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The Sociology of Health, Illness and Medicine

الكلية كلية التمريض     القسم قسم التخصصات التمريضية     المرحلة 3
أستاذ المادة عبد المهدي عبد الرضا حسن الشحماني       01/10/2019 10:10:34


The Sociology of Health, Illness and Medicine
Topics in Medical Sociology:
Epidemiology
Public health efforts and other policy issues
Formal organizational aspects of healthcare
Social and cultural influences on health and illness
The socialization of caregivers
“Micro-politics” among practitioners in healthcare
Caregiver-patient interaction
Epidemiology
Epidemiology is the study of the extent and population-based spread of disease.
Epidemiologists might examine genetic, biological and physical environmental factors in addition to social factors.
Some examples of the uses of epidemiology:
AIDS, TB and other communicable diseases
Hantavirus, "Mad Cow" (SJV) and other animal-borne diseases
Mental illness and its environmental correlates
... and many others. Epidemiology is an important tool for managing public health.

Public Health Efforts and their Impact on Death and Disease
Doctors treat "patients"; public health officers treat communities and societies.
People tend to consider new medical "breakthroughs" in contributing to reductions in mortality and morbidity.
However, public health and "social hygiene" efforts have contributed far more to health than have medical measures:
In 1900, 44% of deaths in N America were due to 11 infectious diseases.
By 1980, that figure was less than 5%.
Nowadays, most deaths are due to the three major chronic conditions: heart disease, cancer and stroke.

The Organization of Healthcare
Healthcare services serve two functions: Direct service functions, and supportive or ancillary functions.
Direct Service:
Individual, patient-based care
Community-based care
Ancillary functions:
Finance
Suppliers
Regulation
Representation
Research
Consulting


Social and Cultural Impacts on Health
One s position in a social structure influences one s health in numerous ways.
Gender
Socioeconomic status
Occupation
Race and ethnicity
Age
Social and Cultural Impacts on Health
All of these factors influence
1. Differential exposure to pathogenic or salutary circumstances
2. Vulnerabilty to disease
3. Access to healthcare resources

The Socialization of Caregivers
Focus on doctors:
Student doctors acquire knowledge to accomplish "hypothesis testing" in medical encounters.
The Socialization of Caregivers
Medical school is thus a period of socialization in which students acquire new competencies.
What about informal socialization?
Doctors learn about professional hierarchies.
Doctors learn to think of patients "objectively," ie:
"Don t let emotions get in the way“
The patient is an "object," an organism that provides data
Doctors acquire sense of selves in the world

Medical Micropolitics
Medical care is NOT doctor care.
Nurses
Physiotherapists
Counsellors
Volunteers
Orderlies
Doctors are "team leaders.“
The "Doctor-Nurse Game": How nurses orient to doctors to perform work but still preserve hierarchy
Caregiver-Patient Interaction
Focus on Doctor-Patient
Hypothesis-testing approach: Doctor asks questions; patient answers. Medical interviewing instruction reinforces this.
Caregiver-Patient Interaction
Patient s role:
Answer questions.
Don t speak unless spoken to.
Don t ask questions.
Don t offer diagnoses.
However, medical complaints are often cast as questions or as "candidate diagnoses."
Doctors SHOULD learn to listen and to encourage questioning and talk on patients part.


المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .