Scientific Appearance and Homeopathy. Determinants of Trust in Complementary and Alternative Medicine.

Several studies have investigated the motivations driving the use of complementary and alternative medicines (CAM). Nevertheless, the general public view of these therapies remains relatively unexplored. Our study identifies the social factors that determine a person's trust in alternative therapies, like homeopathy or acupuncture, drawing conclusions from the results of the Spanish National Survey on the Social Perception of Science and Technology (N = 6,357). We show that trust in the effectiveness of CAM therapies is not mutually exclusive with a belief in science for the general public, pointing to a certain level of disinformation. The comparison with superstitions confirms a clear differentiation with the drivers of trust in analyzed CAM therapies. We argue that scientific appearance of these alternative therapies, in terms of prescription, communication and marketing, may play an important role in determining trust in them for a large part of the population. Furthermore, we confirm that women and those with higher socio-economic status are more likely to express trust in the effectiveness of CAM therapies. Additionally, distrust of the influence of big pharma on health policies seems to have an effect on viewing CAM therapies as more effective. Finally, we argue that media and pharmacies may have an effect on the scientific-like perception of CAM therapies, contributing to the social construction of trust in its effectiveness. Therefore, widespread confusion about the scientific validation of homeopathy may be among the main factors driving its successful extension as a practice.

Caregiver Leave-Taking in Spain: Rate, Motivations, and Barriers.

This paper aims to (1) determine the rate of (full- and part-time) caregiver leave-taking in Spain, (2) identify the reasons conducive to a more intense use of this resource, and (3) ascertain the main obstacles to its use, as perceived by caregivers. All 896 people covered by the sample were engaging in paid work and had cared for dependent adults in the last 12 years. This resource, in particular the full-time alternative, was found to be a minority option. The data showed that legal, work-related, and family and gender norm issues are the four types of factors that determine the decision to take such leaves. The most significant obstacles to their use are the forfeiture of income and the risk of losing one's job. Our results suggest that income replacement during a leave would increase the take-up of these resources. Moreover, enlargement of public care services would promote the use of leave as a free choice of caregivers.

La satisfacción de las necesidades de las personas dependientes de 60 años y más según proveedor de cuidado. España 2008 / Satisfaction of needs of disabled people 60 and over according to care provider. Spain, 2008

Fundamento: A pesar de su importancia para el diseño de políticas públicas, son escasos los estudios sobre el grado en que el cuidado que reciben las personas mayores satisface sus necesidades. Los objetivos de este trabajo son: conocer la prevalencia de personas de 60 y más años que reciben atención y que tienen necesidades de cuidado no satisfechas; y establecer qué proveedor de cuidado (familiar, privado –empleadas de hogar- o público –servicios sociales-) tiene más probabilidades de satisfacer dichas necesidades. Métodos: Se utilizó una muestra de 3.718 personas de 60 y más años no institucionalizadas de la Encuesta de Discapacidad, Autonomía personal y situaciones de Dependencia 2008. Se realizaron tablas de contingencia para conocer la distribución de las necesidades de cuidado no satisfechas y se construyó un modelo de regresión logística binaria para identificar los factores asociados con las necesidades no satisfechas. Resultados: De las personas de 60 y más años que recibían atención, no satisficieron sus necesidades de cuidado 1039 (29%). Respecto a quienes recibieron únicamente cuidado familiar, quienes recibieron sólo cuidado de servicios sociales tuvieron menos probabilidades de tener satisfechas sus necesidades (OR=1,932 sig.=0,001) y quienes recibieron únicamente cuidado privado tuvieron más probabilidades (OR=0,673 sig.=0,015). Conclusiones: Quienes recibieron exclusivamente cuidado privado mostraron más probabilidades de tener satisfechas sus necesidades que quienes recibieron cualquier otra combinación de cuidado. Recibir únicamente atención de servicios sociales se relaciona con una mayor probabilidad de tener necesidades de cuidado insatisfechas, en relación con quienes reciben cuidado familiar o cuidado privado(AU)

