Medical Humanities最新文献

{"title":"An Editor's farewell.","authors":"Brandy Schillace","doi":"10.1136/medhum-2025-013259","DOIUrl":"https://doi.org/10.1136/medhum-2025-013259","url":null,"abstract":"","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":"51 1","pages":"1"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the GP-patient relationship: a historical narration.","authors":"Emma Ladds","doi":"10.1136/medhum-2024-012916","DOIUrl":"10.1136/medhum-2024-012916","url":null,"abstract":"<p><p>The relationship between patients and their doctor is a fundamental concept-particularly within general practice. Many patients and general practitioners (GPs) have a 'common-sense' recognition of the interpersonal connection, usually over time, that makes a relationship meaningful. GPs have consistently striven to emphasise the importance of this connection. While much research has explored the components and influences affecting intersubjective connections, less attention has focused on how the historical, professional, sociopolitical and philosophical contexts have influenced their experience and portrayal. However, recent claims of a crisis in UK general practice resulting from declining relational encounters suggest these are important considerations. In this paper, episodic narration (chronicling) is used to explore five different ages of UK general practice: the emergent period (1815-1948); the expansion of coverage (1949-1965); the professionalisation of general practice (1966-1988); the age of marketisation and neoliberalisation (1989-2004); and the age of technology and fragmentation (2004-present day). A range of sources illustrate micro and macro viewpoints within each period-personal reflections, professional publications, political directives or policies, and representations from the fields of art and literature. This allows for a deeper exploration of contextual influences on the codification and enactment of GP-patient relationships over time and their interpretation and perception. Significant epidemiological and biomedical realities and their respective social interpretation(s), the socioprofessional nature of the GP, that is, their role, societal position and framework of practice, and broader sociopolitical and philosophical factors are explored. Ideological frameworks (from socialism to free market policies and neoliberalism) were particularly important. These determine approaches to funding, service/provider structures, and regulation and governance, which incentivise, enable, or inhibit choices and behaviours among individuals and society, thus impacting the enactment of the GP-patient relationship. If meaningful GP-patient connections are valuable and desirable-as GPs consistently claim they are-we require an honest discussion about the contexts necessary to enable and retain them.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"112-122"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migration and mental health care in South Africa: the question of language in context.","authors":"Christine Anthonissen, Rowan Madzamba, Asithandile Nozewu, Warona Mateane, Leslie Swartz, Sanna Higgen, Brian Hall, Mike Moesko","doi":"10.1136/medhum-2024-012908","DOIUrl":"10.1136/medhum-2024-012908","url":null,"abstract":"<p><p>Access to mental healthcare for migrants is a global problem, with many challenges and barriers, including the issue of language discordance. Most research on this topic comes from well-resourced countries such as those in Europe, Northern America, and Australasia despite the fact that most migration occurs from poorer contexts, such as many in Africa, into more closely situated countries. As an introductory part of a broader international study, we started out investigating the views of key stakeholders in South Africa on language barriers to accessing mental healthcare for migrants and suggestions for how to address these. Two senior researchers interviewed a total of 10 key stakeholders (mental health and primary healthcare providers, some also users of mental healthcare, policymakers in mental healthcare, and refugee centre coordinators) virtually, using semistructured interviews. Interview recordings were transcribed and the content was analysed. The following key themes emerged from our data: general barriers to mental healthcare; linguistic barriers to mental healthcare; proposed solutions to overcoming language discordance and alternatives suggested by professionals and mental health service users. Issues of language were intertwined with a range of other service delivery and political problems. The issue of lack of language concordance is a major concern in providing mental healthcare for migrants in South Africa. This is, however, by no means the only concern, as access to care in general is poor. Innovative, cost-effective local solutions are needed to bridge the enormous gap between needs and service provision.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"147-153"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Through the door: reimagining care and medical humanities.","authors":"Sabina Dosani","doi":"10.1136/medhum-2025-013258","DOIUrl":"https://doi.org/10.1136/medhum-2025-013258","url":null,"abstract":"","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":"51 1","pages":"2-3"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stories of chronic illness: exploring qualitative data through poetic transcriptions.","authors":"Margaret Simmons, Gabriela Carolus, Mahima Kalla","doi":"10.1136/medhum-2024-012918","DOIUrl":"10.1136/medhum-2024-012918","url":null,"abstract":"<p><p>As a research technique, poetic transcription transforms people's stories and enables deeper analysis and engagement between participants, readers and researchers. Chronic illness is often characterised as a 'biographical disruption', which may threaten a patient's self-identity and equanimity. Such disruptions often influence patients' perceptions of imminent life changes, social relationships and cognitive and material resources. Thus, poetic transcription offers a valuable tool for making sense of complex illnesses and lived experiences. This paper demonstrates how raw interview data can be reconstructed into a poetic format to highlight the nuances of people's lived illness experiences, which may remain elusive to them and others. A qualitative survey was conducted with a small group of patient participants, eliciting chronic illness narratives analysed through poetic transcription. Poetic transcription becomes a rigorous and legitimate qualitative research method through multiple iterations and extensive data engagement. Our main themes are focused on biographical disruption, temporality, humour, voice and ableism.