Qualitative Health Research最新文献

Spinal fusion surgery is one of the most common major surgical procedures in youth. Adolescent idiopathic scoliosis (AIS) is the most frequent reason for corrective spinal fusion. AIS (∼25%-47% of cases) and spinal fusion surgeries are associated with pain, including the development of new onset chronic pain for up to 15% of youth. This research used photovoice approaches to explore the journeys of youth from before, during, and after spinal fusion surgery, to demonstrate their experiences both of and beyond pain. Twenty participants were recruited from a previous study conducted by the senior author's lab. Participants captured photos/videos in their daily life (Phase 1); collected previously taken photos/videos from before/during/after their surgery (Phase 2); and participated in individual interviews to reflexively discuss the meaning behind photos/videos (Phase 3). Before interviews, a questionnaire was administered to assess pain characteristics. Nineteen girls/women with scoliosis and one boy/man with kyphosis (12-19 years old, M_age = 16 years) participated; they identified as white (80%), other (15%), and Southeast Asian (5%). The researchers used a reflexive thematic analysis approach, which generated five themes: (1) body aesthetic versus machine; (2) expectations and anticipation of surgery/outcomes; (3) desire of normalcy and freedom; (4) navigating a hoped-for positive surgery experience; and (5) the journey sculpts identity formation and sense of self. Findings support youth advocacy, underscoring the need to validate youth concerns and inform healthcare professionals of the importance of individualized care. Youth perspectives highlighted opportunities for optimizing surgery/healthcare experiences and the psychosocial impacts of scoliosis on body image and appearance.

Participation is widely recognized as an important health determinant for older adults. Exploring interventions to promote active participation of community-dwelling older adults is an important step in translating current knowledge into practice. Few studies have examined community-level interventions to support older adults' participation. The study purpose was to examine the significance of the lived experiences of community-dwelling older adults who participated in an interprofessional healthy aging promotion program. The specific aims were to uncover the narrative significance of the lived experiences and how they evolved and intertwined with the life histories of the older adults 2 years after the intervention ended. A narrative inquiry design was used. Four key informants participated in two semi-structured interviews and a member-checking process. The data were analyzed from a three-dimensional inquiry space of time and continuity, place and context, and social interactions. The findings affirmed three core threads that wove the participants' lived experiences within the program together with their life histories after the intervention. These were enjoyment, learning, and sharing. Four themes revealed the essential elements of the lived experience, and three others exposed participants' growth and life enrichment, all being fundamental to participation. The 3-year community-level intervention was valued and a novel opportunity for facilitating participation and successful aging. It allowed the participants to acquire an evolved vision of self, have meaningful interactions, develop the means to engage in future community activities, implement new self-care strategies, and establish memories and friendships significant for life participation.

In Japan, many pregnant women and mothers suffer from anxiety, depression, and other postnatal issues that can be exacerbated by their birth experiences. While benefiting from advanced medical care, these women's mental and psychological health may be disregarded in their maternity care. Midwives have the potential to play a significant role in improving women's birth experiences. Hence, this study aimed to explore the meaning of the woman-midwife relationship, with a specific focus on sensing peace of mind and trust to improve women's birth experiences. Using a hermeneutic phenomenological approach, 14 Japanese women were interviewed. Sensing peace of mind and trust was one of the significant meanings of the woman-midwife relationship and is articulated across five themes: (1) attuning to the world, (2) different kinds of safety and trust, (3) relying on and entrusting midwives, (4) making a mother, and (5) an emotional bridge. The positive relationship with midwives enhanced the women's mental well-being through allowing the women to attune to the peaceful mind which directed their future perspectives and sustained them in motherhood. They became confident mothers by trusting their midwives. The maternity care system in Japan needs to shift to more relationship-based care to ensure continuity of midwifery care that will improve women's birth experiences and their long-term well-being.

Photovoice is a type of visual research method which supports participants to reflect upon their experiences by capturing digital images. It is a methodology that is routinely used with groups that could be considered vulnerable, as a way of allowing participants to tell their stories for themselves. This article details the process of conducting a Photovoice study with individuals in recovery from problem substance use and reflects on the methodological benefits and challenges of utilising a visual research methodology with this population. Researchers wishing to conduct a Photovoice study with individuals in recovery should be mindful of striking a delicate balance between respecting an individual's autonomy and ensuring their wellbeing. Although ethically complex, Photovoice is an ideal method for research with this population as it allows participants to convey meaning and introduce narratives for themselves in an engaging way.

