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Improving the Ethics Review of Qualitative Health Research: A Comparison of Review Practices and Suggestions for Improvement by Researchers and Members of Research Ethics Committees.
IF 2.6 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE Pub Date : 2024-12-05 DOI: 10.1177/10497323241293709
Sarah Potthoff, Fee Roth, Jochen Vollmann, Matthé Scholten

Most qualitative health research is subject to ethics review and approval by a research ethics committee (REC). While many studies have identified the challenges that current ethics review practices pose to qualitative health research, there is currently a call to move the research focus from the shortcomings of ethics review practices to the possibilities for improvement. The aim of this grounded theory study was to identify possibilities for improvement of current ethics review practices which can count on endorsement from qualitative health researchers and members of REC alike. To this end, we developed interventions for improving review practices through a comparative analysis of qualitative health researchers' experiences with review practices and REC members' discussions about how their review practices operate. Data collection proceeded by means of problem-centered interviews with seven qualitative health researchers and three focus group discussions with 14 REC members in Germany. Our analysis shows two overarching dimensions in the ethics review practice related to the distribution of responsibility for ethically legitimate research and the reasons for ethical concerns about qualitative health research studies. While there was disagreement about concrete suggestions for improvement, our analysis shows that researchers and REC members pursue three shared overarching aims: increasing expertise in qualitative methods among REC members and researchers, improving communication between researchers and RECs, and tailoring ethics review procedures to qualitative health research. We conclude that researchers and REC members need to promote collaboration and collegiality to ensure ethically appropriate review practices for qualitative health research.

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引用次数: 0
Protecting Anonymity in Rural Locales: The Use of Composite Narratives in Intimate Partner Violence Research.
IF 2.6 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE Pub Date : 2024-12-05 DOI: 10.1177/10497323241297091
Anna L Mullany, Aline Gubrium

A crucial consideration in the presentation of findings within intimate partner violence (IPV) research is the protection of participant identities. While it is necessary to center survivors' voices, it is equally important to provide layers of anonymity, especially in smaller rural settings where "everyone knows everyone," and where it is thus difficult to guarantee confidentiality for interlocutors. One such way to protect identity is the use of composite narratives: extracting data from several interviews and blending narrative details into one individual story that highlights cross-cutting themes. The purpose of this paper is to examine the affordances of using composite narratives in presenting research findings from rural survivors of IPV. In addition to providing necessary anonymity, this paper also illustrates how composite narratives can showcase ethnographic specificity and utilize the methodological concept of "narrative shock" to enhance empathy, awareness, intervention, and training around IPV for a wide audience.

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引用次数: 0
Adaptability as a Journey: A Constructivist Grounded Theory Study Exploring the Transition to Motherhood in the Context of Bipolar Disorder.
IF 2.6 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE Pub Date : 2024-12-05 DOI: 10.1177/10497323241297076
Aigli Raouna, Andreea Miruna Mihut, Angus MacBeth

Despite growing evidence that women with bipolar disorder (BD) diagnoses are at a particularly increased risk for perinatal mental and physical health complications, our understanding of their experiences and support needs from pre-conception to early postnatal years is still in its early stages. To address this gap, a qualitative study was carried out employing a constructivist grounded theory approach to identify the underlying processes shaping women's journeys to motherhood in the context of BD. In-depth, semi-structured online interviews were conducted with 10 mothers worldwide with a pre-existing diagnosis of BD and a first child under 5 years of age. Mothers' experiences revolved around a constant interplay between vulnerability and adaptability, leading to the development of the substantive theory of adaptability as a journey. This study proposes that becoming adaptable constitutes a process, with the concept of "projecting adaptability" being influential in this journey. Characterized by the interconnected elements of self-awareness of vulnerability, perceived support from external sources, and ownership of experiences, the ability to envision an adaptable version of oneself along with understanding the path to achieving it played a significant role in women's experiences. Overall, there is a need for a more dynamic understanding of these experiences, providing appropriate support rather than viewing women as simply vulnerable or adaptable. Further research is necessary to explore the transferability of this theoretical framework, especially among mothers from diverse socio-economic backgrounds.