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"96-101"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poetry and well-being: a pilot programme to evaluate the impact of creative writing for patients in short-term and long-term rehabilitation.","authors":"Owen Bullock, Jennifer McFarlane","doi":"10.1136/medhum-2024-013016","DOIUrl":"10.1136/medhum-2024-013016","url":null,"abstract":"<p><p>The value of creative writing as an adjunct to clinical treatment is well-known. Creative writing has been used successfully in a wide range of healthcare and rehabilitation settings, with people suffering from aphasia, dementia, cancer, heart attacks, depression, mental illness, post-traumatic stress disorder and anxiety disorders, and dealing with pain. Poetry, in particular, has been identified as a powerful reflective tool. This project aimed to: facilitate the creation of a safe space in which participants can enjoy open discussion of written works, share readings and offer feedback; give participants the opportunity and basic skills to write expressively and creatively; evaluate whether the writing of poetry can help reframe personal narratives in a controlled setting in ways that facilitate meaningful self-reflection and improve well-being.The programme was delivered through eight face-to-face creative writing workshops, each lasting 1 hour, from February to May 2023. Fourteen participants engaged with the pilot programme. This paper discusses the practical lessons learnt regarding the staging of a programme outside an educational facility, as well as the specific dynamics of the hospital context, including creative pedagogical discoveries made in this participant-driven environment. The programme was evaluated through a survey, responses to which were overwhelmingly positive, especially in the qualitative comments. Participants welcomed the opportunity to express themselves creatively, both through oral storytelling and written work, in the safe space created during the programme. Interactions were dynamic and raised issues that were important to participants, who gave voice to the uniqueness of their experiences, helping re-establish agency.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"140-146"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'You come as a human being…': exploring sense of equality in arts interventions through an ethnographic study of Shared Reading.","authors":"Mette Marie Kristensen, Morten Hulvej Rod, Peter Simonsen, Anna Paldam Folker","doi":"10.1136/medhum-2024-012963","DOIUrl":"10.1136/medhum-2024-012963","url":null,"abstract":"<p><p>Research shows that the arts hold a particular potential for promoting health, well-being and social inclusion for vulnerable people. However, the use and consumption of the arts tend to be socially skewed in favour of people with high cultural, social and economic capital. While extensive research has been conducted on how to create equal access to arts activities for vulnerable groups, little research has investigated how to ensure meaningful engagement with the arts by this group. Shared Reading (SR) has had considerable success in engaging vulnerable groups in collective literary practices, and research suggests that this may partly be due to the unique forms of social and literary engagement that the concept fosters. These forms of engagement, we suggest, lay the foundation for a sense of equality among participants that may promote social connectedness and well-being. On this basis, the present study aims to investigate whether and how a sense of equality may play a role in SR practices. The study found that SR promotes a sense of equality by creating a space where social interaction and relatedness does not hinge on social roles, but rather on lived experiences-and vulnerabilities inherent to these-conveyed through literary texts and shared among participants. However, to promote a sense of equality in SR, meaningful engagement for all participants must be ensured, making facilitation an essential element of SR practices and an important focus in arts interventions in general. We conclude that SR, and arts interventions more generally, may be a promising way to promote a sense of equality, but further research is needed on the specific qualities of and potential contexts for the promotion of a sense of equality.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"4-12"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic challenges: picturing chronic disease by the World Health Organization.","authors":"Alexander Medcalf, Karl Atkin","doi":"10.1136/medhum-2023-012737","DOIUrl":"10.1136/medhum-2023-012737","url":null,"abstract":"<p><p>Chronic diseases are among the leading causes of mortality in the world, the subject of major regional and international efforts to tackle shared risk factors, implement prevention and control measures and set national targets as part of the drive towards universal health coverage. Yet there is a growing conviction that chronic diseases suffer an image problem. It has been suggested that the terminology 'dulls the senses' to the problems, and in an age where the mass media affords unprecedented opportunities to inform and persuade people to care about their health and that of others, chronic disease representation remains a contested and much debated