IF 1.9 4区医学

Health Pub Date : 2023-11-01 Epub Date: 2022-05-09 DOI: 10.1177/13634593221096241

Maja Kolar, Colleen Varcoe, Helen Brown, Rochelle Einboden

{"title":"Involuntary psychiatric treatment and the erosion of consent: A critical discourse analysis of mental health legislation in British Columbia, Canada.","authors":"Maja Kolar, Colleen Varcoe, Helen Brown, Rochelle Einboden","doi":"10.1177/13634593221096241","DOIUrl":"10.1177/13634593221096241","url":null,"abstract":"The Mental Health Act (1996) is legislation that directs voluntary and involuntary psychiatric treatment for people experiencing mental health issues in British Columbia (BC), Canada. This critical discursive analysis explores how BC's Mental Health Act (1996) and the Guide to the Mental Health Act (2005) structure involuntary psychiatric treatment and illustrates how the discourses within these texts constitute people experiencing mental health issues as passive recipients of care. Understandings of people experiencing mental health issues as pathological, incapable, vulnerable and dangerous justify their need for protection and the protection of others. Protection is identified as a central legitimising discourse in the use of involuntary psychiatric treatment. Further, these texts define the roles and responsibilities of police, physicians and nurses in authorising and implementing involuntary psychiatric treatment. This analysis describes how this legislation erodes consent and entrenches social marginalisation. Alternatively, discourses of equity have potential to transform health care practices and structures that reproduce discourses of deficit, vulnerability and dangerousness, shifting towards promotion of the rights and safety of people experiencing mental health issues and crises.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 6","pages":"1076-1095"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49676912","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 it in your basic personality?' Negotiations about traits and context in diagnostic interviews for personality disorders. “这是你的基本性格吗？”人格障碍诊断访谈中关于特征和背景的谈判。

IF 2.1 4区医学

Health Pub Date : 2023-11-01 Epub Date: 2022-05-24 DOI: 10.1177/13634593221094701

Maarit Lehtinen, Liisa Voutilainen, Anssi Peräkylä

{"title":"'Is it in your basic personality?' Negotiations about traits and context in diagnostic interviews for personality disorders.","authors":"Maarit Lehtinen, Liisa Voutilainen, Anssi Peräkylä","doi":"10.1177/13634593221094701","DOIUrl":"10.1177/13634593221094701","url":null,"abstract":"What does it mean to claim that somebody's personality is disordered? The aim in this paper is to examine how the process of diagnosing personality disorders (PD) unfolds on a practical level. We take an in-depth look at PD interviews, paying close attention to the occasional discrepancies in the clinicians' and the patients' approaches to generalising the behaviour of patients to describe their personality. Clinicians are guided by the medical model and structured interviews in their approach. We regard the interview situation as interplay between the institution, the clinician and the patient - and the final diagnosis as an interactional construction between them. Our data consists of video-recorded interviews in Finland with 10 adult patients and three psychiatric nurses. The collection was compiled from 22 excerpts in which the participants orient differently to the generalisability of personality traits. Our observations show that, in these interviews, patients frequently make sense of their behaviour differently from what is expected - not as a reflection of their personality traits, but as an outcome of many situational factors. Our understanding leads us to emphasise the importance of making visible the practices that shape the diagnostic process in psychiatry.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 6","pages":"1033-1058"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49676913","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

On care infrastructures and health practices: How people in health promotion programmes try to change their everyday life. 关于保健基础设施和保健做法：参与健康促进方案的人如何努力改变他们的日常生活。

IF 2.1 4区医学

Health Pub Date : 2023-11-01 Epub Date: 2022-05-18 DOI: 10.1177/13634593221093503

