IF 1.9 4区医学

Health Pub Date : 2025-07-01 Epub Date: 2024-08-08 DOI: 10.1177/13634593241270923

Sue Westwood

引用次数: 0

'The MRI-scan says it is completely normal': Reassurance attempts in clinical encounters among patients with chronic musculoskeletal pain. 核磁共振扫描显示完全正常"：慢性肌肉骨骼疼痛患者在临床会诊中的保证尝试。

IF 1.9 4区医学

Health Pub Date : 2025-07-01 Epub Date: 2024-10-20 DOI: 10.1177/13634593241290185

Trine Cb Andersen, Maja Wilhelmsen, Olaug S Lian

{"title":"'The MRI-scan says it is completely normal': Reassurance attempts in clinical encounters among patients with chronic musculoskeletal pain.","authors":"Trine Cb Andersen, Maja Wilhelmsen, Olaug S Lian","doi":"10.1177/13634593241290185","DOIUrl":"10.1177/13634593241290185","url":null,"abstract":"In clinical guidelines for patients with chronic musculoskeletal pain, reassurance is a key element. The purpose of reassuring patients is to change their views on their illness and, thereby, their actions. However, when symptoms persist without pathological findings, reassurance can be difficult to achieve. Drawing on observations of nineteen naturally occurring hospital consultations with chronic musculoskeletal pain patients, followed by individual interviews with both patients and clinicians, we study how they interact in relation to reassurance. Our main aim is to explore the ways in which clinicians explicitly attempt to provide reassurance, and how patients receive these attempts, before reflecting on facilitating and hindering factors for successful reassurance in relation to the sociocultural context in which their interaction takes place. Through a thematic analysis, four dominating elements of explicit reassurance were identified: (1) education through visualisation, (2) validation through technological findings, (3) validation through physical examination and (4) normalising pain. To gain a deeper understanding of the reassurance process, we then narratively explored dialogical extracts containing these elements. The analysis shows a potential lack of congruence between what patients experience, and the biomedical knowledge clinicians rely on. Despite employing a combination of affective and cognitive modes of reassurance, clinicians tend to build their final conclusions not on patients experiences but on biomedical knowledge, which is knowledge that holds epistemic primacy for themselves. In that sense, their efforts to reassure the patients might also be a way in which they seek to reassure themselves.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"489-509"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463819","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

Telemedicine and patient-centered care: The perspective of primary-care physicians. 远程医疗和以患者为中心的护理：初级保健医生的视角。

IF 1.9 4区医学

Health Pub Date : 2025-07-01 Epub 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":"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":"551-568"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","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

Corrosion of care and disempowerment in acute psychiatry: As seen from the positions of therapists and suicidal patients. 从治疗师和自杀病人的立场看急诊精神病学中的护理腐蚀和权能丧失：从治疗师和自杀患者的立场看问题。

IF 1.9 4区医学

Health Pub Date : 2025-07-01 Epub Date: 2024-12-13 DOI: 10.1177/13634593241303617

Julia Hagen, Birthe Loa Knizek, Heidi Hjelmeland

{"title":"Corrosion of care and disempowerment in acute psychiatry: As seen from the positions of therapists and suicidal patients.","authors":"Julia Hagen, Birthe Loa Knizek, Heidi Hjelmeland","doi":"10.1177/13634593241303617","DOIUrl":"10.1177/13634593241303617","url":null,"abstract":"For people in suicidal crisis, referral to a psychiatric hospital is common. However, acute psychiatry is characterized by a lack of resources in terms of time and beds, making it challenging for therapists to provide person-centered care. In this qualitative study, we explored the experiences and positionings of therapists and suicidal patients in an acute psychiatric ward in Norway. We generated data through participatory observation and interviews with therapists and patients and analyzed the material using principles from Systematic Text Condensation supplemented with an analysis from a Positioning theory perspective. We developed two themes: Therapists positioned as professionals with authority in a context with restricted action radius, and Patients in suicidal crisis positioned as medical subjects with limited influence. In this resource-limited context, therapists managed their work and obligations by simplifying the patient's suffering and suicidality and by emphasizing medical aspects. Ensuring an efficient patient flow was a high priority. The therapists' authority and actions were closely connected to how patients were positioned and their experiences of the care. Positioning theory provides new perspectives for understanding the power imbalance in the positions of therapists and patients. The findings provide insights into acute inpatient psychiatry as a normative field where the choices and actions of both therapists and patients are restricted. In that sense, both patients and therapists can feel powerless. The findings point to significant limitations in the acute mental health care of people in suicidal crisis.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"589-605"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824190","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

Scaffolding patient agency: Conceptualising readers' cognitive work in the comic gutter. 支架式患者代理：将读者在漫画沟中的认知工作概念化。

