Sociology of health & illness最新文献

The proportion of midlife Australian women (45-64 years) whose alcohol consumption is defined as 'long-term risky drinking' increased between 2001 and 2019, with serious health, economic and social impacts. Although overall population consumption trends towards a decline, consumption for this population remains stable, suggesting that current alcohol reduction policies and strategies are ineffective for this population. In this paper, we employ sociological theory on hope to argue for developing alcohol policies that are structured to enable women's hopes for a future that includes alcohol reduction. Drawing on humanistic and positive sociology that is concerned with future-focused enquiries, we undertook semi-structured interviews with 26 midlife women, exploring 'if' they could reduce their drinking, then what hopes might be enabled through alcohol reduction. Women talked about imagined alcohol-reduced futures as enabling hopes for control, responsibility, stability and health in their lives, to support them to care for others and be 'normal'. Quixotic hopes around excitement, freedom and having a 'good life' were expressed to a lesser extent than expected. Our study and findings are analysed in relation to sociological and (post-structural) feminist theories of oppression and political transformation, with implications for alcohol policy scaffolded by engagement with Freire's pedagogy of hope.

Media representations often imply that dementia is preventable through lifestyle choices, potentially blaming individuals for their condition. Crawford's ideology of healthism outlines this form of responsibilisation. Our thematic discourse analysis of focus group discussions demonstrates how different stakeholder groups interpret print media messages differently, with prevention messaging that promotes health behaviours among the general population, simultaneously felt as stigmatising those already affected by dementia. Participant discussions almost exclusively focused on individual-level risk factors (e.g., diet and genetics) rather than population-level modifiable risks (e.g., air pollution and education), reflecting current print media and policy framings. It is worth noting that while participants saw their own/their loved one's dementia as unpreventable, they viewed other cases, especially vascular dementia, as preventable through health choices. Our analysis shows how healthist ideals especially stigmatise specific dementia diagnoses, highlighting where healthist messaging may be particularly harmful. We recommend that media outlets and policymakers emphasise population-level interventions alongside individual actions, and avoid language implying personal responsibility for developing dementia. Our analysis demonstrates how Crawford's healthism is relevant for understanding media representations of dementia, as well as highlighting some much-needed changes.

'Postfeminist healthism' offers an essential framework for understanding how healthism is gendered. In this article, we describe and advance the concept of postfeminist sensibility and its synergistic alignments with healthism. We then consider how postfeminist healthism operates as a subjectifying force for the millions of girls, women, and other feminine-identified people globally-even when it harms their mental or physical health. We use menstrual tracking apps (MTAs) as an indicative example to both demonstrate how a postfeminist healthism acts at the intersections of bodies, subjectivity, and health, and to show the value of a postfeminist healthism in understanding MTAs. Overall, we show the importance of understanding the distinct ways in which healthism is gendered through postfeminism.

Healthcare research globally has seen a renewed shift to increase diversity in research participation. People previously excluded from the production of biomedical knowledge, and often labelled 'underserved', are now a focus of attention. In this paper we discuss an in-depth interview study in South London which aimed to better understand how the very public era of COVID-19 research has affected people's trust, opinions and relationships with health research, focusing on hearing from those with intersectional experiences of inequality and injustice. We suggest that 'underserved', much like 'diversity', obscures historically rooted injustice with narratives of what Chandra Talpade Mohanty calls 'benign variation' and assumptions that health research has always worked in service to others. Rather, we draw on the work of Sara Ahmed to ensure we take participants' concerns, scepticisms or complaints about research seriously. Drawing on participants' narratives of health injustice, we document how participants embody critical dispositions, which demand more complex understandings of health research that incorporate doubts, nuance and multiple sources. Such accounts render into stark relief the underlying power relations in attempts to simplify research participation narratives. This study demonstrates research institutions need to engage in more complex dialogue with communities in order to be worthy of trust.

An expanded view of agency as nuanced and embodied can help us recognise the agency of people with dementia as citizens in everyday life. Places such as gardens, with their sensory and material appeal, have potential to support this but how people with dementia experience gardens is not well understood. This study aimed to explore how people with dementia experience nuanced agency and citizenship in their domestic home gardens, and to identify enabling practices. The research involved conducting walking-with-video interviews with six participants in their gardens and producing narrative videos. A conceptual framework of agency was applied in analysis of visual and spoken data to explore participants' experiences of agency. Participants experienced nuanced forms of agency in their home gardens as they engaged seamlessly with the sensory aspects of their garden and mindfully with the cycle of life. Social connectedness was limited for some participants, who experienced citizenship in other ways, as embodied or envisioned. This research identified the potential for participants to experience new forms of citizenship and discourse. Further research to explore nuanced agency and citizenship in people with dementia over time and in other garden settings is recommended.

