138 terms

Medical Sociology Final Exam

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social construction of illness (def.)
An approach that emphasizes the important influence of social interaction and social networks on the ways that we respond to illness
temporalizing the symptomology (def.)
Setting a deadline for experience of symptoms as in: "If I'm not better by Monday I'll call the doctor"
de-medicalization (def.)
A movement that is underway to reduce the medical profession's control in several areas of life.
emotional reaction (def.)
Suchman states that three distinct processes occur when an individual first senses some health problem. There is physical pain/discomfort and the cognitive reaction that the symptoms are part of an illness. What is the third process?
The national medical association (def.)
The name of the professional society Founded in 1895 for black physicians (who were excluded from membership in the AMA).
malpractice
Litigation intended to compensate patients who have been harmed by the actions or inactions of a physician.
peer review
A quality control mechanism in which physicians scrutinize the work of their fellow physicians on a daily basis.
defensive medicine
The tendency for physicians to require every imaginable test for patients in order to protect themselves from liability in the case of a negative patient outcome.
illness behavior (def.)
the way in which symptoms are perceived, evaluated, and acted upon by a person who recognizes some pain
Theory of help-seeking behavior (def.)
behavior changes when ones wants help
What are the stages of illness experience?
-symptom experience
-assumption of the sick role
-medical care contact
-dependent patient role
-recovery and rehabilitation
What are the two obligations and two exemptions in Parson's sick role?
Obligations:
-wants to get better
-expected to do to a doctor
Exemptions:
-excused from normal roles
-not responsible for illness
What kind of illnesses are neglected in Parson's sick role?
-mental illness
-chronic illness
Why have religious definitions of deviance declined?
-lack rationality
-lack overall acceptance
What is medicalization?
-things are being interpreted into medical terms
-gives medical professionals more power
What are positives and negatives of medicalization?
Positives:
-
Negatives:
-more things are labeled at sickness
-social stigmas of sickness
What is an example of illegitimate or stigmatized illegitimacy?
-having a stammer
What is an example of conditional legitimacy?
-having a cold
What are the 3 factors outlined by Dimatteo and Friedman that influence the decision to seek medical care?
-background of the patient
-patient's perception of illness
-social situation
What are 3 factors that lead to the poor utilizing health services differently than the non-poor?
-less likely to have regular source of care
-more likely to use an ER for routine care
-they are more sick and require longer stays
What is a criticism of self-help groups?
-no significant improvements in symptoms
Which of the following statements accurately describes the labeling approach to illness?
The definition of illness is a subjective matter worked out in particular cultural contexts.
In a study comparing the stigma felt by cancer patients and HIV/AID's patients, what conclusion was drawn by Fife and Wright?
Both types of patients felt stigmatized, but HIV/AIDS patients felt more stigma.
In what ways are married women in some parts of rural India discouraged from seeing a physician when necessary?
All of the above
In Edward Suchman's 'five stages of illness experience' what stage follows the initial experience of symptoms?
Assumption of the sick role
True or False: To be allowed to remain in the sick role, a person must convey a desire to get well.
True
What is the medicalization of deviance?
The transformation of moral and legal deviance into a medical condition
What are the 3 traits that identify a profession according to William Goode?
-autonomy
-rigorous standards
-prestige and identification
What is the difference between proletarianization, corporatization, and deprofessionalization? What are the similarities?
-Proletarianization: physicians have their autonomy stripped from them and replaced by corporate owners (a result of corporatization) (calls for more bureaucracy)

-Corporatization: increasing amount of corporate control of medicine (calls for more bureaucracy)

-Deprofessionalization: over time patients assume more control of their own health
What is the countervailing powers theory?
-when a professional gains dominance, efforts are made by other agents to balance its power
List the internal and external methods of medical control
Internal:
-peer review
-hospital review committees
-state boards of medicine
-the national practitioners data bank
External:
-medical malpractice
What are the consequences of medical malpractice and how do they relate to the practice of defensive medicine?
-insurance premiums
-potential lawsuit
-high cost of malpractice premiums
-defensive medicine is a safety blanket
List the reasons that rural areas have such a hard time maintaining enough practitioners
-personal factors
-professional considerations
-economic factors
How do female doctors practice differently than men?
-different specialties
-different practice patterns
-different type of interaction
What are 2 factors that lead doctors to be unsatisfied with their jobs?
-bureaucratic and institutional control
Which theory states that the medical profession's dominance may be declining?
All of the above
Which of the following strategies have states used to try to modify the malpractice system?
Both a and b
In the past 30 years, the number of physicians in the United States...
has grown significantly faster than the U.S. population
Research regarding internal control of physicians indicates which of the following?
Physicians seldom make public judgments about colleagues
Which of the following arguments accurately describes unionization among physicians?
Growth in union membership has been steady but slow
What is the federal repository for specific information on all health care practitioners called?
National Practitioner Data Bank
Licensed Practical Nurse (def.)
High school graduates who have completed a short vocational program leading to certification as a LPN
Florence Nightingale (def.)