Francesco Miele

{"title":"On care infrastructures and health practices: How people in health promotion programmes try to change their everyday life.","authors":"Francesco Miele","doi":"10.1177/13634593221093503","DOIUrl":"10.1177/13634593221093503","url":null,"abstract":"This paper contributes to challenging common behavioural or cognitive explanations for health and wellbeing outcomes, focussing on social practices through which people, with the help of other subjects, try to improve their health conditions. To renew the debate about health promotion, my work is placed at the intersection between the sociology of health and illness and science and technology studies, adopting the concepts of care infrastructures and health practices that are introduced in the next section. With this goal, my paper draws on a qualitative study concerning a Workplace Health Promotion programme aimed at reducing the risks of Type-2 diabetes and cardiovascular diseases among sedentary workers. The findings illustrate how a care infrastructure in the field of health promotion is designed, put to work, repaired and 'put aside' in relation to two health practices ('doing physical activity' and 'following the Mediterranean diet'). Drawing on the presented case, I show how the change in daily habits in the fields of nutrition and physical activity is a collective effort involving different spheres of life, connecting human and non-human elements and bringing out affective intensities among them.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 6","pages":"980-997"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49676915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A psychosocial exploration of resistances to service user involvement in United Kingdom National Health Service (NHS) mental health services. 英国国家医疗服务体系（NHS）心理健康服务中服务使用者参与阻力的社会心理探索。

IF 2.1 4区医学

Health Pub Date : 2023-11-01 Epub Date: 2022-06-08 DOI: 10.1177/13634593221099103

Timothy Moore, Laetitia Zeeman

{"title":"A psychosocial exploration of resistances to service user involvement in United Kingdom National Health Service (NHS) mental health services.","authors":"Timothy Moore, Laetitia Zeeman","doi":"10.1177/13634593221099103","DOIUrl":"10.1177/13634593221099103","url":null,"abstract":"Policy promotes the active participation of those with lived experience of mental health difficulties in UK NHS mental health services, from the level of collaborative care-planning to service delivery, leadership and development. However, research indicates different forms of resistance to the implementation of such service user involvement. This article reports the findings of a qualitative, interview-based study which used Foucauldian discourse analysis and psychoanalytic theory to understand how resistances are produced through the interplay of clinical mental health professionals' subjectivity and their organisational context. Service user involvement was found to highlight conflicts within clinicians' roles. Central to this conflict was an ambivalent relationship to the power associated with these roles. Power could protect professionals from work related stresses, but could also be used to dominate, silence and coerce service users in ways that conflicted with the core function of providing care. Whilst important, raising awareness of such conflict will arouse discomfort and resistance where psychological defences are challenged. A parallel is drawn with psychotherapeutic change, in which resistance must be understood and worked with as part of meaningful change.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 6","pages":"1096-1114"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49676908","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

Causation, historiographic approaches and the investigation of serious adverse incidents in mental health settings. 心理健康环境中严重不良事件的原因、历史方法和调查。

IF 2.1 4区医学

Health Pub Date : 2023-11-01 Epub Date: 2022-05-03 DOI: 10.1177/13634593221094703

Sahil Bhandari, Øyvind Thomassen, Rajan Nathan

{"title":"Causation, historiographic approaches and the investigation of serious adverse incidents in mental health settings.","authors":"Sahil Bhandari, Øyvind Thomassen, Rajan Nathan","doi":"10.1177/13634593221094703","DOIUrl":"10.1177/13634593221094703","url":null,"abstract":"To improve the safety of healthcare systems, it is necessary to understand harm-related events that occur in these systems. In mental health services, particular attention is paid to harm arising from the actions of patients against themselves or others. The primary intention of examining these adverse events is to inform changes to care provision so as to reduce the likelihood of the recurrence of such events. The predominant approach to investigating adverse incidents has relied on the cause-and-effect conceptualisation of past events. Whilst the merits of approaches which are reliant on cause-and-effect narratives have been questioned, alternatives models to explain adverse incidents in health settings have not been theoretically or empirically tested. This novel article (i) examines the notion of causation (and the related notion of omission) in the context of explaining adverse events in mental health settings, and (ii) draws on a long-established discipline devoted to the study of how the past is interpreted (namely historiography) to theoretically investigate the innovative application of two historiographical approaches (i.e. counterfactual analysis and historical materialism) to understanding adverse events in mental health settings.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 6","pages":"1019-1032"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49676909","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: 1

Disparities in the prevalence of ADHD diagnoses, suspicion, and medication use between Flanders and Québec from the lens of the medicalization process. 从医学化过程的角度来看，佛兰德斯和魁北克之间多动症诊断、怀疑和药物使用的患病率差异。

IF 2.1 4区医学

Health Pub Date : 2023-11-01 Epub Date: 2022-06-07 DOI: 10.1177/13634593221093492

