PubMed · 10642238
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H Bedford, D Elliman. 2000-01-22. Concerns about immunisation.. https://doi.org/10.1136/bmj.320.7229.240
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OBJECTIVE: To discover and explore the factors that result in "false optimism about recovery" observed in patients with small cell lung cancer. DESIGN: A qualitative observational (ethnographic) study in two stages over four years. SETTING: Lung diseases ward and outpatient clinic in university hospital in the Netherlands. PARTICIPANTS: 35 patients with small cell lung cancer. RESULTS: "False optimism about recovery" usually developed during the (first) course of chemotherapy and was most prevalent when the cancer could no longer be seen in the x ray pictures. This optimism tended to vanish when the tumour recurred, but it could develop again, though to a lesser extent, during further courses of chemotherapy. Patients gradually found out the facts about their poor prognosis, partly because of physical deterioration and partly through contact with fellow patients who were in a more advanced stage of the illness and were dying. "False optimism about recovery" was the result an association between doctors' activism and patients' adherence to the treatment calendar and to the "recovery plot," which allowed them not to acknowledge explicitly what they should and could know. The doctor did and did not want to pronounce a "death sentence" and the patient did and did not want to hear it. CONCLUSION: Solutions to the problem of collusion between doctor and patient require an active, patient oriented approach from the doctor. Perhaps solutions have to be found outside the doctor-patient relationship itself - for example, by involving "treatment brokers."
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OBJECTIVE: To examine how breast feeding and bottle feeding are represented by the British media. DESIGN: Content analysis. SUBJECTS: Television programmes and newspaper articles that made reference to infant feeding during March 1999. SETTING: UK mass media. MAIN OUTCOME MEASURES: Visual and verbal references to breast or bottle feeding in newspapers and television programmes. RESULTS: Overall, 235 references to infant feeding were identified in the television sample and 38 in the newspaper sample. Bottle feeding was shown more often than breast feeding and was presented as less problematic. Bottle feeding was associated with "ordinary" families whereas breast feeding was associated with middle class or celebrity women. The health risks of formula milk and the health benefits of breast feeding were rarely mentioned. CONCLUSIONS: The media rarely present positive information on breast feeding, even though this feeding practice is associated with the most health benefits. Health professionals and policy makers should be aware of patterns in media coverage and the cultural background within which women make decisions about infant feeding.