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Biomedical subjects

D Lupton

Publications and source records attributed to D Lupton.

At least 19 recordsLinked to original sources
PubMed2001

'They've forgotten that I'm the mum': constructing and practising motherhood in special care nurseries.

Little sociological research has sought to investigate the ways in which women with hospitalized newborn infants construct and practice motherhood. This article seeks to address this lacuna, using data from a qualitative research project based in two Australian neonatal nurseries. Thirty-one mothers of hospitalized newborns and 20 neonatal nurses were interviewed, and other data were obtained via observations of the nurseries, tape-recorded verbal interactions between parents and nursery staff and casual conversations with mothers and nurses. The data revealed that while the mothers' and nurses' discourses on what makes a 'good mother' in the context of the neonatal nursery converged to some extent, there were important differences. The mothers particularly emphasized the importance of physical contact with their infants and breastfeeding, while the nurses privileged presence in the nursery and willingness to learn about the infant's condition and treatment. There was evidence of power struggles between the mothers and nurses over the handling and treatment of the infants, which had implications for how the mothers constructed and practised motherhood. The mothers attempted to construct themselves as 'real mothers', which involved establishing connection with their infants and normalizing them. In time, many of the mothers sought to position themselves as the 'experts' on their infants. For their part, the nurses attempted to position themselves as 'teachers and monitors of the parents', 'protectors of the infants' and 'experts' by virtue of their medical training and experience. Differences in defining the situation resulted in frustration, resentment and anger on the part of the mothers and disciplinary and surveillance actions on the part of many of the nurses, both covert and overt. The nurses' attitude to and treatment of the mothers was integral in the development of the mothers' relationship with their infants in the nurseries, and this influence extended beyond discharge of the infants.

Child, Hospitalized↗
PubMed2001

The externality of the inside: body images of pregnancy.

This paper draws on literature, empirical data and a range of theoretical perspectives on the maternal body to examine understandings of the relationship between a pregnant woman and her foetus, with a particular focus on the body images used by women to represent this relationship. Psychoanalytic and nursing accounts of the relationship between mother and foetus have often described a symbiotic 'oneness' or unity during pregnancy. Such accounts, however, stress the temporary nature of this unity and identify a series of 'stages' of separation or 'polarisation' between mother and foetus during pregnancy. In contrast, many of the 25 women who participated in our interview study of new motherhood described a confusion of the boundary between self and foetus. For many women the experience of pregnancy and the relationship with the unborn baby was ambiguous and uncertain. Importantly, none of these women described her relationship with the foetus as a series of developmental stages, but rather saw it as fluctuating throughout pregnancy. These findings are more consistent with the work of feminist theorists who describe pregnancy as a dynamic and fluid merging of the inside and the outside of the body/self.

Adult↗
PubMed2000

Technology, selfhood and physical disability.

Much has been written in recent times of the interface between technologies and the human body. The vast majority of this literature, however, focuses on a body that is assumed to be free of physical disability. This article seeks to address this lacuna by presenting findings from an exploratory study using in-depth interviews with fifteen people with physical disabilities living in the Australian city of Adelaide. The dominant research question was to explore the ways in which technologies contribute to the meanings and experiences of the lived body/self with disabilities. The data showed that the interviewees identified several technologies that they used as highly beneficial to allowing them to transcend some aspects of their disabilities. However, the interviewees also identified significant negative aspects to the use of some technologies. They noted that such technologies could serve to mark out people with disabilities as 'different' or 'lacking', acting as a barrier to the achievement and presentation of their preferred body/self.

Persons with Disabilities↗
PubMed1999

The experiences of new fatherhood: a socio-cultural analysis.

For most men, first-time fatherhood involves significant changes in self-identity and their relationship with their female partner. This paper presents some findings from a longitudinal, qualitative study into the first 6 months of new fatherhood for a group of 15 Australian men. The discussion draws on a series of semistructured interviews undertaken on a minimum of four occasions from a few days before the child was born until 5-6 months after birth. We found that first-time fathering in contemporary western society requires men to be simultaneously provider, guide, household help and nurturer. The demands of these roles, and the tensions they sometimes produce, challenge men's relationships with their female partners, the meaning and place of work in their lives and their sense of self as competent adults. Almost all the men we interviewed found the early weeks and months of fatherhood more uncomfortable than rewarding, despite looking forward to fatherhood very positively. Their experience appeared more closely aligned to their difficulties with meeting social expectations and roles rather than individual deficits.

Adult↗
PubMed1999

Theorizing fear of crime: beyond the rational/irrational opposition.

Much has been written about the 'social problem' of fear of crime in the criminological and sociological literature in recent years. We would argue that thus far in this literature, however, there has been too much emphasis on the question 'How rational is people's fear of crime?', a question that largely reduces the complexity of the phenomenon and positions a 'biased' lay response against an 'expert' objective judgment. In this article, we review different epistemological perspectives that can be offered to understand in greater depth the fear of crime phenomenon. We place particular emphasis on those hermeneutic perspectives that go beyond the models of the rationalist, individualistic subject to exploring issues of symbolic representation, discourse and the micro - and macro-contexts in which fear of crime is experienced and given meaning. We also draw upon two case studies from our own empirical research into fear of crime, conducted with the intention of exploring the situated narratives, cultural representations and different levels of symbolic meaning that contribute to the dynamic constitution of fear.

