Culture in Action: Symbols and Strategies

Swidler, Ann

doi:10.2307/2095521

Cited by 6,200 publications

(3,995 citation statements)

References 69 publications

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“…Rather, individuals worked to modify cultural meanings to fit their lives. By crafting meanings, women reclaim agency after a medical event that can be highly impersonal, abstract, and technical (Batt, 1994) Women's meanings postcancer are important because frameworks attached to experience shape subsequent action (Swidler, 1986). Women sought meanings that supported their ongoing efforts to prevent a recurrence or quickly detect a new cancer.…”

Section: Discussionmentioning

confidence: 99%

“…The cultural sociology of Swidler (1986Swidler ( , 2001) provides a framework for conceptualizing how the meanings of survivorship impact women with breast cancer. According to Swidler (2001), individuals possess knowledge of a variety of cultural meanings.…”

Section: Survivorship As a Cultural Tool And Survivorship As Craftworkmentioning

confidence: 99%

“…In Talk of Love (2001), Swidler is interested in how people use some cultural materials while rejecting others, especially as they attempt to "retool" their lives following a major life event or transition. The identity of breast cancer survivor can be conceived of as a "tool" (Swidler, 1986) that women use to become a certain kind of person. Given the disfigurement, disruption, and ontological insecurity brought by cancer (Mathieson and Stam, 1995;Nelson, 1996), it makes sense that women would use survivorship to organize the self and life.…”

Section: Survivorship As a Cultural Tool And Survivorship As Craftworkmentioning

confidence: 99%

“…I then summarize two complementary approaches for understanding how constructions of breast cancer affect women. The first approach posits that survivorship is a tool that women can use to frame their disease experience (Swidler, 1986(Swidler, , 2001). According to the second approach, survivorship is "craftwork" (Frank, 1995), whereby women consciously construct their lives and the meaning of cancer.…”

Section: Introductionmentioning

confidence: 99%

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The meaning of the survivor identity for women with breast cancer

Kaiser

2008

Social Science & Medicine

225

183

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Abstract"Survivor" has become a ubiquitous and largely unquestioned term in culture and cancer discourse. While anecdotal evidence suggests women with breast cancer find fault with survivor images and discourse, the extent to which women identify with or reject the survivor identity has not been empirically studied. This paper examines whether women treated for breast cancer embrace survivorship. Data come from 39 in-depth interviews with women in the United States who completed treatment for breast cancer 3 to 18 months prior to the interview. Despite the positive meanings attached to survivorship, many women altered the meaning of survivorship or rejected survivorship. In particular, the survivor discourse alienated women who struggle with the threat of recurrence, who feel their cancer experience was not severe enough to merit this title, or who desire a private disease experience. These findings illustrate the failure of our cultural conceptions of cancer to adequately reflect lived experience and highlight how individuals actively "craft" illness meanings."I woke up, still alive. Does that mean 'cured'?" Marilyn Hacker, 1994 (cited in Bahar, 2003

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Section: Discussionmentioning

confidence: 99%

Section: Survivorship As a Cultural Tool And Survivorship As Craftworkmentioning

confidence: 99%

Section: Survivorship As a Cultural Tool And Survivorship As Craftworkmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The meaning of the survivor identity for women with breast cancer

Kaiser

2008

Social Science & Medicine

225

183

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“…In contrast to what are variously termed foundational or universal values and which shape action indirectly (Hitlin and Piliavin, 2004;Rokeach, 1973;Swidler, 1986;Vaisey, 2009), the values used in public discourse and framing campaigns are often more directly tied to specific contexts. We term these "contextualized values," as they are articulations that are relevant to domainspecific contexts, such as health care, racism, or sexuality (Patterson, 2014).…”

Section: Consumer Knowledge and Consumer Safetymentioning

confidence: 99%

Increasing public support for food-industry related, obesity prevention policies: The role of a taste-engineering frame and contextualized values