Background: In spite of its importance for policy making, there have been few studies examining the satisfaction of care needs by the different care providers. The aims of this paper are: (1) to estimate the prevalence of dissatisfaction of care needs among people older than 59 years receiving care; and (2) to identify what care provider (family care, private care –paid care- or public care) has a higher probability of satisfying the needs of this population. Methods: This study is based on a sample of 3718 non-institutionalized people older than 59 years from the Survey on Disability, Personal Autonomy and Dependency Situations 2008. The distribution of unmet care needs among different groups of elderly people was cross-tabulated, and a regression logistic model was used to identify factors related to dissatisfaction of care needs. Results: 1,039 (29%) people older than 59 years had dissatisfied care needs. Compared to those receiving only family care, people receiving only public care were more likely to have dissatisfied needs (OR=1.932 sig.=0,001), and people receiving only paid care were less likely to have dissatisfied needs (OR=0.673 sig.=0.015). Conclusions: People receiving only paid care had a higher probability of having their needs satisfied than any other care combination. Those receiving only public care had a lower probability of having their needs satisfied than people receiving family care or paid care(AU)

Paid and unpaid support received by co-resident informal caregivers attending to community-dwelling older adults in Spain.

In this study from Spain, support received from outside the household by informal caregivers of people older than 64 years is analysed. The Spanish Time Use Survey (2002-2003) is used to examine: (1) the proportion of co-resident informal caregivers receiving paid and unpaid support by persons from outside the home; (2) the main factors associated with receipt of external paid and unpaid support; and, (3) factors linked to the amount of support received in terms of time. The study sample included 404 caregivers who cohabited with the person receiving care. We used a modified Andersen Behavioural Model as the analytic framework. Significant differences are observed in receipt of support according to predisposing, enabling and need factors. Overall, support (paid and unpaid) is significantly lower among households with women caregivers. In comparison with the least educated caregivers, higher levels of paid support are observed among those with secondary school or higher education, even when income, household size and receiver's age are included in the model. After controlling for care receivers' disability level and age, unpaid support is significantly higher among employed caregivers, spouses and caregivers living in medium-sized cities, versus unemployed caregivers, other relatives and caregivers living in large cities, respectively. These data highlight the inequalities of resources in terms of caregiver gender, socio-economic status and population size. The findings underscore the need to extend analysis not only to primary caregivers, but to caregiving networks and other types of caregiver support as well.

[Satisfaction of needs of disabled people 60 and over according to care provider. Spain, 2008]. / La satisfacción de las necesidades de las personas dependientes de 60 años y más según proveedor de cuidado. España, 2008.

BACKGROUND: In spite of its importance for policy making, there have been few studies examining the satisfaction of care needs by the different care providers. The aims of this paper are: (1) to estimate the prevalence of dissatisfaction of care needs among people older than 59 years receiving care; and (2) to identify what care provider (family care, private care -paid care- or public care) has a higher probability of satisfying the needs of this population. METHODS: This study is based on a sample of 3718 non-institutionalized people older than 59 years from the Survey on Disability, Personal Autonomy and Dependency Situations 2008. The distribution of unmet care needs among different groups of elderly people was cross-tabulated, and a regression logistic model was used to identify factors related to dissatisfaction of care needs. RESULTS: 1,039 (29%) people older than 59 years had dissatisfied care needs. Compared to those receiving only family care, people receiving only public care were more likely to have dissatisfied needs (OR=1.932 sig.=0,001), and people receiving only paid care were less likely to have dissatisfied needs (OR=0.673 sig.=0.015). CONCLUSIONS: People receiving only paid care had a higher probability of having their needs satisfied than any other care combination. Those receiving only public care had a lower probability of having their needs satisfied than people receiving family care or paid care.

