Blaxter M
Soc Sci Med. 1983;17(2):59-69. doi: 10.1016/0277-9536(83)90356-8.
An analysis is presented of the concept of 'disease' and its causes, held by one group of middle-aged women brought up in poor social circumstances. The diseases which the women talked about, and their ideas of cause, are shown to be the products of a particular medical and social history. The categories of cause which were favoured were infection, heredity and family susceptibility and agents in the environment. The women preferred to reject natural degenerative processes or the idiopathic: inevitability and randomness were both found frightening. It is suggested that the women's models of disease processes (though often factually incorrect) were in principle no different to those of advanced medical science, and no less sophisticated. The most notable features of their talk, however, were the salience of knowing about cause, the strain towards rational explanation and the importance of linking together life events. It is suggested that these are common human traits, which have implications for the interaction between doctors and patients.
本文分析了一群在贫困社会环境中成长起来的中年女性所秉持的“疾病”概念及其病因。这些女性所谈论的疾病及其病因观念，被证明是特定医学和社会历史的产物。她们倾向的病因类别包括感染、遗传、家族易感性以及环境因素。这些女性倾向于排除自然退化过程或特发性病因：她们觉得必然性和随机性都令人恐惧。研究表明，这些女性的疾病过程模型（尽管往往与事实不符）在原则上与先进医学科学的模型并无不同，也同样复杂。然而，她们谈话中最显著的特征是对病因认知的突出、对合理解释的努力以及将生活事件联系起来的重要性。研究认为，这些是人类的共同特征，对医生与患者之间的互动具有启示意义。
