SOCIOLOGICAL DIMENSIONS OF ILLNESS BEHAVIOR
SOCIOLOGICAL DIMENSIONS OF ILLNESS BEHAVIOR
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DOI：
10.1016/0277-9536(95)00025-3
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发表时间：
1995-11-01
影响因子：
5.4
通讯作者：
MECHANIC, D
中科院分区：
文献类型：
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作者：
MECHANIC, D
几乎完全依赖于诊断疾病模式，限制了解决初级医疗保健中常见的疾病和残疾负担。随着人口老龄化和慢性病、残疾和行为障碍的流行，需要新的患者评估和干预方法来扩展传统模式。使用疾病行为作为出发点，我检查残疾的过程和类型的考虑，促进功能和维护病人的生活质量。在个人一级，替代办法包括改变缺陷，提高病人的积极性和鼓励乐于助人的态度，教授应对策略，确定有用的辅助设备，教育家庭成员和雇主以及提供支持。更广泛的观点还表明，残疾过程的各个方面都是社会政策和环境补救的适当问题。在检查各种例子的残疾过程中，本文侧重于自我评价和疾病的行为和社会运动的方式帮助定义和重新定义疾病和残疾的概念。认识到所讨论的各种变化不会轻易实现，本文最后讨论了鼓励更广泛实践方向的趋势以及有助于鼓励和加强这种发展的干预措施类型。
The almost exclusive dependence on the diagnostic disease model limits addressing the burden of illness and disability typically seen in primary medical care. With aging of populations and increasing prevalence of chronic disease and disability and behavioral disorders, new approaches to patient assessment and intervention are needed to extend traditional models. Using illness behavior as a point of departure, I examine the disability process and the types of considerations relevant to promoting function and maintianing patients' quality of life. At the individual level, alternatives include modifying impairments, increasing patient motivation and encouraging helpful attitudes, teaching coping strategies, identifying helpful assistive devices, educating family members and employers and providing support. A broader view also makes clear that varying aspects of the disability process are appropriate issues for social policy and environmental remediation. In examining various examples of the disability process, the paper focusses on self-appraisal and illness behavior and the way social movements help to define and redefine conceptions of illness and disability. Recognizing that the kinds of changes discussed will not come easily, the paper concludes with a discussion of trends encouraging broader practice orientations and the types of interventions that can be helpful in encouraging and reinforcing such developments.