Qualitative Health Research最新文献

{"title":"Prescribing High-Priced Cancer Drugs: Rethinking Physicians' Choice Regarding Expensive Treatments.","authors":"Theau Brigand, Pierre-André Juven, Fanny Vincent","doi":"10.1177/10497323251323223","DOIUrl":"https://doi.org/10.1177/10497323251323223","url":null,"abstract":"<p><p>As the prices of cancer treatments are constantly rising, reaching tens and hundreds of thousands of euros per patient, this article examines the existence and impact of these prices in everyday hospital practice and in relation to medical autonomy. Our study takes place in the French health care system, which is characterized by the coverage of health care costs by the health insurance system. Through ethnographic observations carried out in hematology and thoracic oncology departments, the study explores how prices, although invisible and excluded from medical practice, can come into play in situations of tension at the boundaries of medical, administrative and financial prescriptive frameworks. However, this paper shows how the innovative and complex nature of these costly treatments can be reinterpreted in terms of value and even become a source of credit.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251323223"},"PeriodicalIF":2.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045807","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":"Exploring the Challenges of Empathy in a Therapeutic Context: An Interpretative Phenomenological Analysis.","authors":"Tracy Watson, Rebecca Waters, Lynelle Watts, David Hodgson","doi":"10.1177/10497323251331460","DOIUrl":"https://doi.org/10.1177/10497323251331460","url":null,"abstract":"<p><p>Professionals working in therapeutic contexts are vulnerable to developing occupation-related stress conditions such as burnout, vicarious trauma, and compassion fatigue. In such contexts, empathy is accepted as a crucial component of practice. However, social neuroscience research suggests empathy may adversely impact workers' well-being. While occupation-related problems like compassion fatigue have relevance, they do not fully explain the potential negative effects of empathy on worker well-being. Therefore, our study aimed to explore whether empathy posed a problem for those working in therapeutic contexts. Participants in this study were qualified professionals working in counselling roles under the Medicare Australia Better Access Initiative. Semi-structured interviews were conducted with fifteen participants, and data was analyzed using interpretative phenomenological analysis (IPA). This process led to the discovery of four superordinate themes: (1) Navigating Empathy: A Foundation of Practice and an Emotional Challenge; (2) The Interplay Between Therapists' Lived Experience and Empathic Engagement; (3) Balancing the Demands of Empathy With Career Sustainability and Personal Well-being; and (4) When Values and Beliefs Diverge. Two subthemes are (1) Emotional and Physical Exhaustion and (2) Empathy-The Finite Resource. The findings indicate that while empathy is considered central to practice, various emotional, psychological, and occupational challenges are associated with its use.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251331460"},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054209","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":"Following in Elders' Footsteps: Yarning About Ageing Well in the Torres Strait.","authors":"Rachel Quigley, Chenoa Wapau, Betty Sagigi, Sarah G Russell, Sean Taylor, Sarah Larkins, Edward Strivens, Michelle Redman-MacLaren","doi":"10.1177/10497323251335210","DOIUrl":"https://doi.org/10.1177/10497323251335210","url":null,"abstract":"<p><p>There is a growing body of literature around ageing well for Indigenous Peoples internationally. However, the perspectives of Torres Strait Islander Peoples, one of two First Nations groups in Australia, have not been documented. This qualitative study aims to explore what ageing well means to people living in the Torres Strait and Northern Peninsula Area (NPA) of Australia. Ten yarning circles were conducted with 45 participants from four island and five NPA communities across the region. Reflexive thematic analysis was used to identify seven themes of ageing well. A metaphor of a wongai tree-an endemic Torres Strait region tree-was used to describe those findings. The roots were used to represent the Torres Strait Islander way of life. The trunk represented practicing Torres Strait Islander identity. The branches represented a holistic approach to living a healthy lifestyle. The leaves represented strong leadership and role models. The fruit depicted passing on knowledge, tradition, and cultural practices. A cyclone, an adverse event, represented the challenges to ageing well, with the regrowth representing strong sustained life. Findings highlighted the importance of the cultural determinants of health, which significantly contribute to ageing well. These cultural determinants must be considered when addressing the health of First Nations Peoples, and as such, First Nations voices must be central in the design and implementation of practices and policies that affect them.