{"title":"Losing and Regaining Sense of Control: A Cancer Patient's Interactions With Healthcare Professionals.","authors":"Satu Koskinen, Eeva Aromaa, Päivi Eriksson","doi":"10.1177/10497323251347896","DOIUrl":"https://doi.org/10.1177/10497323251347896","url":null,"abstract":"<p><p>By jointly telling the story of one of us, the authors, we highlight how supportive healthcare relationships can support a patient's sense of agency and open pathways for restoring a sense of control in the midst of serious illness. Drawing on personal experiences of living through cancer as a patient or a caregiver in Finland led us to explore how a sense of control can be lost and gradually regained. Drawing on our shared reflections and experiences as collaborating autoethnographers, we analyzed Satu's, the first author of this article, changing sense of agency and control, focusing on five key episodes over the 18 months following her diagnosis. As we revisited these episodes together, we identified how impersonal and one-sided communication within the healthcare system contributed to her loss of a sense of control. Over time, however, through more dialogic, respectful, and participatory interactions with healthcare professionals, she found ways to reclaim control and agency-not just in navigating illness but in shaping life beyond it. Our collaborative analysis offers new insights into the evolving dynamics of control, agency, and patient-professional interaction. We contribute to the literature on illness management by foregrounding relational, contextual, and socially constructed understandings of control. By illustrating the importance of patient-professional interactions, the study highlights the potential for rebuilding a sense of agency and control through supportive healthcare relationships.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251347896"},"PeriodicalIF":2.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295142","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":"Sense-Making During the RTS,S Malaria Vaccine Pilot Implementation in Ghana.","authors":"Esi Thompson Tani-Eshon","doi":"10.1177/10497323251347922","DOIUrl":"https://doi.org/10.1177/10497323251347922","url":null,"abstract":"<p><p>The pilot implementation of the RTS,S/AS01E (Mosquirix) malaria vaccine marked a significant step in addressing one of Africa's leading causes of mortality by providing essential data that led to its approval for use in children under two years old in malaria-endemic regions. However, little attention has been given to the lived experiences of caregivers and how they made decisions about participating in the vaccine pilot implementation. This paper takes an interpretive phenomenological analysis lens to understand caregivers' process of negotiating participation in the pilot implementation. I conducted 11 in-depth interviews with caregivers in the RTS,S pilot implementation site in the Assin North district in Ghana. Findings reveal that participants engaged in three overarching sense-making processes to negotiate their involvement in the pilot. These were <i>questioning the vaccine</i>, <i>considering political and socio-economic concerns</i>, and <i>biting the bullet.</i> Embodied within these themes are how agency, power, politics, trust in healthcare workers, and knowledge of vaccines undergird respondents' decision-making regarding the pilot implementation. The study evidenced the need for a holistic approach to engaging community members in pilot sites to guide their vaccine decision-making. By identifying the complex decision-making processes that individuals go through, we can better inform vaccine policy and public messaging to guide vaccine decision-making.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251347922"},"PeriodicalIF":2.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289696","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}
William Nelson Mwakalasya, Ana Lorena Ruano, Simon Henry Mamuya, Bente Elisabeth Moen, Aiwerasia Vera Ngowi
{"title":"Pregnancy, Childcare, and Pesticides: Understanding the Health Risks of Women and Children in Small-Scale Horticulture in Tanzania.","authors":"William Nelson Mwakalasya, Ana Lorena Ruano, Simon Henry Mamuya, Bente Elisabeth Moen, Aiwerasia Vera Ngowi","doi":"10.1177/10497323251342176","DOIUrl":"https://doi.org/10.1177/10497323251342176","url":null,"abstract":"<p><p>Women play a significant role in agriculture worldwide, especially in sub-Saharan Africa, where they form a large share of the workforce in horticulture. Horticulture work may expose women to pesticides during pregnancy and childcare, posing serious health risks to women and children. This study explores the experiences of women working in small-scale horticulture in Tanzania during pregnancy and childcare, to understand exposure risks and suggest safety-enhancing interventions. Using the theory of planned behavior framework, five focus group discussions (FGDs) were conducted with women aged from early 20s to mid-40s. The inductive thematic analysis was used for the analysis of the FGDs. We found that gendered roles in horticulture theoretically assign pesticide spraying to men, with women typically handling lighter tasks. However, when men are unavailable, women, even when pregnant, take on all duties, including pesticide spraying. Financial pressures force many women to work during pregnancy and postpartum, sometimes bringing infants into the horticulture environments. Despite some protective efforts reported by women, inadequate safety practices persist due to a lack of formal training on pesticide use. Therefore, traditional gender roles, poverty, and pesticide exposure intersect to create an occupational health challenge for women in small-scale horticulture. The absence of women-centered training on pesticide safety increases health risks both for women and their children. This study recommends gender-sensitive health training, improved access to protective equipment, and economic empowerment for women to help reduce these risks.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251342176"},"PeriodicalIF":2.6,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286889","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}
