SSM. Qualitative research in health最新文献

Based on the 2017 Canadian Survey on Disability, more than two million Canadians 15 years of age or older are living with a mental health-related disability. Subsequently, access and delivery of mental health services in Canada, more specifically in Ontario, have shifted to a shared responsibility between healthcare providers and the individual client's informal caregivers. Unfortunately, the role of the caregiver has been historically underappreciated and undervalued, leaving caregivers with few supports to help them manage and cope with caregiving responsibilities. This paper reports the results of a qualitative descriptive study that explored the lived experiences of caregivers who are providing care to an adult family member who is living with a mental illness in Windsor-Essex County, Ontario. Twenty-one participants volunteered to be interviewed for this study via telephone or online on Microsoft Teams. All interviews were audio-recorded and transcribed verbatim. Data analysis followed Braun and Clarke's framework for reflexive thematic analysis. Four themes were identified from the 21 interviews: 1) personal impact of being a caregiver, 2) stress associated with navigating the system, 3) complexity of the caregiving burden, and 4) caregivers as buffers of the failings of the system. Results demonstrate that caregiving is a stressful responsibility and, without sufficient supports, can impair the wellbeing of both the caregiver and the care recipient. As such, apart from recognizing informal caregivers as partners in the care of persons living with mental illness in the community, there is also a need to acknowledge that they, too, require supports to ensure that their health and well-being are not compromised in providing care to their loved one(s).

Much research exists on conflict of interest in high-performance sport in the global North. Yet, the research conducted particularly into US college football—a fairly unique social site of athletic labor given that the fact that enormous revenue is produced by professionalized work that is not compensated—is largely quantitative in nature. In this study, we conducted semi-structured qualitative interviews with twenty-five former power five football players Based on our conversations with former college football players in order to interrogate in a more granular way how and why conflict of interest undermines health and safety in the sport. We found that the well-being of college football players is consistently jeopardized because of the financial imperatives that shape the sport and compromise the care players receive from medical practitioners beholden to the team's ‘need’ to win at all costs. In addition to the inherent concerns this raises about the state of medicine in college athletics, we would also contend that the experiences of the players we spoke to offer a crucial intervention into the debate over ‘exploitation’ in college sport. While exploitation is generally understood in economic terms based on the question of how and to whom the value produced through the commodity spectacle of college sport is distributed, we contend that it should also be understood in terms of the attendant harms. The testimony in this article contributes to the literature on conflict of interest principally by providing some of the most rich and evocative available testimony about how and why conflict of interest occurs and what the implications are for the players whose care is compromised by it.

1 This study investigates how information and communication technology (ICT) facilitated older adults’ home modification to encompass pre-pandemic activities, as well as the health implications of this transition. Using a sample of 24 adults (65+) who lived in the Toronto area during the first summer of the pandemic (May 2020–August 2020), we conduct a qualitative thematic analysis of interviews about daily life, health, and ICT use. We employ difference of means and proportions tests using De Jong Gierveld 6-item loneliness scores to contextualize qualitative findings. We identified four qualitative themes encompassing a sense of loss of in-person socializing, ICT use to adapt routines and socializing to the home, and impacts on mental and physical health. Older adults adapted their homes into an activity place, although ICT was not key to this transition for everyone. Longing for third places suggests spatial agency is important for emotional well-being.

Delivery in well-equipped facilities is important to prevent the major causes of maternal mortality. Social and structural barriers are well established across low-resource contexts; less understood is the interaction between the psychological dimensions of behavior and a pregnant woman's environment to either facilitate or hinder facility delivery. We conducted formative research applying the behavioral design approach to explore this context shaping decision-making and behavior of pregnant women, and others with influence, in Grand Cape Mount, Liberia. In-depth interviews (n = 58) were conducted in 2021 with pregnant and postpartum women, family members, facility-based providers, trained traditional midwives, community health assistants, and community leaders. Our findings highlight that while most women intend to deliver in a facility, poverty compounds difficulties at each step of the continuum of care, with the cumulative impact making facility-based delivery more difficult for lower-income, rural women to achieve. Delivering in a facility requires extensive planning and saving to overcome these difficulties and we present insights into the context contributing to a series of delays across the course of a woman's pregnancy – from initial care seeking through preparing and seeking care for childbirth, to arriving and receiving care at the facility. Our findings reveal the importance of delays earlier in pregnancy, as poor families have to weigh trade-offs of various aspects of planning and saving more carefully while also faced with chronic scarcity and competing demands for attention. Behavioral solutions that support women to make these difficult decisions and empower communities to address local challenges are still sorely needed.

The social determinants of health is an internationally recognized approach to analyzing the impact of non-medical factors on individual health. However, disability is mostly associated with inherent vulnerability without recognition of the social factors. The goal of this qualitative study is to examine the lived experiences of persons living with spinal cord injury (SCI) in coping and managing their health and functioning and to explore an interaction between their embodied experiences and structural issues that contribute to health and wellbeing of people with spinal cord injuries. A thematic analysis of 30 semi-structured interviews generated three themes that highlighted the tensions between the materiality of disability and the barriers associated with stigma, between the self-management strategies and the healthcare access, and finally between access to the formal supports and the invisible costs of living with a spinal cord injury. The findings emphasize the need to re-evaluate public health approaches, recognize the linkages between inequalities linked to disability, and incorporate an embodiment lens from a disability justice perspective.

Objectives

Housing is an important social determinant of health, but the perspectives of asylum seekers and refugees (ASR) in large, centralised reception centres remain under-researched. We therefore sought to examine which housing aspects in reception centres are deemed relevant for health by ASR in Germany.

Methods

Based on 47 interviews with 42 ASR in Germany originating from three different studies, we conducted a secondary qualitative analysis. We mapped interview transcripts onto existing housing frameworks and generated four central themes regarding the relationship between housing and health in reception centres.

Results

Housing affected ASR health in four key ways: 1) Material conditions, including crowding, hygiene conditions and inability to secure doors, created and exacerbated physical and mental health issues, 2) the unpredictability and instability of housing impeded integration and disrupted social and professional support networks, 3) through forced residential assignment and limited autonomy, "homemaking" is severely constrained, leading to worsened mental health, and 4) reception centres do not make sufficient accommodations for individuals with specific medical needs.

Conclusion

This study offers a broad perspective on the relationship between ASR reception centres and health. It is evident that this housing context is not conducive to health. Instead, centralised accommodation facilities exacerbate existing health conditions through excessive overcrowding, insufficient infrastructure and the inability to meet health-related needs. Stressful living environments and frequent transfers further burden psychosocial health by impeding a sense of belonging and comfort and by disrupting social and care networks. Current accommodation policy and practice need to be reconsidered to safeguard the health of ASR.