IF 2.1 4区医学

Health Pub Date : 2023-09-01 DOI: 10.1177/13634593211064122

Helen T Allan

引用次数: 0

Individualizing the burnout problem: Health professionals' discourses of burnout and recovery in the context of rehabilitation. 职业倦怠问题的个体化:康复背景下健康专业人员的职业倦怠与康复话语。

IF 2.1 4区医学

Health Pub Date : 2023-09-01 DOI: 10.1177/13634593211063053

Maija Korhonen, Katri Komulainen

{"title":"Individualizing the burnout problem: Health professionals' discourses of burnout and recovery in the context of rehabilitation.","authors":"Maija Korhonen, Katri Komulainen","doi":"10.1177/13634593211063053","DOIUrl":"https://doi.org/10.1177/13634593211063053","url":null,"abstract":"This discourse analytical study explores how health professionals (HPs) construct burnout as a form of mental distress in the context of Finnish burnout rehabilitation framed with a particular rehabilitation ethos. Burnout is a fuzzy concept and lacks a disease status. Therefore, it calls for context-specific definition and justification. By highlighting the socially and interactionally produced character of categories of mental distress, the study investigates the kinds of discourses HPs use to formulate \"the problem\" and its solutions, and how people dealing with burnout are categorized in these discourses. The data consists of field notes from the observation of group discussion sessions in two 1-year burnout rehabilitation courses. As a result of the analysis, five partly overlapping discourses were identified: psychological, evolutionary, healthy lifestyle, biomedical, and welfare. Within these discourses, people who experience burnout were categorized as over-conscientious employees, \"good girls,\" \"primitive people,\" self-responsible rehabilitees, patients, and (aging) employees with social and legal rights. Burnout rehabilitation and HPs' views reproduce a cultural and clinical discourse around burnout in which work-related problems are treated as individual-level problems and individuals are responsibilized for the management of mental distress. Based on the results, it is concluded that the hybrid type of interventions that attempt to influence both individual- and work-related problems behind burnout would help to prevent people dealing with burnout from being over-responsibilized for solving problems at the workplace.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 5","pages":"789-809"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10046863","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: 2

Quality-of-life measurement in depression trials: A consumerist relic. 抑郁症试验中的生活质量测量:消费主义的遗物。

IF 2.1 4区医学

Health Pub Date : 2023-09-01 DOI: 10.1177/13634593221074887

Susan McPherson, Jeppe Oute, Ewen Speed

{"title":"Quality-of-life measurement in depression trials: A consumerist relic.","authors":"Susan McPherson, Jeppe Oute, Ewen Speed","doi":"10.1177/13634593221074887","DOIUrl":"https://doi.org/10.1177/13634593221074887","url":null,"abstract":"Quality-of-life measurement in depression is advocated as a patient-centred indicator of recovery, but may instead enhance the mimetic authority of randomised controlled trials (RCTs) which have been roundly critiqued in mental health. In this paper we draw on the social life of methods approach to extend the well-developed critique of RCTs into the field of quality-of-life measurement. We accomplish this through consideration and critique of the conceptual and epistemological development of quality-of-life measurement in depression, including the role of psychometrics in its development. Examining conceptual developments from the 1970s onwards, we consider how the scientific literature on quality-of-life in depression aligns with behavioural economics and consumerism but falls short of engaging with genuinely patient-centred approaches to recovery. We argue that quality-of-life measures in depression were developed within a consumerist model of healthcare in which the medical model was a central pillar and 'choice' a rhetorical device only. While quality-of-life instrument development was largely funded by industry, psychometrics provided no coherent solution to the 'affective fallacy' (high correlations between quality-of-life and depressive symptoms). Industry has largely abandoned the measures, while psychotherapy research has increasingly endorsed them. We argue that in their design and implementation, quality-of-life measures for depression remain based on a commercial model of healthcare, are conceptually flawed and do not support concepts of patient-centred healthcare.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 5","pages":"647-663"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/fb/10.1177_13634593221074887.PMC10423430.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9993041","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: 2

