SSM. Qualitative research in health最新文献

{"title":"Sovereignty in the digital age Indigenous perspectives on health data and emerging technologies","authors":"Samantha Hurst , Kelle Dhein , Joseph Yracheta , Timothy Mackey","doi":"10.1016/j.ssmqr.2025.100698","DOIUrl":"10.1016/j.ssmqr.2025.100698","url":null,"abstract":"","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100698"},"PeriodicalIF":2.5,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976547","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}

{"title":"“Stuck in between two worlds”: Substance misuse among first generation ethnic-Nepali Bhutanese youth and young adults with a refugee life experience","authors":"Rochelle L. Frounfelker ,&nbsp;Georgia Bromley ,&nbsp;Katherine Blomkvist ,&nbsp;Giulia Henckels ,&nbsp;Kirby Child ,&nbsp;Tej Mishra","doi":"10.1016/j.ssmqr.2026.100700","DOIUrl":"10.1016/j.ssmqr.2026.100700","url":null,"abstract":"<div><h3>Objectives</h3><div>There is limited information on the dynamics of alcohol and other drug (AOD) misuse among refugee youth. Over 90,000 ethnic-Nepali Bhutanese refugees have resettled in the United States since 2008, and there is increasing concern for AOD misuse among youth and young adults. The objective of this research was to understand factors influencing the development of AOD issues and barriers to prevention and help seeking among Bhutanese youth and young adults (ages 14–24).</div></div><div><h3>Methods</h3><div>A total of 35 Bhutanese youth and adults participated in key informant interviews. A total of 47 individuals participated in 8 focus groups with Bhutanese parents, Bhutanese youth and young adults, AOD service providers, police and probation officers, Bhutanese business owners, and educators. Data were analyzed using thematic content analysis and informed by the Transnational Theory of Cultural Stress for Alcohol and Other Drug Misuse Risk.</div></div><div><h3>Results</h3><div>Issues related to Bhutanese history and culture included accessibility of AOD and community stigma. Specific to family dynamics, parental engagement, parent-child communication, and family cohesion acted as risk and protective factors. Finally, the theme of communication and trust with external stakeholders revealed that external stakeholders had difficulty engaging with the Bhutanese community and linking people to prevention and intervention services.</div></div><div><h3>Conclusions</h3><div>Findings have implications for culturally-tailored approaches to address AOD misuse. Prevention initiatives need to include efforts within the Bhutanese community, with a focus on family functioning and addressing intergenerational conflict. Psychoeducation for other stakeholder groups is critical to facilitate culturally-sensitive responses to community needs and issues.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100700"},"PeriodicalIF":2.5,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924976","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}

{"title":"Understanding metabolic bariatric surgery stigma through the lived experiences of Dutch women","authors":"Franshelis K. Garcia ,&nbsp;Bob C. Mulder ,&nbsp;Annemarie M.A.E. Wagemakers ,&nbsp;Eric J. Hazebroek ,&nbsp;Kirsten T. Verkooijen","doi":"10.1016/j.ssmqr.2026.100699","DOIUrl":"10.1016/j.ssmqr.2026.100699","url":null,"abstract":"<div><div>Metabolic bariatric surgery (MBS) is an effective treatment for severe obesity, yet patients often face stigma related to both obesity and MBS, complicating their treatment experience. Despite its significance, MBS stigma remains under-theorized in research. This study applies a socio-ecological stigma framework to explore how MBS stigma is experienced by patients in the Netherlands.</div><div>Using qualitative methods, we conducted semi-structured interviews with 16 Dutch women undergoing MBS and employed reflexive thematic analysis to examine how stigma shapes their decision-making, disclosure practices, social relationships, and post-operative adjustment. Four core themes emerged: (1) The Decision-Making Journey, highlighting internal conflicts driven primarily by weight stigma and feelings of personal failure; (2) Disclosure and Reactions, which revealed that sharing MBS decisions often brought social support but also exposed participants to stigma from those outside their immediate circles; (3) Life After Surgery, capturing improvements in health and social engagement alongside ongoing struggles with body image and eating behaviors; and (4) Healthcare Support and Missed Opportunities, reflecting mixed experiences with healthcare professionals and a notable lack of psychological follow-up care.</div><div>Stigma emerged at multiple levels - internalized, interpersonal, and structural - affecting patients’ well-being and access to care. MBS stigma is a pervasive, embedded part of obesity treatment. Our findings emphasize the urgent need for stigma-informed, empathetic healthcare and sustained psychological support throughout patients’ treatment journey. Effectively addressing both weight- and MBS stigma requires change at the institutional level and addressing the moral judgments often tied to obesity treatment to improve patient care and outcomes.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100699"},"PeriodicalIF":2.5,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924975","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}

