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In return-to-work (RTW) negotiations after sickness absence, the work ability of an individual employee becomes a shared interest for the multiple stakeholders representing both the healthcare sector and working life. In practice, the employee, employer and occupational health professionals need to reach a shared understanding of the employee's work ability to enable shared decision-making concerning the plans for sustainable RTW. Drawing on 14 video-recorded RTW negotiations, we used conversation analysis-informed membership categorization analysis to examine how the participants of RTW negotiations discuss the work ability of an employee to pursue a shared understanding of the situation. Work ability was constructed in a very situational way, using illness categories to both explain the work ability of the employee and argue for or against their ability or inability to work. Our study contributes to research on RTW by introducing a new perspective to work ability. We show how work ability is realized during RTW negotiations through interaction, and how participants leverage their cultural understanding of illness and capability when negotiating work ability. We also demonstrate how membership categorization analysis can reveal the situational and consequential aspects of illness and work ability categories.

Patient-centered care (PCC) has become a central aim for healthcare systems worldwide due to recognition of its advantages. The growing use of telemedicine technologies (TT) raises concerns of diminishing interpersonal contact, especially in primary care, and questions the appropriate way of implementing PCC. This article aims to explore primary-care physicians' (PCP) experiences of PCC when using TT. During 2023 in-depth interviews were conducted with 20 Israeli PCP: family physicians and pediatricians. The PCP described their experiences of using TT in their communication with patients as including some characteristics of PCC but not others. They related to TT as a means of forming relationships and communicating with patients, highlighting its individualistic focus and describing it as a way of coordinating care. When describing the use of TT in their communication with patients, they barely related to empathy and respect for the patient, to their own involvement in the treatment, to shared decision-making, or to a holistic focus on the patient. The absence of interpersonal qualities and soft skills communication from the physicians' TT experience seems to erode their personal well-being and professional satisfaction and may even lead to burnout. We therefore recommend instructing PCP to better integrate PCC into their TT communication with patients since it contributes to the quality of healthcare and is significant for the well-being of both patients and physicians.

Since 2020 health workers everywhere have been challenged by the ongoing ramifications of the Covid-19 pandemic. This virus impacted all aspects of life but health-related workplaces particularly, were transformed virtually overnight. Demands were heightened and customary supports came under pressure presenting a huge crisis for health systems. The goal of this study was to explore how this catastrophic pandemic event impacted the wellbeing of healthcare professionals (HCPs) working through this time. Interviews with 57 HCPs from multiple countries and specialty areas were explored utilising inductive content analysis (ICA). Resulting data were then categorised into themes and deductively analysed utilising a method informed by Capability Theory. These were secondary data as the interviews were part of a larger set collected primarily for the purpose of a documentary being made about this experience. This study found that illbeing experiences were prevalent among HCPs. However, significant sources of wellbeing were also evident, and were instrumental in maintaining HCP resilience. Wellbeing was enhanced when HCPs experienced a small number of key capabilities that enabled a broad range of functionings. The capabilities were for (a) participation in positive relationships, (b) a sense of identity, purpose, meaning and value in relation to one's work and (c) ability to provide an appropriate level of medical treatment, care and other role related support. These capabilities were central to HCP wellbeing irrespective of the individual's location and specialty area, however the ability to realise these capabilities in desired functionings was differentially impacted by each individual's unique circumstances.

This paper examines the rhetorical strategies used by stroke survivors to attend to identity aloneness, a phenomenon in which individuals experience a sense of disconnect from others as a consequence of identity change, for which stroke is known as an antecedent. Three stroke survivors, and their spouses, were interviewed about their stroke, social support, and experiences with loneliness and identity change. The data was transcribed using a simplified version of the Jeffersonian method and analysed using a critical discursive psychological approach. This made it possible to examine the way in which the psychological business of identity aloneness was managed in participants' talk via discursive devices such as metaphors and category entitlement, while also leaving room to consider how broader societal discourses were drawn upon. The analysis revealed two critical ways in which participants attended to the issue of identity aloneness: (1) by crafting and occupying a position of resilience; (2) by managing the impact of the post-stroke social world on their identities. These findings offer insight into how the issue of identity aloneness is made sense of by stroke survivors in the context of a discussion with an interviewer. Finally, findings informed future directions for research, including developing a comprehensive theory of identity aloneness using a grounded theory approach and developing and validating a psychometric measure of identity aloneness to be applied in a rehabilitative setting.

Waiting for a child transplant is a form of suffering for parents, yet little research has explored how parents experience waiting and how healthcare providers can impact their waiting experiences. The purpose of this article is to investigate how parents experienced the process of waiting for their child's transplant with a specific focus on the impact of healthcare providers on parents' experience of waiting. Six parents from four different families participated in interviews and observations. Our narrative analysis suggested that parents had no narrative roadmap to navigate waiting and the importance of healthcare providers' tailoring the amount and type of medical information to a parents' needs. We discuss how waiting required parents to be hypervigilant and provide continuity of care for their child, and how this "managerial role" could lead to a loss of trust with their healthcare providers. Parents' accounts were replete with contradictions, and as an extension of this, waiting was full of contradictions. Findings contribute to conceptual, methodological, and practical work exploring how parents live in deep uncertainty about the future, and how healthcare providers can support parents in their child's transplantation and other life-threatening illness contexts.

