Entre sombras e representações: a construção da identidade psicossocial dos adolescentes que vivem com HIV/aids

Esse estudo teve por objeto a construção da identidade psicossocial dos adolescentes que vivem com o vírus da imunodeficiência humana (HIV) e/ou a síndrome da imunodeficiência humana adquirida (aids). Esse objeto de investigação constitui um fenômeno de representação social, uma vez que é elaborado e compartilhado entre os adolescentes soropositivos ao HIV a partir das interações que se processam entre estes e os outros indivíduos ao conviverem em sociedade. Nesse sentido, os objetivos que nortearam a condução dessa pesquisa foram: analisar a construção da identidade psicossocial de adolescentes que vivem com HIV/aids e as representações sociais que o grupo tece sobre si próprio, analisar como essas representações interferem na construção da identidade psicossocial, identificar as especificidades identitárias do adolescente associadas à condição de soropositividade ao HIV e discutir as demandas que a identidade psicossocial do adolescente que vive com HIV/aids propicia para o cuidado de enfermagem e saúde. Trata-se de pesquisa qualitativa, referenciada à luz da perspectiva processual da Teoria das Representações Sociais, bem como pela Teoria da Identidade Social e a Teoria Ego-ecológica. A pesquisa foi autorizada pelo Comitê de Ética em Pesquisa por meio do CAAE número 13650213.9.0000.5259. O estudo foi desenvolvido em um hospital de referência para o tratamento de HIV/aids, localizado na cidade do Rio de Janeiro. Os participantes do estudo foram 42 adolescentes soropositivos ao HIV, com idades compreendidas entre 15 e 22 anos, atendidos no ambulatório da referida instituição de saúde. Os dados foram coletados a partir de um instrumento de contextualização dos sujeitos e um roteiro composto por uma pergunta aberta e uma adaptação do Inventário Multifásico de Identidade Social. A apresentação e discussão dos dados fundamentaram-se nas proposições metodológicas da Teoria Ego-ecológica e da análise de conteúdo temática. Os resultados indicaram que a construção da identidade dos adolescentes soropositivos é mediada por representações sociais elaboradas sobre si e sobre os outros indivíduos, a partir de um processo dialógico psico-contextual, caracterizando-se por traços positivos e negativos que se refletem, tanto em sua saúde quanto na forma de ser e se posicionar no mundo. Esse processo transcorre em meio a um contexto de vivências de adversidades, através do qual o estigma social exerce influência negativa sobre as representações que os adolescentes constroem sobre si, quando se comparam aos outros grupos sociais com os quais interagem em suas relações cotidianas. Conclui-se que tanto a identidade socialmente construída, quanto os impactos ocasionados pela soropositividade precisam ser valorizados pelas autoridades governamentais e pelos profissionais que realizam atendimento nos diversos cenários de atenção à saúde. Essa valorização se faz necessária à medida que configura uma possibilidade de estabelecer percursos que possam dar o necessário amparo e resolutividade às demandas de saúde identificadas entre os adolescentes soropositivos ao HIV, bem como para seus respectivos familiares ou cuidadores.

Memória social de enfermeiros acerca do cuidado de Enfermagem no contexto do HIV/aids: enfrentamentos, afetos e construções representacionais

