Всего статей в данном разделе : 45
Опубликовано на портале: 22-03-2007Emma Rich Sociology of Health and Illness. 2006. Vol. 28. No. 3. P. 284-306.
This paper explores the ways in which young women 'manage' the complexities of the presentation of an anorexic identity, the stigma attached to it, and the relationships that are developed with fellow sufferers. A range of ethnographic data and 'voices' are drawn upon, including a small qualitative study within a leading centre in the UK for the treatment of eating disorders. The paper begins by outlining the ways in which for many young women, anorexia is a stigmatised identity which in various contexts comes to be perceived as an irrational and self-inflicted condition. It was reported by the young women in our study that many of their peers, families and teachers made sense of their eating disorder through a medicalised discourse which focused on visual aspects of weight gain/loss and often stigmatised the condition, reducing it to a position of pathology or irrationality. It is argued that these experiences form a type of 'discursive constraint' (Ronai 1994) which many of the young women attempt to resist by engaging with alternative contexts and relationships through which they can construct more positive self-representations of anorexia or anorexic identities. As is revealed through the various data sources, as these young women negotiate the various discourses which offer them alternative subjectivities, they come to manage anorexia as both an illness and an identity.
Опубликовано на портале: 22-03-2007Michael Bury, David Taylor Sociology of Health and Illness. 2007. Vol. 29. No. 1. P. 27-45.
During the last century demographic and epidemiological transitions have had a radical impact upon health and health service provision. A considerable body of research on the sociological aspects of living with chronic illness has accumulated. Debate has focused on how social environments shape disability-related experiences, and the extent to which individual responses define health outcomes. Through the establishment of the Expert Patients Programme (EPP) in 2001, the Department of Health has sought to enhance NHS patients' self-management capacities. This paper discusses three areas relevant to this: the policy formation process leading up to the EPP's present stage of development; the evidence base supporting claims made for its effectiveness; and the significance of psychological concepts such as self-efficacy in approaches to improving public health. The conclusion discusses NHS developments in primary care and public involvement in health and healthcare, and the implications that initiatives such as the EPP carry for the future. It is argued that to facilitate a constructive process of 'care transition' in response to epidemiological and allied change, awareness of cognitive/psychological factors involved in illness behaviours should not draw attention away from the social determinants and contexts of health.
Опубликовано на портале: 23-03-2007Chris Shilling British Journal of Sociology. 2002. Vol. 53. No. 4. P. 621-638.
This paper revisits Parsons's conception of the 'sick role' and examines the relevance of his writings on the cultural understanding of sickness to the consumption of health in the contemporary era. In terms of current developments, the author focuses on the development of pro-active approaches towards the healthy body, and the growth of "information rich" consumers of health care. These have become prominent themes in sociology, and while Parsons's writings are usually viewed as anachronistic he argues they remain highly pertinent to understanding the emergence of informed, body conscious lay people. If Parsons's analysis of health is more relevant to current circumstances than many critics assume, however, it is not unproblematic. The residual categories associated with the sick role obscure the continued utility of his work on the general cultural values informing health care. It is Parsons's analysis of these values, Chris Shilling suggests, that needs rescuing from restricted understandings of the sick role and highlighting as an important resource for contemporary theorists.
Explaining the Social Patterns of Depression: Control and Problem Solving - or Support and Talking? [статья]
Опубликовано на портале: 19-02-2007Catherine Ross, John Mirowsky Journal of Health and Social Behavior. 1989. Vol. 30. No. 2. P. 206-219.
Research on the social patterns of depression in the community finds consistently that high levels of education and income, being male, and being married are associated with lower levels of depression. Authors attempt to explain these patterns as the result of two essential social perceptions: the sense of controlling one's own life rather than being at the mercy of powerful others and outside forces, and the sense of having a supportive and understanding person to talk to in times of trouble. In theory, the sense of control reduces depression because it encourages active problem solving, and the sense of support reduces depression because it provides others to talk to. They find evidence for the first proposition: persons who feel in control of their lives are more likely to attempt to solve problems. Perceived control and problem solving decrease depression and largely explain the effects of income and education on depression. At the same time they find, however, that support has mixed effects. Support decreases depression, but talking to others when faced with a problem, which increases with the level of support, increases depression. Support explains a small part of the effect of marriage on depression. Control and support have an interactive effect on depression, suggesting that control and support can substitute for one another to decrease depression: a high level of one reduces the need for the other, and a low level of one is remedied by a high level of the other.
Опубликовано на портале: 22-03-2007Susie Scott Sociological Review. 1999. Vol. 47. No. 3. P. 432-460.
Sociological responses to the increase in recent years of psychiatric reports of multiple personality (latterly redefined as Dissociative Identity Disorder) have focused upon its discursive production as a diagnostic category. Drawing on life-history interviews with survivors of extreme childhood abuse - some of whom defined themselves as having 'multiple personalities' - this paper suggests that an adequate sociological account needs to combine analysis of the popular and clinical discourses of dissociation/multiplicity, with an understanding of the relationship between these and particular individual auto/biographies. The production of a narrative of fragmented subjectivity is considered as an active engagement with previously denied and silenced autobiographical experience and with the dominant contemporary discourse that allows for the episodic denial of self-reflexive selfhood. In the light of DID diagnoses being largely applied to/adopted by women, questions are raised concerning the possible impact of the adoption of a multiple identity on individual integrity and autonomy.
