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Medicine - Year 1 > Sociology > Flashcards

Sociology Flashcards

1
Q

What 3 things does medical dominance refer to?

A
  1. The profession’s authority to determine what counts as sickness
  2. Medicine’s dominance over patients
  3. Medical dominance over other health professions ( + in terms of divison of health-related labour)
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2
Q

Descibe the decline of medical dominance

A
  • The rise of manageralism in the health service
  • Development in nursing practice
  • The increasing importace of patients voices in health
  • Changing social conceptualisation (influenced by new media technologies
  • Social movements e.g., disability movement challenge medical dominance
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3
Q

Describe the formation and role of the genermal medical council (GMC)

A
  1. Before 1858 - doctor’ professional qualifications were local (they were licensed to practice in a particular area)
  2. 1858 GMC formed
  • Role was to take charge of medical education and professional registration; to publish a pharmacopeia
  • The Formation of the GMC in 1858 led to the standardisation and professionalisation of medicine across the UK. It gave the medical profession license to regulate itself
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4
Q

What is the sick role model?

A
  • It an influential model of the doctor-patient relationship that casts illness as a form of temporary deviance from one’s usual social role.
  • It positions the doctor as the liegimator of illness
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5
Q

Describe the rights and responsibilities of the patient in the sick role

A

The rights:

  • The sick are not obliged to perform their normal social roles.
  • The sick are not considered responsible for their own state/being ‘in the sick role’

The responsibilities:

  • The sick are obliged to want to get well as soon as possible.
  • The sick are obliged to consult and cooperate with medical experts.
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6
Q

Describe the rights and resposibilites of doctors in the sick role

A

Rights

  • To be treated by society as a professional, with a degree of independance
  • To be allowed access to taboo areas, such as the sick person’s body

Responsibilities

  • To be technically competent
  • To be ‘affectively neutral’ and obective
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7
Q

a) Why may patient’s find the sick role appealing
b) What are other crtiques of the model

A

a)

  • Devolves them of personal responsibility for the cause of their illness.
  • Legitimises avoidance of the unappealing aspects of everyday life – work, chores, being pleasant to people, being active, eating healthily.
  • Suggests that illness should be cured, rather than having to live with the symptoms.
  • Suggests that it’s the doctor’s job to cure them.

b)

  • Puts too much emphasis on work and productivity
  • Lack of attention to chronic illness
  • Gives doctors too much power
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8
Q

Describe the role of the doctors in diagnosing and legitamating illness

A
  • In Parson’s model the ‘sick role’ doctors act as a gatekeeper to the sick role and they legitimate the sick role through naming and diagnosing illness
  • Qualitative studies reveal how illnesses of different kinds are implicitely ranked in hiearchy within medical culture - this means certain illness are stigmatised e.g., psychological illness
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9
Q

What is the difference between sex and gender?

A

‘Sex’ refers to the physical differences between people who are male, female or intersex. A person typically has their sex assigned at birth based on physiological characteristics, including genitalia and chromosome composition.This assigned sex is called a person’s “natal sex”

‘Gender’ involves how a person identifies. Unlike natal sex gender is not made up of brinary forms and is broad spectrum. A person may identify at any point within this spectrum or outside of it entirely

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10
Q

Describe the term ‘trans’

A

“Trans” is an umbrella term to describe people whose current gender identty or way of expressing their gender differs from the sex they were registred with at birth

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11
Q

a) When do we use “trans woman”
b) When do we use “trans male”

A

a) We use “trans women” for someone who was registered male at birth and now identifies as a woman
b) We use “trans man” for someone who was registtered female at birth and now idenitifies as a man

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12
Q

We use “trans woman” or “trans man” in content about the particular health needs of trans people. Provide an example of this

A

There are screening or treatments that trans people need to be aware of like, advising a trans man about cervical and breast screening

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13
Q

What does being “non-binary” mean?

A

Being non-binary means not feeling that your gender identity fits naturally into the generic categories of male and female

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14
Q

When do we use “sex assigned at birth” and the “sex someone was registered with”

A

We use the phrase “sex assigned at birth” when we’re talking about trans health and gender dymorphia etc

In other cases, we use “the sex someone was registered with at birth” because user research shows that most people understand this better as it refers to an actual event

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15
Q

What are the gender-neutral pronouns we use?

A

“they”, “them”, “you”

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16
Q

When do doctors use language about sexuality? and provide an example of these languages

A

We use language about sexuality when it’s helpful to signpost or help people get the health information and access to treatment they need e.g., straight, lesbian, gay, bisexual, men who have sex with men (MSM includes men who may not identify as gay)

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17
Q

What is the favoured term for ‘race’ in health research and why?

