IF 2.3 4区医学

Health Pub Date : 2025-09-01 Epub Date: 2024-12-02 DOI: 10.1177/13634593241303620

Ekaterina Borozdina, Anna Temkina

{"title":"Institutional inconsistencies and professionals' hidden institutional work in Russian pandemic-affected healthcare: The material dimension.","authors":"Ekaterina Borozdina, Anna Temkina","doi":"10.1177/13634593241303620","DOIUrl":"10.1177/13634593241303620","url":null,"abstract":"In recent years, medical sociology has produced a significant amount of publications about the effects of the COVID-19 pandemic on medical care provision and healthcare professionalism around the globe. This study builds on this line of research by looking at a rarely discussed case of pandemic management-the case of Russia's centralized and state-dominated medical sector. In our analysis, we focus on the organizational level and the institutional work of front-line health professionals. Using a neoinstitutional theoretical lens, we show how, as a result of the conflict between professional and managerial logics, pockets of extreme institutional uncertainty emerged within Russian healthcare: \"non-COVID\" healthcare facilities and hospitals rapidly restructured for COVID-19 care. Qualitative interviews with healthcare professionals indicate that institutional misalignment inside these \"gray zones\" translated into the material dimension, significantly impeding the effectiveness of the pandemic response. While sociological literature frequently portrays Russian health professionals as fully subjected to administrative constraints and disempowered, our data allows us to trace their informal institutional work and agency during the health crisis. Through these materially mediated work, our informants attempted to deal with both the challenges of the pandemic and institutional contradictions of the Russian healthcare system. Professionals' institutional work brought some improvements to Russia's pandemic-affected clinical settings. However, being informal and purposefully hidden, it neither constituted a viable solution for medical organizations, nor contributed to the strengthening of professionals' autonomy.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"725-742"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768408","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: 0

When health changes everything: The disruptive side of identity shifts in people with CF. 当健康改变一切：CF患者身份的破坏性方面发生了变化。

IF 2.3 4区医学

Health Pub Date : 2025-09-01 DOI: 10.1177/13634593251366025

Noa Tal-Alon

{"title":"When health changes everything: The disruptive side of identity shifts in people with CF.","authors":"Noa Tal-Alon","doi":"10.1177/13634593251366025","DOIUrl":"https://doi.org/10.1177/13634593251366025","url":null,"abstract":"Cystic fibrosis (CF) is a severe genetic disorder historically associated with low life expectancy. The introduction of CF transmembrane conductance regulator (CFTR) modulator drugs like Trikafta has dramatically improved health outcomes for many people with CF (pwCF), shifting their lived experiences in unexpected ways. This qualitative study explores the psychological and social consequences of such improvements, focusing specifically on identity disruption and emotional adaptation. Utilizing a phenomenological approach, in-depth interviews were conducted with CF patients who had used Trikafta for at least 2 years, alongside an analysis of publicly available blog narratives. The findings reveal two central themes: identity disruption and ambivalent loss. Participants described profound challenges in adjusting to their new health status, including difficulties in redefining their identity after years of viewing themselves as chronically ill. Additionally, they reported a paradoxical sense of loss, grieving aspects of their previous illness experience, such as a sense of urgency in life decisions and strong connections within the CF community. While participants also shared hopeful and forward-looking narratives, this study centers on the less-explored emotional complexities that emerge when long-standing illness-based identities are disrupted. The findings underscore the need for comprehensive psychological support systems to help PwCF process identity shifts and sustain a sense of continuity in their lives.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593251366025"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951729","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

Healthcare seeking for people diagnosed with severe mental illness: Sensations, symptoms and diagnostic work. 为被诊断患有严重精神疾病的人寻求医疗保健：感觉、症状和诊断工作。

IF 2.3 4区医学

Health Pub Date : 2025-09-01 Epub Date: 2024-12-27 DOI: 10.1177/13634593241308497

