SSM. Qualitative research in health最新文献_第10页

Antibiotic resistance and antibiotic use in companion animal veterinary medicine: A qualitative study in Southwestern France 伴侣动物兽药中的抗生素耐药性和抗生素使用：法国西南部的定性研究

IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

SSM. Qualitative research in health

Pub Date : 2025-12-01 Epub Date: 2025-09-09 DOI: 10.1016/j.ssmqr.2025.100632

Sophie Molia , Julien Mattern , Nicolas Fortané

Antibiotic resistance (ABR) is a major global health threat and its connection to antibiotic use (ABU) in animals has been less explored in companion animals compared to food animals. To better understand how French companion animal veterinarians perceive ABR and reduce ABU, we conducted semi-structured interviews with 23 veterinarians (20 practitioners in Southwestern France and 3 institutional officials). Participants noted substantial progress in ABR awareness over the past two decades, despite the low incidence of ABR cases in routine non-referral companion animal care. They considered veterinarians had significantly reduced ABU, driven by concerns over prescription/sale decoupling and efforts such as awareness campaigns, regulations, and best practice guidelines. Personal factors, including values, life experiences, interest in alternative medicine, career paths, and practical experience, also played an important role. However, certain best practices remain inconsistent, particularly antimicrobial susceptibility testing and avoiding peri/post-operative ABU or first-intention cefovecin use in cats. Several factors were widely agreed upon as influencing ABU, including type of pathology, geographic location, veterinary peer influence, and client factors (particularly compliance and financial capacities). Yet, perceptions diverged regarding the impact of pharmaceutical inspections by health authorities, generational differences among practitioners, work pressure, and the corporatization of veterinary practices. While progress has been made, companion animal veterinarians recognized there is still room for ABU improvement. Looking ahead, they called for health authorities to trust veterinarians' clinical judgment, balance required efforts between veterinary and human medicine, avoid punitive actions or unnecessary restrictions, and focus on sensitization (awareness-increasing) through accessible, evidence-based, and context-dependent recommendations.

抗生素耐药性（ABR）是一个主要的全球健康威胁，与食用动物相比，伴侣动物对其与动物抗生素使用（ABU）的关系的研究较少。为了更好地了解法国伴侣动物兽医如何看待ABR并减少ABU，我们对23名兽医进行了半结构化访谈（20名法国西南部的从业人员和3名机构官员）。与会者指出，在过去二十年中，尽管常规非转诊伴侣动物护理中ABR病例的发生率较低，但对ABR的认识取得了实质性进展。他们认为，由于对处方/销售脱钩的担忧，以及宣传活动、法规和最佳实践指南等努力，兽医已经显著减少了ABU。个人因素，包括价值观、生活经历、对替代医学的兴趣、职业道路和实践经验，也发挥了重要作用。然而，某些最佳做法仍然不一致，特别是抗菌药敏试验和避免猫围手术期/术后用药或首次使用头孢维菌素。有几个因素被广泛认为是影响ABU的因素，包括病理类型、地理位置、兽医同行影响和客户因素（特别是依从性和财务能力）。然而，对于卫生当局药品检查的影响、从业人员的代际差异、工作压力和兽医实践的公司化，人们的看法存在分歧。虽然取得了进展，但伴侣动物兽医认识到ABU仍有改进的余地。展望未来，他们呼吁卫生当局信任兽医的临床判断，平衡兽药和人药之间的必要努力，避免惩罚性行动或不必要的限制，并通过可获得的、基于证据的和与环境相关的建议，重点关注致敏（提高认识）。

{"title":"Antibiotic resistance and antibiotic use in companion animal veterinary medicine: A qualitative study in Southwestern France","authors":"Sophie Molia , Julien Mattern , Nicolas Fortané","doi":"10.1016/j.ssmqr.2025.100632","DOIUrl":"10.1016/j.ssmqr.2025.100632","url":null,"abstract":"<div><div>Antibiotic resistance (ABR) is a major global health threat and its connection to antibiotic use (ABU) in animals has been less explored in companion animals compared to food animals. To better understand how French companion animal veterinarians perceive ABR and reduce ABU, we conducted semi-structured interviews with 23 veterinarians (20 practitioners in Southwestern France and 3 institutional officials). Participants noted substantial progress in ABR awareness over the past two decades, despite the low incidence of ABR cases in routine non-referral companion animal care. They considered veterinarians had significantly reduced ABU, driven by concerns over prescription/sale decoupling and efforts such as awareness campaigns, regulations, and best practice guidelines. Personal factors, including values, life experiences, interest in alternative medicine, career paths, and practical experience, also played an important role. However, certain best practices remain inconsistent, particularly antimicrobial susceptibility testing and avoiding peri/post-operative ABU or first-intention cefovecin use in cats. Several factors were widely agreed upon as influencing ABU, including type of pathology, geographic location, veterinary peer influence, and client factors (particularly compliance and financial capacities). Yet, perceptions diverged regarding the impact of pharmaceutical inspections by health authorities, generational differences among practitioners, work pressure, and the corporatization of veterinary practices. While progress has been made, companion animal veterinarians recognized there is still room for ABU improvement. Looking ahead, they called for health authorities to trust veterinarians' clinical judgment, balance required efforts between veterinary and human medicine, avoid punitive actions or unnecessary restrictions, and focus on sensitization (awareness-increasing) through accessible, evidence-based, and context-dependent recommendations.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100632"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From the Town to the Village: Sustaining care in a rural Sudanese hospital 从城镇到村庄：苏丹农村医院的持续护理

IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

SSM. Qualitative research in health

Pub Date : 2025-12-01 Epub Date: 2025-10-31 DOI: 10.1016/j.ssmqr.2025.100662

C. Phifer Nicholson Jr

The Catholic Mother of Mercy-Gidel Hospital (MMH) has served as a referral center in the Nuba Mountains of Sudan since its founding in 2008. From January to March 2023, the author conducted qualitative fieldwork at MMH, seeking to understand what sustains the work of this hospital as well as meaning(s) of MMH to the Nuba and greater Sudan. Findings offer insight into the function and meaning of a rural hospital in a politically fragile setting, contributing to discussions within global health and medicine, including the impact of religion and faith-based health care, institutional accompaniment and “heart” in clinical medicine, and moral underpinnings of care.

天主教慈悲之母医院自2008年成立以来，一直是苏丹努巴山区的转诊中心。2023年1月至3月，提交人在马里联合医院进行了定性实地调查，试图了解是什么维持了这家医院的工作，以及马里联合医院对努巴和大苏丹的意义。调查结果有助于深入了解农村医院在政治脆弱环境中的功能和意义，促进全球卫生和医学领域的讨论，包括宗教和基于信仰的卫生保健的影响、机构陪伴和临床医学中的“心脏”以及护理的道德基础。

引用次数: 0

Epic disappointment: Physicians’ experiences of steerability in data-driven healthcare 史诗般的失望：医生在数据驱动的医疗保健中可操控性的经验

IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

SSM. Qualitative research in health

Pub Date : 2025-12-01 Epub Date: 2025-11-08 DOI: 10.1016/j.ssmqr.2025.100667

Maiju Tanninen , Ilpo Helén , Minna Ruckenstein

This paper examines discrepancies between expectations and actual data management practices in healthcare. It develops the concept of steerability to demonstrate how guidance provided by integrated, multipurpose patient data management systems functions as a sociotechnical feature and a core value in emerging data-driven healthcare, and what happens when the promises of an all-encompassing data infrastructure fail. The paper analyses physician's accounts and criticisms over an Epic-based patient data management system, Apotti, implemented in a public healthcare organization in Finland's capital region. Apotti aimed to standardize care and enhance oversight of the entire healthcare organization through data, following the idea that steerable healthcare functions better. While physicians did not oppose the datafication reform itself, their experiences reveal a stark misalignment between Apotti's steerability and their wants and needs, as it paradoxically both over- and understeered them. Clinicians felt the system fundamentally disrupted the core practices and values of their work, limiting their abilities in providing care. The paper shows how this deep mismatch was related to Apotti's poor fit with the Finnish healthcare system and the healthcare organization's more radical steerability objectives. Given the unfounded promises and misaligned effects, it raises the question of what role steerability plays in driving forward data-driven healthcare.

本文研究了医疗保健中预期和实际数据管理实践之间的差异。它发展了可操作性的概念，以演示集成的多用途患者数据管理系统提供的指导如何作为社会技术特征和新兴数据驱动医疗保健的核心价值，以及当包罗万象的数据基础设施的承诺失败时会发生什么。这篇论文分析了医生对一个基于epic的病人数据管理系统Apotti的描述和批评，该系统在芬兰首都地区的一家公共医疗机构中实施。Apotti的目标是通过数据规范护理并加强对整个医疗保健组织的监督，遵循可指导的医疗保健功能更好的想法。虽然医生们并不反对数据化改革本身，但他们的经历揭示了Apotti的可操控性与他们的需求之间的明显错位，因为它自相矛盾地既过度引导了他们，又缺乏对他们的引导。临床医生认为该系统从根本上破坏了他们工作的核心实践和价值观，限制了他们提供护理的能力。这篇论文显示了这种深度的不匹配是如何与Apotti不适合芬兰医疗保健系统和医疗保健组织更激进的可操作性目标有关的。鉴于毫无根据的承诺和不一致的效果，它提出了一个问题，即可操作性在推动数据驱动型医疗保健方面扮演什么角色。

