Health Sociology Review最新文献

Aboriginal participatory action research (APAR) has an ethical focus that corrects the imbalances of colonisation through participation and shared decision-making to position people, place, and intention at the centre of research. APAR supports researchers to respond to the community's local rhythms and culture. APAR supports researchers to respond to the community's local rhythms and culture. First Nations scholars and their allies do this in a way that decolonises mainstream approaches in research to disrupt its cherished ideals and endeavours. How these knowledges are co-created and translated is also critically scrutinised. We are a team of intercultural researchers working with community and mainstream health service providers to improve service access, responsiveness, and Aboriginal client outcomes. Our article begins with an overview of the APAR literature and pays homage to the decolonising scholarship that champions Aboriginal ways of knowing, being, and doing. We present a research program where Aboriginal Elders, as cultural guides, hold the research through storying and cultural experiences that have deepened relationships between services and the local Aboriginal community. We conclude with implications of a community-led engagement framework underpinned by a relational methodology that reflects the nuances of knowledge translation through a co-creation of new knowledge and knowledge exchange.

Knowledge translation represents an avenue to address the oft-cited chasm between what should and what does happen in healthcare. Knowledge translation encompasses myriad processes through which different knowledges coalesce to inform practice. However, some reports suggest that experiences with knowledge translation are less than favourable. To better understand these experiences, a systematic scoping review of academic literature was conducted to unveil the unintended negative consequences of knowledge translation and how they were addressed. After screening 9,598 publications, six reported evidence of unintended negative consequences. The most prevalent was emotional labour - negative emotional or psychological sequelae, depression, anxiety, powerlessness, and frustration. These consequences were experienced by knowledge translation brokers, knowledge translation recipients, and knowledge translation producers. All but one publication offered some discussion of strategies to manage or mitigate these unintended negative consequences, including co-design, collaboration, and supported dialogue. These findings suggest there is limited research that explicates the unintended negative consequences of knowledge translation. Given the importance of knowledge translation, this review indicates there is considerable opportunity to advance it, in a better-informed way. Only by considering the unintended negative consequences of knowledge translation can they be identified, addressed, and potentially moderated, if not averted.

As the world contends with the COVID-19 pandemic, scientific expertise has permeated political discourse and the phrase 'following the science' is being used to build trust and justify government decision-making. This phrase reflects a problematic assumption that there is one objective science to follow and that the use of scientific knowledge in decision-making is inherently neutral. In this article, we examine more closely the dense and intricate relationships, values, politics, and interests that determine whose knowledge counts, who gets to speak, who is spoken for, and with what consequences, in the translation of scientific knowledge. Drawing key insights from Stengers' Manifesto for Slow Science, we argue that implementation science has a central role to play in problematising the historic dominance of certain voices and institutional structures that have come to symbolise trust, rigour, and knowledge. Yet to date, implementation science has tended to overlook these economic, social, historical, and political forces. Fraser's conception of social justice and Jasanoff's 'technologies of humility' are introduced as useful frameworks to extend the capacity of implementation science to engage the broader public as an 'intelligent public' in the translation of knowledge, during and beyond the pandemic.

Collaborative approaches to knowledge translation seek to make research useful and applicable, by centring the perspectives and concerns of healthcare actors (rather than researchers) in problem formulation and solving. Such research thus involves multiple actors, in interaction with pre-existing ecologies of knowledge and expertise. Although collaboration is emphasised, conflict, dissonance, and other tensions, may arise from the multiplicity of perspectives and power dynamics involved. Our article examines knowledge translation in this space, as both empirical focus and research methodology. Drawing from practice theory and critical pedagogy, we describe knowledge translation as a situated and social process of transformative learning, enabled by reflexive dialogue about practice, and supported by care. With examples from five studies across two countries, we show that practice-based knowledge translation can be mediated by researchers, using video-reflexive ethnography. We describe the importance (and features) of practices of care in these studies, that created psychological safety for transformative learning. We argue that attempts to transform and improve healthcare must account for sustained and reciprocal care, both for, and between, those made vulnerable in the process, and that knowledge translation can, and should, be a process of capacity strengthening, with care as a core principle and practice.

While there is a well-developed body of literature in the health field that describes processes to implement research, there is a dearth of similar literature in the disability field of research involving complex conditions. Moreover, the development of meaningful and sustainable knowledge translation is now a standard component of the research process. Knowledge users, including community members, service providers, and policy makers now call for evidence-led meaningful activities to occur rapidly. In response, this article presents a case study that explores the needs and priorities of Aboriginal and Torres Strait Islander women in Australia who have experienced a traumatic brain injury due to family violence. Drawing on the work of Indigenous disability scholars such as Gilroy, Avery and others, this article describes the practical and conceptual methods used to transform research to respond to the realities of community concerns and priorities, cultural considerations and complex safety factors. This article offers a unique perspective on how to increase research relevance to knowledge users and enhance the quality of data collection while also overcoming prolonged delays of knowledge translation that can result from the research-production process.

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.

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.

This article uses neo-Weberian social closure theory and Bourdieu's theory of symbolic violence to examine the epistemic tension between biomedicine and traditional Chinese medicine (TCM) in Aotearoa New Zealand (NZ), a country that aspires to a multicultural model of healthcare. Drawing on interviews with TCM practitioners and analysis of TCM practitioners' attempt to become a regulated profession, we argue that a multicultural health model remains a myth as biomedical stakeholders deploy material and symbolic forms of social closure that limit the scope of TCM practice. Discourses of the need for scientific evidence, public safety, qualification standards and English language fluency undermine the culturally distinctive but pragmatic forms of medicine that TCM practitioners utilise. This has implications for TCM as practitioners are denied public funding, their scope of practice is limited, and the expectations for TCM to conform to a biomedical model of healthcare have created tensions within the TCM community.

This paper contributes to the debate regarding the adoption/rejection of technologies by focusing on the selective use of therapeutic devices among people with type 1 diabetes. I show that patients often refuse to use a device (either insulin pumps or sensors for glycaemic control), despite suggestions from diabetologists. The study was conducted in Italy in 2019. Theoretically, the paper relied on a perspective that amalgamates actor-network theory and postphenomenology around the key concept of multistability. I then detected the three main features of stabilities that explain device use/non-use: relation to embodied users, contextual embedment (within larger social assemblages), concrete tailoring. Findings helped to stress the relevance of not only focusing on the type of device and its technical functioning, but also unveiling the underlying ongoing and situated socio-technical processes. Selective adoption of devices should be investigated at the level of the whole patient-device assemblage in order to assess the diverse stabilities that may arise from such networks.