Pub Date : 2024-12-01DOI: 10.1016/j.ssmqr.2024.100503
Dara Shifrer , Suzy Fly , Rachel Springer , Xuan Dinh
The mental health of children, and especially adolescents, has been a global public health priority for decades. School-based health centers (SBHCs) are health clinics established in close proximity to elementary and secondary schools for the purpose of increasing access to medical, and particularly mental health services, for children and adolescents. Yet, like other health clinics, SBHCs struggle to overcome structural and interpersonal stigma related to mental health conditions and support. Then, the pandemic threatened the sustainability and efficacy of SBHCs just as youth's mental health needs skyrocketed. We use Stangl et al.’s (2019)framework for health-related stigma to analyze data from 36 interviews with SBHC Coordinators in Oregon and their Educator Partners to investigate: 1) What implications does mental health-related stigma have for SBHCs' delivery of mental health services to children and adolescents? 2) How did these factors change during the pandemic? Consistent with Stangl et al.’s (2019) framework for health-related stigma, mental-health-related stigma is evident in this study in terms of the secondary stigma youth are reported to experience from peers and families in terms of visiting a SBHC for mental health services, as well as in limitations in the quantity and quality of resources dedicated to providing mental health services. The pandemic had contradictory effects, both increasing and reducing stigma along two axes: cultural perceptions of mental health problems and telehealth.
{"title":"School-based health centers and mental health stigma before and during the pandemic","authors":"Dara Shifrer , Suzy Fly , Rachel Springer , Xuan Dinh","doi":"10.1016/j.ssmqr.2024.100503","DOIUrl":"10.1016/j.ssmqr.2024.100503","url":null,"abstract":"<div><div>The mental health of children, and especially adolescents, has been a global public health priority for decades. School-based health centers (SBHCs) are health clinics established in close proximity to elementary and secondary schools for the purpose of increasing access to medical, and particularly mental health services, for children and adolescents. Yet, like other health clinics, SBHCs struggle to overcome structural and interpersonal stigma related to mental health conditions and support. Then, the pandemic threatened the sustainability and efficacy of SBHCs just as youth's mental health needs skyrocketed. We use Stangl et al.’s (2019)framework for health-related stigma to analyze data from 36 interviews with SBHC Coordinators in Oregon and their Educator Partners to investigate: 1) What implications does mental health-related stigma have for SBHCs' delivery of mental health services to children and adolescents? 2) How did these factors change during the pandemic? Consistent with Stangl et al.’s (2019) framework for health-related stigma, mental-health-related stigma is evident in this study in terms of the secondary stigma youth are reported to experience from peers and families in terms of visiting a SBHC for mental health services, as well as in limitations in the quantity and quality of resources dedicated to providing mental health services. The pandemic had contradictory effects, both increasing and reducing stigma along two axes: cultural perceptions of mental health problems and telehealth.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100503"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-18DOI: 10.1016/j.ssmqr.2024.100499
Rebecca Henderson , Grace Parker , Danielle Cooke , Seth Downing , Aqueena Fernandez , Isabella Schultz , Alyssa Nielsen , Alexandra Garcia , Rayon Uddin , Avery Scrabis , Kylie Baer , Eliza Davidson , Lauren Appleby , Catherine Ayers , Carol A. Mathews
Hoarding disorder (HD) affects approximately 2.5% of the population, and is characterized by persistent difficulty discarding or parting with possessions, distress associated with discarding, and resulting clutter or congestion that compromises the utility of living areas. Individuals with HD frequently have poor insight, resulting in difficulty identifying their symptoms as a problem, and relatively few individuals with HD seek and remain engaged in treatment. At the same time, HD has been increasingly prominent in the media, especially in television shows that dramatize the disorder through the depiction of individuals with extreme hoarding symptoms. These shows have both increased public awareness of the disorder and influenced social attitudes surrounding HD. We sought to understand the self-concept of individuals with HD through a qualitative study of their information gathering about HD, the ways they related HD as a disease to their own behavior, and their concept of their behavior as a problem that required treatment. We hypothesized that this process of seeking understanding about HD would play an important role in informing participants’ conception of the breadth and severity of their own symptoms, their own stigmatizing beliefs towards HD, and their willingness to seek treatment. After semi-structured qualitative interviews were conducted with individuals (N = 59) in the United States meeting diagnostic criteria for HD, four main themes were identified: 1) Reacting to media depictions, 2) Identifying HD behaviors in others 3) Quantifying HD behavior in self, and 4) Seeking information and help. From these major themes, several sub-themes emerged, including help-seeking behavior, disgust and distress reactions to HD media, stereotypical beliefs about HD, and motivating experiences through exposure to HD media. Our findings suggest that individuals exhibiting symptoms that meet diagnostic criteria for HD understood HD as a disease primarily through media depictions, although other sources of information were sometimes accessed. They also engaged in comparisons between their own behavior and those of others they thought had HD, and used these comparisons to determine whether their behavior constituted HD or was severe enough to require treatment. Our study suggests that media depictions may have a significant influence on these determinations, and that individuals with HD might benefit from accurate psychoeducation about HD, possibly including the role and/or effect of comparisons between self and others, to help individuals towards seeking treatment.
