Gillespie Chris
Center for Healthcare Organization and Implementation Research, Department of Veterans Affairs, Bedford Massachusetts, USA.
Sociol Health Illn. 2015 Sep;37(7):973-87. doi: 10.1111/1467-9566.12257. Epub 2015 Apr 24.
Those who undergo health screening often experience physical and emotional effects as a result of the screening process. However, the effects of health screening go beyond these physical and mental complications, often having profound social effects for those who are screened. This study explores the social implications of health screening for people who undergo it and are designated as being at risk for potential disease. Through a qualitative analysis of the experiences of individuals with elevated cholesterol levels and men with elevated prostate-specific antigen (PSA) levels, this research offers a description of the experience of being at risk, identifying three primary components: increased medical contact, a restructuring of everyday routines and altered social relationships. Whereas the at-risk health status engendered by current clinical approaches to screening and surveillance has been characterised as proto-disease, this study develops a companion definition of proto-illness to characterise the social experience of life with an identified health risk. Those who are at risk act in ways that are similar to those who are ill. The concept of proto-illness implies that the experience of risk is parallel to the experience of illness and contributes to the sociology of medical screening by establishing a much needed bridge between the two experiences.
接受健康筛查的人往往会因筛查过程而经历身体和情绪上的影响。然而,健康筛查的影响不止于这些身体和心理上的并发症,对于接受筛查的人来说,它往往还会产生深远的社会影响。本研究探讨了健康筛查对接受筛查且被认定有潜在疾病风险的人群的社会影响。通过对胆固醇水平升高的个体以及前列腺特异性抗原(PSA)水平升高的男性的经历进行定性分析,本研究描述了处于风险中的体验,确定了三个主要方面:医疗接触增加、日常活动的重新安排以及社会关系的改变。虽然当前筛查和监测的临床方法所导致的处于风险中的健康状况被界定为原疾病,但本研究提出了一个与之对应的原疾病体验的定义,以描述存在已确定健康风险的生活中的社会体验。处于风险中的人的行为方式与患病者相似。原疾病体验的概念意味着风险体验与疾病体验相似,并通过在这两种体验之间建立一座急需的桥梁,为医学筛查社会学做出了贡献。