A

‘Ethnicity’ is the favoured term in health research because the concept of ‘race’ does not have scientific validity

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18
Q

In terms of health, what are ethnic minority groups more likely to face? Provide examples

A

People from ethnic minority groups are more liekly to face forms of disadvantage that affect their health.

For examples, poor job security, stressful working conditions, unsocial hours, racial discrimination and harassememnt, place-based disavantage (e.g., living in poorl serviced areas)

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19
Q

Describe the sociological aspects of efforts to reduce inequaltities in the UK

A
  • Larger scale quantative research and meta-analysis can demonstrate associations between phenomena
  • Small-scale qualitative research can tell us about the granular and experiential aspects of health inequaltity
  • Successive governmental reports on health inequality in the UK context: Black report (19890), Acheson report (1998), Marmot review (2010)
  • Sociologists are usually part of a wider interdsiciplinary team in these processes - teams include health economists, social epidemiologists, policy specialists
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20
Q

Compare the concepts of belief and expertise

A

Belief is the subjective requirement for knowledge - this means belief is a biased and personal judgement

Expertise is an expert opinion or knowledge, often obtained through the action of submitting a matter to, and its consideration by, experts, an expert’s appraisal, valuation or report /The quality or state of being expert, skill, or expertness in a particular branch of study or report

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21
Q

Discuss ‘lay health beliefs’ over time’

A

In the past

  • Professinal dominance

Now

  • Greater weight given to lived experience of illness and disability
  • Different forms of expertise, not ignorance vs expertise
  • Shift from talking about “lay beliefs” to talking about “lay knowledge” and “lay epidemiology”
  • Emergence of “experts-by-experience”
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22
Q

Describe how lay health belief can affect illness behaviours

A
  • Illness behaviour is learned, starting from childhood
  • Theory of planned behaviour - how beliefs influence behavious; attitudes + subjective norms + percieved control
  • Pressure from others to consult is key trigger to consulting GP
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23
Q

Discuss the tensions around the need for both education and expertise

A
  • In an era where health funding is restricted, patient expertise and patient self-management become valuable features of the health service
  • Idea that patients need to be able to distinguish between what can be managed through self-care and what needs expert attention
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24
Q

What is the difference between structure and agency

A

Structure - determinsm ( we are determined by social structures, or social forces)

Agency - voluntarism (the indivudal has free will)

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25
Q

What is social stratification?

A

The allocation of individuals and groups according to various social hierarchies of differing power, status, or prestige

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26
Q

There are different ways of conceptualising social stratification - Marx’s, Weber’s, NS-SEC, a contemporary perspective. Describe Karl Marx’s perspective

A

Antagonistic polarisation between the two ‘basic’ classes:

  • Capitilists (Bourgeoisie - owners of capital)
  • Working class (Proletariat - wage-labourers)

Marx theorised that this class antagonism would lead inevitably to revolution

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27
Q

There are different ways of conceptualising social stratification - Max’s, Weber’s, NS-SEC, a contemporary perspective. Describe Max’s Weber’s perspective

A
  • Emphasised the importance of class-based life-chances
  • Emphasised other dimensions: ‘honour’ (status) and ‘party’ (political organisation for change)
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28
Q

There are different ways of conceptualising social stratification - Marx’s, Weber’s, NS-SEC, a contemporary perspective. Describe the NS-SEC (National statistics socioeconomic classification) perspective

A
  • Measure employment relations
  • Used in the research domain as a proxy for social class
  • Differentiates occupations in terms of reward mechanisms, promotion prospectives, autonomy and job security
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29
Q

What is an impact of social inequality has had on health?

A

There has been an increase in the disparity in mortality rates between upper and lower social classes

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30
Q

List the mechanisms of health inequality models

A
  • Behavioural model
  • Materialistic model
  • Psychosocial model
  • Life-course model
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31
Q

Describe the relationship between socioeconomic status and health behaviour

A
  • In all countries there are wide disparities in the health status of different social groups
  • The lower an individual’s socio-economic position, the higher their risk of poor health
32
Q

There are higher rates of smoking among manual groups, which will contribute to ill health.

What mechanism of health inequality models best fits this statement?

A

Behavioural model

33
Q

There are lower rates of vegetable intake but elevated rates of the consumption of saturated fats in manual occupational classes.

What mechanism of health inequality models best fits this statement?

A

Behavioural model

34
Q

People in manual occupations exercise less than those in non-manual groups.