囤积症(HD)患者约占总人口的 2.5%,其特征是持续难以丢弃或舍弃财物,丢弃财物时会感到痛苦,以及由此造成的杂乱或拥挤影响了生活区的实用性。HD 患者的洞察力通常很差,因此很难发现自己的症状是一个问题,而且寻求治疗并坚持治疗的 HD 患者相对较少。与此同时,媒体对 HD 的报道也越来越多,尤其是在电视节目中,这些节目通过对具有极端囤积症状的人的描述,将这种疾病戏剧化。这些节目既提高了公众对该疾病的认识,也影响了社会对 HD 的态度。我们试图通过定性研究了解 HD 患者的自我概念,研究内容包括他们收集有关 HD 的信息的情况、他们将 HD 这种疾病与自身行为联系起来的方式,以及他们将自身行为视为需要治疗的问题的观念。我们假设,在寻求对 HD 的理解的过程中,参与者对自身症状的广度和严重程度、对 HD 的鄙视观念以及寻求治疗的意愿的认识将起到重要作用。在对美国符合 HD 诊断标准的个人(N = 59)进行半结构化定性访谈后,确定了四大主题:1) 对媒体描述的反应;2) 识别他人的 HD 行为;3) 量化自己的 HD 行为;4) 寻求信息和帮助。从这些主要主题中又产生了几个次主题,包括寻求帮助的行为、对高清媒体的厌恶和痛苦反应、对高清的刻板印象以及通过接触高清媒体获得的激励体验。我们的研究结果表明,表现出符合 HD 诊断标准的症状的人主要是通过媒体的描述来理解 HD 这种疾病的,尽管有时也会从其他来源获取信息。他们还将自己的行为与他们认为患有 HD 的其他人的行为进行比较,并通过这些比较来确定自己的行为是否构成 HD 或严重到需要治疗。我们的研究表明,媒体的描述可能会对这些判断产生重大影响,而对 HD 患者进行准确的心理教育(可能包括自我与他人之间比较的作用和/或影响)可能会使他们受益,从而帮助他们寻求治疗。
{"title":"A qualitative study of sources of knowledge in individuals with hoarding disorder: The impact of media depictions and social comparisons","authors":"Rebecca Henderson , Grace Parker , Danielle Cooke , Seth Downing , Aqueena Fernandez , Isabella Schultz , Alyssa Nielsen , Alexandra Garcia , Rayon Uddin , Avery Scrabis , Kylie Baer , Eliza Davidson , Lauren Appleby , Catherine Ayers , Carol A. Mathews","doi":"10.1016/j.ssmqr.2024.100499","DOIUrl":"10.1016/j.ssmqr.2024.100499","url":null,"abstract":"<div><div>Hoarding disorder (HD) affects approximately 2.5% of the population, and is characterized by persistent difficulty discarding or parting with possessions, distress associated with discarding, and resulting clutter or congestion that compromises the utility of living areas. Individuals with HD frequently have poor insight, resulting in difficulty identifying their symptoms as a problem, and relatively few individuals with HD seek and remain engaged in treatment. At the same time, HD has been increasingly prominent in the media, especially in television shows that dramatize the disorder through the depiction of individuals with extreme hoarding symptoms. These shows have both increased public awareness of the disorder and influenced social attitudes surrounding HD. We sought to understand the self-concept of individuals with HD through a qualitative study of their information gathering about HD, the ways they related HD as a disease to their own behavior, and their concept of their behavior as a problem that required treatment. We hypothesized that this process of seeking understanding about HD would play an important role in informing participants’ conception of the breadth and severity of their own symptoms, their own stigmatizing beliefs towards HD, and their willingness to seek treatment. After semi-structured qualitative interviews were conducted with individuals (N = 59) in the United States meeting diagnostic criteria for HD, four main themes were identified: 1) Reacting to media depictions, 2) Identifying HD behaviors in others 3) Quantifying HD behavior in self, and 4) Seeking information and help. From these major themes, several sub-themes emerged, including help-seeking behavior, disgust and distress reactions to HD media, stereotypical beliefs about HD, and motivating experiences through exposure to HD media. Our findings suggest that individuals exhibiting symptoms that meet diagnostic criteria for HD understood HD as a disease primarily through media depictions, although other sources of information were sometimes accessed. They also engaged in comparisons between their own behavior and those of others they thought had HD, and used these comparisons to determine whether their behavior constituted HD or was severe enough to require treatment. Our study suggests that media depictions may have a significant influence on these determinations, and that individuals with HD might benefit from accurate psychoeducation about HD, possibly including the role and/or effect of comparisons between self and others, to help individuals towards seeking treatment.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100499"},"PeriodicalIF":1.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-14DOI: 10.1016/j.ssmqr.2024.100501
Sarah Min-Lee Khaw , Caroline S.E. Homer , Red Dearnley , Kerryn O'Rourke , Meghan A. Bohren
Background
Community-based doula support for women and gender-diverse birthing people has a range of benefits in improving maternal outcomes and experiences. However, there is limited research on how doula services operate in Australia. Birth for Humankind is an Australian community-based volunteer doula service, which provides free doula support for women and gender diverse birthing people experiencing social discrimination and financial disadvantage. The aim of this study was to understand facilitators and barriers to implementation and sustainability of a community-based doula service delivered to clients concurrently receiving care at a major maternity hospital in Melbourne, Australia.
