Sociology of health & illness
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Concepts of biographical disruption and repair have been widely applied to chronic illness, but not terminal illness. This paper examines the relevance of these concepts to motor neurone disease (MND), a progressive neurological condition characterised by loss of mobility, speech and ability to breathe or swallow. Survival is usually between two and five years, and some die within a few months. ⋯ Narrative interviews were conducted with 35 people living with MND and 11 family carers; analysis explored how people constructed their accounts as well as what they said. As well as accounts of biographical disruption, we identified a distinctive sense that the diagnosis is a 'death sentence' and life is already over, which we term 'biographical abruption'. We also found instances of biographical repair, as participants sought to make sense of their remaining life, restore normality and control, and find new meaning and identity.
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This article presents an examination of the ways in which responsibility for health is constructed in popular English-Canadian women's magazines. Women's magazines are a unique media form, acting as guidebooks for women on matters relating to feminine gender roles and are important to examine as part of the corpus of societal discourses which frame our understandings of what it means to be healthy and how good health is achieved. Using discourse analysis several techniques were found which reinforce women's individual responsibility to create and maintain good health for themselves and their families. ⋯ The magazines also use the traditional discursive technique of women's personal accounts as both cautionary tales and inspirational stories to encourage readers to actively pursue healthy behaviours. Reflecting and reinforcing the discourse of healthism, women's magazines consistently present health as an important individual responsibility and a moral imperative which creates an entrepreneurial subject position for women. The article concludes by discussing the implications for women's magazine audiences within the ongoing feminist debate about this cultural industry.
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Research indicates that there is a high level of trust in health professionals but also a high level of non-disclosure of mental health issues to general practitioners (GPs). This paper explores the issue of patients' willingness to disclose mental health problems to GPs through interviews with 33 patients from the lower half of the North Island of New Zealand. ⋯ Fear of the consequences of consultation warrants attention if general practice is to be promoted as the preferred point of contact for mental health consultations. The research reported here suggests that trust in a range of institutions and agencies, not just in the individual practitioner, would need to be achieved for the GP to be the preferred point of contact.
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As a society and as individuals, we have come to recognize ourselves as 'death-denying', a self-characterisation particularly prominent in palliative care discourse and practice. As part of a larger project examining death attitudes in the palliative care setting, a Medline search (1971 to 2001) was performed combining the text words 'deny' and 'denial' with the subject headings 'terminal care', 'palliative care' and 'hospice care'. The 30 articles were analysed using a constant comparison technique and emerging themes regarding the meaning and usage of the words deny and denial were identified. ⋯ I suggest that these components of care together constitute what has come to be perceived as a correct 'way to die'. Indeed, the very conceptualisation of denial as an obstacle to these components of care has been integral to building and sustaining the 'way to die' itself. The personal struggle with mortality has become an important instrument in the public problem of managing the dying process.
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Prisoner health is influenced as much by structural determinants (institutional, environmental, political, economic and social) as it is by physical and mental constitutions of prisoners themselves. Prison health may therefore be better understood with greater insight into how people respond to imprisonment - the psychological pressures of incarceration, the social world of prison, being dislocated from society, and the impact of the institution itself with its regime and architecture. ⋯ This paper reports on the findings of an ethnographic study which was conducted in an adult male training prison in England, using participant observation, group interviewing, and one-to-one semi-structured interviews with prisoners and prison officers. The paper explores how different layers of prison life impact on the health of prisoners, arguing that health inequalities are enmeshed within the workings of the prison system itself.