HealthPub Date : 2024-07-01Epub Date: 2023-07-06DOI: 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":"<p><p>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.</p>","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}
HealthPub Date : 2024-07-01Epub Date: 2023-05-16DOI: 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":"<p><p>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.</p>","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}
HealthPub Date : 2024-05-31DOI: 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":"<p><p>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.</p>","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}
HealthPub Date : 2024-05-27DOI: 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":"<p><p>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 <i>normativist-naturalist puzzle</i>: 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.</p>","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}
HealthPub Date : 2024-05-01Epub Date: 2023-04-12DOI: 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":"<p><p>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 <i>nothing at all</i> and <i>everything as potential.</i> Taking this dialectic into account allows us to construct a concept of the void centred around two types of void: a <i>narrative void</i> and an <i>a-narrative void</i>. We maintain that the toxic in addiction can be interpreted as a <i>narco-narrative</i> that is constructed upon an <i>a-narrative void.</i> The clinical implications and technical proposals are briefly explored as openings to a clinical consideration of the void in the field of addictology.</p>","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}
HealthPub Date : 2024-05-01Epub Date: 2023-06-13DOI: 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":"<p><p>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.</p>","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}
HealthPub Date : 2024-05-01Epub Date: 2023-05-17DOI: 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":"<p><p>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.</p>","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}
HealthPub Date : 2024-05-01Epub Date: 2023-05-22DOI: 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":"<p><p>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.</p>","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}
{"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":"<p><p>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.</p>","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}
HealthPub Date : 2024-05-01Epub Date: 2023-04-19DOI: 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":"<p><p>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.</p>","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}