This paper addresses access to formal health care among Cape Verdean immigrants in the Netherlands, and their transnational health‐seeking process in other European countries…
Abstract
This paper addresses access to formal health care among Cape Verdean immigrants in the Netherlands, and their transnational health‐seeking process in other European countries. Three barriers hindering Cape Verdeans' access to care have been identified: lack of information about the health services available, problems in the relationship with health providers and difficulties in dealing with the conditionality of help. These problems are deeply intertwined, and relate to two sets of factors. At the macro‐level these include the organisational and structural characteristics of the Dutch health care system. At the micro‐level, the problems concern the mismatch between users' and providers' expectations of health care provision.Despite the barriers encountered, Cape Verdeans strive to benefit from good health. The informants in this study employ two sorts of strategy to access good health care. On the one hand, they try to adapt their help‐seeking behaviour to the model prevalent in the Netherlands. On the other, they resort to transnational health care use in other European countries, including Portugal and France. These strategies prove Cape Verdeans' resilience in finding the care that is most appropriate to their needs.
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Critical psychiatry appraises and comments upon psychiatric services as they are usually provided. This article, prompted by the publication of a recent book, considers the place…
Abstract
Critical psychiatry appraises and comments upon psychiatric services as they are usually provided. This article, prompted by the publication of a recent book, considers the place of critical psychiatry historically and in the context of contemporary mental health care and treatment.
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“Health literacy” refers to the knowledge and skills required to make optimal use of the health system. In the West, the question “how to live?” is increasingly answered by…
Abstract
Purpose
“Health literacy” refers to the knowledge and skills required to make optimal use of the health system. In the West, the question “how to live?” is increasingly answered by reference to medical and psychological norms and concepts: the concept of “health” has expanded enormously. Teaching migrants to become “health literate” is therefore a process of resocialisation or acculturation. If it is done without regard for their own ideas and values, it will be an attempt at assimilation – and like most such attempts, it will usually fail. If migrants are not consulted and involved in the design of their own health services, the services will not be optimally accessible and inclusive, which will lower the performance of the health system. This paper seeks to argue that becoming a “literate” user of Western health care involves learning a new morality.
Design/methodology/approach
Evidence is presented to illustrate the increasing medicalisation and psychologisation of life in the West and the argument that concepts of health are value‐based.
Findings
Migrants are not empty vessels simply waiting to be filled up by Western expertise; they have their own ideas and values, which may clash with those that underlie health care. Integration of migrants into health systems can only take place through dialogue, in which both sides show respect for each other's views. The confrontation with other ideas and values can enrich mainstream health care in the West.
Originality/value
The paper encourages readers to go beyond a purely technical interpretation of “health literacy” and consider its moral and political dimensions.
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Cha-Hsuan Liu, Ludwien Meeuwesen, Floryt van Wesel and David Ingleby
The purpose of this paper is to test the widely held assumption that underutilisation of mental health services by Chinese living in western countries is due to their different…
Abstract
Purpose
The purpose of this paper is to test the widely held assumption that underutilisation of mental health services by Chinese living in western countries is due to their different beliefs regarding mental illness.
Design/methodology/approach
Qualitative data were analysed from in-depth interviews with 23 Chinese respondents, who gave a total of 30 accounts of a Chinese person they knew who had experienced mental health problems in the Netherlands. Analysis focused on the way these problems were described and explained, as well as the kinds of help regarded as appropriate.
Findings
The beliefs expressed about mental illness did not seem to differ from those current in the west in ways that would form a major barrier to seeking help from mainstream services.
Research limitations/implications
The study was exploratory and the limited sample size did not make it possible to analyse sources of variation in beliefs. Generalisation to other countries would need to take into account the specific characteristics of the Chinese population in those countries.
Practical implications
Simply knowing that a person is of Chinese origin is likely to tell us little about their beliefs concerning mental health. Moreover, traditional Chinese beliefs are not necessarily incompatible with western ones. Service providers should pay more attention to issues such as communication barriers, entitlement to care, knowledge of how the health system works and discrimination.
Originality/value
The paper challenges widely held notions about ethnic Chinese that are seldom empirically tested. It is the first study of its kind in the Netherlands.
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– The purpose of this paper is to present an argument for taking the long view of the retention and preservation of inactive medical records.
Abstract
Purpose
The purpose of this paper is to present an argument for taking the long view of the retention and preservation of inactive medical records.
Design/methodology/approach
Using the theoretical framework of Actor-Network Theory, the author examines medical records, and especially mental health records, as actants that participate in the classification and treatment of patients, and in the development of psychiatry and mental hospitals as social institutions.
Findings
The varied and profound roles of medical records demonstrate the ability for records to have multiple “lives” that can touch many individuals beyond a single human lifetime.
Practical implications
As the current and future custodians of historical medical record collections, information professionals are in a position to be greater advocates for the increased preservation of and mindful access to these materials.
Social implications
Medical records have potential to be cultural heritage documents, especially for emergent communities.
Originality/value
This paper articulates the ways in which medical records are an embedded part of many societies, and affect the ways in which illness is defined and treated. It thus suggests that while laws regarding the retention and destruction of and access to medical records continue to be deliberated upon around the world, such records can have enduring value as information artifacts.
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This paper aims to focus on improvements in the regulated‐sales training team at AXA Sun Life.
Abstract
Purpose
This paper aims to focus on improvements in the regulated‐sales training team at AXA Sun Life.
Design/methodology/approach
Describes how the team was introduced to the TAP learning system and benefits it has brought.
Findings
Reveals that the team now has a robust testing and assessment processes for every program and every delegate. This extends to the trainers, who also go through an annual process to ensure that they have the product knowledge themselves, as well as the skills to deliver it. Emphasizes that, because all materials are now designed to the same format, it is easier for one trainer to pick up the program of another, should the need arise.
Practical implications
Points out that the training team, originally ten strong, is how half the size, yet is delivering more programs than ever.
Originality/value
Highlights the value of consistency when regulatory training is involved.
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The purpose of this article is to examine encounters between Cape Verdean student mothers and Portuguese professionals in the social care sector, and look at what kinds of care…
Abstract
Purpose
The purpose of this article is to examine encounters between Cape Verdean student mothers and Portuguese professionals in the social care sector, and look at what kinds of care relations were established and whether culture is a significant factor.
Design/methodology/approach
The approach was participant observation in appointments, the dynamics of which were examined within a broader analysis of the workings of “authoritative knowledge” and how this interlocks with “cultural authority”.
Findings
The workings of “authoritative knowledge” obscured the influences of the professionals' own culture upon the care provided. The women were thus treated as “problems” in need of “solutions”, in order to conform to normative models of responsible citizens and mothers. By treating issues of birth control and good parenting in isolation from the women's cultural contexts, professionals' attempts to regulate and correct women's behaviour was potentially alienating.
Research limitations/implications
Future research should focus in more detail on how strategies that aim to raise awareness of and accommodate cultural differences can be institutionalized in such a way that they are not dismissed as yet another demand upon overburdened professionals. One of the main limitations of the research was that health professionals were not interviewed.
Originality/value
The article provides original ethnographic data which help to further the debate on intercultural competency for care providers.