Preferences and Expectations for Delivering Bad News Among Korean Older Adults

ABSTRACT

 The purpose of this study was to explore Korean older adults’ perspectives toward physicians’ disclosure of serious illness to patients. Seventy Korean older adults residing in the community were interviewed in person using a semistructured interview guide. Major themes included conflicting desires among participants to: 1) inform the patient directly, 2) inform the patient indirectly, and 3) inform only the family. Subthemes under the first theme included: a) decision making about treatment, b) planning and preparation for the future, c) need for use of an ethical standard, d) consideration of patient coping responses, and e) disclosure of serious illness as a relational process. Disclosure of bad news is more than revealing or concealing information. Needs and preferences regarding to what extent and how information is delivered differ by culture. Thus, understanding preferred communication pathways for advanced care planning in specific cultural frameworks is important. Future studies using clear concepts and measures about serious illness disclosure can better prepare health care professionals in interacting with those from minority cultures. In addition, studies of those with poor health status from diverse cultural groups may further assist social workers to tailor interventions to accommodate cultural needs and expectations in end-of-life settings.     

Advance Directives Among Korean American Older Adults: Knowledge,Attitudes, and Behavior

The study objective was to explore knowledge, attitudes, and behavior about advance directives and how cultural values influence these beliefs. Three focus groups with 23 Korean American older adults were conducted. Advance directives were seen as helpful for ensuring that preferences for unwanted end-of-life treatment are honored and for relieving the decision-making burden on family members. However, some viewed completing advance directives as contrary to focusing on living. Culturally competent education about advance directives for Korean American older adults is necessary to help them make informed decisions about end-of-life care and informing family and health care providers of these preferences.     

Multi-couple reflecting team: preliminary report

The aim of therapeutic help in marital crisis is to break the vicious circle of mutual hurtful accusations. The method that the authors present below involves a group of couples working within a closed cycle of meetings. In the course of successive group meetings, the various couples act as reflecting teams (RTs) for each other. This achieves two objectives: the couple recounting their crisis receives nonthreatening feedback, which helps them to implement positive changes and break out of the self-perpetuating destructive interaction. In addition, the couples acting as the RT learn nonjudgmental, nontheorizing and affirmative communication.     

Selected health behaviors that influence college freshman weight change

OBJECTIVE AND PARTICIPANTS: The authors investigated the effect of physical activity (PA), fruit and vegetable intake, and alcohol use on 6-month weight change in 193 college freshmen (78.8% white, 88.2% women, 94.5% on a meal plan). METHODS: The authors administered a Web-based survey in fall 2002 (baseline) and spring 2003 (follow-up). RESULTS: There was an overall average weight gain of 2.5 lbs (p < .05), although only 57% reported weight gain (M = 7.1 lbs). Fruit and vegetable intake decreased (p = .034), alcohol use increased (p > .05), and PA was unchanged. Weight gain for students with body mass indexes (BMI) > or =25 kg/m2 was nearly twice that of students with BMIs < 25 (p < .05). Students with low-frequency baseline PA were twice as likely to be overweight. Follow-up data showed that students reporting > or = 4 sessions per week (ie, high frequency) of low-intensity PA were twice as likely to have healthy BMIs as students engaging in low- and moderate-frequency PA. CONCLUSIONS: PA interventions should target freshmen with BMIs > or = 25.     

State and Regional Variation in the Effects of Trade on Job Displacement in the US Manufacturing Sector, 1982–1999

Worker-level data from the 1984–2000 Displaced Worker Surveys are employed to examine the effects of trade on manufacturing workers’ probabilities of job displacement. Observed changes in import and export penetration rates yield increases in displacement probabilities for the North Central, Middle Atlantic and South Central regions yet lower displacement probabilities for the Plains/West and Pacific regions. Changes in import and export price indexes lead to increases in displacement probabilities for the Pacific, Southeast and Northeast regions and decreases for the South Central and Middle Atlantic regions. However, while the influences of imports and exports on job displacement vary considerably across states and regions, the estimated net effect of trade on displacement probabilities is minor, generally speaking, when compared to the combined influence of other factors.

Theorizing the institution: foundations,duality, and data

Although a central construct for sociologists, the concept of institution continues to elude clear and full specification. One reason for this lack of clarity is that about 50 years ago empirical researchers in the field of sociology turned their gaze downward, away from macro-sociological constructs in order to focus their attention on middle-range empirical projects. It took almost 20 years for the concept of the institution to work its back onto the empirical research agenda of mainstream sociologists. The new institutional project in organizational sociology led the way. Since then, scholars in this tradition have achieved a great deal but there is still much more to accomplish. Here, future directions for research are considered by reviewing how the concept of the institution has come to be treated by mainstream philosophers, sociologists of science and technology studies, and social network theorists.

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Marketing of Voluntary Organizations as Contract Providers of National and Local Government Welfare Services in the UK

Voluntary organisations have become major providers of numerous social welfare services that previously were supplied by the state. In Britain, between 35 and 40% of the average human services charity’s annual income now derives from government (predominantly local government) sources, meaning that the acquisition of fresh contracts to undertake government funded work, in conjunction with the maintenance of good relations with government funders vis-à-vis current assignments, is increasingly important for ensuring a human service charity’s financial survival. An organization that wishes to obtain new contracts and to keep government bodies satisfied with its present activities will need to market itself effectively. This empirical study examined two aspects of charity marketing relevant to this requirement: the extent to which voluntary organizations applied the principles of strategic account management (otherwise known as key account management) to their relations with government funders, and the organizational characteristics (passion and commitment, low wage costs, etc.) that they emphasized to government bodies when making bids. A number of organizational variables (e.g., mission rigidity, strategic intent, short term operational focus) were employed in regression analyses as possible determinants of: (i) the degree to which a charity used strategic account management; and (ii) the genres of the organizational characteristics that it accentuated when tendering for government funded work.

Contraceptive sterilization in Puerto Rico

For twenty years Puerto Rico has had the world’s highest prevalence of sterilization. From the 1982 Puerto Rico Fertility and Family Planning Assessment we examine whether the probability of obtaining sterilization is changing and what impact sterilization has on fertility, finding that the use of contraceptive sterilization has not declined and will probably continue to increase in Puerto Rico. Nonuse rather than temporary methods of contraception is the second most likely circumstance after sterilization. We also find that sterilization has reduced the total marital fertility rate by over 33 percent, thus having a significant effect on reducing the rate of natural increase; by all indications, it will have a greater effect in the future.     

Simplicity and complexity in the effects of parental structure on high school graduation

As more and more children experience nonintact families because of nonmarital birth or parental marital disruption, researchers have paid more attention to whether nonintact family experiences have negative effects on later life. This study uses data from the National Longitudinal Survey of Youth to consider how experiences of parental structure affect chances of high school graduation. The study shows that the negative effects of parental structure are simpler than theoretical notions might suggest.