An early British nursing reformer who believed that the proper moral, environmental, and physical order was necessary for the restoration of health; she had a profound effect on nursing in the U.S.
Advanced practice nurse (def.)
Registered nurses who have acquired additional education and certification in one or more of about 20 nursing specialties
Certified Nurse Midwife
A registered nurse who is certified by the American College of Nurse-Midwives to assist in childbirth
List 2 factors that led to the decline of midwives in the United States
-decline in birth rates
-regulation
What is the ANA arguing that the AMA vehemently opposes?
-to allow APRNs the legal authority to write prescriptions
Which of the following accurately describes early nurse-midwives in the United States?
Both a and b are correct
Which of the following accurately describes Registered Nurses?
All the above
Regulation of nursing is
a state responsibility
Which of the following accurately describes Licensed Practical Nurses?
Have completed a vocational training program
Research examining the work of nurses shows which of the following to be true?
Both b and c are correct
What is the American Nursing Association?
A professional nursing association
How does gender influence the relationship between nurses and doctors?
Men have traditionally dominated the field of medicine, and women have traditionally dominated the field of nursing, this lead to women taking the submissive/obedient role under the dominant male physician
yin and yang (def.)
Each object in nature is both a unified whole and a whole composed of two parts with opposing qualities (yin and yang). They are constantly in a dynamic interplay shifting from becoming opposites to becoming each other. Disease results from an imbalance.
Dual model of medical care
Many people use alternative healers at the same time as they receive care from medical doctors
subluxations
Chiropractors believe that vital energy flows throughout the body's nerves when in a homeostatic state and that most human illnesses are caused when this vital energy is blocked by misalignments of the vertebrae. By what name are these misalignments known?
curanderismo
The ethnic healing system indigenous to Mexican and Mexican-American communities
List the 5 core components of Complementary medicine. Which would you like to see traditional medicine adopt in everyday practice?
-holism
-the interpenetration of mind, body, and spirit
-the possibility of high-level wellness
-vitalism
-the healing process
Why has traditional biomedicine, rejected much of CAM's practices and traditions?
-nonscientific
What is an example of mainstream medicine incorporating and legitimizing some kinds of alternative medicine?
-chiropractics
Why might CAM practitioners have better doctor-patient relationships than traditional practitioners?
-more sympathetic
-better bed-side manner
Why didn't the AMA want chiropractors to gain legitimacy in the United States?
-they viewed they as quacks
Where did acupuncture originate and what are it basic principles?
-china
-balance of yin and yang
What do Christian Scientists believe is the best way to treat illness? Are there ethical issues involved?
-spiritual healing
Which of the following is often the most reported reason for using an alternative healer?
Back problems
Which of the following statements is true regarding the debate over legalization of medical marijuana?
Several states have endorsed or enacted legalized medical marijuana laws
Which of the following alternative healing practices has received the least vigorous opposition from organized medicine?
Spiritual healing
True or False: Chiropractic is a licensed health profession in all 50 states, and chiropractors are reimbursed by federal, state, and most commercial insurance companies.
True
True or False: After a "hands-off" period for many years, the medical profession has become fearful of the extensive role played by curanderos in Hispanic communities and is now actively working to legally prohibit the practice
False
What is a Native American "singer"?
The primary healer
autonomy (def.)
An ethical principle that prioritizes self-determination
therapeutic communication (def.)
A physician-patient communication process which involves a free and open exchange of information in both directions and the development of rapport.
the mutual participation model (def.)
The patient is a full participant in the physician-patient relationship
informed consent (def.)
Adequate information which is comprehended by a competent patient who gives a voluntary consent
What is the physician's role in the activity/passivity model of the doctor-patient relationship? What is the patient's role in this model?
-makes all important decisions
-relies on doctor for information
What is the difference between the guidance-cooperation model and the mutual participation model in regard to level of patient participation in decision making?
-Guidance-cooperation: obeys (doctor more in charge)
-Mutual participation: larger role for patient (both play active roles)
What are the 4 models that Robert Veatch offers?
-engineering model (no involvement in decision making)
-priestly model (ethical expert)
-collegial model (colleagues)
-contractual model (contract)
What are the 4 principles of the biopsychosocial model?
-patient is addressed as a whole person
-relationship is continuous
-uses both biotechnical and interpersonal skills
-needs and expectations are known
List the 5 barriers to a therapeutic relationship
-setting of medical encounter
-length of medical encounter
-mental state of patient
-mismatched expectations
-language barriers
Why might the "status relation" shift between physician and patient depending upon the gender, race, or class of either party?
-stereotyping
What are the 3 sociological reasons for patient compliance and non-compliance?
-communication process
-health beliefs
-patient self-regulation
Which of the models identified by Sazasz and Hollender most closely resembles the view of Talcott Parsons?
Activity-passivity
For the last century, physician care in the United States has been dominated by which model of health?
The biomedical model
Which of the following is part of genuine therapeutic communication?
All of these are aspects of therapeutic communication
Describe how a doctor could act in a paternalistic manner.
An example is when the doctor overrides a patient's wishes and takes action presumed to be in the patient's best interest, but is unwanted by the patient
What is a barrier of the therapeutic relationship?
language barrier
Medicaid (def.)
