IF 1.9 4区医学

Health Pub Date : 2025-03-01 Epub Date: 2024-02-26 DOI: 10.1177/13634593241234491

Marjo Kolehmainen

引用次数: 0

"Too soft for real psychiatry"? Gendered boundary-making between coercion and dialog in Italian wards. "对真正的精神病学来说太软弱"？意大利病房中强制与对话之间的性别边界划分。

IF 1.9 4区医学

Health Pub Date : 2025-03-01 Epub Date: 2024-02-26 DOI: 10.1177/13634593241234479

Eleonora Rossero, Raffaella Ferrero Camoletto

{"title":"\"Too soft for real psychiatry\"? Gendered boundary-making between coercion and dialog in Italian wards.","authors":"Eleonora Rossero, Raffaella Ferrero Camoletto","doi":"10.1177/13634593241234479","DOIUrl":"10.1177/13634593241234479","url":null,"abstract":"Psychiatric practice has always entailed a coercive dimension, visible not only in its formal expressions (e.g. compulsory treatment) but in many informal and implicit forms. In fact, contemporary psychiatric practices are characterized by an interplay of coercion and dialog to be interpreted not as binary categories but as extremes of a spectrum. Within this perspective, it becomes crucial to draw boundaries attributing meaning to professional identities and practices in psychiatric work. This is particularly relevant in acute wards: to explore this issue, we selected two cases according to a most-different-cases design, one ward with a mechanical-restraint approach compared to one with no-mechanical-restraint. We argue that gender, mobilized to performatively draw distinctions and hierarchies in order to define and justify different approaches to psychiatric crises along the continuum between coercion and dialog, is a key dimension in the boundary-making process. The analysis identifies two main dimensions of drawing gendered boundaries: inter-gender boundaries (overlapping the binary distinction between masculinity and femininity with a more coercive or relational-dialogic approach to crisis) and intra-gender boundaries (distinguishing and ranking of different masculinities and femininities), associating a less coercive orientation with a devirilized masculinity.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"163-180"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971660","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

Bright-siding stigma: Older adults' experiences at a higher weight in Atlantic Canada. 亮边耻辱：加拿大大西洋地区老年人体重增加的经历。

IF 1.9 4区医学

Health Pub Date : 2025-03-01 Epub Date: 2024-03-19 DOI: 10.1177/13634593241238869

Andrea E Bombak, Norma Chinho, Lisa Thomson, Courtney Burk, Sumaiya Akhter, Kathleen O'Keefe, Lee Turner

{"title":"Bright-siding stigma: Older adults' experiences at a higher weight in Atlantic Canada.","authors":"Andrea E Bombak, Norma Chinho, Lisa Thomson, Courtney Burk, Sumaiya Akhter, Kathleen O'Keefe, Lee Turner","doi":"10.1177/13634593241238869","DOIUrl":"10.1177/13634593241238869","url":null,"abstract":"The lived experiences of higher-weight people vary; homogenous samples may fail to capture this diversity. This study develops an in-depth understanding of the lived experiences of higher-weight (Body Mass Index ⩾ 30) older adults (⩾60 years of age) in a Canadian Atlantic province. Participants (n = 11) were interviewed face-to-face using a semi-structured interview guide twice at 2-to-3-month intervals regarding their perceived treatment in social and health situations; how positive and negative healthcare experiences affected their health, lifestyles and healthcare seeking-behaviour; and recommendations in terms of patient experiences, access and inclusion. Participants infrequently reported negative experiences; however, participants' experiences were informed by uptake of moralistic, neoliberal discourses. Thematic content analysis identified two major themes: active citizenship (participants demonstrated internalisation of the imperative for weight loss, healthy lifestyles and active ageing) and bright-siding (participants expressed that a positive attitude could prevent/help cope with stigma). Results suggest that individualistic, rather than collective, political solutions to health and stigma have been taken up by higher-weight older adults in a Canadian Atlantic province, which may hinder attempts at structural reforms addressing stigma.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"236-257"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140158019","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

