By Q. Hamid. Bloomfield College.
And then the bailiff came downstairs purchase avana 100mg free shipping erectile dysfunction drugs egypt, and he said avana 50 mg for sale erectile dysfunction vacuum pump, “The judge is sure you probably won’t do that again, that you’ll be more sensitive. He said we’re going to waive the ticket because you’ve been sitting here for so long. I actually thought to myself, well, ﬁnally there’s some beneﬁt to being handicapped—NOT! Faulty Equipment With increasingly complicated mechanisms and electronic circuitry, equip- ment can falter or fail. Once an airline bent the heavy metal steering shaft of my scooter so badly that it no longer worked. In Phoenix, far from home and my scooter salesman, I fought mounting waves of panic while being passed up the hierarchy of baggage claim representatives. The airline sent my damaged scooter to a local repair shop and rented equipment for my business trip. At least the Phoenix outﬁt unbent the steering shaft, and the scooter limped back to Boston where it received a thorough overhaul. A few weeks after Gerald Bernadine got his scooter, Wheeled Mobility / 217 It went dead on me. I read the instruction book, and it talked about when the battery is dead. I learned that instead of going a month be- tween recharges, it wouldn’t hurt to charge it every week. Charging scooter batteries is easy: after you attach the batteries to the charger unit, plug the charger into a standard electrical outlet. The expe- rience can be terrifying, as for Toombs: I was crossing the plaza outside the university library when my scooter stopped dead in its tracks. I was surrounded by a sea of con- crete embedded with decorative pebbles, marooned in the middle of a ﬂat, completely open area with no trees, no lampposts, no benches anywhere within reach. The nearest “object” was the building, but it was im- possible to reach on my own two feet with nothing to support me. Nor could I easily crawl the distance, given the hard uneven surface of pebbled cement.... The space of the plaza, which a moment be- fore had been bright, sunny, inviting, now suddenly appeared omi- nous. Nowadays, in case of emer- gency, people should always carry cell phones whenever rolling out on the streets—yet who will provide this service to people who can’t afford it? Boris Petrov uses a black, four- wheeled, power wheelchair operated by a little joy stick; it swivels and turns within a tight radius. Petrov’s wheelchair failed, he couldn’t get to the bathroom: since both of his legs were amputated almost to his groin, he cannot crawl. I don’t want to ﬁx one part and then another part and then another part. Petrov made his own repairs, al- though his screws didn’t quite ﬁt the holes. She’ll go to the su- permarket pushing the chair, and she’s got her bundles in the chair. People sometimes seek equipment they later ﬁnd they don’t like; others receive wheelchairs they never really wanted in the ﬁrst place. One expert emphasizes,“The value of offering trial periods before ﬁnalizing a technol- ogy selection cannot be overstated. The consumer must try the device in the actual situations of use (home, work, school)” (Scherer 2000, 124). But unfortunately, most equipment is not available for rental or test drives be- fore purchase, so people have little sense of how the technology will work in their daily lives. People abandon mobility aids more than any other assistive devices (Scherer 1996, 2000; Olkin 1999), with canes, walkers, and braces rejected most often. Marcia Scherer, an expert in rehabilitation psychology, argues that “there is a dynamic interactive relationship among assistive device use, quality of life, and the user’s functional capabilities and temperament” (2000, 117). Most assistive devices are abandoned within the ﬁrst year, es- pecially in the ﬁrst three months. For in- dividuals, non-use of a device may lead to decreases in functional abilities, loss of freedom and independence, increases in expenses, and risk of injury or disease. Device abandonment also represents ineffective use of limited funds by federal, state, and local govern- ment agencies, insurers, and other providers....
But I feel as though generic avana 200mg with mastercard erectile dysfunction guilt in an affair, at this point discount avana 50 mg visa erectile dysfunction caused by zoloft, a doctor isn’t really going to do anything for me that I want. Nelda Norton feels that Tom’s neurologist neglects key questions:“Tom goes to a neurologist maybe once a year, and the neurologist always says, ‘You’re just the same as you were. Mildred Stanberg, in her late eighties and afraid of falling, never broached walking with her physician. After she bought a cane at a local drug store and carried it to her next appointment, the physician noticed it—he adjusted the cane’s height and told her how best to use it. Johnny Baker, her primary care physician, circle the clinic with her as she pushed her walker. Richards remained in terrible pain, still using the walker two years later. For Cynthia Walker, listen- ing is only a ﬁrst step; understanding must follow. Walker recently changed physicians, and she worries about her new rheumatologist. Unless you have a similar experience, a doctor that hasn’t, if you forgive the expression, “walked in our shoes,” can’t have the sensation of sympathy or understanding on that level. In order to instill the power of positive thinking to go on, you have to be lis- tened to ﬁrst. We need a little praise; we need a little understanding—an ear, if you will. And sometimes a person in the medical profession is more interested with moving the cattle through. Lester Goodall believes that physicians feel they are failing people with chronic, incurable conditions, prompting some doctors to build barriers be- tween themselves and their patients. When I ask her how I can get better, she can’t tell me any more than the man on the street. They can give you the clinical diagnosis, but they can’t make you better. Goodall senses that physicians feel this way when “there’s no magic bullet. Few interviewees, however, expect their physicians to raise or sustain these hopes. Around the time of