Thesis (Ph.D.)--Murdoch University, 2007. / Thesis submitted to the Division of Arts and Education. Includes bibliographical references (leaves 314-352).

<p> Patients and care providers fail to embrace the quality-driven relationships that were once part of the clinical consultation. To improve what some have referred to as a dampened relationship social scientists and medical professionals are pursuing a &lsquo;patient-centered&rsquo; model where healthcare is delivered in ways that are &ldquo;respectful and responsive to individual patient preferences, needs, and values&rdquo; (Institute of Medicine 2001:6). The model sets standards for identifying and responding to patient concerns regarding illness and treatment, and cherishes the benefits of shared decision-making and responsibility (Epstein 2000). Undoubtedly, this model works best when the patient&rsquo;s interest and values are central to the delivery of care.</p><p> A sample survey of 94 patients seeking treatment at an urban, hospital-based primary care clinic, are analyzed to answer three separate, but fundamental questions: 1) Is there a significant association between components of cultural capital (marital status and/or education) and patient-centered events? 2) Does the presence of any of these patient-centered events associate itself with a patient&rsquo;s overall experience? And 3) is there a significant association between components of cultural capital and overall patient experience? I hypothesize that marital status and/or education are directly associated with the presence of patient-centered events, that the presence of any one patient centered event is positively correlated with the overall clinical experience, and that a patients overall experience is directly associated with marital status and/or education.</p>

<p>The sociological literature on pain and the body largely emphasizes the social and cultural dynamics of suffering. Within this realm, the medical institution is often paramount in regulating how pain is understood and the responses that are appropriate in managing pain. Less is known about other forms of healthcare that treat pain, namely Complementary and Alternative Medicine (CAM). While most research explains the overall &ldquo;who&rdquo; of the population of CAM users, few studies address the &ldquo;why&rdquo; and the overall effects of using a nonconventional system of medicine. </p><p> This research is aimed at discerning health beliefs and behaviors that are associated with engaging with a nonconventional system of healthcare and how treatment-seeking differs between patients choosing (CAM) and those choosing conventional medicine. Additionally, this study traces the trajectory of patients&rsquo; treatment-seeking behavior and explores whether nonconventional treatment changes outlooks on medicine and other health-related beliefs and behaviors. </p><p> A mixed method design was used to explore whether CAM users (compared with conventional medicine users) are more likely to possess beliefs associated with CAM. A survey-questionnaire was first distributed to pain patients (n=98) in two health office locations: pain management and acupuncture. Since little is known about CAM users&rsquo; decision-making processes, qualitative interviews (n=20) were conducted with people using acupuncture to elaborate on the survey results. </p><p> Statistically significant differences were found among pain management and acupuncture users on measures of proactivity, medication use, and patient-centered care. Additionally, qualitative findings showed that most acupuncture users were initially skeptical of this nonconventional treatment and gradually grew to use it for ailments beyond pain. At the same time, they grew to value the time and intimacy that was shared with their acupuncturist, who often engaged them in holistic approaches to health. The findings suggest strong discontent and resistance to conventional forms of treatment, which were found to be non-validating of pain experiences of patients and their desires to find non-pharmaceutical solutions for pain. This research proposes that CAM patients are demonstrating their ability to make choices on their own behalf without the approval of traditional medical experts and suggests implications for this new autonomy. </p>

<p> The present mixed method study examined the impacts of brief mindfulness training on cultivation of mindfulness traits, physical and emotional well-being, and relationship quality. Twenty-nine graduate students were organized into a control (n = 14) and a treatment (n = 15) group. All participants completed pre/post measures of their mindfulness competencies, physical and emotional well-being, and relationship quality. The treatment group participated in a 4-week mindfulness training workshop. The control group exhibited no significant changes over the study period. The treatment group exhibited significant improvement of self-reported mindfulness competencies and improved emotional and physical well-being and relationship quality. The results of the present study are encouraging, emphasizing the value of brief training designs for cultivating mindful awareness. Continued practice and research in this area is expected to introduce more and more people to the benefits of mindfulness, enabling them to experience the benefits of more personally attuned and aware living. </p>

Thesis (Ph.D.)--University of Adelaide, Dept. of Social Inquiry, 2004. / "January 2004" Includes bibliographical references (leaves 252-273).

Zugl.: Univ. of California, Diss., 2003. / Includes bibliographical references.

醫學在當代受到社會科學的青睞，一般被認為是自1980年來，學術潮流中社會科學對所謂「人的科學」的省思和再出發，包括心理學、社會心理學、文化研究和文學理論等都有新的研究取向，而醫學社會學亦屬於這一潮流，並特別是受到傅科對現代醫學的研究和貢獻的影響。(D. Lupton, 1994:5-6)。本篇論文屬於這新興的醫學社會學思潮中批判性的觀點，主要是在古典社會學的社會變遷理論中，尋找「傅科吊詭」(the Focault paradox)的問題意識的位置。 　　在第一章中，除了回顧和整理醫學社會學的發展和脈絡外，主要的工作還是回應八零年代之後對醫學社會學重返社會學的呼籲，建議將醫學社會學回歸到宗教社會學、法律社會學地位。以此，我們提出了一個分析計畫，也就是用社會學理論中「社會性的」(social)以及「社會的」(Societal)分析層級，討論醫學和社會變遷的問題。也就是將健康(Health)視為一種救贖財，放在西方社會宗教世俗化的過程中來看待醫學的發展；以及將健康作為一種財富(Wealth)的形式，放在政治經濟學的範疇中的分析策略。 　　第二章，論述現代醫學的社會歷程，主要將健康作為救贖財放進「以社會道德、倫理和價值為核心的宗教社會學」中來討論。主要是將醫學放在理性化的洪流中來看待，以及醫學作為新的道德控制機構的過程，在本章中我們討論了韋伯(Weber)理性化的牢籠、以及傅科環形監獄(panopticon)的凝視以及帕森思(Parsons)對美國醫療體系成為重要的價值系統的分析，並在此社會變遷的過程中討論醫學的社會歷程。 　　第三章，採用「將健康作為財富形式的分析路徑」，在這章中我們比較了馬克思和盧梭等兩種對健康和財富的辯證典範。也就是在民主的進程中和資本的積累的歷史趨勢裡，詢問醫學如何來到我們的生活，在本章中除了馬克思主義，我們還討論了美國式民主和醫療社會學的關係。 　　在第四章中我們檢討將醫學社會學作為一般理論的侷限，並以傅科吊詭－也就是公民權的擴張和國家的限制之間的矛盾，在社會變遷中的未來趨勢作總結。 　　最後，本篇論文還附錄一篇現代醫學在臺灣的發展，以十九世紀末的防疫和抗爭事件為例，往國家意識和認同的過程中，討論民族的身體和國家的身體的抗衡。