{"title":"Bridging work: Community health workers’ role as a continuum of building, guiding, sustaining and transforming the path to health equity","authors":"Melina Michelen ,&nbsp;John Billimek ,&nbsp;Salvador Zarate ,&nbsp;Patricia J. Cantero ,&nbsp;Noraima Chirinos ,&nbsp;Rocio Salazar ,&nbsp;Mary Anne Foo ,&nbsp;Samantha Peralta ,&nbsp;Gloria I. Montiel ,&nbsp;Brittany N. Morey ,&nbsp;Sora P. Tanjasiri ,&nbsp;Alana M.W. LeBrón","doi":"10.1016/j.ssmqr.2025.100693","DOIUrl":"10.1016/j.ssmqr.2025.100693","url":null,"abstract":"<div><div>Community Health Workers (CHW) are commonly conceptualized as a ‘bridge’ that connects the community to health-related systems and resources for which they have historically and contemporarily experienced systemic barriers to accessing. Nonetheless, the nuances of the bridge role remain underexamined. The bridge metaphor, by the static nature of a bridge, can overlook the dynamic and relational aspects of CHWs' work beyond simple liaison functions. This qualitative study shows CHWs' work goes beyond liaison roles, expanding on the bridge metaphor. We evaluated narratives from CHWs from Orange County, California and across California (n = 77), as well as Orange County institutional representatives and policy makers (n = 15) regarding CHWs roles as bridges through interviews and focus groups conducted between February 2023–January 2024. Interviews and focus group discussions were recorded, transcribed, and analyzed following a flexible coding approach. Participants provided nuanced details to expand on the CHW role as bridges, well beyond liaising or connecting. Their narratives illuminate the full arc of CHW bridging work, highlighted in three themes: 1) Building: involving working with the community to identify the need for a bridge and building responsive and adaptable bridges accessible to the community, 2) Guiding: encompasses accompanying and guiding the community to access and cross these bridges, and 3) Sustaining and transforming: comprising maintaining a responsive and accessible bridge while working to reduce the structural gaps necessitating such bridges. Such an understanding of CHW roles can provide insights into the efforts needed to sustain this workforce, critical to public health and community wellbeing.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100693"},"PeriodicalIF":2.5,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924982","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}

{"title":"“Implementing a policy is something else”. Governance of a complex health management information system and its digitalization in Tanzania: A qualitative study","authors":"Regine Unkels ,&nbsp;Elibariki Mkumbo ,&nbsp;Ntuli A. Kapologwe ,&nbsp;Fatuma Manzi ,&nbsp;Claudia Hanson ,&nbsp;Helle Mølsted Alvesson ,&nbsp;Andrea B. Pembe","doi":"10.1016/j.ssmqr.2025.100695","DOIUrl":"10.1016/j.ssmqr.2025.100695","url":null,"abstract":"<div><h3>Introduction</h3><div>Health management information systems are crucial for a country's health service planning and monitoring. Research findings indicate however that data produced within this system is often of low quality or not used for decision-making in low-resource settings like Tanzania. Policymaking and -implementation towards efficient data processes and use take place in an environment challenged by limited availability of human and other resources, low levels of supervision and feedback on data quality despite national and international guidance. To better understand how this complexity affects system governance, it is crucial to analyse perceptions and practices of national policymakers and subnational healthcare managers responsible for policy implementation. We therefore aimed to understand how policymakers and health care managers perceive and practice governance of health management information data systems and processes including the introduction of digital technology in Tanzania.</div></div><div><h3>Methods</h3><div>We conducted 16 interviews with policymakers and healthcare managers experienced in governance and use of health management information systems in two districts, two regions and at national level in Tanzania between October 2022 and January 2023. Reflexive thematic analysis grounded in constructivism was used. Themes were developed through reflexive sessions underpinned by complexity theory and Lipsky's theory of street-level bureaucracy.</div></div><div><h3>Results</h3><div>Health management information system governance took place in a complex environment characterized by unpredictable funding and human capacity impairing policy agenda setting and its implementation. Policymakers at national level and healthcare managers at subnational level resorted to different power practices to ensure implementation of national policies and agendas. While policymakers mainly governed data processes using institutionalized means, e.g. international tools and guidance or formal communication platforms, healthcare managers governed implementation by making discrete, contextualized choices on managing relations with other actor groups through negotiation and connection.</div><div>This led to transformed agendas in some cases but also allowed for innovations to make policies work.</div></div><div><h3>Conclusions</h3><div>A new perspective may be needed to understand how governance of routine health information, which is central to health system strengthening, is implemented in policy environments characterized by unpredictability, where governments strive for efficient data use. Drawing on the concept of complex adaptive systems, we propose expanding the definition of Health Management Information System governance to include not only process management but also the relationship management of interdependent actor groups, especially healthcare providers, the primary data collectors.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100695"},"PeriodicalIF":2.5,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924974","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}