issue.This article investigates how WHO created and disseminated visual narratives to raise popular consciousness and build a visual vocabulary around chronic disease in the second half of the 20th century. It examines the measures taken to conceptualise, photograph and publicise chronic diseases, and considers who had control over their representation. In focussing predominantly on cancer, diabetes and cardiovascular disease, it reveals different narratives; the power of scientific and technological progress; individual and community action for health; promising utopian and parallel dystopian visions. It embeds these in a production context which reveals an intricate picturing process involving overcoming challenges of representation. It uses this historical background to discuss issues relating to how chronic disease and chronic pain have been narrated visually, such as the ideas of emotional response, moral failure, how people navigate the 'risk society' and ultimately the concerns regarding the intentional and unintentional influence that the media can have on the image of disease given to society.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"48-58"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In many voices: exploring end-of-life care through patient, caregiver and physician narratives.","authors":"Tracy Moniz, Carolyn Melro, Chris Watling","doi":"10.1136/medhum-2024-012926","DOIUrl":"10.1136/medhum-2024-012926","url":null,"abstract":"<p><p>As the focus on end-of-life care intensifies, so too does the need to better understand the experiences of patients, caregivers and physicians. Delivering empathetic care requires a shared understanding of illness and its meaning and impact. The narratives of patients, caregivers and physicians each offer a distinct perspective on clinical experiences, yet comparative research is uncommon. This study compares written narratives about end-of-life illness and care by these groups.We created an archive of 332 first-person written narratives about end of life (patient=65, caregiver=156, physician=111) published between 1 January 2010 and 31 December 2019 through searching public domains (eg, national newspapers), personal blogs, and academic and literary journals in Canada. A comparative narrative analysis was conducted for patterns of content (eg, theme) and strategy (eg, characterisation).All three groups wrote about feeling gratitude. Patients also emphasised coping with change and carrying on. Caregivers further focused on grieving loss, and physicians most often wrote about valuing humanism. Physicians were most likely to ascribe agency to someone (ie, patients) or something (ie, death) other than themselves and to decentre themselves in the story. Patients and physicians most often made the patient the main character of their stories, while caregivers were as likely to centre the story on themselves as on the patient. Physicians were most likely to describe death as a source of tension, while patients and caregivers described the illness experience, often comparing it to battle. Physicians and caregivers tended to write testimonies, while patients wrote quests.Narrative research can illuminate unique aspects of end-of-life care. While death is a shared experience, each group approaches it differently. The disconnects have potential consequences for how end of life is experienced-whether patients' values are honoured, whether caregivers receive support, and whether physicians experience burn-out. We need to foster learning experiences that integrate these unique perspectives into medical education and practice, including leveraging the affordances of studying written narratives towards this end.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"39-47"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health sciences training for disability inclusion: the need to engage with emotion.","authors":"Brian Watermeyer","doi":"10.1136/medhum-2024-013044","DOIUrl":"10.1136/medhum-2024-013044","url":null,"abstract":"<p><p>Material aspects of disability inequality, such as access to quality services, housing and employment, are an urgent, worldwide concern. Less recognised though, are psychological layers of prejudice and discrimination, which play a significant role in cementing marginality. Against this backdrop, health practitioners can fill influential roles in shaping the self-identity and citizenship entitlement of people with disabilities. Yet, these professionals are, like the balance of society, socialised in environments where ableism is intrinsic, invisible and unquestioned. Disability prejudice has both an emotional and unconscious basis, and overcoming its effects is argued to require a personal engagement with feelings relating to bodily frailty, universal dependency, mortality and other prickly aspects of the human condition with which it is associated. These aspects are all at play in the clinical encounter between a health professional and a patient with disability, but the layered and consequential nature of such interactions for the flourishing and empowerment of people with disabilities, as well as the disability movement as a whole, is poorly understood. Evidence suggests that mere tuition in social justice has limited effects on behaviour in relation to issues of inequality and exclusion. In this paper I reflect on how socialisation in an ableist world can shape how disability is positioned in the clinical encounter, potentially leading to interactions which embed inequality. Drawing on my own experience as disability studies scholar and disabled person, I then describe a teaching method for facilitating shifts in the personal relationships which health sciences students have to disability, in the context of broader attempts to create clinical spaces and relationships in which empathy and self-compassion are encouraged.</p>","PeriodicalId":46435,"journal":{"name":"Medical Humanities","volume":" ","pages":"123-128"},"PeriodicalIF":1.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}