Health最新文献

{"title":"Problems of equity in US HIV integrated planning, 2015-2021: Enacting a bounded justice continuum.","authors":"Stephen Molldrem, Nivan Wadhawan, Alec Manning, Justin D Edwards","doi":"10.1177/13634593251375041","DOIUrl":"10.1177/13634593251375041","url":null,"abstract":"<p><p>The US HIV/AIDS response is notably worse than those of other high-income countries. The country's epidemic is marked by low viral suppression rates, high incidence, lacking coordination, and entrenched disparities along lines of sexuality, race/ethnicity, gender, class, and other factors. In 2010, the <i>National HIV/AIDS Strategy for the United States</i> (<i>NHAS</i>) was launched, centering an equity-oriented vision that prioritized marginalized groups. <i>NHAS</i> implementation required states to create HIV integrated plans to better coordinate services and meet populations' needs. We used Carol Bacchi's \"What's the Problem Represented to Be?\" approach to analyze 20 jurisdictions' plans, focusing on how they incorporated equity-oriented principles articulated in <i>NHAS</i>'s vision statement and other factors such as plans for integration across HIV care, surveillance, and prevention programs. Building on Melissa Creary's concept of \"bounded justice,\" we show that integrated plans enacted a \"bounded justice continuum,\" wherein some states pursued more equity-oriented strategies than others. We argue that this reflects constraints planners faced and the structure of US federalism, where implementing jurisdictions operated in variously restrictive or enabling conditions related to state-level politics, available public health infrastructure, and other factors. Our approach and the bounded justice continuum concept can be useful for scholars studying the rollout of equity-oriented policies in federal systems where local implementations will vary widely. We ultimately arrive at a positive assessment of US HIV integrated planning. However, we also advocate for more transformative reforms to ensure that people living with and affected by HIV can access universal healthcare, social services, housing, and employment.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"389-411"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444718","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}

{"title":"Affective gaps in eHealth communication: Exploring patient experiences with health data on the eHealth platform sundhed.dk.","authors":"Martina Skrubbeltrang Mahnke","doi":"10.1177/13634593251374317","DOIUrl":"10.1177/13634593251374317","url":null,"abstract":"<p><p>The exploratory study examines how patients in Denmark experience health data on the eHealth platform <i>sundhed.dk</i>. The study takes its starting point in the communicative process taking place between patients as platform users and the eHealth platform as a communicative agent. In dialogue with literature at the intersection of eHealth and communication studies, it develops the analytical lens of affective gaps, connecting Peters notion of communicative gaps with Lupton's concept of affective atmospheres. Empirically, the study unpacks the complex, often conflicting experiences that arise when patients attempt to make meaning of and engage with their health data. Building on 24 in-depth, purposefully sampled interviews, the article presents a thorough thematic analysis, showing that patients need to simultaneously deal with states of being (1) informed and insecure, (2) confident and frustrated, and (3) in control and in doubt. Receiving health data on eHealth platforms is a complex and often challenging process for patients, provoking profound and at times unsettling experiences, oftentimes creating vulnerabilities. While gaps and uncertainty have always been a part of health communication, eHealth platforms amplify and reconfigure these dynamics, thus presenting novel challenges for patient-healthcare professional communication. In conclusion, the article calls for further research into the communicative user-platform relations that shape patient experiences with health data, positioning patients as the primary receivers of eHealth communication.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"351-368"},"PeriodicalIF":2.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191477","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}

{"title":"Narrative, moral and institutional effects of childhood ADHD: Listening to teachers and mothers of diagnosed children.","authors":"Galia Plotkin-Amrami, Talia Fried","doi":"10.1177/13634593251358035","DOIUrl":"10.1177/13634593251358035","url":null,"abstract":"<p><p>Building on research on the critical role of laypeople in medicalization and the multi-dimensional character of this process, this study explores the effects and meanings of the ADHD category for mothers and teachers of diagnosed children. Based on interviews with 27 schoolteachers from two different schools and 42 mothers of children diagnosed with ADHD, we show that despite the growing acceptance of ADHD as a medical diagnosis, it exhibits only minor narrative, institutional, and moral effects in school and family arenas. The diagnostic label attributed to children does not resolve blame games and uncertainty about the source of children's difficulties and does not provide many pragmatic benefits for either mothers or teachers. We argue that these limited narrative, moral and institutional effects are shaped by the moral positionings available to mothers and teachers, the institutional status of ADHD as a category of disability, and educational policy. We distinguish medicalization's institutional and interpersonal dimensions and explore their complex interrelations. Our analysis resonates with recent moves in medical sociology toward more pragmatic and practice-based analyses of the effects of medical categories, particularly when enacted outside traditional healthcare settings.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"295-313"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206279","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}

