Search PubMed⌕ Search

Biomedical subjects

A Kleinman

Publications and source records attributed to A Kleinman.

69 records · Page 4Linked to original sources
PubMed1978

Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research.

Major health care problems such as patient dissatisfaction, inequity of access to care, and spiraling costs no longer seem amenable to traditional biomedical solutions. Concepts derived from anthropologic and cross-cultural research may provide an alternative framework for identifying issues that require resolution. A limited set of such concepts is described as illustrated, including a fundamental distinction between disease and illness, and the notion of the cultural construction of clinical reality. These social science concepts can be developed into clinical strategies with direct application in practice and teaching. One such strategy is outlined as an example of a clinical social science capable of translating concepts from cultural anthropology into clinical language for practical application. The implementation of this approach in medical teaching and practice requires more support, both curricular and financial.

Adult↗
PubMedDate not supplied

Culture and somatic experience: the social course of illness in neurasthenia and chronic fatigue syndrome.

An anthropological view of culture and somatic experience is presented through elaboration of the notion that illness has a social course. Contemporary anthropology locates culture in local worlds of interpersonal experience. The flow of events and processes in these local worlds influences the waxing and waning of symptoms in a dialetic involving body and society over time. Conversely, symptoms serve as a medium for the negotiation of interpersonal experience, forming a series of illness-related changes in sufferers' local worlds. Thus, somatic experience is both created by and creates culture throughout the social course of illness. Findings from empirical research on neurasthenia in China, and chronic fatigue syndrome (CFS) in the United States, corroborate this formulation. Attributions of illness onset to social sources, the symbolic linking of symptoms to life context, and the alleviation of distress with improvement in circumstances point to the sociosomatic mediation of sickness. Transformations occasioned by illness in the lives of neurasthenic and CFS patients confirm the significance of bodily distress as a vehicle for the negotiation of change in interpersonal worlds. An indication of some of the challenges anthropological thinking poses for psychosomatic medicine concludes the discussion.

Cross-Cultural Comparison↗
PubMedDate not supplied

Hyperemesis gravidarum: a biopsychosocial perspective.

The literature on the psychological, social and biological factors in the etiology of hyperemesis gravidarum is reviewed. Four cases seen in the last year in psychiatric consultation in a general hospital are then presented to illustrate and highlight the biopsychosocial factors in the literature that seemed most relevant to diagnosis and treatment. Emphasis is placed on the concept of hyperemesis gravidarum as a special type of somatization (an illness behavior in which dysphoric affect is expressed with physical symptoms), whereby physical symptoms are expressed to elicit care by physicians and family and to gain a "time out" from stressful home environments.

Adolescent↗
PubMedDate not supplied

Suicide in contemporary China: a review of China's distinctive suicide demographics in their sociocultural context.

Suicide is a complex phenomenon--arguably a social and a moral deed--occurring within associated psychological, biological, and cultural contexts. We present data on suicide rates in China for 1988, 1990, and 1992 and provide an analysis of their social context. These figures, from the Chinese Public Health Annuals, have never before been publicly reported. These and other recent data indicate that suicide rates in China, although reportedly low in the past, are by global standards alarmingly high among certain demographic groups. They also reveal distinctive epidemiological patterns of suicide in China that contrast with the patterns characteristic of Western societies-for example, higher rates in rural than in urban areas and, among some demographic groups, higher among women than among men. As in the West, however, suicide among the elderly is a major problem in China. The sociocultural context of these data is examined as a means toward understanding their distinctive patterning.

Adolescent↗