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Samenvatting Sociologie van Gezondheid en Welzijn
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Samenvatting voor het vak Sociologie van Gezondheid en Welzijn (slides + eigen aantekeningen)
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SOTA GEZONDHEID EN WELZIJNInhoudsopgave
DEEL 1: ZIEKTEMODELLEN ............................................................................................................................. 10
1 Inleiding............................................................................................................................................... 10
2 5 ziektemodellen ................................................................................................................................. 13
2.1 Biomedisch model (Engel, 1977) ........................................................................................................ 13
2.1.1 Assumtpies van biomedische model ............................................................................................. 13
2.1 Dokter-patiënt relatie binnen biomedische model ....................................................................... 15
2.2 Biopsychosociaal model (Engel, 1977) ............................................................................................... 17
2.2.1 Ontstaan als kritiek op het biomedische model ............................................................................ 17
2.2.2 Assumpties van biopsychosociaal model ...................................................................................... 18
2.2.3 Kritiek biopsychosociaal model ..................................................................................................... 18
2.3 Evolutionair perspectief (Nesse & Williams, 1998) ............................................................................. 19
2.3.1 Evolutionair model vs. biomedische model................................................................................... 19
2.3.2 Evolutionair model: assumpties .................................................................................................... 20
2.3.3 Evolutionair vs. Biomedisch model................................................................................................ 21
2.4 Ecologisch perspectief (Rose, 1985) ................................................................................................... 22
2.4.1 Ecologisch perspectief vs. biomedische model ............................................................................. 22
2.5 Sociologisch model ............................................................................................................................. 23
2.5.1 Afbekaning concepten ................................................................................................................... 23
2.5.2 Ziekenrol (Parsons 1951) ............................................................................................................... 25
2.5.3 Ziekenrol heeft controle functie .................................................................................................... 27
2.5.4 Kritiek op Parsons’ ziekenrol ......................................................................................................... 28
2.5.5 Meerwaarde Parsons’ ziekenrol .................................................................................................... 29
3 Samenvattend ..................................................................................................................................... 29
DEEL 2: WELZIJN EN WELZIJNSZORG.............................................................................................................. 30
1 Het begrip welzijn ................................................................................................................................ 30
1.1 Hedonistische welzijnsbenadering...................................................................................................... 30
1.1.1 Kritiek op economische visie ......................................................................................................... 31
1.2 Eudaimonische welzijnsbenadering.................................................................................................... 31
1.2.1 Toepassing van de eudaimonische welzijnsbendadering: ............................................................ 32
1.3 Sen’s capaciteitsbenadering ............................................................................................................... 32
1.4 ‘Objectieve’ welzijnsmaten ................................................................................................................. 34
1.5 Multidimensionele welzijnsdefinitie ................................................................................................... 35
2 Welzijnszorg ........................................................................................................................................ 35
2.1 Welvaart als catalysator van welzijn? (1)........................................................................................... 35
2.1.1 Welvaart als catalysator van welzijn?............................................................................................ 35
2.2 Doelen van de welzijnszorg ................................................................................................................ 37
2.3 Vormen van de zorg ........................................................................................................................... 37
2.4 Ongelijkheid in zorg ............................................................................................................................ 39
1
, 2.5 Afstemming ........................................................................................................................................ 39
2.5.1 Macro-niveau: ............................................................................................................................... 39
2.5.2 Meso-niveau .................................................................................................................................. 40
2.5.3 Micro-niveau ................................................................................................................................. 40
3 De welzijnszorg in België en Vlaanderen (tekst) ................................................................................... 41
3.1 Gehandicaptenzorg ............................................................................................................................ 42
3.1.1 Diensten en Voorzieningen ........................................................................................................... 42
3.1.2 Individuele materiele bijstand ....................................................................................................... 43
3.1.3 Persoonlijk assistentiebudget (PAB) .............................................................................................. 43
3.1.4 Een ommezwaai: perspectief 2020 - een nieuw ondersteuningsbeleid voor pmh ....................... 44
3.1.5 Persoonsvolgende financiering ..................................................................................................... 44
3.1.6 De rol van de verschillende beleidsniveaus ................................................................................... 44
2 OUDERENZORG ....................................................................................................................................... 44
2.1 Intramurale voorzieningen (residentiel) ........................................................................................ 44
2.2 Ambulante voorzieningen ............................................................................................................. 44
2.3 Tussenvormen ............................................................................................................................... 45
2.4 De zorgverzekering ........................................................................................................................ 45
