The purpose of this review is to describe how pregnant and postpartum women with substance use disorders (SUDs) experience health care encounters in prenatal care, labor and delivery, postpartum, and nursery/neonatal intensive care unit (NICU) settings. Findings from 23 qualitative studies on the topic were synthesized using a metasummary approach. The majority of the studies revealed that pregnant and postpartum women with SUDs tend to experience their health care encounters as conflictual, although some studies revealed that some women experience their health care encounters as supportive. The results of metasummary included a taxonomy of health care encounters. Five types of adverse encounters were identified: judgmental, disparaging, scrutinizing, disempowering, and deficient-care. Three types of beneficial encounters were identified: recovery-based, accepting, and effective-care. The findings suggest the importance of stigma awareness, therapeutic patient-provider communication, patient activation, and integrated care.
This study investigated whether neighborhood social cohesion influenced volunteer intensity over two years. The sample was drawn from Health and Retirement Study respondents who completed the 2010 or 2012 Psychosocial and Lifestyle Questionnaire (n = 12,929). Results showed that compared to nonvolunteers, a one-unit increase in neighborhood social cohesion increased the odds of moderate (OR: 1.07, p < .05) and high volunteering (OR: 1.10, p < .001). However, other productive roles, social contact, and education were significant in distinguishing high intensity from moderate volunteering while neighborhood social cohesion was not. Social workers should consider the neighborhood environment when recruiting volunteers.
Background Chronic kidney disease (CKD) is associated with multiple comorbidities, hospitalizations and mortality. In older adults, social isolation and poor mobility contribute to these outcomes. We tested the hypothesis that a glomerular filtration rate (GFR) <45 mL/min/1.73 m2 (CKD Stages 3b–5) is associated with social isolation and that mobility limitation is a key driver of social isolation in patients with CKD. Methods Data from 9119 participants, ages 57–107 years, from the 2016 wave of the Health and Retirement Study’s Venous Blood Study were used for this cross-sectional analysis. Kidney function measured by estimated GFR (eGFR) was the predictor and patients were classified as CKD Stages 3b–5 or non-CKD Stages 3b–5 (eGFR ≤45 or >45 mL/min/1.73 m2). The outcomes tested were mobility limitation assessed by self-report and social contact and participation measures assessed by the Psychosocial Life Questionnaire. The associations among kidney function, mobility and social isolation were examined with logistic and ordinary least squares regression, adjusted for covariates and testing for interaction with gender. Results Participants with CKD Stages 3b–5 (N = 999) compared with non-CKD Stages 3b–5 were older (74.9 versus 68.2 years, P < 0.001) and fewer were female (15% versus 58%, P < 0.001). CKD Stages 3b–5 were associated with higher odds of difficulty walking several blocks [odds ratio 1.44 (95% confidence interval 1.16–1.78)]. Participants with CKD Stages 3b–5 had reduced social contact and social participation (B = −0.23, P < 0.05; B = −0.62, P < 0.05, respectively). Women with CKD Stages 3b–5 were 2.7 times more likely to report difficulty walking several blocks than men with CKD Stages 3b–5, but social isolation in CKD Stages 3b–5 did not vary by gender. In CKD Stages 3b–5 patients, mobility limitation was a risk factor for reduced social contact and participation but did not explain the poor social contact and participation. Conclusion CKD Stages 3b–5 was associated with both mobility limitation and social isolation in a population-based study of older adults. In contrast to older adults without CKD Stages 3b–5, mobility limitation did not explain the lack of social contact and poor social participation, suggesting other factors are more important.
Objectives: This research examines whether perceived neighborhood disorder influences the use of preventive healthcare services (i.e. influenza vaccine, pneumonia vaccine, cholesterol screening, colonoscopy, and dental care) by older adults and whether social ties buffer the potential adverse effects of perceived neighborhood disorder. Methods: Using data from the 2012 wave of the Health and Retirement Study, binary logistic regression was used to generate odds ratio estimates of preventive healthcare use in the past 2 years. Results: We find that greater levels of neighborhood disorder were associated with fewer dental care visits net of social and health factors. Regular participation in four or more social activities was associated with decreased odds of restricted use and increased odds of receiving a pneumonia vaccine and colonoscopy. Discussion: This research provides evidence that perceived neighborhood disorder may act as a barrier for specific preventive healthcare services and highlights the need for targeted intervention.
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