Qualitative Health Research最新文献

Advancements in surgical, interventional, and intensive-care medicine have significantly increased the life expectancy of individuals born with congenital heart disease (CHD). As a result, growing numbers of affected children now reach adulthood. Despite medical progress, CHD remains a lifelong condition that influences how individuals perceive and shape their lives. This qualitative study explored ideas of a good life among 14 young adults aged 18-29 years living with CHD. Data were gathered through semi-structured phenomenological interviews and analyzed using interpretative phenomenological analysis. The pursuit of a "normal" life, characterized by equal developmental opportunities compared to peers without CHD, emerged as a central pattern. This experience was reflected in four key themes: "My Whole Life I Have to Fight for Normality," "Being Treated Normally by Others Is Part of a Good Development," "Normal Development Includes Lightheartedness," and "I Need to Stand on My Own Two Feet." These findings carry important implications for healthcare providers, particularly regarding the promotion of normality and autonomy among individuals with CHD. Patients should be supported in adopting this perspective-as should their parents, since they significantly shape the lives and well-being of patients during their formative years, playing a crucial role in laying the foundation for healthy development and a good life. At the same time, healthcare providers should avoid paternalistic attitudes that risk replicating patterns of parental overprotection. Finally, our findings point to the importance of future research exploring how gender and cultural background shape ideas of a good life with CHD.

Family caregivers play a vital role in supporting older adults, yet caregiving often brings persistent exposure to mortality, leading to heightened death anxiety and psychological distress. Applying terror management theory (TMT), this study explores how caregivers navigate death anxiety and maintain anxiety-buffering systems (cultural worldviews, self-esteem, and close relationships) while participating in a supportive intervention program. This qualitative study employed in-depth semi-structured interviews (approximately 90 min) with 17 family caregivers of older adults participating in a national caregiver intervention program in Israel. The interviews explored four key domains: (1) caregiving experience, (2) daily challenges, (3) program participation, and (4) program evaluation. Theory-driven deductive content analysis, guided by TMT's framework, was used to identify patterns related to mortality awareness, psychological defenses, and intervention effects. The TMT-driven data analysis revealed three primary themes: (1) "This is death, it is hard, death, of course": Heightened death anxiety in caregiving; (2) "You know there are things you don't talk about, you don't talk about death": Disrupting of anxiety-buffering system due to caregiving; and (3) "You free the soul": Intervention rebuilds anxiety-buffering system and balanced self. This study highlights the need for existentially informed caregiver support programs that integrate TMT principles to address the deeper emotional and philosophical challenges of caregiving. Implications for healthcare professionals, policymakers, and social workers emphasize the importance of developing interventions that not only alleviate caregiver burden but also strengthen resilience by addressing existential fears inherent in caregiving.

Head and neck cancer (HNC) includes a diverse group of cancers, involving complex care pathways and life-altering side effects, including changes to how people communicate. Patient experience is an important outcome of HNC care; however, to date, little research has been conducted to explore the healthcare experiences of those individuals with HNC and associated communication changes. We sought to explore how people with HNC and associated communication changes understand their healthcare experience. An interpretative phenomenological analysis framework was employed, using data from nine individual interviews. Six group experiential themes were identified: (1) Assembling and reassembling supportive scaffolds: The role of significant others and peers in the healthcare experience; (2) Human connectedness in an overwhelming system: Reverence in presence, turmoil in absence; (3) Gathering, disengaging, or epiphany: The fluxing relationship with information; (4) Continuum of healthcare navigation: From frustration to relief; (5) A quest to reclaim self after upheaval; and (6) From confronting to seeking: The desire for professional expertise. Findings show that healthcare engagement and navigation are ongoing for years post-primary treatment. The healthcare experience is often traumatic, but there are moments that bring people from vulnerability to safety with families, peers, and healthcare workers all contributing different roles. This group of people value expertise in their healthcare, have a fluctuating relationship with healthcare information, and begin to rebuild themselves early in the healthcare experience. This research helps to understand the healthcare phenomenon and can guide practices to support people with HNC throughout their continuum of care.

