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The aim of this study is to critically analyze how suicidal behavior and individuals who attempt suicide are problematized and represented in Danish suicide prevention policies. Drawing on a poststructural policy analysis approach inspired by Bacchi and Goodwin, we seek to uncover the underlying assumptions, silences, and potential effects embedded in these problem representations, with particular attention to how certain preventive actions are prioritized while broader social, structural, and relational understandings of suicidality are marginalized. Suicide prevention efforts in Denmark have not led to a reduction in suicides and suicide attempts in the last 20 years. Until recently, the underlying assumptions and constructions shaping national suicide prevention policies have received limited scholarly attention. Following this, our analysis focuses on documents published by key stakeholders and decision-makers involved in the national partnership for the prevention of suicide and suicide attempts in Denmark. The findings indicate that individuals who attempt suicide are predominantly framed as both risky and at risk, due to enduring individual vulnerabilities and mental illness. This dual construction positions the person as an active threat to themselves-engaging in suicidal behavior as a result of poor coping abilities-while simultaneously being a passive victim of external threats such as psychiatric conditions or adverse life circumstances. We argue that these dominant, individualized problem representations frame suicidal behavior as a double-edged risk, narrowing prevention efforts to acute, short-term individual support and treatment. This potentially leaves out the contexts people in suicidal distress navigate as sites of intervention.

Diabetes is a major global health concern, with diabetic foot ulcers (DFUs) presenting a common complication. Interest is growing in people's lived experiences of DFUs, including their management and prevention. Typically, research has highlighted the disruptive and extended impact of DFUs, and has focused on the role of intrinsic, individual factors (e.g. knowledge, physical capabilities and personal choices) in their development and management. The influence of extrinsic, contextual factors, has received comparatively limited attention. To address this potentially important gap in the literature we set out to explore people's experiences of DFUs, using a distinctive, contextually-sensitive, analytical lens. Our analysis led us to identify three over-arching themes: a spectrum of embodied experiences of DFUs; intersection with wider experiences of ill-health; and, framing of (DFU) experiences by broader life circumstances. Within these themes, considerable diversity was evident. Broader life circumstances, in particular, shaped experiences of living with, managing, and preventing reoccurrence of DFUs in markedly different, and previously unacknowledged, ways. We conclude that experiences of DFUs are far more nuanced and contextually-mediated than previously reported, and identify important practical implications for the provision of sensitive and effective support and clinical care. Moreover, we suggest that identifying these sorts of complexities in illness experiences may require larger, and more varied samples and data-sets than have become the norm in qualitative health research, as well as more expansive disciplinary lenses.

Image and performance-enhancing drugs (IPEDs) are primarily injected intramuscularly or subcutaneously, yet traditional harm reduction strategies, focused on blood-borne virus prevention, often overlook the specific health enhancement goals of people who use IPEDs. This study advocates for a collaborative approach to safer injecting practices, informed by the lived-living experiences of people injecting IPEDs, to develop targeted messaging that aligns with their unique motivations. Thirty participants who inject IPEDs were recruited through community networks and partnerships. The study used qualitative focus groups and semi-structured interviews to explore injection practices and safety strategies. Data analysis followed an inductive, line-by-line approach, identifying themes related to injection methods and safer techniques, drawing on matters-of-concern. Stigma and misinformation about IPED injection practices were prevalent, contributing to a heightened risk of infection. Participants expressed anxiety about injection site reactions and reported limited knowledge of safe techniques, with poor injecting literacy leading to risky behaviours like needle reuse and inadequate hygiene. Importantly, participants highlighted that IPED injecting knowledge is often shared through peer support networks. This research calls for reframing harm reduction to focus on health enhancement, optimising injecting techniques, and integrating evidence-based resources, empowering peer-led harm reduction to better support the health aspirations of this population.

