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Med soc > Ch 6-10 > Flashcards

Ch 6-10 Flashcards

1
Q

Sociological definition of health

A

6 primary orientations:
1) physical functioning
2) mental health
3) social well-being
4) role functioning
5) general health perceptions
6) symptoms

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2
Q

Physical functioning

A

A primary orientation of the soc def of health
D: taking care of oneself physically (exercise/able to perform physical tasks)

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3
Q

Mental health

A

A primary orientation of the soc def of health
D: psychological well-being, levels of anxiety/depression, emotions

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4
Q

Social well-being

A

A primary orientation of the soc def of health
D: communicating with friends/family; maintaining social relationships

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5
Q

Role functioning

A

A primary orientation of the soc def of health
D: having freedom/no limitations within roles & being able to fulfill role (no role overload)

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6
Q

General health perceptions

A

A primary orientation of the soc def of health
D: self-assessment of pain/health status (is the pain frustrating?)

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7
Q

Symptoms

A

A primary orientation of the soc def of health
D: the ability to report physiological & psychological symptoms

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8
Q

Biomedical definition of health

A

Solely on individual’s physiological state and presence or absence of symptoms. “Absence of disease.

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9
Q

4 assumptions that LIMIT the Biomedical definition of health’s utility:

A

1) “Presence of disease”
2) “ONLY medical professionals” are capable of defining health & illness
3) Health and illness should be defined SOLEY in terms of physiological function
4) “health” as merely “the absence of disease”

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10
Q

“presence of disease”

A

A limitation of the biomed def of health
Doctors view the presence of disease as being objective, but it is hard to find an accurate presence of disease due to 1) cultural/individual differences in reacting/reporting symptoms; 2) sometimes NO signs/symptoms are present

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11
Q

“ONLY medical professionals” are capable of defining health & illness

A

A limitation of the biomed def of health
Reality: patients & others (e.g. family) are involved in the process

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12
Q

Health and illness should be defined SOLEY in terms of physiological function

A

A limitation of the biomed def of health
people are NOT MERELY BIOLOGICAL BEINGS (not just physiological) — psychological and social creatures (mind-body-soul)

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13
Q

“Health” as merely “the absence of disease”

A

A limitation of the biomed def of health
This definition excludes a lot about well-being and only focuses on disease

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14
Q

WHO definition of Health

A

Inclusive, positive, and proactive view, “…a state of complete physical, social, and mental well-being and NOT mentally the absence of disease or infirmity.”

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15
Q

Parson’s def of Health

A

The ability to perform tasks

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16
Q

Twaddle’s ideas about health and illness

A

Health and illness are on a spectrum

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17
Q

CDC said <___% of Americans are of a “healthy” weight, eat adequate _______, and _____ to stay fit

A

40; fruits/vegetables; exercise

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18
Q

CDC says Americans _____ and _______ too much

A

Smoke; drink

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19
Q

Tobacco kills >_____ Americans/year and has caused ______ deaths world wide

A

400,000; 1 billion

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20
Q

In 1960 ____% of American Adults were >10 lbs overweight, and that percentage has risen to ____% today.

A

28; 68

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21
Q

4 Key Dimensions of Health Behavior

A

1) prevention
2) detection
3) promotion
4) protection

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22
Q

Prevention

A

A key dimension of health behavior
D: employing health protection behaviors (HPBs)/ attempting to stay healthy

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23
Q

Detection

A

A key dimension of health behavior
D: finding the disease before symptoms arise by attending medical exams and screenings

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24
Q

Promotion

A

A key dimension of health behavior
D: persuading people to do health protective behaviors (HPBs) and persuading against health-harming activities.

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25
Q

Protection

A

A key dimension of health behavior
D: societal levels of preventing illness; creating a healthy environment, public health

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26
Q

Health Protective Behaviors (HPBs)

A

Individual actions taken o protect, promote, or maintain health

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27
Q

Prescriptive HPBs

A

Diet, seatbelts, exercise, check-ups, etc.

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28
Q

Proscriptive HPBs

A

Driving safely, not smoking, limiting alcohol, etc

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29
Q

Male vs. Female criteria for defining health

A

M: strength/fitness level
F: Energy, vitality, ability to cope with challenges, maintaining social relationships

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30
Q

Micro-approach to Healthy Lifestyle

A

Americans favor this model; focuses on individual decisions to do positive/negative things for one’s health. People gauge what is good for their health based of the Health Locus of Control (HLC): using previous experience with HPBs to figure out what is “good” for one’s health.