Cognitive impairment in multiple sclerosis quietly fractures memory, identity, and agency long before it is clinically acknowledged. This autoethnography examines the lived experience of cognitive disruption through a feminist lens, where memory loss is not only a neurological event but a challenge to narrative authority, self-definition, and social credibility. Weaving personal narrative with critical inquiry, this work explores the tensions between clinical invisibility and existential disruption, highlighting how gendered expectations and epistemic injustice shape the experiences of women with cognitive disabilities. By situating fragmented memory within broader social, medical, and feminist discourses, this inquiry challenges traditional biomedical models and advocates for a narrative-centered approach to care. In doing so, it calls for structural changes in healthcare, research, and policy that recognize and validate cognitive decline's complex, lived realities.

There is a widespread concern that some aspects of digital media use may be detrimental to mental health. Digital media such as social media, video games, and artificial intelligence profoundly influence the daily lives of young people through practices embedded in global and particular digital cultures. Because digital technologies and their uptake are actively evolving in ways that cannot be fully anticipated, research must "take the long view" to develop robust theories that stand the test of time. The philosophical approach of critical realism, developed by Roy Bhaskar and others in the 1970s-1990s, provides helpful parameters for studying complex phenomena such as the relationship between digital cultures and mental health. Critical realism sees science as a social process that aims to uncover the generative structures of reality, with the understanding that causal mechanisms exist at multiple levels of inquiry, from the material to the social. Drawing from the work of Bhaskar and other critical realists, this article outlines three methodological guiding principles for the study of digital culture and mental health: (1) focusing on the causal effects of digital media, located in individual practices, technologies, sociocultural structures, or elsewhere; (2) combining methods (qualitative and quantitative) and disciplines; and (3) actively engaging with the social dimension of research. Research on digital media and mental health has the capacity to illuminate causal mechanisms and their possibilities for human emancipation, even when these mechanisms are not fully actualized or directly observed.

Any major life transition can present incredible challenges and struggles. When parenthood and immigration co-occur, many adjustments are required, and this poses a higher risk to mental well-being. This study examines the impact of the dual transition of parenthood and immigration in the perinatal period on the mental health of Indian immigrants to Australia. This study was conducted in the Western Sydney region using a qualitative design guided by interpretive description and purposive sampling. Thirteen in-depth interviews were conducted with nineteen participants, including six couple interviews, three with women alone, and four with community cultural informants. Data were analyzed using thematic analysis. The overarching theme "Living between two worlds" captured the participants' journey through immigration and parenthood. Participants' experiences were reflected in three sub-themes: "feeling different and not belonging," "losing confidence," and "feeling liberated," highlighting the social and emotional impact of these transitions. Understanding the challenges faced during the dual transition and their emotional impact can guide health professionals in providing culturally sensitive perinatal care. The findings draw attention to the depth of emotions that immigrants experience and their impact on daily life during dual transitions. They emphasize the urgent need for change in clinical practice and advocate for a structured yet conversational assessment of the immigration experiences during the psychosocial assessments in the perinatal period. The analysis of the findings presents possible solutions for designing targeted interventions for immigrant populations and will help health professionals better understand and support immigrants. The inclusion of men has elucidated gender-specific stressors and support needs.

Although female genital cutting, circumcision, or mutilation (FGC/M) can substantially affect survivors' sexual health, there is limited research on the strategies they use to promote their sexual health. Using intersectionality, this interpretive description study aimed to explore and describe the perspectives and experiences of FGC/M survivors in Canada regarding their sexuality and their sexual health to identify self-driven sexual health promotion strategies. Based on semi-structured interviews with 27 women who underwent FGC/M and were currently living in Canada, we inductively identified three themes: (a) Challenging norms and striving for sexual liberation by educating oneself; (b) Cultivating sexual agency through resilience; and (c) Building a community of care to support sexual empowerment. This study offers guidance to both FGC/M survivors and their healthcare providers on potential sexual health promotion strategies based on education, action, and support. It is a first step toward understanding the sexual health of FGC/M survivors from a global and holistic perspective, moving beyond a narrow focus on anatomical and physiological functioning.

