IF 1.9 4区医学

Health Pub Date : 2024-10-14 DOI: 10.1177/13634593241290190

Yael Keshet, Ariela Popper-Giveon, Tamar Adar

{"title":"Telemedicine and patient-centered care: The perspective of primary-care physicians.","authors":"Yael Keshet, Ariela Popper-Giveon, Tamar Adar","doi":"10.1177/13634593241290190","DOIUrl":"https://doi.org/10.1177/13634593241290190","url":null,"abstract":"Patient-centered care (PCC) has become a central aim for healthcare systems worldwide due to recognition of its advantages. The growing use of telemedicine technologies (TT) raises concerns of diminishing interpersonal contact, especially in primary care, and questions the appropriate way of implementing PCC. This article aims to explore primary-care physicians' (PCP) experiences of PCC when using TT. During 2023 in-depth interviews were conducted with 20 Israeli PCP: family physicians and pediatricians. The PCP described their experiences of using TT in their communication with patients as including some characteristics of PCC but not others. They related to TT as a means of forming relationships and communicating with patients, highlighting its individualistic focus and describing it as a way of coordinating care. When describing the use of TT in their communication with patients, they barely related to empathy and respect for the patient, to their own involvement in the treatment, to shared decision-making, or to a holistic focus on the patient. The absence of interpersonal qualities and soft skills communication from the physicians' TT experience seems to erode their personal well-being and professional satisfaction and may even lead to burnout. We therefore recommend instructing PCP to better integrate PCC into their TT communication with patients since it contributes to the quality of healthcare and is significant for the well-being of both patients and physicians.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241290190"},"PeriodicalIF":1.9,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463818","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

Conceptualising wellbeing among health-care workers during the Covid-19 pandemic. Covid-19大流行期间医护人员幸福感的概念化。

IF 1.9 4区医学

Health Pub Date : 2024-10-06 DOI: 10.1177/13634593241279206

Judith McHugh, Paul Trotman, Helen D Nicholson, Kelby Smith-Han

{"title":"Conceptualising wellbeing among health-care workers during the Covid-19 pandemic.","authors":"Judith McHugh, Paul Trotman, Helen D Nicholson, Kelby Smith-Han","doi":"10.1177/13634593241279206","DOIUrl":"https://doi.org/10.1177/13634593241279206","url":null,"abstract":"Since 2020 health workers everywhere have been challenged by the ongoing ramifications of the Covid-19 pandemic. This virus impacted all aspects of life but health-related workplaces particularly, were transformed virtually overnight. Demands were heightened and customary supports came under pressure presenting a huge crisis for health systems. The goal of this study was to explore how this catastrophic pandemic event impacted the wellbeing of healthcare professionals (HCPs) working through this time. Interviews with 57 HCPs from multiple countries and specialty areas were explored utilising inductive content analysis (ICA). Resulting data were then categorised into themes and deductively analysed utilising a method informed by Capability Theory. These were secondary data as the interviews were part of a larger set collected primarily for the purpose of a documentary being made about this experience. This study found that illbeing experiences were prevalent among HCPs. However, significant sources of wellbeing were also evident, and were instrumental in maintaining HCP resilience. Wellbeing was enhanced when HCPs experienced a small number of key capabilities that enabled a broad range of functionings. The capabilities were for (a) participation in positive relationships, (b) a sense of identity, purpose, meaning and value in relation to one's work and (c) ability to provide an appropriate level of medical treatment, care and other role related support. These capabilities were central to HCP wellbeing irrespective of the individual's location and specialty area, however the ability to realise these capabilities in desired functionings was differentially impacted by each individual's unique circumstances.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241279206"},"PeriodicalIF":1.9,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380691","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

'They think we're just in God's waiting room': A discursive study on identity aloneness in stroke survivors. 他们认为我们只是在上帝的等候室里"：关于中风幸存者身份孤独的话语研究。

IF 1.9 4区医学

Health Pub Date : 2024-09-19 DOI: 10.1177/13634593241279207

Lewis Jefferson, Stephen Dunne

{"title":"'They think we're just in God's waiting room': A discursive study on identity aloneness in stroke survivors.","authors":"Lewis Jefferson, Stephen Dunne","doi":"10.1177/13634593241279207","DOIUrl":"https://doi.org/10.1177/13634593241279207","url":null,"abstract":"This paper examines the rhetorical strategies used by stroke survivors to attend to identity aloneness, a phenomenon in which individuals experience a sense of disconnect from others as a consequence of identity change, for which stroke is known as an antecedent. Three stroke survivors, and their spouses, were interviewed about their stroke, social support, and experiences with loneliness and identity change. The data was transcribed using a simplified version of the Jeffersonian method and analysed using a critical discursive psychological approach. This made it possible to examine the way in which the psychological business of identity aloneness was managed in participants' talk via discursive devices such as metaphors and category entitlement, while also leaving room to consider how broader societal discourses were drawn upon. The analysis revealed two critical ways in which participants attended to the issue of identity aloneness: (1) by crafting and occupying a position of resilience; (2) by managing the impact of the post-stroke social world on their identities. These findings offer insight into how the issue of identity aloneness is made sense of by stroke survivors in the context of a discussion with an interviewer. Finally, findings informed future directions for research, including developing a comprehensive theory of identity aloneness using a grounded theory approach and developing and validating a psychometric measure of identity aloneness to be applied in a rehabilitative setting.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241279207"},"PeriodicalIF":1.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285878","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

Parents' experiences of waiting for their child's transplant: A focus on how healthcare providers can impact the waiting process. 父母等待子女移植的经历：关注医疗服务提供者如何影响等待过程。

IF 1.9 4区医学

Health Pub Date : 2024-09-18 DOI: 10.1177/13634593241281602

Kristina A Smith, Kelly P Arbour-Nicitopoulos, Kimberley Widger

{"title":"Parents' experiences of waiting for their child's transplant: A focus on how healthcare providers can impact the waiting process.","authors":"Kristina A Smith, Kelly P Arbour-Nicitopoulos, Kimberley Widger","doi":"10.1177/13634593241281602","DOIUrl":"https://doi.org/10.1177/13634593241281602","url":null,"abstract":"Waiting for a child transplant is a form of suffering for parents, yet little research has explored how parents experience waiting and how healthcare providers can impact their waiting experiences. The purpose of this article is to investigate how parents experienced the process of waiting for their child's transplant with a specific focus on the impact of healthcare providers on parents' experience of waiting. Six parents from four different families participated in interviews and observations. Our narrative analysis suggested that parents had no narrative roadmap to navigate waiting and the importance of healthcare providers' tailoring the amount and type of medical information to a parents' needs. We discuss how waiting required parents to be hypervigilant and provide continuity of care for their child, and how this \"managerial role\" could lead to a loss of trust with their healthcare providers. Parents' accounts were replete with contradictions, and as an extension of this, waiting was full of contradictions. Findings contribute to conceptual, methodological, and practical work exploring how parents live in deep uncertainty about the future, and how healthcare providers can support parents in their child's transplantation and other life-threatening illness contexts.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241281602"},"PeriodicalIF":1.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285876","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

Sedated beauty: The invisible knife in online narratives about cosmetic breast augmentation. 镇静之美：网上关于隆胸美容的叙述中的隐形刀。

IF 1.9 4区医学

Health Pub Date : 2024-09-16 DOI: 10.1177/13634593241270950

Petra Roll Bennet

{"title":"Sedated beauty: The invisible knife in online narratives about cosmetic breast augmentation.","authors":"Petra Roll Bennet","doi":"10.1177/13634593241270950","DOIUrl":"https://doi.org/10.1177/13634593241270950","url":null,"abstract":"Breast augmentation is a prevalent cosmetic surgery procedure among women in Western societies, and the cosmetic surgery market has witnessed substantial growth. Today, websites and online forums are platforms that feature discussions about cosmetic procedures. A genre on surgery clinic websites is 'patient stories', but also lay-initiated internet forums facilitate discussions and shared experiences related to cosmetic surgery. This study aims to analyse lay-initiated online narratives about cosmetic breast augmentation. The shared narratives contain descriptions of how women who are about to undergo breast augmentation prepare for surgery, the medical procedures that take place on the day of surgery itself, and the experiences and feelings after waking up after anaesthesia. Employing a structural analysis of 30 of these stories, this research illuminates how the surgery stories adhere to a conventional storytelling format, and how key characters within the stories are 'helpers and makers', including relatives, nurses and surgeons. The focus in these narratives revolves around the woman herself, although her active involvement is primarily observed during the preparation phase, with a more passive role assumed during subsequent clinic routines. Despite instances of pain and discomfort in the narratives, the stories are enveloped in an aura of glamour and a spa-like atmosphere. It is discussed how this 'fairy tale' story, narrating a surgical metamorphosis, seems to align with the popularisation of the cosmetic surgery sector.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241270950"},"PeriodicalIF":1.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142285877","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

