Health Sociology Review最新文献

Benzodiazepines are a class of drug extensively used in palliative care. Their use has predominantly been studied within a biomedical framework. Our study instead focused on the sociocultural aspects of benzodiazepine practices. We aimed to explore clinicians, patients and family members' values, beliefs, knowledge and feelings regarding use of benzodiazepines, including in-situ clinical decision-making processes, affects and actions. Social theory understandings of affect, the body and of suffering provided the theoretical lens through which data were analysed. Analysis generated the following themes: (1) A special specialty; (2) The suffering body and the moral imperative to 'settle; (3) The liminal body - living and dying; and (4) Organizational realities. Use of benzodiazepines were largely governed by social and moral norms, cultural expectations and organizational realities as part of affective assemblages of care.

People living with life-limiting illnesses often talk about their ideal experience of 'care' as one where the care itself is hidden. Situated in the sociological literature on places and materialities of palliative care, in this paper I examine the hiding of care in a small, non-clinical respite house in an Australian city. Care is hidden by the at-homeness that staff, guests and volunteers alike all do. Working with Oldenburg's notion of 'third places,' I show how in this illness context the separation between home, work and other places in the community can blur, with respite services 'standing in' for the family home, or acting as a 'homely' extension of the hospital. Such places meet diverse needs beyond pure sociability as in Oldenburg's original conceptualisation.

ABSTRACTComfort is a central aspect of palliative care, encompassing the management of pain and symptoms, as well as how people feel and experience care. Comfort has been argued to be especially tenuous or transient in palliative care, as a constantly shifting set of bodily sensations and relations are anticipated and cared for. In this article, drawing on in-depth interviews and photo elicitation, we explore the accounts of patients, family carers, staff and volunteers from a palliative care service in Australia, to understand how care is configured and facilitated through everyday gestures of comfort. We unpack how comfort (and comforting) is understood, sought, and done, to reveal how it is experienced as a set of social, relational, processual, and dynamic relations between bodies and environments. Our findings reveal how comfort for those nearing the end of life and those who care for them is brought about variously in the familiarity and reliability of things and surroundings, as well as through gestures of intimacy, recognition, and flexibility. We find that while predominantly considered as intentional and momentary, comfort has lasting effects. These lingering affective resonances, we argue, are key to recognising the diversity of what matters to people in palliative care.

Multidisciplinary team meetings are part of the everyday working life of palliative care staff. Based on ethnographic material from community and hospital palliative care teams in England, this article examines these meetings as dynamic routines. Although intended to have a prescribed format to review deaths and collect standardised information to monitor service performance, in practice, the content and conduct of the meetings were fluid, reflecting how this structure did not always match the concerns held by the team. The meetings provided a means for the team to collectively enact and weigh up different values through distributing the care and responsibility for individual patients across the team; jointly 'feeling their way' to determine what care should be offered and in what form; and by caring for their own professional wellbeing in the context of metric-driven healthcare. We observed how staff experienced tensions in 'documenting care' because of a concern that this misrepresented what they felt were core aspects of their role. Whilst team meetings may be considered a formal, routine part of teamwork and care, we interpret them as a dynamic social practice during which palliative care teams continually question 'what really matters' and (re)make what palliative care practice should entail.

This article delves into the underexplored relationship between lay expertise and temporality by analysing semi-structured interviews with parents who treat their autistic children using complementary and alternative medicine (CAM). The analysis indicates that time and temporalities play a significant role in how parents construct and enact their expertise. Faced with uncertainty, urgency, and inadequate support from medical and educational systems, parents assumed crucial responsibilities in managing their children's therapies. Over time, they acquired knowledge and skills, ultimately claiming expertise in caring for their children, making therapy decisions and administering treatments. Parents engaged in complex time work as they attempted to orchestrate everyday, developmental, therapeutic, and social rhythms, alternating their focus between future and present. They endeavoured to synchronise their children's rhythms with those of peers by using CAM therapies not yet adopted into conventional medicine, which they perceived as slow and outdated. This study contributes novel insights into autism care, temporalities of care, and the under-examined nexus between lay expertise and temporality.

