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1.
Environ Manage ; 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38753052

RESUMO

Landscape governance challenges, particularly in peri-urban contexts like the Bannerghatta National Park (BNP) region in South India, exemplify 'wicked' problems due to their inherent complexities. These challenges arise from a mix of conflicting interests, policy ambiguities, and sociocultural dynamics, which often blur the definition of problems and hinder effective solutions. Despite apparent options for resolution, stakeholder disagreements and deep uncertainties about implementation strategies complicate governance. This study, therefore, has two broad objectives. The first objective is to analyze the local discourses surrounding planned policy interventions around the BNP region in South India. Based on the findings, the second objective is to draw insights for sustainable natural resource governance research and practice. We applied Q-methodology to understand the discourses that underpin various conflicts in the rapidly urbanizing elephant corridor at BNP. We elicited information on how various local actors frame solutions to current collective action challenges in the BNP landscape and their perspectives on the proposed eco-sensitive zone notification, as well as the functioning of current policy interventions concerning conservation and development. The study uncovers the micropolitics and power regimes underpinning various natural resource governance challenges and demonstrates the utility of the Q-methodology in bringing diverse perspectives together in response to 'wicked' governance challenges.

2.
Soc Sci Med ; 350: 116927, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38703467

RESUMO

Previous research shows that men who experience erectile or sexual dysfunction may feel uncomfortable discussing their sexual experiences in face-to-face clinical encounters. Part of the reason is the stigma and embarrassment associated with discussing private sexual matters. This study examines how e-patients, or more precisely advice-seekers, and doctors communicate about sexual dysfunction in online medical consultations (OMCs). We conducted a Theme-Oriented Discourse Analysis of relevant OMCs on CH Doctor, a Chinese medical consultation website, to understand how individuals with perceived sexual dysfunction articulate their conditions and how doctors on the platform respond and provide recommendations to these individuals. Our analysis reveals that OMCs afford advice-seekers a place to openly discuss their sexual health issues and gain empowerment from doctors who assist in mitigating the associated social stigma. Upon detailed discourse analysis, however, we find that individuals seeking advice often interpret their sexual experiences as symptoms of illness that requires medical intervention. In response, doctors tend to validate these advice-seekers' preliminary self-diagnoses by treating their conditions as medical issues and characterizing them as psychosocial problems caused by stress and anxiety. Aligning with a critical sociological perspective that views sexual dysfunction as socially constructed problems referenced against dominant norms of sexual functioning, we argue that the medicalization and psychologization of certain sexual behaviors by doctors and advice-seekers discursively reinforce and legitimize essentialist views of hetero-coital sexual interaction. Such views reify penile-vaginal intercourse and ejaculation as the only standard, successful, and desirable form of sexual activity. This may further induce fear and anxiety among adult men whose sexual behaviors do not realistically align with these norms.


Assuntos
Relações Médico-Paciente , Humanos , Masculino , China , Medicalização , Estigma Social , Disfunções Sexuais Fisiológicas/psicologia , Internet , Comunicação , Adulto , Comportamento Sexual/psicologia , Disfunções Sexuais Psicogênicas/psicologia , Encaminhamento e Consulta , População do Leste Asiático
3.
Appetite ; : 107502, 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38777043

RESUMO

The family meal has been extensively investigated as a site for children's acquisition of eating-related behaviors and attitudes, as well as culture-specific rules and assumptions. However, little is known about children's socialization to a constitutive dimension of commensality and even social life: good manners concerning bodily conduct. Drawing on 20th century scholarship on body governmentality and good manners, and building on recent studies on family meal as a socialization site, the article sheds light on this overlooked dimension of family commensality. Based on a corpus of more than 20 h of videorecorded family dinner interactions collected in Italy, and using discourse analysis, the article shows that family mealtime constitutes a relevant arena where parents control their children's conduct through the micro-politics of good manners. By participating in mealtime interactions, children witness and have the chance to acquire the specific cultural principles governing bodily conduct at the table, such as "sitting properly", "eating with cutlery", and "chewing with mouth closed". Yet, they are also socialized to a foundational principle of human sociality: one's own behavior must be self-monitored according to the perspective of the generalized Other. Noticing that forms and contents of contemporary family mealtime talk about good manners are surprisingly similar to those described by Elias in his seminal work on the social history of good manners, the article documents that mealtime still constitutes a privileged cultural site where children are multimodally introduced to morality concerning not only specific table manners, but also more general and overarching assumptions, namely the conception of the body as an entity that should be (self)monitored and shaped according to moral standards.