Power, position and social relations: Is the espoused absence of hierarchy in Open Dialogue naïve? 权力、地位和社会关系：开放对话中没有等级之说是否天真？

IF 1.9 4区医学

Health Pub Date : 2025-03-01 Epub Date: 2024-04-26 DOI: 10.1177/13634593241249101

Rochelle Einboden, Lisa Dawson, Andrea McCloughen, Niels Buus

{"title":"Power, position and social relations: Is the espoused absence of hierarchy in Open Dialogue naïve?","authors":"Rochelle Einboden, Lisa Dawson, Andrea McCloughen, Niels Buus","doi":"10.1177/13634593241249101","DOIUrl":"10.1177/13634593241249101","url":null,"abstract":"Open Dialogue practitioners aim to reduce social hierarchies by not privileging any one voice in social network conversations, and thus creating space for a polyphony of voices. This sits in contrast to the traditional privileging of those voices credited with more knowledge or power because of social position or professional expertise. Using qualitative interviews, the aim of this current study was to explore Open Dialogue practitioners' descriptions of challenges in implementing Open Dialogue at a women's health clinic in Australia. Findings revealed how attempts to rhetorically flatten hierarchies among practitioners created challenges and a lack of clarity regarding roles and responsibilities. As the practitioners tried to adjust to new ways of working, they reverted to taking up engrained positions and power aligned with more conventional social and professional roles for leading therapy and decision-making. The findings raise questions about equity-oriented ways of working, such as Open Dialogue, where intentions of creating a flattened hierarchy may allow power structures and their effects to be minimised or ignored, rather than actively acknowledged and addressed. Further research is needed to consider the implications that shifting power relations might have on the roles and responsibilities of practitioners in the move to equity-oriented services.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"258-275"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854884","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

Patient-led research and displacements of biomedical knowledge production, distribution, and consumption. 患者主导的研究与生物医学知识的生产、传播和消费的位移。

IF 1.9 4区医学

Health Pub Date : 2025-03-01 Epub Date: 2024-04-26 DOI: 10.1177/13634593241249096

Dixi Louise Strand, Mari Holen

引用次数: 0

Beyond the neoliberal label: A historical perspective on sexual actors and responsibility in HIV prevention in England (1986-2023). 超越新自由主义标签：从历史角度看英格兰预防艾滋病的性行动者和责任（1986-2023 年）。

IF 1.9 4区医学

Health Pub Date : 2025-03-01 Epub Date: 2024-03-18 DOI: 10.1177/13634593241238862

Alvaro Martinez-Lacabe

{"title":"Beyond the neoliberal label: A historical perspective on sexual actors and responsibility in HIV prevention in England (1986-2023).","authors":"Alvaro Martinez-Lacabe","doi":"10.1177/13634593241238862","DOIUrl":"10.1177/13634593241238862","url":null,"abstract":"Framed across three distinct periods of the history of neoliberalism and the HIV epidemic in England, this article conducts a detailed examination of the concept of personal responsibility and its contested uses within HIV prevention. The article questions the theoretical potential of neoliberal subjectivities to comprehend behaviours related to the pharmaceuticalised governance (or lack thereof) of gay men's sexual health, exploring the gap between theories emphasising individual responsibility and the practical experiences of gay men. The analysis draws on testimonials from gay men in oral history interviews and archival sources. The article illustrates how the pervasive notion of personal responsibility in England has been co-opted by neoliberal ideologies, leading to the stigmatisation of gay men whose sexual behaviours diverge from public health mandates. The widespread stigmatisation resulting from this ideology underscores a significant limitation in the theoretical framework of neoliberal subjectivities. This constraint extends beyond merely failing to grasp the complexity of sexual behaviours; it also reflects a lack of understanding of any other behaviour related to public health. Therefore, the article concludes by advocating the necessity of employing and constructing alternative theoretical frameworks to comprehend the pharmaceutical governance or lack thereof of gay men's sexual health. Through a concise autoethnography of the authors' pharmaceutical sexual health governance, the article introduces the concept of biocommesuration as an illustrative analysis that transcends the limitations of neoliberal subjectivities.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"220-235"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140143264","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

