Qualitative Health Research最新文献

This study explores the practice of healthcare support workers (HCSWs) working with people with dementia on mental health wards for older people within the National Health Service in the United Kingdom. People with dementia in these settings have complex physical and mental health needs with significant behaviors that challenge and therefore require high levels of staff expertise to meet their needs. Underpinned by the theory of care aesthetics, our primary aim was to raise the visibility of HCSWs' everyday practice in this under-researched area of dementia. Working with three mental health wards over two sites, we used an exploratory, participatory action research methodology with qualitative and ethnographic methods to refine and clarify our understanding of care aesthetics in this practice setting. Over the course of the study, and through a series of collaborative learning groups in each site, we developed an explanatory practice model applying constant comparative analysis to the data to ensure that each stage of the model was iteratively developed and refined with the participating HCSWs. The model demonstrates how HCSWs use sensory, embodied, and relational practice to effectively "tune in" to the person with dementia, to the ward and their colleagues, to themselves and their values, to their craft, and to ward visitors. Being co-present was a resulting linking schema that demonstrated high-quality in-the-moment person-centered care. The model illustrates the range of everyday practices delivered by HCSWs and how care aesthetics has the potential to inform and develop the language of person-centered dementia care.

Intimate partner relationship breakdown is a significant risk factor for suicide in men. Linked to this risk is the emotional upheaval tied to grief and loss-an area that has received little research attention in young men. This study aimed to theorize the emotional and social processes by which young men react to and recover from relationship breakdown. Twenty-two Australian men (aged 19-30 years) who had been through a breakup in the preceding three years participated in individual semi-structured interviews. Constructivist grounded theory was used to analyze interviews and explicate a theory of post-breakup reaction and recovery, that was conceptually advanced with a masculinities framework. Our theory highlighted a process of mixing emotions, where diverse emotions interacted to exacerbate or buffer a core of sadness. The mixing of emotions often spilled into overwhelm, indicated by massing emotions and featuring suicidality for some young men. In response, young men mobilized varied strategies for managing emotions, featuring interlinked processes of withdrawing, distracting, and expressing. With time, recovering was indicated by prioritizing self, wherein participants purposefully centered their needs as requisite to healing. This comprised triaging influences, where young men simultaneously engaged social supports, amid disregarding peer advice to immediately re-partner as this was deemed incompatible with recovering. Finally, in reconciling, young men took on their breakup experiences as a source of learning and resilience. Findings add to the growing body of evidence centering healthy adjustment to relationship breakdown as critical for suicide prevention in men.

The rapid advancement of artificial intelligence (AI) is increasingly shaping research methodologies across disciplines. However, its integration in qualitative research remains controversial due to epistemological, ethical, and human-centered concerns. This study explores the perspectives of 14 expert qualitative researchers from socio-anthropological and healthcare fields working in Italian academic and hospital settings, with a focus on the opportunities, challenges, and future directions of AI use in qualitative inquiry. Through semi-structured interviews and reflexive thematic analysis, four main themes were developed. First, participants expressed ambivalent attitudes-balancing curiosity with technophobia and emphasizing the need for human oversight and contextual interpretation. Second, an anthropological and philosophical dimension was constructed, underscoring the importance of reflexivity, creativity, and researcher identity as essential counterbalances to AI's mechanistic tendencies. Third, researchers acknowledged AI's practical benefits in tasks such as transcription and data management, and they remained skeptical of its ability to perform complex interpretative work. Finally, ethical and sustainability concerns were raised, including algorithmic bias, data privacy, and the environmental impact of AI technologies. The findings reveal persistent epistemological tensions but also highlight emerging opportunities for AI to enhance research efficiency and accessibility, provided that human interpretative agency remains central. Participants stressed the importance of developing robust ethical frameworks, fostering critical reflexivity, and adopting innovative conceptual approaches to responsibly integrate AI into qualitative research and education. This study offers valuable insights for scholars and practitioners navigating the evolving landscape of AI in qualitative inquiry, advocating a balanced approach that leverages AI's potential while safeguarding the human core of qualitative research.

