Qualitative Health Research最新文献

{"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}

{"title":"Lessons From the Past, Hope for the Future: A Qualitative Study on the Lives of Leprosy-Affected Residents of a Leprosy Settlement in Malaysia.","authors":"Norana Abdul Rahman, Vaikunthan Rajaratnam, Noor Hanis M Rafee, Cynthia Ramachandran, Ruth M H Peters, Karen Morgan, Mohamed Rusli Abdullah, Marjolein B M Zweekhorst","doi":"10.1177/10497323251321727","DOIUrl":"https://doi.org/10.1177/10497323251321727","url":null,"abstract":"<p><p>The Sungai Buloh Leprosarium in Malaysia, established in 1930, provided relief for many individuals with leprosy, yet their personal narratives remain largely untold. This study explored the lived experiences of older individuals affected by leprosy at the Leprosarium, focusing on their concerns, needs, and challenges. By examining the historical context and key themes from interviews with leprosy-affected participants, the study aimed to enhance their well-being and provide insights applicable to leprosy-affected individuals in the community, other leprosaria, and older individuals in institutional care settings. The participants comprised eight women and ten men, aged 41-84 years, with a mean age of 73.7 years. These participants, selected via purposive and snowball sampling, were interviewed for 40-45 minutes over two sessions to allow rest breaks. The interviews were transcribed, validated, and analyzed using NVivo 14 software through an inductive-deductive thematic approach. Results showed hope is a transformative coping strategy, emerging as the overarching theme, guiding participants through the challenges of leprosy. Other themes included navigating the bio-psychosocial challenges of leprosy, life within the leprosarium, practical coping strategies in daily life, parental separation from infants at birth and its emotional toll, and expressing gratitude for the opportunities and care provided by the leprosarium. These themes demonstrated how hope shaped participants' resilience and resourcefulness, enabling them to positively reframe their experiences. This study emphasized the role of hope and the importance of support systems in fostering resilience and improving the quality of life of individuals with leprosy and older adults in institutional care settings.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251321727"},"PeriodicalIF":2.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025230","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":"Recognizing and Addressing Health Care Barriers for Transgender and Nonbinary People Living With a Chronic Illness or Disability.","authors":"Emily J Noonan, Laura A Weingartner, Ryan M Combs, Hallie R Decker, Alex Cowand, Sara Williams, Lesley M Harris","doi":"10.1177/10497323251330253","DOIUrl":"https://doi.org/10.1177/10497323251330253","url":null,"abstract":"<p><p>This paper explores the health care experiences of individuals who are transgender and/or nonbinary (TGNB) and live with a chronic illness and/or disability (CI/D). Using an interpretivist epistemological worldview and an intersectional lens, the research team explored the compounded barriers faced by this patient population and propose solutions for improving their care. The study conducted in-depth interviews with TGNB individuals who self-identified as having a CI/D to understand their health and health care experiences. The interdisciplinary research team, which includes individuals with diverse backgrounds and experiences related to gender identity and CI/D, analyzed the data thematically using an iterative interpretive approach. Participants described barriers such as diagnostic overshadowing and provider skepticism that were exacerbated by their dual TGNB-CI/D identities. Participants interacted with health care systems frequently due to ongoing medical needs, which increased the likelihood of negative encounters like misdiagnosis, inappropriate questioning related to their gender identity, and skepticism of their CI/D. Gaslighting experiences further eroded trust in health care providers and contributed to health care inequities. The lack of LGBTQ+ competent care, coupled with discriminatory attitudes, led some participants to forgo seeking essential health care services altogether. Participants identified several strategies to mitigate barriers, including advocating for LGBTQ+ competent care through provider education and training; structural changes to address financial barriers and insurance issues; leveraging telehealth services; and increasing community support networks. By enacting the suggested actionable solutions, which were grounded in participants' voices and experiences, the health care system can reduce disparities and provide better, more affirming health care to this group.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251330253"},"PeriodicalIF":2.6,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006886","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":"Detecting and Preventing Imposter Participants: Methods and Recommendations for Qualitative Researchers.","authors":"Kristina Medero, Hamdi Abdi, CeRon Ford, Sarah Gollust","doi":"10.1177/10497323251333243","DOIUrl":"https://doi.org/10.1177/10497323251333243","url":null,"abstract":"<p><p>During the COVID-19 pandemic, many qualitative researchers were forced to alter their data collection methods as traditional face-to-face interviews and focus groups were prohibited by social distancing requirements. While the shift to remote and digital platforms has undoubtedly provided numerous benefits, such as more flexibility and reach, it has also introduced new challenges, particularly the risk of imposter participants, or dishonest or false participants who fabricate their identities or exaggerate their experiences to join a study. Through reflection on two case studies, we identified several red flags, which we categorized according to phases of the research process-recruitment and data collection. Based on the red flags, we provide methods and recommendations for detecting and preventing imposter participants from impacting the validity and trustworthiness of qualitative research. Researchers must routinely implement these recommendations for qualitative research as technology becomes a more attractive avenue for recruiting potential participants, particularly participants belonging to populations often described as \"hard to reach.