4.
Int J Qual Stud Health Well-being ; 19(1): 2356924, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38796859

RESUMO

PURPOSE: This paper examines the subjective experience of medical interventions on intersex bodies to reduce cancer risk. METHODS: Twenty-five individuals with intersex variations took part in semi-structured interviews, analysed through thematic discourse analysis. RESULTS: Intersex bodies were positioned as inherently sick and in need of modification, with cancer risk legitimating surgical and hormonal intervention. This resulted in embodied shame, with negative impacts on fertility and sexual wellbeing. However, many participants resisted discourses of bio-pathologisation and embraced intersex status. Some medical interventions, such as HRT, were perceived to have increased the risk of cancer. Absence of informed consent, and lack of information about intersex status and the consequences of medical intervention, was positioned as a human rights violation. This was compounded by ongoing medical mismanagement, including health care professional lack of understanding of intersex variations, and the objectification or stigmatization of intersex people within healthcare. The consequence was non-disclosure of intersex status in health contexts and lack of trust in health care professionals. CONCLUSIONS: The legitimacy of poorly-evidenced cancer risk discourses to justify medical intervention on intersex bodies needs to be challenged. Healthcare practitioners need to be provided with education and training about cultural safety practices for working with intersex people.


Assuntos
Neoplasias , Humanos , Masculino , Feminino , Neoplasias/psicologia , Neoplasias/prevenção & controle , Adulto , Pessoa de Meia-Idade , Transtornos do Desenvolvimento Sexual , Medo , Pesquisa Qualitativa , Adulto Jovem , Vergonha
5.
Int J Nurs Stud ; 156: 104807, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38797042

RESUMO

INTRODUCTION: Due to the global aging trend, the number of older people who will spend the last years of their lives in nursing homes is increasing. However, nursing homes have long confronted negative social and public discourses, including stigmas on dementia and life in such facilities. Nevertheless, the remaining time of residents with dementia holds significance, for them and their families, as they seek respect and the ability to make meaningful end-of-life decisions. OBJECTIVE: To explore how nursing home nurses advocate for the remaining lifetimes of residents with dementia. DESIGN: A qualitative research design. SETTING(S): Four nursing homes in Korea from January 2023 to February 2023. PARTICIPANTS: Twenty nurses who provide direct caregiving for residents with dementia and have a minimum of two years' experience in nursing homes were recruited. METHODS: This study employed a critical discourse analysis. Twenty interviews conducted with nursing home nurses were examined to explore the connections between the grammatical and lexical aspects of the language used by the nurses to construct their identities as advocates for residents with dementia and the broader sociocultural context. FINDINGS: Four discourses regarding nursing home nurses advocating for the value of life of residents with dementia were identified: (1) Bridging perspectives: I am a negotiator between medical treatment and residents' families with differing views; (2) Embracing a shared humanity: Residents are no different from me; they just need professional help; (3) Affirming belongingness: Residents still belong to their families, even when care has been delegated; and (4) Empowering voices for change: We are struggling to provide better care in a challenging reality. CONCLUSIONS: This paper highlights the importance of nursing advocacy in safeguarding the remaining time and dignity of individuals with dementia, challenging the stigma surrounding dementia and nursing homes and calling for greater societal and political recognition of the efforts nurses make to preserve the personhood and well-being of these older adults.

