IF 1.9 4区医学

Health Pub Date : 2024-07-01 Epub Date: 2023-06-30 DOI: 10.1177/13634593231185263

Jean-Laurent Domingue, Jean-Daniel Jacob

{"title":"Discursive constructions of family functions in forensic psychiatry: A critical ethnographic perspective.","authors":"Jean-Laurent Domingue, Jean-Daniel Jacob","doi":"10.1177/13634593231185263","DOIUrl":"10.1177/13634593231185263","url":null,"abstract":"Significant barriers remain regarding the implementation of family-centred approaches in the domain of forensic psychiatry despite their effectiveness at increasing adherence to treatment, improving attendance to medical appointments, decreasing readmission rates and reducing episodes of relapse. We attribute these barriers to a fundamental gap in our understanding of the family function and its role within the forensic psychiatric system. Despite requesting to be included and considered as partners, some families feel excluded and sidelined, which causes distress, incomprehension and disengagement. We approached this tension at the discursive level through a critical ethnography of the Review Board and the work of Foucault on psychiatric power, which provided us with a unique opportunity to understand how the role of families are constructed and sustained in the Canadian forensic psychiatric system. To do so, we mobilized data stemming from ethnographic observations and documentary artifacts entitled 'reasons for disposition'. Data analysis allowed us to identify two discursive constructions of familial functions: (1) families as repositories of information and (2) families as supervisory agents. These results have implications for health care professionals and administrators in forensic psychiatry who are increasingly adhering to family-centred care models without questioning what such care or what such family engagement entails.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"526-541"},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9782915","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

From embodiment to evidence: The harmful intersection of poor regulation of medical implants and obstructed narratives in embodied experiences of failed metal-on-metal hips. 从体现到证据：医疗植入物监管不力与金属髋关节失败的体现性体验中受阻叙事的有害交集。

IF 1.9 4区医学

Health Pub Date : 2024-07-01 Epub Date: 2023-06-05 DOI: 10.1177/13634593231179026

Pauline McCormack

{"title":"From embodiment to evidence: The harmful intersection of poor regulation of medical implants and obstructed narratives in embodied experiences of failed metal-on-metal hips.","authors":"Pauline McCormack","doi":"10.1177/13634593231179026","DOIUrl":"10.1177/13634593231179026","url":null,"abstract":"This research presents the results of a study about people with failed metal-on-metal hip implants, and draws on the STS concept of the technological imperative alongside research on the value of patient knowledge in clinical settings and the legitimacy of embodied stories. Popularly understood as positive and life changing, hip replacement surgery was hailed as 'the operation of the century', until a series of widespread failures of hundreds of thousands of hip implants, known collectively as metal-on-metal (MoM) hips, drew attention to the poor regulation of medical implants. This paper argues that poor regulation intersects with narratives of patients' pain, which are obstructed by surgeons and the UK regulatory body, with the effect of denying both patients' embodied experiences of implant failure, and their restitution to good health. Patient narratives about problems with their hip implant are the wellspring from which scientific evidence emerges which can indicate widespread implant failure. By obstructing these narratives the regulatory system undermines the very evidence it needs to operate effectively.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"578-595"},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9929554","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

Good care and adverse effects: Exploring the use of social alarms in care for older people in Sweden. 良好护理与不良影响：探索瑞典老年人护理中社会警报器的使用。

IF 1.9 4区医学

Health Pub Date : 2024-07-01 Epub Date: 2023-06-30 DOI: 10.1177/13634593231185260