{"title":"Framing video consultations in Danish general practice: An ethnographic study of problematizations underpinning digital integration","authors":"Ditte Bonde Stanek ,&nbsp;Ulrik Bak Kirk ,&nbsp;Michal Frumer","doi":"10.1016/j.ssmqr.2025.100694","DOIUrl":"10.1016/j.ssmqr.2025.100694","url":null,"abstract":"<div><div>Video consultations between patients and healthcare professionals have become an established part of Danish general practice. Initially introduced hastily during the COVID-19 pandemic, their use declined afterwards but remained a political priority. In January 2022, video consultations were formalised as a permanent consultation type, and since late 2024, all general practices in Denmark have been required to offer them. While previous research has explored the early adoption of video consultations during the pandemic, little is known about how general practices sustain and routinize their use in everyday care. This study addresses this gap through ethnographic fieldwork conducted in high-use practices in a post-pandemic context. Drawing on Foucault's concept of problematization, it examines the underlying rationalities and framings that shape the use of video consultations. Our findings show that general practitioners and practice staff primarily framed video consultations as tools for efficiency and time management, particularly in follow-up and acute care. They also described video consultations as providing flexibility that helps to ease busy practice schedules and potentially reduce burnout. These findings suggest that, in digitally mature practices, video consultations function as organisational strategies to balance limited resources with increasing demand.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100694"},"PeriodicalIF":2.5,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924972","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}

{"title":"“Do you belong in my circle?” – a retrospective reflexive thematic analysis of the particularity and price of solidarity for socioculturally diverse communities in Switzerland during the COVID-19 pandemic","authors":"Gia Thu Ly ,&nbsp;Cristopher I.Kobler Betancourt ,&nbsp;Balthasar L. Hug ,&nbsp;Annika Frahsa","doi":"10.1016/j.ssmqr.2025.100697","DOIUrl":"10.1016/j.ssmqr.2025.100697","url":null,"abstract":"<div><div>During the COVID-19 pandemic, calls for solidarity were widespread, yet its practice proved fragile and uneven. This study explores how individuals from socio-culturally diverse and often marginalized communities in the canton of Bern (Switzerland) experienced and enacted solidarity. Drawing on the conceptual works by Prainsack &amp; Buyx and Komter, we conducted reflexive thematic analysis of seven focus group discussions with 53 participants and identified two central themes: (1) “<em>Commonality, gratitude and reciprocity as particularities of solidarity”</em>, highlighting how shared values and mutual recognition shaped solidaristic practices; and (2) <em>“Barriers, challenges and costs: the ticket to enter solidarity”</em>, capturing affective labour, limitations of institutional solidarity, and conditions under which solidarity was withheld. Focusing on participants' lived experiences, findings concentrate on three key insights: first, participants experienced positive aspects of solidarity—such as shared purpose and commonality—but these were often offset by emotional and social burdens; second, sociocultural and socioeconomic contexts fundamentally shaped who could afford the costs asscociated with solidaristic engagement; and third, institutional appeals to solidarity were insufficient to sustain collective action, failing to meet participants’ diverse needs and capacities. Solidarity was thus enacted in deeply situated and contingent ways, motivated by ethical and emotional imperatives, yet constrained by structural inequalities. The study underscores the need to consider both affective and socio-structural dimensions when fostering solidaristic practices, offering insights for developing context-specific and culturally responsive strategies to support collective action and social cohesion in times of crisis.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100697"},"PeriodicalIF":2.5,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976546","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}