6.
BMC Psychol ; 12(1): 281, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38773668

RESUMO

BACKGROUND: ADHD is the most common childhood neurodevelopmental disorder. The symptomatology makes the management of ADHD particularly demanding in school, so teachers' training programs have been widely implemented. Nevertheless, these interventions could lead teachers to concentrate on the dysfunctional elements of these students, exposing them to the risk of stigmatisation. Conceptualising stigma and inclusion as narrative processes, the present study observed how teacher ADHD training texts, endorsed by the Italian government, impact on the inclusion process of students. METHODS: The research analysed a corpus of N = 31,261 text occurrences and focused on three areas: (1) ADHD as a clinical condition; (2) the impact of ADHD characteristics in the scholastic setting; (3) interventions to manage ADHD criticalities in school settings. To observe the interactive processes fostered by the narratives under scrutiny, we used Dialogic Science and MADIT methodology, since they allow us to measure the language use modalities through an index: the Dialogical Weight (dW). The value of dW ranges between 0.1 (min) and 0.9 (max) and is linked to the potential outcomes of inclusion for students with ADHD. A low dW accounts for narratives entrenched in personal beliefs presented as absolute truths, undermining inclusion of students with ADHD. In contrast, high dW signals language interaction relying on sharable elements, able to foster social unity and diminish stigma. RESULTS: The results yielded a critical discursive configuration, both in general and for the three distinct areas. We measured an overall Dialogical Weight of 0.4dW and, for the three areas (1) = 0.3dW; (2) = 0.3dW; (3) = 0.4dW. The analysed text does not maximise the triggering of inclusive interactions, as they rely on individual references and present one's narrative as the sole plausible perspective: reinforcing already existing positions and exposing to the risk of stereotyping of the pupils. CONCLUSIONS: The study highlighted how the ADHD training materials analysed, focusing on a purely informational and clinical approach, lose in effectiveness with respect to generating inclusive school settings. Finally, to promote the inclusion of these pupils, elements are offered for outlining an approach based on fostering active participation by all roles involved.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Narração , Estudantes , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Criança , Estigma Social , Masculino , Itália , Feminino , Professores Escolares/psicologia , Instituições Acadêmicas , Capacitação de Professores/métodos
7.
Heliyon ; 10(9): e30089, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38707291

RESUMO

Increasing concerns about the health impacts of sugar consumption has led to the proposition of a sugar-sweetened beverage (SSB) tax in Canada. However, competing concerns related to stigma and equity remain and have not been explored in a Canadian context. As part of a broader study examining the perspectives of various populations on SSB tax acceptability, we examined how residents of an upper-middle class neighborhood conceptualize SSB tax acceptability, and we explored the discourses that inform their discussion. We conducted and analyzed qualitative, semi-structured interviews with residents of an upper-middle class neighborhood in Winnipeg, Manitoba, Canada. Recruitment criteria were residence, adults, and English speaking. Critical discourse analysis methodology was used, and healthism (health moralism) and tax psychology informed the analysis. Eighteen participants volunteered: 15 females and 3 males; all self-identified as white, and all spoke about (grand)parenting. Healthist discourse was utilized in supportive discussion of SSB taxation. With the mobilization of healthism, ideal citizens and parents were described as "health conscious" and those who might be likely to reduce SSB intake because of taxation. Healthism also contributed to their identification of beverages targeted by a tax, versus those they deemed as having redeeming nutritional qualities. Limits to SSB tax support were expressed as fairness concerns, with a focus on the procedural justice of the tax. Participants supported SSB taxation and the discourses they employed suggested support for the tax was perceived as contributing to their construction of the kind of ideal, health-valuing citizens they hoped to embody. However, participants were also concerned about the fairness of implementation, although this did not outweigh the prioritization of good health.