{"title":"Implementation of patient participation in rehabilitation: An approach caught between different ideologies.","authors":"Elin Margrethe Aasen, Marianne Kjelsvik, Lindis Katrine Helberget, Elisabeth Dahlborg","doi":"10.1177/13634593251374321","DOIUrl":"10.1177/13634593251374321","url":null,"abstract":"<p><p>The definition of specialised rehabilitation in Europe has changed from a focus on patients' bodily functions and work tasks to a patient-centred focus prioritising patients' wishes, allowing patients to actively collaborate and set their own goals. This study aimed to explore interprofessional healthcare teams' discursive practice regarding the implementation of patient participation in specialised rehabilitation units in Norway. Data were collected from three focus groups with seven different health professions, totalling 18 healthcare professionals. A corpus-assisted critical discourse analysis outlined by Fairclough was used to analyse the data. Three interdiscursive discourses based on different and opposing ideologies were found: (1) the discourse of standardisation, in which healthcare professionals used international models for rehabilitation goal setting; (2) the discourse of interprofessional experts, in which healthcare professionals constructed themselves as experts; and (3) the discourse of patient responsibility, in which the patients were constructed as having rights and autonomy. The sociocultural practice of implementing patient participation in specialised rehabilitation in Norway highlighted a hegemonic struggle between standardisation; paternalistic and autonomy ideologies; ethical dilemmas between healthcare professionals' knowledge and use of standardised goals; and patients' autonomy, knowledge, and will.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"412-429"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225401","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}

{"title":"Femtech in context: A critical conceptual (re)view.","authors":"Danica Facca, Jodi Hall, Gail Teachman, Joanna Redden, Lorie Donelle","doi":"10.1177/13634593251371327","DOIUrl":"10.1177/13634593251371327","url":null,"abstract":"<p><p>Emerging as a commercial category in 2016, 'femtech' has been publicly celebrated as a category of consumer-based digital health technologies designed to support the unmet and systemically marginalized health needs of women in areas such as menstruation, fertility, pregnancy, postpartum, and menopause, through data-driven apps, wearables, and self-diagnostic tools. Since its emergence, the term femtech has become culturally significant and has taken on a life of its own across commercial, public, and healthcare discourses. Despite the growth of femtech scholarship, clarity is lacking on how different disciplines have challenged the assumptions about sex, gender, health, technology, and innovation that shape dominant understandings of 'who' femtech is for (i.e. fem) and 'what' it constitutes (i.e. tech). Motivated by this research gap, a critical conceptual review was conducted to provide new entry points into critical debates. This article novelly adapts 'diffractive reading' as a methodological approach to bring disciplinary perspectives on femtech into conversation with one another across anthropology, computer science, cultural studies, gender studies, information studies, law, media studies, medicine, and science and technology studies. This article focuses on insights drawn between critiques of femtech which trouble the ideologies, discourses, and practices that shape dominant understandings of 'fem' and 'tech'. In thinking through and with the conceptual boundaries of femtech, this review underscores the ongoing need to examine femtech's role in shaping global dynamics of reproductive, labor, and environmental justice, in addition to neoliberal approaches to healthcare more broadly.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"369-388"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080493","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}

