Pub Date : 2019-07-29DOI: 10.1080/14461242.2019.1633945
K. Dew, J. Barton, J. Stairmand, D. Sarfati, L. Signal
ABSTRACT Patient-centred care requires patients to be active participants in decision-making in consultations. Decision-making participation requires patients to understand their condition and to be able to convey their health literacy to medical specialists they encounter. Based on conversation analysis of 18 audio-recorded consultations between cancer patients and a range of cancer care specialists, this article analyses the ways cancer specialists attempt to ascertain their patient’s understanding of their disease. Cancer specialists routinely enquire about their patient’s understanding. In doing so, they phrase enquiries in different ways, resulting in different patient responses. How questions are phrased can require patients to deal with contradictory norms in the consultation, such as the patient being competent but not assuming medical expertise, and potentially hinder patient participation. Alternatively, questions can allow patients to draw on their own experience and so facilitate greater patient involvement. Questions aimed directly at the patient’s medical understanding result in minimal or negative responses. In contrast, questions directed at what the patient has been told or has experienced, elicit longer and more in-depth responses from the patient. This analysis illuminates the co-construction of cancer specialist consultations and suggests simple ways in which patient involvement in the consultation can be facilitated.
{"title":"Ascertaining patients’ understandings of their condition: a conversation analysis of contradictory norms in cancer specialist consultations","authors":"K. Dew, J. Barton, J. Stairmand, D. Sarfati, L. Signal","doi":"10.1080/14461242.2019.1633945","DOIUrl":"https://doi.org/10.1080/14461242.2019.1633945","url":null,"abstract":"ABSTRACT Patient-centred care requires patients to be active participants in decision-making in consultations. Decision-making participation requires patients to understand their condition and to be able to convey their health literacy to medical specialists they encounter. Based on conversation analysis of 18 audio-recorded consultations between cancer patients and a range of cancer care specialists, this article analyses the ways cancer specialists attempt to ascertain their patient’s understanding of their disease. Cancer specialists routinely enquire about their patient’s understanding. In doing so, they phrase enquiries in different ways, resulting in different patient responses. How questions are phrased can require patients to deal with contradictory norms in the consultation, such as the patient being competent but not assuming medical expertise, and potentially hinder patient participation. Alternatively, questions can allow patients to draw on their own experience and so facilitate greater patient involvement. Questions aimed directly at the patient’s medical understanding result in minimal or negative responses. In contrast, questions directed at what the patient has been told or has experienced, elicit longer and more in-depth responses from the patient. This analysis illuminates the co-construction of cancer specialist consultations and suggests simple ways in which patient involvement in the consultation can be facilitated.","PeriodicalId":46833,"journal":{"name":"Health Sociology Review","volume":"28 1","pages":"229 - 244"},"PeriodicalIF":3.6,"publicationDate":"2019-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14461242.2019.1633945","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43484747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-23DOI: 10.1080/14461242.2019.1642124
C. Varcoe, A. Browne, Amélie Blanchet Garneau
ABSTRACT Racial discrimination is primarily conceptualised and dealt with at the individual level in health research and practice. Most conceptualisations, and the measures which follow, are grounded in stress-coping theories thus reinforcing individual level understandings. This draws attention away from how structures and systems reproduce racial discrimination, and further supports the very racial categorisations upon which racism depends. The purpose of this paper is to discuss the relevance of critical theoretical perspectives in conceptualising racial discrimination and how it is taken-up and measured in health research. Drawing on Indigenous, Black and material feminist, intersectional, critical race, postcolonial and political economy perspectives, we propose that racial discrimination can most usefully be understood as a relational socio-historical concept. Racial discrimination understood at the systemic level in research and measurement will support more effective policies and practices to mitigate intersecting forms of discrimination in healthcare. Critical theoretical approaches to studying racial discrimination in health research could inform future analyses needed to address and limit the harms perpetuated through individual and structural forms of discrimination.
