Anthropology & Medicine最新文献_第5页

The double-edged sword of 'community' in community-based psychosocial care: reflections on task-shifting in rural Nepal. 以社区为基础的社会心理护理中的“社区”双刃剑:对尼泊尔农村任务转移的反思。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2023-09-01 Epub Date: 2023-02-01 DOI: 10.1080/13648470.2022.2161765

Liana Chase

{"title":"The double-edged sword of 'community' in community-based psychosocial care: reflections on task-shifting in rural Nepal.","authors":"Liana Chase","doi":"10.1080/13648470.2022.2161765","DOIUrl":"10.1080/13648470.2022.2161765","url":null,"abstract":"Research in the field of Global Mental Health has stoked hopes that 'task-shifting' to community workers can help fill treatment gaps in low-resource settings. The fact that community workers inhabit the same local moral worlds as their clients is widely framed as a boon, with little consideration of the social and ethical dilemmas this might create in the care of chronic, stigmatized conditions. Drawing on 14 months of ethnographic research focused on psychosocial interventions in Nepal, this paper traces how the multiple roles community workers occupied with respect to their clients - clinician, neighbour, and at times kin - came to bear on the care they provided. In-depth case studies are used to explore two divergent logics of care informing Nepali community workers' practice. While formal psychosocial care guidelines emphasized clients' autonomy, calling for non-judgmental and non-directive forms of emotional support, everyday efforts to 'convince' neighbours and relatives in distress often involved directive guidance oriented toward the restoration of moral personhood and social relations. These approaches could be mutually supportive, but tensions arose when community workers invoked moral standards linked with mental health stigma. This analysis highlights the challenge of mobilizing communities' strengths and resources without inadvertently reproducing their exclusions. It suggests the deployment of community workers to address psychosocial care gaps may entail not only leveraging existing relationships within communities, but also reconfiguring the very terms of relatedness.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":" ","pages":"294-309"},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9153663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Narrating the caring fatigue: stories of the ambivalence of filial care in a caregivers' self-help group in Italy. 叙述照顾疲劳:意大利一个照顾者自助团体中子女照顾的矛盾心理。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2023-09-01 Epub Date: 2023-07-13 DOI: 10.1080/13648470.2023.2171238

Francesco Diodati

引用次数: 0

The family doctor: health, kin testing and primary care in Patna, India. 家庭医生：印度巴特那的健康、亲属检测和初级保健。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2023-09-01 Epub Date: 2023-11-27 DOI: 10.1080/13648470.2023.2255773

Vaibhav Saria, Veena Das, Benjamin Daniels, Madhukar Pai, Jishnu Das

{"title":"The family doctor: health, kin testing and primary care in Patna, India.","authors":"Vaibhav Saria, Veena Das, Benjamin Daniels, Madhukar Pai, Jishnu Das","doi":"10.1080/13648470.2023.2255773","DOIUrl":"10.1080/13648470.2023.2255773","url":null,"abstract":"Private primary care providers are usually the first site where afflictions come under institutional view. In the context of poverty, the relationship between illness and care is more complex than a simple division of responsibilities between various actors-with care given by kin, and diagnosis and treatment being the purview of providers. Since patients would often visit the provider with family members, providers are attuned to the patients' web of kinship. Providers would take patients' kinship arrangements into account when prescribing diagnostic tests and treatments. This paper terms this aspect of the clinical encounter as 'kin testing' to refer to situations/clinical encounters when providers take into consideration that care provided by kin was conditional. 'Kin testing' allowed providers to manage the episode of illness that had brought the patient to the clinic by relying on clinical judgment rather than confirmed laboratory tests. Furthermore, since complaints of poor health also were an idiom to communicate kin neglect, providers had to also discern how to negotiate diagnoses and treatments. Kinship determined whether the afflicted bodies brought to the clinics were diagnosed, whether medicines reached the body, and adherence maintained. The providers' actions make visible the difference that kinship made in how health is imagined in the clinic and in standardized protocols. Focusing on primary care clinics in Patna, India, we contribute to research that shows that kinship determines care and management of illnesses at home by showing that relatedness of patients gets folded in the clinic by providers as well.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":" ","pages":"246-261"},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41189488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient patients: middle-aged British Pakistani women and the intuition of limits to care. 患者:中年英巴女性，直觉限制护理。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2023-09-01 Epub Date: 2023-09-15 DOI: 10.1080/13648470.2023.2236875

