Qualitative Health Research最新文献

{"title":"Story Circles of Black Doulas, Cultural Brokers for Birthing People in Healthcare.","authors":"Kacie C A Blackman, Urmeka Jefferson, Wyconda Cotton-Curtis, Detrich Galloway","doi":"10.1177/10497323241280828","DOIUrl":"10.1177/10497323241280828","url":null,"abstract":"<p><p>Doula care services (in-person, hybrid, and virtual) during the COVID-19 pandemic may vary. The purpose of this study was to explore doulas' experiences as birthing professionals and epistemological resources assisting Black birthing families during the pandemic. Virtual qualitative story circles were conducted with 11 Black doulas who attended births as doulas from January 2020 to December 2021. Participants were recruited in California. The story circles were audio recorded and transcribed verbatim. Transcripts were analyzed using content analysis, with attention to the influence of epistemic injustice (types of injustices inflicted on marginalized groups) on service provision. Additionally, we employed Patricia Hill Collins' Black Feminist Theory which describes \"Black women's ways of knowing\" that disrupts and challenges existing epistemologies. Narrative data revealed (1) doulas are positioned as possessors of epistemic influence in birthing spaces with intersecting social identities, (2) a pervasive oppression of doulas' knowledge, (3) epistemological resilience and disruption, and (4) a commitment to Black indigenous practices. Despite these epistemic unfair structures, systems, and experiences, Black doulas reimagine and establish pathways for birthing families to navigate the healthcare system during intrapartum care.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"932-945"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attending to Power: Stakeholder Perspectives on Training Physicians to Address Intimate Partner Violence.","authors":"Alice Cavanagh, Melissa Kimber, Harriet L MacMillan, Stacey A Ritz, Meredith Vanstone","doi":"10.1177/10497323241276409","DOIUrl":"10.1177/10497323241276409","url":null,"abstract":"<p><p>Intimate partner violence (IPV) is associated with a wide range of mental and physical health concerns. Research suggests that many physicians lack knowledge and skills to adequately respond to patients experiencing IPV. In order to better integrate physicians' contributions into intersectoral responses to IPV, we asked stakeholders with expertise and experience related to IPV about the knowledge, skills, attitudes, and behaviors they wanted them to have. Guided by principles of interpretive description, and using a key informant method, we conducted unstructured interviews with 18 stakeholders in IPV-related frontline, managerial, or policy roles in Ontario, Canada. Data collection and analysis proceeded iteratively through 2022; \"thoughtful practitioners\" outside the research team were recruited at key junctures to provide feedback on formative findings. Stakeholders suggested that \"attending to power\" should be a core principle for medical practice related to IPV. Attending to power encompassed <i>understanding</i> interactional, organizational, and structural power dynamics related to IPV and purposefully <i>engaging</i> with power, by taking action to empower people subjected to violence. Specific recommendations for practice concerned four focal contexts: relationships between partners, between patients and providers, between providers, and in social systems and structures. Strengthening physicians' capacity to attend to power dynamics relevant to their IPV practice is an important step in both improving medical care for people experiencing IPV and integrating physician contributions into other services and supports.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"837-846"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Without IPS I Think I Would Really Fall Apart\": Individual Placement and Support as Experienced by People With Mental Illness-Phenomenological Peer Research Study.","authors":"Marianna Agata Borowska, Kristin Berre Ørjasæter, Marit Borg, Barbara Stenvall, Alexandra Silbermann, Miles Rinaldi, Eóin Killackey, Arnstein Mykletun, Cathrine Moe","doi":"10.1177/10497323241275046","DOIUrl":"10.1177/10497323241275046","url":null,"abstract":"<p><p>Having a job is an important component of recovery from mental illness and a source of economic, social, and health benefits. Most people experiencing severe mental illness (SMI) want to work but are excluded from employment opportunities. Employment specialists (ESs) working in individual placement and support (IPS) teams help persons struggling with SMI obtain competitive employment. This study is a qualitative phenomenological study of 10 IPS participants in the Norwegian context, serving to develop a deeper understanding of the IPS phenomenon as it is experienced in the everyday life of IPS participants. The study was designed as a peer research project including four members of a competence group with experience in IPS and SMI. The results, analyzed using the reflective lifeworld research approach, revealed four constituents: \"Having a safety net along the way toward employment,\" \"Feeling more like a person, not just a patient,\" \"Brighter future,\" and \"Going above and beyond employment support.