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251335210"},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054596","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":"Competing Cultural Discourses of GLP-1 Agonists: An Application of Relational Dialectics Theory.","authors":"Maggie A Unruh, Charee M Thompson","doi":"10.1177/10497323251326041","DOIUrl":"https://doi.org/10.1177/10497323251326041","url":null,"abstract":"<p><p>As GLP-1 medications become more available and FDA approved in a number of cases, discourses related to their use by individuals for purposes of weight loss and management permeate social life. Prominently, weight management is often positioned in society and researched as a private matter of individual choice, behavior, and responsibility. Relational dialectics theory posits culturally dominant discourses and marginalized discourses to be in constant flux with power as central to meaning construction. Therefore, we examine the competing discourses that animate the weight management experiences of people who have used, have considered using, or are currently using GLP-1 medications to manage their weight through the lens of relational dialectics theory. Through an online, qualitative survey (<i>n</i> = 130) and contrapuntal analysis, we identify four discourses: GLP-1s as a magic bullet and quick fix; deservingness; GLP-1s as freedom and control; and GLP-1s as medically necessary. The interplay of these discourses reveals people using GLP-1 medications for weight management as being doubly stigmatized. As such, they are stigmatized both for their weight and their method of weight management resulting in an inability to escape dominant discourses.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251326041"},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016972","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":"Participant Emotional Resiliency Check-In: A Research Technique.","authors":"Meaghan Storey, Jessica Sutherland","doi":"10.1177/10497323251336637","DOIUrl":"https://doi.org/10.1177/10497323251336637","url":null,"abstract":"<p><p>There is a well-established and growing literature on engaging and working with communities throughout the research process. Co-design and collaborative research are becoming common practice among researchers and increasingly a funding incentive and institutional commitment. Research methodologies have been created to formalize these processes and guide both new and experienced researchers wishing to engage in such research. However, gaps around process remain within the literature and research teams are often left to design their own techniques and protocols. Participant Emotional Resiliency Check-ins (PERCs), a term and research technique designed by the authors, aim to facilitate timely participant reflection on their emotional resiliency and to direct their participation in sensitive research accordingly. This research technique takes a strength-based and trauma-informed approach and most importantly is conducted by a peer worker. In this paper, we outline the PERC technique and identify its key features. We also share our considerations and learnings for other research teams wanting to engage in collaborative, sensitive research.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251336637"},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004795","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":"A Social-Ecological Model to Explore Multi-Faceted Drivers of Child Marriage: An Iterative Qualitative Study in Southern Bangladesh.","authors":"Md Abul Kalam, Chowdhury Abdullah Al Asif, Shirin Afroz, Mai-Anh Hoang, Kyly C Whitfield, Aminuzzaman Talukder","doi":"10.1177/10497323251330447","DOIUrl":"https://doi.org/10.1177/10497323251330447","url":null,"abstract":"<p><p>Despite national priorities, legal reforms, and increased investment in interventions, child marriage (CM) remains a significant public health risk, leading to violence, intergenerational nutritional depletion, and poor health outcomes in Bangladesh. Using the social-ecological model (SEM), this iterative qualitative study aimed to understand the drivers of CM at the individual, familial, social/community, and institutional levels to inform policy and programs. A total of 29 focus group discussions (with community members, married and unmarried adolescent girls, and their parents and grandmothers), 44 in-depth interviews (with married and unmarried adolescent girls, and their parents), and 10 key informants' interviews (influential community leaders) were conducted. Findings were drawn through thematic analysis employing both inductive and deductive coding. Identified CM drivers are aligned with the SEM framework. Girls' agency, collective efficacy, self-initiated marriage, and educational performance were individual-level drivers. Family-associated drivers were household poverty, parents' lack of