8.
Int J Drug Policy ; 128: 104430, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38703623

RESUMO

BACKGROUND: A growing body of research has analysed the representations of alcohol and other drugs (AOD) in policy-making, but few studies have focused on the representations reproduced in law-making processes, especially in the context of the regulation of the rights of social and health care service users. This study examined what kind of representations of AOD use are reproduced in the legislative reform of social and health care service users' rights in Finland. The purpose of the reform is to strengthen social and health care service users' rights to self-determination and to reduce the use of restrictive measures. METHODS: As its data, the study used a draft of the bill and stakeholder opinions regarding the reform. 'What's the problem represented to be?' approach as a methodological framework. RESULTS: The study discovered three AOD-related discourses: the Control, Welfare, and Rights and Legality discourses. The Control discourse represented people who use AOD as risky individuals and called for ways to manage risks in treatment situations. The Welfare discourse portrayed people who use AOD as a vulnerable group whose problems should be addressed by the welfare system. The Rights and Legality discourse represented the vague legal definitions of AOD use as the main regulatory problem. The discourses differed in terms of their definitions of self-determination. CONCLUSIONS: The study illustrated how the right to self-determination as a legal concept is contested and can be interpreted in different ways depending on the representations of AOD use. The differing representations highlight the tensions involved in improving the rights of people who use AOD.

9.
Heliyon ; 10(7): e27858, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38560119

RESUMO

Sweden's strategy during COVID-19 with restrictions but no firm closure of the society surprised the rest of the world and was questioned, not least by neighbouring countries. This article analyses public discourses on space and place for health and care in the Swedish daily press during the first year of the pandemic, 2020. Critical discourse analysis was conducted on daily press newspaper articles to approach issues of space, place, health and care during the COVID-10 pandemic. The findings suggest three main discourses. First, a powerful discourse on unity against the threat is articulated, urging citizens in Sweden to be loyal in the national space. Secondly, an affirming national reconstructing discourse is manifested, related to constructions of borders of national space but also in relation to places of family life and social contacts to 'flatten the curve' and stay healthy. Thirdly, later in the period the overarching discourse of the nation and its loyal citizens was torn apart and increasing tensions were articulated due to, as it appeared, the uncertain actions from the government. This study adds to the literature on a theoretical and practical level. Raising awareness on nationalist discourses in relation to place, space, health, and care could prove important in combating inequalities in the local society as well as when cooperating on an international level.

10.
Arch Sex Behav ; 2024 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-38635110

RESUMO

Research on online pornography abstinence movements has predominantly focused on men's perspectives, often within the context of the broader manosphere. This focus has overshadowed the unique experiences and viewpoints of women in these movements. Our study aimed to fill this gap by exploring women-centric perspectives in pornography abstinence forums, particularly Porn Free Women (r/pornfreewomen). Using a mixed methods approach, this study examined the sexual scripts presented in women-dominated pornography abstinence communities. Our structural topic modeling analysis delineated the interplay of therapeutic, heteronormative, and empowerment themes that were evident in women's narratives and expressions. Further, our discourse analysis elucidated three specific scripts: the addiction script, the heterosexual script, and the liberation script. These interweaving narratives show that discussions of women's pornography abstinence are multifaceted and include a variety of perspectives to negotiate. These results contribute to a nuanced understanding of the values of health and well-being, sexual liberation, and feminism within women's pornography abstinence communities.

11.
Heliyon ; 10(7): e28233, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38596052

RESUMO

UNESCO's Intergovernmental Oceanographic Commission launched the United Nations Decade of Ocean Science for Sustainable Development in 2021 to boost global and sustainable Ocean governance. The initiative resulted from historical and political dynamics at the global and lower political scales, with maritime environmental and economic concerns becoming more prominent in 2010. The Ocean Decade's pillars include science and research, sustainability, conservation, and bridging gaps for a global Ocean-Climate-Biodiversity nexus. The Sustainable Development Goals recognized the importance of oceans and marine resources, and the Ocean was officially perceived as a determining factor of Climate Change at CoP 21 in 2015. Portugal has built integrated and far-reaching policies for ocean governance, including significant involvement with an international perspective since the Lisbon World Exhibition in 1998. In addition, the national government established a Ministry of the Sea in 2015 to re-develop relations with its maritime space. This article analyzes and compares the discourse of the United Nations' Sustainable Development Goals reports and the Portuguese government programs (2005-2022) to explore the prominent trends in Portuguese Ocean governance discourse and how global and national perspectives interact. Through this case study, the research aims to develop insights into the multiscalar impacts of promoting global and sustainable Ocean governance and its interaction with national perspectives.