In Ontario, Canada, rising rates of caregiver distress have been the 'canary in the coal mine' for a health system out of balance with the needs of an ageing population. Community-based health and social care professionals are well placed to play an important role in the caregiver support process; however, a gap has remained in the understanding of if and how caregiver support strategies are operationalized or experienced by community service providers (CSPs). The goal of this study was to describe how CSPs interpreted policy and how those interpretations may enable their work in supporting unpaid caregivers. Using a qualitative constructionist design, we interviewed 24 participants and reviewed 92 publicly available documents. Braun and Clarke's method of thematic analysis was used for analysis strategy. Four overarching themes were identified: (1) community care as a priority, (2) sidewalk accountability, (3) creative care planning through partnerships, and (4) challenges to care delivery. We found that the importance of caregivers to the health system was reflected in organizational policy and strategy. There is an opportunity to improve health outcome for caregivers and the population alike through strong leadership and a clear shared vision. Our findings also suggested that social capital was a significant factor in enabling providers in their work, leveraging long-standing relationships, and accumulated local knowledge to implement highly creative care plans.

Family involvement is widely considered an important part of patient care in the intensive care unit. From professional health care organizations, government, and hospital associations, there has been a cultural shift toward family presence as part of a wider commitment to patient-centered care. At the same time, the meaning and impact of family involvement in the intensive care unit setting remain opaque and under-studied. This study employed an ethnographic approach to better understand family involvement in practice and from the perspective of health care professionals and family members by studying an implementation trial of a family involvement tool in two intensive care units over 2 years. The findings revealed that an expanded and self-defined role for family members as carers in the intensive care unit challenged the current configuration of the nurse patient/family relationship and that family members were aware of these dynamics. While the intensive care unit implementation teams were both motivated to implement a novel way of facilitating family involvement, the processual, organizational, and contextual factors in the intensive care units largely determined the possibilities of its application. This suggests that interventions should address the specific context in which they are employed.

This interpretative descriptive study explores how public health measures implemented during the first wave of the COVID-19 pandemic in Quebec, Canada, affected the well-being of older adults. Twenty-six participants aged 60-81 took photographs to depict how COVID-19 public health measures affected their well-being and were invited to discuss their photographs in virtual focus groups. Data were analyzed using thematic analysis. The impacts of health measures on the well-being of participants were framed according to three overarching themes. First, participants endured an intensification of ageism, feeling diminished and excluded from their social spheres. Second, they faced a burden of loneliness due to the loss of connections with their communities, particularly for those who were single and without children. Third, participants highlighted navigating a degradation of social cohesion. This manifested through tensions and distrust in both the public and private spheres, as well as acts of resistance in response to rules deemed unjust. While public health measures were essential to prevent onward transmission of COVID-19 and mortality, they negatively impacted older adults' self-image, loneliness, and trust in society. This study argues for a rethinking of public health norms specific to older adults to address potential sources of inequality. In particular, a greater emphasis is needed on social connectedness and addressing the unique needs of older adults during pandemics.

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.

Public health restrictions to protect physical health during the COVID-19 pandemic had unintended effects on mental health, which may have disproportionately affected some potentially vulnerable groups. This scoping review of qualitative research provides a narrative synthesis of new mothers' perspectives on their mental health during COVID-19 pandemic restrictions through pregnancy to the postpartum period. Database searches in PubMed, CINAHL, and PsycINFO sought primary research studies published until February 2023, which focused on new mothers' self-perceived mental health during the pandemic (N = 55). Our synthesis found that new mothers' mental health was impacted by general public health restrictions resulting in isolation from family and friends, a lack of community support, and impacts on the immediate family. However, public health restrictions specific to maternal and infant healthcare were most often found to negatively impact maternal mental health, namely, hospital policies prohibiting the presence of birthing partners and in-person care for their infants. This review of qualitative research adds depth to previous reviews that have solely examined the quantitative associations between COVID-19 public health restrictions and new mothers' mental health. Here, our review demonstrates the array of adverse impacts of COVID-19 public health restrictions on new mothers' mental health throughout pregnancy into the postpartum period, as reported by new mothers. These findings may be beneficial for policy makers in future public health emergency planning when evaluating the impacts and unintended consequences of public health restrictions on new mothers.