Sociology of Health and Illness
0141-9889
1467-9566
Anh Quốc
Cơ quản chủ quản: WILEY , Wiley-Blackwell Publishing Ltd
Lĩnh vực:
Health (social science)Health PolicyPublic Health, Environmental and Occupational Health
Các bài báo tiêu biểu
The methodology of Focus Groups: the importance of interaction between research participants Abstract What are focus groups? How are they distinct from ordinary group discussions and what use are they anyway? This article introduces focus group methodology, explores ways of conducting such groups and examines what this technique of data collection can offer researchers in general and medical sociologists in particular. It concentrates on the one feature which inevitably distinguishes focus groups from one‐to‐one interviews or questionnaires – namely the interaction between research participants ‐ and argues for the overt exploration and exploitation of such interaction in the research process.
Tập 16 Số 1 - Trang 103-121 - 1994
Sociology of diagnosis: a preliminary review Abstract Diagnoses are the classification tools of medicine, and are pivotal in the ways medicine exerts its role in society. Their sociological study is commonly subsumed under the rubrics of medicalisation, history of medicine and theory of disease. Diagnosis is, however, a powerful social tool, with unique features and impacts which deserve their own specific analysis. The process of diagnosis provides the framework within which medicine operates, punctuates the values which medicine espouses, and underlines the authoritative role of both medicine and the doctor. Diagnosis takes place at a salient juncture between illness and disease, patient and doctor, complaint and explanation. Despite calls for its establishment, almost two decades ago (Brown 1990 ), there is not yet a clear sociology of diagnosis. This paper argues that there should be, and, as a first step, draws together a number of threads of medical sociology that potentially contribute to this proposed sociology of diagnosis, including the place of diagnosis in the institution of medicine, the social framing of disease definitions, the means by which diagnosis confers authority to medicine, and how that authority is challenged. Through this preliminary review, I encourage sociology to consider the specific role of diagnosis in view of establishing a specific sub‐disciplinary field.
Tập 31 Số 2 - Trang 278-299 - 2009
‘Ignorance is bliss sometimes’: constraints on the emergence of the ‘informed patient’ in the changing landscapes of health information Abstract In this paper we describe and analyse results from an empirical study designed to provide insight into factors facilitating and/or inhibiting the emergence of the much‐heralded ‘informed patient’ and its sociological equivalent, the ‘reflexive patient’ or ‘reflexive consumer’. In particular, we seek to examine the relationship between information and empowerment in a healthcare context and assess the significance of the Internet in mediating this relationship. The paper draws on data from interviews with 32 mid‐life women concerned to know about HRT for the relief of menopausal symptoms. Having analysed these women's ‘information practices’, we conclude that constraints on the emergence of the informed patient identity exist within both patient and practitioner communities and within the space occupied by both in the medical encounter. In particular, in this paper we identify a tension caused by the emphasis on ‘information for choice’ in the informed patient discourse which itself obscures the potential conflict between lay and expert/medical knowledges in the clinical encounter.
Tập 25 Số 6 - Trang 589-607 - 2003
The practice of medical technology Abstract In this article, we review 25 years of sociological scholarship published inSociology of Health and Illness on medical technologies. We divide the literature into three theoretical perspectives: technological determinism views medical technology as a political force to shape social relationships, social essentialism emphasizes how medical technologies are neutral tools to be interpreted in social interactions, and technology‐in‐practice highlights the dialectic relationship between technology and its users in health care. While the technology‐in‐practice orientation allows social scientists to critique the high hopes and dire warnings embedded in medical technologies, we argue that the logical next step of this paradigm is to move beyond criticism and influence the creation and implementation of medical technologies.
Tập 25 Số 3 - Trang 97-114 - 2003
Theorising class, health and lifestyles: can Bourdieu help us? Abstract What is the relationship between class, health and life‐styles, and to what extent does health‐related knowledge influence subsequent behaviour? These issues have been a source of considerable debate for medical sociologists and others concerned with promoting ‘healthier’ life‐styles over the years. Yet despite a wealth of empirical material, there has been little attempt to theorise this relationship between class, health and lifestyles and the associated issues of structure and agency, accounts and action it raises. This paper attempts to rectify this lacuna through a critical discussion of the work of Pierre Bourdieu, and its relevance to the class, health and life‐styles debate. In particular, attention is paid to Bourdieu's analysis of the logic of practice, his concepts of habitus and bodily hexis, and the search for social distinction in the construction of (health‐related) life‐styles. The paper concludes with a critical commentary on these issues and the relative merits of Bourdieu's analysis for the sociology of health and illness. It is argued that despite certain limitations regarding issues of agency and ‘choice’, Bourdieu's analysis does indeed shed important light on the health and lifestyles debate, and that further bridge‐building exercises of this nature between mainstream theory and the sociology of health and illness are both necessary and fruitful.
