IF 1.9 4区医学

Health Pub Date : 2024-05-01 Epub Date: 2023-06-13 DOI: 10.1177/13634593231173807

Corina L Vasilescu, Martin McKee, Aaron Reeves

{"title":"Quantitative Textual Analysis as a means to explore corporate interests in food safety.","authors":"Corina L Vasilescu, Martin McKee, Aaron Reeves","doi":"10.1177/13634593231173807","DOIUrl":"10.1177/13634593231173807","url":null,"abstract":"The growing body of scholarship on the commercial determinants of health has, so far, mostly employed qualitative methods but this is now being complemented by a small, yet growing, corpus of quantitative studies. We illustrate the use of one such method, quantitative text analysis (QTA), in a case study of submissions to a public consultation on a draft scientific opinion by the European Food Safety Authority on the chemical acrylamide, demonstrating how this method can be used and insights that might be drawn from it. We use Wordscores as one example of QTA to illuminate the diverse positions taken by actors submitting comments and then assess whether the final policy documents moved towards or away from the positions taken by different stakeholders. We find a broadly uniform position among the public health community, opposed to acrylamide, contrasting with industry positions that were not monolithic. Some firms recommended major amendments to the guidance, largely reflecting the impact on their practices, while policy innovators seeking ways to reduce acrylamide in foods aligned with the public health community. We also find no clear movement in the policy guidance, likely because most submissions supported the draft document. Many governments are required to conduct public consultations, some attracting enormous numbers of responses, with little guidance on how best to synthesise the responses so the default position is often a count of those for and against. We argue that QTA, primarily a research tool, might usefully be applied in analysing public consultation responses to understand better the positions taken by different actors.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"372-389"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9994555","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

Negotiating with digital self-monitoring: A qualitative study on how patients with multiple sclerosis use and experience digital self-monitoring within a scientific study. 与数字自我监测进行谈判：一项关于多发性硬化症患者如何在科学研究中使用和体验数字自我监测的定性研究。

IF 1.9 4区医学

Health Pub Date : 2024-05-01 Epub Date: 2023-05-17 DOI: 10.1177/13634593231175321

Karine Wendrich, Lotte Krabbenborg

{"title":"Negotiating with digital self-monitoring: A qualitative study on how patients with multiple sclerosis use and experience digital self-monitoring within a scientific study.","authors":"Karine Wendrich, Lotte Krabbenborg","doi":"10.1177/13634593231175321","DOIUrl":"10.1177/13634593231175321","url":null,"abstract":"Research shows that patients can have values and use practices that are different from those envisioned by technology developers. Using sociomaterialism as an analytical lens, we show how patients negotiated with digital self-monitoring in the context of a scientific study. Our paper draws on interviews with 26 patients with the chronic neurological disease multiple sclerosis (MS) who were invited to use an activity tracker and a self-monitoring app for a period of 12 months as part of their everyday life. Our study aims to fill a gap: relatively little is known about how digital self-monitoring becomes materialized in the everyday lives of patients with chronic diseases. We show that patients engaged in digital self-monitoring because they are eager to participate in research to contribute knowledge that will benefit the larger community of patients rather than to improve their personal self-management. Although respondents adhered to digital self-monitoring during the study, it is not self-evident that they would do so for private self-monitoring purposes. It became clear that respondents did not necessarily perceive digital self-monitoring as useful for their self-management practices due to their established knowledge and routines. Moreover, respondents referred to the inconvenience of having to perform self-monitoring tasks and the emotional burden of being reminded of the MS because of the digital self-monitoring. We conclude by indicating what could be considered when designing scientific studies, including the suitability of conventional study designs for evaluating technologies used daily by patients and the challenge of integrating patients' experiential knowledge into scientific practices.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"333-351"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11041077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9472827","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

Intercorporeal collaboration: Staging, parsing, and embodied directives in dementia care. 体外协作：痴呆症护理中的分期、解析和体现指令。

IF 1.9 4区医学

Health Pub Date : 2024-05-01 Epub Date: 2023-05-22 DOI: 10.1177/13634593231173809

