Qualitative Health Research最新文献

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.

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.