{"title":"Epic disappointment: Physicians’ experiences of steerability in data-driven healthcare","authors":"Maiju Tanninen , Ilpo Helén , Minna Ruckenstein","doi":"10.1016/j.ssmqr.2025.100667","DOIUrl":"10.1016/j.ssmqr.2025.100667","url":null,"abstract":"<div><div>This paper examines discrepancies between expectations and actual data management practices in healthcare. It develops the concept of <em>steerability</em> to demonstrate how guidance provided by integrated, multipurpose patient data management systems functions as a sociotechnical feature and a core value in emerging data-driven healthcare, and what happens when the promises of an all-encompassing data infrastructure fail. The paper analyses physician's accounts and criticisms over an Epic-based patient data management system, Apotti, implemented in a public healthcare organization in Finland's capital region. Apotti aimed to standardize care and enhance oversight of the entire healthcare organization through data, following the idea that steerable healthcare functions better. While physicians did not oppose the datafication reform itself, their experiences reveal a stark misalignment between Apotti's steerability and their wants and needs, as it paradoxically both over- and understeered them. Clinicians felt the system fundamentally disrupted the core practices and values of their work, limiting their abilities in providing care. The paper shows how this deep mismatch was related to Apotti's poor fit with the Finnish healthcare system and the healthcare organization's more radical steerability objectives. Given the unfounded promises and misaligned effects, it raises the question of what role steerability plays in driving forward data-driven healthcare.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100667"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Emotional responses to potentially traumatic events: An interpretative qualitative analysis of high-risk professionals in relation to their social structures 对潜在创伤性事件的情绪反应：与社会结构有关的高风险专业人员的解释性定性分析

IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

SSM. Qualitative research in health

Pub Date : 2025-12-01 Epub Date: 2025-08-28 DOI: 10.1016/j.ssmqr.2025.100629

Renate Geuzinge , Merel Visse , Eric Vermetten , Joachim Duyndam

Background

Professionals in emergency-focused environments are taught to prioritize emergencies over their own emotions and trained to suppress their own emotional reactions. High-risk professionals in a vertical social structure, such as police officers, military personnel, career firefighters, and perioperative nurses, also tend to develop an us-versus-them mentality with emotional distance from patients or civilians.

Objective

This study explores emotional reactions of police officers, military personnel, firefighters, paramedics, and specialized nurses (emergency room nurses, operating room nurses, and intensive care nurses) to past and present potentially traumatic events. We aim to understand how a social environment that reinforces suppression of emotional reactions and fosters emotional distance from patients and civilians influences their emotional responses.

Methodology

We analyzed fieldnotes from ethnographical research, encompassing 332 h of observations and 71 in-depth interviews with professionals from eight occupational groups. We identified meaning units that were interpreted through the lens of literature on etiology and treatment of trauma-related mental health problems.

Findings

High-risk professionals in a vertical social structure experience unexpected moments of identification with victims or patients, which leads to personal distress and has lasting emotional impact. For those in horizontal social structures, such as paramedics and specialized nurses, we did not observe these sudden, intense emotional reactions. Instead, they seem to experience increased emotionality and exhaustion over the course of their careers.

Conclusion

While emotional distancing may be functional during emergencies, it likely increases the risk of traumatization. This risk is amplified when ingrained during early socialization.

在以紧急情况为中心的环境中，专业人员被教导要优先考虑紧急情况，而不是自己的情绪，并被训练要抑制自己的情绪反应。垂直社会结构中的高风险专业人员，如警察、军人、职业消防员和围手术期护士，也倾向于与患者或平民保持情感距离，形成“我们对抗他们”的心态。目的本研究探讨警察、军人、消防员、护理人员和专业护士（急诊室护士、手术室护士和重症监护护士）对过去和现在潜在创伤事件的情绪反应。我们的目标是了解一个社会环境是如何加强对情绪反应的抑制，并促进与患者和平民的情感距离，从而影响他们的情绪反应的。我们分析了来自民族志研究的现场记录，包括332小时的观察和71次对来自8个职业群体的专业人员的深度访谈。我们通过对创伤相关心理健康问题的病因学和治疗方面的文献进行解读，确定了意义单位。垂直社会结构中的高风险专业人员会经历与受害者或患者认同的意外时刻，这会导致个人痛苦并产生持久的情感影响。对于那些处于水平社会结构的人，比如护理人员和专业护士，我们没有观察到这些突然的、强烈的情绪反应。相反，在他们的职业生涯中，他们似乎会经历更多的情绪波动和疲惫。结论在紧急情况下，情感距离可能有一定的作用，但也可能增加心理创伤的风险。这种风险在早期社会化过程中根深蒂固时就会被放大。