\" However, these problems are structural and require institutional attention. We, therefore, pose recommendations for academia, institutional review boards, publishers, and reviewers of qualitative research.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251333243"},"PeriodicalIF":2.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042138","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":"Ensuring That Marginalized Young People Feel Welcome, Understood, and Empowered in Health Services: A Qualitative Examination of the Service Needs of Aboriginal LGBTQA+ Young People.","authors":"Shakara Liddelow-Hunt, Ashleigh Lin, Yael Perry, Braden Hill, Bep Uink","doi":"10.1177/10497323251329765","DOIUrl":"https://doi.org/10.1177/10497323251329765","url":null,"abstract":"<p><p>A lack of appropriate care and discrimination in healthcare settings likely compounds the existing risks to mental health and well-being for Aboriginal and Torres Strait Islander lesbian, gay, bisexual, trans, queer/questioning, and asexual (LGBTQA+) young people. The current study contributes findings from Aboriginal LGBTQA+ young people's perspectives on their health service needs and preferences. Data consists of qualitative interviews and focus groups with <i>N</i> = 14 Aboriginal LGBTQA+ young people aged 14-25 years in Boorloo (Perth), Western Australia. The data was analyzed using reflexive thematic analysis. Analysis identified three major themes: (1) Unmet need for \"whole self\" care, (2) Communicating to young people that they will be welcome, safe, and cared for, and (3) Engaging communities to address structural inequalities. These findings shed light on the almost complete lack of Aboriginal LGBTQA+ youth-focused care available and point to the importance of health workers and, especially, mental health professionals understanding the broader sociohistorical context that impacts young people's well-being. Ultimately, while many Aboriginal LGBTQA+ young people have positive experiences of receiving care for their health and well-being, there persists a feeling of being unable to wholly exist in healthcare settings.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251329765"},"PeriodicalIF":2.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035221","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":"Compromised Agency in the Subjective Experiences of Temporal Distortions Among Institutionalized Alzheimer's Patients in China: A Qualitative Study.","authors":"Genying Su, Jianxin Ding, Yan Xu","doi":"10.1177/10497323251329764","DOIUrl":"https://doi.org/10.1177/10497323251329764","url":null,"abstract":"<p><p>Temporal distortions in Alzheimer's disease (AD) patients have been extensively studied from neuroanatomical and empirical perspectives. However, the subjective experiences of these temporal disturbances are relatively under-researched. This study, using inductive content analysis, explored the lived experiences of temporal distortions among AD patients in two integrated clinical and elderly care centers in China. Seventeen participants were involved in the study. Three key themes emerged regarding Chinese institutionalized AD patients' experiences of temporal distortions: limited agency in temporal orientation of the present, futile agency in mental time travel to the past, and relinquished agency in the imagination and planning of the future. The study identifies institutional and cultural factors as potential contributing influences. The scheduled institutional routines can constrain AD patients' sense of agency over temporal perceptions. Expectations derived from the Chinese cultural principle of filial piety might also contribute to the participants' relinquishment of agency.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251329764"},"PeriodicalIF":2.6,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054592","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":"\"This Should Be the Answer!\": The Evolution of Relational Dynamic Capabilities in the Co-Production of Maternity Care Services to Vulnerable Women.","authors":"Federica Angeli, Carlotta Gamberini, Elena Ambrosino","doi":"10.1177/10497323251317437","DOIUrl":"https://doi.org/10.1177/10497323251317437","url":null,"abstract":"<p><p>Established models of maternity care delivery in high-income countries have increasingly proved inadequate to address the highly idiosyncratic and heterogenous needs of vulnerable pregnant women, such as ethnic minorities, migrants, and asylum seekers, who still disproportionately suffer from high maternal morbidity and mortality. Intersectionality theory has been salient to represent vulnerable women's lived, subjective experience of inequity in healthcare access; however, it has proved less effective in informing organizational and systemic change able to redress the intersectional disadvantage affecting vulnerable populations. To address these theoretical and empirical gaps, this article develops an in-depth single case study around the HAAMLA team, a specialized community midwifery group active at the Leeds Teaching Hospital NHS Trust in England (UK), which specifically evolved over time to cater to the needs of vulnerable pregnant women. We conducted semi-structured interviews with the midwives and team leadership and triangulated our data with archival material and participant feedback. Building abductively on a novel intersectional, socio-ecological theoretical framework, our findings highlight how HAAMLA midwives developed a radically different model of maternity care delivery that conceptualizes vulnerability as an intersectional, socially constructed category and that co-produces holistic, bespoke care services together with the women and with the external network of partner agencies. In doing so, the team developed and leveraged two key relational dynamic capabilities: adaptive network activation and trust-based relationship building. The article discusses contributions to theory, policy, and practice, while providing fresh insight into a strongly innovative and potentially replicable model of maternity care delivery to vulnerable groups.