"January 2004" / Includes bibliographical references (leaves 297-313) / x, 313 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, School of Social Sciences, Discipline of Gender and Labour Studies, 2004

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Saúde bucal pode ter uma definição diferente para cada contexto e para cada grupo social. Para alguns profissionais da Odontologia pode representar uma boca com dentes livres da doença cárie, perfeitamente alinhados e em boa oclusão; para outros, pode representar uma pessoa integrada na sociedade, satisfeita com as funções de sua boca. Saúde bucal, para cada indivíduo, pode, ainda, modificar-se ao longo dos anos, de seus ciclos de vida, de seus problemas e do ambiente no qual está inserido. Compreender o que representa saúde bucal é compreender um pouco das necessidades e do cotidiano das pessoas. Penetrar no cotidiano de um grupo de pessoas e extrair dele o significado de saúde bucal exige a utilização de instrumentos confiáveis e seguros sob as perspectivas da ética e da ciência. A teoria das Representações Sociais, proposta por Moscovici em 1961, que busca conhecer os conceitos formados no senso comum, através das ideias, valores e práticas do cotidiano de um grupo social, foi a base do presente estudo. O instrumento DIDL (Impactos Dentais na Vida Diária) construído por Leão em 1995, o índice CPOD (Dentes Cariados Perdidos e Obturados), um questionário semiestruturado e entrevista, serviram de guia para a identificação das Representações Sociais de Saúde Bucal dos Usuários Adultos do Serviço Público de Saúde de Vitorino. A preocupação em compreender como este grupo social perde tantos elementos dentários, foi o que despertou o interesse pela presente pesquisa. A população da pesquisa foi obtida através de amostra temporal por adultos da faixa etária de 35 a 44 anos, que procuraram os serviços públicos de saúde para receber tratamento odontológico. No total, 40 indivíduos participaram de todas as etapas da pesquisa, sendo 20 do sexo feminino e 20 do sexo masculino, a renda familiar média foi de 2,40 salários mínimos, com média de 6,88 anos de estudo, e, ocupação que favorecesse a flexibilidade no horário de trabalho como: donas de casa, agricultores e motoristas. Os resultados apontam para um quadro de iniquidade em saúde. O valor do índice CPOD de 20,50 encontrado para o grupo, segundo Classificação da Organização Mundial da Saúde, é considerado elevado para valores acima de 13,9 para esta faixa etária. O coeficiente de confiabilidade para as 36 questões do DIDL, obtido através do alfa de Cronbach, foi de 0,909. Os resultados do DIDL demonstraram que 22,5% dos usuários estavam insatisfeitos, 60% relativamente satisfeitos e 17,5% satisfeitos com a saúde bucal. Observou-se que o acesso aos serviços públicos de saúde durante a infância e adolescência, o paradigma curativo-reparador das práticas odontológicas e as condições sociodemográficas foram determinantes para condução a um quadro de iniquidade em saúde bucal (ou apenas saúde), e levou-os a queixar de muita dor durante a vida. A hipótese de que os usuários perdem seus dentes por falta e/ou dificuldade de acesso é comprovada pelo relato dos próprios usuários e pelos níveis de saúde bucal em que se encontram. Dentro do quadro de iniquidade, encontraram-se ainda desigualdades em relação ao grupo dos insatisfeitos, que apresentaram maior CPOD, menor renda, menor grau de escolaridade e maior média de idade; foram os que relataram mais dor e foram mais incisivos em suas queixas. As representações sociais de saúde bucal do grupo social, como um todo, foram concebidas por eles como “não sentir dor”. Concepção de saúde bucal que pode ser entendida como aquela em que a doença é percebida como uma “ocupação”, ou seja, que a pessoa pode lutar contra a doença, que é possível tratar, não é destrutiva, é temida pela dor, mas sempre é aceita por este grupo social. / Oral health can have a different definition for each context and each social group. For some dental professionals, it may represent cavity-free, perfectly aligned teeth in good occlusion; for others, it may represent a person integrated into society, satisfied with his or her mouth’s functions. Oral health, for each individual, can also change over the years, from its life cycles, its problems and the environment in which it’s in. Understanding what oral health represents is to understand a little about people’s needs and daily lives. Getting inside the daily life of a group of people and extract the meaning of oral health from it requires the use of reliable and safe resources under the perspectives of ethics and science. The theory of Social Representations, proposed by Moscovici in 1961, which seeks to understand the concepts in the common sense, through the ideas, values and practices of everyday life of a social group, was the basis of this study. The DIDL (Dental Impact on Daily Living) tool, developed by Leão in 1995, the DMFT (Decayed, Missing and Filled Teeth) index, a semi-structured survey and interview, served as a guide for the identification of Social Representations of Oral Health in Adult Users of the Public Health Services of Vitorino. The concern over understanding how this social group loses so many dental elements was what sparked interest in this research. The research population was obtained by temporal sample of adults in the 35 to 44 age group, who sought public health services to receive dental treatment. In total, 40 individuals participated in all stages of research, 20 being female and 20 male, the median household income was 2.40 times the minimum wage, with an average of 6.88 years of education, and an occupation that allowed for flexibility in working hours, such as homemakers, farm workers and drivers. The results point to a picture of health inequity. According to the World Health Organization’s Classification, the DMFT index value of 20.50 found for the group is considered high for values above 13.9 for this age group. The reliability coefficient for the 36 questions in the DIDL, obtained through the Crombach’s alpha, was 0.909. The DIDL results showed that 22.5% of users were dissatisfied, 60% relatively satisfied and 17.5% satisfied with their oral health. It was observed that access to public health services during childhood and adolescence, the remedial-restorative paradigm of dental practices, and the socio-demographic conditions were determining factors leading to a framework of inequity in oral health (or just health), and led them to complain of great pain during their lives. The hypothesis that users lose their teeth due to lack and/or difficulty of access is proven by the account of the users and the level of oral health in which they find themselves. Within the framework of inequity, there were still inequalities regarding the group of dissatisfied, which presented higher DMFT, lower income, lower educational level, and higher age average; they were the ones that reported more pain and were more incisive in their complaints. The social representations of oral health of the social group, as a whole, were conceived by them as “not feeling pain”. Concept of oral health that can be understood as one in which the disease is perceived as an “occupation”, i.e., that one can fight against the disease, that can be treated, is not destructive, is feared for the pain, but is always accepted by this social group.

