Doctoral Dissertation Research: Social Contexts of Treatment and Care: Patients and their Families in a Tuberculosis Epidemic

加州大学，洛杉矶博士候选人汉娜赖斯，由琳达加罗博士监督，将探讨疾病的社会背景在日常生活中的病人接受到一个治疗计划，旨在满足现行标准的生物医学护理。为什么一种可以得到有效治疗的疾病仍然以如此高的发病率持续存在？疾病和护理的社会背景是什么，促进或阻碍了成功的治疗？为了解决这些问题，Reiss将在塔吉克斯坦工作，该国是世界上结核病发病率最高的国家之一，治疗失败，违约和死亡的频率很高。她的研究将探讨社会力量，实践和理解，促进或阻碍治疗患者及其家属浏览结核病和治疗。她的研究结合了：1）在整个治疗过程中跟踪患者的纵向设计; 2）对临床和社会互动的双重关注; 3）关注来自家庭和社区的社会支持的组织。 Reiss将通过参与者对家属的观察、对患者、其亲属和临床医生的访谈、疾病叙述以及对临床遭遇的观察来收集数据。这个项目将探讨疾病经验作为一个复杂的社会现象，有助于人类学理论1）在检查传染病，以扩大目前的概念框架的经验，纵向和关系的方法; 2）添加到越来越多的文献，定位健康作为一个家庭，网络和社区的关注;（3）探讨结核病患者护理的社会结构以及社会支持在成功完成治疗中的作用。该项目对提供保健服务具有更广泛的适用性。更好地了解当地的疾病现实情况对开展健康举措至关重要。塔吉克斯坦是结核病流行病对全球健康构成广泛威胁的一个生动例子。

University of California, Los Angeles doctoral candidate Hannah Reiss, supervised by Dr. Linda Garro, will explore the social contexts of illness in the day-to-day lives patients accepted into a treatment program designed to meet prevailing standards of biomedical care. Why does an illness with effective treatment continue to persist with such high incidence rates? What are the social contexts of illness and care that promote or impede successful treatment? To address these questions, Reiss will work in Tajikistan, which has one of the highest incidence rates of tuberculosis in the world and high frequencies of treatment failure, default and death. Her research will explore the social forces, practices, and understandings that promote or impede treatment as patients and their families navigate tuberculosis illness and therapy. Her study combines: 1) a longitudinal design to follow patients throughout treatment; 2) a dual focus on clinical and social interaction; and 3) attention to the organization of social support from families and the community. Reiss will collect data through participant observation with families, interviews with patients, their relatives and clinicians, illness narratives, and observations of clinical encounters. This project will explore the illness experience as a complex social phenomenon, contributing to anthropological theory by 1) incorporating experiential, longitudinal and relational approaches in the examination of infectious disease to expand current conceptual frameworks; 2) adding to the growing body of literature that positions health as a family, network and community concern; and 3) addressing the social structures of care for tuberculosis patients and the role of social support in successful completion of treatment. This project has wider applicability for health care delivery. It is critical to ground health initiatives in a better understanding of local realities of illness. Tajikistan is a vivid example of the tuberculosis epidemic's broad threat to global health.