SSM. Qualitative research in health最新文献

{"title":"Microbes and marginalisation: ‘Facing’ antimicrobial resistance in bedridden patients in a peri-urban area of Thailand","authors":"Phakha Whanpuch ,&nbsp;Anna Perris ,&nbsp;Panoopat Poompruek ,&nbsp;Clare I.R. Chandler ,&nbsp;Luechai Sri-ngernyuang","doi":"10.1016/j.ssmqr.2024.100489","DOIUrl":"10.1016/j.ssmqr.2024.100489","url":null,"abstract":"<div><div>Reducing human-microbial encounters through improved infection prevention and control (IPC) is widely acknowledged to be critical for reducing the emergence, transmission and burden of antimicrobial resistance (AMR). However, despite its centrality in the Global Action Plan (GAP) on AMR and adoption as a goal in National Action Plans around the world, there has been limited progress on reducing the incidence of antimicrobial resistant infections globally. In this paper, we argue that closer attention to different faces of AMR could propel progress in this area, with a focus on bedridden people situated in liminal spaces in the Thai health system and suburban economy. Our ethnographic fieldwork followed the cases of 16 bedridden people through the eyes of their carers and medical staff. We 'descended into the ordinary' to encounter individuals living - and dying - in the shadows of the labour-intensive suburbs of Bangkok. Here, AMR and IPC protocols are operationalised in the context of competing priorities and pragmatic decision-making. Focussing on three ethnographic vignettes, we use the analytic frames of precarity and care to consider how particular (bedridden) bodies are differentially exposed to AMR infections in the context of economic, social, and political arrangements that structure embodied vulnerabilities and forms and foci of care. Whilst the political work of calculating the burden of AMR may be oriented around galvanising support through a sense of magnitude and generalised risk, this research serves as a reminder that the faces of AMR include those who disproportionately shoulder the global burden of AMR, making it at once exceptional and ordinary.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100489"},"PeriodicalIF":1.8,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“I get the referral because nobody else wants to work with this person”: A critical realist analysis of social workers providing care to people living with borderline personality disorder","authors":"Aman Ahluwalia-Cameron,&nbsp;Adrian Guta,&nbsp;Elizabeth Donnelly","doi":"10.1016/j.ssmqr.2024.100488","DOIUrl":"10.1016/j.ssmqr.2024.100488","url":null,"abstract":"<div><div>Borderline personality disorder (BPD) is a mental health condition characterized by unstable relationships, self-image, and emotions, as well as impulsive behaviors and high rates of morbidity and mortality. Provider-based stigmatization of individuals with BPD is associated with poor health outcomes and increased mortality risk. However, little is known about social workers' experiences in providing care to people living with BPD (PLBPD). This study explored social workers' perspectives on the impact of stigma on care for PLBPD. Between April 2020 and January 2021, qualitative semi-structured interviews were conducted with 41 social workers practicing across the continuum of care (e.g., community services and hospitals) in Ontario, Canada. Data were analyzed using Critical Realist Analysis. Four primary themes emerged: (1) stigmatization of PLBPD due to the complexity of their needs (e.g., avoidance, blame, name-calling by providers); (2) lack of BPD-specific training and education in social work curricula; (3) observed stigmatization of PLBPD by social workers and other professionals (e.g., psychologists and physicians); and (4) suggestions for improving care experiences for PLBPD. Results suggest that provider-based stigma remains a significant quality of care issue affecting PLBPD. Further research is needed to understand the scope of these issues among diverse PLBPD populations, within social work practice, and across interprofessional care settings.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100488"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding parenting responsibilities as a challenge to mental healthcare access for mothers with a mental illness in Tyrol, Austria","authors":"Monika Schamschula ,&nbsp;Annette Bauer ,&nbsp;Jean Lillian Paul","doi":"10.1016/j.ssmqr.2024.100490","DOIUrl":"10.1016/j.ssmqr.2024.100490","url":null,"abstract":"<div><div>It is estimated that one out of three individuals will experience a mental illness at some point in their lives. Parenting with a mental illness can be particularly challenging and often requires additional support and resources to navigate through it. One of the challenges is accessing mental healthcare while also having parenting responsibilities. This study aims to explore how mothers with a mental illness in Tyrol, Austria, experience the impact of their parenting