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Temporalities of peer support: the role of digital platforms in the 'living presents' of mental ill-health. 同伴支持的时空性:数字平台在精神疾病 "生活礼物 "中的作用。
IF 2.5 2区 医学 Q2 HEALTH POLICY & SERVICES Pub Date : 2024-03-01 Epub Date: 2024-04-11 DOI: 10.1080/14461242.2024.2322531
Ian Tucker

This paper considers matters of time in online mental health peer support. Significant evidence of the value of peer support exists, with new digital platforms emerging as part of the digitisation of mental health support. This paper draws from a project exploring the impact of digital platforms on peer support through interviews with users of a major UK-based online peer support platform. Drawing on Gilles Deleuze's concept of the 'living present', the paper highlights how notions of past, present and future operate as co-existing dimensions of the present. The analysis highlights how the immediacy of digital platforms elicits expectations of peer support being 'on tap', which creates challenges when support is not received synchronously. Unlike in-person support, digital platforms facilitate the archiving of support, which can (re)enter the present at any moment through asynchronous communication. Anticipations of the future feature as dimensions of the present in terms of feelings regarding when support may no longer be needed. The paper offers potential implications for social scientific understanding of digital peer support, which include valuable insight for mental health services designing and delivering digital peer support.

本文探讨了在线心理健康同伴互助中的时间问题。有大量证据表明了同伴互助的价值,作为心理健康互助数字化的一部分,新的数字平台不断涌现。本文通过对英国一家大型在线同伴支持平台用户的访谈,探讨了数字平台对同伴支持的影响。本文借鉴吉尔-德勒兹(Gilles Deleuze)的 "活在当下"(living present)概念,强调了过去、现在和未来的概念是如何作为当下的共存维度而运作的。分析强调了数字平台的即时性如何引起人们对同伴支持 "随叫随到 "的期望,当支持不是同步接收时,就会产生挑战。与面对面的支持不同,数字平台为支持的存档提供了便利,支持可以通过异步通信随时(重新)进入当下。从何时不再需要支持的感受来看,对未来的预期是当前支持的一个方面。本文为社会科学理解数字同伴支持提供了潜在的启示,其中包括对心理健康服务设计和提供数字同伴支持的宝贵见解。
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引用次数: 0
Spectralities of ADHD: hauntological diagnosis amidst agency, politics and pedagogies. 多动症的幽灵:机构、政治和教学法中的鬼魂诊断。
IF 2.5 2区 医学 Q2 HEALTH POLICY & SERVICES Pub Date : 2024-03-01 Epub Date: 2024-02-19 DOI: 10.1080/14461242.2024.2316736
Sebastián Rojas-Navarro, Samanta Alarcón-Arcos, Ismael Tabilo-Prieto

Hauntology has become an increasingly alluring concept in social sciences to reflect upon everyday life and how subjects dwell upon scenarios pervaded not only by the potency of the actual but also the haunting of the past and the virtual. Drawing on the concept of 'hauntology', we inquire about recurring temporalities and spectrality themes concerning the 'controversial' diagnosis of attention deficit hyperactivity disorder (ADHD) in Chile. Using participant observation and in-depth interviews with health practitioners, teachers, school staff, diagnosed children, and their peers from 3-year-long research, we examine how the performance of the diagnosis by clinicians at times can produce a modification of the temporality of the diagnosed children from that moment forth. Amidst tension created by educational policies, ideas of well-being, pedagogical practices, and everyday living, the diagnosis keeps repeating its agentic capacity while resisting its decay, becoming ever-present and actual. Once cast, the diagnosis acts as a repeating force that can shape every experience, cancelling the possibility for the child to become different by unfolding out of the diagnosis.

鬼魂学 "已成为社会科学中一个越来越诱人的概念,用来反思日常生活,以及人们如何在现实、过去和虚拟的鬼魂萦绕下生活。借鉴 "鬼魂学 "的概念,我们探究了与智利 "有争议的 "注意力缺陷多动障碍(ADHD)诊断有关的反复出现的时间性和幽灵性主题。通过对医疗从业人员、教师、学校工作人员、被诊断儿童及其同龄人进行长达三年的参与观察和深入访谈,我们研究了临床医生在进行诊断时如何对被诊断儿童的时间性产生影响。在教育政策、幸福观念、教学实践和日常生活所造成的紧张关系中,诊断不断重复其代理能力,同时抵制其衰减,成为永远存在的现实。诊断一旦形成,就像一种重复的力量,可以塑造每一次经历,取消了儿童通过走出诊断而变得与众不同的可能性。
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引用次数: 0
The time of cure: hepatitis C treatment and the matter of reinfection among people who inject drugs. 治愈时间:丙型肝炎治疗与注射吸毒者中的再感染问题。
IF 2.5 2区 医学 Q2 HEALTH POLICY & SERVICES Pub Date : 2024-03-01 Epub Date: 2024-02-19 DOI: 10.1080/14461242.2024.2315031
J Rance, J Grebely, C Treloar

