Qualitative Health Research最新文献

American healthcare involves expanding medical technologies and innovations in treatment to improve health outcomes and longevity. Social scientists have argued that this is explained by the moralization of health and cultural attitudes toward imperatives to treat, pointing to the U.S. healthcare system as one that rewards healthy behaviors and "curing" rather than "caring." In this article, we analyze early-stage oncology encounters to understand how patients come to understand what constitutes oncology treatment at the outset of their treatment journey. In these visits (n = 23), we use conversation analysis to identify behaviors used across interactants to frame medically intensive treatment. Ultimately, we find that physicians, patients, and their families orient to patients having a moral responsibility to extend their lives as much as possible through aggressive treatment even when that entails unpleasant side effects, risks, or substantial time investments.

This study investigated the use of group body mapping as a methodological tool to explore experiences of obstetric violence among migrant women from Senegal, Morocco, and Pakistan in Catalonia. The research aimed to assess the effectiveness of group body mapping in identifying the barriers these women faced during pregnancy, childbirth, and the postpartum period, while also highlighting the intersectional dimensions of obstetric violence. The study identified seven key codes-Issues/Barriers, Trust, Gender, Body/Embodiment, Significant Relationships, Employment, and Gender-Based Violence-which were analyzed from an intersectional perspective. Group body mapping was presented as an effective strategy to visualize structural and invisible barriers, offering a deeper understanding of the sociocultural dynamics that affected migrant women's access to and experience of sexual and reproductive health services. This technique complemented traditional research methods by capturing complex narratives and revealing systemic structures tied to social status, gender, religion, language, and age. It empowered women to reclaim agency over their experiences within historically medicalized and colonized healthcare systems. Ultimately, the research highlighted the transformative potential of group body mapping in advancing healthcare equity and promoting culturally and gender-sensitive sexual and reproductive health services for marginalized populations.

Journey maps are graphic representations of participant, user, customer, or patient experiences or "journeys" with a particular phenomenon, product, business, or organization. Journey maps help visualize complex pathways and phases in accessible, digestible ways. They also capture emotions, reactions, and values associated with the processes participants undergo, complemented by images or quotes from participants. Here, we outline the foundations of journey maps in research and in practice settings. Our goal is to describe journey maps to researchers new to the product and emphasize the novelty and utility of journey maps as visual products from qualitative research particularly in a health setting. To explore journey maps-including their benefits, drawbacks, and relevance-we discuss examples including our own process for designing a journey map of food insecure Veterans' experiences using qualitative, in-depth interviews and supported by member checking. Our journey map depicts food insecurity as a repetitive process, a unique contribution given that many journey maps are designed with discrete starting and stopping points. We conclude by discussing the novelty of journey maps as innovative products that researchers can use to identify opportunities for process improvements and innovation using multiple data sources or methods.

Therapeutic communities (TCs) have been a longstanding intervention for individuals with complex mental health needs; however, there remains a lack of research into how UK-based TCs work to support their members. Modifications to TCs include the merging of "concept" and "democratic" TC practices, producing a "fusion" model. The aim of this study was to explore processes of change that occur within a community-based, non-residential "fusion" TC across two community sites. This was done through exploring lived experiences of active members and graduates of an established and a newer TC site. Eleven participants took part in online or face-to-face interviews. Interviews were analyzed using interpretative phenomenological analysis. Three themes emerged from the analysis: (1) Exploring the Authentic Self: Encouraged and Supported in Showing Emotional Vulnerability Within the TC (subthemes: "Nowhere to Hide": Sharing With Others and Looking Back to Move Forward: Reflecting On Change and Self-Discovery); (2) Developing a Sense of Community: Learning to Navigate Relationships Within the TC (subthemes: "They seem to fit": Building Connection With Others and Unravelling the Clashes: Holding Space to Manage and Tolerate Conflict); and (3) "Me to We": The Lasting Benefits of the TC Co-Production Experience. Staff were integral in supporting change identified across all three themes. The findings highlight processes that could be implemented into existing TCs to support change for members and evolve the community structure. The study provides insights into how TC practice could be informed to accommodate the growing diversity of TC members and support staff development.

Artificial intelligence (AI) is now routinely deployed in qualitative health. Comparative evaluations indicate that these systems reproduce coding methods but can falter on culturally nuanced or emotionally complex material. Conventional reflexivity guidelines focus on investigator positionality and provide limited guidance for assessing algorithmic influence at early stages in the analysis process. We introduce the AI-Reflexivity Checklist (ARC), a pre-analysis, evidence-informed checkpoint that sets the appropriate human-in-the-loop (HITL) posture-delegate, assist/augment, or human-led-for LLM-assisted qualitative coding of textual data. Literature from science and technology studies, empirical studies of AI-assisted qualitative analysis, and pragmatic workflow models informed the identification of five decision domains: descriptive scope, contextual variation, experiential depth, ethical exposure, and output reversibility. These domains are operationalized as five sequential prompts completed before AI is introduced. If the planned task is purely descriptive, meanings are stable across contexts, experiential nuance is minimal, ethical risk is low, and outputs can be fully revised or reversed; automation is permitted with routine human verification. Elevated ratings on experiential or ethical domains point to an assist/human-led posture unless pilot evidence meets pre-specified acceptance criteria; lack of reversibility remains a blocker because it precludes audit and repair. ARC extends existing reflexivity practice to encompass algorithmic actors, offers a brief record suitable for review, and mitigates early path-dependency toward indiscriminate automation.