{"title":"Beyond stress and coping: the relevance of critical theoretical perspectives to conceptualising racial discrimination in health research","authors":"C. Varcoe, A. Browne, Amélie Blanchet Garneau","doi":"10.1080/14461242.2019.1642124","DOIUrl":"https://doi.org/10.1080/14461242.2019.1642124","url":null,"abstract":"ABSTRACT Racial discrimination is primarily conceptualised and dealt with at the individual level in health research and practice. Most conceptualisations, and the measures which follow, are grounded in stress-coping theories thus reinforcing individual level understandings. This draws attention away from how structures and systems reproduce racial discrimination, and further supports the very racial categorisations upon which racism depends. The purpose of this paper is to discuss the relevance of critical theoretical perspectives in conceptualising racial discrimination and how it is taken-up and measured in health research. Drawing on Indigenous, Black and material feminist, intersectional, critical race, postcolonial and political economy perspectives, we propose that racial discrimination can most usefully be understood as a relational socio-historical concept. Racial discrimination understood at the systemic level in research and measurement will support more effective policies and practices to mitigate intersecting forms of discrimination in healthcare. Critical theoretical approaches to studying racial discrimination in health research could inform future analyses needed to address and limit the harms perpetuated through individual and structural forms of discrimination.","PeriodicalId":46833,"journal":{"name":"Health Sociology Review","volume":"28 1","pages":"245 - 260"},"PeriodicalIF":3.6,"publicationDate":"2019-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14461242.2019.1642124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49558444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-04DOI: 10.1080/14461242.2019.1614859
K. Willis, S. Maclean
{"title":"New Editorial Team for Health Sociology Review","authors":"K. Willis, S. Maclean","doi":"10.1080/14461242.2019.1614859","DOIUrl":"https://doi.org/10.1080/14461242.2019.1614859","url":null,"abstract":"","PeriodicalId":46833,"journal":{"name":"Health Sociology Review","volume":"28 1","pages":"105 - 106"},"PeriodicalIF":3.6,"publicationDate":"2019-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14461242.2019.1614859","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41550146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-15DOI: 10.1080/14461242.2019.1604150
A. Bombak, A. Meadows, J. Billette
ABSTRACT Weight stigma is pervasive in the US, with body size being pathologised and weight loss urged for those of higher weights. However, there is a growing movement for fat acceptance and body positivity. The present study explored perceptions and experiences of cultural body acceptance trends among Midwestern American women who are trying to, or have tried to, ‘accept’ their bodies. Participants (n = 18) are self-identified women who have ever been labelled ‘obese’ on the Body Mass Index and have ever tried to develop a more positive relationship with their bodies. Participants were interviewed three times over the course of approximately one year using a semi-structured interview guide that explored their perceptions of how society represented and treated those of a higher weight. Interviews were recorded and transcribed verbatim, and interviews and field-notes analysed thematically. Emergent themes included greater (mixed) representation, lip service, and inclusive cultures. Ultimately, participants positioned shifting attitudes towards fat bodies within wider social trends toward greater inclusion and diversity in general, but remained frustrated by ceilings of acceptable size, disingenuous messaging, and cultural backsliding.
