Doctoral Dissertation Improvement Grant: Surgery and Society in Caracas, Venezuela

在卡罗琳·萨金特医生的指导下，研究生劳伦·古尔巴斯将调查委内瑞拉加拉加斯日益增多的整容手术对社会的影响。在许多发展中国家，整容手术正在增加。委内瑞拉社会在审美和阶级优先考虑浅色皮肤和欧洲人的身体特征与官方政府促进种族民主、禁止在人口普查中收集种族数据和禁止基于种族歧视的政策之间表现出特别明显的紧张关系。由于所有委内瑞拉人都可以通过免费的国家医疗保健进行整容手术，一项仔细的科学研究可以揭示普通人是如何忍受种族偏好的，以及这些偏好是如何与性别和阶级的文化观念交织在一起的。该研究将向社区成员和与四个随机选择的外科诊所和一个教学医院有关的个人征求参与。为了获得有关当地种族和阶级概念的初步信息，将对10名女性和10名男性的分层样本进行领域分析。随后将对135名诊所样本（90名女性，45名男性，反映接受手术者的性别比例）和135名社区成员的对照组进行调查。将对关键举报人的子样本进行更深入的访谈，以获得免费清单（以探索与种族和阶级有关的定义）以及种族和阶级类别。此外，她将收集30名患者手术前后的叙述，使用照片引出技术和标准的身体形象评估。最后，她将广泛观察患者、家属和医务人员之间的互动，并跟踪媒体上的相关讨论。数据分析将采用适当的方法进行系统的定性研究（针对自由列表和等级顺序数据），并采用计算机编码文本分析技术对文件、现场记录、患者叙述、身体形象访谈和生活史进行分析。这项研究很重要，因为它有助于理解将整容手术置于其他紧迫的健康问题之上的后果。从理论上讲，这项研究将有助于科学地理解种族、性别和阶级的文化观念如何与健康和外表的流行观念相互作用。这项研究也将有助于研究生的教育。

Under the supervision of Dr. Carolyn Sargent, graduate student Lauren Gulbas will investigate the social effects of the increasing practice of cosmetic surgery in Caracas, Venezuela. Cosmetic surgery is increasing in many developing nations. Venezuelan society exhibits a particularly clear tension between the aesthetic and class priority given to lighter skin and European physical features, and official government policies that promote racial democracy, forbid the collection of racial data in the census, and prohibit discrimination on the basis of race. Because cosmetic surgery is available to all Venezuelans through free national health care, a careful scientific study can reveal how ordinary people live racial preferences, and how these preferences intersect with cultural notions of gender and class.Participation in the research will be solicited from community members and individuals associated with four randomly chosen surgery clinics and a teaching hospital. To elicit initial information about local conceptions of race and class, a domain analysis will be done with a stratified sample of 10 women and 10 men. This will be followed with surveys of a clinic sample of 135 (90 women, 45 men, reflecting gender ratios of those undergoing surgery) and a control group of 135 members of the community. Sub-samples of key informants will be interviewed in greater depth for free lists (to explore definitions associated with race and class) and about racial and class categories. In addition, she will collect 30 patient before-and-after-surgery narratives, using photo elicitation techniques and standard body image evaluations. Finally, she will do extensive observations of interactions between patients, family members, and medical personnel, as well as track relevant discussions in the media. Data will be analyzed with appropriate methods for systematic qualitative research (for the free-lists and rank order data) and computer coded text analysis techniques for the documents, field notes, patient narratives, body image interviews and life histories.The research is important as a contribution to understanding the consequences of privileging cosmetic surgery over other pressing health concerns. Theoretically, the research will contribute to scientific understanding of how cultural notions of race, gender, and class interact with popular notions of good health and appearance. The research also will contribute to the education of a graduate student.