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PubMed1981

An informal appraisal of the current status of 'medical sociology'.

Chairpersons of departments of medicine, pediatrics, and family medicine were sent a questionnaire to determine their experience with, and attitude toward, medical sociology. The results showed that between 40% and 50% of medical students are taught medical sociology during their preclinical years, usually by several departments. Formal instruction was far less common during clinical clerkships and house staff training, although topics dealing with medical sociology were occasionally the subject of grand rounds. The commitment to teaching medical sociology was greatest in departments of family medicine, and least in departments of medicine, with departments of pediatrics occupying an intermediate position. A similar gradient was evident in commitment of departmental resources and enthusiasm for the subject. In general, departments of medicine held a negative attitude toward medical sociology, while departments of family medicine thought the subject was important and worthwhile.

Attitude↗
PubMed1978

Teaching sociology to medical students.

A recent change in many medical curricula has been the introduction of courses in the behavioural sciences. These courses, while introduced with the intention of emphasizing interpersonal and behavioural skills, have not been shown to lead to any of the changes towards which they are directed. Rather, there is evidence that students find these courses 'waffly' and boring. If the sociology component of these courses is to lead to change, then there is the need for a continuing process of evaluation and modification. In this paper we report upon one medical sociology course, its evaluation, subsequent modification and re-evaluation. Our evidence would suggest that sociology courses can lead to changed attitudes and values, but that such changes are contingent upon the overt application of relevant sociological concepts to the health care field.

Australia↗
PubMed1977

Medical sociology for whom?

This article defines the role of a medical sociologist in a medical institution concerned with health care delivery. The role in applied research and teaching is also discussed. The distinction is made between sociology in medicine and sociology of medicine. Five broad areas of research included under the category of sociology of medicine are the consumer of health care; the social, cultural, and economic enviroments as they relate to health and illness; health and illness behavior; patient education; and the evaluation of services provided to the consumer. Research methodologies utilized by sociologists are briefly presented, and research issues of concern in the sociology of medicine are outlined. The knowledge and information provided by a medical sociologist are supplemental to the physician's practice and are expressed ultimately as a benefit for the patient.

Consumer Behavior↗
PubMed1983

The development of medical sociology in Europe.

This general profile of contemporary European medical sociology is derived from a larger study and based on: (1) in-depth sociohistorical analyses and evaluations of the development of the subdiscipline in five European countries; (2) a survey of the background and activities of European medical sociologists (N = 646) in twenty different European countries; and (3) contacts with resource persons and medical sociologists generated by the compilation of a Directory of European medical sociologists. Besides illustrating common features in the origins and developments of European medical sociologies, a number of characteristics of the discipline are highlighted. Special attention is being paid to elements of institutionalization and professionalization of the discipline. Finally, reflections as to the prospects of medical sociology in Europe and the possibility of creating a 'European' medical sociology are offered.

Data Collection↗
PubMed1989

The sociological image of medicine and the patient.

Jack Elinson raises somewhat rhetorical questions about the value of medical care and medical sociology. Behind them is a serious concern with the type and scope of medicalisation in modern society as well as its sociological criticism. This raises the issue of whether the various theoretical images of medicine and the patient which sociology provides are able to account for the effect of the social environment upon morbidity and mortality as shown, for instance, by the Alameda County Study. Three theoretically distinct approaches are discussed in detail, structural functionalism, symbolic interactionism and conflict theory. These characterise medical sociology over the last 30 years. They elucidate more clearly Elinson's own image of medicine and the patient. But none seems to match his standpoint vis-a-vis the medicalisation of care which refrains from citing psychological forces but emphasises the availability of good medical services.

Health Services Accessibility↗
PubMed2007

Developing, integrating, and perpetuating new ways of applying sociology to health, medicine, policy, and everyday life.