awareness, and intra-household gendered preferences. Social/community drivers include norms about the \"ideal\" bride, girls' readiness for marriage, control over girls' sexuality and mobility, fear of violence, family honor, and religious norms. Weak enforcement to prevent CM, limited opportunities for girls, ecological conditions, and long school closures during COVID-19 were key institutional drivers. Findings suggest CM drivers are interconnected across levels of the SEM, implying the need for multi-level interventions. Coordinated efforts to reduce CM may include addressing the harmful CM norms and systemic factors leading to CM, raising community awareness about the adverse outcomes of CM, and offering poverty alleviation and economic opportunities for girls.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251330447"},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051225","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":"Utilizing Aboriginal Participatory Action Research-Dadirri-Ganma to Co-Design the Deadly Dental Home.","authors":"Nicole Stormon, David Carr, Paul Drahm, Kirrily Phillips","doi":"10.1177/10497323251335837","DOIUrl":"https://doi.org/10.1177/10497323251335837","url":null,"abstract":"<p><p>This study aimed to co-design a \"Deadly Dental Home\" for Australian Aboriginal and Torres Strait Islander people (herein referred to as First Nations). Participatory Action Research-Dadirri-Ganma methods utilized respectful listening (Dadirri), self-reflective knowledge sharing (Ganma), and Yarning to design a model of care for the community. Consumers of dental services, community leaders, healthcare providers, and dental service leaders designed a culturally safe and holistic approach to dental care, bringing together First Nations and Western perspectives. A \"Deadly Dental Home\" is a dental service that arranges continuously available, comprehensive, coordinated, and culturally appropriate dental care. The expression \"deadly\" carries a sense of empowerment and positivity within First Nations cultures, representing strength, praise, resilience, and excellence. The research emphasized the integration of cultural needs into dental services. Key themes included Reaching Mob, Dental Care Delivery, and Care Across the Life Journey. Continuous and culturally responsive dental care tailored to different life stages from infancy through elderhood included hands-on education and prevention strategies. The need for a culturally competent workforce, a welcoming dental environment, and flexible appointment scheduling was necessary to foster trust and accessibility. The Deadly Dental Home model promotes a comprehensive approach to care extending beyond traditional dental treatment to address broader health determinants. Continued community engagement, partnership with dental services, and research are essential to refining and implementing this model, ensuring it effectively addresses the unique needs of First Nations people.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251335837"},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990988","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 Earth Is Becoming a Coronavirus\": Children's Perceptions, Knowledge, and Experiences of the COVID-19 Pandemic as Presented in Their Drawings.","authors":"Sofia Gjertsson, Maria Thell, Anna Sarkadi","doi":"10.1177/10497323251334247","DOIUrl":"https://doi.org/10.1177/10497323251334247","url":null,"abstract":"<p><p>Younger children's voices are often overlooked in research and policy, yet their perceptions and experiences are crucial in understanding their needs in planning responses to crisis, such as the COVID-19 pandemic. Existing studies on children's experiences of crises often rely on adult perspectives or are adult-led; a more child-centric approach could be to analyze children's drawings. The aim of this study was to explore Swedish 7- to 11-year-old children's experiences and knowledge of the COVID-19 pandemic, as expressed in their drawings. Drawings from <i>N</i> = 454 children with accompanying texts, from various Swedish municipalities with different socio-economic profiles, were analyzed using a combination of semiotic visual analysis and content analysis. Three main themes emerged: (a) <i>Fun, friends, and freedom are cancelled</i> which pointed to societal changes as a result of the pandemic that impacted the children's own lives, causing high levels of frustration; children saw contrasts between what had been, what is, and what is to come; (b) <i>The world is all upside down</i>, in which the children highlighted their understanding of the virus, how it has changed and impacted the world, as well as existential reflections of their lives and surrounding environment; and (c) <i>The Virus: evil, scary, and dangerous, but masks and sanitizer can help</i> showed the children's understanding of the pandemic as a global event and showed high level of health literacy related to COVID-19. Children were very perceptive and astute to the societal issue at hand. Despite Sweden's relatively lenient measures, the pandemic significantly affected their lives and autonomy.