IF 1.9 4区医学

Health Pub 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":"https://doi.org/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":"13634593241303610"},"PeriodicalIF":1.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Legitimacy and professional boundaries: An institutional analysis of Chinese Medicine in Mainland China and Hong Kong. 合法性与专业界限：中国内地与香港中医药制度分析。

IF 1.9 4区医学

Health Pub Date : 2024-12-02 DOI: 10.1177/13634593241303612

Xiaoli Tian, Sai Zhang

{"title":"Legitimacy and professional boundaries: An institutional analysis of Chinese Medicine in Mainland China and Hong Kong.","authors":"Xiaoli Tian, Sai Zhang","doi":"10.1177/13634593241303612","DOIUrl":"https://doi.org/10.1177/13634593241303612","url":null,"abstract":"The legitimacy of complementary and alternative medicines (CAMs) and their integration into mainstream healthcare have long been a topic in sociological discussions. This study examines the institutional influences on Chinese medicine (CM), an important CAM in mainland China and Hong Kong. In-depth interviews with practitioners and observations in public hospitals facilitate a comparison of the professional boundaries, statuses, and jurisdictions of CM in the two regions. In mainland China, CM has a high degree of state-granted legitimacy with blurred professional boundaries between CM and Western medicine (WM) in a highly integrated healthcare system. However, these blurred boundaries have had the following unintended consequences: (i) devaluation of traditional knowledge in CM education and practices, (ii) biomedicalisation of CM practices wherein a substantial reliance on WM has decreased the utilisation of healing principles in CM and (iii) ambiguity in the efficacy of CM due to the co-use of CM and WM. In contrast, the demarcated professional boundaries in Hong Kong have allowed CM to maintain its knowledge base, even though CM is practised within strict parameters. This study reveals that institutional requirements (on efficiency, accountability and profitability) prioritise the biomedical model and drive the biomedicalisation of CM. Therefore, the lack of clear professional boundaries in the current integrative medical system in mainland China have eroded the knowledge base of CM and undermined the efficacy-based legitimacy of CM.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241303612"},"PeriodicalIF":1.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768411","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

Institutional inconsistencies and professionals' hidden institutional work in Russian pandemic-affected healthcare: The material dimension. 俄罗斯受大流行影响的医疗保健中的制度不一致和专业人员隐藏的制度工作：物质层面。

IF 1.9 4区医学

Health Pub 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":"https://doi.org/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":"13634593241303620"},"PeriodicalIF":1.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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 1.9 4区医学

Health Pub 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":"https://doi.org/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":"13634593241303607"},"PeriodicalIF":1.9,"publicationDate":"2024-12-02","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

Medication literacy and its social contextuality. 用药知识及其社会背景。

IF 1.9 4区医学

Health Pub Date : 2024-11-01 Epub Date: 2023-12-05 DOI: 10.1177/13634593231211520

Noémia Lopes, Carla Rodrigues, Elsa Pegado

{"title":"Medication literacy and its social contextuality.","authors":"Noémia Lopes, Carla Rodrigues, Elsa Pegado","doi":"10.1177/13634593231211520","DOIUrl":"10.1177/13634593231211520","url":null,"abstract":"This article aims to contribute to the discussion about medication literacy, by focussing on the social contextuality of the information mobilised in the use of medicines. We aim to explore the social construction processes of medication literacy, as an essential dimension for a more layperson-centred approach in the promotion of literacy in this field. This approach is justified by the growing social and cultural dissemination of medication use, the diversification of its uses beyond health and illness, and the increasing degree of lay autonomy in managing its use. The article is organised in two main sections. In the first section, we review the social history of medication literacy, including a discussion of the social contextuality of literacy phenomena. In the second section, the analysis of social contextuality is operationalised with a focus on information, covering: (i) ways of relating to institutional information and sources of information about medication; (ii) contexts of sociability in which information is shared and validated. This analysis is empirically supported by selected results from two research projects, conducted in Portugal, on the consumption of medicines and dietary supplements for performance purposes - that is, for the management and/or improvement of cognitive, bodily or relational performance.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"858-876"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138487397","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

Sensing pain: Embodied knowledge in endometriosis. 感知疼痛:子宫内膜异位症的体现知识。

IF 1.9 4区医学

Health Pub Date : 2024-11-01 Epub Date: 2023-12-04 DOI: 10.1177/13634593231214938