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引用次数: 0
Chronic Concealment and Awareness in the Affective Worlds of Young People Living With Chronic Illness.
IF 2.6 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE Pub Date : 2024-12-04 DOI: 10.1177/10497323241304571
Imogen Harper, Alex Broom, Katherine Kenny

From the onset of chronic illness, a variety of challenges emerge-challenges that both persist and evolve as life progresses. For young adults living with chronic illness, the age-specific difficulties of becoming ill while young form a foundation that shapes their experience of illness in enduring ways. This paper draws on a series of in-depth qualitative interviews with 33 young adults (aged 19-29 years old) living with a range of chronic illnesses, including fatigue syndromes, auto-immune diseases, and neurological conditions. Participants demonstrated an emergent chronic consciousness of how others perceived their health, which created a series of fraught affective tussles centered on relational recognition and feared judgment. This article explores the difficulties and concerns participants had when communicating the nature and realities of illness; the emotional toll of attempting to avoid attention and judgment from others regarding their conditions; and the ways in which others could productively and sensitively acknowledge participants' illness experiences. We demonstrate that the process of learning how to navigate these issues was one important way that participants began to integrate their illness (and its implications) into their emerging sense of self and adult life.

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引用次数: 0
Jarring Encounters: Discomfort, Disruption, and Dominant Narratives of Suicide.
IF 2.6 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE Pub Date : 2024-12-04 DOI: 10.1177/10497323241302653
Rebecca Helman, Sarah I Huque, Amy Chandler

In researching experiences and understandings of suicide bereavement across diverse communities in Scotland, we expected to hear difficult, distressing, and painful narratives. However, one of the 31 in-depth qualitative interviews that we conducted was particularly and unexpectedly jarring. In this narrative, Freya explained how her ex-partner took his life after she escaped from his domestic abuse. This narrative produces a deep sense of discomfort in the interviewer, as her expectations about suicide bereavement are disrupted. Taking this discomfort as a starting point, we explore what this jarring encounter tells us about dominant and absent narratives of suicide. We interrogate how this narrative of suicide within the context of domestic violence perpetration bumps up against dominant narratives of a "male suicide crisis" and "relationship breakdown," through which men are positioned solely as "victims." Drawing on perspectives from feminist, affective, and reflexive qualitative research, critical suicide studies, and an abductive approach to analysis, we explore how attending to uncomfortable feelings that are generated within the research encounter can enable us to develop more complex, nuanced, and messy understandings of suicide.

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引用次数: 0
A Participatory Evaluation of an Urban Garden Project in Ecuador: Exploring Factors That Impact the Recovery of People With Severe Mental Health Problems. 对厄瓜多尔城市花园项目的参与式评估:探索影响严重心理健康问题患者康复的因素。
IF 2.6 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE Pub Date : 2024-12-01 Epub Date: 2024-07-20 DOI: 10.1177/10497323241245867
Emilia C Zamora-Moncayo, Bernarda Herrera, June Larrieta, Aimée DuBois, Georgina Miguel Esponda

For the past years, Ecuador has been transitioning away from a hospital-based model of mental healthcare to one that is community-centred. However, challenges associated with hospital-based models endure, notably financial burden faced by those with severe mental health problems (SMHPs) due to labour market discrimination. Employment access for this group is often disregarded in policy planning, despite evidence of its benefits on mental health. Huertomanías, an urban garden initiative in Ecuador founded in 2015, works with individuals with SMHPs, providing work, income, and social inclusion. A case study using a participatory approach was carried out to explore factors that impact the recovery of people with SMHPs. Twelve participants engaged in diverse stages of the research, where several participatory activities were conducted including cognitive mapping, a photovoice project, and interviews. The analysis employed a thematic approach leading to four categories of impact within the urban garden: autonomy (financial and personal), interpersonal relations and relation with the environment, mental health, and family dynamics. A final category of impact was established encompassing external factors (family support and public policy and healthcare services) that influence recovery. Findings suggest that the urban garden promotes autonomy and active participation within society, improves mental health, and transforms family dynamics. Further, this study highlights the importance of community-based mental healthcare (CBMHC), emphasising the need of public policies and healthcare in promoting autonomy through employment and community-centred services. Lastly, the study contributes insights into recovery experiences and CBMHC benefits, informing programme development and similar initiatives in Latin America.