{"title":"Emotional responses to potentially traumatic events: An interpretative qualitative analysis of high-risk professionals in relation to their social structures","authors":"Renate Geuzinge , Merel Visse , Eric Vermetten , Joachim Duyndam","doi":"10.1016/j.ssmqr.2025.100629","DOIUrl":"10.1016/j.ssmqr.2025.100629","url":null,"abstract":"<div><h3>Background</h3><div>Professionals in emergency-focused environments are taught to prioritize emergencies over their own emotions and trained to suppress their own emotional reactions. High-risk professionals in a vertical social structure, such as police officers, military personnel, career firefighters, and perioperative nurses, also tend to develop an us-versus-them mentality with emotional distance from patients or civilians.</div></div><div><h3>Objective</h3><div>This study explores emotional reactions of police officers, military personnel, firefighters, paramedics, and specialized nurses (emergency room nurses, operating room nurses, and intensive care nurses) to past and present potentially traumatic events. We aim to understand how a social environment that reinforces suppression of emotional reactions and fosters emotional distance from patients and civilians influences their emotional responses.</div></div><div><h3>Methodology</h3><div>We analyzed fieldnotes from ethnographical research, encompassing 332 h of observations and 71 in-depth interviews with professionals from eight occupational groups. We identified meaning units that were interpreted through the lens of literature on etiology and treatment of trauma-related mental health problems.</div></div><div><h3>Findings</h3><div>High-risk professionals in a vertical social structure experience unexpected moments of identification with victims or patients, which leads to personal distress and has lasting emotional impact. For those in horizontal social structures, such as paramedics and specialized nurses, we did not observe these sudden, intense emotional reactions. Instead, they seem to experience increased emotionality and exhaustion over the course of their careers.</div></div><div><h3>Conclusion</h3><div>While emotional distancing may be functional during emergencies, it likely increases the risk of traumatization. This risk is amplified when ingrained during early socialization.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100629"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Uncovering clinicians' inquiry-based and impression-based efforts to tailor information in oncology consultations: A focus group study 揭示临床医生基于询问和基于印象的努力，以定制肿瘤咨询信息：焦点小组研究

IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

SSM. Qualitative research in health

Pub Date : 2025-12-01 Epub Date: 2025-10-16 DOI: 10.1016/j.ssmqr.2025.100652

A. Van Ooijen , S.R. Dalhuisen , I. Henselmans , H.W.M. van Laarhoven , J.C.M. van Weert , E.M.A. Smets

Tailoring of health-related information is recommended to address cancer patients' diverse information needs and abilities to understand and process information. While tailored information can improve patients' satisfaction, recall of information and emotional wellbeing, little is known about how oncology clinicians tailor information during consultations. This study examined Dutch oncology clinicians' perceptions and experiences with tailoring of information to individual cancer patients' information needs and cognitive abilities during clinical consultations. Focus group and dyadic interviews were conducted involving 25 clinicians (physicians and clinical nurse specialists). Results show that clinicians interpret information tailoring as a multifaceted act: it occurs in dialogue, involves clinicians and patients, and includes assessing and adjusting of information. Furthermore, two pathways to tailor information emerged: 1) tailoring based on inquiry, which refers to adjusting information based on patients' stated needs and cognitive abilities (e.g., providing requested information), and 2) tailoring based on impressions, referring to the adjusting of information based on assumptions about patient characteristics and behavior (e.g., streamlining information for emotional patients). Last, clinicians mentioned contextual and interpersonal challenges like cultural differences, language barriers, and clinical regulations. Clinicians thus use inquiry-based and impression-based approaches to provide information that is sensitive to patients' (assumed) individual needs and abilities, interaction dynamics and the clinical setting. To ensure that information is accurately tailored, clinicians are encouraged to verify assumptions with patients and be attentive to patients’ cultural backgrounds and possible language barriers. Future research should observe how information is tailored in real clinical interactions and how patients perceive these efforts.