\" IPS functions as an anchor in participants' journey toward employment. Strong and meaningful relationships with an ES seem crucial for IPS participants to gain the strength and confidence essential to engage in the job search. IPS participants experience various challenges in everyday life, resulting in ESs exceeding their vocational role to cover the unmet needs that health services seem unable to fully address. Closer coordination between vocational and health services, as well as a deeper focus on everyday life issues, will positively affect IPS participants' vocational outcomes and quality of life.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"847-862"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Do Men Who Post Publicly on Social Media Author Themselves and Their Experiences of Crohn's Disease? A Dialogical Analysis of Three Cases.","authors":"Lucy Prodgers, Brendan Gough, Anna Madill","doi":"10.1177/10497323241287453","DOIUrl":"10.1177/10497323241287453","url":null,"abstract":"<p><p>Despite distinct sex- and gender-related differences in the presentation and manifestation of Crohn's disease (CD), little research to date has considered men's particular experiences. Whilst hegemonic masculine ideals have been reported to negatively impact men's mental and physical health, increasingly research has emphasized that men engage in a diverse range of practices, including those beneficial to health. One such practice is posting about their illness experiences on social media. The interactive nature of posting online means that a dialogical approach, based on a relational epistemology, is particularly useful. This study therefore asked: \"How do men who post publicly on social media author themselves and their experiences of CD?\" Three participants were recruited, all of whom had a diagnosis of CD, wrote a blog, and posted on other social networking sites (SNSs) about CD. Two resided in Canada and one in the United Kingdom. All were white. For each participant, 2 years of multimodal social media data was downloaded. After screening, in-depth analysis was conducted using a dialogical approach focusing on three key dialogical concepts: genre, chronotope, and forms of authorship. The key findings emphasized the participants' different responses to the lack of predictability caused by CD and the different ways they used social media to gain a greater sense of control over their illness stories and identities, providing important insights into the interaction between masculine identities and illness. Finally, the potential deployment of such methods in future research and within therapeutic contexts was considered.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"887-900"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Management and Relationships: Perspectives of Young Adults With Chronic Conditions and Their Peers.","authors":"Uwe Flick, Gundula Röhnsch","doi":"10.1177/10497323241285761","DOIUrl":"10.1177/10497323241285761","url":null,"abstract":"<p><p>Because their disease is largely managed in the private environment, people with chronic conditions perform \"chronic homework.\" The environment with which self-management is coordinated forms a kind of \"chronic care infrastructure\" in dealing with the disease and, in the case of young adults with chronic conditions (YACCs), is essentially formed by peers. The article investigates how YACCs handle their illness in the context of their peer relationships and how peers see their own role in the context of the YACCs' self-management. What do chronic homework and chronic care infrastructures look like, if the chronic conditions concern young adults in comparatively unstable and non-committal relationships with their peers? Episodic interviews were conducted with 60 YACCs (with type 1 diabetes, cancer, chronic inflammatory bowel disease, and rare conditions) and 30 peers. The interviews were analyzed using thematic coding. The YACCs' statements were compared to the peer perspectives on a case-by-case basis. We found that peers differ in the extent to which they seek to monitor or control the YACCs' self-management. We identified three groups of YACCs: (a) those who focus on their health needs; (b) those who seek to balance their disease management with their need for sociability and belonging; and (c) those who deprioritize their illness in their everyday life in favor of peer acceptance. The multi-perspective approach to YACCs' and their peers' experiences with self-management on the one hand and referring to a range of chronic conditions on the other allows to analyze this issue in a complex and comprehensive way.