This article investigates how older citizens perceive and utilise digital health technologies as part of their everyday health management, health-related risk monitoring and illness prevention. This study draws on empirical data collected as part of the HAIDI research project and include interviews and media go-alongs with 71 individuals aged 75-100 years living in Sweden, Finland and Denmark. Interviews were conducted in 2023, and the transcribed data were analysed using a mix of inductive and deductive approaches. Four overarching themes emerging from the data are explored in the context of late life, reflecting the complexities and nuances of health maintenance and practices in a landscape increasingly shaped by digital health: aiming for self-responsibilisation, utilising digital health technologies for health/risk management, challenging promises of digital health and negotiating health expertise. In this study, the accomplishment of digital health citizenship in late life appeared selective and fluctuating but often also relational, which challenges the existing individualist theorisations of digital health citizenship. This study produces new knowledge on how the oldest citizens navigate the digital health landscape and critically examines the evolving concept of digital health citizenship in the context of ageing, late life and healthcare.

Stroke is a leading cause of complex disability, with many survivors experiencing mobility, cognitive and/or speech and language impairment. This paper explores the relationship between biographical disruption and body studies through experiences of informal care in stroke. Drawing on narratives from 41 interviews with stroke survivors and their wider support network, we use Michael Bury's concept of 'biographical disruption' alongside body studies theorists to construct a framework to understand the role of embodiment within biographical disruption. We draw on Victoria Cluley and colleagues' concept of 'biographical dialectics' to reveal, through our data, an 'embodied dialectics', where past and present embodied experiences of chronic illness exist in a productive tension. We identify three distinct but interlinking aspects: (i) contradictions between past, present and future embodied understandings are generative, leading individuals to produce new forms of embodied knowledge; (ii) tensions create motion, ensuring ongoing dialectical processes that generate creative adaptations and conversations in relation to informal care and embodied practices post-stroke and (iii) these processes are ongoing as the competing demands of autonomy and dependence continue to generate new challenges. In doing so, we highlight the roles of socio-cultural practices and expectations in shaping individual and collective embodied understandings of illness and subsequent disruption.

This article explores the practices of person-centred care in physiotherapy by adopting a complexity-seeking approach. We acknowledge that person-centred care is contextual and produced through relationships, sociomaterial practices and institutional and organisational settings, thus recognising the agency of more-than-human actors. We draw on the concept of practicings, which refers to a constellation of what is said, materialised, routinised and practised. This framework enables us to explore the complex interplay and interrelatedness of factors that constitute person-centred care across various contexts, transcending micro and macro levels. By conducting a secondary analysis of texts from three qualitative studies from Denmark and Aotearoa New Zealand on person-centred care in physiotherapy, we argue that seemingly disciplinary and governing practices can also be understood as practices of person-centred care. Through the application of the practicings concept, we aim to advance sociological constructs of person-centred care. Focusing on the complex network of co-constituting forces allows for a more nuanced analysis of practices of person-centredness in physiotherapy, with applicability to other similar healthcare settings.

In 2020, there were reports that HIV antiretrovirals, specifically the combination tenofovir disoproxil fumarate and emtricitabine (TDF/FTC), had therapeutic potential for COVID-19. In the context of scant empirical evidence at the time to confirm such an effect, we sought to understand the ways that gay and bisexual men (GBM) made sense of-and embodied-information about HIV antiretrovirals in relation to preventing and/or treating COVID-19. We conducted interviews with 26 participants between August and November 2020. To understand how information about, and experiences of, consuming antiretrovirals might form part of assemblages of COVID-19 prevention for GBM in Australia, we draw on Marsha Rosengarten's (2009) concept of 'informed matter'. 'Informed matter' conceptualises the subject (of disease prevention) as involved in a co-constitutive relationship with the contextual dynamics in which it is situated. Participants drew on their understandings of virology, immunology and pharmaceuticals and experiences with antiretrovirals to form perceptions about their function as therapeutics for COVID-19. By looking beyond biotechnologies as causal of behaviour, we can avoid unintended moralism in contexts of potentially different use. We argue that using 'informed matter' is useful to interrogate, often neglected, complex changes in sex-associated biotechnologies in complicated informational contexts, such as a global pandemic.

Antenatal care consultations provide a critical opportunity to enquire about experiences of violence, yet midwives often face structural and practical barriers. Although several countries have implemented guidelines recommending routine enquiry, limited research has examined how midwives introduce this sensitive topic during consultations. This study uses conversation analysis (CA) to examine how midwives introduce questions about violence in 35 antenatal care consultations recorded in Norway, where the topic was raised in 21 cases. In all but one instance, midwives engaged in some form of interactional preparation before asking the question. Our findings identify two main approaches for introducing the topic: a task-oriented approach and a conversational approach. The task-oriented approach is characterised by its routine framing of the enquiry, accomplished through procedural pre-sequences and explicit references to institutional mandates. In contrast, the conversational approach is characterised by a gradual, sequential progression into the topic, achieved through the incorporation of related proxy topics or by responding to troubles-talk. Although each approach has distinct advantages and limitations, our analysis reveals that midwives address enquiries about violence with profound interactional sensitivity. These findings demonstrate how preparatory work functions as an interactional display of delicacy in managing sensitive topics, with implications for training and policy.