Social science & medicine
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Social science & medicine · Jan 1984
Patient evaluation of a cognitive behavioral group program for patients with chronic low back pain.
Traditional approaches to curing patients with chronic benign pain have had only limited success. Rehabilitation becomes therefore more important and in recent years management programs have been developed to achieve this goal. This study was based on the hypothesis that a program can be more effective with its structure according to the comments of patients with respect to the various components of the program. After testing this hypothesis we conclude that such subjective evaluation of treatment is an important factor which merits receiving more attention than previous work has suggested.
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Social science & medicine · Jan 1984
Managing medical mistakes: ideology, insularity and accountability among internists-in-training.
By the end of graduate medical training, novice internists (collectively known as the housestaff) were initiated into the experience of either having done something to a patient which had a deleterious consequence or else having witnessed colleagues do the same. When these events occurred, the housestaff engaged in social-psychological processes, utilizing a variety of coping mechanisms and in-group practices to manage these mishaps. Three major mechanisms were utilized by the housestaff for defining and defending the various mishaps which frequently occurred: denial, discounting and distancing. ⋯ Housestaffers come to feel that nobody can judge them or their decisions, least of all their patients. As they progress through training even internal accountability cohorts--the Department of Medicine, teaching faculty and peers--are discounted to varying degrees. They have developed a strong ideology justifying their jealously guarded autonomy.(ABSTRACT TRUNCATED AT 400 WORDS)
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Social science & medicine · Jan 1984
Distribution of behavioral science faculty in United States medical schools: 1968-1969 and 1978-1979.
The Association of American Medical Colleges' faculty profiles were analyzed for 117 U. S. medical schools for the years 1968/1969 and 1978/1979. ⋯ Although still small in numbers, faculty from other disciplines such as anthropology and sociology have gained increasing acceptance, and these 117 medical schools now employ at least 20 full-time economists and 13 who have earned degrees in political science. The growth of behavioral science faculty has been primarily in clinical departments, and those who are associated with independent departments of behavioral science remained virtually static (87 vs 88) over this 10 year period.
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Social science & medicine · Jan 1984
Dramaturgy of occult practitioners in the treatment of disease and dysfunction entities.
This paper provides a dramaturgical analysis of the beliefs and practices of rural and suburban fortune-tellers in the treatment of disease and dysfunction entities. Based upon in-depth interviews with 21 non-Gypsy fortune-tellers, the client records of a key informant and the second author's first-hand familiarity with select aspects of fortune-telling, the paper examines the role of the fortune-teller as a quasi-practitioner. ⋯ Occult treatment for the conditions tends to mimic the dramaturgy of conventional practitioners through the use of occult rhetoric, labels, client typifications, props and treatment scripts. The management of venereal disease and sexual impotence is examined in detail to illustrate the occult approach to disease and dysfunction entities.
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Social science & medicine · Jan 1984
The spouse's adjustment to chronic pain: cognitive and emotional factors.
Recent research has demonstrated that the pain behaviors displayed by patients who have chronic pain complaints can be rewarded and maintained by the solicitous and attentive responses of spouses. The present study examines cognitive and emotional factors which may underly such solicitous responding by the spouses. In this study spouses completed a questionnaire (The Spouses' Perception of Disease--SPOD) which was designed to determine their perceptions of the patients' chronic pain syndromes. ⋯ The results of this study show that spouse's cognitive interpretation of the patient's chronic pain syndrome is closely associated with the spouse's emotional adjustment and marital satisfaction. Optimism, perception that the patient has a positive attitude along with few psychological problems and the perception that the patient is severely disabled all are associated with more positive emotional status in spouses. The results are discussed in terms of their implications for the rehabilitation of chronic pain patients.