Article contents
Self-Care in Relation to Informal and Formal Care*
Published online by Cambridge University Press: 14 November 2008
Abstract
This paper examines the prevalence, inter-relationships and correlates of various forms of self, informal and formal care. Analyses of data drawn from a random sample of 743 non-institutionalised elderly individuals living in Winnipeg, Manitoba reveal similarities as well as differences among the three types of care. Self- and formal care are somewhat similar, being positively related and having similar correlates. Nevertheless, substitutability as a consequence of medical scepticism is also evident. Both are unrelated to informal care. It is poor health in the form of functional disability and the availability of support through the marital relationship which are the strongest correlates of informal care. In contrast, health (chronic conditions and perceived health status) as well as beliefs in the efficacy of both preventative health behaviours and medical services are among the strongest correlates of self- and formal care.
- Type
- Research Article
- Information
- Copyright
- Copyright © Cambridge University Press 1990
References
NOTES
1 Levin, L. S. and Idler, E. L.The Hidden Health Care System: Mediating Structures and Medicine. Ballinger, Cambridge, 1981.Google Scholar
2 Horowitz, A., Dono, J. E. and Brill, R. ‘Continuity or changes in informal support? The impact of an extended home care program’. Paper presented at the Annual Meeting of the Gerontological Society of America, San Francisco, California, 1983.Google Scholar
3 National Retired Teachers Association (NRTA), American Association of Retired Persons and Wakefield Associates. ‘Family support systems and the aging’. Policy report submitted to the Select Committee on Aging, House of Representatives, 96th Congress, Washington, D.C., 1980.Google Scholar
4 Freidson, E.Professional Dominance: The Social Structure of Medical Care. Atherton Press, New York, 1970.Google Scholar
5 Chappell, N. L. The interface among three systems of care: self, informal and formal. In Ward, R. A. and Tobin, S. S. (eds), Health in Aging, pp. 159–179. Springer, New York, 1987.Google Scholar
6 Shanas, E. and Maddox, G. L. Health, health resources, and the utilization of care. In Binstock, R. H. and Shanas, E. (eds), Handbook of Aging and the Social Sciences, pp. 697–726. Van Nostrand Reinhold, New York, 1985.Google Scholar
7 Evans, R. G.Does Canada have too many doctors? Why nobody loves an immigrant physician. Canadian Public Policy, 11 (1976), 147–160.CrossRefGoogle Scholar
8 Evans, R. G.Strained Mercy: The Economics of Canadian Health Care. Butterworth and Company (Canada) Ltd, Toronto, 1984.Google Scholar
9 Illich, I.Medical Nemesis: The Expropriation of Health. Random, New York, 1976.Google Scholar
10 Helman, C.Feed a cold, starve a fever. Culture, Medicine and Psychiatry, 2 (1978), 107.Google Scholar
11 Pratt, L.The significance of the family in medication. Journal of Comparative Family Studies, 4 (1973), 13–35.Google Scholar
12 Levin, L. S. and Idler, E. L.Op. cit.Google Scholar
13 Levin, L. S., Katz, A. H. and Hoist, E.Self-Care: Lay Initiatives in Health, 2nd edn.Prodist, New York, 1979.Google Scholar
14 Dean, K. J., Holst, E. and Wagner, M. G.Self-care of common illnesses in Denmark. Medical Care, 21 (1983), 1012–1032.CrossRefGoogle ScholarPubMed
15 Elliott-Binns, C. P.An analysis of lay medicine. Journal of the Royal College of General Practitioners, 23 (1973), 255–266.Google ScholarPubMed
16 Sussman, M. B. The family life of old people. In Binstock, R. H. and Shanas, E. (eds), Handbook of Aging and the Social Sciences, pp. 415–449. Van Nostrand Reinhold, New York, 1985.Google Scholar
17 Biaggi, M. ‘Testimony Before the Select Committee on Aging’. House of Representatives, 96th Congress, Washington, D.C., 1980.Google Scholar
18 Horowitz, A., Dono, J. E. and Brill, R.Op. cit.Google Scholar
19 National Retired Teachers Association, American Association of Retired Persons and Wakefield Associates. Op. cit.
20 Maddox, G. L. and Delinger, D. C.Assessment of functional status in a program evaluation and resource allocation model. Annals of the American Academy of Political and Social Science, 438 (1978), 59–70.CrossRefGoogle Scholar
21 Dean, K. J.Self-care responses to illness: a selected review. Social Science and Medicine, 15A (1981), 673–687.Google Scholar
22 Dean, K. J., Hoist, E. and Wagner, M. G.Op. cit.Google Scholar
23 Hickey, T., Dean, K. and Holstein, B. E.Emerging trends in gerontology and 10 geriatrics: implications for the self-care of the elderly. Social Science and Medicine, 23 (1986), 1363–1369.CrossRefGoogle Scholar
24 Dean, K. J. Self-care responses to illness. Op. cit.Google Scholar
25 Dean, K. J. Self-care behaviour: implications for ageing. In Dean, K., Hickey, T. and Holstein, B. E. (eds), Self-Care and Health in Old Age, pp. 58–93. Croom Helm, London, 1986.Google Scholar
26 Levin, L. S., Katz, A. H. and Holst, E.Op. cit. p. 13.Google Scholar
27 Haug, M. R. Doctor–patient relationships and their impact on elderly self-care. In Dean, K., Hickey, T. and Holstein, B. E. (eds), Self-Care and Health in Old Age, pp. 230–250. Croom Helm, London, 1986.Google Scholar
28 Haug, M. R. and Lavin, B. ‘Self-care and the elderly: an empirical assessment’. Paper presented at the Xth World Congress of the International Sociological Association, Mexico City, Mexico, 1982.Google Scholar
29 Haug, M. R.Op. cit.Google Scholar
30 Levin, L. S. and Idler, E. L.Self-care in health. Annual Review of Public Health, 4 (1983), 181–201.CrossRefGoogle ScholarPubMed
