Jean Daniel Jacob

Governing through (in)security: a critical analysis of a fear-based public health campaign

Fear appeals are once again popular in public health campaigns aimed at preventing unhealthy behaviors and dangerous life practices such as smoking, unsafe sexual practices, drug use, alcohol abuse, impaired driving, etc. Every year in the province of Quebec (Canada), a new prevention campaign for sexually transmitted infections is launched by the SLITSS (Service de lutte contre les infections transmissibles sexuellement et par le sang). In 2006–2007, the SLITSS created a fear-based campaign entitled ‘Condoms: They aren’t a luxury’ for the prevention of sexually transmitted infections in young adults. The purpose of this paper is to share the results of a discursive analysis of the documents retrieved from this campaign, which was developed using commercial advertising and marketing strategies. Using situational analysis and the mapping process proposed by Clarke (2005), we critically examine the use of fear appeal in the campaign. Drawing on Michel Foucaults concepts of governmentality and bio-power, we assert that fear should be understood as a bio-political technology deployed to manage/govern young adults’ sexual practices. In doing so, we critique the use of fear as a strategy to create a state of permanent (in)security and challenge the adoption of commercial advertising and marketing strategies to develop public health campaigns.

working under threat: Fear and nurse–patient interactions in a forensic psychiatric setting

&NA; The purpose of this article is to present the results of a study conducted in a Canadian medium‐security forensic psychiatric facility. The primary objective of this qualitative research was to describe and comprehend how fear influences nurse–patient interactions in a forensic psychiatric setting. Eighteen semistructured interviews with nurses were used as the primary source of data for analysis. In brief, the results from this research indicate, as other researchers have demonstrated, that within this highly regimented context, nurses are socialized to incorporate representations of the patients as being potentially dangerous, and, as a result, distance themselves from idealistic conceptions of care. Moreover, the research results emphasize the implication of fear in nurse–patient interactions and particularly how fear reinforces nurses’ need to create a safe environment in order to practice. A constant negotiation between space, “at risk” bodies and security takes place where nurses are forced to scrutinize their actions in order to avoid becoming victims of violence. In parallel, participants also described how being able to self‐identify with patients enabled therapeutic interventions to take place. However, exposure to the patients criminal history fostered negative reactions on the nurses’ part, which impede nursing work.

Nursing so‐called monsters: On the importance of abjection and fear in forensic psychiatric nursing

&NA; Forensic psychiatric nurses work with individuals who may evoke feelings of empathy as well as feelings of disgust, repulsion, and fear. The main objective of this theoretical paper is to engage the readers in a theoretical reflection regarding the concepts of abjection and fear since they both apply to the experiences of caring for mentally ill individuals in forensic psychiatric settings. Our contention is with the potential impact of feelings such as disgust, repulsion, and fear on the therapeutic relationship and, more particularly, with the boundaries imposed on this relationship when these feelings are unrecognized by nurses. Acknowledging that patients may evoke feelings of disgust, repulsion, and fear is essential if nurses wish to understand the implications of these emotions in the therapeutic process. In forensic psychiatric settings, caring for so‐called “monsters” in the face of abjection and fear is not an easy task to achieve given the lack of theoretical understanding regarding both concepts. Given the actual state of knowledge in forensic nursing, we argue that theoretical (conceptual) analyses, as well as ethical and political discussions, are paramount if we wish to understand the specificities of this complex field of nursing practice.

Treatment adherence redefined: a critical analysis of technotherapeutics

GAGNON M, JACOB JD and GUTA A. Nursing Inquiry 2013; 20: 60–70 Treatment adherence redefined: a critical analysis of technotherapeutics Treatment adherence issues in the context of chronic illnesses have become an important concern worldwide and a top priority in the field of health-care. The development of devices that will allow healthcare providers to track treatment adherence and monitor physiological parameters with exact precision raises important questions and concerns. The aim of this study is to interrogate the use of these new technological devices which allow for previously unavailable data to be recorded on an ongoing basis and transmitted via a tiny microchip inserted into the body. Drawing on the work of Michel Foucault, we analyze how this anatomo-political and bio-political instrument serves to discipline chronically ill individuals and govern the health of entire populations who suffer from chronic conditions. To support our analysis, this article comprises three sections. First, we provide an overview of treatment adherence and technotherapeutics. Then, we explain how technotherapeutics concern the government of bodies and conducts at the individual level and population level more generally. Lastly, we provide an example of how this analysis can be connected to routine nursing practice in the field of HIV.

