Representations Of Professionals Research Articles

D’une institution à l’autre : de l’hypercomplexité de l’hôpital à la place singulière des psychologues institutionnels référés à la psychanalyse

ContextThis article aims to open a debate on how our contemporary societal context, both psychically and structurally, shapes the essential institution that is the public hospital. ObjectivesTo achieve this, the authors start with a clinical construction that allows them to highlight the hypercomplexity of the situations encountered daily by those who inhabit these spaces, including patients, their relatives, and the diverse healthcare providers. Following this, they focus on the unique role of the institutional psychologist who is referenced to psychoanalysis. MethodThe situation that opens this text, providing both its starting point and framework, is a clinical fiction. This narrative is composed of fragments from real, recurrently observed situations in our practice, supervision, and research settings – in other words, from foundational cases (Fustier, 2020). We align ourselves with a Freudian tradition, adopting the principle of analytical construction, positing that this situation is an initial level of interpretation of the hypercomplexity we aim to explore throughout this text. ResultsThe hypercomplexity observed and described in this clinical fiction led us to formulate numerous hypotheses and highlight the essential presence of psychoanalysis in hospitals. Psychoanalysis offers the necessary perspective to elaborate and impart meaning to otherwise unthinkable situations. InterpretationsFrom the conjunction of subjective experiences of somatic illness to the institutional issues unique to hospitals – intersected by the divergent representations of healthcare professionals – we emphasize the unique position of the psychodynamically oriented psychologist within this complex system.

Who’s responsible for intellectual displacement? Objective representations of exiled professionals in Canada

The twenty-first century has brought an upsurge in intellectual exile due to protracted crises: important migrant flows from Afghanistan, Syria, Ukraine and Venezuela, to name a few, include professionals with huge integration challenges due to collective trauma, language and recertification barriers. Based on original research with intellectual exiles in Canada, underemployment provokes emotional and physical damage that can be avoided through a more encompassing approach to the Responsibility to Protect (R2P). I propose a model to redefine R2P in terms of hospitality and protection of people displaced by crises, including recognising their past credentials. Our model contributes to previous literature on skilled migration, bridging the fields of conflict resolution and the ethnography of forced displacement. I propose that credential recognition should be an integral part of R2P.

HIV serodifference: the “unsaid” in the social representations of health professionals

RESUMO Objetivo: Analisar as representações sociais na perspectiva do “não dito” de profissionais de saúde sobre a sorodiferença ao HIV. Método: Trata-se de um estudo qualitativo, fundamentado no referencial teórico-metodológico das Representações Sociais, com a Teoria do Núcleo Central e Zona Muda de Jean Claude Abric. Participaram 51 profissionais de serviços especializados da região metropolitana de uma capital do nordeste brasileiro, no período de outubro a dezembro de 2020. Aplicou-se entrevistas com a técnica de substituição da associação livre de palavras. Quanto aos procedimentos analíticos foram realizadas as análises prototípica e de similitude processadas no software Iramuteq. Resultados: Os resultados evidenciaram que o núcleo central demonstrou a presença velada de estigmas e déficit de conhecimento ao tratar da sorodiferença ao HIV, representados nas evocações preconceito, desconhecimento, medo, loucura e amor. Considerações finais: Os significados atribuídos ao núcleo central sinalizam a necessidade de capacitação dos profissionais de saúde envolvidos na rede de atenção à saúde, a fim de possibilitar a práxis do cuidado, e o enfrentamento dos estigmas que permeiam a sorodiferença e provocam o distanciamento entre parceiros e serviços de saúde.

Social representations of Family Health Strategy professionals regarding palliative care for older adults

Social representations of Family Health Strategy professionals regarding palliative care for older adults

HIV serodifference: the "unsaid" in the social representations of health professionals.

To analyze social representations from the perspective of the silent zone of health professionals regarding HIV serodifference. This is a qualitative study, based on the theoretical-methodological framework of Social Representations, with the Theory of the Central Nucleus and Mute Zone by Jean Claude Abric. 51 professionals from specialized services from the metropolitan region of a capital in the northeast of Brazil participated, from October to December 2020. Interviews were applied using the free word association replacement technique, with prototypical and similarity analyzes processed in the Iramuteq software. The results showed that the central nucleus demonstrated the veiled presence of stigmas and lack of knowledge when dealing with HIV serodifference, represented by the expressions prejudice, lack of knowledge, fear, insanity, and love. The social representations attributed to the central core are anchored in prejudice, ignorance, fear, and insanity. Such meanings signal the need for improvements in the knowledge of health professionals involved in the health care network, in order to enable the praxis of care, and to confront the stigmas that permeate serodifference and cause distance between partners and health services.

