IF 2.1 4区医学

Health Pub Date : 2023-07-01 DOI: 10.1177/13634593211060760

Grace Lucas, Ellinor K Olander, Debra Salmon

{"title":"Bodies of concern? A qualitative exploration of eating, moving and embodiment in young mothers.","authors":"Grace Lucas, Ellinor K Olander, Debra Salmon","doi":"10.1177/13634593211060760","DOIUrl":"https://doi.org/10.1177/13634593211060760","url":null,"abstract":"In some countries, including the United Kingdom, young mothers' pregnant and postnatal bodies remain an area of concern for policy and practice, with interventions developed to support improved health behaviours including diet and physical activity. This article explores what young women themselves think and feel about eating and moving during and after pregnancy. Semi-structured interviews with 11 young mothers were conducted within two voluntary organisations. Data were analysed using thematic analysis with the theoretical lens of embodiment, which provided an understanding of how young women's eating and moving habits related to how they felt about their bodies in the world. Four themes situated in different experiences of being and having a body were identified: pregnant body, emotional body, social body and surveilled body. Stress and low mood impacted eating habits as young women responded to complex circumstances and perceived judgement about their lives. Food choices were influenced by financial constraints and shaped by the spaces and places in which young women lived. Whilst young women were busy moving in their day-to-day lives, they rarely had the resources to take part in other physical activity. Holistic approaches that focus on how women feel about their lives and bodies and ask them where they need support are required from professionals. Interventions that address the structural influences on poor diet and inequalities in physical activity participation are necessary to underpin this. Approaches that over-focus on the achievement of individual health behaviours may fail to improve long-term health and risk reinforcing young women's disadvantage.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 4","pages":"607-624"},"PeriodicalIF":2.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10197155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Hype, evidence gaps and digital divides: Telehealth blind spots in rural Australia. 炒作、证据差距和数字鸿沟:澳大利亚农村的远程医疗盲点。

IF 2.1 4区医学

Health Pub Date : 2023-07-01 DOI: 10.1177/13634593211060763

Deborah Warr, Georgina Luscombe, Danielle Couch

{"title":"Hype, evidence gaps and digital divides: Telehealth blind spots in rural Australia.","authors":"Deborah Warr, Georgina Luscombe, Danielle Couch","doi":"10.1177/13634593211060763","DOIUrl":"https://doi.org/10.1177/13634593211060763","url":null,"abstract":"Despite high unmet demand for health services across rural Australia, uptake of telehealth has been slow, piecemeal and ad hoc. We argue that widespread failure to understand telehealth as a socio-technical practice is key to understanding this slow progress. To develop this argument, we explore how technocentric approaches to telehealth have contributed to critical blind spots. First, the 'hype' associated with the technological possibilities of telehealth discourages thoughtful consideration of the unanticipated consequences when technologies are rolled out into complex social fields. Second, it contributes to critical gaps in the telehealth evidence base, and particularly a paucity of analyses focussing on the experiences of service users and patients. A third blind spot concerns the limited attention paid to the social determinants of health and digital divides in rural areas. The final blind spot we consider is an apparent reluctance to engage community stakeholders in co-designing and coproducing telehealth services. We used an iterative approach to identify studies and commentary from a range of academic fields to explain the significance of the telehealth blind spots and how they might be addressed. Insights suggest how expanding understanding of the social dimensions of telehealth could enhance its accessibility, effectiveness and responsiveness to community needs and contexts.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 4","pages":"588-606"},"PeriodicalIF":2.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

The power struggle: exploring the reality of clinical reasoning. 权力斗争:探索临床推理的现实。

IF 2.1 4区医学

Health Pub Date : 2023-07-01 DOI: 10.1177/13634593211054008

Thiani Pillay, Mershen Pillay

{"title":"The power struggle: exploring the reality of clinical reasoning.","authors":"Thiani Pillay, Mershen Pillay","doi":"10.1177/13634593211054008","DOIUrl":"https://doi.org/10.1177/13634593211054008","url":null,"abstract":"Purpose: Historically, clinical reasoning has largely been considered from an empirical, biomedical standpoint. This epistemology, rooted in imperial rule, is influential in how healthcare practitioners practice. An empirical approach to healthcare often oversimplifies the complex nature of clinical reasoning by obscuring the influence of imperial ideologies on decision-making. This can perpetuate inequitable approaches to healthcare delivery which deepen social, political and economic divides globally. This paper aims to explore and challenge this standpoint by exploring how power, imperialism and performativity influences healthcare provision and decision-making amongst healthcare practitioners in dysphagia rehabilitation.Methods: Qualitative exploratory interviews were undertaken with seven South African trained SLPs with experience working in dysphagia. To allow for participation and collaboration from participants, three data collection tools were employed within the interviews: oral histories, cognitive mapping and arts-based tasks. An initial modified thematic analysis followed by a further ideological analysis were undertaken to analyse the data collected.Results: The results suggest that the participants felt influenced by several manifestations of power within healthcare. We argue that this demonstrates that imperial practices can influence knowledge, interaction and context and therefore affect how healthcare practitioners make decisions.Conclusion: By acknowledging the impact of imperialism and power dynamics on healthcare provision and clinical reasoning we can potentially begin to transform the epistemology from which we approach healthcare provision in favour of one which is better suited to the current realities of healthcare to allow for equitable service provision.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 4","pages":"559-587"},"PeriodicalIF":2.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9492173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The immune self, hygiene and performative virtue in general public narratives on antibiotics and antimicrobial resistance. 关于抗生素和抗菌素耐药性的公共叙事中的免疫自我、卫生和行为美德。

