MEDICAL SOCIOLOGY

Sociology and Anthropology Sociology is the study of social behavior or society, including its origins, development, organization, networks, and institutions. It is a social science that uses various methods of empirical investigation and critical analysis to develop a body of knowledge about social order, disorder, and change.

Anthropology Anthropology is the study of humans, past and present. To understand the full sweep and complexity of cultures across all of human history, anthropology draws and builds upon knowledge from the social and biological sciences as well as the humanities and physical sciences.

Introduction Medical sociology is the sociological analysis of medical organizations and institutions; the production of knowledge and selection of methods, the actions and interactions of healthcare professionals, and the social or cultural (rather than clinical or bodily) effects of medical practice.

Health World health organization (WHO) defines health as a state of complete physical, mental and social as well being and not the mere absence of disease.

Who is Normal and Healthy???

(1) Culture Man-made part of environment. Culture is always a dynamic process and therefore, continues to evolve but never with the same pace as scientific, economic or technological progress.

Strategies Physicians cannot solve the person’s problems on their behalf but they can help them solve their problems. Easiest response to transcultural conflict is to behave as if they do not exist, and are not a barrier in the doctor patient relationship. Every individual is expected to behave according to unwritten ethnic customs and traditions and the diversity of behavior should be acceptable and can be created for in out operations, wards, waiting area and therapeutic interaction.

IV. One can make mistakes in transcultural interactions but should not readily accept and acknowledge them and learn from them to never repeat them.

(2) Beliefs, values and Norms They tend to evolve and change but hardly ever completely transform in single lifetime. Beliefs: are tenets with a shared meaning in culture that are held to be true. Example: In most Islamic cultures, the benevolent role of God in the healing process in an established belief.

“Only Allah granted health”

Values: These aspects of a culture are held in high regard, are desirable and therefore worthy of emulation. Example: A doctor is never commercial and business like in his dealing with patients.

Norms: refers the principles of right and wrong actions and rules and laws that govern the acceptable and unacceptable behavior. Example: Intake of alcohol, cannabis and heroine, are considered against norms.

(3) Social Culture These can be based on wealth, education, inheritance or other criteria. Social grading may often have direct relevance of health care provision, interpersonal communication, outlook of life knowledge.

(4) Roles Roles are made up of a set of expectations about how people should behave in certain circumstances. Example: doctor’s role is often taken to be one of being scientific, impartial, knowledge, courteous and friendly.

Patient’s role involves being excused from various obligations, not being blamed for being ill, a commitment to wanting to get well and to following medical advice.

Role conflict Conflict between the demands being both a doctor with a busy clinic and a father with family demands, may result in substantial psychological stress.

(5) The Family Illness does not exist in socially neutral environment. It is identified that the family as an important and integral partner in the assessment and the therapeutic process. “Call the shots”

(6) Child Reading Practices By a combination of reward and punishment and by providing model behavior which the child can emulate, parents and families shape the behavior and lifestyle of their children.

Effective Child Reading Tailoring the demands to intellectual stage of development of child and providing clear and consistent reassurance and reward. Some Children seems to be “difficult” from the very start. Such a child is characterized by negative reaction to events and objects, magnified emotions, slow adaptability to new situations and irregular biological functioning.

(7) Death and Dying Thanatology The fact is deliberately blocked from the conscious awareness, depression and anger towards family, friends and health care workers are also common reactions and demand patience, tolerance and understanding from care givers. Will of God.

(8) Health Belief Models (HBM) and Explanatory Models of Illness Prevention of illness and promotion of health depend in large part upon an individual’s attitude towards help seeking and the value of health. HMB factors includes: Interest and concern with health matters Beliefs about susceptibility to illness Ideas about illness severity

The benefits and costs of carrying out certain actions and beliefs about how well those actions will work.

Spiritual illness Nazar or evil eye Peer or Clergyman

Questions can be asked to access the Patient’s explanatory model of illness: What do you call your problem? What name does it have? What do you think has caused your problem? How do you think it started and what course do you think it will take?

What type of treatment do you think you should receive? What do you think can the illness do to you and those around you?

(9) Social Support Family, friends, work colleagues and other people. Support may also enhance adherence to health advice and rehabilitation.

(10) Role of religion Religion can be considered as collection of beliefs. Spirituality Religion practices Positive influence of faith

Treatment Adherence (Compliance) Failure to follow health related advice is widespread. Failure to adhere to advice is related to patient’s age, illness chronicity, communication and various cognitive factors.

Adhering to treatment Indifference and lack of involvement Appearance of unquestioning obedience Depressed patients Lack of response or inconsistent response of treatment Confusing clinical picture

Essential elements Accurate communication of information between patients and doctor. Emotional support and understanding of patient. Awareness of patient’s health belief models. Help in choosing an acceptable course of action to which a commitment can be made.

Focus on the overall quality of life of the patient. Development of a specific plan to implement the regimen. Recognition of the patient’s depression and hopelessness.

Parameters of psychosocial health & normalcy Dynamism: This term describes the different roles and functions of human being and their changing and evolving nature. Example: Student