Methods
We conducted a qualitative study consisting of 30 in-depth interviews with doulas and managers of the community-based doula service Birth for Humankind, and midwives, doctors and social workers from a maternity hospital. Data were inductively thematically analysed, and themes were then deductively categorised using the Capability, Opportunity, and Motivation (COM-B) model and Theoretical Domains Framework (TDF) to understand behavioural influences and facilitators and barriers to implementing and sustaining the doula service within a hospital setting.
Results
Facilitators to implementation of the doula service included: collaborative relationships; having sound knowledge of referral processes; and being a valued professional doula service with dedicated volunteers. Barriers to implementation included: limited knowledge of the doula service from hospital staff; difficulty in retaining volunteer doulas; being a small non-profit doula service; and limited capacity of hospitals to financially support the doula service. Advocacy for renumerating doulas may be one means to strengthen and sustain existing doula-provider service relationships.
Conclusion
Consideration of establishing strategic partnerships between the doula service and hospitals may create financially-sustainable pathways to enable provision of high-quality, community-based doula support for women and gender diverse birthing people to continue.
背景基于社区的朵拉为妇女和不同性别的分娩者提供支持,这对改善产妇的预后和经历有一系列益处。然而,有关澳大利亚朵拉服务如何运作的研究却很有限。为人类而生"(Birth for Humankind)是一项基于澳大利亚社区的志愿朵拉服务,为遭受社会歧视和经济困难的妇女和性别多样化的分娩者提供免费的朵拉支持。本研究的目的是了解在澳大利亚墨尔本一家大型妇产医院同时为接受护理的客户提供社区朵拉服务的促进因素和障碍,以及该服务的实施和可持续性。我们对数据进行了归纳式主题分析,然后使用能力、机会和动机(COM-B)模型和理论领域框架(TDF)对主题进行了演绎式分类,以了解在医院环境中实施和维持朵拉服务的行为影响因素、促进因素和障碍。结果实施朵拉服务的促进因素包括:合作关系;对转诊流程有充分的了解;朵拉服务是一项有价值的专业服务,有热心的志愿者。实施的障碍包括:医院员工对朵拉服务的了解有限;难以留住志愿朵拉;朵拉服务是一项小型的非营利性服务;医院在财政上支持朵拉服务的能力有限。结论考虑在朵拉服务和医院之间建立战略伙伴关系可能会创建财政上可持续的途径,从而使为妇女和不同性别的分娩者提供高质量的、基于社区的朵拉支持得以继续。
{"title":"Factors affecting the implementation and sustainability of an Australian community-based doula service: A qualitative study","authors":"Sarah Min-Lee Khaw , Caroline S.E. Homer , Red Dearnley , Kerryn O'Rourke , Meghan A. Bohren","doi":"10.1016/j.ssmqr.2024.100501","DOIUrl":"10.1016/j.ssmqr.2024.100501","url":null,"abstract":"<div><h3>Background</h3><div>Community-based doula support for women and gender-diverse birthing people has a range of benefits in improving maternal outcomes and experiences. However, there is limited research on how doula services operate in Australia. Birth for Humankind is an Australian community-based volunteer doula service, which provides free doula support for women and gender diverse birthing people experiencing social discrimination and financial disadvantage. The aim of this study was to understand facilitators and barriers to implementation and sustainability of a community-based doula service delivered to clients concurrently receiving care at a major maternity hospital in Melbourne, Australia.</div></div><div><h3>Methods</h3><div>We conducted a qualitative study consisting of 30 in-depth interviews with doulas and managers of the community-based doula service Birth for Humankind, and midwives, doctors and social workers from a maternity hospital. Data were inductively thematically analysed, and themes were then deductively categorised using the Capability, Opportunity, and Motivation (COM-B) model and Theoretical Domains Framework (TDF) to understand behavioural influences and facilitators and barriers to implementing and sustaining the doula service within a hospital setting.</div></div><div><h3>Results</h3><div>Facilitators to implementation of the doula service included: collaborative relationships; having sound knowledge of referral processes; and being a valued professional doula service with dedicated volunteers. Barriers to implementation included: limited knowledge of the doula service from hospital staff; difficulty in retaining volunteer doulas; being a small non-profit doula service; and limited capacity of hospitals to financially support the doula service. Advocacy for renumerating doulas may be one means to strengthen and sustain existing doula-provider service relationships.</div></div><div><h3>Conclusion</h3><div>Consideration of establishing strategic partnerships between the doula service and hospitals may create financially-sustainable pathways to enable provision of high-quality, community-based doula support for women and gender diverse birthing people to continue.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100501"},"PeriodicalIF":1.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-14DOI: 10.1016/j.ssmqr.2024.100504
Husam Dweik , Ahmad Abu Hadwan , Beesan Maraqa , Ameed Taher , Therese Zink
Background
The West Bank has been under military occupation since 1967. When the Israeli army attacked Gaza after October 7th, 2023, the situation in the occupied West Bank became much worse. We interviewed Palestinian physicians about practicing under occupation and how the Gaza War has impacted their professional and personal lives.
