In American society, where the biomedical profession is institutionalized and its therapies dominate health care, a decision to deviate from prevailing norms can be considered remarkable. Yet research done by Eisenberg et al. (1993) found that unconventional or alternative medicine had an "enormous presence" in U.S. health care and that one in three persons had utilized an unconventional therapy in 1990. The objective of this thesis was to explore this phenomenon. Individuals who had used alternative and biomedical intervention to treat a disorder were recruited through practitioners of alternative therapies. Through semi-structured interviews, case histories focusing on the illness trajectory and treatment choices were obtained. These were analyzed following a method outlined by Glaser and Strauss (1967) for generating grounded theory. The specific purpose of this study was to examine the case histories for a basic social process and to identify key variables which influenced the utilization of both a biomedical and alternative intervention. It was the position of this thesis that treatment responses involved more than the decision to accept or decline a specific therapy. Rather, choices were made by social actors embedded within unique social worlds which were differentiated by social variables (e.g., culture, ethnicity, social class) particular to the individual (see, among others, Brown 1989, Fitzpatrick 1989, Freund and McGuire 1991, Gerhardt 1989, Kleinman 1988, Mumford 1983). Treatment decisions were made within a framework of internalized patterns of interpretation and meaning, dynamically influenced by ongoing interactional and relational patterns; an individual's treatment response could be conceptualized as an emergent, multi-phased process (Pescosolido 1992). Analysis of respondents' case histories supported the notion of a dynamic response process. Individuals described an evolving illness trajectory directed at achieving a desired state of wellness. Disparities between treatment outcomes and the desired goal prompted an evaluation and choice-making process. All respondents had developed a health care conceptualization in which biomedical and alternative therapies were either categorized as effective for specific conditions or occupied a particular place on a health care continuum, thereby perceiving a scope of treatment options beyond those available within biomedicine.
| Identifer | oai:union.ndltd.org:pdx.edu/oai:pdxscholar.library.pdx.edu:open_access_etds-5958 |
| Date | 06 May 1994 |
| Creators | Patricia van Es, Nina |
| Publisher | PDXScholar |
| Source Sets | Portland State University |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Dissertations and Theses |
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