Marie-Christine Brault, Emma Degroote, Mieke Van Houtte

{"title":"Disparities in the prevalence of ADHD diagnoses, suspicion, and medication use between Flanders and Québec from the lens of the medicalization process.","authors":"Marie-Christine Brault, Emma Degroote, Mieke Van Houtte","doi":"10.1177/13634593221093492","DOIUrl":"10.1177/13634593221093492","url":null,"abstract":"The prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) diagnoses and medication use has increased over time around the world, but significant regional differences remain. This paper aims to determine and explain disparities in ADHD prevalence and medication use among school-aged children in two distinct school systems, in Flanders (Belgium) and Québec (Canada). We present detailed descriptive and comparative analyses of data from 35 schools, 114 teachers, and 1046 parents (children) that were collected as part of a comparative international project. The data concern teacher and parent suspicions, teachers' ratings of ADHD-related behaviors in children, teachers' views of medication use, and teachers' beliefs about ADHD. The results show that, compared with Flanders, Québec had significantly more children diagnosed with ADHD and more frequent suspicions of ADHD in children by teachers and parents. We refer to the conceptual, institutional, and interactional levels of medicalization to interpret our findings and conclude that social and cultural readings of children's behaviors differ greatly between regions. Medicalization of children's behaviors is more common in Québec than in Flanders.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 6","pages":"958-979"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1a/b5/10.1177_13634593221093492.PMC10588264.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49676910","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

Imperatives of health or happiness: Narrative constructions of long-term smoking after undergoing lung screening. 健康或幸福的必要条件：接受肺部筛查后长期吸烟的叙事结构。

IF 2.1 4区医学

Health Pub Date : 2023-11-01 Epub Date: 2022-06-06 DOI: 10.1177/13634593221099108

Rebecca E Olson, Ek Xuan Wen, Zoe Staines, Felicia Goh, Henry M Marshall

{"title":"Imperatives of health or happiness: Narrative constructions of long-term smoking after undergoing lung screening.","authors":"Rebecca E Olson, Ek Xuan Wen, Zoe Staines, Felicia Goh, Henry M Marshall","doi":"10.1177/13634593221099108","DOIUrl":"10.1177/13634593221099108","url":null,"abstract":"Tobacco control policies reinforce a health imperative that positions citizens as duty-bound to manage their health by abstaining from or quitting smoking. Limited attention is paid to the repercussions - especially for lung screening - of anti-smoking rhetoric emphasising individual responsibility. Drawing on interviews with 27 long-term smokers involved in an international lung screening trial, this study analysed Australian smokers' narratives of smoking. By attending to stigma and the use of public health rhetoric within personal narratives, we show how narratives underscoring individual responsibility for quitting were layered with conflicting explanations of biological responsibility and normative expectations. Ironically, narratives of individual responsibility potentially undermine smoking cessation. In positioning smokers as responsible for their own healthy choices, such rhetoric also positions smokers as responsible for managing their emotional health, which some did through smoking. Thus, anti-smoking campaigns pit the neoliberal imperative of health against the happiness imperative. These findings have implications for the design and delivery of lung screening campaigns. They also support calls to move beyond health messaging emphasising individual choice, towards acknowledging the moral power of structures and public health campaigns to discipline citizens in unintended ways.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 6","pages":"1115-1134"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49676911","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: 1

Luckily-I am not the worrying kind: Experiences of patients in the Danish cancer patient pathway for non-specific symptoms and signs of cancer. 幸运的是，我不是那种令人担忧的人：丹麦癌症患者路径中癌症非特异性症状和体征的患者经历。

IF 2.1 4区医学

Health Pub Date : 2023-11-01 Epub Date: 2022-05-03 DOI: 10.1177/13634593221096244

Christina Sadolin Damhus, John Brandt Brodersen, Mette Bech Risør

{"title":"Luckily-I am not the worrying kind: Experiences of patients in the Danish cancer patient pathway for non-specific symptoms and signs of cancer.","authors":"Christina Sadolin Damhus, John Brandt Brodersen, Mette Bech Risør","doi":"10.1177/13634593221096244","DOIUrl":"10.1177/13634593221096244","url":null,"abstract":"In Denmark, due to the implementation of the Non-specific Symptoms and Signs of Cancer-Cancer Patient Pathway (NSSC-CPP), more people with symptoms such as fatigue and weight loss are informed that their symptoms might indicate cancer and they are referred to the pathway. But what do patients in the NSSC-CPP experience, in particular, with respect to being in an affective state of anticipation of a cancer diagnosis? We conducted participant observation and semi-structured interviews with patients to investigate their experience of the NSSC-CPP with a specific focus on their perception of symptoms and their thoughts on worrying about cancer. We found that the phrase 'worried about cancer' was not recognised by the participants, but worry was visible in their increased healthcare use and their interpretation of bodily sensations. Our study indicates the need to explore the impact of anticipation and potential cancer worries in participants' everyday lives, as this context mediates their moral roles and responsibilities and restructures their social lives, while keeping uncertainty and probabilities on the table.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 6","pages":"1059-1075"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49676914","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: 1