Sabotage, feeding and collusion after bariatric surgery. And the winner is . . .? A psychodynamic and systemic perspective on sabotage and feeding after bariatric surgery by means of a case series analysis. 减肥手术后的破坏，喂养和勾结。获胜者是……通过一系列病例分析，对减肥手术后的破坏和喂养的心理动力学和系统观点。

IF 1.9 4区医学

Health Pub Date : 2025-02-27 DOI: 10.1177/13634593251319928

Friedrich Stiefel, Laurent Michaud, Céline Bourquin-Sachse, Sophia Quirke-McFarlane, Jane Ogden

{"title":"Sabotage, feeding and collusion after bariatric surgery. And the winner is . . .? A psychodynamic and systemic perspective on sabotage and feeding after bariatric surgery by means of a case series analysis.","authors":"Friedrich Stiefel, Laurent Michaud, Céline Bourquin-Sachse, Sophia Quirke-McFarlane, Jane Ogden","doi":"10.1177/13634593251319928","DOIUrl":"10.1177/13634593251319928","url":null,"abstract":"In the context of bariatric surgery, negative social support has recently been conceptualized in terms of sabotage, feeding behaviour and collusion undermining a person's effort to lose or maintain weight. While sabotage and feeding behaviour are thought to be motivated consciously, collusion is understood as a bond, by which protagonists are tied together sharing an unresolved and unconscious psychological issue such as dependency, domination and submission, and so on. Drawing upon a systemic and psychodynamic understanding, we analysed interviews with patients (n = 10) who had undergone bariatric surgery and their partners (n = 10) focusing on support. We selected interviews (n = 4 + 4), illustrative of sabotage, feeding, collusion and co-evolution based on the comprehensiveness of information, their emblematic quality and suitability to delineate these phenomena. Our analysis confirms that negative social support can be considered as an attempt to reestablish a level of homeostasis within the couple. However, rather than being intentional, we consider that sabotage and feeding behaviour are better conceptualised as consequences of collusive relationships.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593251319928"},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523312","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

Distributed decision-making for lumbar spine surgery: A qualitative interview study with patients and neurosurgeons. 腰椎手术的分布式决策：对患者和神经外科医生的定性访谈研究。

IF 1.9 4区医学

Health Pub Date : 2025-02-26 DOI: 10.1177/13634593251319918

Per Koren Solvang, Tor Ingebrigtsen, Margreth Grotle, Karen Synne Groven, Tone Dahl-Michelsen

{"title":"Distributed decision-making for lumbar spine surgery: A qualitative interview study with patients and neurosurgeons.","authors":"Per Koren Solvang, Tor Ingebrigtsen, Margreth Grotle, Karen Synne Groven, Tone Dahl-Michelsen","doi":"10.1177/13634593251319918","DOIUrl":"https://doi.org/10.1177/13634593251319918","url":null,"abstract":"Lower back pain with or without radiating leg pain is a leading cause of disability worldwide. Several treatment options are available, and this article aims to understand better the decision-making involved in selecting appropriate treatments. A qualitative interview study was conducted with patients with lumbar spinal disorders and neurosurgeons specialising in spine surgery. Both groups of participants were asked to reflect on the decision-making process regarding whether to pursue surgery for back pain. The theoretical approach of distributed decision-making was applied. Results indicated that patients activated diverse information sources and considerations derived from their social networks when in the consultation room. Surgeons, on the other hand, were equipped with research-based knowledge and clinical practice experience. Effective communication was a shared concern for patients and surgeons during the actual decision-making. Factors such as patient diversity, the language used to discuss disease and illness, and the interpretation of risks played pivotal roles in the decision-making process. Regarding self-understanding, patients acted as agents for illness coping in their social networks. Surgeons recognised the imperative skill of facilitating rich patient dialogue as a crucial element in shared decision-making regarding potential surgical interventions. These findings demonstrate the importance of understanding decision-making as a distributed process where patients and clinicians are embedded in social networks and institutional contexts. In this process, patients must be recognised and engaged as individuals with diverse backgrounds and needs, especially during discussions focused on determining the most effective treatment approach for their specific cases.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593251319918"},"PeriodicalIF":1.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500672","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