{"title":"Fat acceptance 101: Midwestern American women’s perspective on cultural body acceptance","authors":"A. Bombak, A. Meadows, J. Billette","doi":"10.1080/14461242.2019.1604150","DOIUrl":"https://doi.org/10.1080/14461242.2019.1604150","url":null,"abstract":"ABSTRACT Weight stigma is pervasive in the US, with body size being pathologised and weight loss urged for those of higher weights. However, there is a growing movement for fat acceptance and body positivity. The present study explored perceptions and experiences of cultural body acceptance trends among Midwestern American women who are trying to, or have tried to, ‘accept’ their bodies. Participants (n = 18) are self-identified women who have ever been labelled ‘obese’ on the Body Mass Index and have ever tried to develop a more positive relationship with their bodies. Participants were interviewed three times over the course of approximately one year using a semi-structured interview guide that explored their perceptions of how society represented and treated those of a higher weight. Interviews were recorded and transcribed verbatim, and interviews and field-notes analysed thematically. Emergent themes included greater (mixed) representation, lip service, and inclusive cultures. Ultimately, participants positioned shifting attitudes towards fat bodies within wider social trends toward greater inclusion and diversity in general, but remained frustrated by ceilings of acceptable size, disingenuous messaging, and cultural backsliding.","PeriodicalId":46833,"journal":{"name":"Health Sociology Review","volume":"28 1","pages":"194 - 208"},"PeriodicalIF":3.6,"publicationDate":"2019-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14461242.2019.1604150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44396409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-11DOI: 10.1080/14461242.2019.1601027
Ángel R. Zapata-Moya, Barbara Willems, Piet Bracke
ABSTRACT Fundamental Cause Theory suggests the replacement of mechanisms that produce the persistent relationship between socioeconomic status and health over time. Understanding how this process operates is central to explaining the reproduction of health inequality. We use data from the Onco-barometer survey (2010) to test a set of hypotheses derived from FCT, Diffusion Of Innovations theory and the intersection between these theories to examine how socioeconomic inequality emerges and evolves across the cycle of diffusion of six relevant preventive practices in Spain: faecal occult blood tests, prostate-specific antigen tests, Papanicolaou tests, mammograms, cholesterol readings and blood-pressure checks. Because these preventive measures are characterised by differing rates of spontaneous knowledge and use amongst the Spanish population, we assume that they are at different stages in the diffusion cycle. Results suggest that SES has a dynamic influence according to the diffusion stage of each preventive measure. We argue that the conjunction of these theories offers a dynamic ‘imagery’ that can help to explain the generation and diminishment of inequalities. Moreover, this integration has the potential to bring ‘social change’ back into the study of health inequalities, which is essential to understanding equitable (and inequitable) returns produced by preventive innovations.
{"title":"The (re)production of health inequalities through the process of disseminating preventive innovations: the dynamic influence of socioeconomic status","authors":"Ángel R. Zapata-Moya, Barbara Willems, Piet Bracke","doi":"10.1080/14461242.2019.1601027","DOIUrl":"https://doi.org/10.1080/14461242.2019.1601027","url":null,"abstract":"ABSTRACT Fundamental Cause Theory suggests the replacement of mechanisms that produce the persistent relationship between socioeconomic status and health over time. Understanding how this process operates is central to explaining the reproduction of health inequality. We use data from the Onco-barometer survey (2010) to test a set of hypotheses derived from FCT, Diffusion Of Innovations theory and the intersection between these theories to examine how socioeconomic inequality emerges and evolves across the cycle of diffusion of six relevant preventive practices in Spain: faecal occult blood tests, prostate-specific antigen tests, Papanicolaou tests, mammograms, cholesterol readings and blood-pressure checks. Because these preventive measures are characterised by differing rates of spontaneous knowledge and use amongst the Spanish population, we assume that they are at different stages in the diffusion cycle. Results suggest that SES has a dynamic influence according to the diffusion stage of each preventive measure. We argue that the conjunction of these theories offers a dynamic ‘imagery’ that can help to explain the generation and diminishment of inequalities. Moreover, this integration has the potential to bring ‘social change’ back into the study of health inequalities, which is essential to understanding equitable (and inequitable) returns produced by preventive innovations.","PeriodicalId":46833,"journal":{"name":"Health Sociology Review","volume":"28 1","pages":"177 - 193"},"PeriodicalIF":3.6,"publicationDate":"2019-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14461242.2019.1601027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59797498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-02DOI: 10.1080/14461242.2019.1600380
Olivia A. King, S. Nancarrow, S. Grace, A. Borthwick
ABSTRACT Diabetes presents a challenge to healthcare services worldwide. Diabetes educators work with individuals and communities to reduce the impact of diabetes. In Australia, diabetes educators derive from one of several primary qualifications including nursing, medicine or a specified allied health background, and have an accredited postgraduate qualification in diabetes education. The peak professional body, the Australian Diabetes Educators Association (ADEA), promotes equivalence of all diabetes educators in terms of their scope of practice. However, in practice, there is evidence of inequities, particularly between those from nursing and allied health backgrounds. This paper uses a neo-Weberian lens to explore the interprofessional role dynamics of a ‘postprofessional’ group of practitioners, who adopt a common role and title to create a professional identity at post-qualifying level. Data were collected via individual interviews with 19 stakeholders and analysed using an abductive template approach. Differential role boundaries between nurse and allied health diabetes educators were established and reinforced in several ways. Diabetes education is considered a sub-specialty of nursing only; access to education and credentialing has been restricted for allied health; reinforcement of professional stereotypes and perceived professional values; and perceived legislative differences in access to medication management for nurse and allied health diabetes educators.
