bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Belgian medical profession, the order of physicians and the sickness funds (1900–1940)
Authors: Schepers Rita 
Published: February 2004

AbstractHow a profession is regulated and by whom are generally considered to be crucial questions. In Belgium, the most important regulator of the medical profession is the Order of Physicians. This institution is generally acknowledged to be a cornerstone of the Belgian profession's ‘overwhelming dominance’ and great autonomy. In this article, I will discuss the developments which led to the establishment of the Order of Physicians in 1938. One of the central themes is that in order to understand its establishment fully one has to take into account the ongoing struggle between profession, sickness funds and government as to the position of the profession within the planned obligatory health insurance system. It is likely that the typically Belgian involvement of interest groups and social movements in the political arena, in order to fight off political interference in issues considered to be private ones, facilitated the acceptance and the establishment of the Belgian Order of Physicians in 1938.
All in the family: social processes in ovarian egg donation between sisters
Authors: Lessor Roberta 
Published: February 2004

AbstractInterviews and participant observation were conducted at a US infertility clinic with women who were attempting to become pregnant with eggs donated by their biological sisters. Sisters who donated eggs were also followed and interviewed regarding their experiences, as were a number of husbands of recipients. Five significant social processes characterising the sisters’ passage through egg donation are discussed: (1) negotiating dissimilar treatment experiences, (2) communicating cautiously, (3) interacting in a triad, (4) disclosing to others, and (5) ‘gift‐giving’. Although participants are generally satisfied with their decision to do sister‐to‐sister egg donation, the unprecedented procedure presents a number of difficulties. If sister‐to‐sister egg donation as a means to biological motherhood continues in the future, these sociological findings suggest areas in which medical personnel may need to provide social and emotional support.
Managing ‘minor’ disorders: pathways to a hospital accident and emergency department
Authors: Calnan Michael 
Published: February 2004

AbstractEmpirical research examining the decision‐making processes involved in the management of problematic signs and symptoms has either focused on a specific condition or examined more general decision rules. The problem with these approaches is the difficulty in identifying which elements are specific to certain complaints and which are more generally applicable. The study presented here shows a comparison of the processes involved in the decision to seek medical care for sufferers with different types of complaint. This comparison identified various different elements in the decision‐making processes which were shown to have considerable implications for their pattern of help‐seeking behaviour and their pathways to the hospital accident and emergency department.
Loss of self: a fundamental form of suffering in the chronically ill
Authors: Charmaz Kathy 
Published: February 2004

AbstractPhysical pain, psychological distress and the deleterious effects of medical procedures all cause the chronically ill to suffer as they experience their illnesses. However, a narrow medicalized view of suffering, solely defined as physical discomfort, ignores or minimizes the broader significance of the suffering experienced by debilitated chronically ill adults. 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. As a result of their illnesses, these individuals suffer from (1) leading restricted lives, (2) experiencing social isolation, (3) being discredited and (4) burdening others. Each of these four sources of suffering is analysed in relation to its effects on the consciousness of the ill person. The data are drawn from a qualitative study of 57 chronically ill persons with varied diagnoses.
Class, perceptions of ‘disordered’ behaviour, and suggestions for therapy: a tri‐cultural comparison
Authors: Heller Peter L. , Quesada Gustavo M. , Chalfant H. Paul 
Published: February 2004

AbstractThis paper presents findings from a tri‐cultural study in which we argue that class differences pertain not only to rates of mental illness but also to recognition of symptoms of mental illness and to recommendations concerning what should be done by those exhibiting ‘disordered behaviour’. It is hypothesized that regardless of respondent's cultural background, the extent to which a deviant behaviour will be defined as a mental health problem, and professional therapy will be suggested as a source of help for that problem, will be positively related to class. Findings from a sample selected from two small West Texas communities, and samples selected from Durange, Mexico, and Juiz de Fora, Brazil, indicate strong support for the first prediction only among the West Texas sample, whereas the second hypothesis concerning therapy suggestions is strongly supported among respondents in all three cultural settings. We conclude that these class differences in perceptions and suggestions concerning five examples of ‘disordered’ behaviours read to respondents relate to conditions of lower‐class life in general. Particularly, structural support found for our hypothesis leads us to suggest a need for informal, nonbureaucratic mental health care systems created to serve lower‐class populations residing in class‐oriented societies, regardless of cultural differences which may exist among these societies.
Discourse processes and the social organization of group therapy sessions
Authors: Vandewater Steven R. 
Published: February 2004