2.5 Beleidsevoluties ............................................................................................................................. 45
2.6 De rol vd verschillende beleidsniveaus.......................................................................................... 45
3 Gezinsbeleid ............................................................................................................................................ 45
3.1 Federale financiële, fiscale en familiale verlofmaateregelen ........................................................ 45
3.2 Kinderbijslag .................................................................................................................................. 46
3.3 Medisch-preventieve zorg en psychosociale en pedagogische ondersteuning............................. 46
3.4 De rol van de verschillende beleidsniveaus ................................................................................... 46
4 Integrale Jeugdhulp ................................................................................................................................. 46
4.1 Vermaatschappelijking .................................................................................................................. 46
4.2 Toegankelijkheid............................................................................................................................ 47
4.3 Wie krijgt welke hulp? ................................................................................................................... 47
4.4 Modulering van hulp ..................................................................................................................... 47
4.5 Continuïteit in de jeugdhulp .......................................................................................................... 47
4.6 Jeugdhulp in crisissituaties ............................................................................................................ 47
4.7 Jeugdhulp in verontrustende situaties .......................................................................................... 47
4.8 Gerechtelijke jeugdhulp ................................................................................................................ 47
4.9 Participatie van jongeren en ouders.............................................................................................. 48
4.10 Organisatie van integrale jeugdhulp.............................................................................................. 48
4.11 Jeugdhulp 2.0 ................................................................................................................................ 48
4.12 De rol van de verschillende beleidsniveaus ................................................................................... 48
5 Algemeen Welzijnswerk (AWW).............................................................................................................. 49
5.1 Private dienstverlening op het regionale niveau: het CAW........................................................... 49
5.2 Publieke dienstverlening op het lokale niveau: het OCMW (Openbaar Centrum voor
Maatschappelijk Welzijn) ............................................................................................................................. 50
5.3 De rol van de verschillende beleidsniveaus ................................................................................... 51
6 Armoedebeleid ........................................................................................................................................ 52
6.1 Federale overheid .......................................................................................................................... 52
6.2 Lokale overheid ............................................................................................................................. 52
6.3 Vlaamse overheid .......................................................................................................................... 52
6.4 De rol van de verschillende beleidsniveaus ................................................................................... 53
7 Minderhedenbeleid ................................................................................................................................. 53
7.1 federale overheid................................................................................................................................... 53
7.2 Vlaamse overheid .......................................................................................................................... 53
7.3 Lokale overheden .......................................................................................................................... 54
7.4 De rol van de verschillende beleidsniveaus ................................................................................... 54
2
, 8 Samenlevingsopbouw ............................................................................................................................. 54
8.1 Samenlevingsopbouw in vlaanderen ............................................................................................. 55
8.2 De rol van de verschillende beleidsniveaus ................................................................................... 55
DEEL 3: SOCIOLOGIE VAN DE CHRONISCHE ZIEKTEN ...................................................................................... 56
1 Inleiding: chronische ziekten ................................................................................................................ 56
1.1 Waarom een sociologie van chronische ziekten? ............................................................................... 56
1.1.1 Oorzaken: ...................................................................................................................................... 56
1.1.2 Sociale dynamieken als... ............................................................................................................... 58
1.2 Robert Strauss (1957): onderscheid tussen... ..................................................................................... 58
1.3 Kathy Charmaz (2009): ....................................................................................................................... 59
2 Biographical disruption ........................................................................................................................ 59
2.1 Van zieke-rol naar “biographical disruption” (1) ................................................................................ 59
2.1.1 Anselm Strauss (1975): .................................................................................................................. 60
2.2 Biographical disruption ...................................................................................................................... 60
2.3 Kritiek op ‘biographical disruption ..................................................................................................... 61
2.4 Kritiek op “biographical disruption” revisited..................................................................................... 62
2.4.1 Larsson & Grassman (2012): .......................................................................................................... 62
2.4.2 Saunders (2017) ............................................................................................................................. 63
2.5 “Biographical disruption” in de late moderniteit................................................................................ 63
2.6 Samenvatting ..................................................................................................................................... 63
3 Narrative reconstruction ...................................................................................................................... 64
3.1 Het chronische aspect ........................................................................................................................ 64
3.2 Narrative reconstruction .................................................................................................................... 64
