IF 1.9 4区医学

Health Pub Date : 2024-11-01 Epub Date: 2023-10-24 DOI: 10.1177/13634593231204173

Ronja Rosenberg Grøn, Charlotte Ettrup Christiansen, Janni Strøm, Mette Terp Høybye

{"title":"The practice of information appraisal: An ethnographic study of a health information intervention.","authors":"Ronja Rosenberg Grøn, Charlotte Ettrup Christiansen, Janni Strøm, Mette Terp Høybye","doi":"10.1177/13634593231204173","DOIUrl":"10.1177/13634593231204173","url":null,"abstract":"As healthcare systems grow increasingly complex, greater demands are placed on patients' abilities to find, understand, appraise, and use health information - often termed their 'health literacy'. Most health literacy research does not focus on information appraisal. When it does, there is a tendency to equate it with patients' assessment of credibility. This reproduces a healthcare-centric understanding of information appraisal where patient agency is omitted. This study explores how participants in a health information intervention practiced information appraisal. The intervention aimed to increase information uptake for people with low back pain by delivering health information to them through animations. This study draws on ethnographic participant observation of the encounters between the intervention and its participants, including 49 rapid interviews and semi-structured telephone interviews with 23 participants carried out in the spring of 2021. Inspired by a social practice approach, the study thoroughly grounds the health literacy subcategory of 'appraisal' in practice. It illustrates that participants appraised the information provided in the intervention according to several factors. These include relating the information to their personal health needs, interpreting the intended audience of the health animations, and prioritising their attention situationally between the animations and other immediate concerns. We suggest that information appraisal is a fundamental component of health literacy and should be considered key in research, policy and practice. To accommodate current healthcare ideals of patient centeredness, empowerment and informed choice, the complex and dynamic ways in which people appraise health information need be considered legitimate practices of health literacy.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"812-830"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49690193","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

Visualising, navigating and making time: The use of a digital solution in treatment and rehabilitation from low back pain. 可视化，导航和创造时间:在腰痛治疗和康复中使用数字解决方案。

IF 1.9 4区医学

Health Pub Date : 2024-11-01 Epub Date: 2023-11-29 DOI: 10.1177/13634593231211496

Charlotte Ettrup Christiansen, Mette Terp Høybye, Ronja Rosenberg Grøn, Camilla Blach Rossen

{"title":"Visualising, navigating and making time: The use of a digital solution in treatment and rehabilitation from low back pain.","authors":"Charlotte Ettrup Christiansen, Mette Terp Høybye, Ronja Rosenberg Grøn, Camilla Blach Rossen","doi":"10.1177/13634593231211496","DOIUrl":"10.1177/13634593231211496","url":null,"abstract":"Illness trajectories are particularly characterised by the temporal dimension of human existence. In the area of low back pain, patients often have challenging temporal experiences such as unproductive waiting time and fragmented, repetitive consultations over many years. This study seeks to investigate relationships between digital technologies, temporal agency, and illness, through describing how users experienced a new digital solution, BackTrace, targeting patients with low back pain. The study builds on six months of ethnographic fieldwork, including semi-structured interviews, participant observation and a workshop. The study shows how the introduction of the digital solution could facilitate new possibilities of temporal actions for individuals living with and receiving care for low back pain. For many research participants, the use of BackTrace facilitated a useful visualisation of their past and present low back pain state; BackTrace could assist participants in navigating different external temporal demands; and it allocated time devoted to managing their back pain in everyday life and in consultations with health professionals. The study discusses how temporality can be a useful analytical entrance point to operationalise and explore the often-desired goal of empowerment in patient pathways.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"877-896"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138459665","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

As if I was a spacecraft returning to Earth's atmosphere. Expanding insights into illness narratives and childhood cancer through evocative autoethnography. 就好像我是一艘返回地球大气层的航天器。通过令人回味的民族志扩展对疾病叙述和儿童癌症的见解。

IF 1.9 4区医学

Health Pub Date : 2024-11-01 Epub Date: 2023-09-20 DOI: 10.1177/13634593231200123

