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Bauer L, Wienke A, Führer A. Compassionate Othering: the construction of refugee patients in medical students' narratives - a qualitative study using story completion. BMC MEDICAL EDUCATION 2024; 24:703. [PMID: 38937730 PMCID: PMC11212417 DOI: 10.1186/s12909-024-05684-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 06/20/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Refugees remain a marginalized population and are exposed to a variety of discriminatory processes, among them Othering which categorizes people as belonging or not-belonging according to certain ascribed characteristics. We explored how the narrative construction of refugee patients by medical students constitutes a form of Othering. METHODS Using story completion, 124 5th year medical students at the Martin- Luther- University Halle-Wittenberg in October 2019 wrote a fictional story in response to a story stem situated in a medical practice. In a comparative approach, one patient presenting with abdominal pain lacks further characterization (version A) and the other is a refugee (version B). The stories were coded using qualitative content analysis by Mayring with a focus on content and narrative strategies (plot structure and perspective). RESULTS We identified four themes: characters, medical condition, access to care and provision of substandard care. The stories were predominantly framed with a medical or an interaction-based plot structure and written from a process-oriented perspective. The themes in version B, supported by their use of narrative strategies, were largely contextualized within the patients' history of migration. An empathic depiction of patient B and the students' compassion for the patients facing substandard care were key motifs as well. CONCLUSION The perception of the version B patients predominantly as refugees establishes their construction as an Other. The students' compassion acts as a representation of societal inequalities and remains an inept response without the tools to counter underlying discriminatory structures. Based on a discourse of deservingness, compassion alone therefore perpetuates Othering and highlights the need for structural competency training in medical school.
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Affiliation(s)
- Lena Bauer
- Institute for Medical Epidemiology, Biometrics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
| | - Andreas Wienke
- Institute for Medical Epidemiology, Biometrics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Amand Führer
- Institute for Medical Epidemiology, Biometrics, and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
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Day CR. The rainbow connection: Disrupting background affect, overcoming barriers and emergent emotional collectives at "Pride in London". THE BRITISH JOURNAL OF SOCIOLOGY 2022; 73:1006-1024. [PMID: 36036212 PMCID: PMC10087935 DOI: 10.1111/1468-4446.12973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 07/10/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
This article focuses on a large-scale parade in the UK that is often overlooked in research concerned with the sociology of political emotions and group dynamics; "Pride in London". This is an annual parade celebrating, and raising awareness about, the LGBTQ+ community and commemorating the Stonewall riots. Following a brief description of the study context, participants and methods, the article illustrates the use of reflexive thematic analysis of 23 interviewee accounts of the parade. Analysis of emotional habitus and affective practices preceding, and on the day of, the parade offer an insight into the manifestation of collective emotion. Three themes are developed exploring the use of recognizable and emotive symbols, physicality of embodied emotion and spatial arrangement and the encompassing nature of group emotion. Finally, the interplay between background and foreground emotion is explored as a way of understanding and demonstrating the fluidity and temporality of affective experience and expression when people are engaged in collective action at a social justice event.
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Affiliation(s)
- Chris Robson Day
- Centre for Trust, Peace and Social RelationsCoventry UniversityCoventryUK
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White AD, Garcia AL. Homophobia and the perception of psychological differences. PSYCHOLOGY & SEXUALITY 2018. [DOI: 10.1080/19419899.2018.1500934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Carter A, Lachowsky N, Forrest JI, Cui Z, Sereda P, Kaida A, Armstrong HL, Card KG, Montaner JS, Moore D, Roth EA, Hogg RS. A latent class analysis of sexual and romantic relationships among HIV-positive and HIV-negative gay and bisexual men in Vancouver. CANADIAN JOURNAL OF HUMAN SEXUALITY 2017. [DOI: 10.3138/cjhs.262.a1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Allison Carter
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Nathan Lachowsky
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
- School of Public Health and Social Policy, University of Victoria, Victoria, BC
| | - Jamie I. Forrest
- School of Population and Public Health, University of British Columbia, Vancouver, BC
| | - Zishan Cui
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Paul Sereda
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
| | - Heather L. Armstrong
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
- Department of Medicine, University of British Columbia, Vancouver, BC
| | - Kiffer G. Card
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
| | - Julio S.G. Montaner
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
- Department of Medicine, University of British Columbia, Vancouver, BC
| | - David Moore
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
- Department of Medicine, University of British Columbia, Vancouver, BC
| | - Eric A. Roth
- Department of Anthropology, University of Victoria, Victoria, BC
| | - Robert S. Hogg
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC
- Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC
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Graham K, Treharne GJ, Ruzibiza C, Nicolson M. The importance of health(ism): A focus group study of lesbian, gay, bisexual, pansexual, queer and transgender individuals’ understandings of health. J Health Psychol 2016; 22:237-247. [DOI: 10.1177/1359105315600236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study investigated understandings of health among lesbian, gay, bisexual, pansexual, queer and/or transgender people, who are under-represented in research. The study involved 12 focus groups in Aotearoa/New Zealand with 47 participants who identified as lesbian, gay, bisexual, pansexual, queer and/or transgender and responded to an advert inviting participants without chronic illnesses. Three themes were inductively formulated: health is important because education and protection efforts are seen as required to preserve health, health is seen as holistic, and contextual factors are seen as creating health risks. These findings provide insights into how lesbian, gay, bisexual, pansexual, queer and/or transgender people’s understandings of health draw upon notions of healthism.