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251334247"},"PeriodicalIF":2.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054697","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":"Becoming Interprofessional: A Longitudinal Study of Professional and Interprofessional Identity Development Across Five Health Professions.","authors":"Sheri Price, Lindsay Van Dam, Meaghan Sim, Cynthia Andrews, John H V Gilbert, Kelly Lackie, Natalie Kennie-Kaulbach, Evelyn D Sutton, Hossein Khalili","doi":"10.1177/10497323251333960","DOIUrl":"https://doi.org/10.1177/10497323251333960","url":null,"abstract":"<p><p>Interprofessional collaborative practice (IPC) occurs when health professions work collaboratively to improve quality of care and enhance patient outcomes. Yet myriad challenges to enacting collaborative practice exist. Interprofessional education for collaborative practice (IPECP) is foundational for promoting collaboration among health professions, yet there is a gap in understanding how students perceive their readiness for IPC and how early socialization experiences may contribute to developing a dual-uni-professional and interprofessional-identity. This study seeks to understand how new practitioners perceive and experience IPC upon entry to practice, and identify individual and systemic factors that facilitate and impede dual identity development. An interpretive, narrative methodology was used to understand the IPC and early professional practice experiences of 24 individuals from a longitudinal study of five health professions. Facilitators to interprofessional identity development included exposure to/working with interprofessional teams, settings, role models, and directly experiencing benefits of collaborative practice during patient care. Impediments include settings and situations where professional stereotyping and hierarchies were reinforced by the dominant uni-professional culture of work environments. Interprofessional socialization and identity development are contingent on exposure to interprofessional role models and settings. Healthcare professionals' dual identity development begins in pre-licensure IPECP but is shaped by socialization experiences within practice. Healthcare institutions need to provide nourishing collaborative environments (time, settings, and contexts) that foster interprofessional collaboration and behaviors and empower dual identity formation. Post-licensure IPECP for healthcare professionals to continue to learn with, from, and about one another in practice is essential for collaborative interprofessional healthcare teams/systems.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251333960"},"PeriodicalIF":2.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040963","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":"Coaches Say Lighter Is Better, but at What Cost? A Qualitative Exploration of the Lingering Impact of Body Image on Disordered Eating in Retired Elite Women Athletes.","authors":"Delaney E Thibodeau, Sara Sutherland, David M Brown, Danika A Quesnel, Catherine M Sabiston","doi":"10.1177/10497323251331800","DOIUrl":"https://doi.org/10.1177/10497323251331800","url":null,"abstract":"<p><p>Women athletes often experience body dissatisfaction and disordered eating, contributing to a heightened risk of developing an eating disorder throughout their athletic career. Yet, the experiences of body image and disordered eating are not understood in retirement from sport. A qualitative description study with semi-structured interviews was used to describe body image and disordered eating in eight retired elite women athletes from various sports. Interviews were transcribed verbatim, analyzed inductively, and organized into three themes. The first theme \"Social influences and instigators of disordered eating while competing in sport\" reflects motivators of disordered eating with sub-themes: (a) coaches are uncaring and unqualified, (b) parents set the \"tone,\" for better or for worse, and (c) peers are not always friends, though some show support. The second theme \"The pinnacle of disordered eating\" depicts behaviors and feelings experienced at the peak of career with sub-themes: (a) losing weight by any means necessary and (b) the physical and emotional tolls. The third theme \"Reshaping the self and compensatory behaviors\" describes participants' experiences after ceasing competition with sub-themes: (a) changes in identity and (b) compensatory eating and exercise. The results highlight diverse social-cultural factors influencing body dissatisfaction and disordered eating onset. Ultimately, results may help inform intervention strategies that will improve the overall health and well-being of women athletes both during sport and into retirement.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251331800"},"PeriodicalIF":2.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051936","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}