Discourses of anxiety in nursing practice : a psychoanalytic case study of the change-of-shift handover ritual

This paper reports on the findings of a study that considered how anxiety might function to organise nurses' practice. With reference to psychoanalytic theory this paper analyses field notes taken during a series of nursing change-of-shift handovers. The handover practices analysed met all the criteria for a ritual, as understood in psychoanalytic theory, and functioned to alleviate anxiety in the short term while symbolically expressing a forbidden and unknown knowledge. We argue that the handover ritual contained certain prohibitions, yet allowed some expression of the prohibited knowledge in a disguised way. The prohibition concerned how the patient affected the nurse, that is, moved the nurse to love and hate the patient. We argue that this prohibition is expressed, in disguise, via the displacement of affection for the patient onto other nurses and through negative stereotyping of some patients. We also argue that these prohibitions of the handover mirror broader prohibitions within nursing, and thus the rituals of the handover become an expression of how professional prohibitions are enacted in practice. We conclude that the important implicit function of the handover ritual is to keep anxiety at bay, thereby enabling the nurse to commence practice rather than being immobilised by the effect of potentially overwhelming anxiety.

Creative suburbs? How women, design and technology renew Australian suburbs

Australian suburbs have long been subjected to negative stereotyping – as aesthetic wastelands, politically conservative, socially isolated and environmentally rapacious – as the last places you would expect creativity. A critical engagement with this discourse and an examination of older as well as some newer suburbs unsettles these characterizations. A broad definition of ‘creativity’ directs attention to what was occurring in 20th century Australian suburbs – with a creative domestic economy and modernist architecture providing strong counters to their negative portrayal. Further, as a sample of Melbourne’s contemporary master-planned estates will illustrate, at least some of this city’s houses and neighbourhoods are at the leading edge of architectural innovation, community building and environmental sustainability – creatively developing alternatives to the stereotypical suburb.

“I call it the blame and shame disease”: a qualitative study about perceptions of social stigma surrounding type 2 diabetes

Abstract
Objectives While health-related stigma has been the subject of considerable research in other conditions (obesity and HIV/AIDS), it has not received substantial attention in diabetes. The aim of the current study was to explore the social experiences of Australian adults living with type 2 diabetes mellitus (T2DM), with a particular focus on the perception and experience of diabetes-related stigma.

Design A qualitative study using semistructured interviews, which were audio recorded, transcribed and subject to thematic analysis.

Setting This study was conducted in non-clinical settings in metropolitan and regional areas in the Australian state of Victoria. Participants were recruited primarily through the state consumer organisation representing people with diabetes.

Participants All adults aged ≥18 years with T2DM living in Victoria were eligible to take part. Twenty-five adults with T2DM participated (12 women; median age 61 years; median diabetes duration 5 years).

Results A total of 21 (84%) participants indicated that they believed T2DM was stigmatised, or reported evidence of stigmatisation. Specific themes about the experience of stigma were feeling blamed by others for causing their own condition, being subject to negative stereotyping, being discriminated against or having restricted opportunities in life. Other themes focused on sources of stigma, which included the media, healthcare professionals, friends, family and colleagues. Themes relating to the consequences of this stigma were also evident, including participants’ unwillingness to disclose their condition to others and psychological distress. Participants believed that people with type 1 diabetes do not experience similar stigmatisation.

Conclusions Our study found evidence of people with T2DM experiencing and perceiving diabetes-related social stigma. Further research is needed to explore ways to measure and minimise diabetes-related stigma at the individual and societal levels, and also to explore perceptions and experiences of stigma in people with type 1 diabetes

‘Fat, four-eyed and female’ 30 years later: A replication of Harris, Harris, and Bochner’s (1982) early study of obesity stereotypes

Objective: This study aimed to replicate Harris, Harris, and Bochner’s (1982) early experiment on obesity stereotyping to examine whether negative obesity stereotypes persist and in what form.

Method: A sample of psychology students (N = 506) read a description of a target described as female or male, overweight or average weight, and wearing glasses or not, who they subsequently rated on 12 descriptors.

Results: Overweight targets were rated as significantly less active, assertive, athletic, attractive, happy, hardworking, masculine, popular, and successful than average weight targets. This negative stereotype effect of target weight was much larger than effects observed for sex or wearing glasses. There were no differences in effect sizes for target weight between this study and the original study.

Conclusions: It was concluded that the negative obesity stereotypes reported by Harris et al. have persisted over a 30-year period, despite the fact that people who are overweight are no longer a minority. Efforts are needed to challenge negative stereotyping of this group. Future research could examine why stereotypes of overweight people are resistant to change.

Extending double standards and stereotyping approaches to hiring older workers

This thesis examined factors underlying discrimination against older job applicants. Drawing upon stereotyping and double standards-based approaches to discrimination the thesis found that positive and negative aspects of the older worker stereotype can have cumulative effects on hiring decisions and may interact with job requirements to affect discrimination.

Weight-control effort and responsibility for weight in obesity stereotyping

Two online experiments investigated whether negative stereotypes of an overweight person are mitigated by their efforts (through dieting and exercise) to control their weight. Stereotyping was evident, substantial and persistent, albeit reduced in the presence of weight-control effort. These findings highlight the robustness of common biases against overweight people.

Optimistic bias for negative and positive events.

Presents results of an investigation into the occurrence of optimistic bias in relation to both positive and negative events, using absolute judgements to assess perceived risk for each of six events. Participants were asked why they offered different ratings for themselves and for others. The results showed that optimistic bias is a pervasive phenomenon that occurs for both positive and negative events. It occurred for all six events when comparisons were made with an unspecified person of the same age and sex, and occurred for three of six events when comparisons were made with the same-sex best friend. Participants could provide information about their own behaviour that they felt justified their positive outlook; however, they implicitly assumed that the comparison target did not engage in the same behaviour. Concludes that risk-reduction education needs to be made personally relevant to the target audience.