Australia has made considerable progress towards the public-health 'elimination' of the hepatitis C virus. Nonetheless, reinfection remains a key challenge, with little understanding regarding the lived complexities of post-cure life among people who inject drugs. Our analysis examines reinfection through the lens of 'time', a largely overlooked and under-utilised analytical concept within the field of hepatitis C. Drawing on qualitative data from a study examining treatment outcomes and reinfection, our analysis concentrates on three participant accounts or 'cases'. Working within a new materialist framework, we combine recent social science scholarship which, firstly, posits cure as a socio-material 'gathering', and secondly, proposes a 'futurology' of hepatitis C and its treatment. We found participant accounts troubled the neat binary of pre- and post-treatment life, instead detailing the challenges of remaining virologically safe while navigating complex, local life-worlds. Rather than a singular, post-treatment future instantiated by cure, participants described the fluid, emergent nature of what we might describe as 'lived' or 'embodied' time, including multiplicities of becoming in a perpetual present. We conclude that our understanding of reinfection needs to move beyond its current, narrow biomedical conception and organising temporal logic to honour and incorporate complexity in practice.

澳大利亚在公共卫生 "消灭 "丙型肝炎病毒方面取得了长足的进步。然而,再感染仍然是一项关键挑战,人们对注射吸毒者治愈后生活的复杂性知之甚少。我们的分析通过 "时间 "这一丙型肝炎研究领域中被忽视和利用不足的分析概念来审视再感染问题。在新唯物主义框架下,我们结合了最近的社会科学学术研究,首先将治愈假定为一种社会物质 "聚集",其次提出了丙型肝炎及其治疗的 "未来学"。我们发现,参与者的叙述对治疗前和治疗后生活的二元对立造成了困扰,相反,他们详细描述了在当地复杂的生活世界中保持病毒安全所面临的挑战。参与者描述的不是治愈后的单一未来,而是我们可以描述为 "生活 "或 "体现 "的时间的流动性和新兴性,包括在永恒的现在中成为的多重性。我们的结论是,我们对再感染的理解需要超越目前狭隘的生物医学概念和时间组织逻辑,以尊重并在实践中纳入复杂性。
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引用次数: 0
Matters of time in health and illness. 健康和疾病中的时间问题。
IF 3.6 2区 医学 Q2 HEALTH POLICY & SERVICES Pub Date : 2024-03-01 Epub Date: 2024-03-20 DOI: 10.1080/14461242.2024.2319943
Mia Harrison, Anthony K J Smith, Sophie Adams
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引用次数: 0
Leaky bodies, vaccination and three layers of memory: bio-immune, social-collective and lived experience. 泄漏的身体、疫苗接种和三层记忆:生物免疫、社会集体和生活经验。
IF 2.5 2区 医学 Q2 HEALTH POLICY & SERVICES Pub Date : 2024-03-01 Epub Date: 2024-03-05 DOI: 10.1080/14461242.2024.2320223
Tereza Divíšek, Dino Numerato

This paper focuses on the omnipresent yet analytically almost invisible role of memory and bodily experiences in childhood vaccination. Previous scholarship on the sociocultural aspects of vaccination has primarily focused on the individual and sociodemographic factors underpinning vaccine hesitancy, the role of healthcare professionals and the politicisation or mediatisation of vaccination. Social practices considering vaccination were primarily explored as a matter of the present. Only little consideration was given to the past, individual biographies and sociohistorical temporalities. To complement this body of work, we focus on cognitively-based, embodied and emotionally-experienced memory related to vaccination. Based on a qualitative study of childhood vaccination conducted in Czechia between 2017 and 2019 consisting of ethnographic observations, in-depth interviews and a document review, we identified three interconnected forms of vaccination memory: bio-immune, social-collective and lived experience. Bio-immune memory refers to the body's physical memory, gained to protect itself from diseases. Social-collective memory focuses on socially shared narratives about diseases and vaccination in the past. The memory of lived experience refers to feelings, embodied knowledge and pain. Our findings may inspire further analysis of childhood vaccination in other geographical contexts and amidst the reconfiguration of attitudes and newly established memories following the COVID-19 pandemic.

