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    Unfinished business : institutional racism and the role of the state in building culturally-inclusive societies : a research report submitted in partial fulfillment of the requirements for the degree of Master of Public Policy, Massey University
    (Massey University, 2003) Radford, Brenda Margaret
    This Research Report represents the findings from an exploratory, literature-based, comparative foundation study of institutional racism and its influence on the public policy process. The research identifies the causal links between colonisation, constitutional frameworks, present-day government policy and institutional racism. In this Report I argue that institutional racism, as a case study of public policy failure, is caused by a lack of appreciation of the macro policy environment, by consequent deficiencies in policy problem analysis and specification and by a paucity of impact evaluation at all stages of the policy process. Institutional racism is a product of the processes of colonisation and of organisational inability to respond to increasing cultural and ethnic diversity because of the controls and rigidity inherent in today's monocultural decision-making paradigms. It causes public policy and service delivery to have discriminatory impacts on some ethnic or cultural groups in the community, so that their achievements and aspirations are impeded and they suffer social and economic disadvantage relative to the majority cultural group. Its corrosive effects on social well-being and cohesion demand attention from public policy decision-makers, but it is not a priority on political agendas. It should be. It is 'unfinished business' in all three nations studied in this research, namely New Zealand, Australia and Britain. Practical illustrations augment the two main themes of the research - namely the impact of colonisation and land alienation on indigenous societies, and the effects of immigration, settlement and integration policies and inadequate social services on new migrants. The research indicates that institutional racism affects most social service domains in New Zealand, Australia and Britain. Several recurrent policy dilemmas are noted, the resolution of which is critical if institutional racism is to be tackled effectively. The long-term solution involves constitutional change.
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    How transsexuals cope with discrimination : a grounded theory : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 1996) Roskilly, Bronwen Avis
    The coping strategies of transsexuals who experience discrimination have previously received little research attention. The primary objective of the present study was to generate a grounded theory to explain how transsexuals cope with discrimination. Eight transsexual individuals were interviewed and each interview was audio taped and transcribed in verbatim. The data was qualitatively analysed utilising the grounded theory methodology. Participants collectively described experiencing numerous instances of discrimination and described using a variety of coping strategies to help alleviate anxiety caused by discrimination. The core category of'understanding discrimination to be an anxiety-provoking phenomenon' emerged from the data. It was determined that the core category was established by three pre-existing conditions. The first of these was an awareness of the self to be vulnerable to discrimination. The second condition was an awareness of discrimination to impact negatively on the self, and the third entailed an understanding of why discrimination occurs. The coping strategies were broken into three selective codes. Participants adopted constructive strategies which were primarily rational and realistic. Cognitive coping strategies addressed anxiety caused by discrimination by changing the appraisal of cognitions pertaining to the discriminatory experience. Direct action strategies were behavioural approaches which entailed the altering of the situation. Implications of these findings are discussed in relation to clinicians working with transgendered people, with emphasis on the common occurrence of discrimination and its detrimental impact on the transsexual.
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    Living large : the experiences of large-bodied women when accessing general practice services : a thesis presented in partial fulfillment of the requirements for the degree of Master of Philosophy (Nursing) at Massey University, Palmerston North, New Zealand
    (Massey University, 2011) Russell, Nicola
    The ‘obesity epidemic’ of the past two decades has resulted in numerous studies reporting higher levels of stigma and discrimination experienced by obese/overweight women, both within the health care system and society in the main. Despite general practice being the most utilised point of access for health care services, there has been very little international or national exploration of the experiences of large-bodied women accessing these services. Utilising a qualitative, descriptive research design, this post-structuralist feminist study has enabled a group of large-bodied women to express their stories of accessing general practice services. Eight self identified large-bodied women volunteered to participate in semi-structured face-to-face interviews. Thematic analysis identified seven themes: Early experiences of body perception, Confronting social stereotypes, Contending with feminine beauty ideals, Perceptions of health, Pursuing health, Respecting the whole person and Feeling safe to access care. The women in this study articulated broader interpretations of health and well-being than those teachings reproduced within dominant bio-medical and social discourses of obesity. When these women’s personal context, beliefs and values are silenced by the health care provider, the rhetoric of health care professional claims of patient-centred care has given way to these women experiencing stigmatisation and a sense of ambiguity about general practice services. However, when space is given for multiple interpretations of obesity to exist within the patient-health care provider relationship, these women feel respected, their health needs are satisfied and they are more comfortable to engage in health screening services. Resisting the powerful socio-cultural milieu which supports the superiority of a slim female body as a signifier of both health and beauty presents a challenge for health care professionals to negotiate. I contend however, that giving consideration to the perspectives of large-bodied women and critically reflecting upon one’s own personal beliefs and attitudes about the overweight/obese, presents an opportunity to ensure clinical practice for this population is truly patient-centred.
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    From experiencing social disgust to passing as normal : self-care processes among Thai people suffering from AIDS : a thesis presented in fulfillment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Palmerston North, New Zealand
    (Massey University, 2008) Siriwatanamethanon, Jirapa
    AIDS is a chronic disease that seriously affects health, emotions, social relations and household economy. People living with HIV/AIDS experience great suffering, stigmatisation and discrimination from other people around them because they know that it is incurable, contagious, evokes social disgust and is a complex disease requiring life-long self-care. This researcher explored ways people with HIV/AIDS take care of their health and manage their lives in the context of stigma and discrimination. A grounded theory study was conducted with 30 participants with HIV/AIDS, in Mahasarakham Province, Thailand. Participants were recruited from an HIV/AIDS day care clinic and by snowball sampling. Data were gathered through in-depth interviews, participant observations and field notes made during home visits. Interviews were tape recorded, then transcribed verbatim. “From experiencing social disgust to passing as normal” was generated inductively from the data as the basic social psychological process of Thai people living with HIV/AIDS. From experiencing social disgust to passing as normal comprised four categories: being HIV/AIDS, making choices, keeping well and feeling empowered. The category “being HIV/AIDS”- discovering the meaning of having HIV/AIDS, comprises four concepts: being diagnosed with HIV/AIDS, being stigmatised, suffering, and learning about HIV/AIDS. The category “making choices”- to live a normal life, involves three concepts: avoiding unhappy situations, getting remarried and seeking support. The category “keeping well”- maintaining emotional and physical health, includes eight concepts: religious practices, keeping a cheerful mind, self-treatment, taking care of the body, keeping the environment clean to prevent getting germs, healthy behaviours, getting healthcare services, and attention to, and concern about, medication. The last category “feeling empowered”- personal and social acceptance of illness, includes eight concepts: being encouraged, acknowledging the disease, social acceptance, tamjai, feeling proud of self, feeling good about life, feeling lucky and having hope. In the context of northeastern Thailand, successful management of HIV/AIDS was underpinned by participants making a transition from “experiencing social disgust” to “passing as normal” within their communities. The desire to live a normal life despite having HIV/AIDS motivated participants to undertake effective self-care in order to remain symptom free (thus avoiding visible signs of the disease), and to selectively disclose their illness to avoid the ongoing risk of stigma and discrimination. The findings of this study are useful in that they will provide Thai health professionals with a clearer conceptualisation of self-care among the Thai population. An inductively derived theory of self-care among Thai with HIV/AIDS can be applied and integrated by health professionals into the self-care models for people living with HIV/AIDS including models used in nursing education, research and practice.