Saúde bucal pode ter uma definição diferente para cada contexto e para cada grupo social. Para alguns profissionais da Odontologia pode representar uma boca com dentes livres da doença cárie, perfeitamente alinhados e em boa oclusão; para outros, pode representar uma pessoa integrada na sociedade, satisfeita com as funções de sua boca. Saúde bucal, para cada indivíduo, pode, ainda, modificar-se ao longo dos anos, de seus ciclos de vida, de seus problemas e do ambiente no qual está inserido. Compreender o que representa saúde bucal é compreender um pouco das necessidades e do cotidiano das pessoas. Penetrar no cotidiano de um grupo de pessoas e extrair dele o significado de saúde bucal exige a utilização de instrumentos confiáveis e seguros sob as perspectivas da ética e da ciência. A teoria das Representações Sociais, proposta por Moscovici em 1961, que busca conhecer os conceitos formados no senso comum, através das ideias, valores e práticas do cotidiano de um grupo social, foi a base do presente estudo. O instrumento DIDL (Impactos Dentais na Vida Diária) construído por Leão em 1995, o índice CPOD (Dentes Cariados Perdidos e Obturados), um questionário semiestruturado e entrevista, serviram de guia para a identificação das Representações Sociais de Saúde Bucal dos Usuários Adultos do Serviço Público de Saúde de Vitorino. A preocupação em compreender como este grupo social perde tantos elementos dentários, foi o que despertou o interesse pela presente pesquisa. A população da pesquisa foi obtida através de amostra temporal por adultos da faixa etária de 35 a 44 anos, que procuraram os serviços públicos de saúde para receber tratamento odontológico. No total, 40 indivíduos participaram de todas as etapas da pesquisa, sendo 20 do sexo feminino e 20 do sexo masculino, a renda familiar média foi de 2,40 salários mínimos, com média de 6,88 anos de estudo, e, ocupação que favorecesse a flexibilidade no horário de trabalho como: donas de casa, agricultores e motoristas. Os resultados apontam para um quadro de iniquidade em saúde. O valor do índice CPOD de 20,50 encontrado para o grupo, segundo Classificação da Organização Mundial da Saúde, é considerado elevado para valores acima de 13,9 para esta faixa etária. O coeficiente de confiabilidade para as 36 questões do DIDL, obtido através do alfa de Cronbach, foi de 0,909. Os resultados do DIDL demonstraram que 22,5% dos usuários estavam insatisfeitos, 60% relativamente satisfeitos e 17,5% satisfeitos com a saúde bucal. Observou-se que o acesso aos serviços públicos de saúde durante a infância e adolescência, o paradigma curativo-reparador das práticas odontológicas e as condições sociodemográficas foram determinantes para condução a um quadro de iniquidade em saúde bucal (ou apenas saúde), e levou-os a queixar de muita dor durante a vida. A hipótese de que os usuários perdem seus dentes por falta e/ou dificuldade de acesso é comprovada pelo relato dos próprios usuários e pelos níveis de saúde bucal em que se encontram. Dentro do quadro de iniquidade, encontraram-se ainda desigualdades em relação ao grupo dos insatisfeitos, que apresentaram maior CPOD, menor renda, menor grau de escolaridade e maior média de idade; foram os que relataram mais dor e foram mais incisivos em suas queixas. As representações sociais de saúde bucal do grupo social, como um todo, foram concebidas por eles como “não sentir dor”. Concepção de saúde bucal que pode ser entendida como aquela em que a doença é percebida como uma “ocupação”, ou seja, que a pessoa pode lutar contra a doença, que é possível tratar, não é destrutiva, é temida pela dor, mas sempre é aceita por este grupo social. / Oral health can have a different definition for each context and each social group. For some dental professionals, it may represent cavity-free, perfectly aligned teeth in good occlusion; for others, it may represent a person integrated into society, satisfied with his or her mouth’s functions. Oral health, for each individual, can also change over the years, from its life cycles, its problems and the environment in which it’s in. Understanding what oral health represents is to understand a little about people’s needs and daily lives. Getting inside the daily life of a group of people and extract the meaning of oral health from it requires the use of reliable and safe resources under the perspectives of ethics and science. The theory of Social Representations, proposed by Moscovici in 1961, which seeks to understand the concepts in the common sense, through the ideas, values and practices of everyday life of a social group, was the basis of this study. The DIDL (Dental Impact on Daily Living) tool, developed by Leão in 1995, the DMFT (Decayed, Missing and Filled Teeth) index, a semi-structured survey and interview, served as a guide for the identification of Social Representations of Oral Health in Adult Users of the Public Health Services of Vitorino. The concern over understanding how this social group loses so many dental elements was what sparked interest in this research. The research population was obtained by temporal sample of adults in the 35 to 44 age group, who sought public health services to receive dental treatment. In total, 40 individuals participated in all stages of research, 20 being female and 20 male, the median household income was 2.40 times the minimum wage, with an average of 6.88 years of education, and an occupation that allowed for flexibility in working hours, such as homemakers, farm workers and drivers. The results point to a picture of health inequity. According to the World Health Organization’s Classification, the DMFT index value of 20.50 found for the group is considered high for values above 13.9 for this age group. The reliability coefficient for the 36 questions in the DIDL, obtained through the Crombach’s alpha, was 0.909. The DIDL results showed that 22.5% of users were dissatisfied, 60% relatively satisfied and 17.5% satisfied with their oral health. It was observed that access to public health services during childhood and adolescence, the remedial-restorative paradigm of dental practices, and the socio-demographic conditions were determining factors leading to a framework of inequity in oral health (or just health), and led them to complain of great pain during their lives. The hypothesis that users lose their teeth due to lack and/or difficulty of access is proven by the account of the users and the level of oral health in which they find themselves. Within the framework of inequity, there were still inequalities regarding the group of dissatisfied, which presented higher DMFT, lower income, lower educational level, and higher age average; they were the ones that reported more pain and were more incisive in their complaints. The social representations of oral health of the social group, as a whole, were conceived by them as “not feeling pain”. Concept of oral health that can be understood as one in which the disease is perceived as an “occupation”, i.e., that one can fight against the disease, that can be treated, is not destructive, is feared for the pain, but is always accepted by this social group.