Este estudo tem como objeto o cuidado de Enfermagem e suas memórias e representações sociais para enfermeiros hospitalares inseridos nas unidades de referências para pessoas que viviam com o HIV/aids no Rio de Janeiro, no decorrer de 1980 a 1991. Os objetivos específicos foram: identificar a memória social do cuidado de enfermagem implementado pelos enfermeiros aos acometidos pelo HIV/aids no Município do Rio de Janeiro; descrever as práticas de cuidado pelos enfermeiros no contexto do recorte temporal adotado no estudo; descrever o processo de enfrentamento da epidemia da aids pelos enfermeiros, tanto no contexto do cuidado de enfermagem no espaço hospitalar, quanto nas relações sociais estabelecidas; analisar as memórias e representações sociais de enfermeiros acerca do cuidado de Enfermagem prestado às pessoas com HIV/aids em situação de hospitalização na primeira década da epidemia. Trata-se de uma pesquisa descritiva, de campo, com abordagem qualitativa, baseada nos pressupostos teóricos da memória social propostos por Sá em sua interface com a teoria de representações sociais no campo da Psicologia Social. Realizada com 30 enfermeiros que atuaram em hospitais considerados de referência para o tratamento de clientes que viviam com HIV/aids. Os dados foram coletados por uma entrevista semiestruturada e a visualização de 12 fac-símiles escolhidos de forma aleatória na imprensa. A população de estudo é predominantemente do sexo feminino e com idade entre 51 a 60 anos. Os principais resultados apontam que a memória social do cuidado de enfermagem se constitui a partir de diferentes objetos representacionais (cuidado de enfermagem, aids e biossegurança), instâncias da memória social (pessoal, pública, prática, coletiva, comuns, histórica oral e histórica documental) e diversos elementos que constituem esta memória (ambiente de cuidado e relações sociais, familiares e laborais, dentre outras). Emergiram sete categorias de análise: O processo do cuidado de Enfermagem: do enfrentamento, da capacitação e do desenvolvimento; Sentimentos dos enfermeiros e dos clientes descritos pelos participantes no processo de cuidar; O processo de cuidado direto ao cliente no início da epidemia; Memórias da autoproteção profissional e da proteção ao cliente no contexto do HIV/aids; Os contextos do cuidado: ambiente, materiais e recursos humanos; Memórias dos enfermeiros sobre os clientes acometidos pelo HIV e Relacionamento interpessoal. Destaca-se que a memória do cuidado de enfermagem se mostra ligada à construção representacional da aids (não familiar/familiar), do cuidado de enfermagem (sem controle/sob controle) e à constituição de um grupo social com forte identidade, o dos enfermeiros da aids. Concluímos que o estudo mostrou o trabalho pioneiro dos enfermeiros com o HIV/aids no ambiente hospitalar. Esses profissionais tiveram que cuidar desses clientes em meio à possibilidade de contaminação, ao mesmo tempo em que desenvolviam um autocuidado, em alguns momentos exagerados devido ao desconhecimento sobre a síndrome, como forma de preservação da sua saúde, bem como de sua família. A memória social como conceito guarda-chuva mostrou-se pertinente para a análise dos dados, permitindo recuperar, ao menos em parte, a dinâmica do cuidado de enfermagem nos primeiros anos da síndrome.

Between respectability and disgrace: schismogenesis and the regeneration of inequality, stigma and social exclusion in Limerick

The thesis examines cultural processes underpinning the emergence, institutionalisation and reproduction of class boundaries in Limerick city. The research aims to bring a new understanding to the contemporary context of the city’s urban regeneration programme. Acknowledging and recognising other contemporary studies of division and exclusion, the thesis creates a distinctive approach which focuses on uncovering the cultural roots of inequality, educational disadvantage, stigma and social exclusion and the dynamics of their social reproduction. Using Bateson’s concept of schismogenesis (1953), the thesis looks to the persistent, but fragmented culture of community and develops a heuristic ‘symbolic order of the city’. This is defined as “…a cultural structure, the meaning making aspect of hierarchy, the categorical structures of world understanding, the way Limerick people understand themselves, their local and larger world” (p. 37). This provides a very different departure point for exploring the basis for urban regeneration in Limerick (and everywhere). The central argument is that if we want to understand the present (multiple) crises in Limerick we need to understand the historical, anthropological and recursive processes underpinning ‘generalised patterns of rivalry and conflict’. In addition to exploring the historical roots of status and stigma in Limerick, the thesis explores the mythopoesis of persistent, recurrent narratives and labels that mark the boundaries of the city’s identities. The thesis examines the cultural and social function of ‘slagging’ as a vernacular and highly particularised form of ironic, ritualised and, often, ‘cruel’ medium of communication (often exclusion). This is combined with an etymology of the vocabulary of Limerick slang and its mythological base. By tracing the origins of many normalised patterns of Limerick speech ‘sayings’, which have long since forgotten their roots, the thesis demonstrates how they perform a significant contemporary function in maintaining and reinforcing symbolic mechanisms of inclusion/exclusion. The thesis combines historical and archival data with biographical interviews, ethnographic data married to a deep historical hermeneutic analysis of this political community.

Stigma and multiple social comparisons in people with schizophrenia

This paper investigates social comparisons in people with schizophrenia. Stigma theories often suggest that people with stigmatized conditions face a chronic threat to self-esteem and that they respond to this in a variety of ways, one of which is by using ingroup downward comparisons. We analysed the spontaneous social comparisons used by, participants in semi-structured interviews. A wide range of comparison dimensions, target others, and groupings were used, most of which did not represent a category of people with schizophrenia in more negative terms than those without the illness. Participants presented themselves positively, referring to downward and lateral comparisons more often than upward comparisons. In addition, although downward comparisons did refer to people with schizophrenia, they were more likely to refer to others who did not have schizophrenia, and to dimensions which were not related to mental illness. It is suggested that investigations of the relations between stigma and self need to take account of the multiple identities and dimensions of comparisons available to people for construing themselves and the social context. Copyright (C) 2001 John Wiley & Sons, Ltd.