Perceptions and use of Universal Health Coverage (Plan Sésame) among the elderly in Dakar (Senegal), impacts on health expenditure related to diabetes and hypertension

In 2006, the Senegalese government set up a health coverage programme for people aged 60 and over - the Plan Sésame - to provide free medical care in all the country's public health facilities. This scheme has been integrated into the Universal Health Coverage (CMU) promoted from 2013. The objective of the study was to describe and analyse the knowledge and representations of professionals and users about health coverage and the Plan Sésame, the use of the scheme by the elderly, to evaluate the amount of medical expenses incurred during a routine medical consultation for the monitoring of their illness (hypertension and diabetes), and to calculate the out-of-pocket expenses related to the consultation. Study conducted between July 2020 and October 2021 in two public health facilities in Dakar. Mixed approach: 1/ qualitative study by semi-directive interviews, informal interviews, observations and field diary with 35 people selected according to a reasoned choice procedure with the aim of diversifying gender, age, social status, therapeutic itineraries for 23 people (including 12 women, ages between 60 and 85 years), and professional activities for 12 health actors; 2/ quantitative cross-sectional study by questionnaire of 225 people (including 141 women) aged 60 and over; we calculated the total cost of the consultation and associated prescriptions (complementary examinations and medicines) as well as the remaining medical expenses (out-of-pocket) and the cost of transporting patients. This is a descriptive exploratory study of a non-representative sample of the elderly population in Senegal. The health professionals interviewed supported the principle of health coverage, but most of them had limited and sometimes imprecise knowledge of the existing schemes and the methods of access or the services covered. Their point of view about the consequences of the Plan Sésame on their practice reveals some contradictions: some complain about the increase in workload, the criticism is extended to all the free schemes which would have a negative impact on daily practice because of the increase in the number of consultations which would be linked to abuse by patients.The interviews highlight the heterogeneity of the knowledge of elderly people about the health coverage intended for them, even though the Plan Sésame has been in place for over ten years. The interviews clearly show that the use of the health coverage system by the elderly depends closely on the information they have and their ability to use it, both for women and men. There is a close link between the level of social integration of people and their use of health coverage: the most socially integrated people are those who know how to use CMU services best. The use of health coverage by the elderly appears to vary according to the individual.Although Plan Sésame is defined as part of a national strategy, its implementation varies according to the health structures and the periods; in the two study sites, the range of services covered by Plan Sésame is very limited, so the coverage provided by Plan Sésame is only partial: between 30 and 50% of the medical costs; the remaining cost of a consultation for elderly patients with hypertension and/or diabetes varies between 24,000 and 28,000 CFA francs.These amounts must be put into perspective with the resources available to people. Statistical studies published in 2021 report that in Senegal the average daily expenditure is 1,390 CFA francs/person/day; and that almost 38% of the population lives on 913 CFA francs/person/ day, which is the poverty line calculated in 2019. Thus, the average out-of-pocket expenses for a follow-up consultation for hypertension, diabetes or a combination of the two diseases represent 15 to 30 days of daily expenditure. While the vast majority of elderly people in Senegal do not have a retirement pension, health expenses are therefore borne by their relatives. Within households, medical expenditure for the elderly competes with basic needs, particularly food, which usually take up more than half of household resources. This indispensable family support places the elderly in a situation of total dependence. In 2021, Plan Sésame does not yet allow for completely free care for the elderly. However, its application, even partial, has resulted in a real reduction in health care costs for the elderly. Its use remains limited due to inconsistent application by most health structures. Its impact is insufficient in view of the amounts that users have to pay in a context of social and economic vulnerability. These observations reinforce the need to work on reducing the price of medical services and strengthening the UHC, in order to improve the equity and performance of the system, and to make it fully functional in all health structures.

