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不平等的神经康复轨迹——一项将场域结构与基于社会阶层的资本转换相结合的纵向案例研究。

Unequal neurorehabilitation trajectories - a longitudinal case study combining field structures with social Class-Based Capital Conversion.

作者信息

Bystrup Mette Ryssel, Hindhede Anette Lykke, Pallesen Hanne, Aadal Lena, Larsen Kristian

机构信息

Department of Culture and Learning, Aalborg University, Copenhagen, Denmark.

Department of Clinical Medicine, Hammel Neurorehabilitation and Research Center, Aarhus University, Hammel, Denmark.

出版信息

Health Sociol Rev. 2022 Nov;31(3):293-308. doi: 10.1080/14461242.2021.2007161. Epub 2022 Feb 27.

Abstract

Inequalities in illness, service provision, and outcomes are well documented in the Nordic universal welfare state. The ways in which inequalities are produced during illness recovery trajectories remain largely unknown. Long-term brain injury rehabilitation in this context provides a window into veiled aspects of inequality and the underlying mechanisms. We examine inequality empirically by combing framing field structures with the classed abilities of families to mobilise capital after a severe acquired brain injury (severe ABI). Using a Bourdieuan theoretical framework, informed by the concepts of field, doxa, cultural health capital (CHC), and rehabilitation capital (RC), we designed a longitudinal case study encompassing professional records, observations, and interviews that tracked and analysed subjects' trajectories. We found that families' consistent accumulation and conversion of capital was crucial after a severe ABI because of the multifaceted rehabilitation process involving many different field specific agendas and doxas. This study supplements previous concepts (CHC and RC) developed in a health care context by including other rehabilitation contexts. These disparities in forms of capital amongst social classes result in winners and losers and were reflected in the rehabilitation trajectories of the young adults, characterised by continuity on one extreme and broken trajectories on the other.

摘要

在北欧普遍福利国家,疾病、服务提供和结果方面的不平等现象有充分的文献记载。然而,在疾病康复过程中不平等是如何产生的,在很大程度上仍不为人知。在这种背景下,长期脑损伤康复为不平等的隐蔽方面及其潜在机制提供了一个窗口。我们通过将框架场结构与家庭在严重后天性脑损伤(重度ABI)后调动资本的分类能力相结合,对不平等进行实证研究。我们使用了一个受布迪厄理论框架启发的理论框架,该框架以场域、常识、文化健康资本(CHC)和康复资本(RC)等概念为基础,设计了一项纵向案例研究,涵盖专业记录、观察和访谈,跟踪和分析了受试者的康复轨迹。我们发现,由于涉及许多不同领域特定议程和常识的多方面康复过程,家庭资本的持续积累和转换在重度ABI后至关重要。本研究通过纳入其他康复背景,补充了先前在医疗保健背景下发展起来的概念(CHC和RC)。社会阶层之间资本形式的这些差异导致了赢家和输家,并反映在年轻人的康复轨迹中,其特点是一端是连续性,另一端是中断的轨迹。

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