IF 1.9 4区医学

Health Pub Date : 2025-07-01 Epub Date: 2024-10-17 DOI: 10.1177/13634593241290184

Amanda Roberts

引用次数: 0

The normativist-naturalist puzzle: Functions and assumptions of health assessment tools. 规范主义者-自然主义者之谜：健康评估工具的功能和假设。

IF 1.9 4区医学

Health Pub Date : 2025-07-01 Epub Date: 2024-05-27 DOI: 10.1177/13634593241255006

Thor Hennelund Nielsen, Lasse Nielsen, Søren Harnow Klausen

{"title":"The normativist-naturalist puzzle: Functions and assumptions of health assessment tools.","authors":"Thor Hennelund Nielsen, Lasse Nielsen, Søren Harnow Klausen","doi":"10.1177/13634593241255006","DOIUrl":"10.1177/13634593241255006","url":null,"abstract":"While there is no shortage in discussions of health assessment tools, little is known about health professionals' experience of their practical uses. However, these tools rely on assumptions that have significant impacts on the practice of health assessment. In this study, we explore health professionals' experiences with health assessment tools, that is, how they define, use, and understand these tools, and whether they take them to measure health and wellbeing. We combine a qualitative, interview-based study of the uses and understandings of health assessment tools among Danish health professionals with a philosophical analysis of these applications and perceptions. Our study shows that contrary assumptions are involved in the use of the tools, to the extent that one can speak of a normativist-naturalist puzzle: health professionals generally apply a normativist conception of health, find health assessment useful and valuable for their clinical practice, but believe that what the tools measure is basically not health proper but some proximal entity of a more naturalist kind. This result demonstrates the complexity of health assessment tools and suggests that they are used with care to ensure both that particular tools are used for the kinds of tasks they are most apt for, and that they are put to use in awareness of their limitations.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"449-467"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158146","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

Rethinking posthumanism in rehabilitation science: Lessons from Indigenous, Black, and decolonial thought. 重新思考康复科学中的后人文主义：来自土著、黑人和非殖民思想的教训。

IF 1.9 4区医学

Health Pub Date : 2025-06-13 DOI: 10.1177/13634593251345082

Eduan Breedt, Erin Tichenor, Kim McLeod, Tim Barlott

{"title":"Rethinking posthumanism in rehabilitation science: Lessons from Indigenous, Black, and decolonial thought.","authors":"Eduan Breedt, Erin Tichenor, Kim McLeod, Tim Barlott","doi":"10.1177/13634593251345082","DOIUrl":"https://doi.org/10.1177/13634593251345082","url":null,"abstract":"Posthumanism is a theoretical paradigm in Western continental philosophy with emerging significance and popularity in the health disciplines. Rehabilitation science scholars in fields like occupational therapy and physical therapy have taken up posthumanism, valuing its interventions into the harms of European humanist conceptualizations of the \"(hu)man\" which perpetuate individualism, ableism, and anthropocentrism. This paper responds to the pervasive use of posthumanism in the rehabilitation science literature-particularly among white scholars in the \"Global North\"-and its omission of sustained engagements with forms of dehumanization (specifically racism, colonialism, and anti-Blackness). For posthuman healthcare and rehabilitation scholarship to have utility beyond white, globally elite populations, we invite fellow rehabilitation science scholars to engage with the important critiques of posthumanism made by Black, Indigenous, and Latin American decolonial scholars. We synthesize these critiques and warnings about the forms of epistemic colonial violence embedded within popular approaches to posthumanism, and query rehabilitation scholars' responsibilities to pause and center theories of the human and posthuman that have long been developed and lived by racialized and Indigenous scholars, activists, and knowledge holders.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593251345082"},"PeriodicalIF":1.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289428","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

'Why can't you just be fine?': An autoethnography of self-harm from a lived experience and nursing perspective. “你为什么就不能好好过日子呢？”：从生活经验和护理的角度，自残的自我民族志。