As a framework for presenting ideas on developing ways to make sociology more applicable, we focus on the recent state of medical sociology research. Data for this paper were generated through a content analysis of a twelve-year period (1993-2004) of the Journal of Health and Social Behavior (JHSB) and Social Science & Medicine (SSM). The analysis aims to determine if the content of JHSB and SSM reflect the breadth of the sub-discipline of medical sociology as well as the stated goals of the journals. The selected issues of JHSB and SSM were coded on the basis of the following attributes: (1) Primary Substantive Topic, (2) Methodology, (3) Data Type and Analytic Technique, and (4) Research and Policy Recommendations. We found that the orientation of JHSB articles was towards generating research and theory that shy away from policy, interdisciplinary approaches, and applied issues. SSM content tends to display more interdisciplinary breadth and variety, but also reflects a dearth of applied recommendations. Our discussion focuses on what JHSB and SSM could be. We present ideas on how the sociological discipline in general-and JHSB and SSM in particular-can help generate and nourish new forms of inquiry that can impact the way research questions are framed. We conclude that such a shift is needed in order to maximize the applicability of social scientific evidence to everyday life, and we share examples situated within a socio-medical context, where there is a particular need for the application of social evidence to practice.

Bibliometrics↗
PubMed1994

Sociology and the nursing curriculum: a note of caution.

One of the consequences of the expansion of degree, and diploma level Project 2000 courses in nursing, has been that students are now exposed to a significant amount of material from academic disciplines other than nursing, at a relatively advanced level. In this paper, one such discipline, sociology, is considered, and its relevance to the nursing curriculum is assessed. Following a consideration of two theoretical models of the relationship between academic disciplines and professional practice (the 'personal education' and 'semantic conjunction' models), it is argued that whilst the implicit rationale for the inclusion of sociology in the nursing curriculum can best be understood in relation to the latter, neither model offers a convincing reason as to why we should teach sociology to nurses. It is argued instead that the nature of sociological knowledge is inherently multi-paradigmatic, and hence reflexive, and so cannot in principle provide a knowledge base for action-oriented conduct such as nursing work.

Curriculum↗
PubMed2001

Sociological perspectives on self-help groups: reflections on conceptualization and social processes.

AIM: The paper discusses two themes: first, professional involvement in self-help groups and secondly, sociological evidence on self-help groups in postmodern society. BACKGROUND: Self-help groups are a growing phenomenon across national borders and social/political systems. They affect the individual participants' activity level, strengthening of their self-perception and sense of belonging. METHODS: The methodological approach chosen is cross-sectional analysis of empirical findings, which is used for concept evaluation. Selected sociological theory is brought into the discussion of the role and significance of self-help groups. FINDINGS: New empirical sociological evidence shows that health care professionals - nurses, psychologists, social workers - have become an integrated part and thus essential actors in self-help groups within as well as outside the framework of the formal health care system. Involvement in self-help groups is a relatively new area of nursing practice and nursing research and serves an important function in that it sheds light on a rather unique form of social practice that is partly organized and managed by the participants themselves. By implementing modern sociological theory, which does in fact discuss social processes and relations as well as network formation, it is possible to investigate group processes unique to self-help groups and whether self-help groups potentially suppress or liberate at the individual as well as at the institutional level. CONCLUSIONS: The pronounced professional involvement leads us to question if it would not be time to re-conceptualize the self-help phenomenon, which on the one hand presupposes professional interaction and on the other hand introduces consultative services in connection with group processes. This indicates that it is necessary to introduce new aspects and themes for discussion in the health care debate and the work that goes beyond the predominantly individual orientated treatment and care function.

Concept Formation↗
PubMed2004

[Social psychiatry without sociology. Analysis of a scientific journal].

AIM: Psychiatry and Sociology have followed separate avenues in Germany since the mid 1970 s. The aim of this work is to investigate their present relationship by means of an analysis of a scientific journal. METHOD: All original works dealing with social psychiatric subjects and appearing in Psychiatrische Praxis in the years 2002 and 2003 were analysed. RESULTS: Sociologists appear to be a minority among the authors. Questions that are explicitly related to sociological theories were an exception, and sociological authors have hardly been quoted. CONCLUSION: Social psychiatric research in Germany is still conducted without Sociology. If social psychiatry is to gain in importance as a scientific discipline, closer cooperation with its mother discipline is imperative. As an example, the application of the rational choice theory in psychiatric research is discussed.

Community Psychiatry↗
PubMed2001

Sociology and the public understanding of science: from rationalization to rhetoric.