Pediatric Diabetes Technology Management: An Italian Exploratory Study on Its Representations by Psychologists and Diabetologists

The incidence of type 1 diabetes (T1D) has increased by about 3% per year over the last two decades. Continuous Insulin Subcutaneous Therapy (CSII) is widely used in the pediatric population with diabetes; however, it requires more preparation by the treating team and a careful selection of its potential users. Prescriptive provisions vary from region to region, and the perspective of health workers in this regard remains an unexplored area. The aim of this research project is to explore the representations of a group of diabetologists and psychologists working in pediatric diabetology throughout the country, regarding their roles, functions, and activities as part of a multidisciplinary team; it also aims to investigate their views on the potential benefits of CSII and the types of individuals who apply for the use of this technology. A socio-anagraphic data sheet was administered, and two homogeneous focus groups were conducted, one for each profession, which were then audio recorded. The transcripts produced were analyzed using the Emotional Text Mining (ETM) methodology. Each of the two corpora generated three clusters and two factors. For diabetologists, a focus on patient care emerged at different levels, involving collaboration with other health professionals and engagement with the community, often incorporating technology in medical interventions. Similarly, psychologists' representations highlighted interdisciplinary networking with a stronger emphasis on the psychological processes involved in managing the disease, from acceptance to the elaboration and integration of diabetes into the family narrative. Understanding the representations of health professionals working in pediatric diabetes with new technologies can contribute to the consolidation of a network of professionals through targeted work on possible critical issues that may arise.

Psychological Safety as an Educational Value in Interprofessional Health Education.

The Interprofessional Education Collaborative competency on values and ethics is defined as "work[ing] with individuals of other professions to maintain a climate of mutual respect and shared values." Essential to mastery of this competency is acknowledging biases, many of which are rooted in historically entrenched assumptions about the value of medical supremacy in health care, popular cultural representations of health professionals, and students' lived experiences. This article describes an interprofessional education activity in which students from several health professions discuss stereotypes and misconceptions about their own professions and other health professions and professionals. Psychological safety in the learning environment is key, so this article also canvasses how authors revised the activity to promote and facilitate open communication.

‘I didn’t feel like I was a doctor’: a qualitative interview study exploring the experiences and representations of healthcare professionals’ capacity to deliver compassionate care and to practice self-care during the Covid-19 pandemic

Objective The increased demand on healthcare professionals (HCPs) during the Coronavirus Disease (Covid-19) pandemic reduces opportunities for HCPs to deliver compassionate care to patients and to maintain self-care. This study explored how HCPs understand and experience compassionate working practices during the Covid-19 pandemic to better support HCPs’ wellbeing and to sustain quality of care. Design All nineteen participants worked as an HCP during the Covid-19 pandemic, resided in the United Kingdom (UK) and took part in individual semi-structured interviews. Main outcome measures Using a thematic analysis approach, we developed three themes: (a) The art of compassionate care: Feeling and action, (b) The impact of Covid-19 on compassionate care and (c) Suffering during Covid-19: The importance of self-compassion and self-care. Results Overall, the analysis illustrated the strong and negative impact that Covid-19 had on the ability to deliver compassionate care, resulting in moral injury and psychological and behavioural difficulties for HCPs, particularly in terms of self-care. Conclusions This research demonstrates an imperative need for organisations to better support HCPs’ health and wellbeing, through a self-care system that promotes self-compassionate and self-care practices.

Taking Care of Forced Migrants Together: Strengths and Weaknesses of Interorganizational Work from the Perspective of Social Workers.

The reception and taking care of forced migrants with mental health issues is undoubtedly a very complex task. The literature shows that reception systems are characterized by a high level of fragmentation due to poor collaboration among services that are required to respond to complex and multidimensional needs brought by forced migrants. Starting from the need to deepen what elements support or hinder the implementation of the services' networks for the care and management of forced migrants, qualitative research was conducted within a constructivist paradigm. As the literature reveals a lack of studies considering the perspective of practitioners, we decided to explore the representations of professionals working with migrants in northern Italy in four different service areas (health and psychological well-being, reception, family, and legal areas). A total of 24 professionals (13 F and 11 M) with an average age of 42.4 years were involved in four focus groups according to the four areas. A paper-pencil content analysis was conducted following IPA guidelines. The results show strengths, weaknesses, and elements of improvement for service network implementation. The needs of forced migrants seem to be effectively met only through a service network that takes shape in the interweaving of social, organizational, group, and individual levels.