Doris Lydahl

{"title":"Good care and adverse effects: Exploring the use of social alarms in care for older people in Sweden.","authors":"Doris Lydahl","doi":"10.1177/13634593231185260","DOIUrl":"10.1177/13634593231185260","url":null,"abstract":"In Nordic countries, 'welfare technology' is a concept used increasingly by policymakers when discussing the promise of digitalisation in care for older people. In this paper, I draw on data from 14 qualitative ethnographic interviews with employees in municipal eldercare in Sweden, as well as observations carried out at a nursing home, to suggest the importance of studying how good care is enacted through welfare technology, whilst simultaneously attending to the adverse effects sometimes consequent from these practices. In this article, I explore what values are supported when doing care with welfare technology, and what values are neglected in this process. The theoretical starting point for this article takes its inspiration from recent discussions of care within Science and Technology Studies (STS). Employing a double vision of care, the article argues for the importance of understanding how good care is enacted with technology, while also attending to what these care practices exclude and neglect. Focusing on the use of social alarms, the article shows that when doing care with such technology, values such as independence, safety and some forms of togetherness and availability were enhanced; while other values such as other forms togetherness and availability, a stress-free working environment and functionality were neglected.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"559-577"},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10086629","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

Reflections of a white healthcare professional researching ethnicized and racialized minorities: Autoethnographically explored emotions revealing implicit advantages and consequences. 一名白人医疗保健专业人员对少数族裔和种族化少数群体的研究反思：通过自编民族志探索情感，揭示隐含的优势和后果。

IF 1.9 4区医学

Health Pub Date : 2024-07-01 Epub Date: 2023-06-30 DOI: 10.1177/13634593231185261

Nina Halberg

{"title":"Reflections of a white healthcare professional researching ethnicized and racialized minorities: Autoethnographically explored emotions revealing implicit advantages and consequences.","authors":"Nina Halberg","doi":"10.1177/13634593231185261","DOIUrl":"10.1177/13634593231185261","url":null,"abstract":"Health research is often embedded in biomedicine in which the goal is to remove all bias. However, this is problematic in research on social issues such as social and health inequities. Therefore, there is growing criticism of health researchers' positions as neutral and invisible. I explore research-based advantages and consequences following my positionings within whiteness, nursing and healthcare professionality. Drawing on two ethnographic studies conducted in Denmark, one among black Nigerian women working in the streets of Copenhagen, the other following patients, defined in Danish healthcare as 'ethnic minorities', in two hospitals in the greater Copenhagen area, I take the point of departure from autoethnographic emotions of 'doing good', 'discomfort' and 'denial'. As I analyse these emotions as a production in the contexts, I show the advantages and consequences of leaving my marked body unmarked. With an intersectional lens, I discuss how health researchers' risk (re)producing social inequalities in health based on for example, avoiding topics of skin colour and experiences of discrimination. Ultimately, what legitimized my access to the people in the field paradoxically also risked delegitimizing their experiences of racialized and ethnicized inequalities. This is not only consequential for the interlocutors but also for the knowledge production, since we as health researchers' risk implicitly avoiding important knowledge if we do not see our own research positionings as a racialized, ethnicized and culturalized matter. Therefore, the need for educational curriculum on racialization and anti-discrimination is imperative within the health professions and as health researchers regardless of profession or research area.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"542-558"},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9782914","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

Experiences and management of urinary incontinence following treatment for prostate cancer: Disrupted embodied practices and adapting to maintain masculinity. 前列腺癌治疗后尿失禁的经历和处理：被打乱的体现实践和适应以保持男子气概。

IF 1.9 4区医学

Health Pub Date : 2024-07-01 Epub Date: 2023-06-30 DOI: 10.1177/13634593231185266

Richard Green

{"title":"Experiences and management of urinary incontinence following treatment for prostate cancer: Disrupted embodied practices and adapting to maintain masculinity.","authors":"Richard Green","doi":"10.1177/13634593231185266","DOIUrl":"10.1177/13634593231185266","url":null,"abstract":"This article explores men's experiences of and management strategies for urinary incontinence (UI) following treatment for prostate cancer. Qualitative interviews with 29 men, recruited from two prostate cancer support groups, explored their post-treatment experiences. Drawing on a conceptual toolkit connecting theories of masculinities, embodiment, and chronic illness, this paper identifies older men's experiences and strategies for managing UI and explores how these are shaped by their masculinities. This article identifies interdependence between managing stigma for UI and maintaining masculinity. Men's embodied practices for engaging in activities in public, crucial to masculine identity, were disrupted. In response, they adopted new reflexive body techniques to manage and resolve their UI, and thereby address the threat to their masculine identities, characterised in three strategies: monitoring, planning, and disciplining. The new embodied practices men described suggest three factors as important components for adopting new reflexive body techniques: routine, desire, and unruliness.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"489-506"},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9782918","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