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Pollard A, Llewellyn C, Smith H, Richardson D, Fisher M. Opt-out testing for HIV: perspectives from a high prevalence community in south-east England, UK. Int J STD AIDS 2013; 24:307-12. [PMID: 23970663 DOI: 10.1177/0956462412472424] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Peoples' perspectives and attitudes towards being offered opt-out HIV testing were explored in a geographical area of high HIV prevalence. Users (n = 31) of sexually transmitted infection (STI) testing services took part in community focus groups in the south-east of England, UK. There was broad support for opt-out HIV testing based on public health and individual health benefits. For this sample, opt-out HIV testing when registering with a general practice surgery and on elective or emergency admission to a general hospital was acceptable, although there were concerns about the rigour of informed consent. Heterosexual participants' criticism of people from higher prevalence groups for HIV declining tests, while maintaining their own right to opt-out, suggested that attitudes towards testing may be influenced by levels of perceived risk. Innovations in HIV testing policies to increase testing rates will benefit from an acknowledgement of the different meanings that testing has.
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Affiliation(s)
- A Pollard
- Brighton & Sussex Medical School, University Hospitals NHS Trust, Brighton, UK
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Demetre J, Tolley M, de Almeida ACF, Laberge Y, Davies G, Akhurst J, Dietrich H, Brennan T, Robertson A, Dunn DS, Neusar A. Book Reviews: Being Human: Psychological and Philosophical Perspectives, Environmental Psychology: An Introduction, How to Study Psychology, Ideology, Psychology, and Law, Professional Ethics: Education for a Humane Society, Psychology in Education, 2nd edn, Psychological Testing and Assessment: An Introduction to Tests and Measurement, 8th edn, Qualitative Interpretation and Analysis in Psychology, Simply Psychology, 3rd edn, Social Cognition: From Brains to Culture, 2nd edn, Teaching Psychology Online: Tips and Strategies for Success. PSYCHOLOGY LEARNING AND TEACHING-PLAT 2013. [DOI: 10.2304/plat.2013.12.3.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- James Demetre
- Department of Psychology and Counselling, University of Greenwich, United Kingdom
| | - Martin Tolley
- Psychology Division, University of Northampton, United Kingdom
| | | | | | - Gareth Davies
- Faculty of Arts, Humanities and Business, University of the Highlands and Islands, United Kingdom
| | - Jacqui Akhurst
- Faculty of Health and Life Sciences, York St John University, United Kingdom
| | - Heike Dietrich
- Department of Psychology, Heidelberg University, Germany
| | - Toni Brennan
- Department of Psychosocial Studies, University of East London & Department of Psychology, Goldsmiths College, London, United Kingdom
| | - Ailie Robertson
- School of Social Sciences, University of the West of Scotland, United Kingdom
| | - Dana S. Dunn
- Department of Psychology, Moravian College, Bethlehem, USA
| | - Aleš Neusar
- Department of Psychology, Philosophical Faculty, Palacký University, Olomouc, Czech Republic
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Abstract
A whole family of qualitative methods is informed by phenomenological philosophy. When applying these methods, the material is analyzed using concepts from this philosophy to interrogate the findings and to enable greater theoretical analysis. However, the phenomenological approach represents different approaches, from pure description to those more informed by interpretation. Phenomenological philosophy developed from a discipline focusing on thorough descriptions, and only descriptions, toward a greater emphasis on interpretation being inherent in experience. An analogous development toward a broader acknowledgment of the need for interpretation, the influence of the relationship and the researcher, and the co-construction of the narrative is mirrored in qualitative analytic theory and the description of newer analytic methods as, for example, Interpretative Phenomenological Analysis and Critical Narrative Analysis, methods which are theoretically founded in phenomenology. This methodological development and the inevitable contribution of interpretation are illustrated by a case from my own research about psychological interventions and the process of understanding in general practice.
