Department of General Practice, Erasmus MC, Rotterdam, The Netherlands.
Sociol Health Illn. 2013 May;35(4):592-609. doi: 10.1111/j.1467-9566.2012.01519.x. Epub 2012 Oct 12.
Although it is recognised that a gluten-free diet has many social implications for coeliac disease patients, not much is known about how such patients actually manage these implications in their everyday interactions. This article examines how dietary restrictions are treated by patients and their families. Data from recorded mealtime conversations of seven Dutch families with children suffering from coeliac disease were analysed using discursive psychology. We found two main discursive strategies by which patients and their families manage the diet during mealtime interactions. A reference to pleasure is used to manage the tension between the child's agency and parental responsibility in the face of health requirements and, by softening the denial of food, the diet is normalised and treated as a shared family practice. The analysis shows that the gluten-free diet is demedicalised and treated as a matter of choice rather than prescription. We conclude with the practical implications of these findings.
虽然人们认识到无麸质饮食对乳糜泻患者有许多社会影响,但对于患者在日常互动中如何实际应对这些影响,人们知之甚少。本文研究了饮食限制是如何被患者及其家人对待的。本文使用话语心理学分析了来自七个荷兰家庭的记录用餐对话的数据,这些家庭都有患有乳糜泻的孩子。我们发现了两种主要的话语策略,患者及其家人在用餐互动中用这些策略来管理饮食。通过提及愉悦感,可以管理孩子的能动性和父母在面对健康要求时的责任之间的紧张关系;通过软化对食物的否定,饮食被正常化并被视为家庭共同实践。分析表明,无麸质饮食被去医学化并被视为一种选择而不是规定。我们最后得出了这些发现的实际意义。