Aged↗
PubMed1998

Representing doctors: discourses and images in the Australian press.

Reports of incidents and issues related to members of the medical profession and the practice of medicine often feature in the western news media. Such intense coverage has incited the interest of both medical sociologists and members of the profession themselves. Thus far, however, very few detailed studies addressing the tenor of news reporting on the medical profession have been published, particularly in relation to the Australian media. This article presents the findings of a systematic and comprehensive analysis of the representation of doctors and the medical practice over a period of 15 months (January 1994 to March 1995) in metropolitan Australian newspapers and major news magazines. The method of critical discourse analysis was employed, including both quantitative analysis and interpretive analysis of the language and visual imagery of the news texts. The study revealed that negative portrayals of doctors were countered by positive representations. While cases of medical negligence, sexual assault and avarice on the part of doctors were often reported, medical successes were also frequently covered. Doctors were overwhelmingly reported as the major authorities on medical matters and as active agents in interacting with patients and other groups such as government officials. It is concluded that while the nature of reporting would suggest that members of the medical profession may be constantly under the spotlight of media scrutiny, they enjoy a significant degree of cultural and social authority in the Australian press.

Australia↗
PubMed1997

Consumerism, reflexivity and the medical encounter.

Much emphasis has been placed recently in sociological, policy and popular discourses on changes in lay people's attitudes towards the medical profession that have been labelled by some as a move towards the embracing of "consumerism". Notions of consumerism tend to assume that lay people act as "rational" actors in the context of the medical encounter. They align with broader sociological concepts of the "reflexive self" as a product of late modernity; that is, the self who acts in a calculated manner to engage in self-improvement and who is sceptical about expert knowledges. To explore the ways that people think and feel about medicine and the medical profession, this article draws on findings from a study involving in-depth interviews with 60 lay people from a wide range of backgrounds living in Sydney. These data suggest that, in their interactions with doctors and other health care workers, lay people may pursue both the ideal-type "consumerist" and the "passive patient" subject position simultaneously or variously, depending on the context. The article concludes that late modernist notions of reflexivity as applied to issues of consumerism fail to recognize the complexity and changeable nature of the desires, emotions and needs that characterize the patient-doctor relationship.

Attitude to Health↗
PubMed1997

Senior school students' experiences and opinions of school-based HIV-AIDS education.

This article reports the findings from the second part of a two-stage study that used both qualitative and quantitative methods to investigate the communication context of school-based HIV-AIDS education in state secondary schools in metropolitan and rural areas of New South Wales. The quantitative data are here described, focusing on a sample of 1005 Year 12 students' responses to a self-administered questionnaire. The data suggest that the students strongly supported the general idea of school-based HIV-AIDS education, but found current offerings lacking in several respects. Students identified a strong need for information about how HIV and AIDS affect the body, for more information about sexually transmissible diseases other than HIV-AIDS, for people with HIV themselves and experts in the field to provide education sessions, and for more small-group discussions. Rural students and those students from schools located in the outer western suburbs of Sydney in particular reported that they had insufficient access to the modes of information that they most preferred. There were some important differences between the responses of female and male students and between the responses of students from different ethnic groups, suggesting that these factors also need acknowledgment when school-based programs are designed for young people.

Adolescent↗
PubMed1996

Infinitesimal risk as public health crisis: news media coverage of a doctor-patient HIV contact tracing investigation.

Among the most prominent health or medical stories covered in 1994 by the Australian news media was that concerning an HIV positive hospital obstetrician and the attempt by the New South Wales Health Department to trace and test 149 women on whom he had operated. All press and television coverage of the issue was reviewed. The surface news narrative of the search for missing, "innocent" mothers potentially infected with a deadly and infectious illness is shown to serve as a "hard news" pretext enabling a wider major discourse to operate about a health system accused as being captive to gay and civil libertarian politics, allowing "guilty" doctors at high risk of HIV to endanger "innocent" patients. Expert consensus held that the women were at "infinitesimal risk" of acquiring HIV. However, media accounts of the investigation all but belied this, illustrating that the news media's framing of risk has more to do with its reproduction of moral outrage components than with "scientific" notions of calculable risk.

Attitude to Health↗
PubMed1995

'Doing the right thing': the symbolic meanings and experiences of having an HIV antibody test.

Very few studies have been undertaken to explore in depth the reasons why individuals seek HIV antibody testing. This paper discusses the socio-cultural meanings surrounding the HIV antibody test, using the findings from a qualitative study directed at understanding why 'low risk' individuals make the decision to have an HIV test, their experiences of testing and their use of the result, especially in negotiating sexual relationships. It is concluded that the less obvious reasons for taking the test include pressure from parents or lovers, as a symbolic closure or commencement of a sexual relationship, the discourse of mutuality, the privileging of 'knowledge' and notions of responsibility and purity. Implications for AIDS education programs and policy are addressed.