Un estudio exploratorio del cuidado provisto por inmigrantes a personas mayores de 64 años en los hogares / Care provided by immigrants to older people in households. An explorative study

Justificación: En España existen carencias en el conocimiento sobre el cuidado provisto por inmigrantes a personas mayores dependientes en los hogares. Objetivo: Realizar un conocimiento exploratorio del tipo de atención que proveen los cuidadores inmigrantes a las personas mayores en hogares. Metodología: Estudio transversal en 24 mujeres inmigrantes que trabajaban en hogares cuidando personas mayores dependientes en la Comunidad de Madrid en 2008. Resultados principales: Todas las cuidadoras realizaron actividades domésticas, el 87% labores de acompañamiento, el 79% ayudas personales y el 75% cuidados sociosanitarios. Dedicaron 3,77 horas diarias a actividades domésticas, 2,27 a acompañamiento, 1,30 horas a ayudas personales en el hogar, y 0,60 horas diarias a cuidados sociosanitarios. Quienes reflejaron menores niveles de autonomía en movilidad y cuidado recibieron más tiempo de cuidados sociosanitarios y de ayudas personales que el resto. Conclusiones: Los cuidados provistos a mayores en los hogares por familiares, instituciones públicas e inmigrantes remunerados responden a demandas similares y son potencialmente sustituibles. Las cuidadoras inmigrantes actúan como conectores de la persona dependiente con su red social y con las instituciones sanitarias y sociales. Se requieren estudios con mayores muestras para profundizar en este fenómeno (AU)

Background: There has been a lack of research examining the type of care provided by immigrants to elderly people in Spain. Aim: To carry out an exploratory analysis of the type of care provided by immigrant caregivers to elderly people in their own homes. Methodology: A cross sectional study was developed based on 24 foreign-born women working in private households caring for dependent elderly people in the Autonomous Community of Madrid in 2008. Main results: All caregivers carried out housework, 87% of them accompanying duties, 79% personal help and 75% nursing care. Caregivers devoted 3.77 hours daily to housework, 2.27 to accompanying duties, 1.30 hours to personal help at home and 0.60 hours to nursing care. Those reporting less autonomy levels in mobility and care received more time in nursing care and personal help than the rest. Conclusion: Care provided to elderly people at home by their relatives, public institutions and employed immigrants responds to similar demands and could be potentially interchangeable. Immigrant caregivers act as connection of the dependent person with his/her social network and with the institution providing health and social services. Larger samples are required to deepen and better our insights (AU)

Las consecuencias del cuidado familiar sobre el cuidador: Una valoración compleja y necesaria / Consequences of family care over caregiver: A complex and necessary assessment

El cuidado provisto por familiares o amigos a los adultos dependientes es un proceso social decisivo para el bienestar de la sociedad española. Este tipo de apoyo tiene intensas consecuencias sobre quienes cuidan. En este artículo se plantea que la valoración precisa del impacto de la dependencia en el entorno social requiere de análisis comprensivos y multidisciplinares, y se elabora una propuesta de clasificación de las consecuencias del cuidado familiar sobre el cuidador. En dicha propuesta estos efectos pueden ser positivos o negativos, y afectar a diferentes dimensiones vitales de los cuidadores: salud, economía o relaciones sociales (AU)

Care provided by relatives or friends to dependent people is a key process to promote wellbeing in Spanish society. This type of support has intense consequences over caregivers' lives. Comprehensive and multidisciplinary analyses are required to assess dependency effects over social network. In this paper we elaborate a classification of types of family care consequences over caregivers. We differentiate between positive or negative consequences, and between consequences affecting caregivers' health, economy and/or social relations (AU)

[Distribution of formal and informal home care for people older than 64 years in Spain 2003]. / Distribución en España del cuidado formal e informal a las personas de 65 y más años en situación de dependencia.