Mental health recovery is a complex phenomenon involving clinical, functional, physical, and social dimensions. The social dimension is understood to involve meaningful relationships and integration with supportive individuals and a wider community. While the recovery model developed from a movement led by consumers and survivors of the mental health system to promote hope, self-determination, and social inclusion, the clinical aspects of recovery have dominated mental health research and practice. The under-investigated area of social recovery calls for psychometrically sound measurement instruments. The purpose of the current study was to develop and validate the Social Recovery Measure (SRM). The study was grounded in disability and mad theories which locate disability at the intersection of the person and the environment. The SRM is a 19-item self-administered instrument scored on a 5-point Likert scale that consists of two domains: Self and Community. Items for the SRM were developed through focus groups and interviews with 41 individuals in recovery from mental health challenges and the preliminary measure was administered to a purposive, nonprobability sample of 228 individuals in recovery. A confirmatory factor analysis (CFA) was conducted and a re-specified model resulted in good model fit. The SRM exhibited excellent internal consistency with a Cronbach's coefficient alpha of .951 and demonstrated excellent test-retest reliability, content validity, and construct validity. Social recovery is highly relevant for social work given the discipline's commitment to disenfranchised populations and investment in creating enabling environments. The SRM has utility for use in evidence based practice and evaluation. The SRM can be used to further research in social recovery, test underlying theory bases, and explore the differential effects of the multiple dimensions of recovery. There is a need to better understand social recovery which this measure can facilitate.