responsibilities in terms of accessing mental healthcare, and which processes contribute to such challenges. We draw from 20 semi-narrative interviews with mothers with a mental illness which were conducted in the context of a larger research project, focusing on developing and evaluating support for families with a parent with a mental illness. We identified three main findings affecting access to mental healthcare services: (1) organisational issues with mental healthcare services, (2) socio-cultural norms around family and care work, and (3) identity-related expectation of being a ‘good mother’ who is always there for her children. The concern for the children's wellbeing was also closely linked to these aspects. It is important, however, to consider the ways in which these findings are interwoven, and that social support could mitigate challenges. The findings of this study contribute to understanding childcare responsibility as a significant challenge to accessing mental healthcare for mothers with a mental illness and recognising it as a structural, socio-cultural, and identity-related phenomenon.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100490"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring parent treatment decision-making in relapsed and refractory neuroblastoma: A qualitative study","authors":"Helen Pearson ,&nbsp;Faith Gibson ,&nbsp;Michelle Myall ,&nbsp;Anne-Sophie Darlington","doi":"10.1016/j.ssmqr.2024.100487","DOIUrl":"10.1016/j.ssmqr.2024.100487","url":null,"abstract":"<div><div>Parents often become involved in making treatment decisions for their child with cancer when there is no standard treatment protocol, typically seen in poor-prognosis cancers. Advances in scientific medicine has led to more treatment options being available for children resulting in parents making repeated treatment decisions depending on their child's response to treatment. The emotional turmoil of their child's cancer diagnosis can be exacerbated when combined with making decisions that have uncertain outcomes. This study aimed to identify, describe, explore, and explain how parents made repeated treatment decisions and the role of emotion in decision-making when their child had relapsed or refractory neuroblastoma, a poor-prognosis cancer.</div><div>Data were collected using qualitative interviews between 2020 and 2022 with parents of children with relapsed or refractory neuroblastoma in the United Kingdom. Data were analysed using Reflexive Thematic Analysis.</div><div>Eighteen parents who made between one to six treatment decisions participated. Decision-making incorporated four themes which enabled, influenced, and informed how parents made treatment decisions: 1) time as a structure within decision-making; 2) uncertainty and its relationships with treatment risk, side effects and outcomes; 3) parent oscillation of their cognitive and emotional adjustment; 4) parent responsibility and involvement in decision-making. Time was the central organising concept which structured and organised parent decision-making. We adopted Orlikowski and Yates’s (2002) temporal structures to characterise the experience of time and Stroebe and Schut’s (1999) dual-processing theory to explore the oscillation of parent adjustment of their situation cognitively and emotionally. A conceptual framework showed the interrelationships of these themes.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100487"},"PeriodicalIF":1.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Institutional and systemic barriers and facilitators affecting healthcare access for Black women in Alberta","authors":"Mary Olukotun ,&nbsp;Adedoyin Olanlesi-Aliu ,&nbsp;Yawa Idi ,&nbsp;Tehseen Ladha ,&nbsp;Paul Bailey ,&nbsp;Regine King ,&nbsp;Bukola Salami","doi":"10.1016/j.ssmqr.2024.100485","DOIUrl":"10.1016/j.ssmqr.2024.100485","url":null,"abstract":"<div><div>Canada's Black population has experienced significant growth in recent years, with substantial increases noted in the prairie provinces. As Black people continue to make up a growing proportion of the population, it is important to understand their experiences in accessing healthcare services, especially for those who are multiply marginalized. We undertook a qualitative study to examine the healthcare access experiences of Black women in Canada. We completed semi-structured interviews with a sample of 30 Black women from Alberta. Our study was guided by intersectionality to examine how Black women's experience of healthcare access is shaped by social processes related to their socio-demographic characteristics such as being Black, a woman, an immigrant or non-immigrant, and having high or low income. From our thematic analysis we identified three key factors that hinders healthcare access for Black women: socioeconomic barriers, health systems issues, and racism. We identified two types of facilitators: community and institutional facilitators and structural facilitators. Our findings elucidate how Black women's experiences of accessing and utilizing health services in Alberta are influenced by overlapping institutional, structural, and systemic factors.