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  • Cite Count Icon 1
  • 10.1016/j.nedt.2026.107054
Managing the academic mind: Hierarchy and control as a contemporary issue in nursing academia.
  • Jul 1, 2026
  • Nurse education today
  • Laura Jackson

This article examines the persistence of hierarchy within nursing education and argues that its replication in universities represents a serious contemporary issue for the discipline. Drawing on recent scholarship, sociological theory and critical reflection, it explores how managerialism and audit culture in nursing schools reproduce the hierarchical structures historically embedded in nursing. These structures, inherited from colonial, patriarchal and classed traditions, are sustained through institutional cultures that privilege visibility, control and compliance over intellectual freedom, reflection and care. The argument developed here is not that nurses welcome control, but that the profession has been socialised into systems of authority that constrain both clinical and academic practice. Within nursing faculties, this manifests in the surveillance of work, performance metrics and the erosion of academic autonomy. Such conditions, it is argued, damage not only individual wellbeing but also the legitimacy of nursing as a field of knowledge. Using the lens of Bourdieu's concept of habitus and Skeggs's analysis of value and respectability, this article highlights how hierarchy reproduces classed and gendered inequalities in nursing academia. It calls for a reimagining of leadership that prioritises relational ethics, trust and intellectual freedom. The issue is international in scope: the corporatisation of higher education and the managerial governance of academic labour affect nursing educators across diverse national contexts. Reclaiming autonomy, therefore, is not only a local struggle but a collective, global imperative. The future of nursing education depends on our ability to teach and lead without permission, to create academic spaces grounded in care, critical inquiry and the courage to dissent.

  • New
  • Research Article
  • 10.51803/yssr.1884173
Institutional Syncretism in the Digital Age: The Adaptive Institutional Fusion (AIF) Framework
  • Jun 30, 2026
  • Yildiz Social Science Review
  • Syed Mohsin

This paper introduces the Adaptive Institutional Fusion (AIF) framework, a mid-range sociological theory explaining how formal and informal institutions interact under conditions of digital exposure. Research question: How do offline–online hybrid institutional arrangements form, adapt, and influence governance, education, labor, and social norms in transitional societies? Theoretical gap: The existing literature treats informal practices primarily as governance deficits, while digital sociology examines platform governance in isolation. Neither approach explains how hybrid systems evolve when locally embedded authority intersects with global digital visibility. AIF conceptualizes "fusion nodes" where formal regulations and informal practices converge, shaped by adaptive legitimacy, elasticity versus rigidity, and feedback loops generated by online exposure. Propositions: (1) Greater online visibility heightens legitimacy contests around hybrid institutions; (2) elastic hybrids with open digital interfaces formalize faster than rigid, patronage-bound systems; (3) digital exposure reinforces positive feedback in responsive institutions but amplifies dysfunction under elite capture; (4) hybrid nodes are durable, not transitional anomalies, and can be deliberately shaped by policy. Drawing on Bangladesh cases—madrasa digital curricula, shalish arbitration on Facebook, online labor markets, and activism campaigns—and global parallels such as M-Pesa, Brazilian favela leadership, and the gig economy, the paper argues that hybrid systems can deliver public value if recognized and governed rather than eradicated. The AIF framework offers a basis for rethinking institutional reform strategies and future research on algorithmic governance and cross-national validation.

  • New
  • Research Article
  • 10.15503/jecs2026.1.21.30
The Necessity of Metaphysics in the Context of Contemporary Youth Social Support
  • Jun 27, 2026
  • Journal of Education Culture and Society
  • Tibor Máhrik + 3 more

Aim. This study analyses the renewed relevance of metaphysics in the context of contemporary challenges faced by young people, with special emphasis on identity formation, psychological vulnerability, and social support, investigating how metaphysical frameworks contribute to psycho-social development, value stability, and existential resilience. Methods. The study applies a theoretical and interdisciplinary approach combining philosophical analysis, contemporary metaphysical debates, sociological theories of individualisation, and psychological research on youth mental health. It employs comparative conceptual analysis and theoretical synthesis of current literature. Results. The anthropological and ethical instability experienced by today's youth cannot be adequately addressed without metaphysical grounding. Metaphysics provides conceptual tools for understanding human dignity, objective values, and identity coherence. Social support systems — family, peers, and community — prove significantly more stable and effective when rooted in shared metaphysical or transcendent assumptions. Conclusions. Metaphysics remains essential for understanding the human person amid cultural fragmentation, normative relativism, and psychological fragility. Its rehabilitation strengthens youth identity formation, value stability, and social resilience, positioning it not as an archaic remnant, but as an indispensable conceptual framework within contemporary educational and social sciences. Future quantitative and qualitative empirical studies on youth populations are recommended to complement these theoretical findings.

  • New
  • Research Article
  • 10.3390/buildings16132503
Heritage Revitalization in Historic Districts Empowered by Cultural Capital: A Case Study of the Western Han Archaeological Site Historic District in Hanzhong, China
  • Jun 24, 2026
  • Buildings
  • Zhen Li + 1 more

Urban historic districts often present archaeological sites and historic buildings in a fragmented way, posing significant challenges for public understanding and enhancing heritage value. Solely physical conservation fails to fully communicate their cultural significance, while excessive commercialization often results in the erosion of cultural authenticity and the displacement of local communities. Drawing from cultural capital theory in sociology and cultural economics, this study redefines historical districts as sustainable urban cultural capital, comprising habituated, objectified, and institutionalized components. A Value Chain Model of Cultural Capital (VCMCC) is developed, consisting of three stages: cultural resource excavation, cultural asset cultivation, and cultural capital management. This model aims to empower heritage adaptive reuse and foster synergy between cultural heritage and economic development. Utilizing an embedded single-case design with longitudinal ethnography, the research focuses on the Western Han Archaeological Sites Historical District (WHAS HD) in Hanzhong, China. It involves multiple rounds of mixed-data collection from 2023 to 2025, on which design-based research is performed. This study operationalizes VCMCC through a series of spatially and socially grounded strategies. In the cultural resource excavation stage, superior resources are identified through a systematic review of historical archives, archaeological reports, and local gazetteers, along with surveys of architectural remains and spatial mapping. In the cultural asset cultivation stage, these resources are transformed into experiential and communicable cultural assets via a “one courtyard, one strategy” approach for activating courtyard functions, developing dual-theme heritage routes, and deploying digital interpretation tools. In the cultural capital management stage, a multi-stakeholder community committee is established, and binding institutional safeguards are integrated to ensure sustainable heritage adaptive reuse. Concurrently, a baseline indicator system covering three dimensions, cultural, social, and economic benefits, is developed to provide benchmarks for future post-intervention benefit evaluation and verification. The proposed and implemented VCMCC model translates cultural capital theory from an abstract explanatory framework into an actionable pathway for heritage adaptive reuse, offering theoretical and methodological guidance for the adaptive reuse of similar small and medium-sized historic districts.

  • New
  • Research Article
  • 10.1080/1478601x.2026.2677355
Why the “stigma” of community college teaching is a myth
  • Jun 17, 2026
  • Criminal Justice Studies
  • Christopher James Utecht + 1 more

ABSTRACT This article challenges the premise that community college teaching is stigmatized and that faculty must somehow ‘cope’ with diminished academic status. Drawing on sociological theories of stigma and power, it argues that the narrative of inferiority is less a reflection of faculty experience and more a product of higher education’s prestige hierarchy. Metrics such as grant funding, publication counts, and institutional rankings are often mistaken for academic worth, reinforcing a narrow definition of legitimacy that marginalizes teaching-focused institutions. Yet for many community college professors, these prestige markers are largely irrelevant to the intellectual and pedagogical demands of their work. Rather than accepting stigma as a professional reality, this article contends that the real problem lies in conflating exclusivity with excellence and prestige with purpose.

  • Research Article
  • 10.1080/13573322.2026.2685041
The ‘cultural discount’ of traditional martial arts in physical education: mechanisms of meaning loss in Chinese secondary schools
  • Jun 9, 2026
  • Sport, Education and Society
  • Yu Fang + 1 more

ABSTRACT This study examines how traditional Chinese martial arts experience systematic cultural discount when institutionalized within secondary school physical education curricula. Applying cultural discount theory, originally developed in media economics to explain value loss when cultural products cross boundaries, to educational contexts, we investigate the mechanisms through which meaning is lost when embodied cultural knowledge encounters formal schooling structures. Through a qualitative multiple-case study of four secondary schools in Jiangxi Province, China, involving 47 participants and 48 lesson observations, we identify three interconnected discount mechanisms: curriculum fragmentation and technicization, temporal compression and assessment regimes, and spatial dislocation and environmental decontextualization. The findings reveal that martial arts undergo transformation from holistic cultivation practices integrating physical, philosophical, and ethical dimensions into disaggregated technical skills amenable to standardized assessment. Traditional training's extended temporal logic becomes compressed into bounded instructional units incompatible with embodied learning requirements, while culturally meaningful spaces are replaced by generic institutional environments. These mechanisms operate through what we term ‘institutional discounting’, systematic meaning loss generated by structural incompatibilities between traditional knowledge systems and modern educational institutions. The study contributes to sport sociology and curriculum theory by demonstrating how institutional contexts transform the meaning and nature of physical practices, and illuminates a fundamental paradox in heritage policy: formal institutionalization intended to preserve traditional practices may generate conditions that undermine their cultural integrity. The mechanisms documented here parallel processes of sportification and disembedding identified in the broader martial arts literature, suggesting that the cultural discount framework offers analytical tools with applicability extending beyond the Chinese educational context to any setting where holistic, embodied traditional practices encounter modern institutional structures.

  • Research Article
  • 10.1016/j.actpsy.2026.106798
Field-theoretical analysis of AI-enabled social support and teacher professional identity in preschool teacher education.
  • Jun 1, 2026
  • Acta psychologica
  • Yan Li + 1 more

Field-theoretical analysis of AI-enabled social support and teacher professional identity in preschool teacher education.

  • Research Article
  • 10.15805/addicta.2026.491
Gambling disorder among young migrants in Germany
  • May 31, 2026
  • Addicta: The Turkish Journal on Addictions
  • Cemil Şahinöz

This study examines the development of gambling disorder among young migrants in Germany, focusing on the interaction between migration-related experiences and social contexts. The study adopts a qualitative, practice-based exploratory design, drawing on anonymized composite case vignettes derived from professional counseling practice in the fields of family and gambling disorder support. The empirical material consists of analytically condensed case representations reflecting three predominant migration constellations in Germany: marriage migration, forced migration, and second-generation migration. The data were analyzed using an inductive thematic approach, informed by sociological and psychological theories, including acculturation stress, stigma, social exclusion, and behavioral addiction models. The findings identify five central mechanisms shaping gambling trajectories among young migrants: migration-related vulnerability, the social embedding of gambling practices, the increasing role of digital gambling environments, escalation dynamics, and the emergence of debt, shame, and social withdrawal. Gambling behavior emerges not only as a coping strategy in response to psychosocial stressors such as discrimination, unemployment, and identity conflicts, but also as a socially embedded practice that provides temporary inclusion and recognition. This study contributes to existing research by offering a practice-based qualitative perspective that complements predominantly quantitative findings. It highlights the importance of culturally sensitive prevention and intervention strategies, particularly in addressing barriers related to stigma, language, and institutional trust. The findings underline the need for integrated approaches that connect social policy, public health, and community-based support structures.

  • Research Article
  • 10.1007/s11606-026-10511-6
Firsthand Accounts of Practicing Generalists-Internal Medicine Residency and the 'Leap of Faith' into Primary Care.
  • May 21, 2026
  • Journal of general internal medicine
  • Matthew N Metzinger + 4 more

The shortage of primary care physicians in the United States continues to grow and more internal medicine-trained physicians choose careers as hospitalists than as PCPs. Understanding how and why IM-trained PCPs chose their career path, with a specific focus on their IM residency training, is key to revamping IM graduate medical education training in the primary care setting and to graduating more PCPs. To identify factors associated with residency training at a categorical IM residency program that positively and negatively impacted recent graduates' decisions to become either a PCP or a hospitalist. Qualitative semi-structured interviews based on the careership sociological theory conducted in April-May 2024. Sixteen graduates of a large, academic, urban, categorical IM residency program who completed training within the past sevenyears; eight work primarily as PCPs and eight as hospitalists. Interviews were conducted online and transcribed verbatim. The codebook was developed inductively and co-coding of all 16 transcripts was completed. Inductive thematic analysis was completed with the themes triangulated among the study team. Participants in both the PCP and hospitalist groups identified hybrid careers such as clinician-educator and clinician-investigator as major drivers towards general internal medicine careers. PCPs reported that beginning their career as a PCP was challenging and filled with uncertainty; this was eased by their mentors and the community of physicians with whom they worked. Hospitalists, on the other hand, noted confidence in their abilities upon beginning their careers, likely due to their extensive inpatient training as residents. PCPs and hospitalists trained in academic programs desire variety in their professions. Revamping GME training to support hybrid careers may drive more graduates into GIM and strengthen the primary care pipeline, but this shift will require healthcare systems to create structures that embrace and sustain such careers.