{"title":"Evicted from paradise: Methodological challenges of posthuman healthcare research.","authors":"David A Nicholls, Clair Hebron, Shirley Chubb","doi":"10.1177/13634593261442953","DOIUrl":"https://doi.org/10.1177/13634593261442953","url":null,"abstract":"<p><p>Interest in posthuman concepts and ideas, philosophies and theories has grown enormously over the last 25 years, and posthumanism is now one of the most vibrant and innovative frontiers in healthcare thinking. At its most basic, posthumanism is a philosophical approach that decentres the human and considers other non-human or more-than-human objects as equally important. But this description belies the many challenges posthumanism presents to the researcher. There are many competing approaches to consider, there is often opaque language to navigate, and there are many structural problems to overcome. In this paper we tackle three major methodological challenges: vitalism, or the question of what gives life to things; transcendence, and the substance problem; and correlation, or latent anthropocentrism. We consider how it might be possible to research with a process-based ontology in a world dominated by substance-based principles. And we conclude with four related recommendations: a focus on key principles, concept creation, deep reading and attention to ontological slippage, before reflecting on our own experiences researching walking for people living with persistent pain.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261442953"},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728944","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}

{"title":"Dehumanization and stigmatization in healthcare: Experiences of individuals with severe mental illness and/or substance use disorder.","authors":"Jacelyn Biondo, Christyn Mitchell, Arin Barth","doi":"10.1177/13634593261437505","DOIUrl":"https://doi.org/10.1177/13634593261437505","url":null,"abstract":"<p><p>Individuals with severe mental illness (SMI) and/or substance use disorders (SUD) face profound levels of stigmatizing behaviors from family members, the general population, employers, and healthcare providers. These stigmatizing behaviors have the potential to deeply affect their emotional, mental, physical, and social wellness. Individuals who experience stigmatization may have decreased self-esteem, self-efficacy, physical and mental wellness, quality of life, and service-seeking in the healthcare sector. We conducted a qualitative phenomenological inquiry with individuals with SMI and/or SUD, exploring their experiences receiving healthcare provisions. The intention of collecting these data was to highlight and amplify the voices of individuals with SMI and/or SUD, as they have historically been silenced. Moreover, we wanted people with lived experience (PWLE) of SMI and/or SUD to inform the development of a de-stigmatization training program for healthcare students. We interviewed focus groups comprising PWLE using open-ended questions from a semi-structured interview guide to better understand their perceptions of and engagement with healthcare providers. Thematic analysis of our data resulted in six themes: (1) Agency in treatment decisions, (2) Emotional and structural challenges to healthcare, (3) Power dynamics in healthcare, (4) Interpersonal relationships between patients and healthcare providers, (5) Healthcare advocacy, and (6) Dehumanization and disregard of patient insight. These findings demonstrate the many ongoing challenges and barriers that individuals with SMI and/or SUD face when seeking healthcare services. Moreover, these data provide important considerations for the development and implementation of future de-stigmatization training programs for individuals in the healthcare sector.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261437505"},"PeriodicalIF":2.3,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689728","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}

{"title":"<i>\"You feel like you're not alone</i>\": Exploring a sociotechnical assembly in suicide prevention.","authors":"Manon Leloup, Charles-Edouard Notredame, Jonathan Dubois, Philippe Courtet, Margot Morgiève","doi":"10.1177/13634593261433114","DOIUrl":"https://doi.org/10.1177/13634593261433114","url":null,"abstract":"<p><p>Suicidal ideation is highly dynamic and can rapidly escalate to suicide attempts. Traditional clinical assessment tools rely on retrospective, one-off evaluations, limiting their effectiveness in timely intervention and individual prevention. Digital technologies offer promising alternatives by enabling real-time, context-sensitive assessments and interventions. In response to this potential, a multidisciplinary French team developed EMMA-a smartphone application designed to assess and help prevent suicide directly from an individual's pocket, as part of a clinical trial. Drawing on new materialist and sociomaterial perspectives, this study aims to explore how the use of EMMA reconfigures relationships and practices within the emerging paradigm of digital suicide prevention. Semi-structured interviews were conducted with individuals experiencing severe suicidal ideation, all of whom participated in the clinical trial and used EMMA over a 6-month period. The goal was to capture their subjective experiences and engagement with the digital tool. Participants initially engaged with EMMA as a source of support during a vulnerable post-hospitalization period, perceiving it as an extension of care. Use was most intense in the early weeks, then declined as their condition improved. While EMMA enabled self-reflection and awareness of emotional patterns, it also elicited ambivalent responses-some found it comforting, others intrusive or overwhelming. The app reshaped connections not only to the self but also to relatives and the healthcare system, acting as a relational interface within a broader network of care. Overall, the findings suggest that using EMMA involved forms of digital intimacy within a sociotechnical assemblage, engaging in a complex feedback loop involving the tool, themselves, their relatives, and the healthcare system. This study highlights that innovation in suicide prevention does not reside solely in technological design, but emerges through socio-material practices and the ways digital tools become entangled with lived experience and care relationships.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261433114"},"PeriodicalIF":2.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645005","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}