How workplaces produce or reduce disability along the career paths of young people with cystic fibrosis. 工作场所如何在囊性纤维化青年的职业道路上产生或减少残疾。

IF 1.9 4区医学

Health Pub Date : 2024-07-01 Epub Date: 2023-07-06 DOI: 10.1177/13634593231185265

Laura Silvestri, Damien Issanchou, Laura Schuft, Sylvain Ferez

{"title":"How workplaces produce or reduce disability along the career paths of young people with cystic fibrosis.","authors":"Laura Silvestri, Damien Issanchou, Laura Schuft, Sylvain Ferez","doi":"10.1177/13634593231185265","DOIUrl":"10.1177/13634593231185265","url":null,"abstract":"Using the theoretical perspective of \"social participation\" as considered in the Human Development-Disability Creation Process, this article examines certain obstacles and facilitators to sustainable access to work among young French adults with cystic fibrosis. Drawing from the analyses of 29 qualitative interviews, the results show how such obstacles do not depend solely on their health status or on the medical management of the illness, but also on the work environments that these young professionals have recently entered or are trying to access. In these contexts, managing information about the illness can represent a means of obtaining cooperation from colleagues and superiors to reduce material or organizational obstacles (e.g. adapted work schedules), as well as a means of preventing socially uncomfortable or disabling situations. In this light, the social participation model can complement Corbin and Strauss' illness trajectory model, by setting the multi-factorial disabling or participatory situations along illness or medical trajectories. This enables dynamic consideration of how workplaces contribute to producing or reducing disability, in interaction with the actions taken by young people with cystic fibrosis to manage their career paths but also the evolution of illness, symptoms, or medical requirements.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"507-525"},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132855","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

Navigating ambivalence: A qualitative study of young fitness self-trackers' engagement with body ideals through social media. 矛盾的导航：对年轻健身自我追踪者通过社交媒体参与身体理想的定性研究。

IF 1.9 4区医学

Health Pub Date : 2024-07-01 Epub Date: 2023-05-16 DOI: 10.1177/13634593231175277

Carsten Stage, Stinne Bach Nielsen

{"title":"Navigating ambivalence: A qualitative study of young fitness self-trackers' engagement with body ideals through social media.","authors":"Carsten Stage, Stinne Bach Nielsen","doi":"10.1177/13634593231175277","DOIUrl":"10.1177/13634593231175277","url":null,"abstract":"This article explores how social media are involved in imagining and sensing body ideals among young fitness self-trackers in Denmark (age 15-24). The analysis is based on 20 interviews and contributes to existing research on social media, body image and self-tracking by showing that social media are central for the fitness practices of the participants, but also that gaining access to practical knowledge, motivational material and visual goals seem to be more important motivations for social media use than personal sharing and interaction. Social media are furthermore understood by the participants as unavoidable, but ambivalent terrains in the sense that cognitive and affective benefits, like knowledge or motivation, can only be accessed and felt by handling the risk of also encountering misinformation and demotivating images of idealised or deceptive bodies. The informants legitimise their engagement with social media by positioning themselves as mature media users able to navigate social media through practices of content dis/engagement. The ambivalence of social media is in other words experienced as both 'elemental' and 'curatable' by the informants; an experience that stresses the need to question the traditional conceptualisation of ambivalence as an inhibition of personal agency and will formation.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"633-650"},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9642772","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

Introducing Point-of-Care PCR technology in general practice: Ambiguities, experiences, and perceptions among health care professionals. 在全科医疗中引入护理点 PCR 技术：医疗保健专业人员的模糊认识、经验和看法。