{"title":"Interprofessional role boundaries in diabetes education in Australia","authors":"Olivia A. King, S. Nancarrow, S. Grace, A. Borthwick","doi":"10.1080/14461242.2019.1600380","DOIUrl":"https://doi.org/10.1080/14461242.2019.1600380","url":null,"abstract":"ABSTRACT Diabetes presents a challenge to healthcare services worldwide. Diabetes educators work with individuals and communities to reduce the impact of diabetes. In Australia, diabetes educators derive from one of several primary qualifications including nursing, medicine or a specified allied health background, and have an accredited postgraduate qualification in diabetes education. The peak professional body, the Australian Diabetes Educators Association (ADEA), promotes equivalence of all diabetes educators in terms of their scope of practice. However, in practice, there is evidence of inequities, particularly between those from nursing and allied health backgrounds. This paper uses a neo-Weberian lens to explore the interprofessional role dynamics of a ‘postprofessional’ group of practitioners, who adopt a common role and title to create a professional identity at post-qualifying level. Data were collected via individual interviews with 19 stakeholders and analysed using an abductive template approach. Differential role boundaries between nurse and allied health diabetes educators were established and reinforced in several ways. Diabetes education is considered a sub-specialty of nursing only; access to education and credentialing has been restricted for allied health; reinforcement of professional stereotypes and perceived professional values; and perceived legislative differences in access to medication management for nurse and allied health diabetes educators.","PeriodicalId":46833,"journal":{"name":"Health Sociology Review","volume":"28 1","pages":"162 - 176"},"PeriodicalIF":3.6,"publicationDate":"2019-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14461242.2019.1600380","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45091823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-18DOI: 10.1080/14461242.2019.1581988
V. Seibel
ABSTRACT Although an increasing number of studies emphasise migrants’ knowledge about their healthcare rights as crucial for their healthcare usage, almost none examine the conditions under which migrants acquire this knowledge. This study contributes to the literature by studying the main determinants of migrants’ knowledge about their healthcare rights: Self-interest and necessity, human capital, and social capital. I use unique data collected through the project Migrants’ Welfare State Attitudes (MIFARE), where we surveyed 10 different migrant groups within Denmark, the Netherlands, and Germany on their relation to the welfare state, including healthcare. Analysing a total sample of 6,864 migrants using multinomial logistic regression analyses I find that migrants’ knowledge about their healthcare rights depends mainly on their education and language skills. Both factors enable migrants to grasp health-related information and to become informed about their healthcare rights. I also observe a network effect since healthcare experiences of family members contribute to migrants’ healthcare knowledge. Social ties to the co-ethnic community, however, do not explain why some migrants know more about their healthcare rights than others. Lastly, I find large differences between migrant groups, which remain even after controlling for all relevant factors.