This paper contributes to the reappraisal of sociological theories of modernity inspired by the sociology of scientific knowledge (SSK). As much as these theories rely on received ideas about the nature of science that SSK has called into doubt, so do they rely on ideas about the public understanding of science. Public understanding of science has been assumed to conform to the monolithic logic and perception of science associated with rationalization, leading to an impoverished view of the cognitive outlook of the modern individual. Rationalization has become the basis for the construction of theoretical critique of science divorced from any clear reference to public understanding, with the result that theory has encountered considerable problems in accounting for public scepticism towards science. However, rather than question rationalization, the more typical strategy has been to propose radical changes in the modernization process, such as postmodernism and the risk society. Against this, an alternative view of public understanding is advanced drawn from SSK and rhetorical psychology. The existence of the sociological critique of science, and SSK in particular, suggests that the meaning of science in modernity is not monolithic but multiple, arising out of a central dilemma over the universal form of knowledge-claims and their necessarily particular, human and social grounding. This dilemma plays out not only in intellectual discourses about science, but also in the public's understanding of science. This argument is used to call for further sociological research into public understanding and to encourage sociologists to recognize the central importance of the topic to a proper understanding of modernity.

Humans↗
PubMed2003

How can sociological theory help our understanding of addictions?

Those who work in the addiction field usually use the pharmacological or medical model, psychological theories of behavior, or operate within the confines of a criminal justice perspective. Contributions from the field of sociology are limited to use of the methods of sociological investigations, primarily population surveys, which, typically, are used to identify groups at-risk for specific types of drug use. Surveys have identified illicit drug use as, predominantly, a problem of young males, whereas prescription drug use is predominantly a problem of middle-aged and older women in industrialized countries. Experts in addiction have accused sociologists who study addiction of being "atheoretical." Paradoxically, in the sociology field, the most highly cited article is Merton's theory of addiction. This article will examine the contributions of sociological theory to our understanding of addiction, including social definitions of "the problem of addiction" and mechanisms to account for individual drug use within a social context that defines it as problematic.

Adaptation, Psychological↗
PubMed1980

Cuckoo in the nest: some comments on the role of sociology in the undergraduate medical curriculum.

Despite the enormous strides that it has made over the past decade the position of sociology within the medical school remains precarious. Its problems are compounded by a failure to develop a coherent defence of its contribution to the education of doctors. In this paper three approaches to the teaching of sociology are identified: the human relations approach; the basic science approach; and the applied science approach. The limitations of each are discussed. It is argued that they offer a distorted version of sociology and represent competing approaches to medical education. It is further argued that sociology must curb its imperialistic tendencies, re-establish the connection between research and teaching, and through its approach both to teaching and the practice of medicine seek to provide a liberating influence in the undergraduate curriculum.

Curriculum↗
PubMed2000

[Poverty and HIV/AIDS: anthropological and sociological aspects].

Focusing on the HIV/AIDS epidemic as a summation of several epidemics coexisting in the same space and drawing on Brazilian epidemiological data, we argue that the epidemic there shows variations already described elsewhere, such as feminization, pauperization, juvenization and interiorization, as a result of the deep inequalities characteristic of Brazilian society. We then examine the contributions of three bodies of sociological and anthropological literature related to HIV/AIDS: 1) sociological research and theory on the impact of recent global economic restructuring and social transformation, and its relationship to public health issues; 2) the cross-cultural and cross-national anthropological and sociological literature on structural factors shaping the course of the epidemic in different settings; and 3) the body of anthropological and sociological research on the synergistic effects of HIV/AIDS, social exclusion, and related social problems in pockets of extreme poverty in the large cities of core countries. We conclude that prevention policies for HIV/AIDS should deal comprehensively with diverse dimensions that determine differential vulnerabilities to the epidemic, thus requiring substantial social transformations.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Bringing our bodies and ourselves back in: reflections on a past, present, and future "medical sociology".

This paper is a revision of an address given upon receipt of the Leo G. Reeder Award for Distinguished Scholarship in Medical Sociology. It was presented on August 14, 1990 to The Medical Sociology Section of the American Sociological Association during its annual meetings, held in Washington, DC. Herein I reflect on the structured silence of personal bodily experience and on the unfinished paradigmatic challenge of feminism as a way of leading to a new praxis in medical sociology.

