ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1992.tb00321.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACT:Self‐care and illness response to a recent medical event were examined based on a mailed questionnaire to a random sample of 416 adults in a frontier area in north‐central Idaho. A total of 494 questionnaires were returned (45% response rate), and 78 were eliminated. Self‐care behaviors were classified as: (1) waiting to see what would happen, (2) purchasing or taking a nonprescription medication, (3) taking a prescription medication that was on hand, (4) taking both a prescription and a nonprescription medication, (5) contacting a physician, and (6) going to a hospital. These six variables were classified into three intervention constructs of no intervention (waiting), informal intervention (self‐medicating), and formal intervention (contacting a health care professional).Fifty‐six percent of the respondents reported self‐medicating behaviors. Correlation analysis indicated that initial self‐care and illness response behaviors in this frontier area were generally appropriate. Three multiple discriminant models were tested to differentiate those people who waited, self‐medicated, and contacted formal providers from those who did not. A significant model could not discriminate between those who waited and those who did not. Models for self‐medicating and contacting formal providers correctly classified cases 60 to 70 percent of the time. The analyses indicate that self‐medicating was more likely to be reported by younger individuals, by those who lived further from the hospital, who perceived their health status to be better, who reported less satisfaction with community health care services, and that the self‐medicating was appropriate. Those respondents most likely to contact the physician reported a lower perceived health status, a higher level of appropriateness of seeking formal health care services, a perceived physician shortage as a serious community problem, greater use of a number of prescription medications in the previous two weeks, and reported living in the community longer than those who did not. The implications of these f

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1992.tb00322.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACT:This paper summarizes the responses of rural elderly people to a variety of symptoms experienced during a three‐week period. Responses to symptoms included causal attributions, consultation patterns, and intervention strategies. Data recorded in diaries during a three‐week period highlight the importance of lay care in the illnesses of older people. Most symptoms were managed by older respondents themselves. When symptoms were discussed with someone else, the consultant was most likely a family member or friend rather than a health care professional. Only one third of the respondents contacted any formal provider about any of their symptoms. The majority of respondents combined medical and nonmedical explanations in interpreting their symptoms. The most frequent response to a symptom was doing nothing. The next two most commonly reported interventions were over‐the‐counter medications and activity limitation. Analyses revealed few differences among residential categories in patterns of illness behavior. Rural‐urban differences often disappeared when controlling for demographic and socioeconomic background which covarv with

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1992.tb00323.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACT:Despite efforts to deinstitutionalize long‐term care, it is estimated that 43 percent of the elderly will use a nursing facility at some point. Whether sufficient nursing facility services will be available to rural elderly is debatable due to cutbacks in governmental expenditures and recent financial losses among nursing facilities. This paper explores the challenges confronting rural nursing facilities in maintaining their viability and strategies that might be considered to improve their longevity. A comparative analysis of 18 urban and 34 rural nursing facilities in New Mexico is used in identifying promising strategic adaptations available to rural facilities. Among other considerations, rural facilities should strive to enhance revenue streams, implement strict cost control measures, emphasize broader promotional tactics, and diversify services commensurate with the constraints of the communities and populations serve

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1992.tb00324.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACT:This research focuses on issues of alcohol consumption among migrant farmworkers in Orange County, NY. Because drinking is a common behavioral response to erratic hard work and camp life, variation in alcohol consumption was analyzed within the context of a holistic perspective on migrant life. Although migrant farmworkers tend to drink more in the camp than in the home community, the multivariate analysis indicates that such variation is primarily affected by socialization and social support factors, not by work‐related variables. Potential strategies for modifying migrant farmworkers’drinking behavior are discussed based on the results of this st

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1992.tb00325.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACT:Economic conditions in farming have been a common thread in explanations of agriculture's high rate of occupational injuries and death. If prices were higher or the farm economy were stronger, it is said, farmers could afford to be safer. However, could afford to be safer does not mean that farmers would be safer. This study examines the question of whether higher farm product prices could be expected to reduce agricultural injury rates. The critique includes a statistical model relating prices and acres per worker to non‐rollover fatal farm injuries, using national data from 1969 to 1987. Contrary to current arguments, the model shows that higher prices historically are associated with higher fatality rates, suggesting that increased prices serve as an incentive for working harder and that the state of the agricultural economy is not a good explanation for high injury rate

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1992.tb00326.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACT:Development of interventions to prevent accidental occupational fatalities requires the prior identification of those at risk and the circumstances surrounding the injuries. A survey of unintentional farm fatalities was conducted using medical examiner reports (RIME) and death certificates (MECD) to identify deaths due to agricultural occupational injuries in North Carolina from 1984 through 1988. Of 393 cases, 123 met the criteria “farmer” listed as occupation on the RIME/MECD and/or “victim” in a rural area performing a farming task when injured. A second aim of this study was to use an existing data base to achieve maximum accuracy in identifying true cases of work‐related farm fatalities.A fatality rate of 41/100,000 agricultural workers was found; the National Institutes of Occupational Safety and Health's National Traumatic Occupational Fatality study criteria would have identified only 57 percent of these. Victims were characterized as middle age (53 years), white (76%), male (100%), full‐time farmers (65%). Injury occurred during harvest season on Monday or Tuesday (47%) between 2 and 6 p.m. (54%). Death was pronounced at the scene (74%), with probable cause listed as tractor (62%). Injury location and land elevation were also related, with the mountain region having twice the fatality rate as the coastal pl

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1992.tb00327.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACT:This paper reviews the nature and extent of drug abuse‐related HIV disease services in the rural United States. Issues concerning the delivery of HIV disease and substance abuse health care services in rural settings are outlined and discusse

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1992.tb00328.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACT:According to the Bureau of Labor Statistics (cf. Crispell, 1990), the medical clerical field is one of the faster growing areas of employment. This paper reports on long‐term employment of trainees involved in nontraditional medical clerical programs. These programs were funded by the Job Training Partnership Act (JTPA) and filled both the needs of the local rural health care facilities and the employment needs of unskilled youths and adults. These nontraditional students of low socioeconomic background and poor work history were successfully mainstreamed into university courses and consequently obtained productive employment.A follow‐up study was conducted of 64 individuals who completed three different, one‐year JTPA programs. The study investigated the following questions: Was the trainee currently employed? If so, was employment related to the training program, and were the quarterly salaries higher than minimum wage and previous salaries? How many different jobs were reported since training? Did the individual retain employment in a rural setting?The JTPA programs at Southern Illinois University included some innovative yet practical components that resulted in very high program completion rates, high initial placement, and a continuing pattern of long‐term employment. These components included: emphasis on training for the most needed positions/jobs that matched university capabilities; the pursuit of higher starting salaries; informing participants of support services; training in job hunting and work readiness; using some individualized, competency‐based instruction; establishing internship arrangements with prospective employers; and careful matching of the trainee to initial placement site with consideration of personality as well

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1992.tb00329.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0890-765X    

DOI:10.1111/j.1748-0361.1992.tb00330.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY