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Barriers: The discursive problematization and transformation of HIV-prevention service provision in England (2016-2020). 障碍：英格兰艾滋病预防服务提供的话语问题化和转型（2016-2020）。
IF 1.4 4区 社会学 Q4 SOCIAL SCIENCES, BIOMEDICAL
Social Theory & Health
Pub Date : 2025-12-11 eCollection Date: 2025-12-01 DOI: 10.1057/s41285-025-00246-5
Adam Christianson

While the statement "patients face barriers" is prevalent in healthcare-related literature, barrier is seldom conceptualized. While reviews of the concept suggest the term is conceptually and methodologically weak, its utility is more nuanced. This article contributes to an emerging critical health literature conceptualizing barriers by outlining their discursive effects in healthcare discourses on HIV-PrEP in England between 2017 and 2020. A Situational Analysis of the alliances and positions taken by English stakeholders in debates over PrEP illustrates how designating something as a barrier facilitates a power struggle about how healthcare is provided and used. In addition to imparting significance on a problem to patient's uptake and use of a healthcare intervention, barriers align the patient's problems with groups of experts. Once integrated into an expert discourse, barriers facilitate the transformation of healthcare services by objectifying the values, preferences and abilities of a patient community and aligning them with their shared political and governmental aims. Barriers, therefore, play an indispensable and strategic role in evidence-based activism and in the broader domains of biological and sexual citizenship with implications for policy and systems management.

虽然“患者面临障碍”这一说法在医疗保健相关文献中很普遍，但障碍很少被概念化。虽然对这个概念的回顾表明，这个术语在概念上和方法上都很薄弱，但它的用途却更加微妙。本文通过概述2017年至2020年期间英格兰HIV-PrEP医疗保健话语中的话语影响，为新兴的关键健康文献概念化障碍做出了贡献。对英国利益相关者在PrEP辩论中所采取的联盟和立场的情景分析说明了将某些东西指定为障碍如何促进关于如何提供和使用医疗保健的权力斗争。除了对患者接受和使用医疗保健干预的问题赋予重要性之外，障碍还将患者的问题与专家小组联系起来。障碍一旦被纳入专家论述，就会使患者群体的价值观、偏好和能力客观化，并使其与共同的政治和政府目标保持一致，从而促进医疗保健服务的转变。因此，障碍在循证行动主义和更广泛的生物和性别公民领域发挥着不可或缺的战略作用，对政策和系统管理产生影响。
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引用次数: 0
Populism, moral foundations, and vaccine hesitancy during COVID-19 COVID-19 期间的民粹主义、道德基础和疫苗犹豫不决
IF 1.6 4区 社会学 Q4 SOCIAL SCIENCES, BIOMEDICAL
Social Theory & Health
Pub Date : 2024-01-12 DOI: 10.1057/s41285-023-00201-2
Jeremiah Morelock, Andressa Oliveira, Hoang Minh Uyen Ly, Crystal Lee Ward
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引用次数: 0
Habits and the socioeconomic patterning of health-related behaviour: a pragmatist perspective 习惯和健康相关行为的社会经济模式:实用主义视角
4区 社会学 Q4 SOCIAL SCIENCES, BIOMEDICAL
Social Theory & Health
Pub Date : 2023-11-02 DOI: 10.1057/s41285-023-00198-8
Anu Katainen, Antti Gronow
Abstract Unhealthy behaviours are more prevalent in lower than in higher socioeconomic groups. Sociological attempts to explain the socioeconomic patterning of health-related behaviour typically draw on practice theories, as well as on the concept of lifestyles. When accounting for “sticky” habits and social structures, studies often ignore individuals’ capacity for reflection. The opposite is also true: research on individual-level factors has difficulty with the social determinants of behaviour. We argue that the pragmatist concept of habit is not only a precursor to practice theories but also offers a dynamic and action-oriented understanding of the mechanisms that “recruit” individuals to health-related practices. In pragmatism, habits are not merely repetitive behaviours, but creative solutions to problems confronted in everyday life and reflect individuals’ relationships to the material and social world around them. Ideally, the pragmatist conception of habits lays the theoretical ground for efficient prevention of and effective support for behaviour change.
