Sociology Flashcards
Give two psychological factors that may influence a patient’s chronic pain
Depression • Anger • Fear/anxiety, lack of control • Family pressures, employment, finances • Compensation/legal issues • Cultural expectations
What is the concept of the ‘sick role’?
The sick role is an influential model of the doctor-patient relationship that casts illness as a form of temporary defiance from one’s social role.
Illness is seen as a threat to the smooth functioning and stability of society.
Doctor and patient both play a role, each has two obligations and two rights
What are the 2 obligations and 2 rights of the patient in the ‘sick role’?
Patient’s obligations
- Demonstrate motivation to get well
- Seek technically competent medical help and co-operate with the clinician
Patient’s rights:
- Exemption from normal role responsibilities
- Not to be held responsible for their sickness
What are the 2 obligations and 2 rights of the doctor in the ‘sick role’?
Doctor’s obligations:
- To be technically competent
- To be neutral and objective - prioritising patient’s welfare
Doctor’s rights:
- To be treated by society as a professional
- To be allowed to examine the patient
In Parson’s model of the sick role, how do doctors legitimate the sick role?
Doctors act as gatekeepers to the sick role. They legitimate the sick role through naming and diagnosing illness
What are some critiques of the sick role?
- Gives the doctor too much power?
- Doesn’t fit well with long term conditions or disabilities where the patient can’t ‘get better’
Key points from lecture 1
- Professionalism of medicine/ formation of GMC
- Medical dominance
- sick role
Can you summarise these topics
What does the concept of medical dominance refer to?
How has it changed over time?
- The profession’s authority to determine what counts as sickness
- Medicine’s dominance over patients
- Medicine’s dominance over other professionals
Medical dominance has reduced now because
- social movements such as disability rights
- more patient autonomy
- developments in nursing practice and development of other health care professional roles with increasing skills, knowledge and autonomy
- patients having higher expectations and knowledge of conditions eg. Due to online information
What happened in 1858 that led to the standardisation and professionalism of medicine across the UK, and why?
Formation of the GMC 1858
Gave the medical profession license to regulate itself
What is the sick role?
Suggest a model that can be used for shared-decision making
And it’s three parts
Three talk model of shared decision making
- Team talk
- Option talk
- Decision talk
Key Points from lecture 2
‘Dealing with complexity and uncertainty’
It’s ok for the clinician not to know all the answers all the time. Key is honesty with the patient, and frame uncertainty positively.
Take a patient-centred view: patient’s goals, preferences and social needs (eg. Harriet’s story about choosing a c-section because of her own birth injury)
Describe the biopsychosocial model of health and illness
The biopsychosocial model suggests that it is the interplay between people’s genetic makeup (biology), mental health and behaviour (psychology) and social and cultural context that determines their health related outcomes.
Health and illness as the result of many intertwined factors, not a single factor
- Biology. Human body: multiple interacting physiological and self-regulating systems
- Psyche. Patient behaviour and mental health
- Society. Patient’s web of relationships. Wider social, political and cultural systems
[Biopsychosocial model was first proposed by George Engel in 1977]
Image is from internet not lecture but thought it was more helpful
What was the key feature of Karl Marx’s model of social hierarchy?
Polarisation of two classes, basically the wealthy / business owners and the labourers.
- Bourgeoisie (owners of capital)
- Proletariat (wage-labourers)
How did the ‘national statistics socioeconomic classification’ conceptualise social hierarchy?
Assigned people to a class depending on their employment. Different jobs rated on pay/reward, promotion prospects, autonomy and job security. Eg. Class 1 - doctor, class 7 - labourers. Harriet says this is an outdated way of looking at things.
What is the contemporary model of social hierarchy/ stratification
Pyramid structure, very rich at the top, those on benefits at the bottom.
Precariat - people with ‘precarious employment. Eg self-employed.
What are the social factors / social determinants of health? Name 5
Education Employment status / unemployment / job insecurity Income level Gender Ethnicity Food insecurity Housing, basic amenities and the environment. Living conditions Early childhood development Social inclusion / discrimination Access to health care
WHO social determinants of health are non-medical factors than influence health outcomes. They are the conditions in which people are born, grow, work, live and age. In all countries, the lower the socioeconomic position of a person, the worse their health.
Name the four models of health inequality
Behavioural
Psychosocial
Materialist
Life-course
In practice the models overlap, and we need to think about health inequality in terms of interactions between factors as well.
What is the behavioural model of health inequality?
Give an example
Behaviours that are health damaging or health promoting, which are subject to individual choice. Eg. Smoking
What is the materialist model of health inequality?
Give an example
Hazards to health that are inherent to social organisation and to which some people have no choice but to be exposed eg. Poor housing, affordability of healthy food
What is the psychosocial model of health inequality?
Give an example
Feelings that affect health behaviours eg shame, embarrassment, fear.
Feelings about high BMI that make it harder to eat well eg shame
Feelings about body size that make the person embarrassed to go to the gym
Fear of being told off by the doctor stopping a smoker going to the doctor for a long standing cough, shame that they didnt quit earlier
What is the life-course model of health inequality?
Give an example
Disadvantages accumulate through childhood and adulthood into old age
Low birth weight due to parents who smoked, exposure to smoke as a child causing asthma, smoking yourself, lung cancer.
High birth weight due to diabetic mother, obese parents pass on attitudes and eating habits leads to obesity in child, obese adult, early death.
Born into family of low income, worse health habits as a child, worse health habits as an adult.
Lack of education - worse job - lower income - affects health, can’t afford healthy food, holidays, no time for exercise, doesn’t know how to cook healthy meals. More exposure to diseases eg Covid affected people in certain jobs a lot more, like taxi drivers who could not work from home
Summary of lecture 3
Social structures
How are the medical and social models of disability?
Can you give an example
Medical model of disability views the physical impairment as the problem
Social model of disability views society/ disabling environment as the problem
Eg. A person in a wheelchair cannot get up a ramp- see picture below