BACKGROUND: There has been a relative lack of research examing the distribution of care to elderly dependent people in Spain. The aim of this paper is to analyse how formal and informal care is provided to elderly dependent people in Spain and to assess the socio-economic conditions in which the different kinds of care emerge. METHODS: This study is based on a sample of the elderly dependent population selected from those who reported the need of care in the 2003 Spanish Health Survey. The distribution of care among older people was cross-tabulated to identify the type of care, while regression models were used to identify the socio-economic characteristics of people receiving formal and/or informal care. RESULTS: Around 7.5% of the elderly people who need care do not receive it. Among those who do receive it, 89.4% receive informal care, 14.8% private care and 8.1% public care. 11.9% of elderly people in the study receive a mix of formal an informal care. Elderly people living in households in which the monthly income exceeds EUR 900 are five times more likely than people living in households in which the monthly income is less than EUR 600 to receive private care instead of public care. People older than 84 years are six times more likely to receive public care than people aged between 65 and 74. CONCLUSIONS: Men are two times more likely than women to receive exclusively informal care. Women are three times more likely than men to receive both kinds of care simultaneously. Formal care complements informal care. Private care is more common than public care. Men, people living in larger-sized households, and people with fewer socio-economic resources are more likely to receive informal care.

Distribución en España del Cuidado Formal e Informal a las personas de 65 años y más años en situación de dependencia / Distribution of Formal and Informal Home Care for People Older than 64 years in Spain 2003

Fundamento: La distribución entre cuidado formal e informal a personas mayores dependientes es una cuestión relativamente inexplorada en España. El objetivo de este trabajo es analizar cómo se distribuye el cuidado informal y formal entre las personas mayores dependientes en España, así como las condiciones sociales y económicas en que se desarrollan estos tipos de cuidado.Métodos: Se utilizó una muestra de personas mayores de 64 años dependientes procedente de la Encuesta Nacional de Salud 2003. Se realizaron tablas de contingencia para conocer la distribución del cuidado entre las personas mayores españolas, y se construyeron varios modelos de regresión logística binaria para identificar los factores asociados a la recepción de los diferentes tipos de cuidado.Resultados: El 7,5% de las personas mayores que necesitan cuidado no lo reciben. De quiénes lo reciben, el 89,4% recibe cuidado informal, el 14,8% servicios privados y el 8,1% servicios públicos. Cuidado formal e informal se combinan en el 11,9% de los casos. Quienes viven en hogares con ingresos superiores a 900 t tienen 5 veces más probabilidades de recibir servicios privados en lugar de cuidado informal que los hogares de menos de 600 t, y los mayores de 84 años tienen 6 veces más probabilidades de recibir apoyo público que los que tienen entre 65 y 74.Conclusiones: Los hombres tienen el doble de probabilidades de recibir sólo cuidado informal, y las mujeres tienen 3 veces más probabilidades de recibir cuidado formal e informal combinado en lugar de un tipo de cuidado. El cuidado formal sirve de complemento al informal, y los servicios de cuidado privados tienen mayor presencia que los públicos. Ser varón, vivir en hogares de mayor tamaño y con menos recursos socioeconómicos incrementa la probabilidad de recibir cuidado informal (AU)

Background: There has been a relative lack of research examing the distribution of care to elderly dependent people in Spain. The aim of this paper is to analyse how formal and informal care is provided to elderly dependent people in Spain and to assess the socio-economic conditions in which the different kinds of care emerge.Methods: This study is based on a sample of the elderly dependent population selected from those who reported the need of care in the 2003 Spanish Health Survey. The distribution of care among older people was cross-tabulated to identify the type of care, while regression models were used to identify the socio-economic characteristics of people receiving formal and/or informal care.Results: Around 7.5% of the elderly people who need care do not receive it. Among those who do receive it, 89.4% receive informal care, 14.8% private care and 8.1% public care. 11.9% of elderly people in the study receive a mix of formal an informal care. Elderly people living in households in which the monthly income exceeds EUR900 are five times more likely than people living in households in which the monthly income is less than EUR 600 to receive private care instead of public care. People older than 84 years are six times more likely to receive public care than people aged between 65 and 74.Conclusions: Men are two times more likely than women to receive exclusively informal care. Women are three times more likely than men to receive both kinds of care simultaneously. Formal care complements informal care. Private care is more common than public care. Men, people living in larger-sized households, and people with fewer socioeconomic resources are more likely to receive informal care (AU)