AbstractThe social organization of group therapy sessions held in a community mental health center is investigated by analysing transcripts of audiotaped and videotaped sessions as well as ethnographic data (field notes and interviews). After describing the structural (i.e. hierarchical and sequential organization of activities during sessions, discourse processes by which group members accomplish this structure are examined. Analyses of participants’ communicative strategies provide insights into the cognitive and behavioral components of the interactive competence required of group members. In contrast to findings of previous research on group therapy, interactive control is found to be distributed among certain clients as well as the therapists.
Time, risk and routine in general practice1
Authors: Horobin Gordon , McIntosh Jim 
Published: February 2004

AbstractThe paper is based on interviews with a sample of 50 general practitioners. It explores their concepts of time’ and ‘task’ in relation to their attempts to create satisfying work roles. There is a contrast between practitioners in urban and rural settings. For urban practitioners the economy of time as a scarce resource generates an element of risk from brief, ‘routine’ diagnosis. For rural practitioners time is not seen as a scarce resource, but they face the risk of working without additional specialist services. For most practitioners the problem is dealt with pragmatically by varying the mix of risky and routine work.
Compliance and risk‐taking: the case of alcoholic liver disease
Authors: Blaxter Mildred , Cyster Richard 
Published: February 2004

AbstractThis paper describes an exploratory study of ‘compliance’ with doctors’ advice in an extreme situation: reduction of drinking, or abstention from alcohol, in patients with alcoholic liver disease. A preliminary postal survey had suggested that at least three‐quarters of these patients continued to drink. An intensive interview study explored the reasons for this. Only a minority of the patients were identified as alcoholic, or had a history suggesting dependence. It was concluded that communication between doctor and patient, and factors involved in the patients’ perception of their illness, were crucial first steps towards a change of behaviour. The statements of doctors had to be reinforced by a subjective appreciation of danger. Even if advice about the management of their condition was understood and accepted, however, what then constituted ‘compliance’ in the patients’ eyes depended very much upon social norms. Even then, the success or failure of attempts to follow the doctors’ advice depended crucially upon the circumstances of the patients’ lives. The model of ‘compliance’ or ‘non‐compliance’ which thus emerges is a complex one which has several stages.
Participation in the medical consultation: the co‐ordination of verbal and nonverbal behaviour between the doctor and patient
Authors: Heath Christian 
Published: February 2004

AbstractThe following paper is concerned with the coordination of verbal and nonverbal behaviour by the doctor and patient in the medical consultation. It explores the relationship between the talk of the patient and the nonverbal behaviour of the doctor and demonstrates how the gaze direction of the doctor plays a crucial part in the articulation of an utterance by the patient. In examining a series of examples drawn from primary health care consultations, the analysis reveals how patients, or more generally speakers, use gestural activity to realign the gaze of their recipient(s) and encourage their participation in talk. In this fashion the paper addresses the problem of how the participants maintain a state of mutual involvement and sustain their integration within social interaction.
Research note: proxy responses in health surveys: a methodological issue
Authors: Briscoe Monica E. 
Published: February 2004

AbstractThe practice of using proxy respondents in health surveys has been identified as a possible cause of confusion in the literature concerning sex differences in morbidity. Specifically, it has been suggested that proxy respondents (usually female) tend to under‐report illnesses of absent persons (usually male) and hence the observation that women suffer from more illness than men may simply be an artifact of this method of data collection. In order to investigate proxy effects, 50 married couples were asked to report symptoms recently experienced by their spouses as well as themselves. A high level of agreement was found between husbands and wives regarding the number and severity of symptoms experienced by each individual, despite considerable differences in health status between sub‐groups. Where there was a discrepancy, it was in the direction of the proxy respondent (of either sex) over‐reporting symptoms. It follows from this that, if anything, the over‐use of female interviewees would tend to minimise observed sex differences in illness. Thus, the excess female morbidity found in health surveys is not attributable to proxy effects but is more likely to result from differences in the way in which men and women experience symptoms.
Integration or marginalisation? Clinical psychology as a strategy for dealing with psychosocial issues in a South African neurosurgery ward
Authors: Miller Tracey , Swartz Leslie 
Published: February 2004

AbstractBiomedicine has been criticised for its failure to take adequate account of psychosocial issues. One attempt to address this has been to employ clinical psychologists in general hospital wards. In order to examine this phenomenon, four cases referred to the first author while she was an intern clinical psychologist working in a Neurosurgery ward are reported and discussed. In addition, interviews were conducted with two clinical psychologists and the head of this Department of Neurosurgery. Issues that emerged from the data included evidence of referral of what could be more accurately termed social or structural problems rather than psychological problems; power imbalances between psychologists and neurosurgeons, and the elaboration of these factors within the particular context of South Africa. Taking account of psychosocial issues by employing clinical psychologists in medical settings may fail in that it may ironically facilitate the marginalisation of these issues, and allow social and political issues to be individualised and pathologised.
Boundary encroachment and task delegation: clinical pharmacists on the medical team
Authors: Mesler Mark A. 
Published: February 2004