AIDS Serodiagnosis↗
PubMed1995

Perspectives on power, communication and the medical encounter: implications for nursing theory and practice.

Over the past few decades there has been an increasing push towards 'enhancing' communication in the medical encounter, with a focus on moving towards a 'mutuality' of patient and health care professional that reduces a perceived 'power imbalance' between the two. Doctors in particular have been constructed as dominating and coercive, either consciously or unconsciously repressing patients' capacity for autonomy. Nurses have typically been represented as less authoritarian in their dealings with patients in their idealized role as caring, kindly and empathetic health professionals. It is therefore often argued that the nurse-patient relationship is more 'equal' and less repressive than the doctor-patient relationship. This article explores critically these assertions in the context of the Foucauldian perspective on the role of power in the medical encounter, and draws out implications for nursing theory and practice.

Communication↗
PubMed1995

Medical and health stories on the Syndey Morning Herald's front page.

Front-page coverage of medical and health stories in the Sydney Morning Herald over the one-year period, April 1992 to March 1993, was analysed. Features of the front-page stories, such as major topics, geographic location, visual imagery, use of news actors and news sources, the representation of medicine and health, the use of language in headlines, and dominant and recurring discourses were examined. Although front-page coverage was often contradictory and paradoxical, allowing space for alternative views on the value or otherwise of medical treatment and preventive health measures, it was predominantly conservative, giving greater voice to elite groups than less powerful groups, such as advocacy, activist and community groups, and to men rather than women. It tended to individualise illness rather than place it in its broader socioeconomic and political contexts.

Attitude to Health↗
PubMed1994

Femininity, responsibility, and the technological imperative: discourses on breast cancer in the Australian press.

The manner in which the popular press represents health issues influences, and is demonstrative of, societal attitudes toward illnesses and those who suffer from them. Cancer is one of the most feared diseases in modern society, and breast cancer attacks women at the bodily site where notions of femininity intersect. This article examines the discourses surrounding breast cancer as represented in the Australian press in the period between 1987 and 1990. It is argued that the press's portrayal of breast cancer during that time drew upon dominant cultural metaphors and discourses concerning femininity, the individual's responsibility for illness, and medical and technological dominance.

Attitude to Health↗
PubMed1993

Planned sexual behaviour of young Australian visitors to Thailand.

OBJECTIVE: To research the knowledge of AIDS and other sexually transmitted diseases among young Australian tourists to Thailand, and their intended sexual behaviour. DESIGN AND SETTING: A cross-sectional survey by anonymous, self-administered questionnaire, of persons seeking pre-travel medical advice in private clinics in five Australian cities. PARTICIPANTS: 213 consecutive patients travelling to Thailand without a spouse or partner. RESULTS: Only 34% of the sample reported a definite intention not to have sex in Thailand. Regarding choice of potential partners: 24.5% more men than women said they would have sex with a Thai national; 13.7% of men said they would have sex with a "bar girl"; and 21.7% more women than men said they would choose a fellow Australian traveller. Eighty-two per cent of the sample reported that they would use condoms 100% of the time, and there was no significant difference between the number of men and women who expressed this intention. CONCLUSIONS: Although not obviously "sex tourists", many young Australian travellers are likely to have sex while visiting Thailand. These data have important implications for education and prevention programs to control the spread of human immunodeficiency virus (HIV) and other sexually transmitted diseases.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Back to complacency: AIDS in the Australian press, March-September 1990.

This paper reports the results of a quantitative and qualitative content analysis of all articles about AIDS published in the Australian metropolitan press during the 7 month period of March-September 1990. During the study period, almost 2800 articles mentioning AIDS were published, representing a drop in number of articles published compared with earlier years. Those issues receiving most press attention included people living with AIDS, AIDS and the law, AIDS policy and politics, the general spread of HIV/AIDS, AIDS education campaigns, drugs and medical treatment, and the HIV/AIDS threat posed to prison officers and health practitioners. The analysis demonstrates that the reporting of AIDS has changed over the course of the epidemic: topics which in the past commanded enormous press attention, such as AIDS as a 'gay plague' and the threat posed by the disease to heterosexuals, are no longer considered as newsworthy. Implications for AIDS health promotion activities are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Choosing alternative therapy: an exploratory study of sociodemographic characteristics and motives of patients resident in Sydney.

Disenchantment with allopathic medicine has coincided with an upsurge in recent years in Australians consulting alternative therapists about their health care needs. Two major government studies have provided valuable independent evidence about the sociodemographic characteristics of users of alternative therapies and about their attitudes to health and medical care. However, the focus of these inquiries was predominantly on the users of chiropractic and osteopathy, just two of the modalities which make up this diverse field. To investigate, among other things, who consults alternative practitioners, how they come to choose a particular therapist, and whether, and on what basis, they have abandoned cosmopolitan medical care or use a combination of alternative and allopathic medicine, we conducted a cross-sectional survey of 289 patients of eight Sydney practices providing a range of alternative modalities. Findings indicate that far from being representative of the Australian community, the majority of our sample population came from a very select group, with a narrow range of socioeconomic backgrounds. The health risk behaviour of those surveyed was also significantly different from that exhibited by the population in general.

Attitude to Health↗