Methods
This qualitative study was conducted from December 2023 to February 2024 and involved 15 individual interviews by reaching out to networks of practicing physicians across the West Bank, purposefully sampling physicians in different geographic locations in hospital and clinic-based practices. The data were analyzed with inductive coding and organized into themes.
Results
Violence and the threat of violence affected many elements of life and health. Restricted mobility, financial hardship, educational challenges, and fear about safety and the future affected physical and psychological health, making patients sicker and physicians' jobs harder. Lack of medications and treatments worsened chronic medical conditions. Mental health care was in demand due to acute stress and persistent trauma. Physicians struggle fulfilling their professional commitment to care for patients. They worried about the future and struggled to care for their families.
Conclusion
Life under occupation on the West Bank has become harsher and more violent with the Gaza War. The chronic exposure to trauma and ongoing uncertainty about the future impact physicians and the next generation of healthcare professionals who will care for their traumatized population. Despite the violations of international codes physicians continued to “honor their duties” to their patients and students.
{"title":"Perspectives of Palestinian physicians on the impact of the Gaza War in the West Bank","authors":"Husam Dweik , Ahmad Abu Hadwan , Beesan Maraqa , Ameed Taher , Therese Zink","doi":"10.1016/j.ssmqr.2024.100504","DOIUrl":"10.1016/j.ssmqr.2024.100504","url":null,"abstract":"<div><h3>Background</h3><div>The West Bank has been under military occupation since 1967. When the Israeli army attacked Gaza after October 7th, 2023, the situation in the occupied West Bank became much worse. We interviewed Palestinian physicians about practicing under occupation and how the Gaza War has impacted their professional and personal lives.</div></div><div><h3>Methods</h3><div>This qualitative study was conducted from December 2023 to February 2024 and involved 15 individual interviews by reaching out to networks of practicing physicians across the West Bank, purposefully sampling physicians in different geographic locations in hospital and clinic-based practices. The data were analyzed with inductive coding and organized into themes.</div></div><div><h3>Results</h3><div>Violence and the threat of violence affected many elements of life and health. Restricted mobility, financial hardship, educational challenges, and fear about safety and the future affected physical and psychological health, making patients sicker and physicians' jobs harder. Lack of medications and treatments worsened chronic medical conditions. Mental health care was in demand due to acute stress and persistent trauma. Physicians struggle fulfilling their professional commitment to care for patients. They worried about the future and struggled to care for their families.</div></div><div><h3>Conclusion</h3><div>Life under occupation on the West Bank has become harsher and more violent with the Gaza War. The chronic exposure to trauma and ongoing uncertainty about the future impact physicians and the next generation of healthcare professionals who will care for their traumatized population. Despite the violations of international codes physicians continued to “honor their duties” to their patients and students.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100504"},"PeriodicalIF":1.8,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-13DOI: 10.1016/j.ssmqr.2024.100505
Alexandra Wollum , Jessica D. Gipson , Amon Sabasaba , Mohamad I. Brooks , Corrina Moucheraud
Drawing on 29 in-depth interviews with health care providers in Dar es Salaam, Tanzania, this paper describes providers’ attitudes and beliefs about contraceptive methods and the extent to which providers consider client choice and autonomy when providing contraceptive care. Interviews were analyzed thematically using the constant comparative approach. Providers described a preference for long-acting reversible methods (i.e., implants and IUDs) primarily due to concerns regarding injectables’ slow return to fertility, exposure to hormones, and concerns about client adherence to pills or injectables. Providers understood the importance of centering a client’s preference to use a specific method and to have a method removed when the client desired. However, providers also described counseling clients toward their own preferences, highlighting a tension between what providers wanted for their clients and client preferences. While most providers described prioritizing client choice even when it contradicted their recommendation, some providers insisted on a certain outcome (e.g., a client taking up an implant), contradicting tenets of informed, full, and autonomous choice. Attention is needed to ensure providers center client autonomy and preferences and guarantee freedom from coercion in contraceptive care.
{"title":"“I am forced to just give it to her because she is the one who wants it”: A qualitative study of providers’ perspectives on contraceptive counseling in Tanzania","authors":"Alexandra Wollum , Jessica D. Gipson , Amon Sabasaba , Mohamad I. Brooks , Corrina Moucheraud","doi":"10.1016/j.ssmqr.2024.100505","DOIUrl":"10.1016/j.ssmqr.2024.100505","url":null,"abstract":"<div><div>Drawing on 29 in-depth interviews with health care providers in Dar es Salaam, Tanzania, this paper describes providers’ attitudes and beliefs about contraceptive methods and the extent to which providers consider client choice and autonomy when providing contraceptive care. Interviews were analyzed thematically using the constant comparative approach. Providers described a preference for long-acting reversible methods (i.e., implants and IUDs) primarily due to concerns regarding injectables’ slow return to fertility, exposure to hormones, and concerns about client adherence to pills or injectables. Providers understood the importance of centering a client’s preference to use a specific method and to have a method removed when the client desired. However, providers also described counseling clients toward their own preferences, highlighting a tension between what providers wanted for their clients and client preferences. While most providers described prioritizing client choice even when it contradicted their recommendation, some providers insisted on a certain outcome (e.g., a client taking up an implant), contradicting tenets of informed, full, and autonomous choice. Attention is needed to ensure providers center client autonomy and preferences and guarantee freedom from coercion in contraceptive care.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100505"},"PeriodicalIF":1.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-10DOI: 10.1016/j.ssmqr.2024.100502
Haruka Nagao
This study aims to identify challenges that women face in accessing prenatal care services in urban China and their coping mechanisms to deal with the challenges. We conducted semi-structured interviews in June and July in 2019 with 38 women who had experience of childbirth within the last five years. Through interviews, this study pays particular attention to a quality of prenatal care services by focusing on women's experiences in seeking for such services. The findings suggest that most participants had access to standardized prenatal care services but faced two challenges: long wait time and short doctor-patient interaction time. These challenges stem from overcrowded hospitals. The findings also illuminate power and information asymmetry between doctors and patients. Women leverage social networks with friends, colleagues, and former classmates to fill in the gap of short doctor-patient interaction by obtaining relevant information about pregnancy and prenatal care services. The analyses of interviews and a social networking site also suggest that online social networks play a similar role to fill in the informational gap. Still, social networks remain a coping mechanism rather than a fundamental solution to the systemic issues within the public health system.