本文重点探讨记忆和身体体验在儿童疫苗接种中无处不在但分析起来几乎不可见的作用。以往有关疫苗接种的社会文化方面的研究主要集中在导致疫苗接种犹豫不决的个人和社会人口因素、医疗保健专业人员的作用以及疫苗接种的政治化或媒介化。考虑疫苗接种的社会实践主要是作为当前问题进行探讨的。对过去、个人履历和社会历史时间性的考虑很少。为了对这些研究进行补充,我们将重点放在与疫苗接种相关的认知记忆、体现记忆和情感体验记忆上。基于 2017 年至 2019 年期间在捷克开展的儿童疫苗接种定性研究,包括人种学观察、深度访谈和文件审查,我们确定了三种相互关联的疫苗接种记忆形式:生物免疫记忆、社会集体记忆和生活经验记忆。生物免疫记忆指的是身体的物理记忆,用于保护自身免受疾病侵害。社会-集体记忆侧重于社会对过去疾病和疫苗接种的共同叙述。生活经验记忆指的是感受、体现知识和痛苦。在 COVID-19 大流行之后,人们的态度和新建立的记忆发生了重构,我们的研究结果可能会启发人们进一步分析其他地区的儿童疫苗接种情况。
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引用次数: 0
My time, your time, our time. Older patients' and GPs' time sensibilities around email consultations. 我的时间、你的时间、我们的时间。老年患者和全科医生对电子邮件咨询的时间敏感性。
IF 2.5 2区 医学 Q2 HEALTH POLICY & SERVICES Pub Date : 2024-03-01 Epub Date: 2024-02-22 DOI: 10.1080/14461242.2024.2316742
Anette Grønning, Line Maria Simonsen, Elle C Lüchau, Elisabeth Assing Hvidt, Maja Klausen

In this study, we discuss how email consultations in general practice operate as a temporal technology, transforming working conditions and power relations between general practitioners (GPs) and patients. We draw on empirical material from Denmark in the form of a set of semi-structured interviews with 53 patients and 15 GPs, including two focus group discussions with 17 GPs. Our theoretical point of departure stems primarily from media theorist Sarah Sharma's (2014) concept of power-chronography, which describes how power is embedded in temporal relations and everyday life and secondarily from sociologist, Judy Wajcman's (2015) concept of multiple temporal landscapes. Patients and GPs calibrate their own time and attune their mutual time according to their expectations and ideas about the other party's time. The patient and the GP can both be viewed as 'time workers' and the email consultation as a digital technology fostering the recalibration of one person's time to that of another, requiring significant labour. The email consultation rearranges the GP-patient boundaries and thereby the power relations. Health institutions ought to consider whose time and labour is being 'saved' with digital systems.

在本研究中,我们讨论了全科医生的电子邮件咨询如何作为一种时间技术,改变工作条件以及全科医生与患者之间的权力关系。我们借鉴了丹麦的经验材料,对 65 岁以上的患者进行了 68 次半结构式访谈,并与 17 名全科医生进行了两次焦点小组讨论。我们的理论出发点主要源于媒体理论家莎拉-夏尔马(Sarah Sharma,2014 年)的 "权力时序图"(power-chronography)概念,该概念描述了权力是如何嵌入时间关系和日常生活中的;其次,我们还借鉴了社会学家朱迪-瓦伊克曼(Judy Wajcman,2015 年)的 "多重时间景观"(multiple temporal landscapes)概念。患者和全科医生根据他们对对方时间的期望和想法,校准自己的时间,调整彼此的时间。患者和全科医生都可以被视为 "时间工作者",而电子邮件咨询则是一种数字技术,它促进了一个人的时间与另一个人的时间之间的重新调整,这需要大量的劳动。电子邮件问诊重新安排了全科医生与病人之间的界限,从而改变了权力关系。医疗机构应该考虑数字系统 "节省 "了谁的时间和劳动。
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引用次数: 0
The paradox of haemodialysis: the lived experience of the clocked treatment of chronic illness. 血液透析的悖论:按时治疗慢性病的生活体验。
IF 2.5 2区 医学 Q2 HEALTH POLICY & SERVICES Pub Date : 2024-03-01 Epub Date: 2024-03-12 DOI: 10.1080/14461242.2024.2319189
Victoria Cluley, James O Burton, Katherine L Hull, Helen Eborall

