Qualitative Health Research最新文献

parkrun is a free, weekly organized mass participation physical activity event providing a remarkable example of at-scale dissemination, with over 1 million participants and 150,000 volunteers in Australia. This qualitative study draws on stakeholders' experiences to explore how parkrun succeeded with its dissemination and sustainability in Australia. Maximum variation and snowball sampling methods were used to select interviewees representing three parkrun stakeholder groups: parkrun Australia employees; volunteer organizers (event directors and ambassadors); and local external stakeholders (e.g., running clubs and landowners). Semi-structured interviews were conducted with 67 adult stakeholders in two phases (February-May and August-October 2023). We conducted a reflexive thematic analysis of interview data to explore contextual factors and mechanisms of parkrun growth and sustainability. We identify four themes to explain the growth and sustainability of parkrun in Australia: "Belief in an essential parkrun" comprises varied but overlapping ideas of what parkrun is fundamentally about; "Fluidity of movement" reflects the way individuals move freely in and out of the parkrun model, between roles and events; "Organizational and individual evolution" describes individuals' engagement journey and how the organization adapted with growth; and "Shared custodianship" reflects the dispersed leadership and shared responsibility across time, place, and people. These themes illustrate elements of the parkrun model that create broad buy-in, foster stakeholder commitment and longevity, and maximize resources for enhanced reach, dissemination, and sustainability. Our findings contribute practice-based evidence that may inform scale-up and sustainment of similar public health interventions.

COVID-19 impacted many men's intimate partner relationships, with distressed and disrupted partnerships consistently featured in commentaries with linkages to mental health challenges. The current study draws from interviews with 23 Canadian-based men, 19-50 years old, who experienced a break-up during COVID-19. Addressing the research question, "What are the connections between masculinities, men's mental health, and intimate partner relationship break-ups during COVID-19?", three thematic findings were derived: (1) Virtually Together and Growing Apart, (2) Mentally Trapped, and Failing Fast and Slow, and (3) Introspections and Moving On. Virtually Together and Growing Apart describes two contexts wherein men were either challenged by being physically apart from their partner or increasingly estranged while cohabitating with their partner during COVID-19. Mentally Trapped, and Failing Fast and Slow speaks to the stresses of being socially isolated and anxieties about the future with those tensions flowing to and from men's relationships. Featured were fast-tracked endings in terms of many participants knowing early-on the partnership was over, amid drawn out finishes wherein men's relationships gradually ended with the easement of COVID-19 restrictions. Introspections and Moving On varied in that many men were intent on processing and deconstructing all that happened in (and to end) their relationship. Men's learnings were leveraged through accessing professional and peer supports to promote self-growth and purposefully build healthier intimate partnerships. The study findings affirm the need for gender-responsive mental health promotion programs to equip men with relationship skills, while also underscoring the necessity for services dedicated to addressing post-COVID-19 injuries.

Minimal research has explored the personal experience of burnout in doctors from any medical speciality. Consequently, we aimed to provide a relatable description and understanding of this globally recognised problem. We employed an interpretative phenomenological analysis (IPA) of face-to-face interviews with seven general practitioners (GPs) in Northern Ireland, having selected interviewees best able to speak about burnout. We sought to understand how these GPs understood their burnout experiences. Our participants' continuous work involved more than their busy weekdays and also working on supposedly off evenings and weekends. In addition, draining intrusive thoughts of work filled most, if not all, of their other waking moments. There was no respite. Work was 'always there.' Being constantly busy, they had no time to think or attend to patients as doctors. Instead, participants were going through the motions like GP automatons. Their effectiveness, efficiency, and caring were failing, while their interactions with patients had changed as they tried to conserve their now-drained energy and empathy. There was no time left for their families or themselves. They now "existed" to continuously work rather than "living" their previous, more balanced lives that at one time included enjoying being a doctor. Worryingly, participants were struggling, isolated, and vulnerable, yet unwilling to speak to someone they trusted. We intend our burnout narrative to promote discussion between medical colleagues and assist in its recognition by GPs and other doctors. Our findings warn against working excessively, prioritising work ahead of family and oneself, and self-isolation rather than seeking necessary support.