3.3 Illness accounts................................................................................................................................... 64
3.3.1 Van ‘beliefs’ naar ‘accounts’ (Radley & Billig, 1996)...................................................................... 64
3.3.2 Publiek en context spelen rol in accounts (Hyden, 1997) ............................................................. 65
3.4 Samenvatting ..................................................................................................................................... 66
3.5 Kritiek ................................................................................................................................................. 66
4 Illness as adjustment ........................................................................................................................... 66
4.1 Twee perspectieven samenvoegen ..................................................................................................... 66
4.2 Adjustment ......................................................................................................................................... 66
4.3 Samenvatting ..................................................................................................................................... 67
5 Belangrijke thema’s ............................................................................................................................. 67
5.1 Onzekerheid........................................................................................................................................ 68
5.2 Adherence .......................................................................................................................................... 68
5.3 Stigma en schaamte ........................................................................................................................... 69
5.4 Functionele beperkingen en kwaliteit van het leven .......................................................................... 69
6 Voorbeelden ........................................................................................................................................ 70
DEEL 4: DE SOCIALE GRADIËNT IN GEZONDHEID............................................................................................ 71
3
, 1 Sociale Causatie Hypothese ................................................................................................................. 71
2 Sociale selectie hypothese ................................................................................................................... 73
2.1 En genen en biologie?......................................................................................................................... 74
2.2 Cross-nationale variatie in depressie.................................................................................................. 75
2.3 Selectie & causatie: een dynamische relatie ...................................................................................... 75
3 Fundamental Cause Theory.................................................................................................................. 76
3.1 SES beïnvloedt meerdere ziektepatronen. .......................................................................................... 77
3.1.1 Breed algemeen effect .................................................................................................................. 77
3.1.2 Sociale gradiënt ............................................................................................................................. 83
3.1.3 Ceiling effect .................................................................................................................................. 84
3.2 SES is gerelateerd aan meerdere risicofactoren. ................................................................................ 87
3.2.1 (On)gezonde levensstijlen ............................................................................................................. 88
3.2.2 Chronische en acute stress ............................................................................................................ 90
3.2.3 Sociale Isolatie ............................................................................................................................... 91
3.2.4 Gebruik van preventieve gezondheidszorg ................................................................................... 93
3.2.5 Slechte levensomstandigheden ..................................................................................................... 94
3.3 De relatie tussen SES en gezondheid is te verklaren doordat hoge SES groepen over meer middelen
beschikken en gebruiken................................................................................................................................... 96
3.4 De relatie tussen SES en gezondheid wordt over de tijd heen gereproduceerd.................................. 96
4 Besluitend: FCT .................................................................................................................................. 100
5 Fundamental causes of health ook op macro-niveau? ........................................................................ 100
6 Inkomensongelijkheid en gezondheid ................................................................................................ 102
6.1 Hoe verklaren we dit?....................................................................................................................... 102
DEEL 5: SEKSUELE EN REPRODUCTIEVE GEZONDHEID: DE SOCIOLOGIE VAN ABORTUS ................................ 103
1 Openingsvraag ................................................................................................................................... 103
2 Definities ........................................................................................................................................... 103
3 Data................................................................................................................................................... 104
4 Gevolgen ........................................................................................................................................... 106
5 Conceptual framework abortion trajectories: Hoe de keuze om al dan niet voor een abortus te kiezen
begrijpen .................................................................................................................................................... 111
5.1 Abortus-specifieke context ............................................................................................................... 111
5.1.1 Bewustzijn van de zwangerschap ................................................................................................ 111
5.1.2 Disclosure .................................................................................................................................... 113
5.1.3 Aanwezigheid van en toegang tot middelen ............................................................................... 114
5.1.4 Pogingen tot abortus ................................................................................................................... 115
5.1.5 Waargenomen en ervaren gevolgen van (poging tot) abortus ................................................... 116
5.1.6 Emoties met betrekking tot zwangerschap, het baren van kinderen en abortus ....................... 116
5.2 Individuele context ........................................................................................................................... 117
5.2.1 Kennis en overtuigingen m.b.t. abortus ...................................................................................... 117
5.2.2 Individuele kenmerken ................................................................................................................ 118
5.3 Regionale, nationale en internationale context ............................................................................... 119
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