Ortiz

Zimmerman

Adler

2016

Social Science & Medicine

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a b s t r a c tBackground: Support for policies to combat obesity is often undermined by a public sense that obesity is largely a matter of personal responsibility. Industry rhetoric is a major contributor to this perception, as the soda/fast food/big food companies emphasize choice and individual agency in their efforts to neutralize policies that are burdensome. Yet obesity experts recognize that environmental forces play a major role in obesity. We investigate whether exposure to a taste-engineering frame increases support for food and beverage policies that address obesity. A taste-engineering frame details strategies used by the food industry to engineer preferences and increase the over-consumption of processed foods and sugary beverages. We also examine the effects of exposure to two contextualized values that have recently been promoted in expert discourseeconsumer knowledge and consumer safety e on public support of policies. Our research shows how causal frames and contextualized values may effectively produce support for new obesity policies. Methods: We use an online survey experiment to test the effects of exposure to a taste-engineering frame (TEF), the value of consumer knowledge (CK), or the value of consumer safety (CS), on level of support for a range of policies. A random sample of adults, age 18 þ living in the United States was included in the study (N ¼ 2580). Ordered logistic regression was used to measure the effects of treatment exposure. The primary outcome was level-of-support for four (4) food-industry related, obesity prevention policies (aka food and beverage policies): 1) require food-manufacturers to disclose the amount of additives in food products on food packaging; 2) require food-manufacturers to advertise food products in accordance with their actual nutritional value; 3) prohibit all high-fat, high-sugar food advertising on television programming watched primarily by children; and 4) increase healthy food availability in work sites, schools, and hospitals. Findings: These data suggest that a taste-engineering frame and contextualized values significantly increase public support for many of the food and beverage policies tested. Conclusions: Applying a taste-engineering frame and/or contextualized values to address obesity advances a population-based policy agenda to counteract the effects of food-industry strategies.

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Hospital Culture and Intensity of End-of-Life Care at 3 Academic Medical Centers

Dzeng

Batten

Dohan³

et al. 2023

JAMA Intern Med

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ImportanceThere is substantial institutional variability in the intensity of end-of-life care that is not explained by patient preferences. Hospital culture and institutional structures (eg, policies, practices, protocols, resources) might contribute to potentially nonbeneficial high-intensity life-sustaining treatments near the end of life.ObjectiveTo understand the role of hospital culture in the everyday dynamics of high-intensity end-of-life care.Design, Setting, and ParticipantsThis comparative ethnographic study was conducted at 3 academic hospitals in California and Washington that differed in end-of-life care intensity based on measures in the Dartmouth Atlas and included hospital-based clinicians, administrators, and leaders. Data were deductively and inductively analyzed using thematic analysis through an iterative coding process.Main Outcome and MeasureInstitution-specific policies, practices, protocols, and resources and their role in the everyday dynamics of potentially nonbeneficial, high-intensity life-sustaining treatments.ResultsA total of 113 semistructured, in-depth interviews (66 women [58.4%]; 23 [20.4%] Asian, 1 [0.9%] Black, 5 [4.4%] Hispanic, 7 [6.2%] multiracial, and 70 [61.9%] White individuals) were conducted with inpatient-based clinicians and administrators between December 2018 and June 2022. Respondents at all hospitals described default tendencies to provide high-intensity treatments that they believed were universal in US hospitals. They also reported that proactive, concerted efforts among multiple care teams were required to deescalate high-intensity treatments. Efforts to deescalate were vulnerable to being undermined at multiple points during a patient’s care trajectory by any individual or entity. Respondents described institution-specific policies, practices, protocols, and resources that engendered broadly held understandings of the importance of deescalating nonbeneficial life-sustaining treatments. Respondents at different hospitals reported different policies and practices that encouraged or discouraged deescalation. They described how these institutional structures contributed to the culture and everyday dynamics of end-of-life care at their institution.Conclusions and RelevanceIn this qualitative study, clinicians, administrators, and leaders at the hospitals studied reported that they work in a hospital culture in which high-intensity end-of-life care constitutes a default trajectory. Institutional structures and hospital cultures shape the everyday dynamics by which clinicians may deescalate end-of-life patients from this trajectory. Individual behaviors or interactions may fail to mitigate potentially nonbeneficial high-intensity life-sustaining treatments if extant hospital culture or a lack of supportive policies and practices undermine individual efforts. Hospital cultures need to be considered when developing policies and interventions to decrease potentially nonbeneficial, high-intensity life-sustaining treatments.

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Culture in Action: Symbols and Strategies

Cited by 6,200 publications

References 69 publications

The meaning of the survivor identity for women with breast cancer

The meaning of the survivor identity for women with breast cancer

Increasing public support for food-industry related, obesity prevention policies: The role of a taste-engineering frame and contextualized values

Hospital Culture and Intensity of End-of-Life Care at 3 Academic Medical Centers

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