IF 1.9 4区医学

Health Pub Date : 2024-12-27 DOI: 10.1177/13634593241308497

Iben Emilie Christensen, Susanne Reventlow, Lone Grøn, Mette Bech Risør

{"title":"Healthcare seeking for people diagnosed with severe mental illness: Sensations, symptoms and diagnostic work.","authors":"Iben Emilie Christensen, Susanne Reventlow, Lone Grøn, Mette Bech Risør","doi":"10.1177/13634593241308497","DOIUrl":"https://doi.org/10.1177/13634593241308497","url":null,"abstract":"For people with mental and somatic illnesses, the interpretive process of attending to a multitude of bodily sensations and recognising them as potential symptoms represents daily and 'chronic homework'. Based on 16 months of ethnographic fieldwork in Denmark, this study explores diagnostic work and healthcare seeking among people with severe mental and somatic illnesses. As multiple studies have shown, the transformation process for a perceived sensation to become a symptom is a socially constructed interpretative process highly dependent on social legitimisation and shaped by prior cultural knowledge. We found that people with severe mental and somatic illnesses often struggle to 'read' the body and its boundaries and to define and distinguish when a symptom becomes a potential sign of illness. Furthermore, they often lack opportunities for social recognition of symptoms due to the absence of social relations. Finally, lifelong experiences with the healthcare system have taught them that they must distinguish between 'mental' and 'somatic' symptoms to fit the systemic organisation of the healthcare system. This deeply rooted mind-body dualism in the organisation of healthcare services and the daily struggles of diagnostic work to comply with this organisation impacted the interlocutors' healthcare seeking strategies. Moreover, even though they 'make up their minds' to seek healthcare, they risk being met with diagnostic overshadowing and reductionist clinical approaches.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241308497"},"PeriodicalIF":1.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894089","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

Caring remotely through 'fitting': Video consultation use in Danish general practice. 通过“装配”远程护理：视频咨询在丹麦全科实践中的应用。

IF 1.9 4区医学

Health Pub Date : 2024-12-26 DOI: 10.1177/13634593241306577

Elle Christine Lüchau, Finn Olesen, Helen Atherton, Jens Søndergaard, Elisabeth Assing Hvidt

{"title":"Caring remotely through 'fitting': Video consultation use in Danish general practice.","authors":"Elle Christine Lüchau, Finn Olesen, Helen Atherton, Jens Søndergaard, Elisabeth Assing Hvidt","doi":"10.1177/13634593241306577","DOIUrl":"https://doi.org/10.1177/13634593241306577","url":null,"abstract":"In this study, we examine how Danish general practitioners (GPs) and general practice staff have fitted their use of video consultation to align with their conceptualisations of good care. Political stakeholders are repeatedly encouraging the use of video consultation in the healthcare sector, discursively referring to optimised use of healthcare resources, increased efficiency and flexibility for and geographical equality among patients. By the end of 2024, it will be mandatory for GPs to offer video consultations to patients in Danish general practice. This raises important questions about the implications of video consultation on the care provided in general practice. Our data consists of 30 semi-structured interviews with GPs and 132 hours of fieldwork conducted across seven clinics from August 2021 to August 2022. We analysed the data following the principles of reflexive thematic analysis and inspired by an abductive approach. Drawing on Annemarie Mol's and Jeanette Pols' conceptualisations of care and fitting, we identified common rationalisations articulated and observed in practice that highlight how fitting video consultation into the care provided in a general practice setting can enable (1) optimised use of busy patients' time), (2) optimised use of clinician and clinic resources, (3) enhanced connection of 'harder to reach' patients and (4) better work experiences for GPs and staff. Our findings demonstrate the variety of video consultation use potentials, contributing to our understanding of the implications of video consultation on the provision of care.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241306577"},"PeriodicalIF":1.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894085","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

A bad migrant: An autoethnographic case study of racism in Australian HIV care. 一个坏的移民：种族主义在澳大利亚艾滋病护理的自我民族志案例研究。

IF 1.9 4区医学

Health Pub Date : 2024-12-18 DOI: 10.1177/13634593241306578

Satrio Nindyo Istiko

引用次数: 0

The IPEDs assemblage: Tracing the entanglements of biomedicine, technology, enhancement and anti-doping policies in sport and society. iped组合：追踪生物医学，技术，增强和反兴奋剂政策在体育和社会中的纠缠。