{"title":"Functionality as defence: A deep-structure hermeneutic study of institutional coping and professional identity during the COVID-19 pandemic.","authors":"Birgitta Schiller, Mathias Grüner, Eva Wimmer, Manfred Reisinger, Isabella Wagner, Jutta Fiegl, Christiane Eichenberg, Kurt Huber, Markus Brunner, Kathrin Mörtl","doi":"10.1177/13634593261437508","DOIUrl":"https://doi.org/10.1177/13634593261437508","url":null,"abstract":"<p><p>This article examines how healthcare professionals working on COVID-19 wards experienced psychosocial burdens during the pandemic and how they managed these within the intersecting pressures of personal vulnerability, professional duty, and institutional expectation. Drawing on deep-structure hermeneutics, 13 qualitative interviews were analysed to explore latent meaning structures underlying professional discourse. From this corpus, one analytically rich interview was selected for an in-depth single-case analysis. It illustrates how a rhetoric of positivity and a strictly maintained professional role served as protective defences against anxiety, helplessness, and loss of control. Within this dynamic, functionality emerged as a latent mode of coping that re-established a sense of agency and order, yet simultaneously suppressed emotional expression and acknowledgement of personal needs. These findings reveal a psychosocial paradox at the heart of clinical work under crisis conditions: maintaining reliability and composure while risking emotional detachment and exhaustion. As a theoretically informed implication of these findings, we propose the potential value of \"<i>spaces of non-functioning\"</i>-temporary contexts that allow relief from performance demands without destabilising professional identity. Such protected spaces may provide a more sustainable balance between care for others and self-care within the culture of contemporary healthcare.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261437508"},"PeriodicalIF":2.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638649","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}

{"title":"Is loneliness being medicalized? Trends from articles in the Web of Science database.","authors":"Mieko Homma","doi":"10.1177/13634593261435151","DOIUrl":"https://doi.org/10.1177/13634593261435151","url":null,"abstract":"<p><p>Public, policy, and media discourses increasingly frame loneliness as a \"modern epidemic,\" raising concerns that this complex emotional and social experience is being medicalized. However, empirical attempts to trace the extent and mechanisms of this process remain limited. Adopting a social constructionist perspective, this article operationally defines medicalization as the process of \"making an experience medical\" and analyzes 23,182 loneliness-related publications in the Web of Science (1980-2024) to map disciplinary locations, citation impact, and temporal growth patterns. Findings show that while psychology maintains a substantial presence, suggesting a prominence of emotional framings, there is marked growth in psychiatry, public health, and neurosciences. This trend may indicate that loneliness is being increasingly incorporated into mental health and neurobiological domains. Drawing on traditional medicalization theories, the article proposes a four-phase trajectory model as a provisional framework for further discussion. Within this framework, psychologization potentially facilitates an individualization that may serve as a basis for biomedical intervention. Furthermore, public health may play an ambivalent role: while retaining its social-reformist orientation, it could potentially accelerate medicalization by reframing loneliness as a \"risk factor.\" Looking forward, it remains to be seen whether frameworks viewing deficits in the quality and quantity of social relationships as health risks will emerge, potentially extending medicalization to domains beyond the individual as risk and surveillance technology advances. Despite its macro-level scope, this study provides empirical insights for the theoretical development of medicalization by exploring how everyday experience aligns with biomedical domains.</p>","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"13634593261435151"},"PeriodicalIF":2.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622765","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}