University of Victoria

Connecting Health Policy, Health Knowledge, and Health Practice II

Sociologists of knowledge and medicine have challenged the assumption that medical science and medical knowledge are “outside of culture” and free from social structural influences. In this vein, this session seeks papers exploring the interconnections between health knowledge, health practice and health policy. For example, papers may explore how the creation of medical knowledge is influenced by health policy. Others may investigate how health provision practices are constrained or determined by health policies and how these relate to health knowledge. Or, presenters may examine the gaps between medical research, medical practice, and medical policy. Submissions focusing on either: an empirical problem, a theoretical problem, or, a methodological problem related to health knowledge, practice and policy are equally welcome.

Session Organizer: Kate Hickey, University of Calgary, hickey.k8@gmail.com

Adventures in Ethnography: Novel Solutions to Practical Challenges

Kristen Desjarlais-deKlerk, The University of Calgary, kdesjarl@ucalgary.ca , Alicia Polachek, The University of Calgary, ajpolach@ucalgary.ca , Jean Wallace, The University of Calgary, jwallace@ucalgary.ca , Jill de Grood, The University of Calgary, jill.degrood@albertahealthservices.ca , Jane Lemaire, The University of Calgary , lemaire@ucalgary.ca

Our ethnographic study aimed to explore the role of the lead physician on Medical Teaching Units (MTU) in university hospitals where medical students and new trainees care for hospitalized patients as part of their medical education. In this setting, the lead physician is responsible for teaching and supervising these learners, ensuring that patients receive high quality care, and leading a multidisciplinary team of providers. In order to study this multidimensional role, two content-naïve observers (non-physician social scientists) and nine content-informed observers (MTU physicians from other university hospitals) carried out observations of lead physicians as they performed their daily activities in two local MTUs. Given the diversity in experience and backgrounds of the observers, our team had to clearly delineate how ethnographic data would be collected and analyzed. This paper describes our research design and rationale, with particular attention to our novel analytic strategy. Specifically, we discuss how we incorporated field note data and preliminary data analysis from multiple observers by treating each observer’s preliminary analysis as the raw data for our team’s subsequent thematic coding. Finally, we highlight the benefits and limitations of taking such an approach.

Tuesday June 4, 2013 10:30 AM - 12:00 PM Building: Elliott Building, Room: E-060

Journey to Recovery: Self-Care and Self Management of Health among Older Chinese Living with Cardiovascular Diseases

Lichun Liu, University of Lethbridge, willaliu@hotmail.com

Funded by the Heart and Stroke Foundation of Canada (2012), this paper examines the self-care and self-management practices among older Chinese Canadians living with heart disease and stroke. A mixed-method is used in data collection, which involves nine focus groups, eight face-to-face/phone individual interviews, and an open-ended email survey. Sixty-two people participated in this research, which included 26 survivors with cardiovascular diseases, 29 caregivers, and 17 health care providers in Ontario. This paper draws on data mainly from the in-depth interviews with survivors of CVD (n=26). A gender-based, lifelong learning approach is used in analysing the informational and educational needs of the Chinese seniors as well as the strategies they employed in self-care and self-management of adverse health conditions by highlighting the intersectionality of gender, age, class (education and income), ethnicity, language, length and location of residence. This paper found that older Chinese participants were actively involved in self-care and self-management, which include physical, mental, emotional and spiritual dimensions of activities and practices. This paper argues that community-based, ethnically friendly health care programs and services need to be expanded, integrated, and coordinated in order to better serve the increasingly diverse aging population in Canada.

Tuesday June 4, 2013 10:30 AM - 12:00 PM Building: Elliott Building, Room: E-060

Medical Knowledge and Uncertainty: Healthcare Workers’ Anxieties about Vaccines

Terra Manca, University of Alberta, tmanca@ualberta.ca

Vaccination is one of medicine’s greatest and most controversial accomplishments. Vaccines began as scientifically unproven preventative treatments and faced opposition from the public as well as scientific and alternative medicines. Few questioned whether immunization was good; rather, disputes focused on uncertainties and risks. Some of this criticism subsided when vaccines demonstrated increasing success in the early-to-mid twentieth century.

In recent decades, however, anxieties about vaccines have resurged, but with little to no support from scientific medicine. Many healthcare workers support vaccines, but those who express uncertainty impact patients’ confidence in this form of preventative treatment. Furthermore, celebrity physicians, anti-vaccination campaigns, and sensationalized media coverage of vaccination could complicate healthcare workers’ role in providing vaccines. In this paper, I relate sociological inquiry about uncertainty in healthcare to the provision of vaccines.

Tuesday June 4, 2013 10:30 AM - 12:00 PM Building: Elliott Building, Room: E-060