SSM. Qualitative research in health最新文献

Food insecurity is a growing global concern, with millions of people suffering from hunger and malnutrition every day. Street-connected children are disproportionately vulnerable to food insecurity due to their living conditions and social status. However, little is known about their food insecurity experience, particularly in low- and middle-income countries. This study, therefore, aims to address this gap by examining the food insecurity experiences of street-connected children in Jimma, Ethiopia. This qualitative study was conducted from July to September 2021, and involved children living on the streets in various parts of Jimma city. In this study, we utilized interviews, focus group discussions, and field observations to investigate food acquisition strategies, hunger experiences, coping mechanisms, and challenges in food access among these children. Our findings indicate that street-connected children struggle to secure adequate, safe, and stable food, encountering pervasive hunger. Their limited resources and income exacerbate their dietary challenges. Their lack of food access not only represents a major challenge in their day-to-day lives but is also central to the various vulnerabilities and adversities they face. Moreover, their persistent hunger complicates their ability to improve their living conditions and exit from the street life. In conclusion, the study underscores the urgent need for focused attention on alleviating food insecurity among street-connected children, particularly in low-income countries.

In the near future, more people with dementia will be living at home within an urban context due to a combination of an increased number of people living with dementia and this past decade's urbanization. A common perception is that home-dwelling people with dementia experience a shrinking world, but emerging research from the UK, Sweden, and the Netherlands has broadened this notion by foregrounding how people with dementia experience neighborhoods as a resource in self-care practices. With this article, we contribute to this emerging body of literature and aim to explore how people with dementia experience the cityscape in relation to the onset and progression of their dementia. This study outlines findings from a 7-month ethnographic study involving 12 home-dwelling people with dementia. Using semi-structured interviews, walking interviews, and photovoice, the study explores how the cityscape of Copenhagen, Denmark, affects the everyday life of home-dwelling people living with dementia. Through thematic analysis, three key themes are identified: interaction with the city's life and space as self-care practices, getting out and about as a way to practice a sense of “being in the world” and the loss of orientation abilities and the changing boundaries of the cityscape. The findings from this study contribute to current discussions concerning how people with dementia experience and perceive city and neighborhood environments.

Qualitative cross-country comparative analysis is a method used to compare qualitative data from two or more countries to generate new insights and understandings for research, policy, and practice. Little is known about what is challenging and/or enjoyable for researchers employing this approach.

This paper reflects on the experiences of 21 researchers who took part in qualitative cross-country comparative analyses for papers that were submitted to a special issue of a peer reviewed journal. We draw on semi-structured interviews with researchers from the UK, Brazil, Japan, Germany, Spain, Australia, Canada, and USA, all of whom are members of the DIPEx International research collaboration.

The cross-country analyses were based on interview studies about various aspects of the COVID-19 pandemic. We explore researchers’ accounts of qualitative cross-country comparative analysis and their perspectives on working in international and interdisciplinary teams. Themes explored include Anglo-centrism, working across disciplines, translation for analysis, and leadership.

We conclude with recommendations for future qualitative cross-country comparative health research endeavours, encouraging more qualitative health research in this sphere. We emphasise the potential of qualitative cross-country comparative research to significantly develop medical sociology and qualitative health research generally, in this case through improving our understanding of complex, potentially global, phenomena, such as experiences of a pandemic.

This paper examines the role of companions in healthcare encounters, focusing on a previously unexamined context: the oncology visit with immigrant patients. By employing a methodological approach that combines elements of Goffman's footing and Conversation Analysis, this study discerns the social dynamics and communicative patterns among doctors, patients, and companions. Our focus on the companion yields an intricate picture of their multifaceted and dynamic participation, highlighting how their roles are not predefined and stable, but rather they are co-constructed and ongoingly negotiated among participants. Specifically, our analysis reveals that while companions initially maintain a peripheral position, aligning with the oncologist's focus on the patient as the primary recipient, they readily engage in active participation when the patient recruits them or when patient recipiency is problematic. As the anamnesis progresses, our investigation highlights the significance of the companion, showing their adept moves in response to the actions of both the patient and the oncologist. Their ability to offer linguistic assistance, insights into the patient's life circumstances, and documentation of previous tests is finely tuned to the developing interaction between the oncologist and the patient. In these ways the companions contribute to a more nuanced understanding of the patient and the overall effectiveness of the visit. The study's findings have significant implications for patient-centered care, particularly in diverse healthcare settings with immigrant patients. By recognizing and leveraging companion participation, healthcare practitioners can create more inclusive and equitable healthcare practices, optimizing their contributions for patient well-being.