建议定制与健康相关的信息，以满足癌症患者不同的信息需求以及理解和处理信息的能力。虽然量身定制的信息可以提高患者的满意度、对信息的回忆和情绪健康，但人们对肿瘤临床医生在会诊期间如何定制信息知之甚少。本研究考察了荷兰肿瘤临床医生在临床咨询过程中根据癌症患者的信息需求和认知能力定制信息的看法和经验。对25名临床医生（内科医生和临床护理专家）进行了焦点小组和二元访谈。结果表明，临床医生将信息定制解释为一个多方面的行为：它发生在对话中，涉及临床医生和患者，包括评估和调整信息。此外，还出现了两种定制信息的途径：1)基于询问的定制，即根据患者陈述的需求和认知能力调整信息（例如，提供所要求的信息）；2)基于印象的定制，即基于对患者特征和行为的假设调整信息（例如，为情绪情绪化的患者简化信息）。最后，临床医生提到了环境和人际挑战，如文化差异、语言障碍和临床法规。因此，临床医生使用基于询问和基于印象的方法来提供对患者（假设的）个人需求和能力、互动动态和临床环境敏感的信息。为了确保信息准确，鼓励临床医生与患者一起验证假设，并注意患者的文化背景和可能的语言障碍。未来的研究应该观察信息是如何在真实的临床互动中被定制的，以及患者如何看待这些努力。

{"title":"Uncovering clinicians' inquiry-based and impression-based efforts to tailor information in oncology consultations: A focus group study","authors":"A. Van Ooijen , S.R. Dalhuisen , I. Henselmans , H.W.M. van Laarhoven , J.C.M. van Weert , E.M.A. Smets","doi":"10.1016/j.ssmqr.2025.100652","DOIUrl":"10.1016/j.ssmqr.2025.100652","url":null,"abstract":"<div><div>Tailoring of health-related information is recommended to address cancer patients' diverse information needs and abilities to understand and process information. While tailored information can improve patients' satisfaction, recall of information and emotional wellbeing, little is known about how oncology clinicians tailor information during consultations. This study examined Dutch oncology clinicians' perceptions and experiences with tailoring of information to individual cancer patients' information needs and cognitive abilities during clinical consultations. Focus group and dyadic interviews were conducted involving 25 clinicians (physicians and clinical nurse specialists). Results show that clinicians interpret information tailoring as a multifaceted act: it occurs in dialogue, involves clinicians and patients, and includes assessing and adjusting of information. Furthermore, two pathways to tailor information emerged: 1) tailoring based on inquiry, which refers to adjusting information based on patients' stated needs and cognitive abilities (e.g., providing requested information), and 2) tailoring based on impressions, referring to the adjusting of information based on assumptions about patient characteristics and behavior (e.g., streamlining information for emotional patients). Last, clinicians mentioned contextual and interpersonal challenges like cultural differences, language barriers, and clinical regulations. Clinicians thus use inquiry-based and impression-based approaches to provide information that is sensitive to patients' (assumed) individual needs and abilities, interaction dynamics and the clinical setting. To ensure that information is accurately tailored, clinicians are encouraged to verify assumptions with patients and be attentive to patients’ cultural backgrounds and possible language barriers. Future research should observe how information is tailored in real clinical interactions and how patients perceive these efforts.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100652"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of travel nursing in shifting nursing practice and careers 旅行护理在护理实践和职业转变中的作用

IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

SSM. Qualitative research in health

Pub Date : 2025-12-01 Epub Date: 2025-08-21 DOI: 10.1016/j.ssmqr.2025.100625

LaTonya J. Trotter , Paula M. Kett , Susan M. Skillman , Bianca K. Frogner

The COVID-19 pandemic expanded both the scale and visibility of travel nursing in the United States. Yet little is known about how this expansion has shaped nurses' understandings of what it means to be a professional. Drawing on semi-structured interviews with 15 U.S.-based travel nurses, this study examines how short-term contract work became a strategic site for reworking core ideals of nursing professionalism. Participants reframed autonomy as a form of professional protection from organizational demands, allowing them to prioritize direct, bedside care while gaining greater control over time away from work. The mobility required for travel nursing fostered new forms of expertise, increased confidence, and broadened nurses’ imagined career trajectories. Rather than signaling a departure from professional values, these experiences suggest a reconfiguration of professionalism that reflects and responds to the pressures of an increasingly unstable healthcare system. By centering the perspectives of travel nurses, this study illustrates how the rise of contingent nursing labor may not simply erode professional values, but instead invite their reinterpretation—even as it raises questions about what is lost when continuity and institutional ties can no longer be taken for granted.

