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In the context of bariatric surgery, negative social support has recently been conceptualized in terms of sabotage, feeding behaviour and collusion undermining a person's effort to lose or maintain weight. While sabotage and feeding behaviour are thought to be motivated consciously, collusion is understood as a bond, by which protagonists are tied together sharing an unresolved and unconscious psychological issue such as dependency, domination and submission, and so on. Drawing upon a systemic and psychodynamic understanding, we analysed interviews with patients (n = 10) who had undergone bariatric surgery and their partners (n = 10) focusing on support. We selected interviews (n = 4 + 4), illustrative of sabotage, feeding, collusion and co-evolution based on the comprehensiveness of information, their emblematic quality and suitability to delineate these phenomena. Our analysis confirms that negative social support can be considered as an attempt to reestablish a level of homeostasis within the couple. However, rather than being intentional, we consider that sabotage and feeding behaviour are better conceptualised as consequences of collusive relationships.

Lower back pain with or without radiating leg pain is a leading cause of disability worldwide. Several treatment options are available, and this article aims to understand better the decision-making involved in selecting appropriate treatments. A qualitative interview study was conducted with patients with lumbar spinal disorders and neurosurgeons specialising in spine surgery. Both groups of participants were asked to reflect on the decision-making process regarding whether to pursue surgery for back pain. The theoretical approach of distributed decision-making was applied. Results indicated that patients activated diverse information sources and considerations derived from their social networks when in the consultation room. Surgeons, on the other hand, were equipped with research-based knowledge and clinical practice experience. Effective communication was a shared concern for patients and surgeons during the actual decision-making. Factors such as patient diversity, the language used to discuss disease and illness, and the interpretation of risks played pivotal roles in the decision-making process. Regarding self-understanding, patients acted as agents for illness coping in their social networks. Surgeons recognised the imperative skill of facilitating rich patient dialogue as a crucial element in shared decision-making regarding potential surgical interventions. These findings demonstrate the importance of understanding decision-making as a distributed process where patients and clinicians are embedded in social networks and institutional contexts. In this process, patients must be recognised and engaged as individuals with diverse backgrounds and needs, especially during discussions focused on determining the most effective treatment approach for their specific cases.

Stigma related to blood-borne viruses (BBVs) and sexually transmitted infections (STIs) has been shown to undermine the quality of healthcare. Given the pervasiveness and multiple manifestations of stigma within healthcare settings, recent research has argued that stigma should be addressed 'universally' i.e. for all stigmatising attributes and conditions, across all healthcare services. As part of the development of a universal approach to stigma, we analyse 20 interviews conducted with key stakeholders with expertise in BBVs, STIs and stigma in Australian healthcare settings. Inspired by research that addresses stigma as a biopolitical and spatial-temporal phenomenon, we examine how stigma weaves through relationships between people, time, space and technologies of healthcare provision. We begin with a discussion of funding structures and time constraints, followed by an examination of matters relating to the geographical location of the clinic and, finally, an analysis of smaller scale service environment space-times. In doing so, we bring attention to significant spatial-temporal matters that shape the production of stigma and address the need to balance universal concerns about healthcare quality with the specific forms of stigma that can emerge in relation to particular health issues and populations, such as BBVs and STIs. Overall, we examine how ambitious responses to stigma such as that proposed by the 'universal precautions' approach broaden our focus beyond interpersonal interactions and help draw attention to a wider range of objects, spaces and temporal dynamics that must be addressed in any effort to address stigma.

Despite extensive research on Western breast cancer (BC) memoirs highlighting how shame profoundly impacts patients' lives making them more vulnerable, Indian BC memoirs remain underexplored, especially in understanding the challenges of shame. This article examines the unique struggles of Indian female BC patients, focusing on their experiences of biographical disruption, the guilt-ridden consciousness of their altered body image, and the shame-induced actions that shape their narratives. Through an analysis of three Indian BC memoirs, Sunshine (2011), To Cancer, with Love (2015) and Cancer, You Picked the Wrong Girl (2021), this article explores how Indian female BC narrators comprehend and articulate their lived experiences of shame and self-perception. The analysis also highlights the diverse coping strategies such as doing humour, normalising breast talk, practising spirituality, and sharing survival lessons employed by these narrators to offer a deeper understanding of the intersection of shame, identity, and healing, and to transcend moments of shame through acts of reconstruction. More importantly, the analysis underscores how these acts of reconstruction provide empowering strategies for navigating the challenges of BC and accentuate the possibility of an autobiographical reconstruction mechanism.