'My cousin said to me . . .' Patients' use of third-party references to facilitate shared decision-making during naturally occurring primary care consultations. 我表弟对我说......'在自然发生的初级医疗咨询中，患者利用第三方参考资料促进共同决策。

IF 1.9 4区医学

Health Pub Date : 2024-09-01 Epub Date: 2023-07-30 DOI: 10.1177/13634593231188489

Olaug S Lian, Sarah Nettleton, Huw Grange, Christopher Dowrick

{"title":"'My cousin said to me . . .' Patients' use of third-party references to facilitate shared decision-making during naturally occurring primary care consultations.","authors":"Olaug S Lian, Sarah Nettleton, Huw Grange, Christopher Dowrick","doi":"10.1177/13634593231188489","DOIUrl":"10.1177/13634593231188489","url":null,"abstract":"In this paper, we explore the ways in which patients invoke third parties to gain decision-making influence in clinical consultations. The patients' role in decision-making processes is often overlooked, and this interactional practice has rarely been systematically studied. Through a contextual narrative exploration of 42 naturally occurring consultations between patients (aged 22-84) and general practitioners (GPs) in England, we seek to fill this gap. By exploring how and why patients invoke third parties during discussions about medical treatments, who they refer to, what kind of knowledge their referents possess, and how GPs respond, our main aim is to capture the functions and implications of this interactional practice in relation to decision-making processes. Patients refer to third parties during decision-making processes in most of the consultations, usually to argue for and against certain treatment options, and the GPs recognise these utterances as pro-and-contra arguments. This enables patients to counter the GPs' professional knowledge through various knowledge-sources and encourage the GPs to target their specific concerns. By attributing arguments to third parties, patients claim decision-making influence without threatening the GPs' authority and expertise, which their disadvantaged epistemic position demands. Thereby, patients become able to negotiate their role and their epistemic position, to influence the agenda-setting, and to take part in the decision-making process, without being directly confrontational. Invoking third parties is a non-confrontational way of proposing and opposing treatment options that might facilitate successful patient participation in decision-making processes, and so limit the risk of patients being wronged in their capacity as knowers.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"775-794"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9897566","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

Progressing the understanding of chronic illness and its treatment: A post-human, ethological understanding of haemodialysis. 加深对慢性疾病及其治疗的理解：对血液透析的后人类伦理学理解。

IF 1.9 4区医学

Health Pub Date : 2024-09-01 Epub Date: 2023-09-14 DOI: 10.1177/13634593231200126

Victoria Cluley, Helen Eborall, Katherine Hull, Niamh Quann, James O Burton

{"title":"Progressing the understanding of chronic illness and its treatment: A post-human, ethological understanding of haemodialysis.","authors":"Victoria Cluley, Helen Eborall, Katherine Hull, Niamh Quann, James O Burton","doi":"10.1177/13634593231200126","DOIUrl":"10.1177/13634593231200126","url":null,"abstract":"Haemodialysis is a common treatment option offered internationally for people requiring kidney replacement therapy. Research exploring haemodialysis is predominantly clinical and quantitative, and improvements to its provision and receipt tends also to be clinically focused. In recent years, however, a number of studies have sought to explore the lived experience of haemodialysis. These studies tend to use semi-structured interviews and present descriptive findings. Such findings serve to raise the profile of patient perspectives and encourage thinking beyond the clinical gaze. To progress this, we apply a post-humanism approach to the understanding of the receipt of haemodialysis. Drawing on findings from a study to explore the experience and impact of in-centre, daytime, haemodialysis we follow Fox and Alldred's ethological toolkit to provide a post-human analysis of haemodialysis. In doing so we argue that haemodialysis exists as a heterogenous and changeable assemblage of multiple and fluid, human and non-human factors that has the capacity to affect. Here we outline this post-human approach and the impact it has for understanding not just haemodialysis but also the receipt of treatment for other chronic illnesses.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"716-735"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233901","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

The contribution of a complex systems-based approach to progressive social resilience. 基于复杂系统的方法对逐步提高社会复原力的贡献。