Elina Helosvuori, Venla Oikkonen

{"title":"Sensing pain: Embodied knowledge in endometriosis.","authors":"Elina Helosvuori, Venla Oikkonen","doi":"10.1177/13634593231214938","DOIUrl":"10.1177/13634593231214938","url":null,"abstract":"The article explores how sensations of pain are turned into embodied knowledge in endometriosis, a chronic gynaecological illness characterized by persistent, possibly paralysing pain. While previous studies have shown how people with endometriosis struggle to achieve accurate diagnosis and effective treatment, we examine the ways in which some of these difficulties are rooted in the complexities of embodied experiences of endometriosis pain and the challenges of translating the sensed patterns and shifts in pain into a language acknowledged within a clinical setting. Building on a phenomenologically inspired approach to chronic pain and drawing on interviews with people diagnosed with endometriosis in Finland, we examine how our interlocutors use their embodied sensations of pain to adapt to the evolving biomedical and lived surroundings in which their pain is evaluated and managed. The analysis shows how living with chronic pain involves constantly attuning to the multitude of symptoms as well as developing personal strategies of communicating sensations of pain to gain medical recognition and care. We argue that while the lived complexities of the body with endometriosis may fall outside the scope of medical practices of measuring, such complexities nevertheless require medical acknowledgment and careful attention.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"937-952"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482326","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 practice of information appraisal: An ethnographic study of a health information intervention. 信息评估实践：健康信息干预的人种学研究。

IF 1.9 4区医学

Health Pub Date : 2024-11-01 Epub Date: 2023-10-24 DOI: 10.1177/13634593231204173

Ronja Rosenberg Grøn, Charlotte Ettrup Christiansen, Janni Strøm, Mette Terp Høybye

{"title":"The practice of information appraisal: An ethnographic study of a health information intervention.","authors":"Ronja Rosenberg Grøn, Charlotte Ettrup Christiansen, Janni Strøm, Mette Terp Høybye","doi":"10.1177/13634593231204173","DOIUrl":"10.1177/13634593231204173","url":null,"abstract":"As healthcare systems grow increasingly complex, greater demands are placed on patients' abilities to find, understand, appraise, and use health information - often termed their 'health literacy'. Most health literacy research does not focus on information appraisal. When it does, there is a tendency to equate it with patients' assessment of credibility. This reproduces a healthcare-centric understanding of information appraisal where patient agency is omitted. This study explores how participants in a health information intervention practiced information appraisal. The intervention aimed to increase information uptake for people with low back pain by delivering health information to them through animations. This study draws on ethnographic participant observation of the encounters between the intervention and its participants, including 49 rapid interviews and semi-structured telephone interviews with 23 participants carried out in the spring of 2021. Inspired by a social practice approach, the study thoroughly grounds the health literacy subcategory of 'appraisal' in practice. It illustrates that participants appraised the information provided in the intervention according to several factors. These include relating the information to their personal health needs, interpreting the intended audience of the health animations, and prioritising their attention situationally between the animations and other immediate concerns. We suggest that information appraisal is a fundamental component of health literacy and should be considered key in research, policy and practice. To accommodate current healthcare ideals of patient centeredness, empowerment and informed choice, the complex and dynamic ways in which people appraise health information need be considered legitimate practices of health literacy.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"812-830"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49690193","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

Visualising, navigating and making time: The use of a digital solution in treatment and rehabilitation from low back pain. 可视化，导航和创造时间:在腰痛治疗和康复中使用数字解决方案。

IF 1.9 4区医学

Health Pub Date : 2024-11-01 Epub Date: 2023-11-29 DOI: 10.1177/13634593231211496

Charlotte Ettrup Christiansen, Mette Terp Høybye, Ronja Rosenberg Grøn, Camilla Blach Rossen