Kaveri Qureshi

{"title":"Patient patients: middle-aged British Pakistani women and the intuition of limits to care.","authors":"Kaveri Qureshi","doi":"10.1080/13648470.2023.2236875","DOIUrl":"10.1080/13648470.2023.2236875","url":null,"abstract":"This paper examines the affective inequalities underpinning the extensive responsibilities of care that are shouldered by chronically ill -middle-aged British Pakistani women. In the context of ethnic health inequalities, chronic illness and premature ageing are ubiquitous. Further, mid-life generates gendered pinchpoints in the dynamics of care. The paper draws on extended conversations with women over seven/eight years and tracks their unsettled perspectives on sabar (patient endurance). Middle-aged women described how, over the long haul of living alongside chronic illness, they intuited that they must place some limits on caring for others, and that care required self-care - not in a biomedical sense, but in the sense of attention to their own bodily and relational needs. The paper extends anthropological critiques of Levinas's philosophy of infinite responsibilities to care, tracking how changes at several temporal scales - the life course, intergenerational re-negotiations - affect care. While social transformations of gender, and the proliferation of neoliberal discourses on self-care do affect the traction of normative notions of selfless care for others, the paper locates women's changing perspectives on sabar primarily in the provocations of everyday life.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":" ","pages":"184-198"},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10243765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

When the clinic becomes home: on the limits of kinship care in an eating disorder treatment centre in Italy. 当诊所变成家:意大利饮食失调治疗中心亲属关怀的极限。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2023-09-01 Epub Date: 2023-09-12 DOI: 10.1080/13648470.2023.2239510

Giulia Sciolli

{"title":"When the clinic becomes home: on the limits of kinship care in an eating disorder treatment centre in Italy.","authors":"Giulia Sciolli","doi":"10.1080/13648470.2023.2239510","DOIUrl":"10.1080/13648470.2023.2239510","url":null,"abstract":"Drawing on fieldwork in a public residential facility for eating disorders in central Italy, the paper examines the relational temporalities of therapeutics by looking at how time affects treatment at the intersection of professional and family care practices. In arguing that 'chronic cases' put into question the specific kind of kinship care that is at the basis of treatment, the paper contributes to the anthropological literature on eating disorders by bringing time under the analytical lens, and to the literature on 'chronicity' by complicating simplified assumptions about structural care problems. In addition, the paper draws on and goes beyond anthropological works that have highlighted the potentially harmful side of kinship - including those that have explored how kinship can be framed as a source of mental distress and at the same time as a therapeutic tool. Kinship as a therapeutic tool here becomes risky because professionals need to borrow from kinship practices in their own work with patients, balancing those with the necessary clinical detachment. The paper shows that the time chronic patients need in residential treatment generates a particularly complex mix between what is seen as 'functional' and what is seen as 'dysfunctional' in kinship care, because the 'efficacy' of the kinship work that is at the basis of treatment rests on that being partial and temporary. Long term care in the facility complicates what otherwise allows clinical detachment: the treatment team ends up literally substituting the patient's family, with professional and family care mixing 'too much' with one another.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":" ","pages":"262-277"},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10213107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Care without heart: kinship, chronic illness, and the emotion of care in Delhi. 无心无旁骛的关怀：德里的亲情、慢性病和关怀的情感。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2023-09-01 Epub Date: 2023-11-27 DOI: 10.1080/13648470.2023.2245308