The US HIV/AIDS response is notably worse than those of other high-income countries. The country's epidemic is marked by low viral suppression rates, high incidence, lacking coordination, and entrenched disparities along lines of sexuality, race/ethnicity, gender, class, and other factors. In 2010, the National HIV/AIDS Strategy for the United States (NHAS) was launched, centering an equity-oriented vision that prioritized marginalized groups. NHAS implementation required states to create HIV integrated plans to better coordinate services and meet populations' needs. We used Carol Bacchi's "What's the Problem Represented to Be?" approach to analyze 20 jurisdictions' plans, focusing on how they incorporated equity-oriented principles articulated in NHAS's vision statement and other factors such as plans for integration across HIV care, surveillance, and prevention programs. Building on Melissa Creary's concept of "bounded justice," we show that integrated plans enacted a "bounded justice continuum," wherein some states pursued more equity-oriented strategies than others. We argue that this reflects constraints planners faced and the structure of US federalism, where implementing jurisdictions operated in variously restrictive or enabling conditions related to state-level politics, available public health infrastructure, and other factors. Our approach and the bounded justice continuum concept can be useful for scholars studying the rollout of equity-oriented policies in federal systems where local implementations will vary widely. We ultimately arrive at a positive assessment of US HIV integrated planning. However, we also advocate for more transformative reforms to ensure that people living with and affected by HIV can access universal healthcare, social services, housing, and employment.

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.

This article examines how drug education professionals understand and respond to the relationship between alcohol and other drug consumption, sex and harm. While recent research examines how these issues are addressed in drug education curriculum, little is known about the perspectives of professionals involved in education design and delivery. Research suggests that agency is centrally important for understanding experiences of harmful, pleasurable or ambiguous sexual encounters in consumption settings. I analyse understandings of the relationship between agency, drug consumption, sex and harm generated during in-depth interviews with drug education professionals. Informed by Karen Barad's relational concepts of agency and response-ability, I examine the agencies that these professionals constitute as the locus of harms related to consumption and sex. Some focus on individual human agency, while others position alcohol and drugs as the primary agents of harm. Throughout the analysis I argue that both approaches offer an impoverished account of drug consumption and sex and inform education approaches that struggle to respond to other significant agencies such as gender. I also examine accounts that grapple with agencies beyond people and drugs. Overall, I argue for drug education approaches that are more response-able to the multiple agencies that together constitute experiences of drug consumption and sex.

Drawing on a posthuman onto-epistemology, this paper explores movements of bodies labelled-as-disabled as creative 'choreographies' that are coproduced through the coming together of multiple material, social, discursive and affective forces across time-spaces. The purpose is to challenge thinking as usual towards re-envisioning differences as potentials rather than deficits. To do so, we consider how disability can move deficit-thinking and how mobility can be put to work to rethink disability. Movement and mobility in relation to disability are frequently discussed in terms of bodily deficits and/or disabling access barriers. Deficit-thinking separates people into categories of disabled or so-called 'abled' wherein reforms are oriented to erasure of differences through providing disabled people with access to a normal/ized life. In this posthuman analysis we advance an affirmative way of thinking about differences by recursively retheorizing disability through movement and retheorizing movement through disability. To do so we present three 'mobility experiments' generated from a recent study conducted with five youth partners who identified as disabled. Within the experiments, we position creative mobilities as micro-activist becomings that suggest avenues for celebrating differences towards instigating radical change. We conclude with a discussion of posthuman disability ethics and the implications of our analysis for thinking and doing differently in healthcare and beyond.

Caring is a fundamental concept in healthcare, yet it is fraught with challenges for people living with complex mental illnesses (CMI). Many scholars theorize relationality and interdependence in their definitions of care, however, there has paradoxically been a sustained failure to involve the testimonies and voices of the people who clinicians are connected to and have interdependent relationships with. Using the work of feminist ethics of care scholars Berenice Fisher and Joan Tronto, we conceptualize care work through relationality and sensitivity to (in)justice. While foregrounding relationality and justice, we used a collective narrative methodology and collective documentation to create stories of care. By documenting stories of care, we hope to contribute to the conversations on care and caring practices.

Prostate cancer, the most common cancer among Finnish men, has a high survival rate. Treatment options vary from active surveillance to radical treatments, with potential long-term or permanent side effects. Traditional cancer narratives frame cancer as a tragedy or a hero story and thus fail to capture the chronic nature of prostate cancer and its impacts on patients' lives. This study analyses the narratives of 22 prostate cancer patients, interviewed twice (1 and 3 years after diagnosis). We found two recurring storylines of prostate cancer narratives, one from radically treated men and the other from men under active surveillance. We analysed how cultural plot types - hero story, tragedy, comedy and irony - appear in the narratives. While tragedy dominated narratives, re-interviews also revealed irony as the tragic elements were caused by the treatment side effects, not the cancer itself. Comedic elements emerged when side effects were reframed as symptoms of ageing. Narratives took on heroic features if the cancer was cured or non-aggressive. The findings underscore the importance of diverse cultural representations to reflect the multifaceted experience of living with prostate cancer and the need for long-term support with the physical and psychological aspects of prostate cancer.

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.