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Problematic social support from patients’ perspective: the case of Systemic Lupus Erythematosus
- Authors:
- MAZZONI Davide, CICOGNANI Elvira
- Journal article citation:
- Social Work in Health Care, 53(5), 2014, pp.435-445.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Several studies demonstrated the importance of psychosocial factors, like social support, for understanding the experience of people with Systemic Lupus Erythematosus (SLE). Less information is available on “problematic support”; that is, instances of support that are perceived as non-supportive, even though the provider’s actions may be well intended. Aim of this qualitative study was to explore the experiences of problematic support from SLE patients’ perspective. Nine women with SLE were interviewed and transcripts were analysed through qualitative content analysis. Three main types of problematic social support were indentified. Oppressive support describes social support offers characterised by excessive worries and unwanted advices. Support denying the illness is characterised by a neglect of the disease or of its consequences. Support based on divergent illness representations is perceived as not punctual and not in line with patients’ actual clinical condition. This study confirms the complexity of providing useful support to SLE patients and suggest that also people living close to patients should represent a target of interventions. (Edited publisher abstract)
The passing dilemma in socially invisible diseases: narratives on chronic headache
- Author:
- LONARDI Cristina
- Journal article citation:
- Social Science and Medicine, 65(8), October 2007, pp.1619-1629.
- Publisher:
- Elsevier
This contribution concerns the experience of chronic diseases and how it disrupts the trajectory of a person's biography, undermining his/her identity, self-reliance and social relationships. The study focuses particular attention on those diseases which have not yet been fully acknowledged and can, therefore, be considered a socially invisible disease: chronic headache is one of these. Thirty-one life stories were collected from patients attending a specialized headache centre in Northern Italy, and selected in order to include all common varieties of chronic headache. Following the principles of grounded theory, interviews began by adopting a minimal theoretical framework which consisted of asking people how they became aware of the objective (disease), subjective (illness) and social (sickness) aspects of their condition. The analysis highlighted particular points in the patients’ life trajectories: first, the biographical disruption that takes place because of the disease; second, how people succeed or fail in identity negotiation, which is vital for developing an acceptable social representation of the disease. Results show that patient's choices follow a vicious circle, where a partial social representation of the disease is produced. People who suffer from chronic headache face a dilemma in social relationships: should they conceal their disease, or make it evident? If they conceal, any possible social representation of the disease is denied, which could lead to carrying the burden of the disease alone, with no social support. On the other hand, making chronic headache visible could result in stigma.
Discharge diagnosis and comorbidity profile in hospitalized older patients with dementia
- Authors:
- ZULIANI Giovanni, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(3), March 2012, pp.313-320.
- Publisher:
- Wiley
Dementia is known to be present in a significant proportion of hospitalised older patients, and may be associated with different pathologies and longer stays in hospital. The aim of this study was to investigate the prevalence of dementia in a large sample of hospitalised older individuals, and to analyse principal discharge diagnosis and related comorbidity in the patients affected by dementia. Data from 51,838 consecutive computerised discharge records of individuals aged 60 years and over from a hospital in Ferrara, Italy were analysed. The number of admissions, length of stay in hospital, primary and secondary discharge diagnosis, number of procedures, and possible death were evaluated. The findings showed that demented patients represented 8.6% of the sample and were older and more likely to be female patients. They were characterised by higher number of admissions to hospital, instrumental clinical investigations, secondary diagnoses, and mortality rate. Among the primary diagnoses, a higher prevalence of cerebrovascular disease, pneumonia, and hip fracture was observed in demented patients. Furthermore, pulmonary embolism, renal failure, septicaemia, and urinary infections were frequently reported in demented patients, but not in controls. As regards secondary diagnoses, dementia was associated with an increased risk of delirium, muscular atrophy and immobilisation, dehydration, cystitis, and pressure ulcers, whereas the risk for other conditions, including cancer, was reduced.
Psychological abuse among older persons in Europe: a cross-sectional study
- Authors:
- MACASSA Gloria, et al
- Journal article citation:
- Journal of Aggression Conflict and Peace Research, 5(1), 2013, pp.16-34.
- Publisher:
- Emerald
There is evidence to suggest that the rate of elder abuse in all its forms is growing. However, because of the difficulty of measuring it, psychological abuse may be underestimated. This cross sectional study used data collected in 2009 as part of the survey “Elder abuse: a multinational prevalence survey, ABUEL”. The participants were 4,467 randomly selected persons aged 60-84 years (2,559 women, 57.3 per cent) from seven EU countries (Germany, Greece, Italy, Lithuania, Portugal, Spain, Sweden). Participants answered a structured questionnaire either face-to-face or a mix of interview/self-response. The overall prevalence of psychological abuse was 29.7 per cent in Sweden, 27.1 per cent in Germany; 24.6 per cent in Lithuania and 21.9 per cent in Portugal. The lowest prevalence was reported in Greece, Spain and Italy with 13.2 per cent, 11.5 per cent and 10.4 per cent, respectively. Similar tendencies were observed concerning minor/severe abuse. The Northern countries (Germany, Lithuania, Sweden) compared to Southern countries (Greece, Italy, Portugal, Spain) reported a higher mean prevalence of minor/severe abuse (26.3 per cent/11.5 per cent and 12.9 per cent/5.9 per cent, respectively). Most perpetrators (71.2 per cent) were spouses/partners and other relatives (e.g. children). The analyses indicate that being from Greece, Italy, Portugal and Spain was associated with a lower risk of psychological abuse. Low social support, living in rented housing, alcohol use, frequent health care use, and high scores in anxiety and somatic complaints were associated with increased risk of psychological abuse.