Localisation of rationality: Life course perspective on the health practices of hospital female care workers

WANG Yanlong, WANG Shilei, LUO Jianjun

Chinese Journal of Journalism & Communication ›› 2023, Vol. 45 ›› Issue (7) : 137-156.

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Chinese Journal of Journalism & Communication ›› 2023, Vol. 45 ›› Issue (7) : 137-156.
Research Articles

Localisation of rationality: Life course perspective on the health practices of hospital female care workers

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Abstract

Female migrant workers are a marginalized group in Chinese society, who face health challenges with little research attention. Some of them work as hospital care workers, which are close to health resources. Guided by culture-centered approach, the study uses in-depth interviews and participant observation to focus on the health practices of female care workers in their life course. The study found that factors such as economic policies, health care systems, family responsibilities and work environment influence their health experiences in the private sphere of the family, in their wandering away from home and in their care work phase. Rural women have localized rational measures, but it was not until they became care workers that they developed health rationalities that juxtaposed traditional vernacular experiences with modern medical experiences. The health practices of female care workers are based on a rationality based on spatiotemporal conditions coupled with driven by “family first” tradition. By unfolding this rationality of rural female care workers, researchers can truly help them to free themselves from the shackles of ‘othering’ health communication.

Key words

Female migrant workers / culture-centered approach / healthy narratives / family first

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WANG Yanlong , WANG Shilei , LUO Jianjun. Localisation of rationality: Life course perspective on the health practices of hospital female care workers[J]. Chinese Journal of Journalism & Communication. 2023, 45(7): 137-156