Eva-Mari Andersen

{"title":"As if I was a spacecraft returning to Earth's atmosphere. Expanding insights into illness narratives and childhood cancer through evocative autoethnography.","authors":"Eva-Mari Andersen","doi":"10.1177/13634593231200123","DOIUrl":"10.1177/13634593231200123","url":null,"abstract":"Today, a majority of children diagnosed with cancer are expected to grow up and live-hopefully until old age. Still, knowledge of the lived experience of childhood cancer survivors is sparse. In pursuit of knowledge expansion, by combining my intersecting roles as an academic, educational counselor, and childhood cancer survivor, I approach my personal illness narrative. By means of evocative autoethnography, I write intentionally vulnerably about my experiences and make them available for consideration. I explore my narrative through archives, artifacts, memories of the past, and conversations evoked in the present. I re-visit the cultural landscape of a southern Norwegian girl growing up in the 00s with cancer. Through this, my illness narrative presents as positioned, tangled, and interwoven with a developmental trajectory. Specific educational experiences seem to linger, and many are related to being absent from or re-entering school after the onset of illness. To grasp the intersecting and conflicting experiences of being very ill while also young, I suggest Erik Erikson's moratorium as a key concept. To complement Arthur Frank's illness narratives of restitution, chaos, and quest, I establish the moratorium narrative. As a fresh resource, the moratorium narrative underlines the need to make sensitive our academic community's gaze on illness trajectories unfolding in formative phases and illness narratives defined by growing up. By providing a point of recognition that prompts elaboration, this could also provide the young and very ill with a much-needed narrative space of opportunity, of which more narratives are invited and insisted upon.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"797-811"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41120855","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

Is Covid-19 "vaccine uptake" in postsecondary education a "problem"? A critical policy inquiry. 高等教育中的Covid-19“疫苗接种”是一个“问题”吗?一个关键的政策调查。

IF 1.9 4区医学

Health Pub Date : 2024-11-01 Epub Date: 2023-11-15 DOI: 10.1177/13634593231204169

Claudia Chaufan

{"title":"Is Covid-19 \"vaccine uptake\" in postsecondary education a \"problem\"? A critical policy inquiry.","authors":"Claudia Chaufan","doi":"10.1177/13634593231204169","DOIUrl":"10.1177/13634593231204169","url":null,"abstract":"Since the launch of the Covid-19 global vaccination campaign, postsecondary institutions have strongly promoted vaccination, often through mandates, and the academic literature has identified \"vaccine uptake\" among postsecondary students as a problem deserving monitoring, research, and intervention. However, with the admission that vaccines do not stop viral spread, that older-age and co-morbidities are major determinants of poor outcomes, and that many vaccine side effects disproportionately affect the young, it cannot be assumed that a risk-benefit analysis favors vaccinating postsecondary students. Drawing from critical policy studies, I appraise the literature on Covid-19 vaccine uptake in postsecondary education. I find that this literature reflects the \"scientific consensus,\" hardly acknowledging contradictory medical evidence, ignoring coercive elements underlying \"vaccine acceptance,\" and neglecting ethical tensions built into the very design of vaccination policies. I discuss potential explanations for my findings, and their implications for academia's role in society in the COVID-19 era and beyond.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"831-857"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134648845","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

'Through a kaleidoscope': A Foucauldian discourse analysis of Belgian policy regarding patients with a migration background and depression in general practices. “通过万花筒”:福柯式话语分析比利时关于移民背景和抑郁症患者的政策。

IF 1.9 4区医学

Health Pub Date : 2024-11-01 Epub Date: 2023-12-04 DOI: 10.1177/13634593231211519

Camille Wets, Piet Bracke, Katrijn Delaruelle, Melissa Ceuterick

{"title":"'Through a kaleidoscope': A Foucauldian discourse analysis of Belgian policy regarding patients with a migration background and depression in general practices.","authors":"Camille Wets, Piet Bracke, Katrijn Delaruelle, Melissa Ceuterick","doi":"10.1177/13634593231211519","DOIUrl":"10.1177/13634593231211519","url":null,"abstract":"A higher prevalence of depression is found among patients with a migration background within the Belgian population. Nevertheless, this group is underrepresented in ambulant and residential mental health care services. Since general practitioners (GPs) have a crucial gatekeeping role, this led some researchers to investigate the possibility of a provider bias influencing GPs' assessment and referral of depressed patients with a migration background. However, GPs' accounts may be influenced by wider professional discourses present at the policy level, which are inevitably linked to institutions regulating the conduct of GPs. Therefore, this study applied a Foucauldian discourse analysis (a) to identify broader professional discourses in Belgian policy documents regarding patients with a migration background and depression in general practices, (b) to examine how patients with a migration background are discursively positioned and (c) to investigate which different balances of power in the relationship between GPs and patients with a migration background are demonstrated in the identified discourses. We identified three recurring discourses: (a) the othering discourse, (b) the health literacy discourse, and (c) the person-centred discourse. Our analysis demonstrated that the former two discourses illustrate the perpetuation of a biomedical discourse. While the last discourse is aligned with a counter-discourse associated with the person-centred care model in health care. Consequently, our analysis demonstrated the construction of a contradictory discursive framework throughout the various policy documents on which GPs might rely when speaking about patients with a migration background suffering from depression.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"897-917"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482327","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