Psychosocial aspects of youth suicide: identifying social representations of health and education professionals from bonfim/mg

In view of the proportion and growth of suicide rates among Brazilian youth, studies that contribute to the expansion of the understanding of death by self-injury in these age groups and to better deal with the issue in practice are becoming increasingly relevant. Thus, a qualitative case study was carried out on theme/category-based content analysis in the light of the Theory of Social Representations with the objective of identifying social representations of young people's suicide by health and education professionals. The study was carried out through in-depth and semi-structured interviews carried out online with professionals from the city of Bonfim/MG, already considered the city with the highest consumption of tranquilizers in Brazil. Through the data, it is considered that it was possible to identify differences between the social representations of general suicide with those of young people, indicating the existence of social representations of young people's suicide by education and public health professionals in the city of Bonfim. Therefore, substance abuse, relationships, psychic pain, and immaturity are considered at the most central core of the social representations of youth suicide. Being self-mutilation and the internet the most recent topics that touched the discussion about the young person's death by self-injury. Through the results, medicalization is questioned as a mental health strategy institutionalized by the municipality and the possible effects of this on the way youths deal with their issues. It examines how much a stigmatized perception of a youth can impact the treatment of the subject from the perspectives that professionals have. Furthermore, the prevention of the suicide demands psychosocial contributions, requiring the involvement of economic sectors and social protection strategies. Being the area of education with its professionals a possible area of prevention of suicide of young people.

I Just Don’t Think about It: Engaging Students with Critical Heritage Discourse through Science Fiction

What does sci fi have to say about and to the people who collect and preserve? Using a scene from Cuarón’s Children of Men as a starting point, the author explores some popular representations of heritage professionals and their spaces in science fiction. These chime with critically engaged museological theory and practice in recognizing the role of museums in past and present injustices. The author asks whether popular sci fi representations can be used as a starting point for discussion and debate in professional training. Can sci fi change the way we work and create different futures for museums?

Representations of Sexuality among Persons with Intellectual Disability, as Perceived by Professionals in Specialized Institutions: A Systematic Review.

The objective of this systematic review is to make an inventory of the representations of the professionals of specialized institutions on the sexuality of persons with intellectual disabilities. The scientific studies were identified according to the PRISMA protocol using 18 databases, with keywords on sexuality and parenthood. Studies were reviewed through a methodological assessment and then a thematic analysis. Twenty-four studies were reviewed and three themes were identified: professionals’ representations of gender, sexuality, and consent; professionals’ perceptions of their role in supporting people’s sexual lives; and the ways in which professionals construct representations of people’s sexual lives. This corpus highlights deep paradoxes in the representations of professionals concerning the socio-affective needs and sexuality of people with intellectual disabilities, creating what we could define as a “system of incompatibility” and leading to difficulties in positioning. Support is still too random and subject to control logics in the name of protecting users, who are perceived as vulnerable. Training and new ways of teamwork appear to be central to supporting the evolution of the representations and practices of professionals. Future research anchored in practices and involving users as well as professionals is necessary to better understand the paradoxical aspects of professionals’ representations and to draw alternative ways of constructing these representations.

Agentes de viajes de Curitiba / PR ‐ Brasil,y sus representaciones sociales en relación a las innovaciones tecnológicas

Since the last years of the 20th century, travel and tourism agencies have undergone technologi‑ cal transformations and changes in their work activities. Technological innovations have led to increased competition and market changes facilitated by the advent of the Internet and information and communica‑ tion technologies (ICT). Based on this analysis, this research aimed at identifying the Social Representations (SR) of Travel Agents (TAs) in relation to technological innovations. The design of this study was based on documentary and bibliographic research, with a qualitative approach and the use of semi‑structured inter‑ views. The Social Representations of agency professionals indicate the need for constant staff training and investment in technology in order to remain in the travel and tourism agency segment.

Is child abuse and neglect a crime or a welfare issue?: Mental representations of both university students and professionals

Is child abuse and neglect a crime or a welfare issue?: Mental representations of both university students and professionals

HIV serodiscordant sexual partners: social representations of health care professionals.

to understand the structure of the social representations of health professionals from HIV/AIDS Specialized Care Services about HIV-positive partners. this is a qualitative study, based on the structural aspect of Social Representations, developed in specialized services of the metropolitan area of a state in the Northeast Region. Fifty-one professionals were interviewed using the technique of free association of words, processed by the software IRaMuTeQ, by means of prototypical and similarity analysis. the central nucleus was constituted by the terms "partnership", "love" and "fear", showing appreciation of meanings inherent to their beliefs, values and experiences that bring possibilities of reflections for health practices. the findings reinforce the impacts generated in the different segments of the lives of people living with HIV and in their emotional bonds. This highlights the need for the implementation of care strategies contemplating the biopsychosocial care model rather than the biological model.