Ripple effects mapping (REM), a qualitative participatory approach to intervention evaluation, is gaining recognition as a useful method for elucidating the long-term intended and unintended impacts of complex public health interventions. The present study applied an adapted REM approach to capture systems and community change associated with the Agenda Gap program. This population-level youth mental health promotion intervention is embedded in multi-sectoral partnerships with long-term and relational outcomes post-program that are difficult to elucidate using traditional program evaluation methods. Using transcript and mind map data generated through an REM process with former Agenda Gap youth collaborators and adult allies, reflexive thematic analysis supported the construction of three thematic program outcomes: (1) Reimagining Future Possibilities, (2) Systems Integration: Transforming School Practices, and (3) Progressing From Ripple Effects to Sea Change. Spanning socioecological levels (i.e., individual, family, community, and societal), the outcomes and their associated sub-themes captured the meaningful impacts experienced by Agenda Gap participants, as well as those more distal to the intervention, in the years following implementation. These findings demonstrate the substantive, multi-level impacts of the program and also illustrate how qualitative, participatory approaches, such as REM, can complement other forms of evaluation to reveal outcomes that are typically overlooked. Recommendations and implications for future research and applications of REM are offered.

Integrative medicine should be understood not as an isolated entity but as a boundary field-a contested space where medical legitimacy, scientific authority, and professional jurisdiction are continuously negotiated. The Spanish case illustrates how regulation functions not merely as a technical or legal instrument but as a mechanism that structures professional practice while also defining what constitutes legitimate medical knowledge. In the absence of formal recognition, integrative medicine practitioners in Spain operate in a contested space where legal ambiguity, institutional constraints, and economic pressures shape their professional trajectories. Drawing on in-depth interviews with Spanish medical professionals engaged in integrative practices, this article explores how these practitioners navigate this terrain and makes two main contributions. First, at the empirical level, it provides one of the first in-depth qualitative analyses of the professional trajectories of integrative medicine practitioners in Spain, a context where CAM remains legally unregulated and politically contested. Second, at the theoretical level, it introduces the concept of "recognition boundaries" to capture how legitimacy is not only a matter of institutional inclusion but also of symbolic and cultural validation. By building on boundary theory and Lamont's work on recognition, we argue that recognition boundaries operate as dynamic, contested markers that shape what is considered acceptable within medical institutions-and who is authorized to speak and act as a legitimate professional. This concept may be applicable to other health systems where professionals operate in liminal spaces, negotiating belonging in the absence of institutional support.

This paper presents findings from qualitative interviews with 19 cancer patients and survivors, examining how they experience and articulate the existential structure Heidegger calls being-towards-death. The study accomplishes two goals. First, it responds to the widespread misinterpretation of Heidegger in contemporary death studies, palliative care, and psycho-oncology. While existing research often treats being-towards-death as a vague metaphor or rhetorical gesture, this study takes Heidegger's account as a serious philosophical framework. Our team-composed largely of phenomenological philosophers-integrated his concepts into every stage of inquiry, from the design of interview protocols to the interpretation of participant narratives. We also employed an original qualitative method, presented in a form that is clear and transferable to future research. Second, we show how engaging Heidegger's account as a substantial framework has direct and unsettling implications for clinical care. If care is to address the human being-not merely stabilize the body-then two practices must be reconsidered. First, the collapse of meaning following diagnosis should not automatically be pathologized, but recognized as a possible opening to authentic existence. Second, symbolic reframing, legacy projects, and spiritual reassurance are not neutral forms of support. They function to deny death's finality and re-anchor the patient in social norms just as those norms begin to lose their hold. Rather than fostering resilience, these strategies may interrupt the one moment when patients can begin to live-and die-on their own terms.

The risk of recurring and cascading disasters is increasing rapidly, with significant implications for community mental health. This study aimed to explore qualitative reports of mental health experiences, changes in social identity, and community connectedness within an area affected by repeated and compounding hazards. The Wooroloo Bushfire in Western Australia occurred during a COVID-19 lockdown in 2021, with ongoing repercussions for the community. Participants comprised 39 adult community members, who participated in individual interviews or focus group discussions conducted 9-26 months after the bushfire. Reflexive thematic analysis identified five key themes outlining the experience of repeated disasters, individual and collective experiences of traumatic stress, ongoing hardships, heightened impacts for young people, and dynamics in community connectedness over time. Despite tremendous resilience, significant loss and delayed rebuilding heightened psychological concerns in the years following exposure. Strengthened community connectedness was actively fostered and often reported, although tensions and frustrations were noted. Community-level supports were perceived as effective, but sustainable and accessible mental health services are needed in disaster-risk settings across Australia.