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31
Q

Macro-approach to Healthy Lifestyle

A

To change community behaviors, including social structures (racism, sexism, unemployment, etc.) BUT corporations resist (tobacco, alcohol, food, etc.)
Calls for Quality Education, Jobs, Public Health, Mass Transit, etc. Doesn’t happen because of costs (increased TAXES).

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32
Q

Women are ___ likely to engage in HPBs.

A

More

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33
Q

In _____, Women enjoy free ________ care

A

Europe; free

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34
Q

Access to diagnostic screening is LIMITED by:

A
  • cost
  • lack of insurance
  • work conflicts
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35
Q

Harvard School of Public Health definition of Binge Drinking

A
  • 5 drinks in one sitting for Men
  • 4 drinks in one sitting for Women
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36
Q

“Austerity”/“Cuts” to Government spending have been to:

A
  • Public education
  • public health
    !! Why not to sports/stadiums/etc???
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37
Q

Mechanic & Volkart’s definition of Illness behavior

A

The way in which symptoms are perceived, evaluated, and acted upon by a person who recognizes some pain, discomfort, or other sign of organic malfunction

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38
Q

Stages of Illness experience (Suchman)

A

Culture and Socal expectations as playing key roles.
1) Symtoms Experience
2) The sick role
3) Medical care contact
4) dependent patient role
5) recovery and rehabilitation

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39
Q

The social construction of illness

A

The definition and ability to cope with illness are culturally and socially determined with the socialization process. “How we learn to be ‘human’ and interact with others.” (Society determines how to act when symptoms are felt).

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40
Q

The sick role

A

Included in the social construction of illness
When one is ill — you not only exit ‘normal’ social roles, but enter into a NEW role with certain exemptions and responsibilities (Parsons)

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41
Q

Labeling Theory

A

Helps define roles of illness; is culturally defined/labels can be subjective.
Sick label —> person enters sick role.

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42
Q

In the sick role, one enters into “_______”, to stay in the Sick Role (legitimately) a person must convey a ______ ___ ___ ____.

A

Normlessness; desire to get well

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43
Q

Pain

A

A key trigger symptom of illness

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44
Q

Almost ____% of American adults experience Chronic Pain

A

60

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45
Q

____% say they’re in constant pain

A

40

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46
Q

Palliative care

A

Has increased recently
D: treating the pain/suffering of seriously ill patients.

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47
Q

In the US, there are _____ hospital-based palliative care programs and _____ HOSPICE programs

A

1,600; 5,300

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48
Q

Medicalization

A

A process allowing the medical professional to determine what is “normal” and “desirable” behavior AND how to control, modify/eliminate “undesirable” behaviors

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49
Q

Results of Medicalization (power)

A

Increased power of medical institutions/professionals
Decreased power of religions & State/government

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50
Q

+/- results of Medicalization

A

+: less stigmatizing/punitive
-: representing some “societal” label of disapproval

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51
Q

Medicalizing deviance

A

Stating that deviance from societal norms is a medical issue that must be treated (LGBTQ, alc, etc.)

52
Q

Illness legitimacy types (Freidson)

A

1) Illegitimate/Stigmatized —> symptoms are minority deviated from “healthy” experience; illness is stigmatized and prevents people from entering the sick role
2) Conditional legitimacy —> exemption of responsibilities if person tries to get better
3) Unconditional legitimacy –> permanently in the sick role

53
Q

_____ concerns/questions about how much _____ Medicine has taken over the ______ of illness

A

Increased; power; social control

54
Q

De-medicalization

A

Powered by money & Sociological critiques (Rosenhan + Szasz)
Reversals:
- deinstitutionalization of medical patients/ other American Psychiatric Association disorders (DSM)
- homosexuality

55
Q

Labeling theory & stuttering

A

Label “stutterer” places people into a category where they are seen as incomplete or different from society.

56
Q

Range of choices for Medical Care & Advice

A

1) Modern medical practitioners
2) Alternative Medical practitioners: traditional/religious healers
3) Non-medical professionals: police/lawyers/social workers
4) Lay advisors: friends/family/etc
5) other/self care

57
Q

Mid 90s: Americans averaged ____ contacts/yr with MDs

A

5-6

58
Q

Class effects of access to health care

A

Poor:
* much less likely to have regular health care (Medicaid doesn’t cover)
* much more likely to use ER as primary care
* less likely to be admitted to hospital but much sicker when they are

59
Q

Race/Ethnicity Effects of access to health care

A

Hispanics: lowers rate of use of health services/sicker when admitted
Black individuals are less likely to have access to health care than whites

60
Q

Gender effects on access to health care

A

M: don’t go/tough it out
W: make 70% of health care decisions; use more health care than men
I.e.: Indian women: husbands must approve; don’t have direct access to family money; don’t go to health clinics alone