{"title":"Prenatal care in urban China: Qualitative study on challenges and coping mechanisms","authors":"Haruka Nagao","doi":"10.1016/j.ssmqr.2024.100502","DOIUrl":"10.1016/j.ssmqr.2024.100502","url":null,"abstract":"<div><div>This study aims to identify challenges that women face in accessing prenatal care services in urban China and their coping mechanisms to deal with the challenges. We conducted semi-structured interviews in June and July in 2019 with 38 women who had experience of childbirth within the last five years. Through interviews, this study pays particular attention to a quality of prenatal care services by focusing on women's experiences in seeking for such services. The findings suggest that most participants had access to standardized prenatal care services but faced two challenges: long wait time and short doctor-patient interaction time. These challenges stem from overcrowded hospitals. The findings also illuminate power and information asymmetry between doctors and patients. Women leverage social networks with friends, colleagues, and former classmates to fill in the gap of short doctor-patient interaction by obtaining relevant information about pregnancy and prenatal care services. The analyses of interviews and a social networking site also suggest that online social networks play a similar role to fill in the informational gap. Still, social networks remain a coping mechanism rather than a fundamental solution to the systemic issues within the public health system.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100502"},"PeriodicalIF":1.8,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-08DOI: 10.1016/j.ssmqr.2024.100498
Katie Wang , Joan M. Ostrove , Robert B. Manning III , Sarah Fodero , Samuel L. Ash , Jessica Whang , Kathleen R. Bogart , Rebecca Cipollina , Michelle R. Nario-Redmond , Jonathan M. Adler , Sarah R. Lowe
People with disabilities (PWD) face elevated mental health concerns and are more likely to utilize mental health services compared to their nondisabled counterparts, yet they also report higher unmet mental health service needs due to myriad attitudinal and environmental barriers to accessing care. Despite these well-documented disparities, little research has examined the nuanced lived experiences of PWD who receive mental health services. Drawing upon semi-structured interviews with 20 U.S. adults with disabilities who were diverse in race/ethnicity, sexual orientation, and gender identity, the present research examined the various structural and interpersonal processes through which ableism undermines the perceived effectiveness and relevance of mental health services. Reflexive thematic analysis identified six themes that characterized participants' ableism experiences in mental healthcare settings, including misplaced assumptions about the impact of disability on mental health, medical trauma and gaslighting, interpersonal ableism, lack of disability knowledge, accessibility challenges, and systematic ableism. These findings highlight the importance of centering PWD's voices in disability-affirmative mental health research and underscore important clinical considerations for fostering accessible and inclusive mental health services.
{"title":"Ableism in mental healthcare settings: A qualitative study among U.S. adults with disabilities","authors":"Katie Wang , Joan M. Ostrove , Robert B. Manning III , Sarah Fodero , Samuel L. Ash , Jessica Whang , Kathleen R. Bogart , Rebecca Cipollina , Michelle R. Nario-Redmond , Jonathan M. Adler , Sarah R. Lowe","doi":"10.1016/j.ssmqr.2024.100498","DOIUrl":"10.1016/j.ssmqr.2024.100498","url":null,"abstract":"<div><div>People with disabilities (PWD) face elevated mental health concerns and are more likely to utilize mental health services compared to their nondisabled counterparts, yet they also report higher unmet mental health service needs due to myriad attitudinal and environmental barriers to accessing care. Despite these well-documented disparities, little research has examined the nuanced lived experiences of PWD who receive mental health services. Drawing upon semi-structured interviews with 20 U.S. adults with disabilities who were diverse in race/ethnicity, sexual orientation, and gender identity, the present research examined the various structural and interpersonal processes through which ableism undermines the perceived effectiveness and relevance of mental health services. Reflexive thematic analysis identified six themes that characterized participants' ableism experiences in mental healthcare settings, including misplaced assumptions about the impact of disability on mental health, medical trauma and gaslighting, interpersonal ableism, lack of disability knowledge, accessibility challenges, and systematic ableism. These findings highlight the importance of centering PWD's voices in disability-affirmative mental health research and underscore important clinical considerations for fostering accessible and inclusive mental health services.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100498"},"PeriodicalIF":1.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-22DOI: 10.1016/j.ssmqr.2024.100492
Temidayo Akinreni , Mark Donald C. Reñosa , Agrin Zauyani Putri , Kerry Scott , Shannon A. McMahon
Diaries have served as a vehicle to document personal narratives and as a research tool. However, diaries remain relatively underutilized in most research disciplines, particularly in the field of global health. This review aimed to explore the application, utility, and methodological potential of diaries as a qualitative data collection tool in the health sector within low- and middle-income countries. We applied a search string across several databases, which yielded 1796 articles that were screened for eligibility. Eleven articles, covering topics including menstrual health, HIV, and mental illness, met our criteria and were included in this review. Across studies, authors highlighted a need to provide instructions in a diary's early pages and make diaries appealing to the participants by incorporating color. Researchers and participants described diaries as an appropriate tool for conducting research especially among vulnerable populations (e.g. children) or on sensitive or stigmatized topics (e.g. HIV and menstrual health). Some participants said that diary entry clashed with existing obligations, leading to time conflicts and increased workload. Challenges related to diary comprehension suggests a need for researchers to engage more pointedly with participants to co-design diaries in a manner that facilitates understandability (e.g. language, use of audio/video recording among low literacy population) and age-appropriateness. An undercurrent across studies entailed a tension between what researchers desire from diaries (insights regarding a phenomenon of interest captured in a relatively timely manner) versus the original purpose of diaries (a space for individuals to note a variety of topics at a self-appointed pace). Studies generally under-report process insights from participants. Most studies stem from 2020 onward suggesting that this qualitative approach may continue to expand in the future. Our review organizes pertinent diary characteristics into a framework that may facilitate reporting of diary usage in global health research.
