Social science & medicine. Part B, Medical anthropology最新文献

A study of 89 young adults who suffered a severe burn injury in childhood was undertaken to assess their psychosocial adjustment to this devastating injury which usually results in visible scarring. The sample consisted of 41 males and 48 females ages 16–28 who were 4–23 years post-burn, with a mean body surface burn of 27% (2–89%). Results indicate that most of these subjects had made a positive adjustment to their injury, as measured by three categories of adjustment: (1) social integration, (2) emotional adjustment and (3) self-esteem. From the analysis of social integration, it was found that the subject population did not differ substantially from the general population in terms of marital status, education, occupation or participation in community and leisure time activities. Analysis of emotional adjustment indicated that the subjects who were able to accept themselves and put their experience in perspective with their worldview had made a positive emotional adjustment. Self-esteem scores were comparable to established norms and were not statistically related to sex, age at date of the burn injury, total body surface area burned, body areas burned or the time since the burn injury. Only present age showed a statistically significant relationship to self-esteem, the meaning of which is questionable. This study concludes that victims of severe burns can and do make a positive adjustment to their injury and that the resulting outcome is not influenced by physical variables relating to the severity of the burn or variables relating to age and sex. Further research will investigate aspects of the burn victim's social support system and individual coping ability in relation to adjustment to severe burns.

Hospital data from the Navajo Reservation indicate that utilization has been responsive to changes in the health care system, Navajo social organization, and disease patterns. Distance of a community from the nearest hospital is the best predictor of hospitalization rates in the community but involvement in the wage economy and household size also enter significantly into the regression. Age of patients is also significantly related to distance as well as to age of the population and to dependence upon welfare. The rate of cholecystectomies in a community is best explained by distance from the nearest hospital offering surgery. This is in contrast to rates of appendectomies and hysterectomies, which appear to be most significantly related to measures of acculturation to the dominant society.

This paper describes a specific process relating to destigmatization and social identity which is a chief dynamic operative in a self-help group for dwarfs, Little People of America. In our society persons of abnormal short stature typically experience varied forms of stigmatized and stigmatizing social interactions within the average sized world. Data are presented here from a recent study of dwarfs and their families which examined a variety of dimensions of the dwarfism experience and the impact of self-help group membership on social identity and life style. It is suggested that a cognitive restructuring of self-image occurs through the process of forced objective perception of others who share a similar physical condition. This acceptance of self-identity and the physical identification of dwarfism then allows the person to lead his/her life more happily and effectively.

This paper presents some preliminary results of a more extensive study on traditional childbearing behavior in rural Korea and its relation to modern maternity and obstetrical care. It is the result of team work between an obstetrician, a medical sociologist and public health specialists. The geographic area of study was Kangwha District, Kyunggi Province, where C. Osgood did his anthropological study on “The Koreans and their Culture” in 1945 [1]. The study was motivated by the observation from literature, that in spite of economic progress, modernisation, and increased availability of care. the utilisation of modern obstetrical and maternity care in rural Korea had increased only little between 1969 and 1978. The findings from literature were supported by results in the maternity care component of the Yonsei University Kangwha Community Health Project. Aquisition of TV had risen faster than the utilisation of trained attendants at birth within the project area. To upraise the behavioral background for these findings a childbearing behavior study was done on 30 rural families with a pregnant woman throughout pregnancy, childbirth and post partum period. Traditional behavior and interactions with modern health services were documented. Information was obtained by open taped interviews with relevant persons in families, neighborhood and health services and by participant observation. The study was structured by a working paper with items for investigation obtained at first from literature and observation on traditional childbearing behavior. This was continually updated with new relevant information from the study. It became possible to identify a “traditional birthing system”. Some relevant aspects of this “traditional Korean birthing system” are presented in this paper: (1) traditional concepts about the physiology of childbearing; (2) course of pregnancy in the rural family; (3) observations on delivery; and (4) post partum concerns in the family.

Anthropologists only recently have turned their attention to stigmatized populations in American society. The papers in this collection address varied issues of stigma and health: life career experiences of those with varied stigmatized illnesses; issues of identity, perception, and cognition related to specific health conditions; modes of coping with stigma—personal and group adaptive strategies, and positive functions of such adaptive strategies. The studies draw from a diverse range of field populations: diabetics, the deaf elderly, dwarfs, and severely scarred former burn patients. These papers originally were presented in a symposium entitled The Anthropology of Stigma organized and chaired by Joan Ablon at the annual meeting of the American Anthropological Association, Los Angeles, November 14–18, 1978.