Tập 17 Số 5 - Trang 577-604 - 1995
Is There a Place for Geography in the Analysis of Health Inequality? This paper considers how ideas and evidence concerning geographical health variation are used in discourses relating to health inequalities. We consider the different concepts of space and place which are employed in these debates. Much of the discussion in the literature focuses on the relative importance of compositional and contextual effects in determining health variation between different geographical areas. We discuss some of the theory which might illuminate the possible impact of place on health inequalities. In the light of this theoretical debate, and focusing mainly on research from Britain, we review the empirical evidence concerning place as a contributor to health inequalities. It is concluded that while individual characteristics are very important for the health inequalities which are observed between people, their geographical setting also has some significance. This has implications for policies aiming to reduce health inequalities.
Tập 20 Số 5 - Trang 645-672 - 1998
Accounts of health and illness: Dilemmas and representations Abstract This paper argues that people's views of health and illness are best understood as accounts that they give to others. In that sense, such beliefs are neither the expression of fixed inner attitudes, nor evidence for shared social representations. Instead, we emphasise the importance of seeing health talk as both ideological and dilemmatic. The paper explores the way in which individuals who speak of health (or illness) in general must also give an account of their health in particular. Reviewing the distinction between ‘private’ and ‘public’ accounts, the article discusses the various rhetorical devices by which this is achieved. This shows how people's talk about health both defines their social fitness and exemplifies their claims to being ill or healthy.
Tập 18 Số 2 - Trang 220-240 - 1996
Theorising Inequalities in Health: The Place of Lay Knowledge This paper contributes to the development of theory and research on inequalities in health. Our central premise is that these are currently limited because they fail adequately to address the relationship between agency and structure, and that lay knowledge in the form of narrative has a significant contribution to make to this endeavour. The paper is divided into three sections. In the first section we briefly review the existing, largely quantitative research on inequalities in health. We then move on to consider some of the most significant critiques of this body of work highlighting three issues: the pursuit of overly simple unidimensional explanations within ‘risk factor’ epidemiology and the (probably inevitable) inability of this research tradition to encompass the full complexity of social processes; the failure to consider the social context of individual behaviour and, in particular, the possibility for, and determinants of, creative human agency; and, thirdly, the need for ‘place’ and ‘time’ (both historical and biographical) to be given greater theoretical prominence. In the final section of the paper the potential theoretical significance of ‘place’ and ‘lay knowledge’, and the relationship between these concepts, in inequalities research is explored. Here we suggest three developments as a necessary condition for a more adequate theoretical framework in this field. We consider first the need for the conceptualisation and measurement of ‘place’ within a historical context, as the location in which macro social structures impact on people’s lives. Second, we argue for a re‐conceptualisation of lay knowledge about everyday life in general and the nature and causes of health and illness in particular, as narratives which have embedded within them explanations for what people do and why – and which, in turn, shape social action. Finally, we suggest that this narrative knowledge is also the medium through which people locate themselves within the places they inhabit and determine how to act within and upon them. Lay knowledge therefore offers a vitally important but neglected perspective on the relationship between social context and the experience of health and illness at the individual and population level.
Tập 20 Số 5 - Trang 619-644 - 1998
Mortality, the Social Environment, Crime and Violence Starting out from the relationship between income equality and indicators of social cohesion and social trust, this paper explores the social processes which might account for the relationship between greater income equality and lower population mortality rates. We note that: homicide shows an even closer relationship to income inequality than does mortality from all other causes combined; there are several reports that homicide rates are particularly closely related to all cause mortality; and that there is a growing body of research on crime in relation to social disorganisation. We use US state level data to examine the relationships between various categories of income inequality, median state income, social trust and mortality. The data suggest that violent crime, but not property crime, is closely related to income inequality, social trust and mortality rates, excluding homicide. The second half of the paper is devoted to literature on the antecedents of violence. Feeling shamed, humiliated and disrespected seem to be central to the picture and are plausibly related to the way in which wider income differences are likely to mean more people are denied access to traditional sources of status and respect. We suggest that these aspects of low social status may be central to the psychosocial processes linking inequality, violence, social cohesion and mortality.
Tập 20 Số 5 - Trang 578-597 - 1998
The impact of management on medical professionalism: a review Abstract In the last three decades, medical doctors have increasingly been exposed to management control measures. This phenomenon has been reflected in a number of studies in various disciplines, including sociology, organisation studies, management, and health service research. This article seeks to provide a comprehensive overview of the studies dealing with the impact of management on professional control. In particular, it seeks to bridge the diversity of assumptions, theoretical perspectives and conceptual underpinnings at play, by exploring synergies between them and opening up new horizons for research. The review shows how the relationship between clinicians and management has been analysed at an organisational level using two interconnected analytical frameworks focusing on the sociocultural and task‐related dimensions of professionalism. In the final discussion, we argue that comparative, longitudinal and cross‐sectional research is necessary, and there is a need to overcome the hegemony/resistance framework in current analyses of the impact of management on professionalism. Such an approach would contribute to the revision of macro theories of professionalism and stimulate emerging research by examining different perspectives towards management in medical specialisations. This approach might also stimulate a discussion of medical professionals’ relationships with members of other professional groups, including nurses and healthcare managers.
Tập 34 Số 4 - Trang 626-644 - 2012