Lars-Christer Hydén, Anna Ekström, Ali Reza Majlesi

{"title":"Intercorporeal collaboration: Staging, parsing, and embodied directives in dementia care.","authors":"Lars-Christer Hydén, Anna Ekström, Ali Reza Majlesi","doi":"10.1177/13634593231173809","DOIUrl":"10.1177/13634593231173809","url":null,"abstract":"This study shows how concerted bodily movements and particularly intercorporeality play a central role in interaction, particularly in joint activities with people with late-stage dementia. Direct involvement of bodies in care situations makes intercorporeal collaboration the basic form for engaging with people with late-stage dementia. By detailed analysis of a videorecording of a joint activity involving a person with late-stage dementia as an example, we show that the process of concerted bodily movements includes not only an interactive bodywork but also a reconfiguration of the routine activities and actions in situ. Reconfigurations often require, and are the outcome of, particular practices for the systematic modification of the embodied conducts of the participants and their use of artifacts in the surrounding environment. These practices, that we highlight in our study, are (1) staging activities through organization and re-organization of body parts, as well as artifacts (rather than using verbal descriptions of activities); (2) decomposing (parsing) activities into smaller parts possible for the person with dementia to perform (rather than using verbal action descriptions); and (3) providing embodied directions and bodily demonstrations of actions (rather than using verbal directives). As a result, we point to these practices for their reflexive roles in the change of the use of modalities in interaction: from mainly using verbal language to the prominence of visual depiction and bodily demonstration as necessary methods to facilitate the participation of people with latestage dementia in joint activities.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"352-371"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11041064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9507091","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 Depressed" and "People with Anxiety" therapists' discursive representations of patients with depression and anxiety in Danish Psychiatry. 丹麦精神病学》中 "抑郁症患者 "和 "焦虑症患者 "治疗师对抑郁症和焦虑症患者的话语表述。

IF 1.9 4区医学

Health Pub Date : 2024-05-01 Epub Date: 2023-05-16 DOI: 10.1177/13634593231173802

Anne Bryde Bryde Christensen, Karoline Dyrloev, Michaela Hoej, Stig Poulsen, Nina Reinholt, Sidse Arnfred

{"title":"\"The Depressed\" and \"People with Anxiety\" therapists' discursive representations of patients with depression and anxiety in Danish Psychiatry.","authors":"Anne Bryde Bryde Christensen, Karoline Dyrloev, Michaela Hoej, Stig Poulsen, Nina Reinholt, Sidse Arnfred","doi":"10.1177/13634593231173802","DOIUrl":"10.1177/13634593231173802","url":null,"abstract":"Stigmatization within mental health care has previously been identified, and some diagnoses have been shown to be particularly exposed to negative attitudes and stigma. However, no previous studies have explored practitioners' discursive construction of patients with different diagnoses within a transdiagnostic group context. We performed discourse analysis on 12 interviews with Danish mental health practitioners, who had been conducting either transdiagnostic psychotherapy (The Unified Protocol) or standard group cognitive behavioral therapy (CBT) with patients treated for anxiety disorders or major depressive disorder. The purpose of this study was to identify how patients with anxiety and depression were represented by therapists. We identified a \"training discourse,\" within which patients were evaluated through perceived motivation, responsibility, active participation, and progression. We argue that this training discourse can be related to a broader neoliberal order of discourse valuing efficiency and agency. The analysis indicated that patients with anxiety were sometimes \"favorized\" over patients with depression, and it is argued that the neoliberal order of discourse and pre-assumptions related to the diagnoses are contributing to this. The interviews indicate that multiple discourses were applied when describing patients, and ambivalence was often detectable. We discuss the findings of the analysis in relation to therapists' general critical attitudes toward the psychiatric system and in relation to broader societal tendencies.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"390-411"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9524747","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

Media portrayals of psychotropic agents in AD/HD treatment: A social constructionist approach. 媒体对AD/HD治疗中精神药物的描述：一种社会建构主义的方法。

IF 1.9 4区医学

Health Pub Date : 2024-05-01 Epub Date: 2023-04-19 DOI: 10.1177/13634593231167060