Models of Illness and the Theory of Society: Parsons Contribution to the Early History of Medical Sociology [статья]
Опубликовано на портале: 05-12-2006Uta Gerhardt International Sociology. 1990. Vol. 5. P. 337-355.
Parsons medical sociology has recently been recognized for its importance to his theory of society. But the double focus of his explanations of illness is not yet widely understood. It comprises a capacity model based on economic thinking and a deviancy model based on psychoanalytic thought. In the 1930s and 1940s Parsons undertook to understand medical practice in order to focus on liberal democracy in modern society. He used medical practice as an example and also as a metaphor to demonstrate the mechanisms of liberal democracy as against those of capitalism , socialism and the then contemporary racism. By considering this background, the link between models of illness and the theory of society, established in The Social System, ought to be recognized by Parsons’ critics who then might not have charged him with advocating a non-democratic solution to the problem of how the social order is possible. By recommending the recognition of the double focus of Parsons’ illness explanation, and its viability for his theory of action system, it is argued that Parsons was criticized too readily in the 1960s and that his humanistic standpoint can be recovered by focusing on his early contribution to medical sociology.
Опубликовано на портале: 23-03-2007Simon Johnson Williams Health. 2005. Vol. 9. No. 2. P. 123-144.
This article revisits Parsons’ insights on medicine, health and illness in the light of contemporary debates in medical sociology and beyond. A preliminary balance sheet of the Parsonian legacy is first provided, taking on board standard accounts and criticisms of Parsons’ work within medical sociology to date. The remainder of the article, in contrast, involves a close re-reading of Parsons in the light of contemporary sociological debates on the body, emotion, trust, uncertainty and health, including late modern and postmodern interpretations of his work. Parsons, it is concluded, despite his (many) critics and detractors, has much to contribute here, not simply in terms of past insights, but also with regard to the present and future
Опубликовано на портале: 23-03-2007Alisa Lincoln Sociology of Health and Illness. 2006. Vol. 28. No. 1. P. 54-75.
The influence of social factors on involuntary hospitalisation has been an important and controversial area of sociological focus for many years. Traditionally, social control theory has been used to understand disproportionate rates of involuntary hospitalisation among marginalised and powerless groups. However, dramatic changes in the social context of mental healthcare have necessitated a re-examination of the role of social factors in involuntary hospitalisation. In this study 287 psychiatric emergency room visits were examined in order to test hypotheses for understanding social influences on disposition. Little support for the traditional social control hypothesis was found. People from marginalised groups were not disproportionately involuntarily hospitalised, but instead were disproportionately treated and released from the hospital as people's social resources were used to access care rather than to prevent hospitalisation. This study highlights the importance of the historical relevance of our theoretical understanding of the relationship between social factors and involuntary commitment.
"Listen to My Madness": Understanding the Experiences of People with Serious Mental Illness [статья]
Опубликовано на портале: 04-03-2007Helen Lester, Jonathan Q. Tritter Sociology of Health and Illness. 2005. Vol. 27. No. 5. P. 649-669.
This article explores the salience of disability theory for understanding the experiences of people with serious mental illness. Drawing on data from a focus group study, authors suggest that users experience both impairment (as embodied irrationality) which can, in itself, be oppressive, and also have to manage their lives within a largely disabling society. They outline some of the strategies adopted by users to manage their situation and ensure they access and receive health services, and illustrate how these are a result of the complex relationship between disability and impairment. It is suggested that using a framework of the social model of disability provides a useful way of understanding and making sense of the experience of users with serious mental illness.
"The Illness is Part of the Person": Discourses of Blame, Individual Responsibility and Individuation at a Centre for Spiritual Healing in the North of England [статья]
Опубликовано на портале: 23-03-2007Stuart McClean Sociology of Health and Illness. 2005. Vol. 27. No. 5. P. 628-648.
While the growth in usage and practice of varying forms of complementary and alternative medicine (CAM) continues apace, social science has increasingly turned to CAM's often individualistic approach to health and illness. CAM has been perceived as both partly a cause of and a response to the well-documented ideology in modern healthcare of "individual responsibility for health". This occasionally manifests in a 'victim-blaming' ideology amongst both orthodox and CAM practitioners alike. These issues emerged as key themes in an ethnographic study of a Centre for spiritual healing in the North of England. By drawing upon a range of qualitative data gained through the researcher's participation at this healing centre, author argues that the healers' focus on individual responsibility for health is not so much a part of the current socio-political health ideology of "victim-blaming", rather, it is illustrative of an important contemporary social phenomenon: the movement towards the subjectification and personalisation of public life.
Опубликовано на портале: 23-03-2007Larry Nuttbrock Research on Aging. 1986. Vol. 8. No. 3. P. 368-387.