Breast augmentation is a prevalent cosmetic surgery procedure among women in Western societies, and the cosmetic surgery market has witnessed substantial growth. Today, websites and online forums are platforms that feature discussions about cosmetic procedures. A genre on surgery clinic websites is 'patient stories', but also lay-initiated internet forums facilitate discussions and shared experiences related to cosmetic surgery. This study aims to analyse lay-initiated online narratives about cosmetic breast augmentation. The shared narratives contain descriptions of how women who are about to undergo breast augmentation prepare for surgery, the medical procedures that take place on the day of surgery itself, and the experiences and feelings after waking up after anaesthesia. Employing a structural analysis of 30 of these stories, this research illuminates how the surgery stories adhere to a conventional storytelling format, and how key characters within the stories are 'helpers and makers', including relatives, nurses and surgeons. The focus in these narratives revolves around the woman herself, although her active involvement is primarily observed during the preparation phase, with a more passive role assumed during subsequent clinic routines. Despite instances of pain and discomfort in the narratives, the stories are enveloped in an aura of glamour and a spa-like atmosphere. It is discussed how this 'fairy tale' story, narrating a surgical metamorphosis, seems to align with the popularisation of the cosmetic surgery sector.

In this paper, we explore the ways in which patients invoke third parties to gain decision-making influence in clinical consultations. The patients' role in decision-making processes is often overlooked, and this interactional practice has rarely been systematically studied. Through a contextual narrative exploration of 42 naturally occurring consultations between patients (aged 22-84) and general practitioners (GPs) in England, we seek to fill this gap. By exploring how and why patients invoke third parties during discussions about medical treatments, who they refer to, what kind of knowledge their referents possess, and how GPs respond, our main aim is to capture the functions and implications of this interactional practice in relation to decision-making processes. Patients refer to third parties during decision-making processes in most of the consultations, usually to argue for and against certain treatment options, and the GPs recognise these utterances as pro-and-contra arguments. This enables patients to counter the GPs' professional knowledge through various knowledge-sources and encourage the GPs to target their specific concerns. By attributing arguments to third parties, patients claim decision-making influence without threatening the GPs' authority and expertise, which their disadvantaged epistemic position demands. Thereby, patients become able to negotiate their role and their epistemic position, to influence the agenda-setting, and to take part in the decision-making process, without being directly confrontational. Invoking third parties is a non-confrontational way of proposing and opposing treatment options that might facilitate successful patient participation in decision-making processes, and so limit the risk of patients being wronged in their capacity as knowers.

Haemodialysis is a common treatment option offered internationally for people requiring kidney replacement therapy. Research exploring haemodialysis is predominantly clinical and quantitative, and improvements to its provision and receipt tends also to be clinically focused. In recent years, however, a number of studies have sought to explore the lived experience of haemodialysis. These studies tend to use semi-structured interviews and present descriptive findings. Such findings serve to raise the profile of patient perspectives and encourage thinking beyond the clinical gaze. To progress this, we apply a post-humanism approach to the understanding of the receipt of haemodialysis. Drawing on findings from a study to explore the experience and impact of in-centre, daytime, haemodialysis we follow Fox and Alldred's ethological toolkit to provide a post-human analysis of haemodialysis. In doing so we argue that haemodialysis exists as a heterogenous and changeable assemblage of multiple and fluid, human and non-human factors that has the capacity to affect. Here we outline this post-human approach and the impact it has for understanding not just haemodialysis but also the receipt of treatment for other chronic illnesses.

The use of resilience in social practice has evolved from a theoretical framework at the intersection between individuals and their social ecology. Critics argue this theory still results in policies and practices that are too individualised, with the potential for negative social consequences. This paper further critiques contemporary understanding of resilience theory and its application. It juxtaposes complex systems theory with a social inequalities oriented resilience practice. This provides a paradoxical approach. It is acknowledged that state and public policy decisions and actions can be anti-resilient, undermining community and social resilience that already exists in the form of social relationships, self-organisation and co-production. Nevertheless, collective social resilience also illustrates the potential of local and service user organisations to contribute to an overall transformational change process.

Logic modelling is used widely in health promotion planning for complex health and social problems. It is often undertaken collaboratively with stakeholders across sectors that hold and enact different institutional approaches. We use hermeneutic philosophy to explore how knowledge is 'lived' by - and unfolds differently for - cross-sectoral stakeholders during comprehensive primary healthcare service planning. An Organisational Action Research partnership was established with a non-government organisation designing comprehensive primary health care for individuals experiencing homelessness in Adelaide, Australia. Grey literature, stakeholder input, academic feedback, a targeted literature review and evidence synthesis were integrated in iterative cycles to inform and refine the logic model. Diverse knowledge systems are active when cross-sectoral stakeholders collaborate on logic models for comprehensive primary health care planning. Considering logic modelling as a hermeneutic praxis helps to foreground and explore these differences. In our case, divergent ideas emerged in how health/wellbeing and trust were conceptualised; language had different meanings across sectors; and the outcomes and data sought were nuanced for various collaborators. We explicate these methodological insights and also contribute our evidence-informed, collaboratively-derived model for design of a comprehensive primary health care service with populations experiencing homelessness. We outline the value of considering cross-sectoral logic modelling as hermeneutic praxis. Engaging with points of difference in cross-sectoral knowledge systems can strengthen logic modelling processes, partnerships and potential outcomes for complex and comprehensive primary health care services.