Postmodernism, health and illness

Retreat Hospital, York, England.
Journal of Advanced Nursing (Impact Factor: 1.74). 02/1996; 23(1):201-5. DOI: 10.1111/j.1365-2648.1996.tb03153.x
Source: PubMed


This paper examines the value of drawing on ideas from poststructuralism and postmodernism in an attempt to understand the relationship between health, culture and society. Medical and professional discourses have come under increasing criticism for being uncaring, stigmatizing and disempowering. This paper supports a postmodernist approach which allows analysis of the fabrication of 'health', 'illness' and 'patient' subjectivity and the effect of the inscription on the body. It is suggested that health care professionals need to be more reflexive about their own knowledge claims and to resist the discursive practices which disempower and reduce choice.

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    • "Post-structural ideas, we argue, must be used consciously and reflexively, providing us with the conceptual tools that enable us to be much more aware of the complexity, context, history and power that is operating in any situation. Poststructuralist ideas can, therefore, be harnessed for the benefit of midwifery research without sacrificing our commitment to improving people's lives by generating knowledge (Mitchell 1996, Heslop 1997, Walker 1997, Francis 2000, Allen and Harding 2001, Stajduhar et al 2001, Fahy 2002). Denzin acknowledged the need to respond to these post-structural criticisms and insights. "
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    ABSTRACT: Aim To present an adaptation of interpretive interactionism that incorporates and honours feminist values and principles. Background Interpretive interactionism as described by Denzin can be useful when examining interactive processes. It is especially useful when events affect turning points in people's lives. When issues of power and power imbalances are of interest, a critical post-structural lens may be of use to the researcher. The authors planned to examine the interactions between midwives and women at the 'epiphaneal' points of decision making during second-stage labour. It became clear that it was necessary to honour and thus incorporate feminist principles and values in their methodology. Data sources This paper draws on a recently completed PhD project to demonstrate the application of post-structural feminist interpretive interactionism. Twenty six midwives representing each state and territory across Australia who were representative of every model of midwifery care offered in Australia were interviewed to gauge their experiences of what they believed represented good and poor case examples of decision making during second-stage labour. Review methods The authors critique the philosophical underpinnings of interpretive interactionism, and then modify these to acknowledge and incorporate post-structural and feminist ideologies. Discussion Interpretive interactionism is a useful methodology when the research question is best addressed by examining interactional processes and the meanings people make of them, especially if these occur at turning points in people's lives. Interpretive interactionism methodology can and should be improved by taking account of issues of power, feminism and post-structural values. Conclusion Post-structural feminist interpretative interactionism has much to offer healthcare researchers who want to develop methodologically robust findings. Implications for practice/research Post-structural feminist interpretive interactionism enables the researcher to be more cognisant of the complex social political and historical context of midwifery. Researchers using feminist and post-structural ideologies will enhance research findings when these tools are applied consciously and reflexively.
    Nurse researcher 09/2013; 21(1):14-22. DOI:10.7748/nr2013.
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    • "This opportunity to recognize and renew connections to others, to values and to spiritual beliefs has been described as offering a renewed sense of connectivism (Arai and Pedlar, 2003; Carlisle et al., 2009). The eudaimonic interpretation of well‐being can be seen to reflect the post‐modernist perspective which values local narratives (Mitchell, 1996), prioritizes subjectivity and temporality (Weinblatt and Avrecht‐Bar, 2001) and rejects universality. Weinblatt and Avrecht‐Bar (2001) state that the term " subjective meaning " is in itself a post‐modern term and asserts the utility of a post‐modern perspective in enabling an occupational therapist to provide functional interventions which are practical for the client. "
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    ABSTRACT: Contemporary critique of the philosophy and theory of occupational therapy has asserted that the mainstream of the profession holds a westernized view of the world and that occupational therapy has been shackled to notions of health/illness and the medical establishment for too long, hampering movement into social and political spheres. Strategies and developments have been proposed to combat these biases, which have included increased cultural relativism and a re-focus on the subjective experience of occupation. The value placed on "being" in occupational therapy philosophy is described alongside the related terms of occupational integrity and spirituality. Drawing on theory and research from psychology, this paper proposes the construct of eudaimonic well-being as both relevant and valuable to occupational therapy in re-conceptualizing the profession, countering some of the central tensions in the identity of the profession and re-asserting that well-being through occupation is for all and for humanity. Finally, the paper proposes that well-being, in a eudaimonic sense, should be advertised and evidenced as a routine outcome of occupational therapy and consolidated into occupational therapy models as a relevant and meaningful concept. Copyright © 2011 John Wiley & Sons, Ltd.
    Occupational Therapy International 03/2011; 18(3). DOI:10.1002/oti.316 · 0.78 Impact Factor
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    • "Nursing theorists, such as Mitchell (1996) and Cheek (2000) have also found Foucault's contributions on the clinic, the gaze, the panoptican and governmentality particularly useful and relevant in their analyses of the regulation and discipline of bodies within the fields of knowledge known as 'health'. This application of Foucault's work highlights the ways in which healthy (rather than 'sick') bodies are disciplined, inscribed and regulated, subject to the power/knowledge of experts within the realms of governance (Mitchell, 1996 81:202). My interest is in the way bodies are disciplined and regulated – reinscribed as either risky or safe bodies -within the epistemologically dualist fields of obstetrics and midwifery. "
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    ABSTRACT: This thesis highlights the ways in which the practices of contemporary midwives in Aotearoa/New Zealand are caught within the intersection of an array of competing discourses. The context for this is the reconstruction of midwifery in Aotearoa/New Zealand as an autonomous feminist profession founded on partnership with women. Interviews and participant observation with midwives, based mainly in one New Zealand city, are the basis of an analysis of the complexity of midwives’ praxis as professionals. The analysis draws on insights from critical and feminist approaches to Foucault’s theories of discourse, power and the subject. It includes discussion of the conditions which came to produce and authorise the concept of ‘partnership’. Which subjects can speak about partnership, and when? What claims are made about it? What challenges it? Partnerships between midwives and women are theorized in the thesis as highly complex and contingent networks of strategic and productive relations. Differing sites of practice/negotiations are analysed as spaces of/for governance. For midwives this negotiative work takes place within the contested terrain of what is (re)constructed as ‘normal birth’. This includes the provision of, or resistance to, epidural analgesia/certification and defensive practice. These practices and knowledges are undertaken within professional discourses of women’s/consumer choice and midwifery accountability. While midwifery’s theoretical and emancipatory political projects are articulated as a counter discourse to medical hegemony, some midwifery practices inadvertently re-inscribe pregnant/birthing bodies within medicolegal frameworks. This is an outcome, not of the sovereign power of obstetrics over women/midwives, but of attempts by midwives themselves to negotiate heterogeneous forms of risk and keep birthing women, and their own practices, safe. Within these relationships and practices of freedom, the midwife performs professionally to construct herself as what I call an ‘auditable subject’. These processes produce self-regulation and the disciplinary normalisation of midwives/midwifery. The technologies of the midwife/self occur within the relations of ruling that render the pregnant/birthing bodies of women, and the labouring bodies of midwives, increasingly amenable to subtle forms of liberal governance.
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