Iben Emilie Christensen, Susanne Reventlow, Lone Grøn, Mette Bech Risør

{"title":"Healthcare seeking for people diagnosed with severe mental illness: Sensations, symptoms and diagnostic work.","authors":"Iben Emilie Christensen, Susanne Reventlow, Lone Grøn, Mette Bech Risør","doi":"10.1177/13634593241308497","DOIUrl":"10.1177/13634593241308497","url":null,"abstract":"For people with mental and somatic illnesses, the interpretive process of attending to a multitude of bodily sensations and recognising them as potential symptoms represents daily and 'chronic homework'. Based on 16 months of ethnographic fieldwork in Denmark, this study explores diagnostic work and healthcare seeking among people with severe mental and somatic illnesses. As multiple studies have shown, the transformation process for a perceived sensation to become a symptom is a socially constructed interpretative process highly dependent on social legitimisation and shaped by prior cultural knowledge. We found that people with severe mental and somatic illnesses often struggle to 'read' the body and its boundaries and to define and distinguish when a symptom becomes a potential sign of illness. Furthermore, they often lack opportunities for social recognition of symptoms due to the absence of social relations. Finally, lifelong experiences with the healthcare system have taught them that they must distinguish between 'mental' and 'somatic' symptoms to fit the systemic organisation of the healthcare system. This deeply rooted mind-body dualism in the organisation of healthcare services and the daily struggles of diagnostic work to comply with this organisation impacted the interlocutors' healthcare seeking strategies. Moreover, even though they 'make up their minds' to seek healthcare, they risk being met with diagnostic overshadowing and reductionist clinical approaches.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"652-675"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894089","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

Caring remotely through 'fitting': Video consultation use in Danish general practice. 通过“装配”远程护理：视频咨询在丹麦全科实践中的应用。

IF 2.3 4区医学

Health Pub Date : 2025-09-01 Epub Date: 2024-12-26 DOI: 10.1177/13634593241306577

Elle Christine Lüchau, Finn Olesen, Helen Atherton, Jens Søndergaard, Elisabeth Assing Hvidt

{"title":"Caring remotely through 'fitting': Video consultation use in Danish general practice.","authors":"Elle Christine Lüchau, Finn Olesen, Helen Atherton, Jens Søndergaard, Elisabeth Assing Hvidt","doi":"10.1177/13634593241306577","DOIUrl":"10.1177/13634593241306577","url":null,"abstract":"In this study, we examine how Danish general practitioners (GPs) and general practice staff have fitted their use of video consultation to align with their conceptualisations of good care. Political stakeholders are repeatedly encouraging the use of video consultation in the healthcare sector, discursively referring to optimised use of healthcare resources, increased efficiency and flexibility for and geographical equality among patients. By the end of 2024, it will be mandatory for GPs to offer video consultations to patients in Danish general practice. This raises important questions about the implications of video consultation on the care provided in general practice. Our data consists of 30 semi-structured interviews with GPs and 132 hours of fieldwork conducted across seven clinics from August 2021 to August 2022. We analysed the data following the principles of reflexive thematic analysis and inspired by an abductive approach. Drawing on Annemarie Mol's and Jeanette Pols' conceptualisations of care and fitting, we identified common rationalisations articulated and observed in practice that highlight how fitting video consultation into the care provided in a general practice setting can enable (1) optimised use of busy patients' time), (2) optimised use of clinician and clinic resources, (3) enhanced connection of 'harder to reach' patients and (4) better work experiences for GPs and staff. Our findings demonstrate the variety of video consultation use potentials, contributing to our understanding of the implications of video consultation on the provision of care.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"693-711"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894085","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

Boundary-work of primary care physicians using telemedicine technologies for communication. 使用远程医疗技术进行沟通的初级保健医生的边界工作。

IF 2.3 4区医学

Health Pub Date : 2025-09-01 Epub Date: 2024-12-02 DOI: 10.1177/13634593241303607