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100485"},"PeriodicalIF":1.8,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Older, gay men's navigation of mental health and substance use challenges: A qualitative exploration","authors":"Ingrid Handlovsky ,&nbsp;Tessa Wonsiak ,&nbsp;Bernadette Zakher ,&nbsp;Olivier Ferlatte ,&nbsp;Hannah Kia ,&nbsp;John L. Oliffe","doi":"10.1016/j.ssmqr.2024.100484","DOIUrl":"10.1016/j.ssmqr.2024.100484","url":null,"abstract":"","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100484"},"PeriodicalIF":1.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667321524000933/pdfft?md5=c2558e0fbfad17b2a71d2ee222e5a8dc&pid=1-s2.0-S2667321524000933-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“It seemed like she just wanted me to suffer”: Acts of obstetric racism and birthing rights violations against Black women","authors":"Dorian S. Odems ,&nbsp;Erica Czaja ,&nbsp;Saraswathi Vedam ,&nbsp;Na’Tasha Evans ,&nbsp;Barbara Saltzman ,&nbsp;Karen A. Scott","doi":"10.1016/j.ssmqr.2024.100479","DOIUrl":"10.1016/j.ssmqr.2024.100479","url":null,"abstract":"<div><h3>Introduction</h3><p>Studies that examine obstetric violence and mistreatment during perinatal care demonstrate that Black women experience higher levels of harm and abuse than other racialized groups. Yet these gender-based concepts do not fully recognize the intersectional gender-and race-based harms that Black women experience within the context of quality, safety, and human rights violations in the U.S. healthcare system.</p></div><div><h3>Methods</h3><p>We performed qualitative secondary analysis from Black women participants in the Giving Voice to Mothers (GVtM) study (n = 304). Primary data collection for the GVtM survey spanned from 2016 to 2017, and our analysis occurred in 2023, focusing on the interpretation of open-ended responses to three categories of inquiry: worst experiences with perinatal care, experiences of being pressured to undergo medical interventions, and desired revisions to birthing experiences. We employed a deductive approach and applied two analytic frameworks – obstetric racism and the Black Birthing Bill of Rights (BBBR)– to categorize Black women's narratives of harm during perinatal care as quality, safety, and human rights violations.</p></div><div><h3>Results</h3><p>Black women described perinatal care experiences with considerable violations of the BBBR, including disrupted time with babies, racially discordant care, and unaffordable care. These experiences illustrated all six domains of obstetric racism.</p></div><div><h3>Conclusion</h3><p>This study contributes to an emerging body of Black feminist approaches to knowledge production in obstetric patient safety, emphasizing the critical intersection of gender and race. Furthermore, this study underscores the value of using Black-women-defined frameworks with typologies to interpret the distinct experiences of Black women instead of the more limited gender-based concepts of obstetric violence, mistreatment, and respectful maternity care that lack historical context and contemporary implications of anti-Black racism and misogynoir.</p></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100479"},"PeriodicalIF":1.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266732152400088X/pdfft?md5=8f8f28cf9adae780fdd94d1164ad705a&pid=1-s2.0-S266732152400088X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Mammograms are kind of my pacifier”: The cultural context of women's preference for annual mammograms in a risk-based screening cohort","authors":"Katherine Leggat-Barr,&nbsp;Galen Joseph,&nbsp;Leslie Riddle,&nbsp;Mikaella Caruncho,&nbsp;Barbara Koenig,&nbsp;Jennifer James","doi":"10.1016/j.ssmqr.2024.100476","DOIUrl":"10.1016/j.ssmqr.2024.100476","url":null,"abstract":"<div><div>Population genetic testing and risk-based screening have the potential to shift how we determine risk and screen for breast cancer. While much attention has been paid to the experiences of individuals who may be at elevated risk for breast cancer, less is known about how those at average risk make decisions about their health. Through qualitative interviews with 30 participants, we explore how those enrolled in a risk-based screening trial who are determined to be at average risk for breast cancer make screening decisions. We consider how the social context of breast health, known as ‘pink ribbon culture,’ and the pervasiveness of annual mammography as the standard of care make risk-based screening less acceptable for many participants. Risk-based screening paradigms assume that individuals will assess their risk quantitatively based on the risk models that are used. Yet, our findings demonstrate that social and cultural factors influence decision-making surrounding breast cancer screening, an important consideration when implementing risk-based screening programs. We will begin to address a gap in knowledge about how women who are told they are average risk after risk-based screening (most of the population) and recommended to screen less than annually make screening decisions.