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D Mechanic

Publications and source records attributed to D Mechanic.

At least 37 records · Page 2Linked to original sources
PubMed1989

Medical sociology: some tensions among theory, method, and substance.

Why is it that quantitative and qualitative researchers on health issues often have divergent findings and conclusions? Exploration of such differences can be a useful way of bringing separate intellectual enclaves in medical sociology together and also can stimulate future inquiries. Some differences can be resolved by more precise definitions, by comparable frequency and timing of measurement, and by careful evaluation of meaning contexts. The triangulation of methods, using diaries as a bridge between surveys and qualitative measurement, offers particular promise. Improved theory on the relationships of method to data, and more attention to behavioral sequences and the social context of measurement, can serve as a stimulant to innovative solutions.

Data Collection↗
PubMed1989

Divorce, family conflict, and adolescents' well-being.

The relative effects of family conflict and divorce on the well-being of adolescents were examined in a longitudinal study of a heterogeneous community sample. Higher levels of family conflict were associated with increases in adolescents' depressed mood, anxiety, and physical symptoms over time. In contrast, neither recent divorce nor earlier divorce was associated with longitudinal changes in any health outcomes. Also, adolescents living in intact families with high conflict had significantly poorer well-being than those living in families of divorce with low conflict. Finally, the longitudinal effects of divorce and family conflict did not differ by age and sex, but Hispanic adolescents experienced more negative effects of family conflict than non-Hispanic whites, and the well-being of Asian adolescents was influenced more strongly by recent divorce.

Adolescent↗
PubMed1988

Factors associated with Medicare beneficiaries' interest in HMOs.

In this study we explore the demographic and health status factors associated with HMO awareness and enrollment interest among 314 Medicare beneficiaries. The results reveal that older adults most aware of HMOs were more demographically advantaged than others. In contrast, those most interested in information and HMO enrollment reported more financial vulnerability. An unanticipated finding was that self-reported health status and health care utilization were not associated significantly with HMO awareness or enrollment interest. If replicated, the findings suggest that relatively healthy Medicare beneficiaries with financial vulnerabilities could be enrolled in HMOs without necessarily increasing the proportion of high medical care utilizers.

Aged↗
PubMed1987

Gender differences in the acquisition of prescribed drugs: an epidemiological study.

It is often assumed that women received more prescribed drugs because they have different attitudes towards illness and medical care, higher anxiety and more time to visit physicians, or because physicians are biased. This study examines an alternative explanation, that is, much of the excess is associated with women's reproductive role. The study involved a detailed audit of the medical and pharmacy records of 862 men and women. Results showed that women received more prescribed drugs during the 2-year study period. However, the differences between men and women were not the same for all age groups. As expected, the differences were most apparent during the peak child-bearing years. Further analysis showed that the gender differences were virtually eliminated after excluding women with female-specific diagnoses and excluding the drug categories used to prevent or treat female-specific conditions. Previous studies based on gross measures of self-reported drug use seem to have underestimated the importance of factors that relate to women's reproductive role.

Adolescent↗
PubMed1987

Seeking help for psychologic problems. A replication and extension.

Patterns of seeking help for psychologic problems were investigated using interview and medical record data in a representative community sample and a sample of mental health clinic users from the same eligible population. In multivariate analyses, users of psychiatric services, compared with nonusers, were significantly younger, more likely to be separated or divorced, more psychologically distressed, and physically symptomatic. They were also more likely to use a large multispecialty clinic, compared with satellite clinics, and less likely to have membership in the prepaid medical plan established by the multispecialty clinic. Users had a greater reported propensity to seek help for anxiety and were more likely to know other mental health services users. Confiding social support was not significantly associated with use of mental health services, controlling for psychologic symptoms. Substantial social selection in seeking help was evident at both high and low levels of psychologic distress. Mental health users, compared with nonusers, reported more of most types of symptoms studied, except withdrawal, obsessive-compulsive symptoms, and alcohol consumption. Particular social characteristics and symptoms were associated with seeking help in general and other characteristics were more specifically linked to choice of a particular provider.

Adult↗
PubMed1987

Correcting misconceptions in mental health policy: strategies for improved care of the seriously mentally ill.

In the decades immediately following World War II a strong coalition of professionals and reformers emerged to shape agendas, debates, and national policy on caring for the mentally ill. The heterogeneity of mental health problems, the demographic shifts in populations at risk, and the realities of designing and implementing effective programs, were often overlooked; yet profound elements of change have taken place. Components essential for maintenance of function and rehabilitation have yet to be linked into a responsible alternative to long-term or episodic hospital care.

Community Mental Health Services↗