While many sociologists have conceptualised medical and experiential modes of knowing health and illness, less attention has been given to the concept of empathetic knowledge. That is, knowledge derived from close association with others living with a particular condition. This article investigates empathetic modes of knowing among families marked by illness, drawing on 52 h of video recordings of support group sessions for children of parents with mental illness in Denmark and interviews with 11 participating children. Inspired by the sociology of empathy, the analysis shows that empathetic knowledge involves knowing illness from the outside (through observations of the ill person's body) and from the inside (through the affective impressions left on the next of kin's own body). This empathetic knowledge is relational, bodily and affective, and, together with other ways of knowing, it shapes everyday lives and projects imagined futures. The article demonstrates that the concept of empathetic knowledge can advance our sociological understandings of next of kin.

In this paper, we explore negotiations around sexuality and gender diverse identities together with sexual practices, and the materialities of bodies, as they relate to the sampling and recruitment of LGBTQ+ participants in health social science research. The basis of our research note is a reflection on our experiences of undertaking a study on the social dimensions of antimicrobial resistance (AMR) in the context of sexually transmitted infections (STIs). We aimed to identify tensions and important considerations in the sampling and recruitment of LGBTQ+ populations in health and social science research. Recognising the fluidity and diversity of gender and sexuality, the multiple meanings attached to them, and the proliferation of gender and sexuality identifiers, we argue for the critical importance of reflexivity in curating a sampling frame, which is respectful of LGBTQ+ diversity. This contributes to the growing body of work that reflects on how to develop meaningful and informed approaches to do research with LGBTQ+ populations. We do this by complicating the often-linear presentation of sampling and recruitment processes within scholarly research.

This study explored how people who use drugs (PWUD) experience and respond to stigma in biomedical chronic non-cancer pain management. Thematic analysis of in-depth interviews with PWUD (n = 26) who had sought care for chronic non-cancer pain in public hospitals in Uyo, Nigeria, drew on the idea of stigma as process of social reproduction and the concept of borderwork. Accounts framed stigma as a normalised feature of healthcare that emerged under different circumstances and operated to position chronic non-cancer pain patients who were PWUD as illegitimate subjects underserving of care. Stigma was widely seen as something to be expected, and was often tolerated by PWUD due to its ubiquity. However, they enacted borderwork marking-off stigma experiences that violated values of fairness and humaneness as well as those that spurned traditional gender norms. Participants responded to intolerable stigma through various acts of resistance, including dropping out of care. Stigma creates barriers to adequate pain management and establishes a context where basic care is accessed at the cost of fundamental human rights and dignity. Routine toleration of stigma helps to naturalise the phenomenon and render it invisible. Resistance to stigma provides a basis for interventions to address all forms of stigma in healthcare.

The consumption of performance and image-enhancing drugs (PIEDs) is commonly pathologised in public health discourse as stemming from an unhealthy relationship to masculinity, and is often framed as intrinsically 'risky' and fundamentally at odds with 'good health'. This article examines Australian health promotion materials on PIEDs to analyse their role in shaping notions of good health, normal gender and appropriate self-improvement. To do so, it draws on the work of Butler, Law and Latour to consider how these materials co-constitute men and their health, often in problematic ways. First, we examine the ways in which PIEDs are constituted via a politics of the 'natural', then consider how the health promotion materials on PIEDs participate in the regulation of appropriate, healthy masculinity, and conclude by examining how adolescent masculinity is co-constituted with PIEDs. We observe a key tension between health promotion's avowed interest in improvement and optimisation and its treatment of PIED consumers as aberrant, vulnerable and insecure subjects whose drive to enhance and optimise is characterised by pathology and addiction. We conclude by arguing that health promotion materials on PIEDs fail to acknowledge the exceedingly normative character of enhancement practices in contemporary society.