Emilija Zabiliūtė

{"title":"Care without heart: kinship, chronic illness, and the emotion of care in Delhi.","authors":"Emilija Zabiliūtė","doi":"10.1080/13648470.2023.2245308","DOIUrl":"10.1080/13648470.2023.2245308","url":null,"abstract":"Drawing on ethnography of one family's life with diabetes in a poor settlement in Delhi's suburbs, this paper examines the relationship between emotional structures of care and kinship in the face of chronic illness. While anthropologists have argued for a relational understanding of care and discussed how, in India, modernity and social transformations have resulted in crises of familial care, less attention has been paid to the emotional terrains of care and its difficulties as they unfold in concrete relationships over time. This paper demonstrates how emotional intensities define the possibilities, limits, and ambivalence of kin care for the chronically ill. Described as care without heart, this mode of attention implies a continuation of care labour that maintains kinship ties and holds the possibility of kin futures, but is disinvested emotionally and feels unsatisfactory. The analytic of care without heart expresses a particular mode of care by which persons navigate dominant moral regimes around gendered family responsibilities and imperatives of love in relationships, but without fully subscribing to them. Care without heart at once signifies an inadequate form of care, invokes North Indian normative moral regimes around family care responsibilities and emotions, and acknowledges the shortcomings of these regimes and norms of relatedness.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":" ","pages":"230-245"},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41103797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Isabella's lion: circular care, kinship, and healing in Brazilian Candomblé. 伊莎贝拉的狮子：巴西坎多姆布雷的循环关怀、亲情和治愈。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2023-09-01 Epub Date: 2023-11-27 DOI: 10.1080/13648470.2023.2240171

Hannah McNeilly

{"title":"Isabella's lion: circular care, kinship, and healing in Brazilian Candomblé.","authors":"Hannah McNeilly","doi":"10.1080/13648470.2023.2240171","DOIUrl":"10.1080/13648470.2023.2240171","url":null,"abstract":"This paper centers on Isabella, a Candomblé follower who struggled with severe rheumatoid arthritis from an early age, arguing that care and self-care practices in Candomblé are intertwined to such extent that they challenge the dichotomy of caring and being cared for. In contrast to a linear model of care that positions care-giver and care--receiver at opposite ends of care relationships, the concept of 'circular care' describes forms of care that are directed at others and simultaneously at oneself. Exploring the religious kinship in a Candomblé house - with Candomblé deities (orixás) and between humans - this paper shows how circular care blurs the distinction between self and other. The emic concept of 'the double mirror' illustrates the -'constitutive alterity' of humans and orixás who relate to each other through kinship building and collective care practices. Since circular care frames one's care for the orixás and the religious family as healing self-care, failing to provide the correct care may in turn be experienced as detrimental self-neglect. The concept of circular care thus enables a deeper understanding of complex dynamics of care and self-care in the contexts of chronic illness, religion, kinship, and beyond.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":" ","pages":"199-214"},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10308058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hegemony versus pluralism: Ayurveda and the Movement for Global Mental Health. 霸权与多元主义:阿育吠陀和全球心理健康运动。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2023-06-01 DOI: 10.1080/13648470.2020.1785842

Murphy Halliburton

{"title":"Hegemony versus pluralism: Ayurveda and the Movement for Global Mental Health.","authors":"Murphy Halliburton","doi":"10.1080/13648470.2020.1785842","DOIUrl":"https://doi.org/10.1080/13648470.2020.1785842","url":null,"abstract":"Under the aegis of the World Health Organization, the Movement for Global Mental Health and an Indian Supreme Court ruling, biomedical psychiatric interventions have expanded in India augmenting biomedical hegemony in a place that is known for its variety of healing modalities. This occurs despite the fact that studies by the WHO show better outcomes in India for people suffering from schizophrenia and related diagnoses when compared to people in developed countries with greater access to biomedical psychiatry. Practitioners of ayurvedic medicine in Kerala have been mounting a claim for a significant role in public mental health in the face of this growing hegemony.This study examines efforts by ayurvedic practitioners to expand access to ayurvedic mental health services in Kerala, and profiles a rehabilitation center which combines biomedical and ayurvedic therapies and has been a key player in efforts to expand the use of Ayurveda for mental health. The paper argues for maintaining a pluralistic healing environment for treating mental illness rather than displacing other healing modalities in favor of a biomedical psychiatric approach.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":"30 2","pages":"85-102"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13648470.2020.1785842","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9628353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Infertility as inevitable: chronic lifestyles, temporal inevitability and the making of abnormal bodies in India. 不孕是不可避免的:在印度，长期的生活方式，暂时的必然性和不正常身体的形成。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2023-06-01 DOI: 10.1080/13648470.2021.1874872