Social categorizations, social comparisons and stigma: Presentations of self in people with learning difficulties

Self-categorization theory stresses the importance of the context in which the metacontrast principle is proposed to operate. This study is concerned with how 'the pool of psychologically relevant stimuli' (Turner, Hogg, Oakes, Reicher & Wetherell, 1987, p. 47) comprising the context is determined. Data from interviews with 33 people with learning difficulties were used to show how a positive sense of self might be constructed by members of a stigmatized social category through the social worlds that they describe, and therefore the social comparisons and categorizations that are made possible. Participants made downward comparisons which focused on people with learning difficulties who were less able or who displayed challenging behaviour, and with people who did not have learning difficulties but who, according to the participants, behaved badly, such as beggars, drunks and thieves. By selection of dimensions and comparison others, a positive sense of self and a particular set of social categorizations were presented. It is suggested that when using self-categorization theory to study real-world social categories, more attention needs to be paid to the involvement of the perceiver in determining which stimuli are psychologically relevant since this is a crucial determinant of category salience.

Methadone as Social Control: Institutionalized Stigma and the Prospect of Recovery

Methadone maintenance treatment (MMT) is an intervention used to treat opioid (heroin) dependence. Several investigators have found that MMT is effective in reducing heroin use and other behaviors; however, a disproportionate number of MMT clients leave treatment prematurely. Moreover, MMT outcome variables are often limited in terms of their measurement. Utilizing an integrated theoretical framework of social control and stigma, we focused on the experiences of methadone maintenance from the perspective of clients. We pooled interview data from four qualitative studies in two jurisdictions and found linkages between social control and institutional stigma that serve to reinforce "addict" identities, expose undeserving customers to the public gaze, and encourage clients to be passive recipients of treatment. We discuss the implications for recovery and suggest recommendations for change.

How are Girls' Attitudes Toward Cyberbullying Affected by Drama for Social Intervention?

This is a study exploring teenaged girls’ understanding and experiences of cyberbullying as a contemporary social phenomenon. Participants included 4 Grade 11 and 12 girls from a medium-sized independent school in southwestern Ontario, Canada. The girls participated in 9 extracurricular study sessions from January to April 2013. During the sessions, they engaged with Drama for Social Intervention (Clark, 2009; Conrad, 2004; Lepp, 2011) activities with the intended goal of producing a collective creation. Qualitative data were collected throughout the sessions using fieldnotes, participant journals, interviews, and participant artefacts. The findings are presented as an ethnodrama (Campbell & Conrad, 2006; Denzin, 2003; Saldaña, 1999) with each thematic statement forming a title of a scene in the script (Rogers, Frellick, & Babinski, 2002). The study found that girl identity online consists of many disconnected avatars. It also suggested that distancing (Eriksson, 2011) techniques, used to engender safety in Drama for Social Intervention, might have contributed to participant disengagement with the study’s content. Implications for further research included the utility of arts-based methods to promote participants’ feelings of growth and reflection, and a reevaluation of cyberbullying discourses to better reflect girls’ multiple avatar identities. Implications for teachers and administrators encompassed a need for preventative approaches to cyberbullying education, incorporating affective empathy-building (Ang & Goh, 2010) and addressing girls’ feelings of safety in perceived anonymity online.

Telling the truth about HIV? Testing and disclosure in a culture of stigma

Étude de cas / Case study

The role of drama in the teaching of speaking and listening as the basis for social capital

This paper explores how the concept of 'social capital' relates to the teaching of speaking and listening. The argument draws on Bourdieu's notion that a common language is an illusion but posits that an understanding of the grammar of speech can be productive in the development of both an understanding of what constitutes effective speech and the development of competence in speaking. It is argued that applying structuralist notions of written grammar is an inadequate approach to understanding speech acts or enhancing the creative use of speech. An analysis is made of how typical features of speech relate to dramatic dialogue and how the meaning of what is said is contingent upon aural and visual signifiers. On this basis a competent speaker is seen as being one who produces expressions appropriate for a range of situations by intentionally employing such signifiers. The paper draws on research into the way drama teachers make explicit reference to and use of semiotics and dramatic effectiveness in order to improve students' performance and by so doing empower them to increase their social capital. Ultimately, it is concluded that helping students identify, analyse and employ the aural, visual and verbal grammar of spoken English is not an adjunct to the subject of drama, but an intrinsic part of understanding the art form. What is called for is a re-appraisal by drama teachers of their own understanding of concepts relating to speech acts in order to enhance this area of their work.

The use of drama to teach social skills in a special school setting for students with autism.

For children with autism, social challenges may be both part of the disability and a barrier to accessing education. This paper reports on a project which used drama to address such challenges by drawing on the social skills of non-autistic peers in a special school setting. The paper demonstrates how drama’s flexibility may be harnessed in order to help students support each other’s development of creative and communicative skills. Focusing on two children in particular, specific examples are given to illustrate how they participated in group work, made imaginative contributions to verbal and physical representations, and engaged with abstract ideas. The project’s outcomes suggest, given a concrete structure and an invitation to collaborate, drama can be a powerful learning medium for children with ASD. The conclusion reflects on the diverse meaning of inclusive practice which can be achieved within specialist settings.