Intersectionality and Control: Implications for Health Outcomes

perceived control;Psychology;Social Sciences;Psychology

Vargas, EmilyLiu, J Rebecca ;

University of Michigan

关键词: perceived control;    Psychology;    Social Sciences;    Psychology;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/149882/emvargas_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

Perceived control—a psychological mechanism— is conceptualized as an individual-level perception, in which events in one’s life are within one’s control. Across multiple domains, perceived control is regarded as a protective psychological mechanism and is generally associated with positive outcomes. Despite the importance of this research, there are several significant gaps in the perceived control literature that I address in my dissertation, in the context of health.In Chapter 2, I examine the impact of perceived control within a sample of women undergoing surgery. These women were given clinical suspicion of having gynecological cancer. There is little work examining the link between perceived control and psychological health, especially for women undergoing cancer surgery. I consider the importance of the medical context, specifically the diagnosis, route of procedure, and the fact that patients have no behavioral control in the context of surgery. I find that increased perceived control was related to better preoperative psychological health, through a reduction in negative affect. I conclude the chapter by discussing the implications of these findings in the context of improving women’s health. Our findings indicate that increased perceptionsof health locus of control were related to a significant increasein preoperative psychological health through a reduction innegative affeIn Chapter 3, I challenge the explicit and implicit notion in the extant literature that all women’s perceptions of control are homogenous. To address this, I use data from The Study of Women’s Health Across the Nation (SWAN) and conduct an exploratory longitudinal analysis of perceptions of control over approximately 10 years. Results in this study suggest that important differences by race/ ethnicity of women exist. Hispanic women fared the worst, because on average their perceived control significantly decreased over time. Hispanic women may be at a health disadvantage as they age. I conclude this chapter by discussing the implications of my found patterns in the context of health care disparities. In Chapter 4, I examine if control can be influenced by the nature of the interpersonal environment. I use a qualitative study to examine how experiences of incivility in a hospital context impact individuals’ perception of control. In a survey, participants were told to write about an experience of incivility they experienced in a hospital and then mention if this event impacted their sense of control. I use interpretative phenomenological analysis to analyze participants’ text responses. Results suggest that interpersonal mistreatment shapes one’s sense of control in various ways, and these may have long-term implications. In Chapter 5, I discuss the overarching findings across all three studies, including the ways in which perceived control influences a number of health outcomes, functions across time, and how perceived control can be interpersonally constructed. I also provide important critiques to the general perceived control literature. First, it is necessary to integrate an intersectionality perspective in the study of perceived control. Women of color are systematically ignored in the literature, and this harms our understanding of perceived control. Second, researchers need to seriously consider how conditions of respect can influence perceived control. Perceived control is not simply a stable individual-level variable, rather it is much more dynamic and interpersonally constructed than originally theorized. Together it is necessary that future researchers critically engage with the construct of perceived control to help deepen our understanding of the construct.