The rhetoric of therapy in forensic psychiatric nursing.

&NA; The objective of this paper is to present the results obtained from a qualitative research study conducted in a forensic psychiatric setting and to explore the dual role associated with being both “agents of care and agents of social control.” Following the narratives provided by nurses working in this field, the analysis that follows will problematize the rhetoric of therapy in forensic psychiatric nursing. In order to support the analysis, this article comprises four sections. The first section will briefly review the studys methodological considerations. Using a combination of Foucault and Goffmans work, the second section provides an empirical contextualization of correctional environments and their effects on nursing care. The third section explains the effects of having a contradictory mandate of care and custody from Festingers (1957) theory of cognitive dissonance. Lastly, the fourth section provides a critique of disciplinary interventions in forensic psychiatric nursing, as it is explained by the participants.

Humanism in forensic psychiatry: the use of the tidal nursing model

The humanist school of thought, which finds resonance in many conceptual models and theories designed to guide nursing practice, needs to be understood in the context of the total institution, where the individual is subjected to a mortification of the self, and denied autonomy. This article will engage in a critical reflection on how humanism has influenced nursing theorists and the subsequent production of conceptual models and theories, especially as they relate to the field of forensic psychiatric nursing. Although humanism provides optimism for nurse-patient relations, this article explores the incapability of such a philosophy to acknowledge the power relationships between individuals and its inability to explain the day-to-day realities experienced in forensic nursing, where the possibility of interpersonal violence reshapes nursing care. The tidal model will be discussed in detail as an example of a recently developed humanistic nursing model. Viewed from this perspective, it is clear that humanistic philosophy and its subsequent models of care are in discordance with the highly specialized field of forensic nursing.

The culture of fear: expanding the concept of risk in forensic psychiatric nursing

The purpose of this article is to present, in part, the results of a nursing research that aimed at describing how fear influences nurse-patient interactions in a forensic psychiatric setting. Guided by an inductive research design (grounded theory), the analysis of data revealed that nurses incorporate a risk discourse into their practice. As a result, our data show that cultural narratives of risk affect the experience of nursing care and nurses’ day-to-day management of potential threats embodied by the patients. Furthermore, we assert that risk management is enmeshed in a cultural script that justifies the deployment of precautionary actions.

Locating the qualitative interview: reflecting on space and place in nursing research

Interview location has been widely overlooked in the nursing literature. This paper presents a discussion of interview location in the context of nursing research with particular emphasis on the concepts of space and place. It draws on six research projects that were conducted between 2008 and 2013 in Canada, and is informed by key texts on the concepts of space and place. We argue that thinking about space and place in the context of interviewing is one way to engage in reflexivity. The reflexive accounts featured in this paper support the need for nursing researchers to engage in explicit analysis of their own interview locations and to discuss the significance of space and place in their own work. These accounts suggest that location is a fundamental aspect of the interview process.

Understanding the domestic rupture in forensic psychiatric nursing practice.

The objective of this article is to examine the tensions that exist between care and custody in correctional environments by presenting the (im)possibilities of psychiatric nursing practice within this context. The analysis will be guided by empirical data obtained from a qualitative research conducted in a correctional setting. Semistructured interviews with nurses were conducted and used as the primary source of data for analysis. This article will explore the contextual characteristics of psychiatric nursing practice in correctional settings, describe the alienating effects of this context on nursing practice, theorize nurses’ experience using Festinger’s theory on cognitive dissonance, and, finally, explore how some nurses engage in the reconstruction of their care to counter the effects of working in correctional settings.

Expanding our understanding of sovereign power: on the creation of zones of exception in forensic psychiatry.

The purpose of this paper is to engage with the readers in a theoretical reflection on nursing practices in forensic psychiatric settings. In this paper, we argue that practices of exclusion in forensic psychiatric settings share some common ground with Agambens description of sovereign power and, consequently, the possible creation of zones of exception in this environment. The concept of exception is, therefore, purposely used to shift our thinking, highlight the political forces surrounding exclusionary practices in forensic psychiatric nursing, and explore the ethical tensions that arise for nurses who become entangled in the control of these zones of exception. We argue that ethical and political discussions regarding this phenomenon are necessary if we wish to further understand the complexities of this field of practice and promote constructive change.