Beyond deterrence: Reconceptualizing denial strategies and rethinking their emotional effects

Žilinčík, Samuel; Sweijs, Tim

doi:10.1080/13523260.2023.2185970

Cited by 5 publications

(3 citation statements)

References 76 publications

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“…Denial is a defence mechanism by which an individual refuses to recognise or acknowledge objective facts or experiences, A person who is in denial is trying to protect themself from a truth that is painful to accept [ 21 ]. In the case of this study, denial was often attributable to inadequate knowledge and information about death and dying.…”

Section: Resultsmentioning

confidence: 99%

R425 first year student nurses ‘experience of encounters with death of a patient during clinical placement

Molefe

2024

BMC Nurs

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Background In the course of caring, nurses often experience the death of patients, and this experience has an effect on the nurse. Every nurse responds to this experience in a different way, and it can be either a negative emotional response, or a positive emotional response. As part of their curriculum, R425 first-year student nurses are placed in clinical facilities to acquire competency in nursing skills, and here they may be exposed to patients dying. R425 is a South African Nursing Council regulation relating to the approval of and the minimum requirements for the education and training of a nurse (General, Psychiatric, and Community) and Midwife, leading to registration. End-of-life care can be rewarding, yet emotionally and psychologically challenging. Little is known about R425 first-year student nurses’ experiences of patients dying while being cared for by nurses on clinical placement. The study, therefore, explored and describes R425 first-year student nurses’ experiences of the death of a patient during clinical placement. Method A qualitative exploratory descriptive and contextual research design was adopted, and a purposive, nonprobability sampling approach applied. Data were collected through unstructured individual interviews with 15 R425 first-year student nurses. Data were analysed using content analysis. Results Four themes emerged, namely, knowledge, psychological trauma, low self-esteem, and nutritional disorders, and subthemes were identified. Results reveal both negative and positive responses to encountering the death of patients, with more negative responses, and fewer positive responses. Conclusion Results show that first-year student nurses struggle to cope with the death of a patient, mainly because they lack knowledge and the skills required to provide end-of-life nursing. It is the requirement for student nurses to be competent in a skill, ‘last office’, which involves laying out of a dead person. Such skill can be deferred in the first year of study, and can only be introduced at a later stage, either in third year or fourth year of study, when students are better equipped with knowledge and skills relating to dealing with death. There is a need to review the curriculum of R425 first-year student nurses, so that outcomes such as death and dying can be introduced in the third or fourth year of study.

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Section: Resultsmentioning

confidence: 99%

R425 first year student nurses ‘experience of encounters with death of a patient during clinical placement

Molefe

2024

BMC Nurs

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“…Denial is a defense mechanism in which an individual refuses to recognise or acknowledge objective facts or experiences, A person who is in denial is trying to protect herself from the truth that is painful for her to accept it [30]. Participants of the study were in denial regarding death of a patient: "I kept on arguing with my colleague that the patient has pulse, I guess I was in a denial" P-B.…”

Section: Denialmentioning

confidence: 99%

R425 first year student nurses ‘experience of encounters with death of a patient during clinical placement

Molefe

2023

Preprint

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Background R425 first year student nurses encountered death of patients at their earliest time of training due to the curriculum that expects them to be placed in various clinical facilities to obtain psychomotor skills competencies. These encounters have been found to be very difficult and challenging for first year student nurses, because of inadequate knowledge and skills to effectively deal with death of a patient. The aim of this study is to explore and describe R425 first year student nurses ‘experience of encounters with death of a patient during clinical placement. Method A qualitative-exploratory-descriptive and contextual research design was conducted, using a purposive, nonprobability sampling approach. Fifteen R425 first year student nurses voluntary agreed to participate in the study. Unstructured individual interviews were conducted with all fifteen participants. Results Four themes emerged, namely, knowledge, psychological trauma, low self-esteem, and nutritional disorders. Themes had sub-themes. Results confirmed that indeed first year student nurses are not coping in dealing with death of a patient during clinical placements. Conclusion Due to inability of R425 first year student nurses to cope in dealing with death and dying of a patient during clinical placement, it is evident that in that level of training, it is too early to expose students to skills such as last offices, and such skills can be deferred and introduced at a later stage of training. There is, therefore, a need for review of curriculum for R425 first year student nurses.

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“…Traditionally, deterrence is about "discouraging or restraining a nation-state from taking unwanted actions" [4] by either denying an adversary the ability to achieve its objectives (deterrence by denial) [5]- [7] or threatening to impose cost following the actions (deterrence by punishment) [8], [9]. In writings on conventional and nuclear deterrence, it is widely acknowledged that perceptions are key to successful deterrent efforts [4] in the sense that the adversary must perceive "that the costs likely to be incurred from his initiative will outweigh the potential gains" [10].…”

Section: Introductionmentioning

confidence: 99%

A Bayesian Network Approach to Hybrid Threat Modelling

Vonk,

Sweijs,

Minicozzi

2024

Preprint

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Western governments have adopted an assortment of counter-hybrid threat measures to defend against hostile actions below the conventional military threshold. The impact of these measures is unclear because of the ambiguity of hybrid threats, their cross-domain nature, and uncertainty about how countermeasures shape adversarial behaviour. This paper presents a model to simulate the impact of countermeasures on hybrid threat behaviour through a Bayesian Network approach - a probabilistic modelling technique. The model balances the costs of countermeasures, their ability to dissuade the adversary from executing hybrid threats, and their potential to mitigate the impact of hybrid threats. We run 1000 variants of a semi-synthetic scenario simulating the strategic interaction between attacking agent A and defending agent B over a cyber attack on critical infrastructure to explore the effectiveness of a set of five different counter-hybrid threat measures. Counter-hybrid measures range from strengthening resilience and denial of the adversary's ability to execute a hybrid threat to dissuasion through the threat of punishment. Our analysis primarily evaluates the overarching characteristics of counter-hybrid threat measures This approach allows us to generalize the effectiveness of these measures, rather than attributing results to measures individually. In addition, we discuss policy relevance and outline future research avenues.

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Beyond deterrence: Reconceptualizing denial strategies and rethinking their emotional effects

Cited by 5 publications

References 76 publications

R425 first year student nurses ‘experience of encounters with death of a patient during clinical placement

R425 first year student nurses ‘experience of encounters with death of a patient during clinical placement

R425 first year student nurses ‘experience of encounters with death of a patient during clinical placement

A Bayesian Network Approach to Hybrid Threat Modelling

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