Biomedical model of disease:
health = absence of disease.
disease centered, specialized to location of disease, pathogen is at center of medical interest. cause of disease is found thru symptoms. Dr as detective. Patient is deferential to doctor and will comply w treatment.
Difference b/wn a "disease" and an "illness"?
disease = alteration in bio structure or function. verifiable measurements.
a technical malfunction or deviation from biological norm, as scientifically diagnosed. (implies lack of humanity). objectively measurable pathological condition of the body.
Illn
DIfferentiate b/wn "naturalistic" and "personalistic approaches to illness
naturalistic explanation assumes illness is due to impersonal, mech causes in nature that have potential to be understood and cured by science (ie, malnutrition, parasites, injury)
personalistic explanation - illness seen as due to acts or wishes of other
Discuss lay accounts of health, disease, and illness
conceptualize health as - functional fitness -reserve of strength to cope w sick -energy & vitality, -ability to carry thru day unimpeded.
illness affects all aspects of life! sick is socially isolating. draw from -med knowl, religion, alt healing, suppor
Define "patient narratives" and be able to evaluate them
ill people draw upon certain narratives to make sense of their sickness. Restitution model (happy ending, good for western cultures), chaos model (explains how illness upsets my life, doesn't necessarily end well, but documents my experience), quest model
contrast the functionalist and political economy views of the doctor-patient relationship
Both perspectives see medicine as a "moral exercise" used to define normality, punish deviance, and maintain social order.
Functionalist thought - medical professional must act as a necessary institution of social control, by providing medicine as a mecha
Know the general focus of the theoretical lens: medical anthropology
addresses biolog, cult, and polit econ dimensions of health illness and healing historically and presently.
health issues are related to broader intersecting systems of environ, ecol, gender, other identities. critical analysis of how know abt health is f
Know the general focus of the theoretical lens: psychology
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Know the general focus of the theoretical lens: sociology
functionalism, political economy, social constructiveness
Know the general focus of the theoretical lens: philosophy
*it is dr.s responsibility toward patient that comes first. today, dr.s are more focused on tech skill, not patient service. change this
integration of medical expertise and medical ethics.
- should a certain treatment be done? does it benefit the patient
What are the overall stats on heart disease?
10.2% of females, 12.8% of males. (higher in hispanic) increases a lot w age. Concentrated in south. dierctly overlays map of poverty. 4x more likely than breast cancer. higher in black females.
Who does heart disease affect?
latinos, af ams. the poor, southerners (more risk factors) kills more women than men. mostly ages 60-80
At what age does heart disease strike?
anytime, can be young but rates dramatically inc w age
what are the categories of risk factors for heart disease?
behavioral (no exercise, bad diet, tons of alc, drugs, smoking)
psychosocial (anger, depression)
societal (low SES, racial minority, women)
Discuss the role of gender in heart disease.
Different biological manifestations of HD. Women erode, men explode (think how men vs women distribute fat). Treatments focus on the male form of the disease, and aren't effective to treat women, so many women die. Harder to detect in women.
-risk factors
What did LaVeist and colleagues discover about race and patient perspectives?
dr.s give better care to whites than blacks. blacks are more likely to die, be deceived in hospitals, unknowingly participate in harmful trial, dr won't answer their questions, drs dont take black seriously. even if dr.s think its same care, patients feel
What are Schniederman's categorizations of risk factors and his strategies for intervention?
behavioral (smoking drugs, fat food, no exercise)- interventions (quit smoking, get help & education, exercise more, get fitness coach)
psychosocial (depression, stress) - interventions (CBT, stress management, positive psychosocial interactions, have fun
How does the film Partners of the Heart relate to readings and class discussion on heart disease?
black dr couldn't even be classified as a dr, so black patients had no representation. esp at end of movie, his work was very important in being role model for black students.
Doctor/patient interaction - do patients always adhere to treatment plans? Why or why not?
No, there are often barriers to care that keep patients for following treatment. Ie, if dr prescribes healthy food and patient lives in food desert/no fresh produce / dr prescribes exercise but neighborhood is unsafe and patient can't afford equipment / d
Doctor/patient interaction - what techniques do doctors use to increase adherence?
teachback method, folllwup w patient, make sure they schedule next appt b4 they leave
Doctor/patient interaction - can you bring in specific examples from the video lecture on the importance of physical touch in the doctor-patient encounter
The patient can feel "written off" if there is minimal/no physical exam conducted by the doctor. Physical becomes like a reassuring ritual. Medical scribe allows doctor to have physical interaction w patient
Define modifiable risk factors. How do they apply to both heart disease and diabetes?
Ailments of lifestyle/behavior which are in the patient's control to avoid. People with money and wealth with access to healthy options but they lack education or possibly the will power to change lifestyles.
Define non-modifiable risk factors. How do they apply to both heart disease and diabetes?
People with genetic predispositions, people living in underprivileged areas, no access to water, healthy food, exercise, high stress environ.s
List and explain the 3 main types of diabetes. Who are we likely to see w/ each type?
Type I diabetes - body cannot react to insulin normally. it is genetic
Type ii- often in overweight ppl, body is under so much strain that cells wear down and can no longer react to insulin.
Type gestational diabetes - occurs in 2nd/3rd month of pregnancy
review the following barriers to diabetes management - health literacy and numeracy
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review the following barriers to diabetes management - spoken language
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review the following barriers to diabetes management - culture
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review the following barriers to diabetes management - race
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review the following barriers to diabetes management - internal physical
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review the following barriers to diabetes management - external physical
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review the following barriers to diabetes management - psychosocial
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review the following barriers to diabetes management - psychological
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how does stress add to the onset and management of chronic health conditions such as heart disease and diabetes?
Be able to define stress, give examples of a stress experience, and discuss both direct and indirect ways this experience impacts the conditio
stress w old age (loss of friends and freedom) obese (stigma, other health issues) fam history (worry about getting it) gestational- i had that i could get type 2. ethnicitity bc cult norma. cause withdrawal from social, missing fulfillment of norms.
what is the link b/wn poverty and diabetes? use the film bad sugar to support your answers
indian tribes, no access to water, no fresh food.