12.
Front Sociol ; 9: 1374488, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38577241

RESUMO

Introduction: As sexuality in physical education (PE) is often treated as a taboo subject, social media platforms, online chats, and internet forums are emerging as spaces where it is negotiated more openly and broadly by current and former actors of the field. This paper contributes to a better understanding of the discursive construction of sexuality in PE in such online communication. Methods: In line with The Sociology of Knowledge Approach to Discourse (SKAD) we investigate basic schemes of interpretation of sexuality with a heterogeneous sample of threads (17 threads from seven different online forums) on different PE situations in Germany. The threads are analyzed using grounded theory coding procedures. Results: Our discourse analysis reveals that the multifaceted and often controversial online discussions are structured by two dominant schemes of interpreting students' sexuality in PE, both of which are differentiated in complex ways: The online communication draws on - and by that reproduces - a nature and a culture perspective on constellations of body, sex, gender, and sexuality. We detail how from each perspective, different knowledge about these constellations, different everyday phenomena and problems in PE, and different norms for dealing with these phenomena and problems become important. Discussion: Discussing these results in the context of previous literature, we argue that it is important to address sexuality in a subject-specific approach and take the discursive knowledge and fundamental schemes of interpretation into account that shape the (im-)possibilities of addressing sexuality in PE.

13.
UCL Open Environ ; 6: e1975, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38586275

RESUMO

For decades, the European Union (EU) has been addressing issues related to climate change and ecological degradation as a self-proclaimed pro-environmental and human rights-oriented actor. Correspondingly, the topic of the so-called environmentally driven migration entered the EU discourse at the dawn of the new millennium. Considering the EU's interest in the human rights and environmental/climate issue areas, I argue it is important to ask what the Union's approach to this matter has been. Thus, this article assesses the European Union discourse related to the topic of environmental migration over the past 20-year period. Through the theoretical lens of the Copenhagen School of Security Studies and the normative power EU conception, this paper critically analyses the EU's securitisation of climate change in relation to persons referred to as environmental migrants. Based on a qualitative discourse analysis, the preliminary results imply that the topic has been receding into the background of the EU agenda. In line, environmental migrants have been pushed aside by a multiplicity of other subjects threatened by climate change, thus receiving lesser attention in the EU climate change and migration management policies. Overall, the findings show a shift from an alarmist discourse to more pragmatism on the EU's behalf and a larger focus on adaptation and resilience in most affected areas. With this in mind, this article questions the normative standard the EU sets for itself when it comes to the case of environmental migrant protection.

14.
Artigo em Inglês | MEDLINE | ID: mdl-38597411

RESUMO

The research employs a single embodied case study design with the aim to examine the discourse of men accessing and receiving mental health support alongside those who are the providers of the support. Three groups of adults were interviewed: men who had experienced mental health problems and had attempted to access mental health support; lay people who supported them, such as partners and non-mental health professionals and professionals, such as mental health nurses, social workers, clinical psychologists and general practitioners. Critical discourse analysis (CDA) is used to identify discourses around three emergent themes: well-being, power and dominance and social capital. Participants seeking mental health support often referred to mental health services as not listening or that what was offered was not useful. A lack of belonging and community disconnectedness was apparent throughout all participant interviews. The study is reported according to the COREQ guidelines.

15.
Clin Neuropsychol ; : 1-29, 2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38605497

RESUMO

Objective: Limited normative data (including psychometric properties) are currently available on discourse tasks in non-dominant languages such as Laurentian (Quebec) French. The lack of linguistic and cultural adaptation has been identified as a barrier to discourse assessment. The main aim of this study is to document inter-rater and test-retest reliability properties of the picnic scene of the Western Aphasia Battery - Revised (WAB-R), including the cultural adaptation of an information content unit (ICU) list, and provide a normative reference for persons without brain injury (PWBI). Method: To do so, we also aimed to adapt an ICU checklist culturally and linguistically for Laurentian French speakers. Discourse samples were collected from 66 PWBI using the picture description task of the WAB-R. The ICU list was first adapted into Laurentian French. Then, ICUs and thematic units (TUs) were extracted manually, and microstructural variables were extracted using CLAN. Inter-rater reliability and test-retest reliability were determined. Results: Excellent inter-rater reliability was obtained for ICUs and TUs, as well as for all microstructural variables, except for mean length of utterance, which was found to be good. Conversely, test-retest reliability ranged from poor to moderate for all variables. Conclusion: The present study provides a validated ICU checklist for clinicians and researchers working with Laurentian French speakers when assessing discourse with the picnic scene of the WAB-R. It also addresses the gap in available psychometric data regarding inter-rater and test-retest reliability in PWBI.