Female↗
PubMed1989

Caregiving, ethical and informal: emerging challenges in the sociology of health and illness.

The concept of care, integral to medical sociology and to the sociology of health and illness, suggests new challenges in two key areas of this field: 1) within professional socialization, an examination of socialization to ethical thinking, behavior, and identity among professional caregivers, building on the substantial literature already accumulated; 2) in the arena of hidden or informal care providers, an analysis of male and female informal providers and the productive work, other than care, done by these individuals. In both analyses, as well as in all medical sociology and sociology of health and illness, gender, race, and class require more attention. Both analytic endeavors influence the substance and the contours of the field.

Ethics, Professional↗
PubMed1991

Industrial accidents are produced by social relations of work: a sociological theory of industrial accidents.

Industrial accidents are produced by social relations work. This sociological explanation of accidents differs from the hypotheses on which the majority of modern safety practices are based, which reduce accident causes to unsafe acts and unsafe conditions. Accidents are seen as produced at each of three levels of social relations of work (rewards, command and organisation), and also non-socially at the individual-member level. The resulting hypotheses were tested using data collected according to a semi-experimental design in seven plants in which shift (day/night), shift type (rotating/fixed), technological type and management styles were the factors controlled for. Because of the design, machines, materials and, in most cases, workers were the same across shifts and social relations varied. The sociological theory proved capable of explaining most of the variation in inter-shift differences in accident rates, and, when tested statistically, appeared to have greater explanatory power than competing hypotheses. It is concluded that accidents can be prevented by workers who exercise auto-control at all levels and by management which, in the absence of worker orientations favourable to auto-control, engages in safety management as defined sociologically. A practical consequence for ergonomics is that when plant, equipment and processes are to be modified, an attempt to understand their interaction with the social relations of work should be made. A theoretical consequence is that sociological insights should be incorporated into the perspective of the ergonomics discipline.

Journal Article↗
PubMed2003

Research into patients' perspectives: relevance and usefulness of phenomenological sociology.

BACKGROUND: The dominant epistemology underpinning much inquiry in the field of patient evaluation of health care is positivist, with categorization and quantification being high priorities, despite the highly personal and dynamic nature of people's responses to their health care experiences. The mis-match between underpinning theoretical assumptions and the nature of the subject under investigation has led to ineffectiveness in much current inquiry into patients' perspectives. More needs to be learnt about patients' processes of evaluation prior to any summary assessment of the quality of their care. AIMS: This paper documents the search for a close fit between a study's research questions and a theoretical perspective with which to underpin the research. It describes the benefits of identifying a specifically relevant perspective, in this case phenomenological sociology, and discusses the potential of that particular perspective to underpin research within health care. METHODS: Research questions relating to patients' processes of evaluation were established. The possible contribution of a range of interpretative methodologies was considered. While all were relevant to some degree, phenomenological sociology was identified as having considerable specific potential to illuminate the patient's process of evaluation. FINDINGS: The particular strengths of phenomenological sociology relevant to the investigation of patients' processes of reflection are in highlighting the importance of subjectivity; its insistence on a clear link from theoretical development right back to the raw data; its wealth of evocative ideas and concepts that support the investigation of the development of interpretation; and the relatively accessible language and style of its texts. CONCLUSION: Time spent evaluating the potential contribution of different theoretical perspectives to a study is worthwhile, as a good choice can not only support but also enhance the quality of the research. Phenomenological sociology has much potential to underpin research into patient evaluation of health care and in nursing research more widely.

Attitude to Health↗
PubMed1979

Sociologic influences on decision-making by clinicians.

Recent articles on clinical decision-making have proposed sophisticated quantitative methods for improving the physician's clinical judgment. Actual clinical decisions, however, are influenced by interactions between the clinician, the patient, and the sociocultural milieu as well as by biomedical considerations. This paper explores these sociologic influences on the decision-making process. Four types of sociologic factors influence the clinician's judgment: the characteristics of the patient; the characteristics of the clinician; the clinician's interaction with his profession and the health care system; and the clinician's relationship with the patient. To illustrate sociologic influences on clinical decision-making, this paper presents observations from the literature of sociology, clinical psychology, psychiatry, and medicine. Further studies are needed to provide additional empirical information.

Attitude of Health Personnel↗