Sexual health and well-being (SH&WB) in late midlife is an important yet underexplored aspect of healthy aging. Satisfying sexual activity contributes to psychological and relational well-being, yet midlife is marked by physiological changes, health issues, and social transitions that can affect sexual functioning. Existing research has mostly focused on adults over 60 or on clinically diagnosed sexual problems, leaving late-midlife experiences largely overlooked. This qualitative study addresses that gap by examining how late-midlife adults (50-64) in Poland perceive and navigate SH&WB challenges, shedding light on their experiences. Forty participants (25 women, 15 men) took part in semi-structured, in-depth interviews, and reflexive thematic analysis was applied. Many participants did not identify themselves as belonging to the "aging" group, often describing themselves as "too young" to experience age-related sexual concerns. Consequently, common changes (e.g., lower libido, vaginal dryness, and erectile difficulties) were seldom perceived as distressing or problematic. Participants typically managed these changes independently through creative, tactful strategies and by addressing psychosocial factors, reserving help-seeking for instances of severe distress or disruptions to sexual activity. These findings suggest that healthcare providers should respect late-midlife adults' perspectives and avoid over-medicalizing normal sexual changes. Instead, SH&WB should be integrated into routine care in a supportive manner that encourages open dialogue and proactive engagement, laying the groundwork for assistance if future needs arise.

Care-experienced mothers represent a vulnerable population at the intersection of complex childhood adversity and the challenges of parenthood, making them a crucial focus for research on mental health. The current study aimed to explore how care-experienced women perceive and manage the impact of motherhood on their mental health. Using interpretative phenomenological analysis, we examined how care-experienced mothers interpret and make sense of motherhood and mental health in their specific contexts. Through the analysis of five mothers' interviews, four superordinate themes were identified: (1) The value and fragile benefits of motherhood; (2) When the past and present collide; (3) The value and power of identities; and (4) Engagement with services: the push and pull. The findings suggest that care-experienced mothers are more vulnerable to distress when their identities are solely tied to motherhood and when they experience power imbalance in support services. This highlights the importance of fostering self-worth beyond the maternal role and the need to provide accessible non-stigmatizing services. It is therefore important for policymakers and health professionals to work in collaboration with care-experienced mothers to establish compassionate, tailored, and ongoing support beyond statutory care. This support will be crucial in helping mothers with care histories maintain better mental health and consequently equip them to develop healthier relationships with their children and themselves.

Narrative medicine is an interdisciplinary field that merges storytelling with medicine. Its distinctive feature lies in the integration of evidence-based medicine and a patient-centered care approach, prioritizing the individual over the disease. In recent years, narrative medicine has gained exponential significance. However, despite the growing interest in this field, there is a notable paucity of systematic studies exploring narrative medicine from the patient's and their caregivers' perspective. This literature review employs the PRISMA 2020 guidelines to analyze research studies focusing on the impact of narrative medicine on the illness experience of patients and their caregivers. A comprehensive search was conducted across databases: MEDLINE, PsycINFO, EBSCO Psychological and Behavioral Science, the Cochrane Library, and CINAHL. Two authors independently assessed the eligibility of the studies and extracted the data. There are employed keywords related to "Narrative Medicine" and "Narrative-Based Medicine" appearing in the titles or abstracts of works up to February 2024. Through a process of screening and data extraction from the initial pool of 724 articles, 58 full-text articles were assessed and 42 studies meeting the inclusion criteria were identified and critically analyzed. Despite methodological heterogeneity that may limit generalizability, the review highlights a positive impact of narrative medicine on patient and caregiver perspectives. Additionally, patient and caregiver narratives not only positively influence their well-being but also highlight their concerns and their requirements. This review addresses methodological limitations and suggests future research directions to bridge gaps in the literature. Challenges such as methodological heterogeneity and the paucity of standardized protocols persist.