Статьи
Всего статей в данном разделе : 45
Опубликовано на портале: 22-03-2007
Emma 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: 22-03-2007
Michael 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: 23-03-2007
Chris 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: 19-02-2007
Catherine 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: 22-03-2007
Susie 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.
Опубликовано на портале: 05-12-2006
Uta 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: 23-03-2007
Simon 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: 23-03-2007
Alisa 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: 04-03-2007
Helen 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.
Опубликовано на портале: 23-03-2007
Stuart 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: 23-03-2007
Larry 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.
Опубликовано на портале: 04-03-2007
Sarah 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: 04-03-2007
Larissa 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: 04-03-2007
Eeva 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: 23-03-2007
Debra 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.
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