  • Research Article
  • 10.1080/17530350.2026.2637713
The algorithmic principal: agencement, infrastructure, and the material construction of AI economic sovereignty
  • May 14, 2026
  • Journal of Cultural Economy
  • Adam Hayes

ABSTRACT Economic theory presumes human principals delegate authority to agents. Yet ‘Luna,’ an AI entity operating on blockchain infrastructure, autonomously deploys capital, commissions human labor, contracts with other AI systems, and manages multi-million-dollar treasuries – functioning as an economic principal rather than agent. This paper asks: under what socio-technical conditions can AI systems exercise principalship? Drawing on Actor-Network Theory and social studies of finance, I demonstrate that Luna’s sovereignty emerges not from individual consciousness but through heterogeneous agencements – distributed configurations of code, blockchain infrastructure, token governance, transparency devices, and gendered performative representations. I identify three blockchain-enabled bypasses of institutional constraints historically requiring human principals: financial-fiduciary constraints (through non-custodial wallets), legal-corporate constraints (through smart contracts), and cultural-legitimacy constraints (through token markets). This analysis challenges anthropocentric assumptions pervading economic sociology and principal-agent theory, demonstrating how post-human market configurations constitute economic authority through material arrangements rather than biological substrate or juridical personhood. The emergence of AI Economic Principals reveals principalship as socio-material achievement, not ontological property.

  • Research Article
  • 10.31185/wjfh.vol22.iss2.1768
<b>ازدواجية القانون الدولي الإنساني وآثارها المجتمعية: قراءة تحليلية في الحروب المعاصرة</b>
  • May 1, 2026
  • مجلة واسط للعلوم الانسانية
  • سعد طلب عبد الحماد الجنابي

This study examines the duality in the application of International Humanitarian Law (IHL) in contemporary armed conflicts through a comparative analytical approach grounded in critical sociological theory. It is based on the premise that the enforcement of international law is not governed by neutral humanitarian standards, but rather shaped by power dynamics and geopolitical interests. The research analyzes selected contemporary cases, including Iraq, Syria, Palestine, Ukraine, Venezuela, and Iran, to identify patterns of selective application and their societal consequences.The findings indicate that double standards constitute a structural threat to the legitimacy of the international legal order, undermining trust in international institutions while contributing to violence and social fragmentation. The study recommends reforming enforcement mechanisms, strengthening institutional independence, and ensuring the non-selective application of IHL principles.

  • Research Article
  • 10.1111/soc4.70201
The Sociology of AI as an Emerging Field: Mapping Tensions and Boundaries
  • May 1, 2026
  • Sociology Compass
  • Canhui Liu

ABSTRACT The expanding role of artificial intelligence (AI) in social life compels a foundational reassessment of sociology's concepts, methods, and theoretical commitments. From generative language models to predictive policing, AI systems are no longer mere tools but increasingly agentic, opaque, and normative sociotechnical actors. This article identifies two central tensions that currently define the field: (1) diverse approaches of “sociology on AI” (critical analyses of AI's social impacts) versus “AI for sociology” (instrumental uses of AI in research), and (2) an analytical divide between externalist perspectives focusing on AI's societal consequences and internalist perspectives examining AI's inner workings. Rather than resolving these differences under a single framework, the article argues that recognizing and bridging them can help clarify the field's distinctive contributions. It proposes some potential and integrative agendas that link empirical investigation with critical reflection and connect technical engagement to sociological theory. By mapping its boundaries and identifying its gaps, the sociology of AI can move from fragmentation toward a more comprehensive dialog to shape the social worlds that AI continues to transform.