AbstractThe sociological literature on pharmacy is sparse, relative to that on physicians and nurses, especially in light of recent changes in the nature of health care and pharmacy's expanded ‘clinical’ role. Moreover, some of this literature presents contradictory perceptions of the clinical pharmacy role; some are perceiving it as encroaching on physicians' role boundaries, while others perceive its few new tasks to be delegated. This article is based on extended participant observation of clinical pharmacists in two northeastern teaching hospitals in the U.S. Data are presented on the clinical tasks the pharmacists performed, the potential boundary conflicts they posed for other members of the medical team, the resolutions of these conflicts, and the role boundaries perceived by relevant participants. From this analysis it is argued that the literature on pharmacy's boundary encroachment is not so much contradictory as incomplete. Implications for pharmacy and the analysis of role boundaries is discussed in conclusion.
Mediating illness: newspaper coverage of tranquilliser dependence
Authors: Gabe Jonathan , Gustafsson Ulla , Bury Michael 
Published: February 2004

AbstractThe purpose of this paper is to illustrate the value of insights from media studies for medical sociology by focusing on the cultural and ideological messages transmitted in newspaper coverage of tranquilliser dependence. An analysis of 62 stories recounting the experiences of individual tranquilliser users reveals that journalists concentrate on two kinds of person – the celebrity and the ordinary user‐ in their reports. The ways in which the press deploys these users' experiences of tranquilliser dependence and withdrawal and their relationship with the medical profession are then analysed, with particular attention being given to the cultural and ideological meanings embedded in its descriptions of such experiences and relations. The paper ends with a discussion of the reasons for the transmission of such meanings by the press and their possible effect on different audiences.
The social construction of noncompliance: a study of health care and social service providers in everyday practice
Authors: Fineman Norman 
Published: February 2004

AbstractThis study investigates the social construction of noncompliance by clinicians, social workers, and alcohol counsellors in a multiservice health care and social service agency. Based upon data from in‐depth interviews and long term observations, it is suggested that noncompliance, like other categories of deviance, is socially constructed and subjectively denned and interpreted. Staff members of this agency subjectively defined noncompliance as the extent to which clients' behaviours deviated from expectations of appropriate, proper and reasonable client behaviour. In addition, staff members interpreted the meanings of clients' noncompliance by subjectively assessing the intent underlying their clients' noncompliant acts. Their assessments, in turn, served to structure their subsequent interactions with clients and provided the rational and moral bases for constructing the strategies they used to manage clients' noncompliant behaviours and bring about compliance.
Husbands' participation in fertility treatment: they also serve who only stand and wait
Authors: Meerabeau Liz 
Published: February 2004

AbstractThe paper examines the participation of men in outpatient consultations at three fertility clinics, and draws comparisons with participation in pregnancy and childbirth, in which there are also diffuse statements about support, but little concrete activity. It is argued that the medical consultation has difficulty accommodating a triad, and assumes a commonality of aims which may not exist. The alternative, which would involve addressing the dynamics of the couple's relationship, may not be achievable within the confines of the outpatient setting.
Eager for medicalisation: the social production of infertility as a disease
Authors: Becker Gay , Nachtigall Robert D. 
Published: February 2004

AbstractThe social and cultural basis of medicalisation is explored through an examination of infertility, a social condition that has recently been recast as a disease. Infertility illustrates a basic dilemma of medicalisation: the health care system reflects the same value system at work throughout society. Placing social problems within a biomedical framework does not provide a satisfactory solution for conditions that deviate from cultural norms because those norms are replicated in biomedical ideologies about the nature and treatment of disease. We examine three phases of this dilemma through an analysis of data collected in in‐depth interviews with 43 American couples who were undergoing infertility treatment: 1) the disparity between initial expectations about ease and speed of treatment and its actual complexity, 2) the confrontation with medical definitions of abnormality, and 3) the cumulative effects of treatment, in which emotional exhaustion from infertility treatment vies with the continuing need to ‘fix’ the infertility and produce a pregnancy. We conclude that individuals' efforts to eradicate feelings of abnormality for their childlessness by lending medical legitimacy to their failure to conceive are undermined by entering a medical system in which concepts of disease and abnormality are implicit.
Nursing work, nurses' knowledge, and the subjectification of the patient
Authors: May Carl 
Published: February 2004

