Revision Session + Sample Questions

Question 1

What are the three main types of knowledge production and the assumptions underlying each?

Answer 1

Positivism - natural history, range & biographical aspects
Critical realism - the real World exists ‘out there’ independent of our experience
Interpretivism - capture & understand meaning of a social action for agent performing it

Question 2

What does ontology mean?

Answer 2

Ontology concerns our assumptions about the nature of reality.

Question 3

What does epistemology mean?

Answer 3

Epistemology means theory of knowledge, or how it is we can know anything about the world.

Question 4

What are the advantages of the scientific method? (4)

Answer 4

• Tightly controlled independent variable allow comparison of effect on dependent variable
• Randomised controlled trial gold standard of medical interventions
• Replicable, reliable, objective
• Evidence based medicine (anecdotal evidence can be proved wrong and turn out to be harmful)

Question 5

What is the main disadvantage of the scientific method?

Answer 5

• Does not and cannot accommodate inconsistencies, confounding and outliers

Question 6

Describe the two main ontological positions with their assumptions.

Answer 6

Objectivism/Realism - the social world is objective, out there, independent of us who perceive it

Subjectivism/Idealism/Constructionism - the social world is constructed by us - constructions are built up from the perceptions and actions of social actors.

Question 7

Describe positivism and interpretivism (positions of epistemology) and the difference between the two.
Relate these two approaches to two different applications in the health field.

Answer 7

Positivism - the application of empiricist natural science to the study of society. Reality is unitary and can only be understood through the scientific approach. Research is conducted in a value-free way: the researcher is independent of the data and detached (doesn’t influenced or is not influenced by the research).

Interpretivism - people and institutions are different from material objects and the natural world and therefore require a different approach. People are ‘social actors’ who interpret their everyday social roles in accordance with the meanings they give to these roles. The goal of research is to understand the subjective meanings and reality of social actors in order to make sense of their motives, actions and intentions in a meaningful way.

Question 8

Why is adherence important and what is it?

Answer 8

Adherence is the extent to which a patient’s behaviour, with respect to taking medication, corresponds with agreed recommendations from a healthcare provider. It has three components - persistence, initiation adherence and execution adherence.

Poor adherence to treatment of chronic diseases is a worldwide problem. The consequences of poor adherence to long-term therapies are poor health outcomes and increased health care costs. It compromises the effectiveness of treatment.

Question 9

What is the average rate of adherence according to the WHO?

Answer 9

Adherence to long-term therapy for chronic illnesses in developed countries averages 50%. In developing countries, the rates are even lower.

Question 10

Describe three practical/moral steps that should be taken to improve adherence.

Answer 10

Three from:

• Doctor embark on an iterative reasoning process with the patient (patient centred medicine)
• Acknowledge and engage patient as a moral agent
• Acknowledge patients are embedded in social relationships and that they are accountable to and responsible for others (context of family, community and livelihood)
• Acknowledge intersubjectivity and relational aspects of autonomy and choice

Question 11

Understand the different points of view in relation to patients paying for their own healthcare or being denied treatment due to their lifestyle behaviours.

Answer 11

CCG’s rationing services due to funding deficit, which has led to the question of should obese patients be refused routine operations across the NHS?

Yes - it will help the NHS save money
No - the NHS is meant to be for everyone. Denying these patients means not adhering to clinical guidelines.

Question 12

What is meant by sociological perspectives?

Answer 12

This links the individual and the social and explore the relationship between two levels of attribution of responsibility. It applies frameworks to explain varied responses of individuals.

Question 13

Name two different types of sociological perspectives and the assumptions underlying them.

Answer 13

Two from:

Social constructionist - shared understanding or construct of death & dying formed through values, norms, social practices & contingencies. Social determinants of mortality To what extent are our beliefs about health largely social constructions? To what extent are our lives driven by our need to deny the uncertainty inherent in life?

Phenomenological existentialist - meaning & significance of individual embodied experiences

Anthropological cultural - cultural thoughts systems integrate their ideas about mortality into their language, religions, values, rituals – cultural death systems.

Biomedical - biological reality, dying trajectories, palliative care, advanced directives, death certification. Population statistics on mortality & morbidity.

Question 14

Define ‘habitus’.

Answer 14

This means the social norms, tendencies, habits, resources that are taken for granted and so guide behaviour, i.e. structured determining ways to think/feel/act that become internalised and are seen as part of character.

Question 15

Explain the term ‘biopower’ in relation to health.

Answer 15

The technologies, knowledges, discourses, politics and practices used to bring about the production and management of a state’s human resources.
Biopower analyses, regulates, controls, explains and defines the human subject, its body and behaviour.

Question 16

Describe what is meant by ‘medicine as a social ideology’.

Answer 16

Not a body of scientific and neutral truths about the nature of existence. It presents an image of health that fits with the culture of industrial capitalist societies. A new morality/ethics of individualism.

Question 17

Describe what is meant by the term ‘cultural norms’.

Answer 17

The term ‘culture’ refers to attitudes and patterns of behaviour in a given group. ‘Norm’ refers to attitudes and behaviours that are considered normal, typical or average within that group.

Question 18

Describe three different binaries and how these relate to medical practice.