Past, present and imaginary: Pathography in all its forms. 过去、现在和想象:各种形式的病理学。

IF 2.1 4区医学

Health Pub Date : 2023-09-01 DOI: 10.1177/13634593211060759

Annemarie Jutel, Ginny Russell

{"title":"Past, present and imaginary: Pathography in all its forms.","authors":"Annemarie Jutel, Ginny Russell","doi":"10.1177/13634593211060759","DOIUrl":"https://doi.org/10.1177/13634593211060759","url":null,"abstract":"Diagnosis is a profoundly social phenomenon which, while putatively identifying disease entities, also provides insights into how societies understand and explain health, illness and deviance. In this paper, we explore how diagnosis becomes part of popular culture through its use in many non-clinical settings. From historical diagnosis of long-deceased public personalities to media diagnoses of prominent politicians and even diagnostic analysis of fictitious characters, the diagnosis does meaningful social work, explaining diversity and legitimising deviance in the popular imagination. We discuss a range of diagnostic approaches from paleopathography to fictopathography, which all take place outside of the clinic. Through pathography, diagnosis creeps into widespread and everyday domains it has not occupied previously, performing medicalisation through popularisation. We describe how these pathographies capture, not the disorders of historical or fictitious figures, rather, the anxieties of a contemporary society, eager to explain deviance in ways that helps to make sense of the world, past, present and imaginary.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 5","pages":"886-902"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10345728","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: 1

A narrative exploration of identity in adults with de novo scoliosis. 新生脊柱侧凸成人身份的叙事探索。

IF 2.1 4区医学

Health Pub Date : 2023-09-01 DOI: 10.1177/13634593211067892

Lucy Tweedlie, Laura Simonds, Paul Hanna, Darren F Lui

引用次数: 0

Taking care of oneself and others: The emotion work of women suffering from a rare skin disease. 照顾自己和他人：患有罕见皮肤病的女性的情感工作。

IF 2.1 4区医学

Health Pub Date : 2023-09-01 Epub Date: 2022-01-06 DOI: 10.1177/13634593211064127

Yannick Le Henaff, Stéphane Héas, Pascal Joly

引用次数: 1

From domestication to imperial patronage: Deconstructing the biomedicalisation of occupational therapy. 从驯化到帝国赞助:解构职业治疗的生物医学化。

IF 2.1 4区医学

Health Pub Date : 2023-09-01 DOI: 10.1177/13634593211067891

Pier-Luc Turcotte, Dave Holmes

{"title":"From domestication to imperial patronage: Deconstructing the biomedicalisation of occupational therapy.","authors":"Pier-Luc Turcotte, Dave Holmes","doi":"10.1177/13634593211067891","DOIUrl":"https://doi.org/10.1177/13634593211067891","url":null,"abstract":"Occupational therapy knowledge emerged in the 19th century as reformist movements responded to the industrialisation of society and capitalist expansion. In the Global North, it was institutionalised by State apparatuses during the First and Second World Wars. Although biomedicine contributed to the rapid expansion and establishment of occupational therapy as a health discipline, its domestication by the biomedical model led to an overly regulated profession that betrays its reformist ideals. Drawing on the work of Deleuze and Guattari, our aim in this article is to deconstruct the biomedicalisation of occupational therapy and demonstrate how resistance to this process is critical for the future of this discipline. The use of arts and crafts in occupational therapy may be conceptualised as a 'nomad science' aesthetically resisting the domination of industrialism and medical reductionism. Through the war efforts, a coalition of progressive nurses, social workers, teachers, artisans and activists metamorphosed into occupational therapists. As it did with nursing, biomedicine proceeded to domesticate occupational therapy through a form of 'imperial' patronage subsequently embodied in the evidence-based movement. 'Occupational' jargon is widely used today and may be viewed as the product of a profession trying to establish itself as an autonomous discipline that imposes its own regime of truth. Given the symbolic violence underlying this patronage, the future of occupational therapy should not mean behaving according to biomedicine's terms. As a discipline, occupational therapy must resist the appropriation of its 'war machine' and craft its own terms through the release of new creative energy.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 5","pages":"719-737"},"PeriodicalIF":2.1,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10423433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10365524","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: 5

Patient narratives of hope in stem cell technologies: Trust in biomedicine and the body's natural ability to heal itself. 患者对干细胞技术的希望叙述:对生物医学和身体自然自愈能力的信任。