不健康行为在低社会经济群体中比在高社会经济群体中更为普遍。社会学试图解释与健康有关的行为的社会经济模式，通常利用实践理论和生活方式的概念。在考虑“粘性”习惯和社会结构时，研究往往忽略了个人的反思能力。反之亦然:对个人层面因素的研究很难涉及行为的社会决定因素。我们认为，习惯的实用主义概念不仅是实践理论的先驱，而且还提供了对“招募”个人进行健康相关实践的机制的动态和行动导向的理解。在实用主义中，习惯不仅仅是重复的行为，而是对日常生活中遇到的问题的创造性解决方案，反映了个人与周围物质和社会世界的关系。理想情况下，习惯的实用主义概念为有效预防和有效支持行为改变奠定了理论基础。
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引用次数: 0
Inequity in palliative care: class and active ageing when dying 姑息治疗中的不平等:死亡时的阶级和积极老龄化
4区 社会学 Q4 SOCIAL SCIENCES, BIOMEDICAL
Social Theory & Health
Pub Date : 2023-09-28 DOI: 10.1057/s41285-023-00196-w
Iben Charlotte Aamann, Betina Dybbroe
Abstract The purpose of this article is to explore social inequity in palliative care in Denmark, a country that is seen as a stronghold of universal health care. Using data stemming from 2 years of research, we have selected two cases for analysis. They consist of palliative conversations with two quite different patients. Drawing on sociocultural class theory, we find that the conversations involve social exclusion processes due to discourses of active ageing. We find that one privileged patient performs in line with an entrepreneurial self and is supported by the nurse. The other, disadvantaged patient performs in a passive way, and the conversation mainly alleviates the disrespect he has experienced in healthcare encounters. We conclude that palliative care reinforces classifying practices and distinctions between “good” and “bad” patients, when active ageing becomes a dominant factor. We suggest improving the quality and sensitivity of medical training and call for increased reflexivity among professionals on the unequal situation of patients in order to reduce inequity in access to health care when close to death.
摘要本文的目的是探讨社会不平等的姑息治疗在丹麦，一个国家被视为全民医疗保健的据点。利用2年的研究数据，我们选择了两个案例进行分析。它们包括与两个完全不同的病人的缓和对话。根据社会文化阶级理论，我们发现由于积极老龄化的话语，对话涉及社会排斥过程。我们发现一个特权病人的表现符合企业家的自我并得到护士的支持。另一方面，弱势患者表现得很被动，谈话主要是为了减轻他在医疗保健遭遇中所经历的不尊重。我们的结论是，当积极老龄化成为主导因素时，姑息治疗加强了分类实践和“好”和“坏”患者之间的区别。我们建议提高医疗培训的质量和敏感性，并呼吁专业人员加强对患者不平等状况的反思，以减少在接近死亡时获得医疗保健方面的不平等。
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引用次数: 0
Correction to: Postcolonial riskscapes: risk, trust, and the community-based response to Ebola virus disease in Liberia 修正:后殖民风险状况:利比里亚埃博拉病毒病的风险、信任和社区应对
4区 社会学 Q4 SOCIAL SCIENCES, BIOMEDICAL
Social Theory & Health
Pub Date : 2023-09-12 DOI: 10.1057/s41285-023-00197-9
Jarrett Rose, S. Harris Ali, Kathryn Wells, Mosoka Fallah
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引用次数: 0
Negotiating body and power in forensic mental health care 法庭精神卫生保健中的谈判主体和权力
IF 1.6 4区 社会学 Q4 SOCIAL SCIENCES, BIOMEDICAL
Social Theory & Health
Pub Date : 2023-03-30 DOI: 10.1057/s41285-023-00193-z
Virve Repo, Päivi Kymäläinen
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引用次数: 0
Contextualizing race and sex-related health disparities: doing difference and sexual risk behaviors 将种族和性别相关的健康差异情境化：行为差异和性风险行为
IF 1.6 4区 社会学 Q4 SOCIAL SCIENCES, BIOMEDICAL
Social Theory & Health
Pub Date : 2022-11-09 DOI: 10.1057/s41285-022-00189-1
J. Wade
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引用次数: 0
Professionalization of Chinese medicine practice in Canada: from medical pluralism to neo-orientalism 加拿大中医执业专业化:从医学多元主义到新东方主义
IF 1.6 4区 社会学 Q4 SOCIAL SCIENCES, BIOMEDICAL
Social Theory & Health
Pub Date : 2022-11-09 DOI: 10.1057/s41285-022-00191-7
M. Islam
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引用次数: 0
Street-level bureaucrat's coping strategies in health policy implementation: a comparative case study from Sawla-Tuna-Kalba district of Ghana 基层官员在卫生政策实施中的应对策略:来自加纳Sawla-Tuna-Kalba区的比较案例研究
IF 1.6 4区 社会学 Q4 SOCIAL SCIENCES, BIOMEDICAL
Social Theory & Health
Pub Date : 2022-11-04 DOI: 10.1057/s41285-022-00190-8
Daniel Dramani Kipo-Sunyehzi
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引用次数: 0
UK public opinion on reasons to oppose healthcare privatisation: a failure of neoliberal persuasion and discursive politicisation 英国公众对反对医疗私有化理由的看法:新自由主义说服和话语政治化的失败
IF 1.6 4区 社会学 Q4 SOCIAL SCIENCES, BIOMEDICAL
Social Theory & Health
Pub Date : 2022-08-29 DOI: 10.1057/s41285-022-00185-5
Jane. Thomas, Sean Tunney
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引用次数: 0
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