diagnosis, especially for diseases with widely varying clinical courses (some people do well, others do poorly), hopeful physicians can buoy spirits and help people confront the new uncertainty of their lives. Candy Stoops was diagnosed with myasthenia gravis in her late twenties, and she asked Dr. Candy knows her disease, and she no longer relies on her neu- rologist to predict her future. There are people who are worse off, much worse off, and they’re doing it. Among people age sixty-ﬁve and older, about 95 percent (regardless of mo- bility difficulties) have a source of care they usually visit when sick. So do roughly 90 percent of persons age eighteen to sixty-four years with mo- bility difficulties, compared to only 81 percent without mobility impair- ments. Older people are more likely than younger people to see physicians, and rates of doctor visits increase as mobility dif- 134 People Talking to Their Physicians table 11. Use of Health-Care Services No Physician Visits At Least One in Last Year (%) Hospitalization (%) Mobility Difficulty Age 18–64 Age 65+ Age 18–64 Age 65+ None 30 14 5 11 Minor 11 8 17 21 Moderate 8 6 23 26 Major 7 5 32 37 ﬁculties worsen. Among persons age eighteen to sixty-four years with major mobility difficulties, 22 percent use specialists as their usual care- giver, compared to 4 percent of younger persons without impaired mobil- ity. Almost everybody at least sixty-ﬁve years old has Medicare insurance, so lacking coverage is rarely a problem for them. Among persons age sixty-ﬁve and older, over 20 percent with major mobility difficulties report they don’t like, trust, or believe in doctors, com- pared to 7 percent of persons without impaired mobility. Perhaps this gap reﬂects prior experiences and expectations—from patients’ perspectives, physicians may have provided little help. Reason for Having No Usual Source of Health Care No Insurance/ Doesn’t Like, Trust, or Can’t Afford It (%) Believe in Doctors (%) Mobility Difficulty Age 18–64 Age 65+ Age 18–64 Age 65+ None 19 3 3 7 Minor 39 5 7 9 Moderate 40 5 5 8 Major 27 6 10 20 people are often less satisﬁed with their physicians than healthier persons (Hall et al. Johnny Baker, her primary care physician, and his nurse practitioner colleague.
PROBING FOR MORE DETAIL X That’s interesting; can you explain that in more de- tail? You’ll ﬁnd that most people are uncomfortable during silences and will elaborate on what they’ve said rather than experience discomfort buy discount avana 200mg on line impotence age 40. Also purchase avana 100mg on line erectile dysfunction operations, you may ﬁnd it helpful to summarise what people have said as a way of ﬁnding out if you have understood them and to determine whether they wish to add any further information. Another useful tactic is to repeat the last few words a per- son has said, turning it into a question. The following piece of dialogue from an interview illustrates how these techniques can be used so that the researcher does not in- ﬂuence what is being said. HOW TO CONDUCT INTERVIEWS / 73 Janet: ‘Well, often I ﬁnd it really diﬃcult because I just don’t think the information’s available. I wer- en’t exactly naughty at school, I just didn’t really bother, you know, I didn’t really like it that much, if I’m honest with you. SUMMARY X Practise with the recording equipment before the inter- view takes place. It might be useful to conduct some pilot interviews so that you can become familiar with the recording equipment. X Develop an interview schedule, starting with general, 74 / PRACTICAL RESEARCH METHODS non-personal issues. X Check the recording equipment works and make sure you have enough tapes, batteries, paper, pens, etc. X Check that you have a suitable venue in which to carry out the interview, free from noise and interruptions. X Make sure you know how to get to the interview and arrive in good time. X Negotiate a length of time for the interview and stick to it, unless the interviewee is happy to continue. X Check recording equipment is working without draw- ing attention to it. X Achieve closure, thank them and leave a contact num- berincasetheywishtogetintouchwithyouabout anything that has arisen. HOW TO CONDUCT INTERVIEWS / 75 X Respect their conﬁdentiality – do not pass on what has been said to third parties unless you have requested permission to do so. They are popular within the ﬁelds of market research, political research and educational research. The focus group is facilitated by a moderator who asks questions, probes for more detail, makes sure the discussion does not digress and tries to ensure that everyone has an input and that no one person dominates the discussion. If you are interested in running focus groups for your re- search you will need to acquire a basic understanding of how people interact in a group setting and learn how to deal with awkward situations (see Table 8). However, the best way to become a successful moderator is through experience and practice. If possible, try to sit in on a focus group run by an experienced moderator. Once you have done this, hold your own pilot focus group, either with friends or ac- tual research participants. You might ﬁnd it useful to video tape this focus group so that you can assess your body lan- guage, see how you deal with awkward situations, analyse how you ask questions, and so on. Don’t be disappointed if your ﬁrst few groups do not go according to plan. In all focus groups you need to explain the purpose of the group, what is expected of participants andwhatwillhappentotheresults. Negotiatealength for the discussion and ask that everyone respects this as it can be very disruptive having people come in late, or leave early. Usually one and a half hours is an ideal length, although some focus groups may last a lot longer. Assure the participants about anonymity and conﬁdenti- ality, asking also that they respect this and do not pass on what has been said in the group to third parties. You may ﬁnd it useful to produce and distribute a Code of Ethics (see Chapter 13). Asking questions General, easy to answer questions should be asked ﬁrst.
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