A jointly funded federal-state local program designed to make health care more available to the poor
managed competition (def.)
The name given to the Clinton health care reform package that attempted to address both problems of access and cost
preferred provider organizations (def.)
A set of providers that contracts with employers or insurers to provide a comprehensive set of health care services on a fee-for-service basis, usually at a discounted rate
hospice (def.)
Programs which provide medical and nursing care, support services, and bereavement counseling for terminally ill patients and their families
The percentage of the GDP spent on health care in the United States
is much higher than in any other country
The majority of Americans without health insurance
are in families with an employed worker
Efforts to contain health care costs in the United States include which of the following?
Only b and c
Hospital emergency room services
are the point of hospital admission for an increasing number of patients
Studies have shown health care through a HMO
is less expensive than other delivery modes
What is a walk in center?
Walk-In Centers provide services without an appointment for minor medical problems
What is an HMO?
prepaid plans in which a group of physicians and hospitals provide health care in return for a fixed premium from enrollees
persistent vegetative state (def.)
A condition in which a patient is no conscious and is irretrievably comatose and is being nourished artificially, but is respirating on his or her own
living will (def.)
A document signed by a competent person that provides explicit instructions about desired treatment if the person is ever in a position where her or his wishes cannot be expressed
weak required consent (def.)
The current organ donation policy in the United States: it requires hospitals to notify families and patients of the organ donation option
telemedicine (def.)
The on-line sharing of medical information
What are the 3 different ways in which hospitals can be run and owned?
-Nonprofit hospitals
-For-profit hospitals
-Government hospitals
Which of the following is consistent with a dystopian view of technology?
Only a and c
Which of the following is an important recent advance in medical imagine?
Magnetic resonance imaging
True or False: According to the Harvard "brain death" definition of death that has been used since the late 1960s, when a person is irretrievably comatose, and is able to breathe only through means of an artificial respirator, the person is legally dead.
True
True or False: In the Helga Wanglie case, the court ruled that hospitals have the right to disconnect an incompetent patient in a persistent vegetative state from an artificial respirator even against the wishes of family members
False
What is the most commonly used "new reproductive technology" in the United States?
Intrauterine insemination (IUI)
Brain death
artificially respirating
Organ donation policy in the United States
-voluntarism
the Beveridge report (def.)
The 1942 report in Great Britain that recommended major societal reforms including increased government involvement in healthcare; it was the first step to universal health care
cultural influences on health care policy (def.)
Important norms and values in a society
structural influences on health care policy (def.)
Permanent and enduring features of a society including political structure, economic systems, and demographic makeup
the "national" (def.)
The name the British use to describe their national insurance program
What are the 4 major influences on the structure of a health care system in a particular country?
-physical environment
-historical and situational events
-cultural norms and values
-structure of society
What are the 4 types of health care systems?
-private insurance with private, entrepreneurial services
-national health insurance with private, regulated services
-national health insurance with public, regulated services
-national health insurance state-run system (socialized medicine)
What country has the highest infant mortality rate, Canada, Britain, or United States?
United States
How does education of doctors differ between China and United States?
-Chinese work as resident physicians before taking their boards
When did Canada adopt their universal health care coverage?
1968
How is Canada's health care distributed and paid for?
-taxpaying citizens
-all services deemed necessary are covered
How do Canadians rate their own health care system?
they like it
What is the major problem with Britain's health care system?
-staff shortages, overworked workers, and longer waiting times
In a recent rating of the world's health systems by the WHO, the United States
was rated 39th behind most modern and even some much less wealthy countries
In which of the following countries is the level of centralization (involvement of the national government) greater than in the United States?
All of the above
In which country are there now drastic shortages of basic medical supplies?
Russia
In which of the following countries are most physicians privately employed?
Canada
Which of the following is one of the three distinct processes activated by an initial perception of pain or discomfort?
Both a and b
Which of the following statements does not accurately describe Talcott Parsons' understanding of the sick role?
When one becomes ill, he or she typically departs from normal social roles and enters into a state of normlessness
Which of the following is not cited in the text as an example of de-medicalization?
Hyperkinesis
Patients continue to have many worries even as they enter the "dependent-patient role" and "recovery and rehabilitation" stages. Which of the following was identified as being a chief worry during these stages?
All of the above
Which of the following statements about income and the use of health services is true?
All of these statements are true
Which of the following statements accurately summarizes the relationship between gender and use of health services?
Women use many more health care services than men, even after the effects of reproductive services are controlled
In the past 30 years the number of physicians in the United States
Has grown significantly faster than the US population
Which of the following statements accurately describes unionization among physicians?
Growth in union membership has been steady but slow
How does the rate of chemical dependency among physicians compare to that in the general population?
30 to 100 times greater among physicians
Which of the following statements describes specialization selection for women and men?
A and B are correct
Which of the following accurately describes the ratio of physicians to population?
Much larger in urban areas than rural areas
Which of the following accurately describes early nurse-midwives in the US?
Both a and b are correct
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