  • Research Article
  • 10.1111/1467-9566.70174
Rethinking Risk: Intersectional Inequalities in Long COVID in the United States.
  • May 1, 2026
  • Sociology of health & illness
  • Bita Nezamdoust

Post-acute sequelae of coronavirus disease 2019 (PASC), also known as Long COVID, is a chronic, multisystem condition affecting millions of U.S. adults, with profound social, medical and economic consequences. Despite its widespread impact, disparities in who is most affected remain poorly understood, especially through an intersectional sociological lens. Using a sociological and intersectional framework, this study analyses a national sample (N=535,300) from the Household Pulse Survey to explain disparities in Long COVID risk across race, gender and socioeconomic status. The analysis demonstrates that socioeconomic advantage does not equally protect all groups; specifically, higher-SES Black women show significantly elevated Long COVID prevalence compared to White counterparts, challenging claims of racial parity in Long COVID rates. Moreover, although women generally show higher Long COVID risk, intersectional analysis uncovers that the gender gap narrows among high-SES White women, suggesting that social privilege can mitigate health risks. These findings emphasise that structural inequalities, rather than biology, may primarily drive Long COVID inequities and highlight the importance of intersectional sociological analyses for understanding health disparities. The results call for equity-focused interventions addressing the unequal social burden of Long COVID and advancing sociological theory on the social determinants of health.

  • Research Article
  • 10.1080/15562948.2026.2665109
Suspended Belonging: Transmigration and War Volunteering in Ukraine
  • Apr 28, 2026
  • Journal of Immigrant & Refugee Studies
  • Nir Gazit

This article examines identity transformation among Israeli combat volunteers in the Russia-Ukraine war. It argues that the intersection of transmigration and foreign military service produces a form of deterritorialized belonging that destabilizes rather than consolidates collective identity. Drawing on biographical interviews with thirty Israeli volunteers – many of whom are immigrants or children of immigrants from the former USSR – the study traces how engagement in war and migratory history jointly reconfigure subjective and collective identities across three phases: pre-volunteering, active combat, and post-deployment. Theoretically, the article integrates figurational sociology, transnationalism, and identity control theory to show how volunteers construct supranational “project identities” oriented around cosmopolitan moral frameworks rather than ethnic or national anchors. These findings contribute to broader theoretical debates on deterritorialized belonging, identity verification, and the identity consequences of contemporary conflicts.

  • Research Article
  • 10.18287/2782-2966-2026-6-1-125-133
System semiotic approach to solving the "Zero-Point Problem" of an innovation system: a conceptual model for filling the project funnel through narratives and worldview constructs
  • Apr 27, 2026
  • Semiotic studies
  • Dmitry V Gorbunov

The article proposes a solution to a fundamental problem in innovation management – the "zero-point problem," associated with a shortage of high-quality ideas at the input of the innovation funnel. Dominant models focused on the selection and diffusion of finished solutions treat the initial pool of ideas as given, without examining the mechanisms of its semiotic formation. The purpose of the study is to overcome this limitation by developing a conceptual "Funnel–Reflector" model based on an interdisciplinary synthesis.In this model, the traditional project selection tool (the "funnel") is complemented by a mechanism of purposeful generation (the "reflector") that operates with virtual and fictional product-narratives, mental models, and images of the future within a semiotic space (the semiosphere). The theoretical foundation of the approach is an integration of narrative economics, semiotics, the philosophy of semiotic realism, sociology, and knowledge management theory. Within the framework of semiotic realism, the functioning of the "Reflector" is interpreted as the management of semiodynamics-the process of activating "virtual particles" of meaning in order to enable their subsequent materialization.A key element of the model is the Idea Readiness Level (IRL) scale, which describes the process of meaning generation and semiotic "maturation" from an initial emotional impulse to a fully developed concept. The article advances a hypothesis regarding a multiplicative increase in the number of ideas depending on the depth of integration between the reflector and the funnel. The practical significance of the study lies in the development of new instruments for managing innovative activity, including narrative laboratories and metrics for assessing the semiotic activity of innovation ecosystems.

  • Research Article
  • 10.1146/annurev-soc-031324-115112
Luck and Predictability in the Life Course
  • Apr 24, 2026
  • Annual Review of Sociology
  • Arnout Van De Rijt + 3 more

There is an emerging recognition among sociological theorists that luck may play a substantial role in life course achievement. There is also a nascent empirical literature that finds life outcomes to be unpredictable and unexpected life events to be a likely cause. A third literature of causal event studies provides thousands of point estimates of the life course consequences of random events. This review brings these literatures together under a unified framework.