IF 2.1 4区医学

Health Pub Date : 2024-05-31 DOI: 10.1177/13634593241254988

Line Maria Simonsen, Natasja Eilerskov, Rikke Sand Andersen, Jens Soendergaard, Jesper Bo Nielsen, Dorte Ejg Jarbøl, Trine Thilsing, Kirubakaran Balasubramaniam, Elisabeth Assing Hvidt

{"title":"Introducing Point-of-Care PCR technology in general practice: Ambiguities, experiences, and perceptions among health care professionals.","authors":"Line Maria Simonsen, Natasja Eilerskov, Rikke Sand Andersen, Jens Soendergaard, Jesper Bo Nielsen, Dorte Ejg Jarbøl, Trine Thilsing, Kirubakaran Balasubramaniam, Elisabeth Assing Hvidt","doi":"10.1177/13634593241254988","DOIUrl":"https://doi.org/10.1177/13634593241254988","url":null,"abstract":"In this paper we present findings from a qualitative ethnographic study investigating the experiences and perceptions of general practitioners and other practice staff when introducing a new point of care diagnostic test technology (point of care polymerase chain reaction (POC PCR)) in general practice in Denmark. The ethnographic study was conducted in five general practice clinics, involving observations in four of the clinics and interviews with general practitioners and practice staff in all five clinics. Following an initial analytic phase in which barriers and facilitators in the implementation process of the Point-of-Care test were identified, we developed theoretically informed themes, drawing upon Hartmut Rosa's social theory of technological acceleration. These themes included ambiguous experiences and perceptions of: (i) diagnostic specification and inflation embedded in diagnostic practices; (ii) empowerment and erosion of professional judgment; (iii) strategies of security and insecurity in communication; (iv) the interdependence between professional autonomy and economic structures associated with organizational power; and (v) subjective and organizational time. We discuss how diagnostic technologies simultaneously contribute to and disrupt treatment safety, efficiency, and medical decision-making. Using Rosa's sociological concepts of alienation and resonance, this article furthermore explores how these ambiguous dynamics are experienced in general practice settings. It also examines the implications of navigating a heterogeneous socio-technical and medical landscape and what it means to be a health professional in a contemporary general practice environment that is increasingly shaped by diagnostic technologies.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241254988"},"PeriodicalIF":2.1,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179629","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 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 2.1 4区医学

Health Pub 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":"https://doi.org/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":"13634593241255006"},"PeriodicalIF":2.1,"publicationDate":"2024-05-27","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

Void and narrative in the clinic of addictions: A theoretical proposal. 成瘾诊所中的虚无与叙事：理论建议。

IF 1.9 4区医学

Health Pub Date : 2024-05-01 Epub Date: 2023-04-12 DOI: 10.1177/13634593231167064

Clément Cimolaï, Vincent Bréjard

{"title":"Void and narrative in the clinic of addictions: A theoretical proposal.","authors":"Clément Cimolaï, Vincent Bréjard","doi":"10.1177/13634593231167064","DOIUrl":"10.1177/13634593231167064","url":null,"abstract":"We propose a connection between the void and addiction via psychoanalysis and current developments in narration in the context of the psychoanalytic clinic. We maintain that the addicted subject is shaped in particular by a relationship to the void evolving from the disruptive effects of the narrative. Our modern era is marked by a parallel evolution towards an unbearable void, to be filled at all costs. The neo-liberal promise of 'filling' the void with consumer objects in turn feeds the illusion of a so-called freedom, based on alienation to the inseparable duos of growth/jouissance and productivism/consumerism. The void has a multidisciplinary heritage (philosophy, physics, art, psychology) underlining certain aspects of a dialectic of the void that fluctuates between nothing at all and everything as potential. Taking this dialectic into account allows us to construct a concept of the void centred around two types of void: a narrative void and an a-narrative void. We maintain that the toxic in addiction can be interpreted as a narco-narrative that is constructed upon an a-narrative void. The clinical implications and technical proposals are briefly explored as openings to a clinical consideration of the void in the field of addictology.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"412-430"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9283358","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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