AbstractAlthough sociologists interested in health and illness have extensively deployed the work of Michel Foucault in recent years, few studies have examined the ways in which this is of use in understanding nursing practice. This paper explores the ways in which nurses' accounts of their work and relationships with patients reflect a discourse of the social. While these accounts reflect a thoroughgoing accommodation of the importance of ‘knowing’ the patient as more than an object of clinical practice and procedure, they also reveal the practical problems that must be negotiated in attempting to do so. Foucault's notion of the clinical gaze is deployed in interpreting these accounts, and the question of power and resistance in nursing work is discussed.
Care = organisation + physical labour + emotional labour
Authors: James Nicky 
Published: February 2004

AbstractThe formula‘care = organisation + physical labour + emotional labour' identifies component parts of ‘carework’ as they were observed at a hospice. A comparison between women's domestic carework and that of the hospice nurses is made firstly to clarify the component elements of care and secondly to show how the interrelation and balance of the components differs in the two settings. It is argued that family care has been a model for hospice care but that division of labour in hospices, which replicates hospital labour‐divisions, results in an inflexibility in hospice care which is incompatible with the ‘family’ model. In the final section it is suggested that emotional labour is likely to be increasingly recognised as part of health care but that the concept of ‘total care’ needs to be questioned.
Women in a women's job: the gendered experience of nurses
Authors: Porter Sam 
Published: February 2004

AbstractThe aim of this paper is to examine how the structural influence of gender affects nurses in their working lives. Gender segregation exists both within and between the occupations of medicine and nursing. It is largely founded on the social construction of a skills/caring dichotomy. An analysis of how the gender of nurses and doctors affects their interactions with co‐workers reveals that the increasing proportion of female doctors has attenuated power differences between the two occupations. Examination of nurses' attitudes to gender demonstrates that they are very aware of the problem, despite a tendency to accept credentialist justifications of inequality. As a result of this they are becoming more assertive. The issue of sexual stereotyping is addressed and it is noted that popular mythology about sexual relations between doctor and nurses is highly misleading. Privatised aspirations are having a decreasing influence over nurses' working lives. In conclusion, while gender inequality is losing some of its power in nurse‐doctor relationships, it is becoming an increasingly significant factor in the relationship between male nurse managers and female workers.
The image of health: variations in perception by social class in a French population
Authors: D'Houtaud A. , Field Mark G. 
Published: February 2004

AbstractIn order to determine how a population defines the meaning of health, a study was made using a sample of 4,000 respondents from Lorraine, in the north‐eastern part of France. The respondents, all of whom were undergoing a health examination, were asked to respond to an open‐ended question on what health meant to them. A total of 6,172 replies were obtained whose contents were classified into 41 main themes themselves regrouped under 10 heading (or groups of themes).The responses were clearly linked to the socio‐economic class position of the respondents, which was the most discriminating variable, and the one discussed here. There was a gradient from the higher, non‐manual classes to the lower manual classes, the former conceiving health more in personalized, positive and expressive terms, and the latter more in negative, socialized and instrumental terms, thus reflecting the complementary positions of social classes as mediated through the occupational structure.
Art, science, faith and medicine: the implications of the placebo effect
Authors: Price Linnie 
Published: February 2004

AbstractThe placebo effect has been shown to account for between 30 to 40 per cent of the efficacy of ‘active’ medication for a wide range of pathologies and is probably a powerful agent of cure in other therapies, for example surgery. Medicine has failed, at least explicitly, to confront the implications of this powerful effect, attending to it mainly as a nuisance variable to be controlled for in clinical trials. This paper argues that the existence and extent of the placebo effect represents a challenge to the assumptions behind much medical practice, and throws doubt on the validity of locating disease and healing within a paradigm of scientific rationality.
Clinical uncertainty: is it a problem in the doctor‐patient relationship?
Authors: Calnan Michael 
Published: February 2004

AbstractThere has been little consideration of the implications of clinical uncertainty about diagnosis, prognosis and treatment although these uncertainties might represent a real threat to professional autonomy. This paper, using evidence from a range of empirical studies, examines whether in the everyday practice of medicine clinical uncertainty is a real threat to professional autonomy. The evidence suggests that only rarely does clinical uncertainty present management problems for the doctor. The evidence also suggests that the image of the patient being duped by medical or bourgeois ideology, as presented in the work of some macro theorists, is inaccurate.