61
Q

Self-care

A

Important concept including behaviors to
- promote optimal health
- prevent illness
- detect symptoms of ill health
- heal acute illness
- manage chronic conditions
Increasing bc increased medical info availability + alternative medicine + cost of care

62
Q

Concerns of dependent-patient role

A
  • loss of personal independence
  • withdrawal from key social roles
  • changed body image
63
Q

Stigmas associated with illness

A

1) social rejection: discrimination, avoidance, awkwardness
2) financial insecurity: hard to get/keep a job
3) internalized shame: self-blame; maintaining secrecy
4) social isolation: loneliness, feelings of inadequacy/uselessness; detachment

64
Q

Early 20th century is when physicians gain _____ in medical field by replacing ____ and ____.

A

Dominance; family; church

65
Q

The church was historically _____ than just religion, encompassed _____, ________, etc.

A

Greater; government; health care

66
Q

Physician dominance over medical field strengthened with AMA overseeing ____ & ______.

A

Licensure; education

67
Q

What gave the AMA power:

A
  • supply of doctors (drive out “untrained”)
  • complete control of medicine
  • won great trade of 1910
68
Q

Recently: as corporation fluency/power _____, medical profession’s power ______.

A

Increases/rises; decreases/falls

69
Q

By 2000, ____ of MDs were in the AMA, a ______ from ____ in 1963

A

1/3; decline; 4/5

70
Q

Corporatization of Medicine

A

Includes overwhelming influence of Health Maintenance Organizations (HMOs), hospital corporations, hospital construction firms, labs and pharmaceutical corporations.
They prioritize money, which results in a decrease of MD autonomy

71
Q

Deprofessionalization

A

MDs lose their monopoly over medical information as there is increased patient knowledge and assertiveness.

72
Q

Proletarianization

A

MDs become more like employees; must follow the “allowed’ treatments for different disorders. Decrease in autonomy.

73
Q

Unionization of MDs/health workers

A

A strategy to regain control of their work/autonomy: steady and slow rise

74
Q

AMA as a Professional Organization

A

How AMA won the great trade
1) rigorous standards: stringent education/training
2) significant autonomy: progression handles education/licensure/quality of care
3) considerable prestige & identification w/ in profession: increased income/prestige comes from 1 & 2

75
Q

Countervailing Power Theory

A

When profession achieves dominance (ex. Particular type of medicine;
Increased efforts by others (ex. Different types of healers, government, advocacy groups, etc) to balance that profession’s power.

76
Q

Social control of medicine

A

Can/should doctors regulate themselves internally, or should there be external control?

77
Q

Internal control

A

Peer reviews, hospital reviews, state boards of medicine, and national practitioner data bank (NPDB)

78
Q

External control

A

Including Medical Malpractice (when errors occur it’s considered failure of internal control

79
Q

Malpractice (legal definition)

A

All three things needed
1) proof of injury/damage
2) proof of health care provider’s negligence
3) proof that the negligence is what caused the injury

80
Q

Malpractice litigation

A

Is intended to compensate patients whose harm by actions (or inactions) of a physician could have been prevented and to discourage such harms from occurring

81
Q

Incidence/Severity of Malpractice litigation statistics

A
  • 1960: 1:100 physicians accused; mid 1980s: 17:100
  • decrease cases/physicians since late 80s
  • ~ 20% of cases result in pay-out
  • most actual cases don’t get filed
82
Q

Consequences of Medical Malpractice crisis

A

1) defensive medicine: more tests to confirm disease
2) increased medical malpractice insurance: physicians need to pay more for insurance
3) embittered doctors: patients=walking law suite
4) doctors stopping service/practice
5) increased strife between MDs and lawyers

83
Q

Efforts to reduce medical malpractice crisis

A

1) improve physician-patient relationships (improve communication)
2) capping monetary value on malpractice award: MDs/insurance like; lawyers/patients dislike
-constitutional problem: legislative usurping judicial prerogative
- no-fault insurance system: quicker/less adversarial than current system w/ smaller payments

84
Q

US Physician Demographics

A
  • increases physicians over last 30 years
  • increased woman physicians (300% in last 20 years)
  • urban areas have better physician:patient ratio (better recourses/pay for physicians)
  • PCPs decline in favor of specialists; now rebounding
  • women more likely to be PCPs + take salaried posts
  • men more likely to train surgery
85
Q

Historical/structural racism/sexism

A
  • older MDs overwhelmingly men
  • younger MDs more evenly distributed
  • only 7% of US MDs are racial/ethnic minorities; many ‘foreigners
86
Q

Physician work life

A
  • relatively strenuous
    -hard work-like balance (irregular hours)
87
Q

Coping with Medical work stress

A
  • drugs/ alcohol (30-100 times greater than the general population)
  • psycological depression
88
Q