Phenylketonuria (PKU) is a rare metabolic condition characterised by an inability to metabolise phenylalanine (Phe), found in many foods. When pregnant with PKU, women must adhere to a strict low-Phe diet. If they do not, foetal abnormalities or pregnancy loss can occur. Pregnancies are therefore closely clinically monitored and dominated by dietary management, leaving little "space" for women's emotional experience. This article explores the emotional impact of PKU during pregnancy and how this effects pre-natal bonding. Based on interviews with six women with PKU, conducted whilst they were pregnant, this article explores their unusual and previously undocumented experience. Image-making during interviews allowed women to uncover aspects of their experience that might otherwise have remained hidden. Interpretative phenomenological analysis of the transcripts and images generated five themes summarising the women's experiences. Some themes reiterated findings from previous studies, for example, the huge cognitive burden associated with PKU pregnancies and the importance of both expert and informal support to successful pregnancy management. However, new understanding also emerged, including rich description of the emotional load of these pregnancies and strategies that women use to manage this. Anxiety about baby safety was central to their experiences, and the effect of this on pre-natal bonding was explored. This article calls for increased formal and informal support for women with the emotional aspects of their PKU pregnancies, for example, the creation of "attachment-aware" services that support women with their anxiety, promoting strong pre-natal attachment and subsequently protecting maternal and infant mental health throughout pregnancy and beyond.

In Belgium, adults with psychiatric disorders can opt for euthanasia under strict conditions. The impact of these euthanasia trajectories on close relatives remains insufficiently studied. This research is the first in Belgium to explore the concrete experiences and support needs of relatives involved in psychiatric-based euthanasia trajectories by means of an in-depth interview study. The interviews with 18 relatives were conducted from March to May 2023 and analyzed using inductive thematic coding. The results reveal the complex and ambivalent emotional and cognitive experiences among relatives. Experiences with euthanasia trajectories varied from positive to negative, marked by shared feelings of surrealism and unreality. This included the farewell process that relatives go through, regardless of whether euthanasia was carried out. While the desired level of involvement varied, everyone sought some degree of recognition and understanding for their complex position during the euthanasia procedure, aiding in a better comprehension and contextualization of the request. The level of actual involvement and support depended on the stage of the euthanasia request, their social network, and the reasons behind the request. There was a demand for transparent communication, more emotional and practical support, and assistance in coping with the emotionally charged process. Specific attention is needed for the emotional and cognitive rollercoaster, even if euthanasia is not ultimately pursued. Future research should employ a longitudinal design to gain deeper insights into relatives' fluctuating experiences and support needs throughout euthanasia trajectories. Seeking greater context diversity and combining perspectives in cluster research can improve understanding of interconnected needs.

Healthcare workers (HCWs) experience occupational stressors that negatively impact emotional well-being and exacerbate turnover intentions. In the wake of the COVID-19 pandemic, the resultant acute care turnover rates have reached an all-time high. In addition, occupational stressors lead to psychological stress, including moral distress, defined as the dissonance between perceiving what the right course of action is and encountering an obstacle to acting accordingly. This qualitative descriptive study explored the perceptions of patient-facing HCWs in acute care hospital settings regarding the workplace stressors they encountered and the role of hospital-based chaplains in addressing emotional well-being and stress with 33 interviews. Findings suggest that HCW frequently experience work-related moral distress and seek relief by interacting with hospital chaplains. Chaplain care, common in American healthcare facilities for the spiritual care of patients, is an easily accessible resource to HCWs. Facilitating chaplain-HCW interactions may be an effective strategy for responding to moral distress and improving healthcare workers' well-being.