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"916-931"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contesting Cannabinoid Hyperemesis Syndrome: How Narratives of Cannabis Shape Diagnosis Contestation and Treatment Resistance.","authors":"Heith Copes, Megan Webb, Jessica Valles","doi":"10.1177/10497323241279079","DOIUrl":"10.1177/10497323241279079","url":null,"abstract":"<p><p>Cannabinoid hyperemesis syndrome (CHS) is characterized by the onset of cyclic bouts of severe nausea and vomiting in chronic cannabis users. As the number of CHS diagnoses rises, it is important to understand how people experience the disease. Using a narrative framework, we explore how the symbolic meaning participants associated with cannabis shaped the way they experienced diagnosis and treatment of CHS. To do this, we relied on semi-structured interviews with 24 people who self-reported having CHS. Participants had very positive perceptions of cannabis, which contributed to them contesting the diagnosis and resisting the treatment. They initially contested the diagnosis because they believed that cannabis was beneficial and helped with nausea, that claims about the harms of cannabis were part of a larger medical conspiracy to stigmatize it, and that they had different symptoms than those with CHS. They resisted treatment recommendations of abstinence and sought to continue using cannabis by trying new routes of administration, using only certain types of cannabis, reducing the amount or frequency of use, or substituting other substances. Findings point to the importance of understanding how narratives can shape the way people respond to diagnosis and treatment.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"876-886"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making Conscientious Decisions: Engaging in Venous Leg Ulcer Self-Management Following Nurse-Led Patient Education.","authors":"Paul Bobbink, Géraldine Gschwind, Philip Larkin, Sebastian Probst","doi":"10.1177/10497323241285692","DOIUrl":"10.1177/10497323241285692","url":null,"abstract":"<p><p>Venous leg ulcers (VLUs) provoke multiple symptoms and impact individuals and society as a whole. Their treatment and prevention strategies require individual's involvement in self-management strategies. Insufficient knowledge with regard to prevention, management, and treatment has been identified as a critical factor related to VLUs and their recurrence. Therapeutic patient education (TPE) proposed as part of a management strategy for this population provides unclear benefits regarding wounds healing or prevention of recurrence. The aim of the study was to develop a theory explaining how individuals with a VLU experience an individualized nurse-led TPE program regarding self-management strategies. The constructivist approach of Charmaz to the grounded theory method was used to develop the theory. A total of 26 individuals contributed to the co-construction of the theory through face-to-face or telephone semi-structured interviews. Data analysis and data collection occurs simultaneously with a comparative process to reveal the conceptual categories, apply theoretical sampling, and define theoretical saturation. The theory of \"Conscientiously Engaging in Self-Management\" was co-constructed with the participants encapsulating four categories: \"Being influenced by my own story,\" \"Being personally informed,\" \"Making conscientious decisions to engage in self-adapted management strategies,\" and \"Integrating a conscientious way of living.\" This theory highlights individuals' voices and stories toward their journey of VLU self-management taking contextual factors into consideration. This new theory offers new knowledge about implementation of self-management strategies for individuals living with a VLU and will inform clinical practice and contribute to the development of targeted interventions.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"901-915"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participatory Surveillance and Candidacy: A Discourse Analysis of Views on Self-Testing for Proteinuria in Pregnancy.","authors":"Bethany E Jakubowski, Katherine L Tucker, Layla Lavallee, Hannah Wilson, Lucy Mackillop, Lucy C Chappell, Richard J McManus, Lisa Hinton","doi":"10.1177/10497323241274270","DOIUrl":"10.1177/10497323241274270","url":null,"abstract":"<p><p>Actively involving people in self-monitoring and management during their pregnancy is an emerging clinical and social practice. Self-monitoring of blood pressure and self-testing for proteinuria, key diagnostic tests for pre-eclampsia, are becoming commonplace in hypertensive pregnancies. While evidence exists on the acceptability and feasibility of self-monitoring blood pressure, evidence for self-testing for proteinuria in pregnancy is thin, with little knowledge of how it might affect the traditional structures of maternity care. As part of a diagnostic accuracy study on self-testing for proteinuria, pregnant people and healthcare professionals were recruited to a qualitative study to