Yan Wang, Chun-Yu Li, Li-Hua Jin, Hai-Lian Zhang, Xiang-Dan Shen
{"title":"Minimizing and/or Avoiding Disease Progression Risk in Patients With the Three Highs: A Grounded Theory Study.","authors":"Yan Wang, Chun-Yu Li, Li-Hua Jin, Hai-Lian Zhang, Xiang-Dan Shen","doi":"10.1177/10497323251342468","DOIUrl":"https://doi.org/10.1177/10497323251342468","url":null,"abstract":"<p><p>Hypertension, diabetes, and dyslipidemia, collectively referred to as the \"three highs,\" pose a growing global health threat and have a significant impact on individuals' well-being. However, research addressing the primary concerns of patients managing all three diseases simultaneously is limited. In this study, we utilized classic grounded theory to identify the primary concerns of patients with hypertension, diabetes, and dyslipidemia, as well as to explore how these patients address their concerns. First, we employed purposive sampling and conducted open coding on the collected data until the core category emerged. To refine the core category, we then used theoretical sampling and carried out selective coding on the data until the core category achieved saturation. Subsequently, we performed theoretical coding on the data until the theory began to emerge and achieved saturation. Finally, we conducted a literature review and manually sorted the data to refine and ultimately complete the construction of the theory. Data collection and analysis were carried out simultaneously with each other. In the two-stage sampling, 3 participants from a community and 17 from the People's Hospital of Huaxian County, Henan Province, were selected. Semi-structured interviews were conducted between January and February 2024. Our findings indicate that patients with the three highs are primarily concerned about the risk of disease progression. They address these concerns through their perceptions, assessments, decision-making, control measures, and evaluations of those controls. These findings offer a theoretical framework for understanding patients with the three highs and for assisting them in effectively managing their diseases.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251342468"},"PeriodicalIF":2.6,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276251","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}
Lauren Catlett, Ames Simmons, Ishan C Williams, Virginia LeBaron, Charley Burton, Gracie M Barker, Kimberly D Acquaviva
{"title":"Multilevel Factors Affecting Health Equity for Transgender and Gender Diverse Older Adults.","authors":"Lauren Catlett, Ames Simmons, Ishan C Williams, Virginia LeBaron, Charley Burton, Gracie M Barker, Kimberly D Acquaviva","doi":"10.1177/10497323251342162","DOIUrl":"https://doi.org/10.1177/10497323251342162","url":null,"abstract":"<p><p>The population of transgender and gender diverse (TGD) older adults in the United States may face inequities in the healthcare system due to factors at multiple levels. Research is needed to identify factors that limit and facilitate equitable healthcare delivery for this population. Therefore, researchers conducted a qualitative descriptive study called Shaping Affirming Futures with Elders of all gender experiences (SAFEage) to identify and explore factors that affect health equity for TGD older adults living in the United States. Through purposeful and snowball sampling, researchers enrolled 20 TGD older adults of diverse gender identities and racial and ethnic backgrounds. In Phase 1 of the study, participants discussed their healthcare experiences during semi-structured interviews. In Phase 2, participants reviewed study findings in individual and group sessions. Researchers coded transcripts of interviews and review sessions both deductively and inductively, conducting a thematic analysis informed by the conceptual framework Intersectionality Research for Transgender Health Justice. With participant input, researchers developed six primary themes describing factors that limit (L) and facilitate (F) health equity at (1) structural, (2) systemic, and (3) social levels of influence: (L1) Oppression driving adverse healthcare experiences; (L2) Gaps in healthcare resources and support; (L3) Disadvantages yielding poor health outcomes; (F1) Health justice promoting affirming healthcare experiences; (F2) Catalysts for change in healthcare; and (F3) Assets fostering agency and well-being. Study findings may inform future research, clinical practice changes, and policies that would promote equitable and inclusive healthcare for TGD older adults.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251342162"},"PeriodicalIF":2.6,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267705","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}
Rachel VanEvery, David Johnson, Ysabella Jayne Willett, Wihsé Spring, Stephanie D George, Era Mae Ferron, Michelle Butt, Jessica E Pace, Bonnie Freeman, Amy L Wright