Luo, Weixiang. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 90-105). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts also in Chinese.

This study was conducted using a quantitative design and statistical analysis to determine the extent to which social support will influence an individual's decision to seek treatment for a medical illness. Main findings include significant correlations between measures of perceived and tangible social support and treatment compliance.

The Community Mental Health Act of 1963 launched the deinstitutionalization movement, whereby individuals with serious mental illnesses were released from psychiatric hospitals and began living and receiving mental health care in the community (Carling, 1995). However, these actions have not necessarily integrated those individuals into all aspects of community life (Dewees, Pulice, & McCormick, 1996). This is unfortunate because people with serious mental illnesses frequently report that community integration is not only important to them, but that it also aids in reducing symptoms and promoting recovery (Townley, 2015). Although past research suggests that receiving mental health care in the community has a positive impact on symptom management, the influence of other community factors (e.g., sense of community, community participation) has yet to be fully explored (Segal, Silverman, & Temkin, 2010). Furthermore, there is lack of understanding as to how these community factors influence other aspects of recovery, such as mental and physical health. As such, the goal of the current study is to better understand the association between community participation and recovery by investigating sense of community as a potential mediating factor between community participation, psychological distress, mental health, and physical health. Data were collected from 300 adults with serious mental illnesses utilizing community mental health services in the United States. Results indicated that sense of community partially mediated the association between community participation and mental health, as well as psychological distress, and fully mediated the association between community participation and physical health. Implications include contributing to the current knowledge base about the role of community factors in recovery and informing future interventions aimed at promoting community integration of adults with serious mental illnesses.

The study of social relationships and health has been one of the main issues of sociology. A growing number of literatures have demonstrated the association between social relationships and health. The findings generally showed that people who were socially integrated, received social support, and participated in non-working social organizations tended to be physically and psychologically healthier than those who were not; however, less is known about the process and structure of social relationships in the sociological investigation of health. Studies were often limited in that they did not thoroughly investigate the determinants of social relationships in relation to health. In the present study, I suggest that social contexts will enlarge our understanding of the association between social relationships and health. I employ the term social contexts to refer to distinctive dimensions of social structures and institutions in which individuals are embedded. If social contexts are probable determinants of social relationships, social contexts appear to have an effect on health status as well as social relationships. Despite this proposition, few studies have examined the associations among social contexts, social relationships, and health in an integrated analytical framework. The main objective of this project is, thus, to examine the association among the distinctive layers of social contexts--family, workplace, and neighborhoods--, social relationships and health. Using the first and second wave of the Americans’ Changing Lives panel data, I test four main research questions. First, are social contexts associated with health outcomes? Second, are social contexts predictive of a variety of social relationships? Third, do social relationships account for the association between social contexts and health outcomes? Finally, do social contexts moderate the association between social relationships and health outcomes? Neighborhood contexts are associated with depression and self-rated health of the first wave net of controls. Neighborhood contexts are predictive of a variety of social relationships. Social relationships account for the associations between the percentage of households receiving public assistance, foreign-born residents, and female-headed households, and depression of the first wave. Some of the associations between social relationships and health outcomes are moderated by neighborhood contexts, and the moderating effects vary by the types of social relationships. Workplace contexts are generally associated with depression, but not largely associated with self-rated health. Workplace contexts are predictive of a variety of social relationships. Social relationships only moderately account for the effects of job decision latitude, physical demands, and psychological demands on depression of the second wave, and psychological demands on self-rated health of the first wave. The associations between social relationships and health outcomes are moderated by workplace contexts in some cases, and the moderating effects vary by the types of social relationships. Family contexts are generally associated with depression and self-rated health in both cross-sectional and longitudinal settings. Family contexts are predictive of a variety of social relationships. Social relationships mediate some of the associations between family context variables and health; the effect of family context variables on self-rated health of the second wave are explained by social relationships in models of having children, parental chronic stress, mother support, child support, and spouse support. Some of the associations between social relationships and health status are moderated by family contexts, and the moderating effects vary by the types of social relationships. / text