{"title":"Visualising, navigating and making time: The use of a digital solution in treatment and rehabilitation from low back pain.","authors":"Charlotte Ettrup Christiansen, Mette Terp Høybye, Ronja Rosenberg Grøn, Camilla Blach Rossen","doi":"10.1177/13634593231211496","DOIUrl":"10.1177/13634593231211496","url":null,"abstract":"Illness trajectories are particularly characterised by the temporal dimension of human existence. In the area of low back pain, patients often have challenging temporal experiences such as unproductive waiting time and fragmented, repetitive consultations over many years. This study seeks to investigate relationships between digital technologies, temporal agency, and illness, through describing how users experienced a new digital solution, BackTrace, targeting patients with low back pain. The study builds on six months of ethnographic fieldwork, including semi-structured interviews, participant observation and a workshop. The study shows how the introduction of the digital solution could facilitate new possibilities of temporal actions for individuals living with and receiving care for low back pain. For many research participants, the use of BackTrace facilitated a useful visualisation of their past and present low back pain state; BackTrace could assist participants in navigating different external temporal demands; and it allocated time devoted to managing their back pain in everyday life and in consultations with health professionals. The study discusses how temporality can be a useful analytical entrance point to operationalise and explore the often-desired goal of empowerment in patient pathways.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"877-896"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138459665","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

As if I was a spacecraft returning to Earth's atmosphere. Expanding insights into illness narratives and childhood cancer through evocative autoethnography. 就好像我是一艘返回地球大气层的航天器。通过令人回味的民族志扩展对疾病叙述和儿童癌症的见解。

IF 1.9 4区医学

Health Pub Date : 2024-11-01 Epub Date: 2023-09-20 DOI: 10.1177/13634593231200123

Eva-Mari Andersen

{"title":"As if I was a spacecraft returning to Earth's atmosphere. Expanding insights into illness narratives and childhood cancer through evocative autoethnography.","authors":"Eva-Mari Andersen","doi":"10.1177/13634593231200123","DOIUrl":"10.1177/13634593231200123","url":null,"abstract":"Today, a majority of children diagnosed with cancer are expected to grow up and live-hopefully until old age. Still, knowledge of the lived experience of childhood cancer survivors is sparse. In pursuit of knowledge expansion, by combining my intersecting roles as an academic, educational counselor, and childhood cancer survivor, I approach my personal illness narrative. By means of evocative autoethnography, I write intentionally vulnerably about my experiences and make them available for consideration. I explore my narrative through archives, artifacts, memories of the past, and conversations evoked in the present. I re-visit the cultural landscape of a southern Norwegian girl growing up in the 00s with cancer. Through this, my illness narrative presents as positioned, tangled, and interwoven with a developmental trajectory. Specific educational experiences seem to linger, and many are related to being absent from or re-entering school after the onset of illness. To grasp the intersecting and conflicting experiences of being very ill while also young, I suggest Erik Erikson's moratorium as a key concept. To complement Arthur Frank's illness narratives of restitution, chaos, and quest, I establish the moratorium narrative. As a fresh resource, the moratorium narrative underlines the need to make sensitive our academic community's gaze on illness trajectories unfolding in formative phases and illness narratives defined by growing up. By providing a point of recognition that prompts elaboration, this could also provide the young and very ill with a much-needed narrative space of opportunity, of which more narratives are invited and insisted upon.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"797-811"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41120855","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

Is Covid-19 "vaccine uptake" in postsecondary education a "problem"? A critical policy inquiry. 高等教育中的Covid-19“疫苗接种”是一个“问题”吗?一个关键的政策调查。

IF 1.9 4区医学

Health Pub Date : 2024-11-01 Epub Date: 2023-11-15 DOI: 10.1177/13634593231204169

Claudia Chaufan

{"title":"Is Covid-19 \"vaccine uptake\" in postsecondary education a \"problem\"? A critical policy inquiry.","authors":"Claudia Chaufan","doi":"10.1177/13634593231204169","DOIUrl":"10.1177/13634593231204169","url":null,"abstract":"Since the launch of the Covid-19 global vaccination campaign, postsecondary institutions have strongly promoted vaccination, often through mandates, and the academic literature has identified \"vaccine uptake\" among postsecondary students as a problem deserving monitoring, research, and intervention. However, with the admission that vaccines do not stop viral spread, that older-age and co-morbidities are major determinants of poor outcomes, and that many vaccine side effects disproportionately affect the young, it cannot be assumed that a risk-benefit analysis favors vaccinating postsecondary students. Drawing from critical policy studies, I appraise the literature on Covid-19 vaccine uptake in postsecondary education. I find that this literature reflects the \"scientific consensus,\" hardly acknowledging contradictory medical evidence, ignoring coercive elements underlying \"vaccine acceptance,\" and neglecting ethical tensions built into the very design of vaccination policies. I discuss potential explanations for my findings, and their implications for academia's role in society in the COVID-19 era and beyond.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"831-857"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134648845","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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