16.
Clin Obes ; 14(3): e12666, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38660941

RESUMO

In early 2023, a new type of weight loss medication, Wegovy (semaglutide), was made available in Denmark. Both subsequent media coverage and public demand were huge. Wegovy is only available by prescription, primarily via general practitioners. However, there is very little knowledge about how healthcare professionals (HCPs) in general practice might deal with the great demand for and attention surrounding a new weight loss drug. The aim of this qualitative study was, therefore, to explore how Wegovy is managed and negotiated in general practice, particularly in terms of prescribing and follow-up. We conducted a focused ethnography study based on direct observation of consultations and both formal and informal interviews with seven doctors and four nurses from three general practices in Denmark. Using discourse analysis, we identified four central discourses revolving around trust in medicine, individual responsibility for health, the cost of weight loss medication, and the importance of shared decision-making. This study shows that the availability of a new, sought-after weight loss medication presents both opportunities and challenges for HCPs in general practice. The management of Wegovy involves numerous factors, including medical, economic, organizational, interpersonal and moral concerns.


Assuntos
Fármacos Antiobesidade , Medicina Geral , Pesquisa Qualitativa , Humanos , Dinamarca , Feminino , Masculino , Fármacos Antiobesidade/uso terapêutico , Redução de Peso , Pessoa de Meia-Idade , Adulto , Obesidade/tratamento farmacológico , Confiança , Clínicos Gerais/psicologia , Atitude do Pessoal de Saúde
17.
J Clin Nurs ; 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38528438

RESUMO

AIM: To improve the effectiveness of nursing clinical handover through a qualitative, tailored communication intervention. DESIGN: A multisite before and after intervention using qualitative ethnography combined with discourse analysis of nursing handover interactions. METHODS: We implemented a tailored ward-based intervention to redesign nursing handover practice with co-constructed recommendations for organisational and cultural change on seven wards across three affiliated metropolitan hospitals between February 2020 and November 2022. The intervention was informed by pre-implementation interviews and focus groups with nursing, medical and allied health staff and patients (n = 151) and observed and/or audio-recorded handover events (n = 233). Post-intervention we conducted interviews and focus groups (n = 79) and observed and/or audio-recorded handover events (n = 129) to qualitatively evaluate impact. RESULTS: Our translational approach resulted in substantial changes post-intervention. Nurses conducted more shift-to-shift handovers at the bedside, with greater patient interaction and better structured and more comprehensive information transfer, supported by revised handover documentation. Redesigned group handovers were focused and efficient, communicating critical patient information. CONCLUSION: Contextualised training combined with changes to ward-level systemic factors impeding communication results in improved nursing handovers. Practice change requires strong executive leadership and project governance, combined with effective ward-level leadership, collaboration and mentoring. The speed and degree of change post-intervention demonstrates the power of interdisciplinary collaborative research between hospital executive, ward leadership and communication specialists. RELEVANCE TO CLINICAL PRACTICE: Nurses are more likely to conduct efficient group handovers and informative, patient-centred bedside handovers in line with policy when they understand the value of handover and have practical strategies to support communication. Communication training should be combined with broader ward-level changes to handover practice tailored to the ward context. A multilevel approach results in more effective practice change. REPORTING METHOD: We adhered to the COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION: We interviewed patients on study wards pre and post intervention.