IF 1.9 4区医学

Health Pub Date : 2024-12-18 DOI: 10.1177/13634593241306569

Timothy Piatkowski, Luke Turnock, Nick Gibbs, Cameron Duff

{"title":"The IPEDs assemblage: Tracing the entanglements of biomedicine, technology, enhancement and anti-doping policies in sport and society.","authors":"Timothy Piatkowski, Luke Turnock, Nick Gibbs, Cameron Duff","doi":"10.1177/13634593241306569","DOIUrl":"https://doi.org/10.1177/13634593241306569","url":null,"abstract":"The US Anti-Doping Agency (USADA) and Ultimate Fighting Championship (UFC) recently ended their anti-doping partnership amidst controversy. We treat this decision, and the motivations underpinning it, as a means of exploring the complexities of anti-doping norms and the blurred lines between image and performance enhancing drug (IPED) use in sport and wider society. Drawing ideas from assemblage thinking, we analyse the evolving power dynamics surrounding IPED use, anti-doping policy, and the role of popular athletes in shaping societal perceptions of the use of, and potential harms associated with IPEDs. The study offers a case analysis of recent controversies in the UFC to investigate the entanglements of biomedicine, technology and celebrity culture in what we call the IPED assemblage. The 2023 termination of the USADA-UFC partnership has sparked debates about shifts in anti-doping standards, raising concerns about weaker testing protocols and perceptions of IPED normalisation. The case of Conor McGregor's injury recovery and alleged IPED use underscores the blurred lines between therapeutic and enhancement drug use within the IPED assemblage, challenging conventional distinctions between 'good' and 'bad' drugs in the context of sports management and anti-doping policy making. We highlight the inadequacy of current doping policies in responding to the IPED assemblage and highlight the need to shift public discourse to foster a more critical understanding of therapeutic and enhancement strategies to drive innovation in anti-doping frameworks.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241306569"},"PeriodicalIF":1.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846446","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

Inegalitarian effects on access to vaccines of delegating Covid-19 vaccination to a private online appointment platform: The French case. 将Covid-19疫苗接种委托给私人在线预约平台对疫苗获取的不平等影响：法国案例

IF 1.9 4区医学

Health Pub Date : 2024-12-13 DOI: 10.1177/13634593241306574

Selma Ghomari, Charlotte Serrano, Amélie Beaugrand, Maud Gelly

{"title":"Inegalitarian effects on access to vaccines of delegating Covid-19 vaccination to a private online appointment platform: The French case.","authors":"Selma Ghomari, Charlotte Serrano, Amélie Beaugrand, Maud Gelly","doi":"10.1177/13634593241306574","DOIUrl":"https://doi.org/10.1177/13634593241306574","url":null,"abstract":"A great deal of research has shown that health inequalities are the product of socially unequal wear and tear of bodies, socially differentiated use of the healthcare system and unequal access to care, as well as healthcare professionals' differentiating practices. However, public policies are rarely the focus of recent investigations on the production of health inequalities. How can public policies produce or even amplify health inequalities, but also reduce them, or fail to do so? This study aims to investigate the impact of online appointment booking on effective access to Covid-19 vaccination. Through a quantitative survey of the first weeks of vaccination against Covid-19 in 2021 in an undeserved French suburb called Seine-Saint-Denis, this paper shows how the vaccination policy has contributed to reproducing and amplifying inequalities towards Covid-19: middle and upper classes are significantly more represented among people vaccinated (67%) than in the population of Seine-SaintDenis (41%), and working classes are significantly less represented (33%) than in Seine-Saint-Denis (59%). The people vaccinated are more highly educated and more often French than the population of SeineSaint-Denis. Online appointment favoured more educated people.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241306574"},"PeriodicalIF":1.9,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824192","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 : 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":"13634593241303617"},"PeriodicalIF":1.9,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Välkky's voyage on to a hospital ward: Expectations, explorations and emergent robocentric nursing care. Välkky的医院病房之旅：期望，探索和紧急机器人中心护理。

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

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