With increased corporatization of medicine:

A
  • increased workloads
  • decreased pay
  • decreased mission of service
89
Q

Elizabeth Blackwell

A

1st woman to get a medical education

90
Q

18th/19th century: _______/_______ limited opportunities

A

Racism/sexism

91
Q

Later half of 19th century (minority education)

A

14 Women’s colleges and HBCs (Howards)

92
Q

1904: AMA’s _____________ increased as an initial “accreditor” agency

A

Council on Medical Education

93
Q

Currently: _____ Medical Schools in the US and ____ in Canada accredited by the _____________ (_____)

A

141;17; Liaison Committee on MEdical Education (LCME)

94
Q

2012-2013 ~ _______ applications for ______ slots

A

45,000; 20,000

95
Q

Average applicant applied to ___ schools

A

14

96
Q

Women are ___ of medical school students

A

1/2

97
Q

____ in minority students with ____ in public school funding

A

Decrease; cuts

98
Q

Medical School Stress causes

A

“Medical school syndrome”; decreased free time; decreased family/friends time; increased seeking for high-paying specializations

99
Q

Detached Concern/Desensitization

A

Emotional distance from patients because of degree of knowledge to be a doctor; taught by medical schools to prevent poor effects from the loss of a patients
AMA is trying to promote teaching compassion

100
Q

Pellegrino’s 4 Areas of Compassion

A

1) selecting Humanistic students for Medical School
2) Increased behavioral and social sciences (med soc)
3) teaching values, ethics, and humanities
4) positive faculty role models (treat students with compassion)

101
Q

Medical residence are ______ able to practice medicine if __________________.

A

Legally; under the supervision of a licensed physician

102
Q

Medical students focus on _____ rather than _____ & don’t typically change ______ choices during graduate school (Conrad)

A

Disease; illness; career

103
Q

Advanced practice nurse

A

RNs w/ additional education and certification in one or more (of about 20) nursing specialties

104
Q

Licensed practical nurse (LPN)

A

High school graduates who have completed short, vocational program leading to certification as an LPN

105
Q

Nurse practitioner

A

An RN with additional training able to provide 70-80% of basic preventative and primary care

106
Q

Certified nurse midwife

A

An RN who is certified by the American College of Nurse Midwives to assist in childbirth

107
Q

_____ regulate nursing in the US

A

States

108
Q

Avenues to be an RN

A
  • 3 year hospital-based school of nursing
  • 2 year program in community college
  • major in Nursing BA
109
Q

Nursing has become:

A

Increasingly bureaucratized (with corporitization of medicine) and less about patient care.

110
Q

Aiken’s Study (nursing)

A

Across 5 countries: 43,000 nurses expressed discontent with:
- too few nurses to provide quality care
- increased workload
- increased time spent on non-nursing tasks

111
Q

Physician assistants

A

Less autonomous than nurse practitioners

112
Q

Certified registered nurse anesthetists

A

Administer about 65% of all anesthetic in the US

113
Q

MAJOR OBSTACLE for “Mid-level practitioners”

A

Lack of 3rd party reimbursed coverage; not getting paid

114
Q

Primary prevention

A

Before a disease or health-related event occurs

115
Q

Secondary prevention

A

After a disease or health event occurs

116
Q

REAL leading cause of death

A
  • smoking
  • sedentary lifestyle
  • poor diet
  • alcohol
117
Q

Smoking = _____ cause of ____ death

A

Leading; preventable

118
Q

____ of adults smoke (down from ___ in 2005)

A

15.5%; 20.9%

119
Q

Smoking rates higher in ___, ____, _____ and ____

A

Men; lower educated; disables; LGBT

120
Q

_ in _ people die from smoking per year

A

1; 5

121
Q

____ said giving the right amount of nourishment and exercise would be the safest way to health

A

Hippocrates

122
Q

________ = 4th leading underlying cause of mortality

A

Physical inactivity/sedentary lifestyle

123
Q

Benefits of exercise

A

Reduces mortality rates of all causes/ cardiovascular-related diseases

124
Q

Best way to loose weight

A

Dieting

125
Q

Cardiac, Vascular, and Pulmonary Rehab

A

Phase I: inpatient (education, family support, ROM exercises)
II: 2-3 months; individual treatment plan, monitored exercise, counseling
III: lifetime; continued exercise, lifestyle modification, no supervision

126
Q

Cardiovascular Rehab (CR) resulted in an average ___ MET increase

A

2.3

127
Q

Cardiovascular Rehab (CR) resulted in a ____ smoking cessation rate

A

37%

Med soc (4 decks)

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