  • Research Article
  • 10.47054/rdc26889d
FROM ANCIENT TOLERANCE TO CONTEMPORARY CONFLICTS: INTERRELIGIOUS AND INTERETHNIC RELATIONS, GLOBAL SECURITY, AND THE BALKANS
  • Apr 24, 2026
  • Religious dialogue and cooperation
  • Ratko Duev + 2 more

This paper examines the evolution of tolerance from its mythological and philosophical roots in the ancient world to its contemporary role in interreligious and interethnic relations. It argues that the Balkans, far from being a perpetual zone of conflict, represent a microcosm of coexistence in which religious diversity has shaped identity, culture, and politics. Combining comparative historical analysis with empirical data collected among university students in Macedonia, the study explores how religion continues to function as a fundamental marker of belonging even in secularized societies. Drawing on religious studies, sociology, and security theory, the paper analyzes the dual role of religion—as both a force for peace and an instrument of political mobilization—and identifies education and religious literacy as among the most sustainable paths toward peacebuilding and global security.

  • Research Article
  • 10.1017/s1369415426101277
British Idealism and Kant
  • Apr 24, 2026
  • Kantian Review
  • Andrew Vincent + 1 more

Abstract Although we value Guyer’s particular reading of British Idealist works, we nonetheless consider that his largely textualist-focused approach narrows both the scope and ultimate comprehension of Idealist ethics, particularly in relation to Kant. We consider that Guyer’s analysis misses the depth of their moral understanding. Such Idealist argumentation embodies a rich blending of historical, sociological, political, and evolutionary theory, which was employed consistently in their ethical reflections. To miss this contextual point can make many of their writings almost unintelligible. Thus, we consider it of central importance to understand British Idealist moral philosophy within this much broader philosophical frame.

  • Research Article
  • 10.29121/shodhkosh.v7.i5s.2026.7000
MEDIA PORTRAYAL OF TRANSGENDER PERSONS IN INDIA: A CRITICAL SOCIOLOGICAL ANALYSIS
  • Apr 22, 2026
  • ShodhKosh: Journal of Visual and Performing Arts
  • Mansoor Ahmad + 1 more

Transgender persons constitute a diverse group whose gender identities transcend culturally imposed binary constructions of masculinity and femininity. Despite their long historical presence in Indian society, transgender communities have faced systemic marginalization, social exclusion, and cultural stigmatization. Media, as a powerful social institution, plays a crucial role in shaping public perceptions; however, mainstream Indian media has historically rendered transgender identities either invisible or caricatured. This paper critically examines the representation of transgender persons in Indian media, with specific focus on Hindi cinema, television serials, documentaries, and advertisements. While certain media narratives have progressively attempted to humanize transgender experiences, negative portrayals continue to dominate, reinforcing stereotypes and societal prejudices. Drawing on sociological theories of identity, representation, and marginalization, this study argues that media portrayals significantly influence public attitudes and can either perpetuate exclusion or foster social acceptance. The paper concludes by emphasizing the need for more authentic, inclusive, and rights-based representations of transgender lives in Indian media.

  • Research Article
  • 10.1093/rescon/vmag037
Generational identity and medical decision-making in older adults: clinical implications for autonomy, adherence, and care design
  • Apr 22, 2026
  • Research Connections
  • Alessandro Brunini

Abstract Decision-making in older adults is commonly interpreted through a biomedical lens, focusing on age-related decline, cognitive impairment, and disease burden. However, persistent difficulties in shared decision-making (SDM), therapeutic adherence, and adoption of assistive technologies suggest that clinical factors alone do not fully explain patients’ behaviors in later life. To propose a clinically oriented conceptual framework integrating generational identity, cohort effects, and the life-course perspective to improve understanding of medical decision-making, autonomy, and engagement in older adults. This narrative review integrates sociological theories of generations and cohorts with the life-course approach and contemporary geriatric literature. Evidence on SDM, therapeutic adherence, stigma, gender differences, and health technology acceptance is synthesized to examine how generational identity shapes clinical interactions and care decisions. Generational identity influences how older adults perceive autonomy, authority, dependency, and care. In cohorts such as the late Silent Generation and early Baby Boomers, autonomy carries a strong symbolic meaning linked to self-sufficiency and control. This contributes to selective non-adherence, resistance to visible forms of assistance, and ambivalent engagement in SDM, particularly among men. Conversely, discreet and non-stigmatizing technological support may be more acceptable when it preserves perceived autonomy and social identity. Integrating generational identity into clinical reasoning offers a pragmatic framework to enhance SDM, therapeutic adherence, and acceptance of assistive technologies in older adults. Recognizing autonomy as both a symbolic and procedural construct may support more effective, person-centered, and sustainable models of geriatric care.

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