31 Levin, L. S. and Idler, E. L. Ibid. p. 181.
32 Levin, L. S., Katz, A. H. and Holst, E.Op. cit. p. 13.Google Scholar
33 Dean, K. J. Self-care behaviour. Op. cit.Google Scholar
34 Dean, K.J. Ibid. p. 62.
35 Dean, K. J. Self-care responses to illness. Op. cit.Google Scholar
36 Hickey, T., Dean, K. J. and Holstein, B. E.Op. cit.Google Scholar
37 Dean, K. J.Lay care in illness. Social Science and Medicine, 22 (1986), 275–284.CrossRefGoogle ScholarPubMed
38 Dunnell, K. and Cartwright, A.Medicine Takers, Prescribers and Hoarders. Routledge & Kegan Paul, London, 1972.Google Scholar
39 Fleming, G. V., Giachello, A. L., Anderson, R. M. and Andrade, P.Self-care: substitute, supplement or stimulus for formal medical care services. Medical Care, 22 (1984), 950–966.CrossRefGoogle ScholarPubMed
40 Anderson, J., Buck, C., Danaher, K. and Fry, J.Users and non-users of doctors: implications for self-care. Journal of the Royal College of General Practitioners, 27 (1977), 155.Google ScholarPubMed
41 Bush, P. and Rabin, D.Who's using nonprescribed medicines? Medical Care, 14 (1976), 1014.CrossRefGoogle ScholarPubMed
42 Haug, M. R.Age and medical care utilization patterns. Journal of Gerontology, 36 (1981), 103–111.CrossRefGoogle ScholarPubMed
43 Coulton, C. and Frost, A. K.Use of social and health services by the elderly. Journal of Health and Social Behaviour, 23 (1982), 330–339.CrossRefGoogle ScholarPubMed
44 Haug, M. R. and Lavin, B.Op. cit.Google Scholar
45 Dean, K. J., Holst, E. and Wagner, M. G.Op. cit.Google Scholar
46 Segall, A.Age differences in lay conceptions of health and self-care responses to illness. Canadian Journal on Aging, 6 (1987), 47–65.CrossRefGoogle Scholar
47 Segall, A.Op. cit.Google Scholar
48 Levin, L. S. and Idler, E. L. The hidden health care system. Op. cit.Google Scholar
49 Wallston, K. A., Wallston, B. S. and DeVellis, R.Development of the multidimensional health locus of control (MHLC) scales. Health Education Monograph, 6 (1978), 160–170.CrossRefGoogle ScholarPubMed
50 Lau, R. R.Origins of health locus of control beliefs. Journal of Personality and Social Psychology, 42 (1982), 322–334.CrossRefGoogle ScholarPubMed
51 Mechanic, D. (ed.) The epidemiology of illness behavior and its relationship to physical and psychological distress. In Symptoms, Illness Behavior and Help-Seeking Prodist, Neale Watson Academic Publications, New York, 1982.Google Scholar
52 Chappell, N. L.Op. cit.Google Scholar
53 Coulton, C. and Frost, A. K.Op. cit.Google Scholar
54 Wolinsky, F. D., Coe, R. M., Miller, D. K., Prendergast, J. M., Creel, M. J. and Chavez, M. N.Health services utilization among the noninstitutionalized elderly. Journal of Health and Social Behaviour, 24 (1983), 325–337.CrossRefGoogle ScholarPubMed
55 Banks, M., Beresford, S., Morrell, D., Walker, J. and Watkins, C.Factors influencing demand for primary medical care in women aged 20–44 years: a preliminary report. International Journal of Epidemiology, 4 (1975), 189–195.CrossRefGoogle ScholarPubMed
56 For further information, consult Chappell, N. L., Strain, L. A. and Badger, M.Self-care in health and in illness. Comprehensive Gerontology, 2 (1988), 92–101.Google ScholarPubMed
57 Chappell, N. L.Measuring functional ability and chronic health conditions among the elderly: a research note on the adequacy of three instruments. Journal of Health and Social Behaviour, 22 (1981), 90–102.CrossRefGoogle ScholarPubMed
58 Bengtson, V. L., Mangen, D. and Landry, P. The multi-generation family: concepts and findings. In Garms-Homolova, V., Hoerning, E. M. and Schaeffer, D. (eds), Intergenerational Relationships, C. J. Hogrefe, New York, 1984.Google Scholar
59 Lau, R. R. and Ware, J. F.Refinements in the measurement of health-specific locus-of-control beliefs. Medical Care, 19 (1981), 1147–1158.CrossRefGoogle ScholarPubMed
60 Wallston, B. S., Wallston, K. A., Kaplan, G. D. and Maides, S. A.Development and validation of the health locus of control (HLC) scale. Journal of Consulting and Clinical Psychology, 44 (1976), 580–585.CrossRefGoogle ScholarPubMed
61 Chappell, N. L., Strain, L. A. and Badger, M.Op. cit.Google Scholar
62 Chappell, N. L. The interface among three systems of care. Op. cit.Google Scholar
- 21
- Cited by