Healing gardens, a longstanding feature of medical institutions, have garnered attention from scholars for their health-promoting properties across various stages of research. Through a historical literature review and contemporary case analysis of healing gardens, this research investigates how to achieve therapeutic integration by fostering effective connections between buildings and nature through typological design. Combined with qualitative and design-driven research methodologies, including the use of visualization tools such as drawings, models, and images, six models of building-nature integration in contemporary healthcare architecture are identified. This article bridges a research gap in the field of healing garden design and concludes by demonstrating that “typology” is only a design strategy according to context and building performance. In addition to positions of healing gardens, critical factors such as spatial organization, aesthetics, and sustainability, incorporating elements such as accessibility, readability, comfort, and ecological factors, must be carefully considered to achieve integration.

Background

Hospice palliative care aims to provide timely interventions and holistic care that focusses on quality of life for people who are terminally ill. In the first two years of the Covid-19 pandemic the national political and healthcare contexts changed significantly. Throughout this time hospices had to repeatedly adjust their approach to supporting terminally ill people, many of whom were especially vulnerable to Covid-19.

Aim

The aim of this paper was to explore hospice patients, carers, staff and senior managers stories to identify how changing pandemic narratives affected their understanding of hospice palliative care as timely, holistic and supporting quality of life.

Methods

Narrative analysis of in-depth interviews with patients, carers, staff and senior managers (n = 70) recruited from hospices across the West-Midlands, UK, in 2020–22.

Findings

We identified four ‘pandemic narratives’ (reaction; revision; resilience; (re)normalisation) in the participants' accounts of hospice palliative care support in the first two years of the pandemic. In each narrative we explore how Covid-19 and the associated pandemic guidance affected what quality of life was understood to be; how what was considered to be timely care could change during the palliative care journey; and, how different ideas of holistic care were emphasised as the hospice and wider healthcare context changed.

Conclusion

This is the first-time stories about the first two-years of the Covid-19 pandemic from hospice patients, carers, staff and senior managers have been analysed together. We identified how the pandemic brought an existential challenge to ideas of what hospice palliative care is and could be. Our findings suggest that ‘living with covid’ will continue to affect hospice palliative care's ideals of timeliness of care, holistic support, and quality of life left.

The Canadian HIV pre-exposure prophylaxis (PrEP) guidelines recommend both daily and on-demand dosing for gay, bisexual, and queer men (GBQM), meeting additional risk criteria. However, limited research explored how GBQM implement pausing, on-demand, discontinuation, and resumption of PrEP, including the contextual factors affecting decision-making. Using a relationally situated implementation science framework, we examined how GBQM tailor PrEP use to changing social and sexual circumstances. We conducted 109 longitudinal interviews with current and former PrEP users from Ontario (n = 18) and British Columbia (n = 20), Canada, at three time points between 2020 and 2022. We identified three dynamic PrEP use trajectories: pausing, on-demand, and stopping. Pausing involved brief breaks followed by a return to daily use during heightened sexual activity. Others followed the 2-1-1 on-demand schedule, while some stopped PrEP with plans to resume if social and sexual circumstances change. During the COVID-19 pandemic, participants paused PrEP when sexual activities decreased, restarting daily use when sexual engagements resumed. Others paused due to relationship changes or sexual inactivity, resuming PrEP in anticipation of sex. On-demand PrEP was adopted to manage side effects or save costs. Some stopped PrEP for sustained periods due to monogamy, private insurance loss, side effects, or low perceived HIV risk. Participants expressed concerns regarding lack of information on these strategies, relying on online sources or peers for guidance. Most participants obtained enough PrEP knowledge to adapt use appropriately. Comprehensive education campaigns on adaptable PrEP use effectiveness and strategies to discontinue and resume PrEP for clinicians and GBQM should be implemented.