References

[1]
安东尼·吉登斯(1984/2016). 《社会的构成:结构化理论大纲》(李康,李猛译). 北京: 中国人民出版社.
[2]
曹昂(2020). 健康意义、另类视角与本土情境——“文化中心路径”对健康传播学的批判与重构. 《新闻与传播研究》,(7),57-76+127.
[3]
曹晋, 曹浩帆(2021). 流动民工的男女平权与代际父权制再生产——基于大都市医院“双薪护工”劳动与微信沟通实践的分析. 《南京大学学报(哲学·人文科学·社会科学) 》,(3),82-94+159-160.
[4]
杜姣(2017). 城市化背景下农村老人利他型自杀的形成机制分析——基于鄂中地区S村的个案研究. 《南方人口》,(2),50-61.
[5]
胡百精(2012). 健康传播观念创新与范式转换——兼论新媒体时代公共传播的困境与解决方案. 《国际新闻界》,(6),6-10+29.
[6]
胡雨濛(2021). “防疫”标语的健康动员:话语策略、框架与权力结构. 《国际新闻界》,(5),86-105.
[7]
李强, 邓建伟, 晓筝(1999). 社会变迁与个人发展:生命历程研究的范式与方法. 《社会学研究》,(6),1-18.
[8]
刘丽平(2020). 1949-1965年四川卫生防疫事业概述. 《重庆交通大学学报(社会科学版)》,(6),35-42.
[9]
马瑞丽, 朱明宝, 刘二鹏(2022). 生育行为对中国农村老年健康的影响效应——基于健康生产与生命历程理论. 《西北人口》,(3),69-81.
[10]
梅笑, 涂炯(2022). 效率与温情:大病照护中的情感劳动何以可能. 《妇女研究论丛》,(3),53-67.
[11]
潘蕾, 张辰瑜, 陈敏(2022). 上海市5所三级甲等医院护工职业防护知-信-行现状调查. 《职业与健康》,(17),2350-2354.
[12]
四川省地方志编纂委员会(编)(1996). 《四川省志·医药卫生志》. 成都: 四川辞书出版社.
[13]
石智雷, 吴志明(2018). 早年不幸对健康不平等的长远影响:生命历程与双重累积劣势. 《社会学研究》,(3),166-192+245-246.
[14]
宋健(2022). 透过照料危机审视照料劳动的社会价值. 《人民论坛》,(10),56-59.
[15]
孙文中(2022). 生命历程视角下女性农民工城市融入的分化. 《广东社会科学》,(4),209-221.
[16]
佟新(2017). 照料劳动与性别化的劳动政体. 《江苏社会科学》,(3),43-54.
[17]
邢朝国(2021). “自己小心”:信息不对称与照料劳动中的健康风险规避策略. 《社会学评论》,(2),199-217.
[18]
徐开彬, 万萍(2017). 西方健康传播研究的五个主要领域. 《新闻与传播评论》,(1),254-274.
[19]
姚泽麟, 王彦珂(2023). 医疗护理工作的“护士+护工”服务模式——基于管辖权视角的社会学分析. 《东南大学学报(哲学社会科学版)》,(1),88-97+147.
[20]
赵龙伟, 刘爱玉(2022). “三转婆姨”是如何变为城市护工的——以“吕梁山护工”为例. 《山东女子学院学报》,(6),53-67+101.
[21]
周敏(1995). 《唐人街——深具社会经济潜质的华人社区》. 北京: 商务印书馆.
[22]
中国新闻网(2009). 百年三次交锋中医惨败本土阵地被“科学”挤压.检索于 https://www.chinanews.com/jk/jk-hyxw/news/2009/08-26/1835877.shtml.
[23]
中央档案馆(编)(2013). 《中共中央文件选集:1949年10月-1966年5月》. 北京: 人民出版社.
[24]
Basnyat I., & Dutta M. J. (2012). Reframing motherhood through the culture-centered approach: Articulations of agency among young Nepalese women. Health Communication, 27(3), 273-283.
Based upon the culture-centered approach that foregrounds the relevance of interrogating the taken-for-granted assumptions that circulate in the dominant models of health communication on family planning, this article argues that traditional approaches to reproductive health campaigns are concerned with safe motherhood (e.g., fertility, birth spacing, hospital delivery) rather than with the processes through which women construct, negotiate, and maintain meanings of motherhood and health within their cultural contexts. In doing so, this traditional framework leaves out the broader sociocultural, political, and economic contexts of social structures that constrain and enable the possibilities for health in the realm of motherhood. The culture-centered approach notes the erasure of these voices of women from dominant epistemic structures, and seeks to interrupt knowledge production by co-constructing meanings of reproductive health through dialogues with women at the margins. Therefore, in-depth interviews were conducted to centralize experiences of the cultural participants, allowing alternative health meanings to emerge within their local contexts. In particular, highlighting narratives of young Nepalese women living under poverty, we are able to understand how women actively (re)construct meanings of motherhood within their localized cultural spaces.
[25]
Basu A. (2010). Communicating health as an impossibility: Sex work, HIV/AIDS, and the dance of hope and hopelessness. Southern Communication Journal, 75(4), 413-432.
[26]
Cao A., & Wang M. (2021). Exploring the health narratives of Chinese female migrant workers through culture-centered and gender perspectives. Health Communication, 36(2), 158-167.
[27]
De Vincentis. G., Monari F., Baldari S., Salgarello M., Frantellizzi V., Salvi E., Reale L., Napolitano S., Conti G., & Cortesi E. (2018). Narrative medicine in metastatic prostate cancer reveals ways to improve patient awareness & quality of care. Future Oncology, 14(27), 2821-2832.
To describe the journey of patients with metastatic castration-resistant prostate cancer (mCRPC) in treatment with radium-223.A multiperspective analysis was performed using narrative medicine in four Italian centers.The substantial impact of mCRPC on quality of life through all phases of the disease was described. After an initial lack of awareness of the disease or denial of its effects, symptoms of pain, fatigue and side effects often led to sadness, fear and loneliness. The majority underwent radium-223 therapy positively, restoring their quality of life and routine activities.Using narrative medicine, the importance of a patient-centered approach in the pathway of care for patients with mCRPC through all the stages of the disease was highlighted.
[28]
Dutta M. J. (2005). Theory and practice in health communication campaigns: A critical interrogation. Health communication, 18(2), 103-122.
In recent reviews of the body of work on health campaigns, communication scholars discussed the importance of reflective thinking about the capacity of campaigns to effect change; this reflective thinking is especially important in the realm of the increasing gaps in society between the health rich and the health poor and the increasing marginalization of the poorer sections of society. This article critically reviews 3 central theories of health communication campaigns that represent the dominant cognitive approach: theory of reasoned action, health belief model, and the extended parallel process model. After articulating the limitations of these theoretical approaches, the article summarizes new directions in theory, methodology, and application of health communication campaigns targeting marginalized populations.
[29]
Dutta M. J. (2007). Communicating about culture and health: Theorizing culture-centered and cultural sensitivity approaches. Communication Theory, 17(3), 304-328.
