4 health and illness Flashcards

1
Q

psychology

A

is the scientific study of people, the mind and behaviour.

applied and academic

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2
Q

anthropology

A

study of human culture

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3
Q

history

A

recording and interpretation of past events

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4
Q

sociology

A

is the study of social behaviour of society, including its origins, development, organisation, networks, and institutions.

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5
Q

epistemology

A

study of knowledge

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6
Q

ontology

A

the study of the nature of being. ontology considers whether facts are constructed in people’s minds or whether they exist in an external world.

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7
Q

Structural functionalism

A

MACRO

Auguste Comte
- society as objective reality

different components are interdependent, work together to promote stability

via socialisation–> learn rules of society

linked to positivism (1 objective reality)

quant approach

Parsons, Durkheim-> linked to this

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8
Q

Social conflict

A

macro

Marx

competition of resources

material production to generate wealth for society

–> different social classes

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9
Q

Interpretivism

A

micro

focused on how people interpret the world

-> small scale social interactions

behaviour and communication –>symbols–> influences persons interpretation of society

a) symbolic interprevitism: language as a way to become self-conscious beings

behaviour linked to others reactions

can get labelling/ stigma

b) social constructivist: all social knowledge constructed

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10
Q

positivism vs constructivism

A

positivism: one objective truth

constructivism: rejects one truth, each of use generate our won rules and models

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11
Q

sick role

A

Parsons

right:
- exempt from blame
- exempt from normal responsibilities

obligations:
- want to get better
- seek medical care

good: acute

weak:
- can blame individuals
- why seek medical care
- chronic
- end of life ?get better

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12
Q

doctor-patient relationship

A

Byrne & Long

doctor centered
- doctor led, patient passive

patient centered
- shared decision making, patient active
- improves compliance, self-care

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13
Q

Concepts of health

A

WHO: state of complete physical and mental wellbeing, bot absence of disease

Ottawa charter: resources for everyday life

Canguilhem: ability to adapt to environment

Huber: adapt and self manage

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14
Q

deviance

A

Becker

behaviour unacceptable within a particular society

sanctions
correction
punishment
treatment

parsons: illness deviance, doctor control

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15
Q

labelling

A

Lemert/Becker

Labelling occurs when individual attributes and characteristics are identified by others and given a negative label.

primary: behaviour before labelling has occurred (eg individual illness)

secondary: individual status once they have been labelled as deviant (eg doctor diagnosis)

-> leads to STIGMA

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16
Q

stigma

A

Goffman: attribute that is deeply discrediting within a particular social interaction

causes:
- inequality
-fear
- misinformation

consequences:
- felt stigma: shame. guilt
- enacted stigma: abuse, reduced access

address:
- virtuous cycle: action -> reduce felt - reduced enacted

tackle:
- legislation
- education
- language
- treatment
- public know exposure
- public know diagnosis

17
Q

ICF definitions of impairment, disability and handicap

A

WHO ICF-11 (international classification of Functioning, Disability and Health)

impairment: bodily functions

disability to activities

handicap to social roles.

Marmot: social gradient in disability free LE

18
Q

Barthel

A

hospital tool for activites of daily living

19
Q

sociological approaches to disability

A
  1. parsons sick role
  2. Gerhardt:
    - crisis model: label + stigma
    - negotiation model: illness loss of self, need to maintain ‘normality’ focus on adaptation rather then deviant identity
  3. Bury:
    - Biographical disruption: loss of confidence and body and then social and self identity
  • chronic illness result of shared experience with interaction of others –> ‘renegotiate’ relationships

good and bad aspects of illness
–> individual activily copes

  1. Active coping
    - uses concept of ‘comeback’ (corbin and strauss)
    - physical: medical rehab and treatement
    - biographical: link past life to future life
  2. Charmaz:
    - bewiliderment: from diagnosis –> illness crisis-> why me, why now, what to do???
    -
  3. social model of disability
    - people are disabled by societal bariers rather than impairements
  • Socioeconomic context important: means of production in west continues disabiity

environment and culture changes

?no objective, can it all be overcome

20
Q

iatrogenesis

A

disease caused by medicine

clinical: direct harm

social: overmedicalisation: C-sections

structural: medicine as spiritual coping

21
Q

black report

A

on health inequality
- artefact
- social selection
-behavioural and cultural
- materialistic

whitehall study

22
Q

social capital

A

value to social network: provide norms and sanctions

  • bonding: strengthen links
  • bridging: links outside group (networking)

micro, meso and macro level

Prof Chetty: opportunity atlas

23
Q

social epidemiology

A

study of the social
determinants of the distribution of disease within
a population.

24
Q

kaiser pyramid

A

shows majority of people self care, few complex people need professional care

25
Hospital as social institutions
Positive: - employer - purchaser - community resource - research facility - education and training bad: -polluter - isolation
26
Professionalism
Parsons: (doctor) defined knowledge base patients defer to doctors self governing exploit power public service commitment protection for pts against exploitation other: - qualifications - professional body - occupational closure
27
balance of clinical autonomy
revalidation guidelines cost competition management
28
Care seeking behaviour
1. socio-cultural theory mechanic - visibility -seriousness -disruption - frequency of symptoms -tolerence - knowledge - denial - competing needs -interpretation -availability of treatment zola triggers - interpersonal crisis - perceived interference with activities - sanctioning by others - symptoms beyond a certain time 2. economic theory - income and economic agency 3. structural/ functional - deviance 4. social network - decisions made in consultation with network
29
Social justice
Fairness that extends beyond individual rights 1. distributive : fair distribution 2. procedural: how decisions made 3. interactional: treat each other 4. retributive: punish 5. restorative Distributive - utilitarianism - Rawl veil of ignorance procedural - consistent - neutral - can be corrected - ethical - all parties
30
equity vs equality
equity: fairness - social justice - vertical (unequal need unequal supply) Vs horizontal (same need same supply) equality: same for all
31
Pritoritisation
outline principles Vs define practices Tools: 1. Save to invest 2. PBMA (programme budgeting and marginal analysis) 3. Multi-criteria decision analysis
32
deterministic sensitivity analysis
One or more parameters are manually changed (usually across a pre-specified range) and the results are analysed to determine to what extent the change has an impact on the output values. often pre-specified one way: one time multi way: several parameters
33
probabilistic sensitivity analysis
also called stochastic use distributions of parameters eg use distribution generated in a clinical trial for an effect estimate --> a cost effectiveness acceptability curve (CEAC)