Ariela Popper-Giveon, Yael Keshet, Tamar Adar

{"title":"Boundary-work of primary care physicians using telemedicine technologies for communication.","authors":"Ariela Popper-Giveon, Yael Keshet, Tamar Adar","doi":"10.1177/13634593241303607","DOIUrl":"10.1177/13634593241303607","url":null,"abstract":"Implementing telemedicine technologies (TT) for patient-physician communication leads to the emergence of new structures of boundaries. Hence, boundary work theory can provide a useful lens for examining how primary care physicians (PCPs) experience TT. The objective of this research was to examine the experiences of PCPs in using TT in their communication with patients. During 2023 in-depth interviews were conducted with 20 Israeli PCPs: family physicians and pediatricians. The concept of boundary work emerged as a focal point, with three forms of boundary work identified in the PCPs' descriptions of their TT experiences: collaborative, competitive, and configurational. Interviewees described improved collaboration with patients who find it difficult to get to the clinic and better service for administrative issues. However, they reported constant power struggles to maintain their authority. They expressed concern about treatment failure and suggested that healthcare organizations reconfigure TT so that it can be used to provide optimal care. They suggested that healthcare organizations should instruct physicians how to best manage TT consultations and regulate its usage. This article demonstrates that while implementing TT in primary care has many advantages, it uncovers boundary work for maintaining power and authority that both PCPs and healthcare organizations should take into account in practice as well as in policy.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"763-778"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768467","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

'One time my gut and psyche talked to each other': The flexible use of mind-body dualism to articulate socially situated selves. “有一次，我的内心和心灵互相交谈”：灵活地使用身心二元论来表达处于社会地位的自我。

IF 2.3 4区医学

Health Pub Date : 2025-07-28 DOI: 10.1177/13634593251358046

Tine Friis, Monica Greco, Louise Whiteley

{"title":"'One time my gut and psyche talked to each other': The flexible use of mind-body dualism to articulate socially situated selves.","authors":"Tine Friis, Monica Greco, Louise Whiteley","doi":"10.1177/13634593251358046","DOIUrl":"https://doi.org/10.1177/13634593251358046","url":null,"abstract":"Instead of pursuing the dissolution of mind-body dualism, this article argues for examining when and to what purposes it is mobilised. The article explores notions of the 'gut', 'psyche' and 'self' as mobilised in descriptions of personal experiences, which were examined through collective memory-work with three groups of women. Rather than responding to direct questions about mind-body dualism, participants wrote memories from the prompt One time my gut and psyche talked to each other. . . Our analysis shows that the memories use 'gut' and 'psyche' to articulate 'selves', and these articulations illuminate and help participants navigate the social situations that structure the experiences they describe. More generally, our memory-work shows that meanings of 'gut' and 'psyche' - and thus implicit ideas about mind-body dualism - are flexible and unsettled. They find their meaning(s) in the ways their relations are articulated, but also via attributions of agency and responsibility. We argue that this is not as such problematic. Rather, our analysis calls for an orientation towards appreciating, rather than fixing or controlling, this mutability. Our memory-work offers and exemplifies such an orientation, and develops the use of memory prompts that provocatively contain the very categories that are in question, rather than trying to avoid their premature articulation or dissolution.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593251358046"},"PeriodicalIF":2.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729859","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

A collective narrative of care and complex mental illness. 一个关于护理和复杂精神疾病的集体叙述。

IF 2.3 4区医学

Health Pub Date : 2025-07-28 DOI: 10.1177/13634593251358048

Tanya Park, Eduan Breedt, Megan Sommerfeld, Lindsay Komar, Nicole Tailby, Karlee Podritske, Tim Barlott

引用次数: 0

'I don't know if there's a happy ending to this story': An analysis of prostate cancer narratives in a follow-up setting. “我不知道这个故事是否会有一个圆满的结局”：一项对前列腺癌后续研究的分析。

IF 2.3 4区医学

Health Pub Date : 2025-07-28 DOI: 10.1177/13634593251358052

Laura Lahti, Piia Jallinoja

{"title":"'I don't know if there's a happy ending to this story': An analysis of prostate cancer narratives in a follow-up setting.","authors":"Laura Lahti, Piia Jallinoja","doi":"10.1177/13634593251358052","DOIUrl":"https://doi.org/10.1177/13634593251358052","url":null,"abstract":"Prostate cancer, the most common cancer among Finnish men, has a high survival rate. Treatment options vary from active surveillance to radical treatments, with potential long-term or permanent side effects. Traditional cancer narratives frame cancer as a tragedy or a hero story and thus fail to capture the chronic nature of prostate cancer and its impacts on patients' lives. This study analyses the narratives of 22 prostate cancer patients, interviewed twice (1 and 3 years after diagnosis). We found two recurring storylines of prostate cancer narratives, one from radically treated men and the other from men under active surveillance. We analysed how cultural plot types - hero story, tragedy, comedy and irony - appear in the narratives. While tragedy dominated narratives, re-interviews also revealed irony as the tragic elements were caused by the treatment side effects, not the cancer itself. Comedic elements emerged when side effects were reframed as symptoms of ageing. Narratives took on heroic features if the cancer was cured or non-aggressive. The findings underscore the importance of diverse cultural representations to reflect the multifaceted experience of living with prostate cancer and the need for long-term support with the physical and psychological aspects of prostate cancer.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593251358052"},"PeriodicalIF":2.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144729858","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