IF 2.1 4区医学

Health Pub Date : 2023-07-01 DOI: 10.1177/13634593211046832

Mark Dm Davis, Davina Lohm, Paul Flowers, Andrea Whittaker

{"title":"The immune self, hygiene and performative virtue in general public narratives on antibiotics and antimicrobial resistance.","authors":"Mark Dm Davis, Davina Lohm, Paul Flowers, Andrea Whittaker","doi":"10.1177/13634593211046832","DOIUrl":"https://doi.org/10.1177/13634593211046832","url":null,"abstract":"This paper employs an assemblage lens to generate analyses of general public narratives on antimicrobial resistance (AMR). Global efforts to reduce AMR include communications aiming to promote general public awareness, provide knowledge, encourage careful antibiotics use, and discourage demands for them. These efforts are somewhat compromised by the assumptions they make of individual lack of knowledge and motivation and the manner in which the AMR problem is framed in isolation from the biological, social and economic structures that produce it. Conceptualising AMR as an effect of antimicrobial assemblages of which publics are but one part, we analysed interviews with the general public on the lived experience of infections, antibiotic treatments and AMR. Far from science and policy discourse on AMR, these narratives showed antibiotics to be partly solutions to the social and biomedical challenges of infection, framed by self-defensive immunity and hygiene, the affective benefits of 'immune boosting', and the imperative to sustain the moral standing of the healthy citizen. Failing public awareness and action on AMR can be attributed to public health messages that overlook the social, affective and moral dimensions of infection care and separate AMR from its socio-economic drivers.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 4","pages":"491-507"},"PeriodicalIF":2.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Parental experiences of the liminal period of a child's fatal illness. 父母在孩子患绝症的最后阶段的经历。

IF 2.1 4区医学

Health Pub Date : 2023-07-01 DOI: 10.1177/13634593211046850

Bernadetta Janusz, Maciej Walkiewicz

{"title":"Parental experiences of the liminal period of a child's fatal illness.","authors":"Bernadetta Janusz, Maciej Walkiewicz","doi":"10.1177/13634593211046850","DOIUrl":"https://doi.org/10.1177/13634593211046850","url":null,"abstract":"The article offers a description of parents' experiences of their child's ultimately fatal illness as it unfolds over the successive stages of medical treatment, in the context of the liminality theory. The parents (N = 23) were interviewed 1-4 years after their child's death. The research method involved conducting narrative interviews with parents in order to obtain a spontaneous narration of the child's illness as it unfolded. The grounded theory approach, including the narrative and performative aspects of such parental utterances, was applied as the main research strategy. The results provide insight into the main areas and processes of common parental experiences, such as the pervasive sense of becoming trapped in timelessness and ambiguity. Further states reported by parents included oscillating between a distancing stance and involvement, and a dualistic relationship with medical staff and the medical system: between alignment and disharmony. The study indicates the importance of treating delivery of such a diagnosis as a process rather than as a one-time event. The sense of ambiguity is treated as a kind of necessary parental coping mechanism, whilst the sense of timelessness gives parents a unique sense of time in which they do not have to think about the child's potentially imminent death.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 4","pages":"439-457"},"PeriodicalIF":2.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9552574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Kidney failure, status passage, and the transitional nature of living with the disease: A qualitative study in Argentina. 肾衰竭，状态传递，和生活与疾病的过渡性质:在阿根廷的定性研究。

IF 2.1 4区医学

Health Pub Date : 2023-07-01 DOI: 10.1177/13634593211046842

Javier Roberti, Juan Pedro Alonso, Leandro Blas, Carl May

{"title":"Kidney failure, status passage, and the transitional nature of living with the disease: A qualitative study in Argentina.","authors":"Javier Roberti, Juan Pedro Alonso, Leandro Blas, Carl May","doi":"10.1177/13634593211046842","DOIUrl":"https://doi.org/10.1177/13634593211046842","url":null,"abstract":"The span of kidney failure (KF) has been extended by advances in treatment. To elucidate the lived experiences of people with KF, we draw on Glaser and Strauss's theory of status passage. Semi-structured interviews were conducted with 50 patients with KF and 14 health professionals, from two healthcare facilities in Buenos Aires, Argentina. The theory informed on the temporal dimensions of people's passages and dimensions related to what actors know of this passage. We described the status passage as a sequence of transitions (starting dialysis, receiving a transplant, returning to dialysis) that have devastating effects on patient's roles, and are accompanied with fear and experience of wasting time. Temporal aspects were crucial and planning was useless; indeed, timing of statuses was uncertain. With a transplant, certain roles and capacities could be regained. Some patients were not aware of the chronic nature of the disease and the ultimate reversibility of the transplant. Control over the passage was minimal because of the unpredictable prognosis of the disease but patients employed strategies to regain it. Control was even more limited for people who migrated to receive a treatment; whose lives were completely altered. Status passage theory signaled the overwhelming impact of the passage on all aspects of people's lives, the uncertainty of the transitions, lack of control and awareness of essential aspects, and unexpected aspects of desirability, adding to our understanding of how people experience this disease and its treatments.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 4","pages":"458-475"},"PeriodicalIF":2.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9854334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Unintended harm: A qualitative study of "harm" upon people who inject drugs in Bangkok, Thailand. 意外伤害:对泰国曼谷注射毒品的人“伤害”的定性研究。

