1 University of Colorado-Denver, Denver, CO, USA.
J Health Soc Behav. 2018 Jun;59(2):170-184. doi: 10.1177/0022146518756860. Epub 2018 Feb 14.
The term patient noncompliance emerged in the 1970s as a tool for analyzing why people do not follow medical directives. Despite its early popularity, the term has languished in sociology while flourishing in biomedical arenas. It seems flaccid in a contemporary healthcare context as it overestimates physician authority and is tone-deaf to biomedicalization. I draw from sociological and anthropological traditions, as well as qualitative interviews with terminally ill patients ( N = 26) and their caregivers ( N = 16), to consider facets of a biomedicalized health experience and implications for an updated vision of compliance. First, pathways to care have proliferated under biomedicalization. With increased pathways comes increased need for understanding how treatment plans are socially constituted and assessed. Finally, increased complexity demands a more diverse vocabulary for understanding health related decisions. This paper is a call to sociologists to take the lead in transforming and updating this consequential concept.
患者不依从这个术语在 20 世纪 70 年代出现，是分析人们为何不遵循医疗指示的工具。尽管它在早期很流行，但这个术语在社会学中已经式微，而在生物医学领域却蓬勃发展。在当代医疗保健环境中，它似乎显得软弱无力，因为它高估了医生的权威，对生物医学化也置若罔闻。我借鉴了社会学和人类学的传统，以及对绝症患者（N=26）及其护理人员（N=16）的定性访谈，来考虑生物医学化健康体验的各个方面，以及对更新的依从性观念的影响。首先，在生物医学化的影响下，治疗途径大量涌现。随着治疗途径的增加，我们需要更多地了解治疗计划是如何在社会中构成和评估的。最后，日益复杂的情况需要一个更具多样性的词汇来理解与健康相关的决策。本文呼吁社会学家带头转变和更新这一重要概念。