IF 1.9 4区医学

Health Pub Date : 2025-05-26 DOI: 10.1177/13634593251342902

Caroline da Cunha Lewin

{"title":"'Why can't you just be fine?': An autoethnography of self-harm from a lived experience and nursing perspective.","authors":"Caroline da Cunha Lewin","doi":"10.1177/13634593251342902","DOIUrl":"https://doi.org/10.1177/13634593251342902","url":null,"abstract":"Psychiatric discourse problematises self-harm as a psychopathological behaviour indicative of individualistic deficiency. This guides clinical priorities in treatment whilst negating salient components and individual preferences. Conversely, survivor-controlled research emphasises underacknowledged aspects of self-harm, such as its embodied emotionality as embedded within sociocultural context. This suggests a need for re-theorisation. Autoethnography (AE) utilises the researcher as the main source of data to elucidate social phenomena. Through AE, I consider my lived and professional experiences, as a registered general nurse, of self-harm by referring to my medical notes, memory reflections and personal diary entries as contextualised to self-harm literature. This lived experience (LE) perspective of self-harm is derived from subjective experience and contemporary literature, framed within survivor epistemology. This novel understanding argues that people with self-harm may experience immersive, aversive embodied emotionality arising from sociocultural and relational conflict. It considers self-harm as supporting the person to (1) be an integrated whole; (2) employ self-care; and (3) connect with oneself and others. This LE perspective directly critiques dominant psychiatric conceptualisations, instead compassionately framing self-harm as socially implicated. This could improve societal understanding, reduce pejorative attitudes and benefit people with LE.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593251342902"},"PeriodicalIF":1.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150310","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

From (in)dependence to interdependence: A qualitative study on multiplicity in assemblages of agency and addiction recovery. 从依赖到相互依赖：代理和成瘾恢复组合多样性的定性研究。

IF 1.9 4区医学

Health Pub Date : 2025-05-22 DOI: 10.1177/13634593251342997

Florian De Meyer, Griet Roets, Wouter Vanderplasschen, Clara De Ruysscher

{"title":"From (in)dependence to interdependence: A qualitative study on multiplicity in assemblages of agency and addiction recovery.","authors":"Florian De Meyer, Griet Roets, Wouter Vanderplasschen, Clara De Ruysscher","doi":"10.1177/13634593251342997","DOIUrl":"https://doi.org/10.1177/13634593251342997","url":null,"abstract":"The concept of agency in substance use recovery remains contested, positioned between deficit-based models emphasizing dependence and recovery paradigms highlighting personal strengths and capacities. However, the latter approach has faced criticism for individualizing responsibility, overemphasizing independence, and promoting normative notions of citizenship. This is particularly visible in the context of recovery without treatment. Commonly referred to as \"natural recovery,\" many people recover without engaging with formal addiction treatment or mutual aid. This study explores the lives of individuals in recovery without treatment, using an assemblage perspective to capture its complexity and relational nature. Eighteen in-depth interviews with participants in recovery without treatment from alcohol and/or other drug problems were conducted following the lifeline interview method. Transcripts were analyzed using reflective thematic analysis informed by assemblage theory. Two overarching themes emerged: (1) \"agency while losing and gaining control,\" illustrating addiction as an ambivalent aspect of subjectivity that both enables and constrains; and (2) \"agency, multiplicity, and emergence,\" demonstrating how agency operates within dynamic assemblages of shifting elements and forces, rather than as a fixed state. Our findings imply an understanding of agency as interdependent and emergent within multiplicities. Hence, we argue that recovery and the influential strengths-based concept of recovery capital should be cautious of simplifying practices that risk reproducing individualist and normative notions of recovery. We discuss recovery as a practice of freedom and identify avenues for further research.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593251342997"},"PeriodicalIF":1.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119379","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 embodied experience of genetic inheritance in hereditary thrombophilia. 遗传性血栓性疾病的基因遗传体验。

IF 1.9 4区医学

Health Pub Date : 2025-05-01 Epub Date: 2024-08-08 DOI: 10.1177/13634593241271011

Edina Tomán, Judit Nóra Pintér, Rita Hargitai

{"title":"The embodied experience of genetic inheritance in hereditary thrombophilia.","authors":"Edina Tomán, Judit Nóra Pintér, Rita Hargitai","doi":"10.1177/13634593241271011","DOIUrl":"10.1177/13634593241271011","url":null,"abstract":"Our study focuses on exploring the embodied experiences of genetic inheritance within and between bodies. Drawing on insights from studies on embodied experiences and family risk we examine how interviewees perceive their vulnerability, negotiate family narratives, genetic inheritance, and the transmission of genetic knowledge within families. To answer these questions, we conducted an interpretative phenomenological analysis, based on 10 in-depth interviews with patients with thrombophilia diagnosis and venous thromboembolic disease, in Hungary. Three Experiential Themes were identified: The body as a repository of risk (1), Family heritage (2), and The borderline of thrombophilia-liminality (3). Our study has found that patients living with thrombophilia interpret their bodies as repositories of genetic risk. It seems that an important aspect of adapting to thrombophilia is the creation of genetically vulnerable identities. Alongside the new identity(ies), living with risk can induce newly discovered forms of familial responsibility, within the common identification experience of family history and succession. Based on our research, we see that individuals living with thrombophilia experience the liminality of borderlands. In some cases, however, the space between health and illness represents a dynamic permeability for people with thrombophilia, which can be triggered by medical uncertainty in addition to individual experiences and life events.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"373-395"},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901559","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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