{"title":"A methodological review of solicited diaries as a qualitative tool in health research in low- and middle-income countries","authors":"Temidayo Akinreni , Mark Donald C. Reñosa , Agrin Zauyani Putri , Kerry Scott , Shannon A. McMahon","doi":"10.1016/j.ssmqr.2024.100492","DOIUrl":"10.1016/j.ssmqr.2024.100492","url":null,"abstract":"<div><div>Diaries have served as a vehicle to document personal narratives and as a research tool. However, diaries remain relatively underutilized in most research disciplines, particularly in the field of global health. This review aimed to explore the application, utility, and methodological potential of diaries as a qualitative data collection tool in the health sector within low- and middle-income countries. We applied a search string across several databases, which yielded 1796 articles that were screened for eligibility. Eleven articles, covering topics including menstrual health, HIV, and mental illness, met our criteria and were included in this review. Across studies, authors highlighted a need to provide instructions in a diary's early pages and make diaries appealing to the participants by incorporating color. Researchers and participants described diaries as an appropriate tool for conducting research especially among vulnerable populations (e.g. children) or on sensitive or stigmatized topics (e.g. HIV and menstrual health). Some participants said that diary entry clashed with existing obligations, leading to time conflicts and increased workload. Challenges related to diary comprehension suggests a need for researchers to engage more pointedly with participants to co-design diaries in a manner that facilitates understandability (e.g. language, use of audio/video recording among low literacy population) and age-appropriateness. An undercurrent across studies entailed a tension between what researchers desire from diaries (insights regarding a phenomenon of interest captured in a relatively timely manner) versus the original purpose of diaries (a space for individuals to note a variety of topics at a self-appointed pace). Studies generally under-report process insights from participants. Most studies stem from 2020 onward suggesting that this qualitative approach may continue to expand in the future. Our review organizes pertinent diary characteristics into a framework that may facilitate reporting of diary usage in global health research.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100492"},"PeriodicalIF":1.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16DOI: 10.1016/j.ssmqr.2024.100495
Chris Degeling , Sittichoke Chawraingern , Gwendolyn L. Gilbert , Claire Hooker , Su-yin Hor , Jane Williams
Essential workers generate and maintain basic services that populations must receive, without interruption, to sustain a healthy, functional society. When SARS-COV-2 spread around the world, mundane low-paid work in essential non-healthcare industries such as supermarkets, became high risk, makeshift and unpredictable. Drawing on recent scholarship in the sociology of work, we conducted 32 interviews to capture how supermarket workers in Australia navigated the trade-offs and moral choices entailed in performing essential roles in non-health settings during a pandemic. We found that, as key assumptions about the resilience of globalised modernity and its supporting systems were tested, supermarket workers found themselves at the centre of experiments and public debates about the effectiveness and appropriateness of different infection control measures. Compensating for a lack of preparedness by governments and corporations, they were forced to accept, and then tasked with resolving inconsistencies between the political economy of low paid work and the moral economy of social provision. Given the experiences of those who found themselves in essential roles outside healthcare, there is an urgent need to reconceptualize what ‘successful’ pandemic preparedness and response entails. Reflecting on their experiences, these workers told us that expressions of solidarity and concern, from those not sharing their position of biological and financial precarity, were of little value. Drawing on the market logics that define their employment as essential and replaceable, the workers we spoke to observed that fair renumeration for risks and better protections were the most important considerations in recasting how societies prepare for future pandemics.
