Family health care decision making

How do families choose a health plan when offered the option of insurance or a Health Maintenance Organization (HMO)? Choices are influenced by health consumerism, decision variables, family health needs, family composition, family socioeconomic status, and knowledge about HMOs. Subjects in the research reported here chose insurance or one of four HMOs; control subjects had no HMOs available. The model is estimated with LOGIT regression, yielding a pseudoR ² of.22 for the adjusted model. Participation in the decision process, number of chronic illnesses, and knowledge about HMOs all are significantly and positively associated with choosing an HMO; also, young adults are more likely than older adults to choose HMOs. The consumerism variable fails to attain significance. LOGIT analysis of the adjusted model indicates that the model predicted 72% of plan choices correctly. Suggested research for other family forms, for the poor, and for the elderly's health plan choices are discussed.     

Assessing Lund's critical values for testing for outliers in linear regression models

This note assesses Lund's critical bounds as approximations to the critical values of a size-a test for detecting single outlier in a multiple linear regression model. A Monte Carlo experiment shows that the empirical sizes are very close to the nominal sizes, and the regressors have little effect on the empirical sizes. Lund's tables are revised to higher accuracy.     

Ethnicity-of-Interviewer Effects Among Mexican-Americans and Anglos

A general interpersonal deference explanation for ethnicity-of-interviewereffects is tested with a random survey of Anglos and Mexican-Americansusing Anglo and Hispanic interviewers and questions relatedto Mexican-American culture. The theory was most clearly supportedamong Anglo respondents. The mixed support found among Mexican-Americanssuggests that deference is strongest when questions deal withthe culture represented by the interviewer, not the respondent.     

"We just happen to live here": two social workers share their stories about Oregon's Death with Dignity Law

This article is written more like a conversation with the reader rather than a strictly academic piece. The purpose is to share from a more personal perspective the unique circumstances and challenges faced by two social workers in Oregon as they grappled with the Death with Dignity Law. The law has been in effect for six years and a May 2004 decision from the Ninth U.S. Circuit Court allowed the law to remain a legal end-of-life option. Each writer has a unique voice on the process of social work involvement in practice, research, and policy since the law was originally passed in 1994.     

The healing power of dogs: Cocoa's story

Animals bring a sense of "at homeness" and even normalcy to people who are hospitalized or live in health care facilities. Illnesses, separation from family, fear, loneliness, and even depression may be lessened for those who receive a therapy dog visit by providing a welcome change in routine and something to look forward to. Individuals are often more active and responsive during and after a visit. Just stroking and petting a dog requires the use of hands and arms, as well as the motions of stretching and turning. Dogs are also unconcerned with age or physical ability; they accept people as they are. This alone causes many to reach out and interact with dogs. Animals provide a focus for conversation and a common interest. As Cocoa's human partner can attest, a pet also makes it easier for strangers to talk. Cocoa is known by so many people at the facilities she visits that residents' family members often stop to talk with "Cocoa's mom" when they meet her in the community, asking questions about how Cocoa is doing. When Cocoa is no longer able to perform her services, many in her community will mourn. Cocoa's story, as well as the limited research literature, supports the positive physical and psychological effects of animals, but continued research on the effect of therapy animals on health outcomes is needed. As advocates for clients, nurses are in key positions to facilitate the inclusion of animals in clients' care. Although not for everyone, including those who react negatively to animals or who are allergic, pet therapy offers important possibilities for providing holistic care that extends not only to clients, but also to family members and staff, and to the pets themselves.     

The family caregiving career: implications for community-based long-term care practice and policy

Informal (i.e., unpaid) long-term care for disabled older adults is often chronic, but it is only recently that research has considered the longitudinal implications of family caregiving. In particular, investigators have conceptualized caregiving as a "career," and within the caregiving career, a number of diverse trajectories and transitions can occur. Following a summary of these findings, this paper considers how longitudinal caregiving research can influence and potentially address key policy and practice concerns, especially in the delivery and support of community-based long-term care (CBLTC) services. It is suggested that with the refinement of the informal long-term care literature, existing policy and practice to support caregiving families can be similarly advanced.     

The research pendulum: multiple roles and responsibilities as a researcher

Qualitative research on sexual identities has highlighted the use of oral narratives to understand the lives of lesbians and gay men. Feminist ethnographers, sociologists and queer theorists have further posed methodological inquiries to the issues of insider/outsider, the possibilities of an erotic subject and the matter of representation. Using interview data with Hong Kong lesbians, this paper discusses a researcher's multiple positionalities and its effects on both the researched and the researcher. Being self-reflexive requires a researcher to test her or his own boundaries and to take up social responsibilities as the interpreter of texts. This paper calls for further dialogue between a researcher's subject positions, research processes and the final presentation of findings. doi:10.1300/J155v10n03_02.