Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medica...Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medicare HMO in Los Angeles were asked to list all the illnesses experienced by older adults that they could recall, and those listing HBP or HTN were asked to further list and discuss its symptoms, causes, treatments and prevention. Responses were tape recorded, transcribed, and analyzed to develop a systematic “sentence completion by card sort” follow-up procedure. Consensus Analysis (CA) of the systematically collected data identified shared EM for HBP/HTN. The model presented here is similar to models of HBP/HTN described by researchers working with patients from different regions and different ethnic groups, suggesting that there is a widely shared lay or popular model for this disease. Stress, lifestyle (diet, exercise, weight, and substance use), heredity and aging are thought to be the major causes of HBP/HTN. Physicians are thought to be the appropriate source of care, as HTN/HBP is serious, life threatening, and potentially disabling. The study of cultural understandings and shared EM of disease has direct relevance for clinical practice and public health education. For a disease such as HTN/HBP, knowing where and how such explanations differ systematically between patients and clinicians, and what impact this may have on patterns of adherence to prescribed treatment is a crucial area of concern.展开更多
The deprivation, importation, situational, and administrative control models have been used to explain inmate violence. More recently, HIV risk behaviors of inmates have been explained with the deprivation and importa...The deprivation, importation, situational, and administrative control models have been used to explain inmate violence. More recently, HIV risk behaviors of inmates have been explained with the deprivation and importation models. The goal of this study is to assess the utility of these models in describing inmate HIV risk behaviors and to identify additional models that may exist. Forty seven ex-offenders released from prison within three months of the study were recruited from a community based organization. They participated in focus group discussions that explored the contexts surrounding inmate engagement in HIV risk behaviors in prison. Data were analyzed using NVivo 7 and results were organized into themes. Inmates engaged in sex in exchange for money and for affection. Inmates who were drug users before incarceration were more likely to abuse drugs in prison. Security measures, if effective, deterred the entrance of illegal substance into prison, but when security is lax, inmates take the opportunity to engage in sex, and illegal substances are brought into prison. Our results reveal that deprivation, importation, situational, and administrative control factors are associated with HIV risk behaviors among inmates and they can be used in explaining these behaviors. The association of risk behaviors with long or life sentences suggests that fatalism may play a role in risk behaviors among inmates. Fatalism is a factor which requires future examination.展开更多
文摘Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medicare HMO in Los Angeles were asked to list all the illnesses experienced by older adults that they could recall, and those listing HBP or HTN were asked to further list and discuss its symptoms, causes, treatments and prevention. Responses were tape recorded, transcribed, and analyzed to develop a systematic “sentence completion by card sort” follow-up procedure. Consensus Analysis (CA) of the systematically collected data identified shared EM for HBP/HTN. The model presented here is similar to models of HBP/HTN described by researchers working with patients from different regions and different ethnic groups, suggesting that there is a widely shared lay or popular model for this disease. Stress, lifestyle (diet, exercise, weight, and substance use), heredity and aging are thought to be the major causes of HBP/HTN. Physicians are thought to be the appropriate source of care, as HTN/HBP is serious, life threatening, and potentially disabling. The study of cultural understandings and shared EM of disease has direct relevance for clinical practice and public health education. For a disease such as HTN/HBP, knowing where and how such explanations differ systematically between patients and clinicians, and what impact this may have on patterns of adherence to prescribed treatment is a crucial area of concern.
文摘The deprivation, importation, situational, and administrative control models have been used to explain inmate violence. More recently, HIV risk behaviors of inmates have been explained with the deprivation and importation models. The goal of this study is to assess the utility of these models in describing inmate HIV risk behaviors and to identify additional models that may exist. Forty seven ex-offenders released from prison within three months of the study were recruited from a community based organization. They participated in focus group discussions that explored the contexts surrounding inmate engagement in HIV risk behaviors in prison. Data were analyzed using NVivo 7 and results were organized into themes. Inmates engaged in sex in exchange for money and for affection. Inmates who were drug users before incarceration were more likely to abuse drugs in prison. Security measures, if effective, deterred the entrance of illegal substance into prison, but when security is lax, inmates take the opportunity to engage in sex, and illegal substances are brought into prison. Our results reveal that deprivation, importation, situational, and administrative control factors are associated with HIV risk behaviors among inmates and they can be used in explaining these behaviors. The association of risk behaviors with long or life sentences suggests that fatalism may play a role in risk behaviors among inmates. Fatalism is a factor which requires future examination.