{"title":"The Journey of Fatherhood: A Community-Led and Father-Focused Approach to Understanding Indigenous Parenting.","authors":"Rachel VanEvery, David Johnson, Ysabella Jayne Willett, Wihsé Spring, Stephanie D George, Era Mae Ferron, Michelle Butt, Jessica E Pace, Bonnie Freeman, Amy L Wright","doi":"10.1177/10497323251334543","DOIUrl":"https://doi.org/10.1177/10497323251334543","url":null,"abstract":"<p><p>The experience of Indigenous men as they become fathers is not well documented in the literature, and available parenting programming in Canada often does not account for their unique perspectives. Supports and resources for expecting parents can be an effective way to support the transition to parenthood, yet most programs focus on women and mothers and integrate only Euro-Western approaches and values of parenting. Providing resources that meet the needs of Indigenous fathers is important, as a father's involvement in the lives of his children has been demonstrated to have significant benefits, including improving parent-infant attachment and a reduction in parental depression. Using Charmaz's grounded theory approach, this community-led study seeks to understand the transition to fatherhood experienced by Indigenous men. A total of 18 Indigenous men participated in semi-structured interviews to share their experiences of becoming fathers, and their programming needs. A Steering Committee including Indigenous community members and parents guided the creation and implementation of the project, including participating in collaborative data analysis. The core category, the <i>Journey of Fatherhood</i> is organized into five sub-categories: visioning fatherhood, planning for fatherhood, the birth of a baby, pursuing fatherhood, and navigating fatherhood. The findings support a new understanding of the transition to fatherhood for Indigenous men, highlighting a holistic approach to parenting and an appreciation for life-long learning. Incorporating an understanding of the <i>Journey of Fatherhood</i> into local parenting programs and resources may better meet the needs of Indigenous fathers and their families, and improve their engagement in services.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251334543"},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259148","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}
Raymond G De Vries, Lisa Kane Low, Meagan Chuey, Samia Abdelnabi, Maryn Lewallen
{"title":"When Evidence Fails to Change Practice: Examining the Persistence of Continuous Fetal Monitoring.","authors":"Raymond G De Vries, Lisa Kane Low, Meagan Chuey, Samia Abdelnabi, Maryn Lewallen","doi":"10.1177/10497323251347137","DOIUrl":"https://doi.org/10.1177/10497323251347137","url":null,"abstract":"<p><p>Using scientific evidence to guide medical practice seems self-evident but, in certain specialties, it has proven difficult to realize. Use of continuous electronic fetal monitoring (cEFM) during labor is a case in point: research has shown that when compared to intermittent auscultation (IA), use of cEFM in uncomplicated labors of healthy women offers no clinical benefit and may result in unneeded interventions, and yet it remains common practice in obstetric care. In this study, we used observations on a labor and delivery unit and interviews with key informants to investigate the factors that drive the use of cEFM in the face of contrary evidence. Our observations of clinician behaviors regarding the use of cEFM and documentation of the effect of unit workflow on decisions about monitoring allowed us to identify several factors that drive the non-evidence-based use of cEFM. These include fear of liability, training, hospital unit policies, perceptions of patient desires, and workflow on the unit. What we learned about the continued use of cEFM offers insight into other instances where evidence fails to be implemented in practice. Our recommendations for how to align fetal assessment during labor with research evidence include more and better education about modes of fetal assessment for expectant parents and clinicians, hospital policies that encourage reflection on research evidence when making clinical decisions, attention to the way policies and protocols discourage use of IA, and making visible the clinical and economic benefits of evidence-based practice.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251347137"},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250353","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}
Jasset Puc-Vázquez, Karla Rossanet Dzul-Rosado, Luz Arenas-Monreal, Carlos N Ibarra-Cerdeña, María Teresa Castillo-Burguete
{"title":"\"You Pinch It With the Nail Clipper, and You Kill It\": A Reflexive Thematic Analysis of How Maya Families Prevent and Manage Tick Bites in Yucatan, Mexico.","authors":"Jasset Puc-Vázquez, Karla Rossanet Dzul-Rosado, Luz Arenas-Monreal, Carlos N Ibarra-Cerdeña, María Teresa Castillo-Burguete","doi":"10.1177/10497323251344058","DOIUrl":"https://doi.org/10.1177/10497323251344058","url":null,"abstract":"<p><p>In peasant livelihoods, families are regularly exposed to ectoparasites such as ticks, and thus to the diseases they carry. Little is known about how rural families' knowledge influences health in domestic and community environments. We applied reflexive thematic analysis (RTA) to family preventative and curative strategies for tick exposure and bites in a Maya community in Yucatan, Mexico. Data were collected over six months via participant observation and 26 semi-structured interviews with fifteen women homemakers, five peasant farmers, three traditional healers, and three biomedical professionals. Three themes became apparent via RTA: \"Socialization and normalization of tick management,\" \"Pragmatism and observation,\" and \"Women Caregivers.