COVID-19大流行扩大了美国旅行护理的规模和知名度。然而，对于这种扩张如何影响护士对专业人士的理解，人们知之甚少。通过对15名美国旅行护士的半结构化访谈，本研究探讨了短期合同工作如何成为重塑护理专业核心理念的战略场所。参与者将自主权重新定义为一种不受组织需求影响的专业保护形式，允许他们优先考虑直接的床边护理，同时在下班后获得更大的控制权。旅行护理所需的流动性培养了新形式的专业知识，增强了信心，拓宽了护士想象的职业轨迹。这些经历并不是背离专业价值观的信号，而是建议重新配置专业精神，以反映和应对日益不稳定的医疗保健系统的压力。通过以旅行护士的视角为中心，本研究说明了临时护理劳动力的兴起不仅会侵蚀专业价值观，反而会促使他们重新诠释专业价值观——即使它提出了这样的问题：当连续性和机构关系不再被视为理所当然时，失去了什么。

{"title":"The role of travel nursing in shifting nursing practice and careers","authors":"LaTonya J. Trotter , Paula M. Kett , Susan M. Skillman , Bianca K. Frogner","doi":"10.1016/j.ssmqr.2025.100625","DOIUrl":"10.1016/j.ssmqr.2025.100625","url":null,"abstract":"<div><div>The COVID-19 pandemic expanded both the scale and visibility of travel nursing in the United States. Yet little is known about how this expansion has shaped nurses' understandings of what it means to be a professional. Drawing on semi-structured interviews with 15 U.S.-based travel nurses, this study examines how short-term contract work became a strategic site for reworking core ideals of nursing professionalism. Participants reframed autonomy as a form of professional protection from organizational demands, allowing them to prioritize direct, bedside care while gaining greater control over time away from work. The mobility required for travel nursing fostered new forms of expertise, increased confidence, and broadened nurses’ imagined career trajectories. Rather than signaling a departure from professional values, these experiences suggest a reconfiguration of professionalism that reflects and responds to the pressures of an increasingly unstable healthcare system. By centering the perspectives of travel nurses, this study illustrates how the rise of contingent nursing labor may not simply erode professional values, but instead invite their reinterpretation—even as it raises questions about what is lost when continuity and institutional ties can no longer be taken for granted.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100625"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From ‘best practice’ to ‘best Fit’. Evaluating the implementation of Video Reflexive Ethnography as an improvement tool in a NICU setting 从“最佳实践”到“最适合”。评估视频反射性人种学在新生儿重症监护室环境下作为改进工具的实施

IF 1.8 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

SSM. Qualitative research in health

Pub Date : 2025-12-01 Epub Date: 2025-07-16 DOI: 10.1016/j.ssmqr.2025.100608

Henry Blom , Jessica Mesman , Kathleen Van Royen , Katja De Grande , Evelien Raman , Elke Moens , Twan Mulder

引用次数: 0

Transportation, administrative burden, and COVID-19: A structural intersectional analysis of barriers to HIV care among Black sexual minority men living with HIV in the US South 交通、行政负担和COVID-19：美国南部感染艾滋病毒的黑人性少数男性艾滋病毒护理障碍的结构交叉分析

IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

SSM. Qualitative research in health

Pub Date : 2025-12-01 Epub Date: 2025-11-22 DOI: 10.1016/j.ssmqr.2025.100675

Chadwick K. Campbell , Hannah E. Reynolds , Kirstin Kielhold , Daniel E. Siconolfi , Stephen D. Ramos , Susan M. Kegeles , Erik D. Storholm

While much research has focused on individual (e.g., mental health, substance use) and structural factors (e.g., stigma, institutional racism) driving HIV inequities, less studied are the macro-structural factors like policies governing healthcare and transportation. Using the framework of structural intersectionality, we explore how transportation barriers and administrative burden – the experience of accessing safety net services as burdensome – interfered with sustained HIV care engagement among Black sexual minority men living with HIV (BSMM+) in the US South. Between July 2022 and September 2023, we conducted qualitative interviews with 27 BSMM+. Interviews averaged 60 min, and data were analyzed using codebook thematic analysis. Transportation barriers included limited bus routes, reduced capacity during COVID-19, and long travel times. Administrative burden included: not knowing how to access benefits; inconsistent benefit eligibility, required frequent renewals of public insurance; and waiting in long lines for services. Most barriers existed prior to, and were exacerbated by, COVID-related restrictions. Further, barriers intersected such as when reduced capacity on public transit overlapped with changing clinic hours. Individual-level factors have long been the focus of HIV prevention and care interventions. Our findings offer important insights into how macro-structural barriers influence HIV care engagement. Importantly, macro-structural barriers do not impact all people equally. The need for, and access to transportation and safety net services vary by factors such as race, class, and geography, with the most marginalized being the most likely to face these hurdles. Additional research and policy changes are needed to address macro-structural factors and achieve equitable HIV outcomes.