IF 2.1 4区医学

Health Pub Date : 2023-07-01 DOI: 10.1177/13634593211046841

Niphattra Haritavorn

{"title":"Unintended harm: A qualitative study of \"harm\" upon people who inject drugs in Bangkok, Thailand.","authors":"Niphattra Haritavorn","doi":"10.1177/13634593211046841","DOIUrl":"https://doi.org/10.1177/13634593211046841","url":null,"abstract":"Given the highly pervasive health threats faced by people who inject drugs, harm reduction has been implemented in Thailand. Although harm reduction is a particularly effective public health strategy for reducing risky behavior, it is currently practiced with minimal understanding of unintended harm-drug policy, social exclusion, stigma, and discrimination-for people who inject drugs (PWID) in Thailand. This study aims to understanding the \"unintended harm\" encountered by people who inject drugs in Bangkok in their everyday lives through social interaction at all levels of society from macro, micro, and individual levels. In-depth interviews were conducted with 28 people who inject drugs in Bangkok (21 men and 7 women) and 4 people who are a nurse, a community leader, a policeman, and a family member (2 men and 2 women). The result shows that individuals, society, and politics are not separable phenomena and all produce harm upon people who inject drugs. These unintended harms on the macro, micro, and individual level are closely linked; each in their own way poses a threat to the health and well-being of people who inject drugs and embody negative social responses as the people who inject drugs become typecast as \"deviants.\" In conclusion, there is an urgent need to develop a \"harm reduction\" model that addresses unintended harm and could be integrated within the existing socio-cultural context of Thai society.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 4","pages":"525-539"},"PeriodicalIF":2.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The mouth and oral health in the field of dementia. 口腔和口腔健康领域的老年痴呆症。

IF 2.1 4区医学

Health Pub Date : 2023-07-01 DOI: 10.1177/13634593211049891

Sasha Scambler, Sarah Curtis, Jill Manthorpe, Kritika Samsi, Yvonne M Rooney, Jennifer E Gallagher

引用次数: 3

Caring for affective subjects produced in intimate healthcare examinations. 关爱亲密医疗检查中产生的情感对象。

IF 1.9 4区医学

Health Pub Date : 2023-05-01 Epub Date: 2021-05-27 DOI: 10.1177/13634593211020072

Jenny Gleisner, Ericka Johnson

引用次数: 0

Access to intervene. An ethnographic study of public health practices targeting health inequalities. 可以进行干预。针对卫生不平等问题的公共卫生实践的人种学研究。

IF 2.1 4区医学

Health Pub Date : 2023-05-01 DOI: 10.1177/13634593211032869

Mette Terp Høybye, Ditte Herring Holt, Morten Hulvej Rod

{"title":"Access to intervene. An ethnographic study of public health practices targeting health inequalities.","authors":"Mette Terp Høybye, Ditte Herring Holt, Morten Hulvej Rod","doi":"10.1177/13634593211032869","DOIUrl":"https://doi.org/10.1177/13634593211032869","url":null,"abstract":"Much public health research has devoted attention to the question of how interventions aimed at reducing health inequalities can access so-called \"hard-to-reach\" populations. This work has generally reflected an instrumentalist approach, which implies the preexistence of particular target groups characterized by specific public health problems. The key research interests are to find ways to effectively alleviate health inequalities and to identify the best ways to intervene to address disparate health problems among certain groups of people. Based on ethnographic research with public health officers in four Danish municipalities, this article turns the issue on its head by examining how public health officers gain access to intervene in practice and, as part of this process, define and delineate target groups and public health problems. Through detailed descriptions of two ethnographic cases, we develop the argument that public health interventions carry with them moral differentiations that may contradict the overall intention of reducing health inequalities. We adopt a theoretical perspective developed by Lakoff and Collier, suggesting that public health interventions can be understood as \"regimes of living.\" This leads us to the conclusion that the practices of gaining access result in the production of unforeseen target groups and new moral configurations where the value of health becomes linked to other types of value, most importantly economic value. For public health officers, the complicated issue of gaining access to intervene is not simply a matter of finding practical solutions; it also defines and delineates the scope of public health itself.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 3","pages":"362-377"},"PeriodicalIF":2.1,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/13634593211032869","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9284428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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