The increasing prevalence of prostate cancer cases calls for new ways to improve diagnostic pathways and patient care. Artificial intelligence (AI)-powered tools offer potential to streamline prostate cancer diagnostics, yet little is known about how patients perceive and experience these technologies. This study investigates how patients diagnosed through an AI-powered prostate cancer diagnostic tool express trust in AI. Based on 18 semi-structured qualitative interviews with men who underwent AI-supported diagnostics, data were analyzed using reflexive thematic analysis. Three dimensions of trust were developed. First, participants described a foundational trust in the healthcare system and professionals, shaped by previous positive encounters. Second, this interpersonal trust was central to their acceptance of AI, as participants relied on healthcare professionals and their expertise to explain, justify, and endorse AI technology. Third, participants recognized AI's potential to enhance diagnostics but emphasized the demand for human oversight and second opinion, due to concerns about accountability and AI's lack of intuition and holistic clinical oversight. Participants were more forgiving of human errors than those made by AI, highlighting the relational and moral dimensions of trust in healthcare. These findings underscore the importance of human relationships in shaping how patients engage with AI technologies and how trust in healthcare professionals remains a critical mediator for acceptance of AI in clinical settings. Understanding patients' trust in AI requires attention to the sociotechnical context in which care is delivered. In conclusion, trust in healthcare professionals remains paramount and is crucial for the acceptance of AI in prostate cancer diagnostics.

Reflexivity holds multiple nuanced, yet largely complementary, definitions depending on disciplinary orientation, yet it is steadily being recognized as a necessary component of trustworthy research and evaluations. There is a rich body of exercises to interrogate positionality, yet the breadth and interdisciplinary nature of this body can be difficult to navigate. Through a metasynthesis approach, we created a live network of 89 citations conceptualized around defined reflexivity practices. Three core concepts emerged from this metasynthesis: (1) strategies to integrate reflexivity in health services research across all stages of the research process, (2) identification of exemplary cases of reflexivity, and (3) scaffolding of practices across the research cycle. Interdisciplinary strategies encompass tools and activities that may produce insights or inform next steps for researchers. We present a model of how reflexivity activities may be integrated across the research cycle. We find that each stage of the research process presents opportunities for researchers to leverage reflexive tools and activities in their teams to produce insights, increase trustworthiness of the research process, or inform next steps. Intentional engagement in reflexivity can help researchers and evaluators more meaningfully acknowledge and respond to their biases and assumptions, which can lead to more meaningful engagement with their subject material, co-researchers, and participants.

In recent years, artificial intelligence (AI) has gradually permeated the medical sector, bringing about multifaceted changes in healthcare practices. Existing studies demonstrate significant gains of AI for clinical application in terms of performance and innovation. While this literature largely emphasizes technological advancements, it often overlooks AI's human and professional implications. AI may not replace humans in the near future due to ethical, legal, and technical constraints, but it is already reshaping work practices as well as professional and institutional dynamics in ways that remain underexplored. This paper addresses this gap by focusing on physicians in hospital-based settings, where AI tools are already shaping clinical routines and professional roles. We therefore use a qualitative approach, conducting semi-structured interviews with 19 physicians from diverse specializations in Belgium, who use AI for clinical purposes. The analysis of the interviews, using the framework of identity work to explore how physicians make sense of their professional identity and legitimize their work in relation to AI, reveals the persistent tension between compliance and resistance. AI tools, even when having the potential to serve as substitutes, appear to be primarily used as complementary aids. Physicians often regard them as a second opinion, one they do not hesitate to override, rather than trusting them for decision-making. These findings are key to reassessing physicians' autonomy and agency in relation to AI, elucidating the processes by which physicians constantly negotiate their identity amid growing AI adoption.