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Affiliation(s)
- Annette Sofie Davidsen
- University of Copenhagen, Research Unit for General Practice and Section of General Practice, Copenhagen, Denmark
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Jowett A, Peel E, Shaw RL. Sex and Diabetes: A Thematic Analysis of Gay and Bisexual Men’s Accounts. J Health Psychol 2011; 17:409-18. [DOI: 10.1177/1359105311412838] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Around 50 per cent of men with diabetes experience erectile dysfunction. Much of the literature focuses on quality of life measures with heterosexual men in monogamous relationships. This study explores gay and bisexual men’s experiences of sex and diabetes. Thirteen interviews were analysed and three themes identified: erectile problems; other ‘physical’ problems; and disclosing diabetes to sexual partners. Findings highlight a range of sexual problems experienced by non-heterosexual men and the significance of the cultural and relational context in which they are situated. The personalized care promised by the UK government should acknowledge the diversity of sexual practices which might be affected by diabetes.
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Hurley M, Prestage G. Intensive sex partying amongst gay men in Sydney. CULTURE, HEALTH & SEXUALITY 2009; 11:597-610. [PMID: 19499392 DOI: 10.1080/13691050902721853] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Intensive sex partying is a framework developed to analyse specific frequent behaviours amongst a small minority of gay men in Sydney, Australia. The behaviours included a higher frequency of dance party attendance, more frequent sex, more anal sex, multiple sex partners, more unprotected anal intercourse with casual partners and more frequent drug taking. These occur at a contextual intersection between a sub-group of sexually adventurous gay men and 'party boys'. The men appear to be involved in both high-risk, adventurous sex practices and a specific form of partying distinguishable from dance partying and 'clubbing'. Sex partying occurs on multiple sites (domestic spaces; within dance parties; sex parties; sex-on-premises venues) and appears to be geared to the maximisation of sexual pleasure. Intensive sex partying describes this coincidence of factors and locates them in relation to the multiple pleasures offered by sex partying. It emphasises the importance of 'intensity' in order to understand better the relations between sex, drug use, pleasure, care and risk in some gay men's lives.
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Affiliation(s)
- Michael Hurley
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.
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Braun V, Terry G, Gavey N, Fenaughty J. 'Risk' and sexual coercion among gay and bisexual men in Aotearoa/New Zealand-key informant accounts. CULTURE, HEALTH & SEXUALITY 2009; 11:111-124. [PMID: 19247858 DOI: 10.1080/13691050802398208] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Research over the past decade on rape and sexual coercion among gay and bisexual men has shown that significant numbers of men report some form of unwanted or coerced sexual experience. Most studies have investigated the prevalence and impact of sexual assault, with little exploration of the nature and meanings of sexual coercion. This paper contributes to understandings of the latter, analysing the notion of 'risk' as it appeared in the talk of 23 key informants interviewed. These informants offered expert perspectives on the issue of sexual coercion and unwanted sex among gay and bisexual men, based on their professional and community experience. Thematic analysis led us to identify two predominant patterns of talk around risk: a focus on sociocultural contexts as risky for sexual coercion and a focus on certain types of individuals as vulnerable and 'at risk' of sexual coercion. Accounts of individual risk fit with currently dominant prevention models, which work to strengthen individuals' abilities to avoid or resist coercion. The accounts that emphasised context fit with recent theorising which suggests broader interventions are also necessary to prevent sexual coercion, ones that challenge normative constructions of sexuality and sexual practice.
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Affiliation(s)
- Virginia Braun
- Department of Psychology, The University of Auckland, Auckland, New Zealand.
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Langdridge D. Phenomenology and Critical Social Psychology: Directions and Debates in Theory and Research. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2008. [DOI: 10.1111/j.1751-9004.2008.00114.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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