\" A principal finding is that local participants only associated tick bites with skin ailments, which they treated at home using mostly homemade remedies, as well as some biomedical products. Based on their knowledge of and experience with ticks, their preventive strategies in the domestic sphere focused on minimizing tick contact with the skin, preventing ticks from entering the house, and protecting children. All family members contributed to implementing anti-tick strategies, using knowledge created through communal processes influenced by economic factors and experiences with similar illnesses. One biomedical professional commented that the study population's lack of awareness about the magnitude of the disease risk from ticks is alarming, referring to tick-borne <i>Rickettsia</i> as a \"sleeping giant.\" Our findings underscore that acknowledging and understanding domestic knowledge and strategies is vital to developing programs to assist rural populations in better controlling this and other disease vectors.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251344058"},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250350","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}
Djoeke Besselink, Feija D Schaap, Harriët Jager-Wittenaar, Sven J Geelen, Martine J Sealy, Evelyn J Finnema, Fons van der Lucht
{"title":"Maintaining Well-Being in Times of Limited Social Contacts: Experiences of Community-Dwelling Older Adults Living Alone During the COVID-19 Pandemic.","authors":"Djoeke Besselink, Feija D Schaap, Harriët Jager-Wittenaar, Sven J Geelen, Martine J Sealy, Evelyn J Finnema, Fons van der Lucht","doi":"10.1177/10497323251345333","DOIUrl":"https://doi.org/10.1177/10497323251345333","url":null,"abstract":"<p><p>Sudden disruptions to the social environment of older adults living alone, such as the COVID-19 pandemic, can challenge their ability to maintain well-being. This study employed an interpretative phenomenological analysis to explore how Dutch older adults (≥65 years) living alone maintained their well-being during the COVID-19 pandemic. Between June and October 2021, we conducted 20 semi-structured interviews with older adults living alone in the Netherlands. Participants were recruited through online newsletters and home care and social work institutions. We identified three key themes. The theme \"Filling the void of being alone\" captures participants' ongoing search for a sense of connection, and the challenges they faced related to social exclusion. The theme \"Navigating challenging situations to maintain well-being\" illustrates participants' struggle with disrupted daily routines and how they tried to regain a sense of control to stay well. Lastly, the theme \"Reverberating echoes of the past\" conveys how participants' life histories shaped their responses to the pandemic and the role of acceptance in this process. Overall, our results highlight great individual variability in how older adults living alone maintained their well-being during the COVID-19 pandemic. This underscores the need for interventions and support strategies that accommodate the unique needs of older adults living alone when opportunities for social engagement are limited.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251345333"},"PeriodicalIF":2.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250351","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":"\"The Idea of Not Having to Prove Anything in the Way I Needed, That Would Be Really Helpful\": Exploring Adolescents' and Parents' Understanding of Youth Participation During Patient-Initiated Brief Admission Enrollment in Psychiatric Inpatient Care.","authors":"Jennie Moberg","doi":"10.1177/10497323251340935","DOIUrl":"https://doi.org/10.1177/10497323251340935","url":null,"abstract":"<p><p>Enrollment in psychiatric inpatient care represents a pivotal moment in a young person's life, one that often reverberates through the entire family. This study seeks to illuminate how adolescents and parents navigate youth participation during Patient-Initiated Brief Admission enrollment, shedding light on how such involvement fosters recovery from mental health problems. Drawing on interviews with five adolescents and five parents, the study unpacks the intricate dynamics of participation, with thematic analysis revealing the underlying patterns and complexities. To deepen the understanding, theoretical frameworks of epistemic injustice and ecological systems theory are employed, offering rich perspectives on the interplay of knowledge, power, and the parental role in shaping participatory experiences. The findings show that participation is not a static concept but a relational process, rooted in trust and profoundly influenced by adolescents' ability to articulate their care needs. This capacity emerges as a cornerstone for enhancing meaningful participation and promoting recovery. Moreover, including parents in the enrollment process provides a dual vantage point-highlighting both the benefits and the challenges of inpatient care-while simultaneously enriching the participatory experience. The study underscores that youth participation in inpatient care is inherently dynamic, evolving through relationships with adults and fluctuating in intensity and frequency. Recognizing adolescents as emerging adults, capable of increasing autonomy despite health challenges, is essential to fostering equitable and empowering care. This perspective, crucial during inpatient enrollment, serves as a safeguard against epistemic injustice, ensuring that participation remains a pathway to recovery rather than a barrier.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251340935"},"PeriodicalIF":2.6,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250349","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}