understand their experiences of, and attitudes to, self-testing. Multiple qualitative methods were used, including interviews, focus groups, and free text postcards. A discourse analysis was conducted to understand how self-testing might inform and reshape routine antenatal care. Analysis revealed a tension between the empowering concept of participatory surveillance, which pregnant people and healthcare professionals were broadly positive about, and the adjudications made by healthcare professionals about the candidacy, or <i>suitability</i>, of certain pregnant people to self-test. Candidacy is a framework for understanding what influences access to healthcare for socially disadvantaged groups, including professional judgments that impact access to interventions. While participatory surveillance was felt to have the potential to empower pregnant people in antenatal care, the loss of the traditional clinical gaze was disquieting for some, and pregnant people and healthcare professionals were reluctant to cede professional responsibility.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"863-875"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I Believe in Santa Claus\" and Ozempic: A Foucauldian Discourse Analysis of Holiday Health Advertising.","authors":"Phillip Joy, Meredith Bessey, Linda Mann","doi":"10.1177/10497323251350876","DOIUrl":"https://doi.org/10.1177/10497323251350876","url":null,"abstract":"<p><p>This study examines the weight-related discourses in holiday advertising for Ozempic, a prescription drug originally developed for diabetes management but now widely marketed for weight loss. Sponsored Facebook advertisements for Ozempic were collected throughout December 2024, with 12 ads analyzed through Foucauldian discourse analysis. This analysis identifies three interrelated discursive constructs: (1) Santa Takes Ozempic, (2) Ozempic as the Perfect Holiday Gift, and (3) Medical Authority Meets Holiday Cheer. These advertisements use cultural symbols like Santa Claus and New Year's resolutions messaging to (re)produce dominant and contested discourses about fatness and weight loss, while constructing pharmaceutical intervention as both a necessity and a gift. The analysis highlights how these marketing strategies mobilize biopower, construct self-surveillance as normative, and contribute to the commodification of health, reinforcing weight stigma under the guise of holiday celebration.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251350876"},"PeriodicalIF":2.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Qualitative Research in Community Engagement to Capture and Mitigate Vulnerability Mechanisms in the Face of Infectious Diseases: Insights From a Research-Based Program in Five European Countries During the COVID-19 Pandemic.","authors":"Mandy Geise, Jacob Osborne, Paul Grohma, Tamara Giles-Vernick, Benedetta Lana, Papa Mamadou Diagne, Zeliha Öcek, Uršula Lipovec Čebron, Neza Vodopivec, Anja Brunec, Jean Paul Baldacchino, Maurice Said, Gisella Orsini, Victoria Sultana, Concetta Vaccaro, Anna-Maria Volkmann, Ruth Kutalek, Michel Dückers","doi":"10.1177/10497323251346407","DOIUrl":"https://doi.org/10.1177/10497323251346407","url":null,"abstract":"<p><p>Various frameworks have been proposed for carrying out community engagement (CE) in the context of infectious disease response, but few have done so through a lens of vulnerability and even fewer, if any, have compared cases across countries. This paper reflects on the implementation of a project based on social science research and CE to capture and mitigate vulnerability mechanisms, which was carried out in France, Germany, Italy, Malta, and Slovenia during the COVID-19 pandemic. Using qualitative data collected through interviews, a focus group discussion, and project meetings, we describe how a stepwise CE process was carried out in the context of an international, multi-sectoral project. As such, this paper sheds light on the applicability of the methodology, the strategies followed, and overlapping themes encountered during the CE implementation. In all five countries, researchers created overviews of multiple vulnerability case descriptions situated in communities affected by the COVID-19 pandemic. Several recurring themes played a role in the CE process in the different settings: the challenges of finding, defining, and working with(in) communities; the role and position of researchers \"in action\"; stakeholders and power dynamics; timing of stakeholder involvement; translating qualitative data on vulnerability mechanisms into practical solutions; and sustainability and institutional integration. It is important to consider these themes when planning future initiatives to apply social and behavioral science methods to address and mitigate vulnerabilities in communities confronted with pandemics or other crisis contexts.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251346407"},"PeriodicalIF":2.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}