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100476"},"PeriodicalIF":1.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sources of moral distress among obstetrician-gynecologists after Dobbs: A qualitative, multi-state study","authors":"Mara Buchbinder ,&nbsp;Kavita S. Arora ,&nbsp;Samantha M. McKetchnie ,&nbsp;Erika L. Sabbath","doi":"10.1016/j.ssmqr.2024.100483","DOIUrl":"10.1016/j.ssmqr.2024.100483","url":null,"abstract":"<div><p>Since the US Supreme Court's 2022 decision in <em>Dobbs v Jackson Women's Health Organization,</em> 18 states have enacted functional bans on abortion, yet little is known about how these laws contribute to workplace stress and its sequelae among clinicians. The purpose of this study was to characterize sources of moral distress—which occurs when a clinician knows the right course of clinical action but is barred from taking that action by external constraints—among obstetrician-gynecologists (OB-GYNs) in states with abortion bans. We conducted qualitative, semi-structured interviews with 54 OB-GYNs practicing in 13 of 14 states where abortion was illegal as of March 2023. Using a qualitative descriptive coding approach, we identified four types of clinical situations leading to moral distress: delaying treatment for patients with obstetric complications, conflict with other clinicians, denying care they would have provided locally prior to <em>Dobbs</em>, and restrictions on clinical counseling. These situations provoked feelings of anger, frustration, helplessness, and emotional exhaustion. Participants attributed moral distress to the cumulative toll of routinely being unable to provide evidence-based healthcare, in addition to the acute burden of managing obstetric emergencies in legal gray areas, which was relatively rarer. The findings demonstrate a previously unreported source of moral distress: the everyday chipping away of professional integrity that occurs when OB-GYNs cannot care for patients in the way that patients need. Next steps include developing institutional-level policies and programs to support clinicians and enable them to practice ethical medicine in abortion-restrictive policy environments.</p></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100483"},"PeriodicalIF":1.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667321524000921/pdfft?md5=a52a63ad13eba50c1a68478cd7e52f21&pid=1-s2.0-S2667321524000921-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘ … You become a prisoner of your life’: A qualitative study exploring the experience of joint pain and accessing care in Hai, Tanzania","authors":"Emma Laurie ,&nbsp;Elizabeth F. Msoka ,&nbsp;Sally Wyke ,&nbsp;Nateiya M. Yongolo ,&nbsp;Christopher Bunn ,&nbsp;Perry Msoka ,&nbsp;Emma McIntosh ,&nbsp;Blandina T. Mmbaga","doi":"10.1016/j.ssmqr.2024.100481","DOIUrl":"10.1016/j.ssmqr.2024.100481","url":null,"abstract":"<div><p>The increased prevalence of non-communicable diseases (NCDs) in recent years has led many Low- and Middle-Income Countries (LMICs), including Tanzania, to develop policies to manage their burden. Musculoskeletal (MSK) conditions, such as arthritis, account for 20% of all years lived with disability in LMICs, but the NCD strategies rarely address them. There is substantial research on the disruption MSK conditions cause to people's lives within High-Income Countries, but very little is known about the lived experiences in LMICs. We investigated the experience of MSK conditions in 48 in-depth qualitative interviews with participants from the Hai District in Tanzania, East Africa, all of whom had a MSK disorder (confirmed through clinical examination as part of a broader study). We found that loss of mobility and pain associated with MSK disorders severely limits people's everyday lives and livelihoods. Help from others, mainly those within a household, is necessary for most tasks and those with limited or no support experience particular problems. We found barriers to accessing care and treatment in the form of high direct and indirect (through travel) care costs within formal health services in Tanzania. We argue for increased attention to the growing problem of MSK disorders in LMICs and that this agenda should be driven by a patient-centred approach which designs services accessible to the target population and designed to recognise their embodied expertise.</p></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"6 ","pages":"Article 100481"},"PeriodicalIF":1.8,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667321524000908/pdfft?md5=ff42337ea0fdf64bde5c93b0f570dc5b&pid=1-s2.0-S2667321524000908-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}