'My cousin said to me . . .' Patients' use of third-party references to facilitate shared decision-making during naturally occurring primary care consultations. 我表弟对我说......'在自然发生的初级医疗咨询中，患者利用第三方参考资料促进共同决策。

IF 1.9 4区医学

Health Pub Date : 2024-09-01 Epub Date: 2023-07-30 DOI: 10.1177/13634593231188489

Olaug S Lian, Sarah Nettleton, Huw Grange, Christopher Dowrick

{"title":"'My cousin said to me . . .' Patients' use of third-party references to facilitate shared decision-making during naturally occurring primary care consultations.","authors":"Olaug S Lian, Sarah Nettleton, Huw Grange, Christopher Dowrick","doi":"10.1177/13634593231188489","DOIUrl":"10.1177/13634593231188489","url":null,"abstract":"In this paper, we explore the ways in which patients invoke third parties to gain decision-making influence in clinical consultations. The patients' role in decision-making processes is often overlooked, and this interactional practice has rarely been systematically studied. Through a contextual narrative exploration of 42 naturally occurring consultations between patients (aged 22-84) and general practitioners (GPs) in England, we seek to fill this gap. By exploring how and why patients invoke third parties during discussions about medical treatments, who they refer to, what kind of knowledge their referents possess, and how GPs respond, our main aim is to capture the functions and implications of this interactional practice in relation to decision-making processes. Patients refer to third parties during decision-making processes in most of the consultations, usually to argue for and against certain treatment options, and the GPs recognise these utterances as pro-and-contra arguments. This enables patients to counter the GPs' professional knowledge through various knowledge-sources and encourage the GPs to target their specific concerns. By attributing arguments to third parties, patients claim decision-making influence without threatening the GPs' authority and expertise, which their disadvantaged epistemic position demands. Thereby, patients become able to negotiate their role and their epistemic position, to influence the agenda-setting, and to take part in the decision-making process, without being directly confrontational. Invoking third parties is a non-confrontational way of proposing and opposing treatment options that might facilitate successful patient participation in decision-making processes, and so limit the risk of patients being wronged in their capacity as knowers.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"775-794"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9897566","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

Progressing the understanding of chronic illness and its treatment: A post-human, ethological understanding of haemodialysis. 加深对慢性疾病及其治疗的理解：对血液透析的后人类伦理学理解。

IF 1.9 4区医学

Health Pub Date : 2024-09-01 Epub Date: 2023-09-14 DOI: 10.1177/13634593231200126

Victoria Cluley, Helen Eborall, Katherine Hull, Niamh Quann, James O Burton

{"title":"Progressing the understanding of chronic illness and its treatment: A post-human, ethological understanding of haemodialysis.","authors":"Victoria Cluley, Helen Eborall, Katherine Hull, Niamh Quann, James O Burton","doi":"10.1177/13634593231200126","DOIUrl":"10.1177/13634593231200126","url":null,"abstract":"Haemodialysis is a common treatment option offered internationally for people requiring kidney replacement therapy. Research exploring haemodialysis is predominantly clinical and quantitative, and improvements to its provision and receipt tends also to be clinically focused. In recent years, however, a number of studies have sought to explore the lived experience of haemodialysis. These studies tend to use semi-structured interviews and present descriptive findings. Such findings serve to raise the profile of patient perspectives and encourage thinking beyond the clinical gaze. To progress this, we apply a post-humanism approach to the understanding of the receipt of haemodialysis. Drawing on findings from a study to explore the experience and impact of in-centre, daytime, haemodialysis we follow Fox and Alldred's ethological toolkit to provide a post-human analysis of haemodialysis. In doing so we argue that haemodialysis exists as a heterogenous and changeable assemblage of multiple and fluid, human and non-human factors that has the capacity to affect. Here we outline this post-human approach and the impact it has for understanding not just haemodialysis but also the receipt of treatment for other chronic illnesses.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"716-735"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233901","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 contribution of a complex systems-based approach to progressive social resilience. 基于复杂系统的方法对逐步提高社会复原力的贡献。