{"title":"Determinants of migrants’ knowledge about their healthcare rights","authors":"V. Seibel","doi":"10.1080/14461242.2019.1581988","DOIUrl":"https://doi.org/10.1080/14461242.2019.1581988","url":null,"abstract":"ABSTRACT Although an increasing number of studies emphasise migrants’ knowledge about their healthcare rights as crucial for their healthcare usage, almost none examine the conditions under which migrants acquire this knowledge. This study contributes to the literature by studying the main determinants of migrants’ knowledge about their healthcare rights: Self-interest and necessity, human capital, and social capital. I use unique data collected through the project Migrants’ Welfare State Attitudes (MIFARE), where we surveyed 10 different migrant groups within Denmark, the Netherlands, and Germany on their relation to the welfare state, including healthcare. Analysing a total sample of 6,864 migrants using multinomial logistic regression analyses I find that migrants’ knowledge about their healthcare rights depends mainly on their education and language skills. Both factors enable migrants to grasp health-related information and to become informed about their healthcare rights. I also observe a network effect since healthcare experiences of family members contribute to migrants’ healthcare knowledge. Social ties to the co-ethnic community, however, do not explain why some migrants know more about their healthcare rights than others. Lastly, I find large differences between migrant groups, which remain even after controlling for all relevant factors.","PeriodicalId":46833,"journal":{"name":"Health Sociology Review","volume":"28 1","pages":"140 - 161"},"PeriodicalIF":3.6,"publicationDate":"2019-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14461242.2019.1581988","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49126707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-18DOI: 10.1080/14461242.2019.1579664
H. Hanisch, P. Solvang
ABSTRACT This study analyses the narratives of people on long-term sick leave due to low back pain. We draw upon the theory of justification – as developed by the French sociologists Luc Boltanski and Laurent Thévenot – to investigate how the informants’ narratives evoke and rely upon three ‘orders of worth’. These are the industrial order concerning being a productive citizen, the domestic order of home and family, and the civic order positioning the citizen in the regulations of the welfare state. In-depth interview interpretations map a strongly normative urge to work. The interviews also demonstrate how this urge in interwoven with social interactions in specific arenas: a troubled home life when not working, ways of keeping in touch with work, and complex negotiations of the possibility of non-work. The different orders of worth do more than point towards their ‘own’ arena: Norms and values of the domestic order, in particular, point toward the need for return to work rather than towards life at home (non-work). We conclude that the narratives deal more with the trouble of sick leave than with the enjoyment of work. Hence, the urge to work is just as much a turn away from non-work.
{"title":"The urge to work: normative ordering in the narratives of people on long-term sick leave","authors":"H. Hanisch, P. Solvang","doi":"10.1080/14461242.2019.1579664","DOIUrl":"https://doi.org/10.1080/14461242.2019.1579664","url":null,"abstract":"ABSTRACT This study analyses the narratives of people on long-term sick leave due to low back pain. We draw upon the theory of justification – as developed by the French sociologists Luc Boltanski and Laurent Thévenot – to investigate how the informants’ narratives evoke and rely upon three ‘orders of worth’. These are the industrial order concerning being a productive citizen, the domestic order of home and family, and the civic order positioning the citizen in the regulations of the welfare state. In-depth interview interpretations map a strongly normative urge to work. The interviews also demonstrate how this urge in interwoven with social interactions in specific arenas: a troubled home life when not working, ways of keeping in touch with work, and complex negotiations of the possibility of non-work. The different orders of worth do more than point towards their ‘own’ arena: Norms and values of the domestic order, in particular, point toward the need for return to work rather than towards life at home (non-work). We conclude that the narratives deal more with the trouble of sick leave than with the enjoyment of work. Hence, the urge to work is just as much a turn away from non-work.","PeriodicalId":46833,"journal":{"name":"Health Sociology Review","volume":"28 1","pages":"126 - 139"},"PeriodicalIF":3.6,"publicationDate":"2019-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14461242.2019.1579664","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49514135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-12DOI: 10.1080/14461242.2019.1578984
Natalie Jovanovski, K. Cook
ABSTRACT The nutritional health and wellbeing of children, and by extension their weight, is a heated topic in contemporary discussions of food and health, particularly for low-income populations. Despite contrary understandings, there remains a dominant societal framing that parents – in particular low-income mothers – are solely responsible for the status of their children’s health and wellbeing. In this paper, we examine how low-income mothers are positioned within the academic literature to reveal where responsibility for children’s health and well-being is positioned. We present a meta-synthesis of 18 qualitative studies to identify how mothers’ food choices and feeding are positioned, and the recommendations that researchers identify for promoting child health within this discursive terrain. We found that low-income mothers faced multiple challenges relating to cost, convenience, concerns about health and wellbeing. However, many of the recommendations made by researchers focused extensively on behavioural interventions aimed at the vulnerable mother rather than structural interventions to support mothers’ feeding practices. We argue that discourses of low-income motherhood must recommend structural, and not just individual, change to counteract dominant constructions of the ‘vulnerable-empowered mother’.