Patients' online information-seeking and sharing has sparked worries about medical misinformation and declining trust in biomedical professionals. At the same time, scholars advocate for including patients as knowers in the clinical encounter. Yet we lack empirical insights into the differing ways care providers and patients substantiate health-related knowledge. This article thus examines (1) how both groups substantiate claims about contraceptive side-effects, (2) the ways their substantiation processes differ and (3) how we can navigate this epistemic tension in contraceptive care. I draw on data from nine interviews with Dutch contraceptive care providers (one nurse practitioner, one gynaecologist and seven general practitioners) and 17 contraceptive users, observations of 11 contraceptive consultations in the Netherlands and analysis of Dutch clinical guidelines. Results reveal that patients substantiate their claims through combining embodied modes of knowing with self-experimentation as well as validation through social media exchanges. Care providers switch between two complementary approaches: demarcating biomedical knowledge from non-scientific claims and clinical tinkering. I show that epistemic tensions between provider and patient may arise because the two groups have differing definitions of what a side-effect is and differing evaluations of information shared online. Based on these findings, I argue that care providers invalidating information shared online may contribute to patients' growing distrust in biomedical authority while collaborative tinkering may provide a common ground for care providers and patients to co-create knowledge.

The aim of the study was to better understand the experiences of women living with a history of breast cancer by analyzing the metaphors they use to describe their experiences. Data were collected through individual narrative interviews with 10 women, who were between 4 years and 13 years post-diagnosis. Their narratives were analyzed using Interpretative Phenomenological Analysis. The results are presented from an existential perspective and are conceptualized using the metaphor of the home. Our interpretation suggests that participants were in search of a habitable world, seeking to (1) dwell in oneself, (2) dwell with others and (3) dwell in the world. The results were discussed using an intersubjective conceptual framework, enriched by the work of Stolorow on human suffering and emotional trauma. The study expands upon existing literature on the use of metaphors in cancer patients and contributes to reveal their richness and diversity, beyond the dominant war metaphor.

Caring practices during vaccination encounters are deeply interwoven with materiality, encompassing everyday objects and elements that play a crucial role for all actors involved. However, the significance of these materialities in shaping caring relationships within vaccination practices has been largely overlooked. This research seeks to fill that gap by exploring how mundane elements, such as the objects present during vaccination, contribute to the relational dynamics of the experience. Through a qualitative approach involving participant observation of vaccination encounters and interviews with 30 healthcare professionals, four key themes emerged: (i) objects as comfort devices, (ii) caring as gifts, (iii) reinvented medical instruments, and (iv) creating a friendly environment. These findings suggest that material elements are not merely passive tools but active "co-participants" in the vaccination process, influencing the interactions and emotional exchanges that occur. By acknowledging the role of materiality, this research enhances our understanding of vaccination as a relational experience, highlighting the importance of considering these often-overlooked factors in both practice and policy. The study offers valuable insights into how healthcare professionals can utilize materialities to foster more empathetic and supportive vaccination environments.

Corporate Social Responsibility (CSR) refers to initiatives undertaken by corporations that aim to make a positive impact on society. It is unclear to what extent these aims are achieved in relation to population health. We explored the evidence for mechanisms by which CSR has positive or negative effects on population health through a systematic-narrative hybrid review of 97 relevant articles. We found few examples overall that could trace a CSR initiative through to verifiable impacts on the population. Our review found that generally the evidence for the impacts of CSR on population health was patchy, highly heterogenous and of varying quality. We found some potential positive impacts of CSR on health; including on poverty alleviation, development, health care, the environment and the health and wellbeing of workers. Some CSR initiatives were rebranding of core functions, such as HR practices and employee wellbeing strategies, or were a partial redressing of the problems the corporation itself is creating, such as CSR initiatives that sought to improve workplace safety, reduce corporate environmental footprints or relocate people displaced by mining activities. We situate these impacts in relation to the role and intent of CSR, and argue that meaningful progress on CSR can only be made with greater transparency and reporting of initiatives to more fulsomely evaluate their impacts - as well as the political economy in which these sit. It is further critical to strengthen government regulation and oversight to maximise any public good that can come from CSR, and minimise the negative consequences reported in research literature.

The present study examined how individuals who have been clinically diagnosed as obese explain their decision to undergo bariatric surgery and how they deal with the stigmatization that such a decision may entail. A total of 23 participants (15 women and 8 men) who were awaiting bariatric surgery within the Spanish healthcare system, were interviewed about their weight trajectory and their decision to undergo this surgery. In order to examine the participants' stories, a narrative analysis of the interviews was conducted, with attention to both content (what they told) and structure (how they told) and examining the stories in line with the socially and culturally available narratives that they had access to, and the context in which the stories were produced. The participants explained their weight trajectory through the origin of their weight, the failure to control it, and their decision to have surgery to solve the weight problem. The narrative of a sick body that needs to be restored appeared to function as a schema or script through which participants attempted to defend themselves from anti-fat narratives that assume personal failure while at the same time presenting themselves as deserving to be operated on. Through their narratives, they positioned themselves as undeserving of stigma but did not challenge the stigma itself.

This paper explores temporalities and experiences of time drawn from an analysis of interview data from a critical narrative inquiry of the experiences of young adults living with home mechanical ventilation (HMV). The analysis centers the ideological effects of dominant discourses that shape understandings of time in the Euro-Western world and the ways in which young adults' stories prompt a rethinking of time in health research and praxis. Data generation involved interviews and photo-elicitation with five young adults (ages 18-40). A critical narrative analysis of participants' stories surfaced the influence of ableist, developmentalist, and neoliberal discourses of time and the creative resistance that points to the potential of crip orientations to time in opening up possibilities for living. Implications for practice and research are offered.