IF 1.9 4区医学

Health Pub Date : 2024-09-01 Epub Date: 2023-08-30 DOI: 10.1177/13634593231195784

Philip Haynes, Angie Hart, Suna Eryigit-Madzwamuse, Matthew Wood, Josie Maitland, Josh Cameron

引用次数: 0

Logic modelling as hermeneutic praxis: Bringing knowledge systems into view during comprehensive primary health care planning for homelessness in Australia. 作为解释学实践的逻辑建模：在澳大利亚无家可归者的综合初级卫生保健规划中引入知识系统。

IF 1.9 4区医学

Health Pub Date : 2024-09-01 Epub Date: 2023-09-25 DOI: 10.1177/13634593231200129

Kristen Foley, Toby Freeman, Lisa Wood, Joanne Flavel, Yvonne Parry, Fran Baum

{"title":"Logic modelling as hermeneutic praxis: Bringing knowledge systems into view during comprehensive primary health care planning for homelessness in Australia.","authors":"Kristen Foley, Toby Freeman, Lisa Wood, Joanne Flavel, Yvonne Parry, Fran Baum","doi":"10.1177/13634593231200129","DOIUrl":"10.1177/13634593231200129","url":null,"abstract":"Logic modelling is used widely in health promotion planning for complex health and social problems. It is often undertaken collaboratively with stakeholders across sectors that hold and enact different institutional approaches. We use hermeneutic philosophy to explore how knowledge is 'lived' by - and unfolds differently for - cross-sectoral stakeholders during comprehensive primary healthcare service planning. An Organisational Action Research partnership was established with a non-government organisation designing comprehensive primary health care for individuals experiencing homelessness in Adelaide, Australia. Grey literature, stakeholder input, academic feedback, a targeted literature review and evidence synthesis were integrated in iterative cycles to inform and refine the logic model. Diverse knowledge systems are active when cross-sectoral stakeholders collaborate on logic models for comprehensive primary health care planning. Considering logic modelling as a hermeneutic praxis helps to foreground and explore these differences. In our case, divergent ideas emerged in how health/wellbeing and trust were conceptualised; language had different meanings across sectors; and the outcomes and data sought were nuanced for various collaborators. We explicate these methodological insights and also contribute our evidence-informed, collaboratively-derived model for design of a comprehensive primary health care service with populations experiencing homelessness. We outline the value of considering cross-sectoral logic modelling as hermeneutic praxis. Engaging with points of difference in cross-sectoral knowledge systems can strengthen logic modelling processes, partnerships and potential outcomes for complex and comprehensive primary health care services.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"673-697"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41128898","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

'To improve quality of life': Diverging enactments of a value in nephrology clinical practices. “提高生活质量”：肾脏病临床实践中价值的不同体现。

IF 1.9 4区医学

Health Pub Date : 2024-09-01 Epub Date: 2023-09-29 DOI: 10.1177/13634593231200128

Anna Mann

{"title":"'To improve quality of life': Diverging enactments of a value in nephrology clinical practices.","authors":"Anna Mann","doi":"10.1177/13634593231200128","DOIUrl":"10.1177/13634593231200128","url":null,"abstract":"Quality of life has become a central value in the provision of healthcare for patients with chronic conditions. This has engendered debates in critical medical sociology on the non-neutral effects that valuing health and illness, medical interventions, and health care delivery in terms of quality of life yields. Focusing on the case of nephrology, this paper presents qualitative data collected in Austria of two dialysis units in which nephrologists initiated projects aimed towards 'the improvement of patients' quality of life'. Whereas the first involved nurses supporting patients in the administration of peritoneal dialysis at home, the second implied the provision of treatment and care exclusively focused on a well-being 'in the here and now' to patients. By conceptualising physicians as actors within networks of relations and values enacted in practices, it analyses how in both dialysis units reference to quality of life enabled nephrologists to problematise the provision of standard haemodialysis treatment to multi-morbid, elderly patients, to develop a new treatment protocol, and to interest and enrol others in the provision of healthcare according this new protocol. Valuing medical interventions in terms of quality of life not only leads to a governmentalization of living and an economisation of health. It also allows physicians to articulate a socio-medico-ethical problem - the availability of life-prolonging technologies for a growing population of elderly, multi-morbid patients - and develop solutions locally. What the solutions consist in may fundamentally differ, however.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"698-715"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41115937","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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