Dietary restraint and negative affect as mediators of body dissatisfaction and bulimic behavior in adolescent girls and boys

Stice's dual pathway model of dietary restraint and negative affect was examined in both adolescent girls and boys. Self-report measures assessing body dissatisfaction, dietary restraint, negative affect and bulimic behavior were administered to 267 girls and 199 boys aged between 12 and 16 years. The findings for the girls were consistent with Stice's model, in that they indicated that both dietary restraint and negative affect mediated the relationship between body dissatisfaction and bulimic behavior. For the boys who desired a thinner body size, only negative affect was found to mediate the relationship between body dissatisfaction and bulimic behavior. On the other hand, for boys who desired a larger body size, both body dissatisfaction and dietary restraint were found to exert an independent effect on bulimic behavior. As boys can aspire to two contrasting and seemingly opposite body size ideals, the findings highlight that the relationship between body dissatisfaction, dietary restraint, negative affect and bulimic behavior are more complex in males than in females. Further research using longitudinal designs is needed in order to test the directional and bidirectional nature of the observed interrelationships.

Self-esteem and negative affect as moderators of sociocultural influences on body dissatisfaction, strategies to decrease weight and strategies to increase muscles among adolescent boys and girls

The study was conducted to examine the impact of sociocultural influences and the moderating role of self-esteem and negative affect on body dissatisfaction and body change strategies for both adolescent boys and girls. Surveys designed to assess body dissatisfaction, body change strategies to decrease weight and increase muscles, perceived sociocultural pressures to lose weight and increase muscles, self-esteem and negative affect were administered to 587 boys and 598 girls aged between 11 and 15 years. The majority of respondents were from Anglo-Australian backgrounds (83%) with the remainder being from Asian and European non-English-speaking backgrounds. The sociocultural influences were found to significantly predict body dissatisfaction and body change strategies for both boys and girls. However, in the case of boys, self-esteem was found to moderate the impact of the sociocultural influences in predicting body change strategies. It was primarily the boys with low self-esteem who were more affected by the sociocultural pressures whereas the girls were affected independently of their self-esteem. Negative affect was also found to play a moderating role on some of the sociocultural influences in predicting strategies to increase muscles. Both boys and girls with higher levels of negative affect were more likely to be affected by sociocultural messages directed at increasing muscles. The results from the present study demonstrate that as well as examining the direct influence of sociocultural pressures, it is also important to examine how these may be moderated by self-esteem and negative affect.

Body image, strategies to change muscles and weight, and puberty. Do they impact on positive and negative affect among adolescent boys and girls?

The purpose of this study was to examine the impact of strategies to both decrease weight and increase muscle tone on negative (depression, anxiety) and positive affect among adolescent males and females. The respondents were 1185 adolescents (587 males, 598 females) who were enrolled in grades 7 and 9 (mean age for MALES=13.22 years; mean age for FEMALES=13.21 years). Respondents completed the Body Image and Body Change Inventory that assessed body image satisfaction, body image importance, body change strategies to decrease weight, body change strategies to increase muscle tone, and food supplements. Respondents also completed the Pubertal Development Scale, the depression and anxiety scales of the Depression Anxiety and Stress Scale, and the positive affect items from the Positive and Negative Affect Scale. Structural equation modelling was used to determine how body satisfaction and importance, body change strategies, and puberty impacted on depression, anxiety, and positive affect. The results demonstrated that for both boys and girls, there was a strong association between body change strategies and negative affect. For boys, body dissatisfaction did not predict negative affect, although this was a strong predictor for girls. Body change strategies did not strongly predict positive affect for either boys or girls, although body image satisfaction was a strong predictor for both genders. The implications of these findings for obtaining a better understanding of the role of pubertal development, body image, and body change strategies in predicting positive and negative affect among adolescent males and females are discussed.

Social comparisons and negative affect as indicators of problem eating and muscle preoccupation among children

The present study examined the utilization of social comparison practices and the role of negative affect in predicting body dissatisfaction, problem eating, and muscle preoccupation among young children. Participants were 236 children aged between 8 and 10 years. Children's eating, exercising, and muscle concerns were examined using a modified version of the Children's Eating Attitudes Test (ChEAT), which included additional items pertaining to muscle bulk and exercising. Consistent with past findings, body mass index (BMI) was found to be the sole unique indicator of body dissatisfaction for both boys and girls. Utilization of social comparison practices with adults was the main unique indicator of the modified ChEAT factors for boys, while BMI was the main unique indicator of the modified ChEAT factors for girls. In addition, negative affect was associated with binging, food preoccupation, and social pressure to eat for boys and dieting and muscle preoccupation for girls. Findings are discussed in relation to previous studies with adolescents and adults.

Are negative perceptions of the accounting profession perpetuated by the introductory accounting course? An Australian study

This study investigates perceptions of the work of accountant:! held by first-year accounting students as part of a national survey of accounting students. First-year commerce students from five tertiary institutions were surveyed about their perceptions of the accounting profession as well as their intention to complete a major study of accounting at tertiary level. lnfluences on the formation of their perceptions formed an important part of the study. The results reported in this paper serve to illustrate that the majority of students surveyed had negative perceptions of accounting. The source of influences on perceptions indicated that perceptions were mainly derived from tertiary education experiences. As perceptions influence choice of major and career choice, the findings have important implications for accounting educators and professional accounting bodies