Answer 18

Patient and doctor
Objectivism and subjectivism
Positivism and interpretivism

Question 19

Suicide rates are highest in which of the groups below…?

Answer 19

Men aged 35-49

Question 20

If a doctor finds out that a patient is experiencing domestic violence which of the following should they do..?

Answer 20

Suggest referral for domestic violence advocacy and treat symptoms

Question 21

Self-management in the context of chronic illness refers to…?

Answer 21

Health professionals supporting people to self-care

Question 22

What describes the social model of disability?

Answer 22

Disabling environments prevent people from participating in social activities such as work

Question 23

The bottom 50% of households own approximately how much of the UK’s wealth?

Answer 23

10%

Question 24

Which of the items below is a key finding of the Whitehall II study?

Answer 24

Social position affects health outcomes

Question 25

What is a ‘social’ risk factor for diabetes?

Answer 25

Ethnicity

Question 26

Which disease is the single biggest cause of severe physical disability in the UK?

Answer 26

Stroke

Question 27

In order to obtain valid consent for a biomedical intervention the doctor must…

Answer 27

Offer the patient adequate information

Question 28

What best describes ‘temporalising’ as a trigger to seeking medical help (according to Zola)?

Answer 28

Setting a personal deadline

Question 29

Which one of the following is not recognized as a level of society?
The household
The office
The global village
The nation state
The community

Answer 29

The office

Question 30

What are social norms?

Answer 30

Rules and expectations about interaction that regulate social life

Question 31

In idealized views of science, the experimental method is said to involve…

Answer 31

Isolating and measuring the effect of one variable upon another

Question 32

Define the social determinants of health.

Answer 32

These are the complex, integrated and overlapping social structures and economic systems – such as social environment, physical environment, health services, and structural and societal factors - that are responsible for health inequities. They are shaped by the distribution of wealth, power and resources throughout local communities, nations, and the world.

Question 33

Describe what is meant by health inequities.

Answer 33

The unfair, unjust and avoidable causes of ill-health.

Question 34

Define the health inequity loop.

Answer 34

NEED TO COMPLETE

Question 35

Define the Inverse Care Law.

Answer 35

Health care resources tend to be distributed in inverse proportion to need – those who need healthcare the most get less, whilst those who have the least need get most of the resources.

Question 36

Provide three reasons why knowing and understanding the social determinants of health is important for doctors.

Answer 36

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Question 37

Provide the names of three policy documents relating to the social determinants of health

Answer 37

Black report 1982 – “spending an ever increasing amount of GDP on health services whilst not being able to demonstrate that the higher spending is related to better health”
Acheson Report 1998 Independent Inquiry into inequalities in health DOH
WHO 2008 Closing the gap in a generation: health equity through action on the social determinants of health.

Question 38

Name the three most deprived areas in England.

Answer 38

Tendring district, north east Lincolnshire, blackpool -
UK
Hackney, Newham & Tower Hamlets - London

Question 39

What is the child poverty rate in Tower Hamlets as compared with the London average?

Answer 39

49% compared to 37% for London average

Question 40

Name three policy documents related to health and wellbeing in Tower Hamlets.

Answer 40

NEED TO COMPLETE

Question 41

How does the Black Report 1980 use class descriptors?

Answer 41

Social classes are segments of the population sharing broadly similar types and levels of resources, with broadly similar styles of living and some shared perception of their collective condition.
I. Professional (eg accountant, doctor, lawyer)
II. Intermediate (eg manager, schoolteacher, nurse)
IIIn. Skilled non-manual (eg clerical worker, secretary, shop assistant)
IIlm. Skilled manual (eg bus driver, butcher, coal face worker, carpenter)
IT. Partly skilled (eg agricultural worker, bus conductor, postman)
V. Unskilled (eg laborer, cleaner, dock worker)

Question 42

What is the difference between absolute poverty and relative poverty?

Answer 42

Relative poverty – a standard which is defined in terms of the society in which an individual lives, so it differs between countries and over time. An income-related example would be living on less than X% of average UK income.
Absolute poverty - a set standard which is the same in all countries and which does not change over time. An income-related example would be living on less than $X per day.

Question 43

What is childhood poverty?

Answer 43

Childhood poverty - UK in 2010 the Labour Government defined a child as being poor when it lives in a household with an income below 60% of the UK’s average (£272 a week before housing costs).

Question 44

Describe the meaning of social exclusion.

Answer 44

Social exclusion - relating to the alienation or disenfranchisement of certain people within society, i.e. in poverty where people lack many of the opportunities that are available to the average citizen. Unless the poorest can keep up with growth in average incomes, they will become more excluded from the opportunities that the rest of society enjoys. This reduces overall social cohesion in our society.

Question 45

Define subjectivity.

Answer 45

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Question 46

Describe how the sociological term ‘field’ relates to subjectivity.

Answer 46

Relationships between people and their experiences, and the location which they occupy, are composed of various social and cultural fields.
A field is the landscape that gets used in a particular way.
Each field has its own rules & regulations, procedures, assign roles & positions, regulates behaviours, & what can be said, and produces hierarchies.
Identity or subjectivity is shaped by operations in that field.

Question 47

What is a discourse?

Answer 47

Type of language associated with an institution

Question 48

What is the Life course perspective?

Answer 48

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Question 49

What is Social Action for Health?

Answer 49

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