| Project/Area Number |
06610166
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
社会学(含社会福祉関係)
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| Research Institution | KYOTO UNIVERSITY |
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Principal Investigator |
HOGETSU Makoto Kyoto University, Faculty of Letters, Professor, 文学部, 教授 (50079018)
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| Project Period (FY) |
1994 – 1995
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| Project Status |
Completed (Fiscal Year 1995)
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| Budget Amount *help |
¥1,600,000 (Direct Cost: ¥1,600,000)
Fiscal Year 1995: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 1994: ¥900,000 (Direct Cost: ¥900,000)
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| Keywords | Chronic Illness / Illness Trajectory / Uncertainty / Danger / Dilemma / Coping Strategy / 病気軌道 / 診療上の「問題」 / 交渉 / 制度的回避 / 医療 / 診療上の問題 / 問題への対処戦略 / 副作用 / 協働活動 |
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| Research Abstract |
This paper is to see what problems there are at the medical encounter of chronic illness and to find out how doctor and patient co-worked to cope with them. I observed doctor-patient interaction and taperecorded their conversation at examination room for out-patients of the rheumatics in a medical school hospital.
I find two types of problematic situations which they have to manage during medical encounter process : One is the uncertainty of illness trajectory and the danger might be caused by side effects of medicine. These problems are even nowadays unavoidable under medical treatment for rheumatoid arthritis. Another problem is that they are often in a dilemma as to whether to obey strictly the restriction of health insurance rules or to consider patient's convenience in terms of the amount of medicine or appointment. They seem to have devised the coping strategies to control these problems. The followings are typical strategies : frank conversation without technical terms to make it easy to check the present illness trajectory stage ; negotiation to get the agreement or satisfaction enouth to continue the co-operative work. Through this negotiation, they sometimes use institutional evasion in conspiracy such as writting down prescription as much as possible without a real diagnosis.
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