{"title":"The vulnerable-empowered mother of academic food discourses: a qualitative meta-synthesis of studies of low-income mothers and food provisioning","authors":"Natalie Jovanovski, K. Cook","doi":"10.1080/14461242.2019.1578984","DOIUrl":"https://doi.org/10.1080/14461242.2019.1578984","url":null,"abstract":"ABSTRACT The nutritional health and wellbeing of children, and by extension their weight, is a heated topic in contemporary discussions of food and health, particularly for low-income populations. Despite contrary understandings, there remains a dominant societal framing that parents – in particular low-income mothers – are solely responsible for the status of their children’s health and wellbeing. In this paper, we examine how low-income mothers are positioned within the academic literature to reveal where responsibility for children’s health and well-being is positioned. We present a meta-synthesis of 18 qualitative studies to identify how mothers’ food choices and feeding are positioned, and the recommendations that researchers identify for promoting child health within this discursive terrain. We found that low-income mothers faced multiple challenges relating to cost, convenience, concerns about health and wellbeing. However, many of the recommendations made by researchers focused extensively on behavioural interventions aimed at the vulnerable mother rather than structural interventions to support mothers’ feeding practices. We argue that discourses of low-income motherhood must recommend structural, and not just individual, change to counteract dominant constructions of the ‘vulnerable-empowered mother’.","PeriodicalId":46833,"journal":{"name":"Health Sociology Review","volume":"28 1","pages":"107 - 125"},"PeriodicalIF":3.6,"publicationDate":"2019-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14461242.2019.1578984","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46327563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-02DOI: 10.1080/14461242.2018.1475249
E. Tolhurst, M. Carey, Bernhard Weicht, P. Kingston
ABSTRACT In England there has been substantial policy development and an academic drive to promote the goal of ‘living well’ for people with dementia and their family members. This article critically evaluates the feasibility of this intention, with reference to the experience of those caring for people with the condition. Qualitative data are utilised from a study which explored how couples negotiate relationships and care. The focus of this paper is the perspectives of spousal carers and the challenges they encounter within their caring role. Views were obtained via semi-structured joint interviews where the carer participated alongside the person with dementia. The extent to which living well with dementia is a credible aspiration for carers is examined via three themes: identity subsumed under care responsibilities; the couple as an isolated family unit; and barriers to professional support. The findings highlight that experience of caring is highly complex and fraught with multiple practical, emotional and moral pressures. It is asserted that research into dementia and care relationships must avoid a zero sum situation, prompted by living well discourses, where attempts to bolster the position of people with dementia compound the marginalisation and stigmatisation of informal carers.
{"title":"Is living well with dementia a credible aspiration for spousal carers?","authors":"E. Tolhurst, M. Carey, Bernhard Weicht, P. Kingston","doi":"10.1080/14461242.2018.1475249","DOIUrl":"https://doi.org/10.1080/14461242.2018.1475249","url":null,"abstract":"ABSTRACT In England there has been substantial policy development and an academic drive to promote the goal of ‘living well’ for people with dementia and their family members. This article critically evaluates the feasibility of this intention, with reference to the experience of those caring for people with the condition. Qualitative data are utilised from a study which explored how couples negotiate relationships and care. The focus of this paper is the perspectives of spousal carers and the challenges they encounter within their caring role. Views were obtained via semi-structured joint interviews where the carer participated alongside the person with dementia. The extent to which living well with dementia is a credible aspiration for carers is examined via three themes: identity subsumed under care responsibilities; the couple as an isolated family unit; and barriers to professional support. The findings highlight that experience of caring is highly complex and fraught with multiple practical, emotional and moral pressures. It is asserted that research into dementia and care relationships must avoid a zero sum situation, prompted by living well discourses, where attempts to bolster the position of people with dementia compound the marginalisation and stigmatisation of informal carers.","PeriodicalId":46833,"journal":{"name":"Health Sociology Review","volume":"28 1","pages":"54 - 68"},"PeriodicalIF":3.6,"publicationDate":"2019-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14461242.2018.1475249","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43036444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：