Josef Qaderi, Jonas Lindblom

{"title":"Media portrayals of psychotropic agents in AD/HD treatment: A social constructionist approach.","authors":"Josef Qaderi, Jonas Lindblom","doi":"10.1177/13634593231167060","DOIUrl":"10.1177/13634593231167060","url":null,"abstract":"In recent decades there has been a significant increase in diagnosing children and adults with Attention-Deficit/Hyperactivity Disorder (AD/HD), and in the use of pharmacological treatment with Ritalin, Concerta and Strattera for AD/HD. This development has given rise to scientific criticism, claiming that the pharmaceuticals prescribed by doctors are, to a large extent, ineffective or harmful. This study discusses media's portrayal of treatment of AD/HD. The aim of the article is to develop a social constructionist perspective, highlighting how scientific critique of pharmaceuticals for AD/HD is handled in the mass media. The authors introduce the concept of \"psychopharmacological extensibility,\" which demonstrates the importance of collective definitional processes in society. Psychopharmacological extensibility reflects the fact that the perception of AD/HD agents as beneficial medicines or harmful drugs is open to interpretation and dependent on social factors related to context, power, rhetoric, and marketization. The empirical data are based on 211 articles from eight of the largest newspapers in Sweden, published between 2002 and 2021. The result shows that Swedish mass media, in numerous ways, neglects or undermines the scientific criticism made, thereby facilitating an increased use of the diagnosis and of psychotropic agents in society.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"431-449"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9389402","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

Peer support for accepting distressing reality: Expertise and experience-sharing in psychiatric peer-to-peer group discussions. 接受痛苦现实的同伴支持：精神科同伴小组讨论中的专业知识和经验分享。

IF 1.9 4区医学

Health Pub Date : 2024-05-01 Epub Date: 2023-02-27 DOI: 10.1177/13634593231156822

Elina Weiste, Melisa Stevanovic, Lise-Lotte Uusitalo, Hanna Toiviainen

{"title":"Peer support for accepting distressing reality: Expertise and experience-sharing in psychiatric peer-to-peer group discussions.","authors":"Elina Weiste, Melisa Stevanovic, Lise-Lotte Uusitalo, Hanna Toiviainen","doi":"10.1177/13634593231156822","DOIUrl":"10.1177/13634593231156822","url":null,"abstract":"Peer-based interventions are increasingly used for delivering mental health services to help people with an illness re-examine their situation and accept their illness as part of their life story. The role of the peer supporter in these interventions, known as experts-by-experience (EbE), is situated between mutual peer support and semi-professional service delivery, and they face the challenge of balancing an asymmetric, professional relationship with a reciprocal, mutuality-based, equal relationship. This article investigates how EbEs tackle this challenge when responding to clients' stories about their personal, distressing experiences in peer-based groups in psychiatric services. The results show how the EbEs responded to their clients' experience-sharing with two types of turns of talk. In the first response type, the EbEs highlighted reciprocal experience-sharing, nudging the clients toward accepting their illness. This invoked mutual affiliation and more problem-talk from the clients. In the second response type, the EbEs compromised reciprocal experience-sharing and advised clients on how to accept their illness in their everyday lives. This was considered less affiliative in relation to the client's problem description, and the sequence was brought to a close. Both response types involved epistemic asymmetries that needed to be managed in the interaction. Based on our analysis, semi-professional, experience-based expertise involves constant epistemic tensions, as the participants struggle to retain the mutual orientation toward peer-based experience-sharing and affiliation.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"450-469"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11041083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9358562","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

Layers of senses: Experiencing intercorporeality in teletherapy. 感官的层次：在远程治疗中体验体际现实。

IF 1.9 4区医学

Health Pub Date : 2024-05-01 Epub Date: 2023-03-13 DOI: 10.1177/13634593231156811