过去几年来,厄瓜多尔一直在从以医院为基础的精神卫生保健模式向以社区为中心的模式过渡。然而,与医院模式相关的挑战依然存在,特别是有严重精神健康问题(SMHPs)的人因劳动力市场歧视而面临的经济负担。尽管有证据表明就业对心理健康有益,但在政策规划中往往忽视了这一群体的就业途径。厄瓜多尔的城市花园倡议 "Huertomanías "成立于2015年,它与有严重精神健康问题(SMHPs)的人合作,为他们提供工作、收入和社会包容。我们采用参与式方法开展了一项案例研究,以探讨影响 SMHPs 患者康复的因素。12 名参与者参与了研究的不同阶段,并开展了多项参与性活动,包括认知地图绘制、摄影舆论项目和访谈。分析采用了主题方法,在城市花园中得出了四个影响类别:自主性(经济和个人)、人际关系和与环境的关系、心理健康和家庭动态。最后一类影响包括影响康复的外部因素(家庭支持、公共政策和医疗保健服务)。研究结果表明,城市花园促进了自主性和对社会的积极参与,改善了心理健康,并改变了家庭动态。此外,本研究还强调了以社区为基础的精神医疗保健(CBMHC)的重要性,强调了公共政策和医疗保健在通过就业和以社区为中心的服务促进自主性方面的必要性。最后,这项研究有助于深入了解康复经验和基于社区的精神保健的益处,为拉丁美洲的计划制定和类似举措提供信息。
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引用次数: 0
COVID-19 Public Health Restrictions and New Mothers' Mental Health: A Qualitative Scoping Review. COVID-19 公共卫生限制与新妈妈的心理健康:定性范围审查。
IF 2.6 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE Pub Date : 2024-12-01 Epub Date: 2024-07-20 DOI: 10.1177/10497323241251984
Ammanie Abdul-Fatah, Michelle Bezanson, Sebastian Lopez Steven, Emily Tippins, Sarah Jones, Heather MacDonald, Renate Ysseldyk

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.

在 COVID-19 大流行期间,为保护身体健康而采取的公共卫生限制措施对心理健康产生了意想不到的影响,这可能对一些潜在的弱势群体造成了不成比例的影响。本定性研究范围综述对 COVID-19 大流行期间,从怀孕到产后,新妈妈对其心理健康的看法进行了叙述性综述。在 PubMed、CINAHL 和 PsycINFO 数据库中搜索了截至 2023 年 2 月发表的主要研究,这些研究关注大流行期间新妈妈自我感觉的心理健康(N = 55)。我们的综合研究发现,新妈妈的心理健康受到了一般公共卫生限制的影响,这些限制导致她们与家人和朋友隔离、缺乏社区支持以及对直系亲属的影响。然而,针对母婴医疗保健的公共卫生限制最常被发现对产妇的心理健康产生负面影响,即医院政策禁止分娩伴侣在场和亲自照顾婴儿。以往的综述仅研究 COVID-19 公共卫生限制与新妈妈心理健康之间的定量联系,而本研究对定性研究的综述则增加了研究的深度。在此,我们的综述展示了 COVID-19 公共卫生限制对新妈妈在整个孕期到产后期间的心理健康所产生的一系列不利影响。在评估公共卫生限制对新妈妈的影响和意外后果时,这些发现可能会对决策者在未来的公共卫生应急计划中有所帮助。
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引用次数: 0
"At Least I Use Magnesium Before I Go Clubbing": Health Perspectives, Risk Denial Techniques, Risk Balancing, and Edgework in Recreational Club Drug Use.
IF 2.6 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE Pub Date : 2024-12-01 DOI: 10.1177/10497323241300044
Marit Edland-Gryt

This article explores understandings of health and risk in relation to club drug use, through in-depth interviews with young adults (n = 35) using club drugs in Oslo, Norway. In contemporary society, negotiations around physical health are at the center of people's perceptions of everyday life. From a sociological perspective, risk perceptions and health perspectives can be seen as affecting the use of various club drugs and the meaning given to these phenomena. The aim of this study is to explore how young adults perceive drug use and health and how they relate to health perceptions in their clubbing experiences. At the theoretical level, the article aims to develop risk denial theory as outlined by Peretti-Watel, by proposing a fourth risk denial technique in addition to scapegoating, self-confidence, and comparison between risks. This fourth technique is described as Compensating behaviors and shows how young adults' emphasis on health both in talk and action is important for understanding their behaviors. The participants describe what they did and emphasized in their talk that this was important. Findings demonstrate how the compensating behaviors consist of both actions and talk; they talk about exercise, use of supplements, and fluid replacement; this is a risk denial technique that arguably also works as a form of harm reduction from below. The study offers insights into how and why young adults use club drugs and explores how they legitimize such use.