Studies exploring the relationship between time and chronic illness have generally focused on measurable aspects of time, also known as linear time. Linear time follows a predictable, sequential order of past, present and future; measured using a clock and predicated on normative assumptions. Sociological concepts addressing lifecourse disruption following diagnosis of chronic illness have served to enhance the understanding of lived experience. To understand the nuanced relationship between time and chronic illness, however, requires further exploration. Here, we show how the implicit assumptions of linear time meet in tension with the lived experience of chronic illness. We draw on interviews and photovoice work with people with end-stage kidney disease in receipt of in-centre-daytime haemodialysis to show how the clocked treatment of chronic illness disrupts experiences of time. Drawing on concepts of 'crip' and 'chronic' time we argue that clocked treatment and the lived experience of chronic illness converge at a paradox whereby clocked treatment allows for the continuation of linear time yet limits freedom. We use the concept of 'crip time' to challenge the normative assumptions implicit within linear concepts of time and argue that the understanding of chronic illness and its treatment would benefit from a 'cripped' starting point.

探讨时间与慢性疾病之间关系的研究通常侧重于时间的可测量方面,也称为线性时间。线性时间遵循过去、现在和未来的可预测顺序,使用时钟测量,并以规范假设为前提。针对慢性病诊断后生命历程中断的社会学概念有助于加深对生活经历的理解。然而,要理解时间与慢性病之间的微妙关系,还需要进一步的探索。在此,我们将展示线性时间的隐含假设如何与慢性病的生活体验产生矛盾。我们通过对接受中心日间血液透析的终末期肾病患者的访谈和摄影舆论工作,来展示慢性病的计时治疗是如何扰乱时间体验的。根据 "慢性 "时间和 "慢性 "时间的概念,我们认为定时治疗和慢性病患者的生活体验存在一个悖论,即定时治疗允许线性时间的延续,但却限制了自由。我们使用 "跛行时间 "的概念来挑战线性时间概念中隐含的规范性假设,并认为从 "跛行 "的起点来理解慢性病及其治疗将是有益的。
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引用次数: 0
Beyond the challenge to research integrity: imposter participation in incentivised qualitative research and its impact on community engagement. 除了对研究诚信的挑战:冒名顶替者参与激励性定性研究及其对社区参与的影响。
IF 2.5 2区 医学 Q2 HEALTH POLICY & SERVICES Pub Date : 2023-11-01 Epub Date: 2023-10-24 DOI: 10.1080/14461242.2023.2261433
Kerryn Drysdale, Nathanael Wells, Anthony K J Smith, Nilakshi Gunatillaka, Elizabeth Ann Sturgiss, Tim Wark

Participant recruitment for qualitative research often offers incentives (honoraria; financial compensation) to increase participation and to recognise lived expertise and time involved in research. While not necessarily a new concern for survey and other quantitative based research, 'spam', 'bot', and other inauthentic forms of research participation has rarely been an apparent issue for qualitative research, given it often involves levels of interaction with potential participants prior to the conduct of in-depth interviews and other methods of data generation. This is no longer the case. A troubling new occurrence has meant that recruitment calls for qualitative research with incentives on public-facing social media have attracted 'imposter' expressions of interest and research participation. In this commentary, we explore this challenge that goes beyond research integrity. In particular, we consider the risks of employing strategies to screen for legitimate participants and the importance of building trust and maintaining community engagement.

定性研究的参与者招募通常提供激励措施(酬金;经济补偿),以提高参与度,并认可参与研究的专业知识和时间。虽然“垃圾邮件”、“机器人”和其他不真实的研究参与形式不一定是调查和其他基于定量的研究的新问题,但对于定性研究来说,这很少是一个明显的问题,因为它通常涉及在进行深入访谈和其他数据生成方法之前与潜在参与者的互动水平。现在已经不是这样了。一个令人不安的新情况意味着,在面向公众的社交媒体上招聘定性研究的呼吁吸引了“冒名顶替者”表达兴趣和参与研究。在这篇评论中,我们探讨了这一超越研究诚信的挑战。特别是,我们考虑了采用策略筛选合法参与者的风险,以及建立信任和保持社区参与的重要性。
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引用次数: 0
'It's not within my control': local explanations for the development of lung cancer in China. “这不是我能控制的”:当地人对中国肺癌发展的解释。
IF 3.6 2区 医学 Q2 HEALTH POLICY & SERVICES Pub Date : 2022-11-01 Epub Date: 2022-06-22 DOI: 10.1080/14461242.2022.2085056
Jiong Tu, Elanah Uretsky, Lu Kang, Juan Yuan, Jiudi Zhong

