complex social dynamics. Informed primarily by sociology, the book engages with the WHO's social determinants of health approach and draws on contributions from history, political economy and policy analysis to examine issues such as class, gender, ethnicity and indigeneity, and the impact they have on health. A Sociological Approach to Health Determinants is a comprehensive resource that provides a new perspective on the influence of social structures on health, and how our understanding of the social can ensure improved health outcomes for people all over the globe.

  • 12 - A strengths-based palliative approach for the frail older adult living in residential aged care

  • from Part 3 - End of life care
  • Wendy Moyle, Griffith University, Queensland, Deborah Parker, University of Queensland, Marguerite Bramble, Griffith University, Queensland
  • Book:
    Care of Older Adults
    Published online:
    06 August 2018
    Print publication:
    19 September 2014, pp 179-191

  • Summary

    Learning objectives

    After reading this chapter you will be able to:

  • Have an understanding of a palliative approach in residential aged care.

  • Understand the key features of an evidence-based palliative approach in residential aged care.

  • Understand how to apply a strengths-based approach to a palliative approach for people living in residential aged care.

  • Understand specific issues in providing a palliative approach for people with dementia.

    • Introduction

    This chapter extends some of the issues introduced to you in Chapter 10 which identified a model of palliative care that has been developed specifically for Australian residential aged care facilities (RACFs). This comprehensive evidence-based model of a palliative approach in residential aged care is encapsulated in an evidence translation product known as the Palliative Approach Toolkit (Parker, Hughes & Tuckett, 2011). Before we explore this model of care we will briefly review some of the research and issues specific to providing a palliative approach in RACFs. The final section of the chapter will identify some specific issues for people with dementia in RACF and some programs that have been developed to address these.

  • 13 - Evidence-based nursing interventions: a good death and fostering pain relief

  • from Part 3 - End of life care
  • Wendy Moyle, Griffith University, Queensland, Deborah Parker, University of Queensland, Marguerite Bramble, Griffith University, Queensland
  • Book:
    Care of Older Adults
    Published online:
    06 August 2018
    Print publication:
    19 September 2014, pp 192-202

  • Summary

    Learning objectives

    After reading this chapter you will be able to:

  • Have an understanding of what constitutes a ‘good death’ for older people.

  • Understand the principles of evidence-based nursing in relation to pain assessment and management.

  • Understand specific issues in the assessment and management of pain for people with dementia.

  • Understand how to apply a strengths-based approach to pain assessment and management for older people.

    • Introduction

    In Chapter 10 we reviewed the history of palliative care with specific reference to developments in Australia and New Zealand. Chapter 11 focused on advance care planning, which is a critical aspect of providing a strengths-based palliative approach for older people. Chapter 12 specifically looked at some of the research regarding providing a palliative approach in residential aged care facilities (RACFs) and the evidence-based model within the Palliative Approach Toolkit. This chapter delves further into what makes a good death for older people and then specifically focuses on one common symptom that can influence whether a good death is possible – pain. Pain is one of the most common symptoms and always features in discussions with people who know they are dying, families supporting that person or staff providing the care. The phrase most associated with achieving a good death is that it is ‘pain free’. In the final section of the chapter we will examine specific issues in regard to pain management and people with dementia.

Page 54 of 73