IF 2.1 4区医学

Health Pub Date : 2023-07-01 DOI: 10.1177/13634593211046834

Lindsay J DePalma, Lauren D Olsen, John H Evans

{"title":"Patient narratives of hope in stem cell technologies: Trust in biomedicine and the body's natural ability to heal itself.","authors":"Lindsay J DePalma, Lauren D Olsen, John H Evans","doi":"10.1177/13634593211046834","DOIUrl":"https://doi.org/10.1177/13634593211046834","url":null,"abstract":"The scholarship on patient hope in biomedical technologies describes two narratives of hope: the biomedical and the individual. The biomedical narrative represents patients' beliefs that the institution of science will eventually produce treatment for their disease, whereas the individual narrative represents patients' beliefs that they can alter their prognosis through affective and behavioral modifications. The distinct analytical categories of \"biomedical\" and \"individual,\" however, fail to account for the fact that patient hope has been found to be much more complex. Building upon extant literature, we contribute to the understanding of the complexity of patient hope in biomedical technologies by examining a case that highlights interdependencies between the biomedical and individual narratives: hope in stem cell technologies (SCTs). We draw upon interviews with patients with Parkinson's Disease, and find two narratives of hope: a biomedical narrative, as captured above, and an additional hybrid narrative, which we call a nature narrative. The nature narrative reflects patients' beliefs that scientists will eventually create SCTs that will allow their individual body to naturally heal itself, which combines a biomedical and an individual narrative.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 4","pages":"476-490"},"PeriodicalIF":2.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870032","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: 3

The making and unmaking of Hashimoto's thyroiditis: On the mismatch between illness and disease. Results from an Italian study. 桥本甲状腺炎的产生与消除:论疾病与疾病的不匹配。这是意大利一项研究的结果。

IF 2.1 4区医学

Health Pub Date : 2023-07-01 DOI: 10.1177/13634593211048370

Mario Cardano, Eleonora Rossero

{"title":"The making and unmaking of Hashimoto's thyroiditis: On the mismatch between illness and disease. Results from an Italian study.","authors":"Mario Cardano, Eleonora Rossero","doi":"10.1177/13634593211048370","DOIUrl":"https://doi.org/10.1177/13634593211048370","url":null,"abstract":"The diagnostic process in contemporary medical practice is increasingly technical, specialised and relying on population-based ranges of biological normalcy. Disease is defined according to a hierarchy of evidence that privileges specialist knowledge and marginalises subjective experiences of illness. Medical and individual definitions of the situation can conflict in two ways: (i) a diagnosis is made in the absence of symptoms, (ii) individual suffering does not constitute 'real' disease if it is not validated by scientific evidence. This article investigates how the discrepancy between specialist and embodied knowledge is experienced and tentatively solved by patients' self-narratives. Starting from the analysis of 22 in-depth interviews with people affected by autoimmune diseases, we focus on the subgroup affected by Hashimoto's thyroiditis. Applying the most-different-systems design, we confront two flesh-and-blood ideal-types of illness narratives characterised by a mismatch between illness and disease. Their diagnostic trajectories are outlined and discussed as poles of a continuum of experiences resulting from different configurations of medical evidence of disease and subjective evidence of illness.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 4","pages":"508-524"},"PeriodicalIF":2.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9492170","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

The UK COVID-19 contact tracing app as both an emerging technology and public health intervention: The need to consider promissory discourses. 英国新冠肺炎接触者追踪应用既是一种新兴技术，也是一种公共卫生干预：需要考虑承诺话语。

IF 2.1 4区医学

Health Pub Date : 2023-07-01 Epub Date: 2021-11-23 DOI: 10.1177/13634593211060768

Gabrielle Samuel, Rosie Sims

{"title":"The UK COVID-19 contact tracing app as both an emerging technology and public health intervention: The need to consider promissory discourses.","authors":"Gabrielle Samuel, Rosie Sims","doi":"10.1177/13634593211060768","DOIUrl":"10.1177/13634593211060768","url":null,"abstract":"The UK's National Health Service (NHS) COVID-19 contact tracing app was announced to the British public on 12th April 2020. The UK government endorsed the app as a public health intervention that would improve public health, protect the NHS and 'save lives'. On 5th May 2020 the technology was released for trial on the Isle of Wight. However, the trial was halted in June 2020, reportedly due to technological issues. The app was later remodelled and launched to the public in September 2020. The rapid development, trial and discontinuation of the app over a short period of a few months meant that the mobilisation and effect of the discourses associated with the app could be traced relatively easily. In this paper we aimed to explore how these discourses were constructed in the media, and their effect on actors - in particular, those who developed and those who trialled the app. Promissory discourses were prevalent, the trajectory of which aligned with theories developed in the sociology of expectations. We describe this trajectory, and then interpret its implications in terms of infectious disease public health practices and responsibilities.","PeriodicalId":12944,"journal":{"name":"Health","volume":"27 4","pages":"625-644"},"PeriodicalIF":2.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10196686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870041","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

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