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251317437"},"PeriodicalIF":2.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991398","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":"Healthcare Professionals' Emotions of Distance and Connection When Dealing With Patients' Vaccine Hesitancy: Interaction Styles, Values, and Implications.","authors":"Emeline Brosset, Emma Anderson, Amanda Garrison, Dawn Holford, Harriet Fisher, Patrick Peretti-Watel, Stephan Lewandowsky, Pierre Verger","doi":"10.1177/10497323251320921","DOIUrl":"https://doi.org/10.1177/10497323251320921","url":null,"abstract":"<p><p>Healthcare professionals (HCPs) play a primary role in the delivery of population-based vaccination programs. Their emotional well-being can influence the quality of their relationships with patients and generally the outcome of their consultations. This qualitative study sought to identify the types of emotions that HCPs feel during conversations with vaccine-hesitant patients and their styles of interaction. Semi-structured interviews were conducted between June and November 2022 with 41 HCPs (mainly general practitioners and nurses) responsible for vaccinating patients: 23 in England and 18 in France. Framework analysis showed that participants reported numerous emotions, some associated with connection to patients (such as self-confidence and satisfaction) and others with distance (including anger, frustration, unease, and exhaustion). We identified four clusters of emotions reported together when reflecting on interactions with vaccine-hesitant patients: \"self-confidence and emotional empathy\" (satisfaction, sadness regarding the patient's situation); \"anxiety and insecurity\" (doubts about skills, concern for the patients); \"exhaustion and weariness\" (feeling of incompetence, nervousness); and \"discredit and frustration\" (feeling discredited, anger). Three styles of interaction were identified: most HCPs reassured and encouraged patients to get vaccinated (\"patient-centered\" style), some sought to convince them (\"adamant\" style), and some to inform them without discussion (\"detached\" style). In our study, HCPs describing a patient-centered interaction style emphasized emotions of connection more than of distance in their discourse, in contrast to those describing an adamant or detached style. Our results suggest that training programs offered to HCPs involved in vaccination discussions should consider the importance of emotions associated with vaccine discussions.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251320921"},"PeriodicalIF":2.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021186","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":"Ethnography of User Involvement: Navigating a Blurred Research Position.","authors":"Malene Lue Kessing, Sine Kirkegaard","doi":"10.1177/10497323251328538","DOIUrl":"https://doi.org/10.1177/10497323251328538","url":null,"abstract":"<p><p>This article explores the methodological dilemmas that arise when conducting ethnography of user involvement in mental healthcare settings. Public health systems commonly integrate the experiences and insights of service users to enhance service quality and \"empower\" participants. In health research, there is a growing interest in coproducing research with participants, leading to an expanding body of literature on collaborative research methodologies. However, little attention has been given to how the concept of user involvement changes standards and expectations for how we conduct ethnographic research. Drawing on two Danish studies on user involvement initiatives, we demonstrate how the increased political and organizational focus on user involvement both encourages and contests a blurred research position that cuts across well-established participant categories such as \"service user\" and \"service provider.\" This blurred position intensifies dilemmas related to the researcher's positionality, personal biography, emotional reflexivity, and representation of knowledge. By critically engaging with our fieldwork experiences, we identify methodological dilemmas that may inspire researchers in the field of qualitative health research.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251328538"},"PeriodicalIF":2.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041204","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":"Working With Value Complexity in Healthcare.","authors":"Lieke Oldenhof, Violet Petit-Steeghs, Rik Wehrens, Sander van Haperen, Marjolijn Heerings","doi":"10.1177/10497323251330999","DOIUrl":"https://doi.org/10.1177/10497323251330999","url":null,"abstract":"<p><p>In this paper, we argue for a rethinking of complexity in healthcare in terms of value complexity. Although widely adopted in healthcare, the positivist roots of complexity theory have thus far limited its applicability to understand the wicked nature of many healthcare challenges. We draw on a new pragmatist approach to contend that values are situated and embedded in practice, and demonstrate how values and practices co-develop in ways resembling complex systems. We employ this analytical lens in a secondary analysis of prior ethnographic and action research undertaken between 2010 and 2022 in the context of Dutch healthcare. These studies were conducted in the context of older person care and the (care) services for people with chronic diseases, disabilities, and mental illness. Based on our findings, we bring forward a layered conceptualization of value complexity. Additionally, we illustrate three ways in which practitioners and scholars manage value complexity: \"working around,\" \"working against,\" and \"working with\" complexity. We consider the (dis)advantages of each of these strategies. We conclude that \"working with\" complexity is difficult in practice yet provides untapped potential to responsibly manage value conflicts.</p>","PeriodicalId":48437,"journal":{"name":"Qualitative Health Research","volume":" ","pages":"10497323251330999"},"PeriodicalIF":2.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988584","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}