Ariela Popper-Giveon, Yael Keshet

{"title":"Layers of senses: Experiencing intercorporeality in teletherapy.","authors":"Ariela Popper-Giveon, Yael Keshet","doi":"10.1177/13634593231156811","DOIUrl":"10.1177/13634593231156811","url":null,"abstract":"Teletherapy, namely, therapy that uses technology for communication between patients and therapists, is challenged by the impersonal nature of remote and digital communication. Using Merleau-Ponty's theoretical concept of intercorporeality, which refers to the perceived reciprocity between two people's bodies during communication, this article aims to elaborate on spiritual caregivers' experience of interacting with patients during teletherapy. Semi-structured in-depth interviews were conducted with 15 Israeli spiritual caregivers who use various forms of teletherapy (Zoom, FaceTime, phone calls, WhatsApp messages, etc.). Interviewees emphasized their physical presence with the patient as a main principle in spiritual care. They indicated the involvement of nearly all senses in physical presence therapy, which allows for joint attention and compassionate presence. When making use of various communication technologies in teletherapy, they reported the involvement of fewer senses. The more senses involved in the session and the clearer it is that space and time are shared by both caregiver and patient, the stronger the caregiver's presence with the patient. Interviewees experienced teletherapy as eroding the multisensory joint attention and intercorporeality and, hence, the quality of care. This article points at the advantages of teletherapy for therapists in general and spiritual caregivers in particular but claims, nonetheless, that it challenges the main principles of therapy. Joint attention in therapy is, fundamentally, a multisensory phenomenon that may be understood as intercorporeality. Our use of the notion of intercorporeality sheds light on the reduction of the senses involved in remote interpersonal communication and its impact on care and, more generally, the interpersonal communication experienced during telemedicine. This article's findings may also contribute to the field of cyberpsychology and to therapists engaged in telepsychology.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"470-486"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9099605","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

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 2.1 4区医学

Health Pub 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":"https://doi.org/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":"13634593241249101"},"PeriodicalIF":2.1,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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 2.1 4区医学

Health Pub Date : 2024-04-26 DOI: 10.1177/13634593241249096

Dixi Louise Strand, Mari Holen

引用次数: 0

Clinical context and communication in shared decision-making about major surgery: Findings from a qualitative study with colorectal, orthopaedic and cardiac patients. 大手术共同决策中的临床环境与沟通：对结肠直肠癌、骨科和心脏病患者的定性研究结果。

IF 2.1 4区医学

Health Pub Date : 2024-03-21 DOI: 10.1177/13634593241238857

Gemma Hughes, Timothy J Stephens, Lucas M Seuren, Rupert M Pearse, Sara E Shaw

{"title":"Clinical context and communication in shared decision-making about major surgery: Findings from a qualitative study with colorectal, orthopaedic and cardiac patients.","authors":"Gemma Hughes, Timothy J Stephens, Lucas M Seuren, Rupert M Pearse, Sara E Shaw","doi":"10.1177/13634593241238857","DOIUrl":"https://doi.org/10.1177/13634593241238857","url":null,"abstract":"Increasing numbers of older people undergo major surgery in the United Kingdom (UK), with many at high risk of complications due to age, co-morbidities or frailty. This article reports on a study of such patients and their clinicians engaged in shared decision-making. Shared decision-making is a collaborative approach that seeks to value and centre patients' preferences, potentially addressing asymmetries of knowledge and power between clinicians and patients by countering medical authority with greater patient empowerment. We studied shared decision-making practices in the context of major surgery by recruiting 16 patients contemplating either colorectal, cardiac or joint replacement surgery in the UK National Health Service (NHS). Over 18 months 2019-2020, we observed and video-recorded decision-making consultations, studied the organisational and clinical context for consultations, and interviewed patients and clinicians about their experiences of making decisions. Linguistic ethnography, the study of communication and interaction in context, guided us to analyse the interplay between interactions (during consultations between clinicians, patients and family members) and clinical and organisational features of the contexts for those interactions. We found that the framing of consultations as being about life-saving or life-enhancing procedures was important in producing three different genres of consultations focused variously on: resolving problems, deliberation of options and evaluation of benefits of surgery. We conclude that medical authority persists, but can be used to create more deliberative opportunities for decision-making through amending the context for consultations in addition to adopting appropriate communication practices during surgical consultations.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593241238857"},"PeriodicalIF":2.1,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140184261","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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