What mechanism of health inequality models best fits this statement?

A

Behavioural model

35
Q

Poor-quality, and damp housing are associated with worse health and particularly with higher rates of respiratory disease in children.

What mechanism of health inequality models best fits this statement?

A

Materialistic model

36
Q

Low socio-economic status, low pay and insecurity produce inadequacies in diet and dietary values.

What mechanism of health inequality models best fits this statement?

A

Materialistic model

37
Q

Longitudinal studies show that low birth weight is a predictor of socio-economic disadvantage through childhood and adolescence.

What mechanism of health inequality models best fits this statement?

A

Life-course model

38
Q

Health problems in childhood and youth can produce a downward socio-economic drift.

What mechanism of health inequality models best fits this statement?

A

Life-course model

39
Q

The highest health risks are found among those who both grow up, and remain in, disadvantaged material circumstances.

What mechanism of health inequality models best fits this statement?

A

Life-course model

40
Q

High workload combined with low control over work tasks may negatively affect the immune system.

What mechanism of health inequality models best fits this statement?

A

Psychosocial model

41
Q

Poor social support within the family context may also produce high levels of psycho-social stress leading through to impaired health.

What mechanism of health inequality models best fits this statement?

A

Psychosocial model

42
Q

a) How does the medical model regard disability?
b) What are the limitations of this?

A

a)

  • Regards disability as a direct consequence of an underlying disease or disorder
  • Reductions in disability can only be achieeved through the improvement of the underlying pathology

b) Model endengers stigmatizing language and does not recognize social and psychological factors

43
Q

a) How does the social model regard disability?
b) What are the limitations?

A

a)

  • Emphasizes that activity limitations and participation restrictions result from social and environmental constraints
  • So individuals are limited not only by their medical condition but also by the behaviour of other people towards them and by the environment barriers e.g., inaccessbility of buildings or poor sound systems

b)

  • It served a political purpose but it doesn’t allow for the idea that people are disabled by both society and their bodies
  • It doesn’t consider pain or frailty
  • It doesn’t take into account psychosocal aspects on impairment
44
Q

How does the psychological model regard disability?

A
  • Emphasizes that activites performed (or not performed) by someone with a health condition are infuenced by the same psychological processes that affect the performance of these behaviours by people without disabilities
  • Thus two people with identical medical conditions, living in identical social and environmental situations, may face very different activity limitations because of their cognitions, emotions or coping strategies
45
Q

Describe the ICF (International classification of functioning, disability and health) model

A
  1. Medical, sociological and psychological models combined together
  2. Disability and functioning are seen a multi-dimensional concepts relating to:
  • Body functions and structures
  • Activities and activity-limitations
  • People’s participation and the participation-restriction they experience
  • Environmental barriers they experience
46
Q

Name the three influential ideas of adapting to chronic pain

A
  1. Charmaz (1984) ‘loss of self’
  2. Bury (1982) ‘biological disruption’
  3. Williams (1983) ‘narrative reconstruction’
47
Q

Describe the Charmaz (1984) ‘loss of self’ idea

A

A fundamental form of that suffering is the loss of self in chronically ill persons who observe their former self-images crumbling away without the simultaneous development of equally valued new ones

48
Q

Describe Bury (1982) ‘biographical disruption’ idea

A

Chronic illness involves a recognition of the worlds of pain and suffering possibly even of death, which are normally only seen as distant possibilites or the plight of others

49
Q

Describe Williams (1983) ‘narrative reconstruction’

A

Adapting to impairment involves processing biographical disruption and building new life narratives

50
Q

Discuss how envionmental factors can contribute to disability

A

There are environmental factors that provide people with disabilities an added independance to explore opportunities in the economic and social world:

  • Affordable aids and equipment
  • Support arrangements in educational and workplace settings
  • Mainstream education
  • Accessible public transport
  • Personal assistance
  • Home modifications

There are also features in the environment that may act as barriers for different people n different circumstances

  • Evironmental barriers often limit or prevent a person with a disabilty from fully participating in social, occupational, and recreational activities
  • E.g., or a wheelchair-user, environmental barriers may include stairs, narrow doorways, heavy doors, or high counter tops
51
Q

Describe a best practice approach to working with disabled people

A
  • Person-centred
  • Treat people with respect and dignity
  • Speak to the person, not to their relative, carer or support worker: disabled person is expert on their own life
  • Make eye contact
  • Be patient with people who experience obstacles in communicating (deaf, intellectual dsabilities, speech impediments etc)
  • Ask “need to know” not “want to know” questions
  • Use appropriate language (“people first”)
  • Avoid “diagnostic over-shadowing”
  • Avoid making assumptions
52
Q