Rates of lung cancer in China are rising rapidly, creating an urgent need for prevention. Effective prevention measures require understanding local beliefs and perceptions about the risk for developing lung cancer. This article explores the explanations that Chinese lung cancer patients and their families give about the aetiology of their disease. Fifty-three interviews were conducted among lung cancer patients and their family members at a large tumour hospital in southern China. Participants presented a complex multifactorial explanation of lung cancer associating their disease with risks like tobacco use, occupational exposures, environmental pollution, lifestyle changes, and personal characters. While these are all standard risk factors commonly associated with lung cancer, participants presented them within a larger contextual frame of structural issues that impede their ability to change their behaviours. Using a social ecological model, we demonstrate how China's socio-cultural environment shapes assumptions about the risk of lung cancer with particular reference to work, home, social situations, and the natural environment.

中国的肺癌发病率正在迅速上升,迫切需要进行预防。有效的预防措施需要了解当地对患肺癌风险的信念和看法。本文探讨中国肺癌患者及其家属对其病因的解释。在中国南方一家大型肿瘤医院对53名肺癌患者及其家属进行了访谈。参与者提出了一个复杂的多因素解释,将肺癌与烟草使用、职业暴露、环境污染、生活方式改变和个人性格等风险联系起来。虽然这些都是通常与肺癌相关的标准风险因素,但参与者在阻碍其改变行为能力的结构性问题的更大背景下提出了这些因素。使用社会生态模型,我们展示了中国的社会文化环境如何形成关于肺癌风险的假设,特别是在工作、家庭、社会环境和自然环境方面。
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引用次数: 0
Structural violence and barriers to pain management during an opioid crisis: accounts of women who use drugs in Nigeria. 阿片类药物危机期间的结构性暴力和疼痛管理障碍:对尼日利亚吸毒妇女的描述。
IF 3.6 2区 医学 Q2 HEALTH POLICY & SERVICES Pub Date : 2022-11-01 Epub Date: 2021-07-07 DOI: 10.1080/14461242.2021.1950024
Ediomo-Ubong Ekpo Nelson

Chronic pain management among marginalised populations have been extensively researched in North America, particularly amidst the opioid crisis. But little published research exists on this subject from Africa. This study explored experiences and management of chronic pain among marginalised women in the context of regulation of opioid prescribing using data from 16 qualitative interviews with women who use drugs (WWUD) in Uyo, Nigeria. Chronic pain was exacerbated by structural and everyday violence that acted to marginalise women and create a context of risk for inadequately managed pain. Participants experienced difficulty accessing biomedical pain management due to structural and systemic barriers, including cost, restrictions on opioid prescribing, stigma and other discriminatory practices, communication barriers and lack of social support. Restrictions on opioid prescribing and systemic discriminations against marginalised WWUD encouraged reliance on informal sources for falsified and substandard medications for pain treatment, which increased the risk of harm. Findings highlight a need for multi-component responses that address structural and systemic barriers to pain management, including improving access to opioid medications.

在北美,边缘化人群的慢性疼痛管理已经得到了广泛的研究,特别是在阿片类药物危机期间。但很少有来自非洲的关于这一主题的公开研究。本研究利用对尼日利亚尤约吸毒妇女(WWUD)进行的16次定性访谈的数据,探讨了在阿片类药物处方监管背景下边缘化妇女慢性疼痛的经历和管理。结构性暴力和日常暴力加剧了慢性疼痛,这些暴力使妇女边缘化,并造成疼痛管理不当的风险。由于结构性和系统性障碍,包括成本、对阿片类药物处方的限制、耻辱和其他歧视性做法、沟通障碍和缺乏社会支持,与会者难以获得生物医学疼痛管理。对阿片类药物处方的限制和对边缘化妇女的系统性歧视鼓励了对非正规来源的伪造和不合格药物的依赖,从而增加了伤害的风险。研究结果强调需要采取多成分反应,解决疼痛管理的结构性和系统性障碍,包括改善阿片类药物的可及性。
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引用次数: 8
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Health Sociology Review
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