This study was conceived by nurse researchers working throughout the pandemic on a COVID ward, aiming to explore in depth the experience of ward staff. Full ethical approval was obtained and in-depth unstructured interviews were conducted with staff members (two doctors, two healthcare assistants, two allied health professionals, and four nurses). Data analysis followed a psychosocial approach using psychoanalytic theory as a tool for examining data. Whilst previous research has identified the emotional labor of work during the COVID pandemic, with subsequent impact on staff mental health and well-being, this is the first study to demonstrate the usefulness of psychoanalytic methodology in this context. Deeper consideration of the internal world and affective experience of the participants in relationship to external events and context enables a complex interpretive understanding of the phenomena. This study therefore provides valuable insight on a different level to that attained through traditional quantitative and qualitative research methods. A psychoanalytic lens of analysis enabled us to develop a model of the elements which combined to lead to psychological disturbance, the institutional defences that inadvertently compounded the experience as traumatic, the personal meaning derived from the experience, which staff members relied on to survive, and the lasting impact. We add to the evidence base around experience of the COVID pandemic, highlighting the profound and long-lasting impact on staff and demonstrating the value of psychoanalytic research methodology. We conclude by discussing the implications of our study for future practice, particularly in terms of leadership and staff well-being.

This study examined how young adults navigate digital self-representation during episodes of depression, focusing on the shift from curated personas to vulnerable disclosures on social media. Grounded in Goffman's dramaturgical theory and Meyrowitz's notion of blurred frontstage/backstage boundaries, the research explores social media as both a performative stage and an emotional refuge. A two-phase qualitative method was employed: digital content related to depression was first mined from participants' social media accounts, and then explored further through semi-structured interviews. Thematic analysis revealed that participants initially masked their struggles to avoid stigma, but many transitioned to more authentic disclosures as a means of seeking support. This shift introduced emotional risks including misrecognition and judgment prompting users to strategically curate content and manage visibility. Rather than a binary of "real" versus "fake" identity, online self-presentation emerged as fluid, contextual, and emotionally negotiated. The study contributes methodologically and theoretically to qualitative health research by adapting dramaturgical theory to digital contexts and highlighting social media's dual role in youth mental health: performative and therapeutic.

Patients on dialysis develop unique relationships with their providers, fellow patients, and the broader healthcare system. This network of relationships is a well-established key factor influencing both their healthcare experience and mortality rates. Yet, despite ongoing efforts to improve these networks of relationships, health outcomes remain unfavorable for dialysis patients. Investigating the formation of these relationships through a social media platform provides valuable insight into patients lived experiences, shedding light on pervasive power dynamics as seen from the patient perspective while addressing methodological gaps present in the literature. Analyzing social media platforms helps identify critical areas for improvement that may have been overlooked to enhance the experience and outcomes of patients on dialysis. In this paper, we use Foucauldian discourse analysis to examine 41 posts and their associated comments from the r/dialysis forum on Reddit, focusing on the first year of dialysis initiation and exploring how societal discourse shapes and is shaped by peer-to-peer interactions, impressions, communities, and frameworks. In this study, we highlight how power and resistance are reflected in the discursive choices made by patients, as well as its influence on their conceptualizations of the patient-provider relationship as they begin their dialysis journey. These insights add to the dearth of current literature that use social media platforms and discourse analysis in investigating healthcare experiences. They lay the groundwork for better supporting a vulnerable clinical population and provide a foundation for future academic research using this methodology.

Fathers report feeling sidelined and being treated as secondary parents in healthcare settings. Despite their vital caregiving contributions, fathers remain underrepresented in pediatric palliative care research, particularly outside oncological contexts. This qualitative study, using a phenomenological hermeneutical design, explores the lived experiences of Norwegian fathers raising children with progressive life-limiting conditions. Thirteen fathers of children aged 1-18 years participated in in-depth, semi-structured interviews conducted online or in person. All children had received a diagnosis at least 12 months prior, lived at home, and received varying levels of care support. The analysis followed a modified version of Ricoeur's interpretation theory, as described by Lindseth and Norberg in their three-step phenomenological hermeneutical method, and revealed four themes: (1) "Balancing between grief and relief," where fathers described emotional ambivalence during the diagnostic phase; (2) "Searching for stability in an unpredictable life," where fathers often turned to information and peer support to manage uncertainty; (3) "Feeling homebound yet making space for life," where many felt confined to the home but made deliberate efforts to create meaningful experiences for their children and themselves; and (4) "Juggling between being a dad, caregiver, and breadwinner," where fathers navigated complex and often conflicting roles. The findings highlight the emotional and practical challenges fathers face and underscore the importance of recognizing their unique support needs. Proactive involvement in care planning, access to pediatric palliative care services, peer networks, and respite opportunities are essential not only for the child's well-being but also to sustain fathers' caregiving capacity.

Artificial intelligence (AI) is increasingly integrated into care systems, yet little is known about how care service providers perceive and respond to AI in their service provision in the context of supporting culturally and linguistically diverse migrants with disabilities. This study draws on an intersectionality-informed, arts-based research approach to explore how care providers make sense of AI, with attention to how their perceptions are shaped by social identities, professional experiences, and media narratives. A one-act play, constructed from data collected through participatory workshops with 15 care providers, illustrates that participants engage with AI as a relational, emotionally charged, and socially situated phenomenon. Their understanding reflected intersecting experiences of racialization, migration, gender, and labor precarity, as well as exposure to dominant media portrayals of AI. Their narratives showed a mix of fear, ambivalence, and cautious optimism rooted in concern about job security and loss of relational care, alongside hopes that AI might enhance accessibility and reduce human error. The play-based format captured the dialogic, affective, and embodied dimensions of participants' meaning-making, challenging technocratic and disembodied ways of knowing about AI and care. Findings suggest that inclusive and reflective spaces are critical for care providers to engage meaningfully with AI technologies and that intersectionality must inform the design, governance, and implementation of AI in care settings.