Research

From Passive to Active Consumers: Ageing and Consumption in Britain 1963-1998

This is a 2-year project (2005-2007) funded by the ESRC Cultures of Consumption research programme. People approaching retirement, entering retirement or currently living in retirement will have difference experiences of later life to their predecessors. With increasing affluence and the growth of a consumer society, ageing is more differentiated. This project, using existing statistical resources answers the question: what are the patterns of consumption, leisure and work amongst people aged 50+ from 1963-1998? The project focuses on whether older cohorts of the retired engage less with consumer society than do those cohorts with whom they share retirement. This research also addresses whether there will be greater social differentiation in terms of consumption patterns within and between each successive cohort over time. This study will conduct cross-sectional historical comparison of people aged 50, 60 and 70 over ten year time spans utilising large data sets such as the Family Expenditure Survey. Using indicators such as levels of income and ownership of particular goods, we will be able to look at level of affluence in each cohort as well as their consumption patterns. Our analysis will allow us to identify consumption patterns among cohorts of older people over the past 40 years and relate them to changing patterns of consumption in society as a whole.

How is psychosocial adversity related to asthma morbidity and access to care? A qualitative study

Funded by Asthma UK, this is a collaborative study with colleagues at Queen Mary’s School of Medicine and Dentistry, London. Over a period of 18 months the study is exploring the effects of stress on the onset of severe asthma attacks in a bid to improve methods for controlling the condition.

We will interview 45 people with asthma who have been admitted to hospital and 25 people with severe symptoms who have not been admitted to hospital. The study participants, who will come from a range of social, cultural and ethnic backgrounds, will be asked how they think stressful events in their lives, such as divorce or bereavement, might have affected their asthma and their ability to control the condition. They will also be asked about their support networks such as friends and family and about their relationship with their general practitioner.

The study will also explore the attitudes of GPs and the significance they give to psychosocial factors when advising people on the best ways to cope with asthma. It should identify factors that might lead to improvements in methods for controlling severe asthma.

Patients' and carers' experiences of continuity of care in long-term conditions and the relationship of continuity of care to outcomes (mental health)

This five year study aims to explore the issues covered by the term ‘continuity’ with service users themselves and the relatives, friends and professionals who provide care for them, by finding out about the care people receive and the impact of continuity of care on their health. It aims to invite users and carers to help develop an interview or questionnaire that can be used to measure continuity of care form their perspectives.

The impact of the introduction of GPs with special interests on intra-professional relationships and clinical practice.

This three year project is a collaborative study with StaRNet (the South Thames Primary Care Research Network). The study aims to explore the evolving role of GPs with Special Interests (GPSI), its impact on clinical practice, intra-professional communication and on the relationships within the medical profession. The study will focus on:

• Communication between GPs and specialists
• GPs other than those developing specialist (secondary care) skills

Decision making in primary care: patients as partners in resource allocation

A two year study funded by the Department of Health, Health in Partnership initiative. The study examined the different criteria used by GPs when making decisions about whether or not to use particular treatments, focusing on aspirations for greater user involvement in these decisions.

Findings

Our findings suggest that if patient involvement in health care decision-making is to be increased, then questions of scarcity will need to be taken into account. GPs and patients saw patient involvement in positive terms but they had different understandings of it. Patients tended to see involvement as an end in itself. That is to say, they were often glad to have been involved in the decision-making process, even if the eventual outcome was not what they had been seeking originally. For some GPs, involvement served a more instrumental purpose and was used as a ‘tool’ which assisted them in managing or persuading patients. It remained the case, however, that most GPs tended to identify very strongly with the role of patient advocate. However, their other roles created tensions and contradictions particularly with respect to wider responsibilities to budgets, populations, and wider society. The availability of resources varied locally and this had an impact on the capacity of GPs and patients to engage in shared decision-making.

Collaborative Researchers Addressing the Sociology of Health (CRASH).

In 1999, we established an informal forum at St George’s called CRASH. It aims to provide a space for discussing and sharing knowledge and experience of sociological approaches to health and illness. Meetings provide the opportunity to discuss research ideas, issues in social theory, discuss journal papers and work in progress. CRASH meets once a month and discussions are posted on the web site.

Collaboration

We have joint appointments and strong collaborative research links with the Faculty of Health and Social Care Sciences. We are undertaking collaborative research with Professor George Ellison (Identity and the new genetics), Mr Chris Hart (Nursing Profession and liaison psychiatry), Dr Sarah Li (Symbiotic niceness), Ms Theresa Nash (Sexual Health in Schools), Mr Robert Stanley (Ethics). We have strong links with other research groups in the Division of Community Health Sciences including Health Services Research, Psychology, Epidemiology and Primary Care. We also have collaborations with Department of Mental health Sciences (Continuity of Care Studies).