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引用次数: 0
Personal Narratives From a Mental Health Community Art-Based Project: Insights From Collaborative Creation.
IF 2.6 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE Pub Date : 2024-12-01 DOI: 10.1177/10497323241298899
Jaume Cases-Cunillera, Ruben Del Río Sáez, Salvador Simó-Algado

Community arts interventions demonstrate positive effects on mental health recovery by fostering creativity, self-expression, and social interaction. This study explores the participation process in the Artistic Couples project, which provides collaborative spaces for artists with mental health conditions and local artists. We followed up six artistic couples participating in the project using a narrative-in-action process over 6 months in various community settings. Our aim was to understand the experiences of artists during their participation in Artistic Couples and to uncover the mental health benefits derived from their involvement. Coupled and individually semi-structured interviews and participant observation were employed. Data analysis was conducted using narrative analysis. The results of the collaborative process among participants are reflected in three primary areas: (1) Meeting, engagement, and connection; (2) Dialogue, teamwork, and creative process; and (3) Personal development and learning. The research findings suggest that participating in the Artistic Couples project facilitates self-expression, a sense of social connection, and improved artistic skills among participants, fostering mutual support and effective interpersonal communication. Moreover, participants reported experiences of learning and personal development. Consequently, the study advocates for creating new community spaces that encourage collaborative practices within mental health services. These spaces should promote free expression and facilitate discussions on personal matters, including mental health challenges.

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引用次数: 0
Rethinking Barriers and Enablers in Qualitative Health Research: Limitations, Alternatives, and Enhancements. 重新思考定性健康研究中的障碍和促进因素:限制、替代方案和改进。
IF 2.6 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE Pub Date : 2024-12-01 Epub Date: 2024-03-09 DOI: 10.1177/10497323241230890
Abby Haynes, Victoria Loblay

Explorations of barriers and enablers (or barriers and facilitators) to a desired health practice, implementation process, or intervention outcome have become so prevalent that they seem to be a default in much health services and public health research. In this article, we argue that decisions to frame research questions or analyses using barriers and enablers (B&Es) should not be default. Contrary to the strengths of qualitative research, the B&Es approach often bypasses critical reflexivity and can lead to shallow research findings with poor understanding of the phenomena of interest. The B&Es approach is untheorised, relying on assumptions of linear, unidirectional processes, universally desirable outcomes, and binary thinking which are at odds with the rich understanding of context and complexity needed to respond to the challenges faced by health services and public health. We encourage researchers to develop research questions using informed deliberation that considers a range of approaches and their implications for producing meaningful knowledge. Alternatives and enhancements to the B&Es approach are explored, including using 'whole package' methodologies; theories, conceptual frameworks, and sensitising ideas; and participatory methods. We also consider ways of advancing existing research on B&Es rather than doing 'more of the same': researchers can usefully investigate how a barrier or enabler works in depth; develop and test implementation strategies for addressing B&Es; or synthesise the B&Es literature to develop a new model or theory. Illustrative examples from the literature are provided. We invite further discussion on this topic.

对理想的卫生实践、实施过程或干预结果的障碍和有利因素(或障碍和促进因素)进行探讨已变得如此普遍,以至于在许多卫生服务和公共卫生研究中似乎已被默认。在本文中,我们认为不应默认使用障碍和促进因素(B&Es)来提出研究问题或进行分析。与定性研究的优势相反,B&Es 方法往往绕过了批判性的反思,可能导致研究结果肤浅,对感兴趣的现象理解不深。B&Es方法缺乏理论依据,依赖于线性、单向过程、普遍理想的结果以及二元思维等假设,这与应对医疗服务和公共卫生所面临的挑战所需的对背景和复杂性的丰富理解相悖。我们鼓励研究人员在提出研究问题时进行知情审议,考虑各种方法及其对产生有意义知识的影响。我们探讨了 B&Es 方法的替代方法和改进方法,包括使用 "整套 "方法;理论、概念框架和宣传理念;以及参与式方法。我们还考虑了如何推进现有的基准与环境研究,而不是做 "更多相同的事情":研究人员可以深入调查某项障碍或促进因素是如何起作用的;制定并测试解决基准与环境问题的实施策略;或综合基准与环境文献,制定新的模式或理论。本报告提供了文献中的示例。我们邀请大家就这一主题展开进一步讨论。
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引用次数: 0
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Qualitative Health Research
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