Discuss how body image is formed

A
  • Body image is formed in a social and cultural context
  • Cultural representations of the body (e.g., TV, films, social media) can reinforce or query social norms and cultural ideals
  • Institutuions (e.g., medical education, the NHS) can play a role in highlighting and challenging problematic norms and ideals
53
Q

Define ‘nuclear families’

A

Families that consisit of two generations of family members living in the same household (parents and their children)

54
Q

Define ‘extended families’

A

Vertically etxended - conists of 3 or more generate (grandeparnets, parents, children)

Horizontally extended - aunts, uncles, cousins i.e., relations as the same generation as parents

55
Q

Define ‘symmetrical family’

A

Where a family divides all responsibilities equally between partners

56
Q

Define ‘arranged marriage’

A

Where one or both people do not or cannot consent to the marriage

57
Q

Define ‘co-habiting couple family’

A

A living arragement whereby a couple who is not married or a couple who is in a civil partnership live together in the same household

58
Q

Define ‘queer family’

A

LGBT people raising one or more children as parents or foster care parents

59
Q

Define ‘donor conception’

A

Means that eggs, sperm or embryos or both eggs and sperm (double donation) from donors are used to help with conception when one or both partners in a heterosexual couple are infertile. It can also be used to aid family building for women without a male partner and lesbian couples

60
Q

Describe the changes in the make-up of UK families

A
  • Increase in the number of cohabititing couple families
  • Increase in the umber of people living alone over the last 10 years
  • Increase in the number of people aged 20-34 years living at home with their parents
  • Increase in the number of same-sex families in the UK
61
Q

Describe the relationship between family structure and health outvomrd

A
  • People living together in bigger households (e.g., asian family structure) have a higher risk of being exposed to infectious diseases
  • Often refugees and migrants live in crowded housing leading to poorer health outcomes
  • Suicide risk is lowest in those with family ties
  • Married people are healthier than non-married people if spouse is present in the household
  • People without any family ties ‘kinless’ are more at risk of social isolation which leads to poorer health outcomes e.g. greater risk of CVD, hypertension, cancer, depression, morepain, premature mortalitity
  • Children living with married parents have better mental and physical health and lower mortality than children livign with cohabiting or single parents (due to greater stabilitiy associated with marriage e.g., stable socal networks and married parients more financially stable so better health care access)
  • Those in strained and conflicted marriages have worse health than the unmarried, including the divorced
  • For childen, better relationship quality with parents is linked to better health in adolescene and adulthood
62
Q

Describe the different ideas that society think a child should do

A

Western society/idea: a child should be educated in school

Argicultural societies/societies wth a lot of family businesses - the child should help the parents

63
Q

What are informal carers?

A

Informal carers are carers who provide care on an unpaid basis, often to family members

64
Q

Descibe the role of informal carers within families

A
  • They help maintain a sense of continuity in the lives of those they care for
  • They help maintain a sense of identity of the person receiving care.
65
Q

Describe the impact of caring for the family on informal carers

A
  • People providing unpaid care are at an increased risk of psychlogcial stress
  • Carers are at a significant risk of having a mental health problem and the risk of negative impact on a carer’s mental health is more likely when caring for someone with a disability and higher care needs
  • The carer’s employment is negatively affected when unpaid care is provided for many hours a week (although under the Care Act (2014) local authorities have a duty to provide services and support to carers whose employment is at risk)
66
Q

Describe the support carers need

A
  • Peer and emotional support
  • Practical, financial, and domestic help
67
Q

What is social gerontology?

A

The study of the social aspects of ageing, and of ageing populations

68
Q

What is chronological ageing?

A

How old a person is in terms of time since birth

69
Q

What is biological ageing?

A

Changes in a person’s physical state that accompany chronological ageing

70
Q

What is functional age?

A

Defined on the basis of functional measures of daily living

71
Q

What is social ageing?

A

Social expectations about how people should behave or appear as they grow older

72
Q

What are some cognitive changes of ageing that may have clinical implications?

A
  • Older adults may need longer to search their memory ro retrieve information
  • Older adults may find it harder to filter background noise
73
Q

List the determinants of treatment/compliance

A
74
Q
A

D

75
Q
A

A

76
Q

Why may people experience ageing differently?

A

Peple may experience ageing differently due to social and structural disadvantages that accumulate overtime

Medicine - Year 1 (61 decks)

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