18.
Qual Health Res ; : 10497323241238628, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38529595

RESUMO

Healthy eating (HE) and pro-eating disorder (pro-ED) websites are popular sources of dietary and weight loss information, social support, and lifestyle inspiration. However, the discursive styles and language used by authors/moderators and users of these two site genres have not been widely studied or compared. Forty-three HE websites and twenty-four pro-ED websites were analysed using Fairclough's model of critical discourse analysis. Findings indicate that sites share common characteristics in terms of power relations played out by authors, 'successful' dieters, and those attending these sites. These power plays encourage moral and spiritual commitment to the care of one's body, with authoritative language used to support readers' loyalty and adherence to dietary plans. On HE sites, medicinal properties were attributed to 'clean' or 'pure' foods, whereas pro-ED sites conveyed their importance for weight reduction. Healthy eating sites were largely entrepreneurial, promoting products or themselves. Pro-eating disorder sites typically featured discussions of bodily disgust, the chastisement of others, and self-discipline in the name of 'Ana', such that dieting came to be framed as part of a devotional, often punitive, body project. On both sites, morality discourses were gendered around the thin female body and the 'ideal mother', with occasional praise for muscular male bodies. Our findings indicate how transitioning from healthy eating preoccupations to eating disorders may be facilitated by normalising discussions about restrictive dieting and the shaming of bodies, overseen by self-appointed diet 'experts' and 'buddies' online.

19.
BMC Nurs ; 23(1): 153, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38439003

RESUMO

BACKGROUND: Intensive care unit (ICU) nurses working in South Korea report experiencing uncertainty about how to care for patients undergoing withdrawal of life-sustaining treatments (WLT). A lack of consensus on care guidelines for patients with WLT contributes to uncertainty, ambiguity, and confusion on how to act appropriately within current law and social and ethical norms. To date, little has been discussed or described about how ICU nurses construct meaning about their roles in caring for dying patients in the context of wider social issues about end-of-life care and how this meaning interacts with the ICU system structure and national law. We aimed to better understand how ICU nurses view themselves professionally and how their perceived roles are enabled and/or limited by the current healthcare system in South Korea and by social and ethical norms. METHODS: This qualitative descriptive study was conducted using in-depth, semi-structured interviews and discourse analysis using Gee's Tools of Inquiry. Purposive sampling was used to recruit ICU nurses (n = 20) who could provide the most insightful information on caring for patients undergoing WLT in the ICU. The interviews were conducted between December 2021 and February 2022 in three university hospitals in South Korea. RESULTS: We identified four categories of discourses: (1) both "left hanging" or feeling abandoned ICU nurses and patients undergoing WLT; (2) socially underdeveloped conversations about death and dying management; (3) attitudes of legal guardians and physicians toward the dying process of patients with WLT; and (4) provision of end-of-life care according to individual nurses' beliefs in their nursing values. CONCLUSION: ICU nurses reported having feelings of ambiguity and confusion about their professional roles and identities in caring for dying patients undergoing WLT. This uncertainty may limit their positive contributions to a dignified dying process. We suggest that one way to move forward is for ICU administrators and physicians to respond more sensitively to ICU nurses' discourses. Additionally, social policy and healthcare system leaders should focus on issues that enable and limit the dignified end-of-life processes of patients undergoing WLT. Doing so may improve nurses' understanding of their professional roles and identities as caretakers for dying patients.

20.
Sociol Health Illn ; 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38506159

RESUMO

Conceptualisations of grief have transformed significantly in recent decades, from an experience accepted and expressed in community spaces to a diagnosable clinical phenomenon. Narratives of this transformation tend to focus on grief's relationship to major depression, or on recent nosological changes. This paper examines the possibility of a new narrative for medicalisation by grounding in the networks of language and power created around 'grief' through a critical discourse analysis of psy-discipline articles (n = 70) published between 1975 and 1995. Focusing on shifts in definitions of, methods used to approach, and rationales motivating study of the experience, it posits that the psy-disciplines exerted exclusive expertise over grief decades before its creation as a diagnosis. By reconceptualising grief in the terms of psy-specific symptoms and functional performance and by approaching it with the decontextualising and interventionist methods of an increasingly scientific psy-discipline, the psy-community medicalised grief between 1975 and 1995. Identifying neoliberal and other cultural influences shaping this process of medical construction and reconsidering narratives of grief's history mindful of the powers exerted in medicalisation, this paper establishes that these moments played a critical role in the development of the present's grief.

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