This study examines sick role identification and sick role retention as interrelated aspects of socialization to a chronic sick role. Focusing on physically impaired older people (55-85) and adopting an interactionist view, sick role socialization is seen in terms of both conformity (mirroring the role casting of others) and improvisation (portraying sickness in pursuit of social support, legitimated dependency, and relief from social strain). Both models are generally supported by the data.
The Mundane Realities of the Everyday Lay Use of the Internet for Health and Their Consequences for Media Convergence [статья]
Опубликовано на портале: 04-03-2007Sarah Nettleton, Roger Burrows, Lisa O'Malley Sociology of Health and Illness. 2005. Vol. 27. No. 7. P. 972-992.
The internet is now a major source of health information for lay people. Within the medical, sociological and popular literatures there have been three main responses to this development. They may be classified as 'celebratory', 'concerned' and 'contingent'. This paper falls into the third category and, drawing on techniques of discourse analysis, examines people's accounts of their use of online health resources. It identifies six implicit rules – which is called 'rhetorics of reliability'– that people readily draw upon when articulating why they trust some online sources and not others. In addition participants locate their accounts within broader discursive frameworks in order to present themselves as 'sensible' users. The article concludes by suggesting that there is an emerging concordance between the lay use of the internet for health and illness and dominant (generally) biomedical conceptions of what constitutes 'good quality' health information.
Опубликовано на портале: 04-03-2007Larissa Remennick Sociology of Health and Illness. 2006. Vol. 28. No. 1. P. 21-53.
Since the mid-1990s, the Israeli medical scene has witnessed a real boom in elective prenatal testing for inherited diseases that has spread beyond risk groups to the general Jewish population, especially of Ashkenazi (European) origin. This study tried to identify key social influences involved in the growing range and prevalence of prenatal genetic tests as they emerged from women's own perspective. Twenty-seven women having blood tests for genetic mutations were interviewed at two types of genetic clinics, and re-interviewed after getting test results. The names of 23 women who chose not to have elective tests were obtained from testers, and these non-testers were interviewed for comparison. Women's accounts suggest that elective genetic testing is more acceptable, if not normative, among educated middle class Ashkenazi women, and is more often questioned and refused by lower class Mizrahi women, as well as religious women of any ethnic origin. The key forces that drive women's choice of prenatal genetic diagnosis include the fear of having a sick and/or socially unfit child in an unsupportive environment; strong endorsement of testing by gynaecologists; popular and professional discourse on the common Ashkenazi mutations causing genetic anxiety in this ethnic group (i.e. apprehension of multiple known and unknown dangers hidden in its genetic makeup); and the emerging social pressure for comprehensive prenatal screening as an indispensable part of good motherhood. Many women described the experience of testing as frustrating because of the long wait for results and difficulty of their interpretation and subsequent decision-making. Women who rejected elective tests explained their decision by moral/religious objections to abortion and/or eugenic aspects of prenatal screening, as well as by prohibitive costs and poor understanding of the tests' meaning and implications. Yet, few informants voiced objections to the excessive medicalisation of pregnancy as such; ethno-national motives of reproductive decisions were also uncommon in this group. More critical reflection is clearly needed from both providers and users of elective genetic screening before the more widespread uptake of this practice.
Опубликовано на портале: 04-03-2007Eeva Sointu Sociology of Health and Illness. 2006. Vol. 28. No. 3. P. 330-349.
This article is premised on a need to understand and analyse how those turning to alternative and complementary medicines conceptualise the role of these practices; to ask what kind of 'health' is produced through alternative and complementary medicines and how might the help provided by these practices relate to questions of identity, self and subjectivity? Even though alternative and complementary medicines can be utilised in the face of serious illness, the healing produced through these practices is here argued to transcend physiological health and relate rather to a subjectively assessed sense of 'wellbeing'. In this article, authour analyses what this wellbeing entails, in particular, in terms of contemporary understandings of selfhood as well as in relation to the production of appropriate emotions through 'emotion management'. It is argued that the wellbeing produced through alternative and complementary health practices can be conceptualised as a means of asserting a particular kind of self as well as a means of negotiating identities offered to people in wider societal discourses and institutions. This article is based on qualitative interviews with both practitioners and users of varied alternative and complementary medicines. The focus is on women's experiences.
Опубликовано на портале: 23-03-2007Debra Parker-Oliver OMEGA: The Journal of Death and Dying. 2000. Vol. 40. No. 4. P. 493 - 512 .
The social construction of a dying role is emerging in response to terminal illness for which the sick role is no longer functional. When people are in the process of dying, in the absence of a dying role, they take on the rights and responsibilities of the sick role to which they have been socialized. This is problematic for the individual who will not get well no matter how hard the effort. Hospice, a professional community with a central purpose of bringing the drama of dying to an appropriate close, marks the transition from a sick role to a dying role. This article looks at how the hospice community directs this transition and redefinition of self for the dying and significant others. Utilizing the symbolic interactionist and phenomenlogical perspective and the sick role theory of Talcott Parsons, this view of the drama is demonstrated through stories of hospice patients.