虽然许多研究集中在导致艾滋病毒不平等的个人因素（如精神健康、药物使用）和结构因素（如耻辱、体制性种族主义）上，但对宏观结构因素（如管理医疗保健和交通的政策）的研究较少。利用结构交叉性的框架，我们探讨了交通障碍和行政负担-获得安全网服务的经验是负担-如何干扰美国南部感染艾滋病毒的黑人性少数男性（BSMM+）的持续艾滋病毒护理参与。在2022年7月至2023年9月期间，我们对27名BSMM+进行了定性访谈。访谈平均为60分钟，数据分析采用代码本主题分析。交通障碍包括公交路线有限、2019冠状病毒病期间运力下降以及旅行时间长。行政负担包括：不知道如何获得福利；福利资格不一致，需要频繁更新公共保险；还要排长队等候服务。大多数障碍在covid - 19相关限制之前就存在，并因这些限制而加剧。此外，当公共交通容量减少与诊所时间变化重叠时，障碍就会交叉。长期以来，个人层面的因素一直是艾滋病毒预防和护理干预的重点。我们的研究结果为宏观结构障碍如何影响艾滋病毒护理参与提供了重要见解。重要的是，宏观结构障碍对所有人的影响并不平等。对交通和安全网服务的需求和获取因种族、阶级和地理等因素而异，最边缘化的人最有可能面临这些障碍。需要进行更多的研究和政策改革，以解决宏观结构因素并实现公平的艾滋病毒结果。

{"title":"Transportation, administrative burden, and COVID-19: A structural intersectional analysis of barriers to HIV care among Black sexual minority men living with HIV in the US South","authors":"Chadwick K. Campbell , Hannah E. Reynolds , Kirstin Kielhold , Daniel E. Siconolfi , Stephen D. Ramos , Susan M. Kegeles , Erik D. Storholm","doi":"10.1016/j.ssmqr.2025.100675","DOIUrl":"10.1016/j.ssmqr.2025.100675","url":null,"abstract":"<div><div>While much research has focused on individual (e.g., mental health, substance use) and structural factors (e.g., stigma, institutional racism) driving HIV inequities, less studied are the macro-structural factors like policies governing healthcare and transportation. Using the framework of structural intersectionality, we explore how transportation barriers and administrative burden – the experience of accessing safety net services as burdensome – interfered with sustained HIV care engagement among Black sexual minority men living with HIV (BSMM+) in the US South. Between July 2022 and September 2023, we conducted qualitative interviews with 27 BSMM+. Interviews averaged 60 min, and data were analyzed using codebook thematic analysis. Transportation barriers included limited bus routes, reduced capacity during COVID-19, and long travel times. Administrative burden included: not knowing how to access benefits; inconsistent benefit eligibility, required frequent renewals of public insurance; and waiting in long lines for services. Most barriers existed prior to, and were exacerbated by, COVID-related restrictions. Further, barriers intersected such as when reduced capacity on public transit overlapped with changing clinic hours. Individual-level factors have long been the focus of HIV prevention and care interventions. Our findings offer important insights into how macro-structural barriers influence HIV care engagement. Importantly, macro-structural barriers do not impact all people equally. The need for, and access to transportation and safety net services vary by factors such as race, class, and geography, with the most marginalized being the most likely to face these hurdles. Additional research and policy changes are needed to address macro-structural factors and achieve equitable HIV outcomes.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100675"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Re-making selves and social worlds: Experiences of live-in substance use treatment among adolescents experiencing social structural marginalization in Vancouver 重塑自我与社会世界：温哥华经历社会结构边缘化的青少年的生活药物使用治疗经验

IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

SSM. Qualitative research in health

Pub Date : 2025-12-01 Epub Date: 2025-09-05 DOI: 10.1016/j.ssmqr.2025.100631

Monique Sandhu , Madison Thulien , Cameron R. Eekhoudt , Drew Friesen , Eva Moore , Martha Ignaszewski , Sarah Bagley , Rossio Motta-Ochoa , Emily Jenkins , Danya Fast

Across many settings in Canada and the US, overdose is now a leading cause of death among 10 to 18-year-olds. In the Canadian province of British Columbia (BC), there have been increased efforts to connect adolescents with substance use treatment, including live-in programs. While much previous work has focused on barriers to treatment among youth, less research has examined how adolescents, and in particular those experiencing high levels of residential instability, homelessness, and institutionalization via child protection, criminal legal and housing systems, understand and experience these programs. This qualitative study draws on semi-structured interviews with 37 adolescents and those who were very recently adolescents aged 14 to 20 who planned to access, were accessing or had recently accessed “Cypress Place” (a pseudonym), a live-in treatment program for adolescents in Vancouver, BC. Drawing on concepts of self and social world-making, our findings reveal that the changes adolescents envisioned making through live-in treatment extended far beyond abstinence from substance use, to encompass significant shifts in who they were and who they surrounded themselves with. While the weight of the social structural contexts that “followed” youth into treatment could powerfully undermine their abilities to make desired changes, this study nevertheless provides insights into how transformative projects of self and social world-making can be better supported across their treatment trajectories. Namely, providers and programs can work to bridge the kinds of self and social transformations achieved during live-in treatment with what comes next by providing opportunities for youth to stay connected and prioritizing the development of skills for living well – as individuals and as part of collectivities – that open up possibilities for recovery and healing over the longer term.