{"title":"Reconciling market and moral logics on a minimum wage: Supermarket work in Australia during the first two years of the SARS-COV-2 pandemic","authors":"Chris Degeling , Sittichoke Chawraingern , Gwendolyn L. Gilbert , Claire Hooker , Su-yin Hor , Jane Williams","doi":"10.1016/j.ssmqr.2024.100495","DOIUrl":"10.1016/j.ssmqr.2024.100495","url":null,"abstract":"<div><div>Essential workers generate and maintain basic services that populations must receive, without interruption, to sustain a healthy, functional society. When SARS-COV-2 spread around the world, mundane low-paid work in essential non-healthcare industries such as supermarkets, became high risk, makeshift and unpredictable. Drawing on recent scholarship in the sociology of work, we conducted 32 interviews to capture how supermarket workers in Australia navigated the trade-offs and moral choices entailed in performing essential roles in non-health settings during a pandemic. We found that, as key assumptions about the resilience of globalised modernity and its supporting systems were tested, supermarket workers found themselves at the centre of experiments and public debates about the effectiveness and appropriateness of different infection control measures. Compensating for a lack of preparedness by governments and corporations, they were forced to accept, and then tasked with resolving inconsistencies between the political economy of low paid work and the moral economy of social provision. Given the experiences of those who found themselves in essential roles outside healthcare, there is an urgent need to reconceptualize what ‘successful’ pandemic preparedness and response entails. Reflecting on their experiences, these workers told us that expressions of solidarity and concern, from those not sharing their position of biological and financial precarity, were of little value. Drawing on the market logics that define their employment as essential and replaceable, the workers we spoke to observed that fair renumeration for risks and better protections were the most important considerations in recasting how societies prepare for future pandemics.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100495"},"PeriodicalIF":1.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-11DOI: 10.1016/j.ssmqr.2024.100493
Emmanuel F. Koku
Over the past two decades, research on the conceptualization, measurement, and refinement of stigma has grown extensively due to increasing recognition of stigma as a driver of adverse health outcomes. While these lines of research have generally recognized that stigma is enacted in social relationships, few analysts have characterized how the structure and composition of these relationships influence stigma, particularly among immigrant populations. In response, this paper integrates data from social network analysis and in-depth interviews to explore the experiences of and responses to stigma by African immigrants living with HIV in the United States.
All participants reported that they anticipated, experienced, and internalized stigma within their personal networks. Many concealed their status and disclosed to only trusted associates, family members, and medical providers. Building on findings from previous studies, we found that the meanings and belief systems (particularly African cultural discourses that link HIV with mortality, immorality, retribution, and silence) matter for how stigma is assigned, enacted, experienced, and resisted. Our analyses also revealed that the structure of participants personal networks (i.e, the extent to which their associates were connected to each other, and how integrated/involved they were in these network relationships) intensified or diluted their exposure to stigmatizing discourses, depending on the composition (resourcefulness/quality) of their personal networks. Such network connections (i.e., social capital) translate into rewards if they are supportive and accepting, and costs if they stigmatize.
By showing how individuals can use their social networks to stigmatize or support their peers, this study advances theoretical expositions on (1) how the meanings and belief systems held by individuals matter for understanding social network/structural processes,(2) how social networks shape how stigma is assigned, enacted, experienced and resisted,(3) the costs and downsides of social capital, which are often neglected through emphasis on its salutary impacts. Our findings underscore the need for interventions that leverage the salient properties of personal networks to understand, conceptualize, measure, and reduce stigma.
{"title":"Social networks and stigma: The experiences of African immigrants living with HIV in the United States","authors":"Emmanuel F. Koku","doi":"10.1016/j.ssmqr.2024.100493","DOIUrl":"10.1016/j.ssmqr.2024.100493","url":null,"abstract":"<div><div>Over the past two decades, research on the conceptualization, measurement, and refinement of stigma has grown extensively due to increasing recognition of stigma as a driver of adverse health outcomes. While these lines of research have generally recognized that stigma is enacted in social relationships, few analysts have characterized how the structure and composition of these relationships influence stigma, particularly among immigrant populations. In response, this paper integrates data from social network analysis and in-depth interviews to explore the experiences of and responses to stigma by African immigrants living with HIV in the United States.</div><div>All participants reported that they anticipated, experienced, and internalized stigma within their personal networks. Many concealed their status and disclosed to only trusted associates, family members, and medical providers. Building on findings from previous studies, we found that the meanings and belief systems (particularly African cultural discourses that link HIV with mortality, immorality, retribution, and silence) matter for how stigma is assigned, enacted, experienced, and resisted. Our analyses also revealed that the structure of participants personal networks (i.e, the extent to which their associates were connected to each other, and how integrated/involved they were in these network relationships) intensified or diluted their exposure to stigmatizing discourses, depending on the composition (resourcefulness/quality) of their personal networks. Such network connections (i.e., social capital) translate into rewards if they are supportive and accepting, and costs if they stigmatize.</div><div>By showing how individuals can use their social networks to stigmatize or support their peers, this study advances theoretical expositions on <strong>(1)</strong> how the <em>meanings and belief systems</em> held by individuals matter for understanding <em>social network/structural processes</em><strong><em>,</em></strong> <strong>(2)</strong> how <em>social networks</em> shape how <em>stigma</em> is assigned, enacted, experienced and resisted,<strong>(3)</strong> the <em>costs and downsides</em> of <em>social capital</em>, which are often neglected through emphasis on its salutary impacts. Our findings underscore the need for interventions that leverage the salient properties of personal networks to understand, conceptualize, measure, and reduce stigma.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100493"},"PeriodicalIF":1.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}