While the issue of intimate partner homicide (IPH) has gained increasing focus, research that pinpoints the experiences of women who survived an attempted IPH is limited. Specifically, studies that aim to understand the aftermath of surviving such incidents are scarce. Thus, the aim of the present study was to explore the emotional experience of IPH survivors following the attack. An interpretive phenomenological analysis was used to analyze the narratives of 11 women who had survived an attempted homicide by their partner. Four major themes emerged: Living between dichotomies: A fragmented identity; Embodied fear: A fear that will not go away; The loss of future: A life divided; and The loneliness of surviving the "unsurvivable." Utilizing the ambiguous loss theory to examine the emotional ramifications of IPH indicates that survivors navigate persistent confusion and struggle to comprehend the loss. This involves challenges in moving forward and achieving resolution, conflicting emotions related to the loss, minimal recognition of the grief, and limited support from the social environment.

Inspired by Freud's "Mourning and Melancholia" and expanding upon his notions within the social context, this article proposes an innovative concept called "age melancholy" to describe the multifaceted elements of social loss experienced by empty nest older adults. While most studies emphasize a psychological-individualist approach to this phenomenon, age melancholy frames older age as a process marked by a loss of social engagements. The findings are grounded in anthropological fieldwork conducted from 2010 to 2013 in a lower-income neighborhood of Tel Aviv. They are based on deductive comprehension of social melancholy, combined with inductive qualitative analyses of 29 meetings within a designated narrative group of older Mizrahi women-Jewish immigrants from Islamic countries. The results reveal that empty nest older adults perceive their loneliness, fragile health, and approaching death as interrelated aspects of social detachment, leading to melancholy. However, whereas their emotional experiences are tainted by age melancholy, it is temporal and contextual and may be mitigated through social support.

Older adults with bipolar disorder experience distinct challenges compared to younger age groups with bipolar disorder. They potentially require adaptations to the care they receive. This study aimed to explore experiences of care and changing care needs in older adults with bipolar disorder. People with bipolar disorder (aged ≥60) were recruited through three NHS Trusts in the North West of England, charity organisations, a confidential university participant database, and social media. Participants completed single time-point biographical narrative interviews, which were analysed using narrative analysis. Sixteen participants' accounts led to the creation of four themes: (1) 'Navigating the disruption caused by diagnosis'; (2) 'The removal of services that provided hope'; (3) 'Later life: We are on our own now'; and (4) 'Changing care needs in later life: We still need support'. The care needs of older adults with bipolar disorder appear to change over time, and services often fail to offer adequate, tailored care for this group at present. Current support requires adaptation to be effective and appropriate and to enable this group to age well in later life.

Long-acting injectable pre-exposure prophylaxis for HIV prevention (LAI-PrEP) was approved for use in the United States in 2021, yet little is known about perceptions of LAI-PrEP among transgender and nonbinary young adults, a group that faces substantial barriers to HIV prevention. We investigated US transgender and nonbinary young adults' perceptions of and attitudes toward LAI-PrEP and how perceived advantages and disadvantages of LAI-PrEP related to the PrEP continuum of care. We conducted semi-structured interviews with 31 transgender and nonbinary young adults who reported oral PrEP use or were PrEP-eligible. We analyzed responses using both a deductive RADaR approach, to identify LAI-PrEP perceptions relevant to the PrEP continuum of care, and an inductive thematic analysis to explore key themes. In this study, all PrEP-experienced and most PrEP-naïve participants indicated an interest in LAI-PrEP, citing advantages over daily oral medication (e.g., fewer adherence challenges). Three key themes emerged: (1) Some participants linked perceived advantages of LAI-PrEP to experiences with gender-affirming care (e.g., familiarity with needles via hormone use). (2) Participants weighed trade-offs and contextual factors that influenced their LAI-PrEP preferences (e.g., interest contingent on whether location for receiving injection was geographically accessible). (3) Participants envisaged alternative delivery methods that could enhance LAI-PrEP acceptability and uptake (e.g., home injection). HIV prevention programs should incorporate the insights of transgender and nonbinary young adults to ensure that emerging HIV prevention technologies are accessible and responsive to the needs and concerns of people of all gender modalities.