IF 1.9 4区医学

Health Pub Date : 2024-09-01 Epub Date: 2023-08-30 DOI: 10.1177/13634593231195784

Philip Haynes, Angie Hart, Suna Eryigit-Madzwamuse, Matthew Wood, Josie Maitland, Josh Cameron

引用次数: 0

Logic modelling as hermeneutic praxis: Bringing knowledge systems into view during comprehensive primary health care planning for homelessness in Australia. 作为解释学实践的逻辑建模：在澳大利亚无家可归者的综合初级卫生保健规划中引入知识系统。

IF 1.9 4区医学

Health Pub Date : 2024-09-01 Epub Date: 2023-09-25 DOI: 10.1177/13634593231200129

Kristen Foley, Toby Freeman, Lisa Wood, Joanne Flavel, Yvonne Parry, Fran Baum

{"title":"Logic modelling as hermeneutic praxis: Bringing knowledge systems into view during comprehensive primary health care planning for homelessness in Australia.","authors":"Kristen Foley, Toby Freeman, Lisa Wood, Joanne Flavel, Yvonne Parry, Fran Baum","doi":"10.1177/13634593231200129","DOIUrl":"10.1177/13634593231200129","url":null,"abstract":"Logic modelling is used widely in health promotion planning for complex health and social problems. It is often undertaken collaboratively with stakeholders across sectors that hold and enact different institutional approaches. We use hermeneutic philosophy to explore how knowledge is 'lived' by - and unfolds differently for - cross-sectoral stakeholders during comprehensive primary healthcare service planning. An Organisational Action Research partnership was established with a non-government organisation designing comprehensive primary health care for individuals experiencing homelessness in Adelaide, Australia. Grey literature, stakeholder input, academic feedback, a targeted literature review and evidence synthesis were integrated in iterative cycles to inform and refine the logic model. Diverse knowledge systems are active when cross-sectoral stakeholders collaborate on logic models for comprehensive primary health care planning. Considering logic modelling as a hermeneutic praxis helps to foreground and explore these differences. In our case, divergent ideas emerged in how health/wellbeing and trust were conceptualised; language had different meanings across sectors; and the outcomes and data sought were nuanced for various collaborators. We explicate these methodological insights and also contribute our evidence-informed, collaboratively-derived model for design of a comprehensive primary health care service with populations experiencing homelessness. We outline the value of considering cross-sectoral logic modelling as hermeneutic praxis. Engaging with points of difference in cross-sectoral knowledge systems can strengthen logic modelling processes, partnerships and potential outcomes for complex and comprehensive primary health care services.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"673-697"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41128898","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

'To improve quality of life': Diverging enactments of a value in nephrology clinical practices. “提高生活质量”：肾脏病临床实践中价值的不同体现。

IF 1.9 4区医学

Health Pub Date : 2024-09-01 Epub Date: 2023-09-29 DOI: 10.1177/13634593231200128

Anna Mann

{"title":"'To improve quality of life': Diverging enactments of a value in nephrology clinical practices.","authors":"Anna Mann","doi":"10.1177/13634593231200128","DOIUrl":"10.1177/13634593231200128","url":null,"abstract":"Quality of life has become a central value in the provision of healthcare for patients with chronic conditions. This has engendered debates in critical medical sociology on the non-neutral effects that valuing health and illness, medical interventions, and health care delivery in terms of quality of life yields. Focusing on the case of nephrology, this paper presents qualitative data collected in Austria of two dialysis units in which nephrologists initiated projects aimed towards 'the improvement of patients' quality of life'. Whereas the first involved nurses supporting patients in the administration of peritoneal dialysis at home, the second implied the provision of treatment and care exclusively focused on a well-being 'in the here and now' to patients. By conceptualising physicians as actors within networks of relations and values enacted in practices, it analyses how in both dialysis units reference to quality of life enabled nephrologists to problematise the provision of standard haemodialysis treatment to multi-morbid, elderly patients, to develop a new treatment protocol, and to interest and enrol others in the provision of healthcare according this new protocol. Valuing medical interventions in terms of quality of life not only leads to a governmentalization of living and an economisation of health. It also allows physicians to articulate a socio-medico-ethical problem - the availability of life-prolonging technologies for a growing population of elderly, multi-morbid patients - and develop solutions locally. What the solutions consist in may fundamentally differ, however.","PeriodicalId":12944,"journal":{"name":"Health","volume":" ","pages":"698-715"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41115937","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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