{"title":"Do-it-yourself hormones: constructing credible knowledge in an online transgender forum","authors":"Natasa Stoli,&nbsp;Klasien Horstman,&nbsp;Olga Zvonareva","doi":"10.1016/j.ssmqr.2025.100692","DOIUrl":"10.1016/j.ssmqr.2025.100692","url":null,"abstract":"<div><div>On the continuum of patient participation between ‘‘informed patients'’ and ‘‘patients in control’‘, DIY pharmaceuticals are considered the most radical because they are produced outside regular medical professional and regulatory contexts. While some see DIY pharmaceuticals as an important contribution to making pharmaceuticals more accessible, others are concerned because they circumvent established procedures for assessing safety and efficacy. We studied a particular case of DIY pharmaceuticals: citizen drug developers who enable access to hormone therapy in transgender health care through the home production of hormones. By studying an online community of DIY hormone producers, we aimed to gain insight into how they strive to develop knowledge practices that are credible and safe. Theoretically, we drew from science and technology studies scholarship on knowledge credibility and patient participation in knowledge production. We relied on a qualitative study of an online forum to generate our data. The analysis shows how citizen drug developers constructed and performed standards of safety and efficacy in sharing knowledge within their community and how these standards were ensured. DIY pharmaceuticals can be an unconventional but important pathway for citizen participation in biomedical knowledge production, employing strategies for performing credible knowledge outside formal laboratory spaces and in the absence of external supervision.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100692"},"PeriodicalIF":2.5,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924977","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}

{"title":"Beyond access: Racial and socioeconomic disparities in device use among youth with type 1 diabetes","authors":"Cassidy Puckett ,&nbsp;Jenise C. Wong ,&nbsp;Berty D.C. Arreguín ,&nbsp;Jennifer K. Raymond ,&nbsp;Stephanie S. Crossen ,&nbsp;Kevin Yen","doi":"10.1016/j.ssmqr.2025.100690","DOIUrl":"10.1016/j.ssmqr.2025.100690","url":null,"abstract":"<div><div>Racial and socioeconomic disparities in medical device use among youth with type 1 diabetes (T1D) are well documented. Inequities in access can arise in the unequal prescription of insulin pumps and continuous glucose monitoring (CGM) devices. Once prescribed, challenges to device use can also create inequities, but less is known about racial and socioeconomic disparities in post-access challenges such as barriers to use at school. Using focus group data from three mixed-method studies of youth with T1D (N = 50) and their caregivers (N = 56), we compare the experiences of higher-income and majority White youth to lower-income and predominantly Latinx and Black youth. We find many similarities, along with two striking differences. First, lower-income and majority Latinx and Black youth express more fear and victimization from bullying at school, which can lead to device discontinuation. Second, these youth and their caregivers report few connections to other families managing T1D but many connections to those with T2D. This social network configuration promotes the typicality assumption that these youth have T2D, which carries significant stigma and limits diabetes-related social capital that might otherwise support device use. Overall, our findings extend health inequities research by identifying unique challenges faced by lower-income and majority Latinx and Black youth with T1D in utilizing medical innovation.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100690"},"PeriodicalIF":2.5,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924973","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}

{"title":"Institutional objection to abortion care in Australia: Exploring the perspectives and experiences of key interest-holders","authors":"Casey M. Haining ,&nbsp;Bronwen Merner ,&nbsp;Lindy Willmott ,&nbsp;Louise A. Keogh ,&nbsp;Julian Savulescu","doi":"10.1016/j.ssmqr.2025.100685","DOIUrl":"10.1016/j.ssmqr.2025.100685","url":null,"abstract":"<div><div>Each Australian jurisdiction has decriminalised abortion. Despite this, abortion-seekers face multiple barriers to access, among them is encountering objection by individual health practitioners (conscientious objection) or institutions (institutional objection). This article reports on a qualitative interview study that examined 41 key interest-holders’ perspectives and experiences of institutional objection to abortion. Framework analysis resulted in the generation of four themes: (1) institutional variation in different aspects of abortion care; (2) impacts of institutional objection affected multiple interest-holders; (3) attitudes towards accommodating institutional objection; and (4) suggestions for reimagining institutional objection regulation. Our findings suggest that institutional objection manifests in different ways across settings and results in harm to both patients and health practitioners. Consequently, current approaches to regulating institutional objection should be revisited. Such approaches should consider minimum levels of transparency, information provision, and explore other opportunities for service provision and de-stigmatisation.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100685"},"PeriodicalIF":2.5,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924979","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}