在加拿大和美国的许多地方，药物过量现在是10至18岁青少年死亡的主要原因。在加拿大不列颠哥伦比亚省（BC），已经加大了将青少年与药物使用治疗联系起来的努力，包括住家项目。虽然之前的许多工作都集中在青少年的治疗障碍上，但很少有研究调查青少年，特别是那些经历高度居住不稳定、无家可归和通过儿童保护、刑事法律和住房系统制度化的青少年，如何理解和体验这些项目。这项定性研究采用半结构化访谈的方式，对37名青少年和14至20岁的青少年进行访谈，这些青少年计划、正在或最近参加了“柏树之家”（化名），这是不列颠哥伦比亚省温哥华的一个青少年住家治疗项目。根据自我和社会世界形成的概念，我们的研究结果表明，青少年通过同居治疗所设想的改变远远超出了对物质使用的戒断，还包括他们是谁以及他们周围的人的重大转变。虽然“跟随”年轻人进入治疗的社会结构背景的重量可能会严重削弱他们做出期望改变的能力，但这项研究仍然提供了关于如何在他们的治疗轨迹中更好地支持自我和社会世界创造的变革项目的见解。也就是说，提供者和项目可以通过为青年提供保持联系的机会，并优先发展个人和集体的良好生活技能，从而为长期的恢复和康复开辟可能性，从而将在住家治疗期间实现的各种自我和社会转变与接下来的情况联系起来。

{"title":"Re-making selves and social worlds: Experiences of live-in substance use treatment among adolescents experiencing social structural marginalization in Vancouver","authors":"Monique Sandhu , Madison Thulien , Cameron R. Eekhoudt , Drew Friesen , Eva Moore , Martha Ignaszewski , Sarah Bagley , Rossio Motta-Ochoa , Emily Jenkins , Danya Fast","doi":"10.1016/j.ssmqr.2025.100631","DOIUrl":"10.1016/j.ssmqr.2025.100631","url":null,"abstract":"<div><div>Across many settings in Canada and the US, overdose is now a leading cause of death among 10 to 18-year-olds. In the Canadian province of British Columbia (BC), there have been increased efforts to connect adolescents with substance use treatment, including live-in programs. While much previous work has focused on barriers to treatment among youth, less research has examined how adolescents, and in particular those experiencing high levels of residential instability, homelessness, and institutionalization via child protection, criminal legal and housing systems, understand and experience these programs. This qualitative study draws on semi-structured interviews with 37 adolescents and those who were very recently adolescents aged 14 to 20 who planned to access, were accessing or had recently accessed “Cypress Place” (a pseudonym), a live-in treatment program for adolescents in Vancouver, BC. Drawing on concepts of self and social world-making, our findings reveal that the changes adolescents envisioned making through live-in treatment extended far beyond abstinence from substance use, to encompass significant shifts in who they were and who they surrounded themselves with. While the weight of the social structural contexts that “followed” youth into treatment could powerfully undermine their abilities to make desired changes, this study nevertheless provides insights into how transformative projects of self and social world-making can be better supported across their treatment trajectories. Namely, providers and programs can work to bridge the kinds of self and social transformations achieved during live-in treatment with what comes next by providing opportunities for youth to stay connected and prioritizing the development of skills for living well – as individuals and as part of collectivities – that open up possibilities for recovery and healing over the longer term.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100631"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

“Gasoline on a fire that was already burning”: Black Americans’ reasons for acquiring firearms in the early pandemic era “火上浇油”：美国黑人在早期大流行时期购买枪支的原因

IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

SSM. Qualitative research in health

Pub Date : 2025-12-01 Epub Date: 2025-08-22 DOI: 10.1016/j.ssmqr.2025.100612

Katelin Hoskins , Gabriela Kattan Khazanov , Arielle Thomas , Johnny Williams II , Caroline S. O'Brien , Vivek Ashok , Kelly Sebetka , Matthew Miller , Brooke Dorsey , Joseph Simonetti

引用次数: 0