III persons and capable workers: Constructing work ability in return-to-work negotiations after sickness absence. 病人和有能力的工人：在病假后重返工作岗位的谈判中构建工作能力。

IF 1.9 4区医学

Health Pub Date : 2025-07-01 Epub Date: 2024-10-14 DOI: 10.1177/13634593241290176

Hanna Keränen, Sanni Tiitinen, Pirjo Juvonen-Posti, Elina Weiste, Soile Seppänen, Leena Ala-Mursula

{"title":"III persons and capable workers: Constructing work ability in return-to-work negotiations after sickness absence.","authors":"Hanna Keränen, Sanni Tiitinen, Pirjo Juvonen-Posti, Elina Weiste, Soile Seppänen, Leena Ala-Mursula","doi":"10.1177/13634593241290176","DOIUrl":"10.1177/13634593241290176","url":null,"abstract":"In return-to-work (RTW) negotiations after sickness absence, the work ability of an individual employee becomes a shared interest for the multiple stakeholders representing both the healthcare sector and working life. In practice, the employee, employer and occupational health professionals need to reach a shared understanding of the employee's work ability to enable shared decision-making concerning the plans for sustainable RTW. Drawing on 14 video-recorded RTW negotiations, we used conversation analysis-informed membership categorization analysis to examine how the participants of RTW negotiations discuss the work ability of an employee to pursue a shared understanding of the situation. Work ability was constructed in a very situational way, using illness categories to both explain the work ability of the employee and argue for or against their ability or inability to work. Our study contributes to research on RTW by introducing a new perspective to work ability. We show how work ability is realized during RTW negotiations through interaction, and how participants leverage their cultural understanding of illness and capability when negotiating work ability. We also demonstrate how membership categorization analysis can reveal the situational and consequential aspects of illness and work ability categories.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"529-550"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463816","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: 0

Välkky's voyage on to a hospital ward: Expectations, explorations and emergent robocentric nursing care. Välkky的医院病房之旅：期望，探索和紧急机器人中心护理。

IF 1.9 4区医学

Health Pub Date : 2025-07-01 Epub Date: 2024-12-04 DOI: 10.1177/13634593241303610

Sarah Nettleton, Nik Brown, Karl Atkin, Luna Dolezal, Sanna Metsäketo, Daniel Robins

{"title":"Välkky's voyage on to a hospital ward: Expectations, explorations and emergent robocentric nursing care.","authors":"Sarah Nettleton, Nik Brown, Karl Atkin, Luna Dolezal, Sanna Metsäketo, Daniel Robins","doi":"10.1177/13634593241303610","DOIUrl":"10.1177/13634593241303610","url":null,"abstract":"Drawing on ethnographic fieldwork in Finland, we report on the trial of a teleoperated care robot named Välkky introduced onto a fully operational hospital neurological ward. Our data revealed a narrative arc where participants' early expectations of the hospital-based trial altered as the project unfolded. Greeted with techno-excitement and experimental enthusiasm about the place of robotics in reshaping roles within clinical care, Välkky became the focus for collaborative in situ learning, adaptation and redesign amongst the roboticists, designers, nurses, patients, and managers. Välkky acted as an 'attractor' provoking thinking about, and a reimagining of, future arrangements of care. Our empirically informed insights seek to pave the way for real-world nuanced thinking that pushes beyond human/non-human and success/failure binaries. Building on debates in STS and feminist posthumanism, we propose a robocentric approach, which encourages us to 'queer' health care robots, and to understand them as fluid, hybrid, distributed and relational figures, rather than purely as inert, mechanical, non-human objects that might replace humans. Nursing care practices by and with robots will generate new meanings and practices of care that will emerge iteratively, as caring relations, relationships and practices develop within the context of operational ward environments. Robots may or may not be able support care, but they will invariably challenge what care is.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"569-588"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768444","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: 0

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