The Latent Functions of Welfare and Need-Satisfaction of the Disadvantaged

In a study carried out among a representative sample of Jewish Israeli adults, a paradigm of need-satisfaction by direct welfare assistance has been developed and, to a great extent, empirically supported. Multivariate analysis revealed that, despite the fact that it is recognized as indispensible in facilitating basic living conditions, direct welfare assistance, whatever its kind, predicts frustration rather than need-satisfaction. The data ascertain that attributing to the welfare assistance the latent functions of preserving consumers\u27 inferiority and of pursuing the agencies\u27 and the welfare workers\u27 interests rather than those of the consumers, constitute a major factor in the resulting feeling of frustration. Dependence, a sense of deprivation, and the attribution of these latent functions, rather than need-satisfaction beyond those of facilitating basic living conditions, are greatly predicted by receiving direct welfare assistance

Chronic illness, stress and coping

The study investigated the factors that may alleviate the emotional distress of chronically ill persons, enhance their coping capacity and prevent further acceleration of the deterioration in their condition. Based on recent approaches to breakdown and stress, the seriousness of a chronically ill person's situation was hypothesized as resulting from the inadequacy of the individual's and his primary group's coping resources and inexpediency of the professional emotional support. A study carried out among a representative sample of Jewish Israeli adults gave support to the hypothesized insufficiency of individual resources. Data highlighted the significance of the physician's emotional support as the most sought for yet least attainable resource in alleviating distress. The study lends further support to previous evidence of the importance of the physician's affective behavior in the patient's wellbeing. It also ascertained the role that primary groups' emotional support may have in the readjustment of the chronically ill.

Primary care practitioners' likelihood to engage in a bio-psychosocial approach: An additional perspective on the doctor-patient relationship

On the basis of a comprehensive study among Israeli primary care practitioners a multivariate framework aimed at furthering the understanding of salaried physicians' likelihood to engage in a bio-psychosocial approach has been developed and empirically verified. The framework augments earlier work on physicians' behavior by further specifying the concept of bio-psychosocial approach and the incentives and preconditions for such an approach. Multivariate analysis highlights the weight of the motivating, facilitating and impeding factors in shaping the primary care practitioners' likelihood to engage in a bio-psychosocial approach. Conclusions are drawn regarding implications for the organization of care providing organizations.bio-psychosocial approach primary care family medicine stress-disease relationship instrumental behavior affective behavior

The plight of primary medical care: The problematics of 'committedness' to the practice

A multivariate paradigm, aimed at furthering the understanding of the factors underlying the problematics of practising primary medical care, has been developed and empirically supported. A study among a sample of Israeli primary care physicians and a comparison group of hospital physicians revealed an empirical 'structure of committedness', ascertaining that the committedness to practise primary care is contingent on the 'intrinsic' satisfaction and rewards as well as the 'extrinsic' rewards from the professional community (namely, prestige), derived from bio-medical (but not psycho-social) intervention activities. The data ascertain that salaried general practitioners and specialists employed in Sick Funds primary care clinics perceive themselves the least rewarded both intrinsically and extrinsically, and consequently the least committed to their field of practice. Specialists in family practice perceive themselves more rewarded, both intrinsically and extrinsically, the general practitioners (i.e. enjoy higher prestige), and hence are more committed to their field of practice.bio-medical intervention committedness to practice doctor's prestige family medicine general practice primary medical care private practitioner psycho-social intervention sick-fund

Disability, stress and readjustment: The function of the professional's latent goals and effective behavior in rehabilitation

The paper focuses on the factors which may possibly explain why rehabilitation agencies' assistance may eventually result in maladjustment--a conclusion inferred from recent studies on the readjustment of disabled persons. Multivariate analysis of data from a study among Israeli disabled war veterans ascertains that the rehabilitant's perception of the rehabilitator as pursuing a predominant though latent goal of promoting his/her own interests, constitutes a major factor in the intervention's detrimental outcomes. The rehabilitator's demonstration of 'affective' (sincerely humane) behavior, on the other hand, counteracts the eventually deleterious consequences. The study renders further support to the frequently emphasized significance of the rehabilitant's subjective assessment of the demands confronting him in their becoming stressors. The data ascertains that it is not the severity of the impairment itself, but rather the subjective assessment of its implication that may have stress-arousing consequences. The present study contributes a further development of the previously established paradigm of 'Readjustment of Disabled Persons', contributing to the understanding of the factors facilitating and impeding readjustment.disability stress rehabilitation professional goals

Practice compatibility and type of framework: Essential dimensions in the salaried primary care practitioners' approach to practice

A multivariate paradigm, aimed at furthering the understanding of the factors underlying the devotion to practice of salaried primary care practitioners, has been developed and subjected to empirical verification. A study among a sample of Israeli primary care practitioners (N=134) revealed an empirical structure of 'Practice Compatibility', suggesting that the devotion to practice is conditioned by the clinical and professional role compatibility. Compatibility in turn is contingent on the practitioners' conviction in the sincerity of manifest health care oriented goals of the care-providing-framework. The herein developed notion of 'Practice Compatibility' facilitated the distinction between types of employing frameworks according to the factors predicting the salaried primary care practitioners' devotion to practice. In this respect the contribution of the present study is in identifying the factors underlying the salaried practitioners' motivation to practice. However, contrary to the expected, practice compatibility does not predict the primary care practitioners' likelihood to demonstrate affective behavior. Thus the data were unable to repudiate earlier evidence regarding the significance of the private fee-for-service framework in predicting affective behavior.primary medical care holistic approach to medical care instrumental behavior affective behavior health insurance sick fund clinical compatibility role compatibility

Primary medical care and coping with stress and disease: The inclination of primary care practitioners to demonstrate affective behavior

A study carried out among a sample of Israeli primary care practitioners ascertained that doctors are less inclined to demonstrate affective (humane) than instrumental (medical treatment) behavior toward patients. Data ascertain the contradiction between these components of behavior which is inherent in the primary care practitioner's frame of reference. Affective behavior, in the doctor's frame of reference. constitutes to a great extent both an impedment to medical performance as well as a possible threat to his dominance. Family medicine is not an exception in this case; in fact, it rather aggravates the contradiction between affective and instrumental behavior, and the threat to the family practitioner's dominance is even stronger. Data allude that only the enhancement of the practitioner's profit may further his inclination to demonstrate affective behavior. The importance of this study has to be understood in the light of accumulating evidence stressing the importance of the practitioner's affective behavior in alleviating anxiety and possible promotion of recovery.