Accounting for health and illness: A social psychological investigation

Stainton Rogers, Wendy (1989). Accounting for health and illness: A social psychological investigation. PhD thesis The Open University.



This thesis identifies and describes some of the main accounts for health and illness that are current in British culture, placing them within broader contexts of psychological, sociological, traditional, religious and moral discourses; within broader explanatory frameworks; and, by way of an analysis of these ecological aspects, seeks to illuminate our understanding of such accounting.

A combination of Q and ethnographic methods were used to elucidate a variety of alternative ways that people "make sense" of health and illness. Three main studies were conducted. The first two investigated accounting for health and illness within a broad framework of accounts as "explanations"; as moral judgements and prescriptions; and as defining meaning. The third study focussed on the external/internal explanatory framework, and demonstrated that accounting is far more complex than the Wallston and Wallston (1981) "Health Locus of Control Construct' would suggest. Some accounts stressed "internality", some "externality", some a combination of both, and others viewed this construct as non-salient. These latter included accounts about personal autonomy, and, importantly, the 'medical model" account.

In the thesis overall, among the accounts identified were ones based upon notions of : "the wonders of modern medicine"; "stress"; "the cultural critique'; 'a healthy lifestyle", 'tradition"; "individual autonomy", 'Theism'; and "Willpower". These accounts are assumed to operate both within individual subjectivity and popular discourse, offering people a variety of complementary 'texts' with which to weave narratives, drawing upon different 'texts" according to situational and other demands. Thus accounting is portrayed as an active, thoughtful and sometimes contradictory 'storymaking" activity, and people as competent negotiators of reality.

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