Anindita Majumdar

{"title":"Infertility as inevitable: chronic lifestyles, temporal inevitability and the making of abnormal bodies in India.","authors":"Anindita Majumdar","doi":"10.1080/13648470.2021.1874872","DOIUrl":"https://doi.org/10.1080/13648470.2021.1874872","url":null,"abstract":"In seeking to explore the meaning of chronic and chronicity, the association with infertility is neither immediate nor evident. However, this paper explores this relationship by analyzing the idea of infertility in relation to chronicity. In the linkages that come forth the idea of chronic lifestyle emerging from certain ways of being and living, as well the imaginings associated with the chronic body become important nodes of exploring the relationship between infertility and chronicity. Most importantly, the role that time plays in marking the chronic state is seen to be especially potent in the practice of infertility treatment, and the narratives that emerge around its temporal inevitability. The rhetoric that marks the diagnosis and prescription of treatment is often based on the identification of the body as susceptible to reproductive decline and failure, due to the contingencies of modern living. This often translates into a more sustained involvement with ARTs, which may or may not fulfil the required desire for a child. In this paper I seek to analyse the ways in which practitioners of infertility medicine create an image of an affliction that borders on chronicity. In the process, I question the idea of both chronic diseases and chronicity by looking at how illness is imagined in narratives that IVF specialists create in public, and through the idea of a cure for infertility. By analysing data collected through ethnographic fieldwork, this paper aims to build on the idea of the chronic as inevitable within clinical discourse and practice.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":"30 2","pages":"120-134"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9984078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Chronic relationships and mental health care: global pharmaceuticals in a local healing shrine in India. 慢性关系和精神保健:印度当地治疗圣地的全球药品。

IF 1.8 4区社会学

Anthropology & Medicine Pub Date : 2023-06-01 DOI: 10.1080/13648470.2023.2212212

Shubha Ranganathan

{"title":"Chronic relationships and mental health care: global pharmaceuticals in a local healing shrine in India.","authors":"Shubha Ranganathan","doi":"10.1080/13648470.2023.2212212","DOIUrl":"https://doi.org/10.1080/13648470.2023.2212212","url":null,"abstract":"The paper explores how chronicities and chronic relationships are fostered at a state-sponsored community psychiatry clinic that has been affiliated with a Sufi shrine in western India. The clinic provides free psychotropic treatment to patients, most of whom are pilgrims visiting the shrine. While the clinic has been lauded for its collaborative approach of blending 'medicine and prayer' in the provision of mental health care, observations of clinical encounters reflect the prevalence of a strongly medicalized perspective of mental illness, where local narratives of distress are reframed as globalized categories of mental disorder, thereby permitting pharmacological intervention. Importantly, in a context where free medicines are offered just as other freebies are in development initiatives in India, this results in the creation of long-term, 'chronic' relationships with patients who only seem to return for medicines, never recovering. This paper illustrates how 'chronicity', in many ways, is built into the project from the beginning itself. It becomes evident in the assumptions of the officials and psychiatrists that mental illness is chronic, in the case files of patients that record their consultation and medication histories, and in the clinical conversations about the importance of compliance to treatment. Given that historically, community mental health emerged in the context of reducing long hospital stays and deinstitutionalizing mental health care, it is important to reflect on how these policies and practices result in the creation of a cadre of chronic out-patients.","PeriodicalId":8240,"journal":{"name":"Anthropology & Medicine","volume":"30 2","pages":"135-152"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9987172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0