Diane Gibson

The informative process in private medical consultations: A preliminary investigation

Abstract The communication of information has assumed an increasingly important role in general practitioner consultations. This paper reports on a preliminary investigation of the informative elements of doctor-patient interaction. The research methods employed in this study provided for an examination of both patients views and expectations about the provision of information concerning their illnesses as well as their behaviour toward seeking such information during their actual consultation. The major consideration which directed this research concerned the means by which information was gained and the influence of both patient and doctor on the communicative process. In particular, the study was concerned with the extent to which information was provided in response to active requests from patients or whether it was largely determined by what the doctor chose to proffer. Our interview data indicated that patients exhibited a surprising lack of knowledge concerning their illnesses even though they attached considerable importance to gaining such information. Moreover, our observations of the doctor-patient interviews revealed that patients—largely because of their own passivity-gained little additional information during the course of their consultation.

Parasitism and phallocentrism in social provisions for the aged

Aging is a sexed issue. Women are the majority of the aged population, the majority of informal carers, the majority of service providers and the majority of recipients of formal care. Yet traditional gerontology accorded sex the status of a descriptive variable, rather than a central category of analysis and explanation. For its own part, feminism remained largely preoccupied with the first forty years of the female cycle. Recent years have, however, seen a growing awareness of the peculiar and particular problems confronting women in an aging society, and a range of empirical studies have emerged which canvass aspects of those debates. This article draws together a wide-ranging but fragmented literature from a number of countries. The first part of the argument concerns the extent to which and the ways in which the care of the aged is parasitic upon the unpaid and poorly paid labor of women in general, and old women in particular. The second part characterizes existing social provisions for the aged as phallocentric, in that they privilege and correspond with the interests, experiences and preferences of men, advantaging them in relation to women.

The Australian Class Structure: Some Preliminary Results from the Australian Class Project

This paper describes the class structure of the Australian workforce in terms of the theoretical approaches developed by Erik Olin Wright. The two class profiles presented and discussed are Wrights contradictory class location schema and his second schema based on the exploitation of assets. The distributions of class according to occupational group, gender and age are also discussed.

Regulation and Reform: Promoting Residents' Rights in Australian Nursing Homes

The residents rights movement has a relatively recent history in Australia, although it is well established in the United States. The recent Ronalds consultancy (1988-1989) established a national policy agenda for the residents rights movement in Australia, including a Charter of Residents Rights and Responsibilities, a Resident/Proprietor Agreement, independent advocacy services and complaints units with the Department of Health, Housing and Community Services. A less well publicised aspect of recent reforms to the aged care system also converges significantly on the issue of residents rights. In 1987, a new and sophisticated system of nursing home regulation was introduced by the Australian government. The standards monitoring program, which is at the forefront of international developments in this field, is resident centred and outcome oriented. The data presented here suggest that the program has contributed toward the development of residents rights in nursing homes, via improved commitment amongst management, and greater participation by residents. Yet overall progress in residents rights remains precarious. Several conflicts of interest and sources of constraint are identified.

Politics, Policy and Performance: The Primary Prevention of Disease in Two Community Health Centres in Queensland

A major goal underlying the community health programme initiative in Australia was the prevention of disease. The clients and people in the communities served by two Brisbane community health centres were studied to determine the extent to which (a) they had received preventive advice; (b) they had acted upon such advice. Comparative data on non-client community samples were also examined. The data indicate that there is little preventive activity and little evidence of changes in behaviour associated with preventive programs in the two health centre areas. The apparent failure of at least one major goal of the community health programe in Queensland is attributable to, amongst other factors, political and structural forces which impeded the successful implementation of this policy initiative.

Book Reviews : THE HOUSING AND LIVING ENVIRONMENT FOR RETIRED PEOPLE IN AUSTRALIA. Edited by Ross Thorne. Sydney, Hale and Iremonger, 1986. 348pp.

changes to the conclusions made in the earlier Nil and HSCAP reports. For example, he shows that the N 1’1’s conclusion that mortality had reached long-term stability had to be substantially revised in the light of subsequent sharp declines in mortality. Likewise, it is not unexpected that some of I)r. Ilugo’s material will soon be dated. Ilis conclusion that rates of divorce will continue to rise in Australia for some time yet is looking doubtful. No mention is made of the possible impact on future mortality of AIDS. The book highlights the large loss of population from Victoria to Queensland in the years 1976-81, yet in the most recent year for which data are available, 1985-86, Victoria gained population from Queensland. The author’s conclusion that a realignment of infrastructure will be needed-to deal with the ,rural renaissance’ may now require some rethinking. And what of his observation that the establishment of the Australian Institute