[30]
Dutta M. J. (2008). Communicating Health: A Culture-Centered Approach. Malden, MA: Polity Press.
[31]
Dutta M. J., & Basu A. (2008). Meanings of health: Interrogating structure and culture. Health communication, 23(6), 560-572.
Based on the argument that context ought to be centralized in discourses of health communication, this article applies the culture-centered approach to engage in dialogue about issues of health with 18 men in rural West Bengal. The culture-centered approach is based on dialogue between the researcher and the community members, with the goals of listening to the voices of cultural members in suggesting culture-based health solutions. In this project, our discursive engagement with the participants suggests that health is primarily constructed as an absence, framed in the realm of minimal access to healthcare resources. In a situation where the resources are limited, the participants discussed the importance of trust in their relationship with the local provider. Health was also seen as a collective resource that was both an asset of the collective and a responsibility of the collective. Finally, the participants also pointed out the ways in which corruption in the structure introduced a paradox in policy discourse and the material conditions of the participants.
[32]
Dutta M. J. (2012). Hunger as health: Culture-centered interrogations of alternative rationalities of health. Communication Monographs, 79(3), 366-384.
[33]
Dutta M. J., & Acharya L. (2015). Power, control, and the margins in an HIV/AIDS intervention: A culture-centered interrogation of the “Avahan” campaign targeting Indian truckers. Communication, Culture & Critique, 8(2), 254-272.
[34]
Dutta M. J. (2017). Culture-centered communication and social change: Listening and participation to transform communication inequalities. Intercultural communication, 9, 309-327.
[35]
Dutta M. J. (2018). Culturally centering social change communication: Subaltern critiques of, resistance to, and re-imagination of development. Journal of Multicultural Discourses, 13(2), 87-104.
[36]
Lewis N., & Sznitman S. R. (2017). You brought it on yourself: The joint effects of message type, stigma, and responsibility attribution on attitudes toward medical cannabis. Journal of Communication, 67(2), 181-202.
[37]
Nichols P., Horner B., & Fyfe K. (2015). Understanding and improving communication processes in an increasingly multicultural aged care workforce. Journal of Aging Studies, 32(1), 23-31.
[38]
Rogers E. M. (1994). Up-to-date report. Journal of Health communication, 1(1), 15-24.
[39]
Sun K., & Dutta M. J. (2016). Meanings of care: A culture-centered approach to left-behind family members in the countryside of China. Journal of Health Communication, 21(11), 1141-1147.
Critical studies of health communication foreground the importance of meanings as organizing frameworks for constituting health. The contested and contradictory meanings articulated around health offer insights into the constraining and enabling roles of structures. Through ethnographic fieldwork conducted in a village in China embedded within the activist framework of the culture-centered approach, this project explores understandings of family care amid left-behind families in rural China against the backdrop of the migration of the middle generation of working adults from families located in rural contexts to cities. We work with the culture-centered approach to explore local meanings of care, understanding everyday care as integral to the health of an aging population that has been erased from the discursive space by market reforms and the hegemonic narrative of national development in China.
[40]
Stephens C. (2011). Narrative analysis in health psychology research: Personal, dialogical and social stories of health. Health Psychology Review, 5(1), 62-78.
[41]
Yehya N. A., & Dutta M. J. (2010). Health, religion, and meaning: A culture-centered study of Druze women. Qualitative Health Research, 20(6), 845-858.
Against the backdrop of contesting the mainstream biomedical models of health communication, the culture-centered approach suggests dialogic research methodologies to coconstruct meanings of health through direct engagement with cultural communities. In this project, we engaged in in-depth interviews and informal conversations with elderly Druze women and their caregiver daughters to develop an understanding of the intersections of religion and health meanings in the context of aging women in this Lebanese community. Attending to the cultural constructions of health, particularly in religious contexts, opens up the discursive spaces of health communication to alternative cosmologies of health, illness, healing, and curing. Four themes emerged as a result of our grounded theory analysis: health as faith; mistrust, privacy, and modern medicine; polymorphic health experiences; and health as structure. These themes serve as the backdrop for playing out the competing tensions between the local and the global in the realm of interpretations of health meanings.
[42]
Zoller H. M., & Kline K. N. (2008). Theoretical contributions of interpretive and critical research in health communication. Annals of the International Communication Association, 32(1),89-135.

Footnotes

1. 2018年,四川省实现基本医保市级统筹。意味着从理论上讲,现行的城乡居民基本医疗保险可以实现省内异地结算,但要面临复杂的线上申报和线下的流程和手续。同时,不同层级的医院报销比例也不同。一旦遇到重大疾病,对护工群体而言难以支撑所在医院的医疗费用,返乡治病将成为大多数护工的唯一选择。

Funding

This article is a phased achievement of the 2019 National Social Science Foundation project “Theory, Path, and Evaluation Research on the Construction of Public Welfare Communication Power”(19BXW090)
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