'The day you start lifting is the day you become forever small': Bodybuilders explain muscle dysmorphia. “从你开始举重的那一天起，你就变得永远渺小”：健美运动员解释肌肉变形障碍。

IF 2.1 4区医学

Health Pub Date : 2023-11-01 Epub Date: 2022-04-27 DOI: 10.1177/13634593221093494

Mair Underwood, Roberto Olivardia

{"title":"'The day you start lifting is the day you become forever small': Bodybuilders explain muscle dysmorphia.","authors":"Mair Underwood, Roberto Olivardia","doi":"10.1177/13634593221093494","DOIUrl":"10.1177/13634593221093494","url":null,"abstract":"Muscle dysmorphia (MD) is a pathological preoccupation with muscularity characterised by negative body image, compulsive behaviours, and obsessive thoughts. Since its first identification academics have suggested that it is caused by sociocultural factors. Despite this there has been very little research exploring the role of sociocultural factors in the development and maintenance of MD, and no research that examines MD from within its cultural context. Instead the medical model of MD has dominated understanding. This model presents professionals as the experts on this disorder, and sufferers as pathological individuals in need of expert treatment. This renders cultural context largely irrelevant to understandings of MD. In this paper we present a different kind of expertise with regards MD. We describe the expertise of those most likely to suffer from MD, and upon whom medical descriptions of MD are based: bodybuilders. Specifically, we describe how bodybuilders explain MD (their definition, theory of aetiology and experience of MD, as well as their suggested management strategies), and compare these explanations to the dominant medical model. Through a consideration of the expertise of bodybuilders we break the tunnel vision of medicine, and suggest ways we can move beyond our current under-developed understanding of MD. This paper examines MD from within its cultural context, and in so doing it lays the foundation for a sociocultural explanatory model of MD. If we are to significantly reduce the harms of this disorder we cannot rely solely on treating the few individuals who present to clinicians. Rather we must develop ways to help sufferers to manage their disorder, and to prevent the development of this disorder among those at risk in the first place. To do this we must understand the sociocultural dimensions of MD, and collaborate with bodybuilding communities.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 6","pages":"998-1018"},"PeriodicalIF":2.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49676916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A solidarity paradox - welfare state data in global health data economy. 一个团结悖论——全球健康数据经济中的福利国家数据。

IF 2.1 4区医学

Health Pub Date : 2023-09-01 DOI: 10.1177/13634593211069320

Karoliina Snell, Heta Tarkkala, Aaro Tupasela

{"title":"A solidarity paradox - welfare state data in global health data economy.","authors":"Karoliina Snell, Heta Tarkkala, Aaro Tupasela","doi":"10.1177/13634593211069320","DOIUrl":"https://doi.org/10.1177/13634593211069320","url":null,"abstract":"Nordic welfare states have well institutionalised practises of gathering health and social wellbeing data from their citizens. The establishment of population registers coincided with the building of welfare state institutions and a social contract relying on solidarity. During the last decade, the significance of Nordic registers and health data has increased and they have become sources of economic value. Recent policies expect registers, health data and biobanks to attract international investments, making Nordic countries world-leaders in the global health data economy. In this article we question the conditions and boundaries of solidarity in the emerging data-driven health economy. We argue that the logics of welfare state and data-driven health economy create a paradox - the data economy is not possible without the welfare state data regime, but the logic of data-driven health economy contradicts the value bases of the welfare state data regime and therefore the justifications for data gathering and use become questionable. We develop the concept of solidarization to describe the process by which individuals are expected to behave in a solidaristic way to support data gathering and related policy processes. We demonstrate the solidarity paradox through a recent legislative and data infrastructure reform in Finland and discuss it in relation to academic literature on solidarity.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 5","pages":"664-680"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10365530","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: 4

Health最新文献