Barriers and facilitators on hand hygiene and hydro-alcoholic solutions' use: representations of health professionals and prevention perspectives

SummaryBackgroundHealthcare-associated infections pose a serious problem in terms of health and mortality. Their prevention is a necessity, and healthcare professionals are one of their main vectors. Thus, they must be at the centre of preventative strategies. As hydro-alcoholic solutions (alcohol-based hand rub) represent the most effective means of preventing these infections, it is necessary to identify the representations, barriers, and facilitators of their use.MethodForty-six healthcare professionals from two areas in France, New Aquitaine and Guadeloupe, were questioned about their practices through semi-structured registered interviews and four focus groups. Each interview and focus group were transcribed then analysed through lexicometric and thematic content analyses.ResultsThe interviewed identified several barriers and facilitators related to the composition and characteristics of hydro-alcoholic solutions (unpleasantness, harmfulness, personal preferences for other hand hygiene products), personal factors (work habits, cognitive bias, lack of knowledge and communication) and organizational (professional constraints, product accessibility, financial resources).ConclusionStrategies to prevent healthcare-associated infections should be constructed with consideration of psychosocial facilitators and barriers for healthcare professionals in using hydro-alcoholic solutions. These strategies should also ensure that they are well informed about the effectiveness of alcohol-based solutions, through prevention campaigns and scientific articles. This awareness should equally be conveyed with educational tools that involve healthcare professionals and use the social dynamics of their work environment.

Las relaciones de otredad, alteridad e inclusión identitaria cultural de estudiantes inmigrantes en espacios escolares municipalizados en la región metropolitana

The article describes the findings of a doctoral thesis aimed at interpreting the cultural integration of immigrant students in two Chilean schools, as well as representations of teachers, managers, classroom teachers, non-teaching professionals, parents and/or guardians and students on the relations of Otherness, appreciation of Otherness and Cultural Identity. Findings: Both schools the relations of Otherness with the immigrant student are of superficial character, lack to deepen the own characteristics of differentiation such as: Psychosocial and Sociocultural. In relation to the Otherness, both institutions, there is not installed the understanding of the change in the reciprocal alternation of the cultures that recognizes the different one as a valid interlocutor in a dialogical, ethical and political project. Finally, the valuation of the Cultural Identity, in both institutions prevails an assimilating approach of cultural adaptation, which implies submission and identification to the system of values of the culture that receives.

Representações sociais de profissionais de saúde sobre doenças transmissíveis

Objetivo: Analisar a estrutura das representações sociais de profissionais de saúde sobre doenças transmissíveis. Metodologia: estudo qualitativo sustentado na Teoria das Representações Sociais, em sua abordagem estrutural, composto por amostra intencional e não-probabilística de 90 profissionais de saúde. Dados coletados por questionário de evocações livres ao termo indutor doenças transmissíveis e analisados pela técnica do quadrante de quatro casas, auxílio do software Ensemble de Programmes Permettant l’analyse dês Evocations 2005 e pela análise de similitude. Resultados: Evidenciaram uma estrutura representacional de profissionais de saúde sobre doenças transmissíveis constituída por três dimensões: individual; social e imagética, que foram gerenciadas por um núcleo central formado pelos termos DST, HIV e ignorância. As dimensões e o núcleo central desta estrutura representacional indicaram os significados como ausência práticas individuais e coletivas na prevenção e tratamento destas entidades mórbidas. Conclusão: A estrutura representacional identificou a necessidade das mudanças de práticas profissionais para o enfrentamento destas enfermidades no sentido de orientar novas atitudes individuais e coletivas na prevenção, promoção e reabilitação acerca das doenças transmissíveis.

Downside: The Perpetrator of Violence in the Representations of Social and Health Professionals.

Gender-based violence is a widespread phenomenon and pandemic that affects women’s lives. Many interventions have been activated for perpetrators, but the dropout rate is still high. In order to draw up guidelines for responsibly and sustainably dealing with the phenomenon, this study is aimed at investigating the professionals’ perception of the perpetrator as a useful element in designing innovative intervention policies. Open interviews were carried out with welfare and health professionals and the Grounded Theory Methodology was used to analyze the collected data. These results detect attitudes of social health personnel and their feelings of impotence towards gender-based perpetrators because of the emergence of an inevitable repetitiveness of the violent behavior, as well as the “normality of violence” in a patriarchal culture and its “transversality”. This reflective knowledge allows for the opportunity to develop best transformative attitudes toward the phenomenon. According to the results, it is urgent to establish an active and convinced alliance with the healthy part of the man, through specific prevention paths, in order to activate an authentic motivation for change and its sustainability.