Stigmatising space-times: Addressing healthcare stigma beyond interpersonal interactions. 污名化时空：超越人际互动解决医疗保健污名化问题。

IF 1.9 4区医学

Health Pub Date : 2025-02-25 DOI: 10.1177/13634593251323000

Gemma Nourse, Adrian Farrugia, Kate Seear, Emily Lenton, Elena Cama, Carla Treloar

{"title":"Stigmatising space-times: Addressing healthcare stigma beyond interpersonal interactions.","authors":"Gemma Nourse, Adrian Farrugia, Kate Seear, Emily Lenton, Elena Cama, Carla Treloar","doi":"10.1177/13634593251323000","DOIUrl":"https://doi.org/10.1177/13634593251323000","url":null,"abstract":"Stigma related to blood-borne viruses (BBVs) and sexually transmitted infections (STIs) has been shown to undermine the quality of healthcare. Given the pervasiveness and multiple manifestations of stigma within healthcare settings, recent research has argued that stigma should be addressed 'universally' i.e. for all stigmatising attributes and conditions, across all healthcare services. As part of the development of a universal approach to stigma, we analyse 20 interviews conducted with key stakeholders with expertise in BBVs, STIs and stigma in Australian healthcare settings. Inspired by research that addresses stigma as a biopolitical and spatial-temporal phenomenon, we examine how stigma weaves through relationships between people, time, space and technologies of healthcare provision. We begin with a discussion of funding structures and time constraints, followed by an examination of matters relating to the geographical location of the clinic and, finally, an analysis of smaller scale service environment space-times. In doing so, we bring attention to significant spatial-temporal matters that shape the production of stigma and address the need to balance universal concerns about healthcare quality with the specific forms of stigma that can emerge in relation to particular health issues and populations, such as BBVs and STIs. Overall, we examine how ambitious responses to stigma such as that proposed by the 'universal precautions' approach broaden our focus beyond interpersonal interactions and help draw attention to a wider range of objects, spaces and temporal dynamics that must be addressed in any effort to address stigma.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593251323000"},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500679","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

Narratives of reconstruction: Looking beyond biographical disruption through three Indian breast cancer memoirs. 重建的叙事：透过三个印度乳腺癌回忆录超越传记的中断。

IF 1.9 4区医学

Health Pub Date : 2025-02-19 DOI: 10.1177/13634593251319929

Mahua Bhattacharyya, Ajit K Mishra

{"title":"Narratives of reconstruction: Looking beyond biographical disruption through three Indian breast cancer memoirs.","authors":"Mahua Bhattacharyya, Ajit K Mishra","doi":"10.1177/13634593251319929","DOIUrl":"https://doi.org/10.1177/13634593251319929","url":null,"abstract":"Despite extensive research on Western breast cancer (BC) memoirs highlighting how shame profoundly impacts patients' lives making them more vulnerable, Indian BC memoirs remain underexplored, especially in understanding the challenges of shame. This article examines the unique struggles of Indian female BC patients, focusing on their experiences of biographical disruption, the guilt-ridden consciousness of their altered body image, and the shame-induced actions that shape their narratives. Through an analysis of three Indian BC memoirs, Sunshine (2011), To Cancer, with Love (2015) and Cancer, You Picked the Wrong Girl (2021), this article explores how Indian female BC narrators comprehend and articulate their lived experiences of shame and self-perception. The analysis also highlights the diverse coping strategies such as doing humour, normalising breast talk, practising spirituality, and sharing survival lessons employed by these narrators to offer a deeper understanding of the intersection of shame, identity, and healing, and to transcend moments of shame through acts of reconstruction. More importantly, the analysis underscores how these acts of reconstruction provide empowering strategies for navigating the challenges of BC and accentuate the possibility of an autobiographical reconstruction mechanism.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593251319929"},"PeriodicalIF":1.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457601","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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