SSM. Qualitative research in health最新文献_第2页

The sociocultural ecology of resilience: A comparative study among women in the United Kingdom 心理弹性的社会文化生态学：英国女性的比较研究

IF 1.8

SSM. Qualitative research in health Pub Date : 2025-06-27 DOI: 10.1016/j.ssmqr.2025.100597

Caitlyn D. Placek , Lora Adair , Julieta Baker , Susan Robson

{"title":"The sociocultural ecology of resilience: A comparative study among women in the United Kingdom","authors":"Caitlyn D. Placek , Lora Adair , Julieta Baker , Susan Robson","doi":"10.1016/j.ssmqr.2025.100597","DOIUrl":"10.1016/j.ssmqr.2025.100597","url":null,"abstract":"<div><div>Resilience is often framed as an internal, individual process. However, this perspective overlooks the complex relationship between individuals and their social and ecological contexts. Drawing on insights from evolutionary anthropology, psychology, and public health, this paper explores how women who use drugs from two regions in the United Kingdom perceive resilience and navigate intricate sociocultural environments of recovery. It also considers factors that promote resilience and those that can cause harm. This study was conducted in two regions of England: Northeast England (n = 14), including Newcastle upon Tyne and Durham, and Greater London (n = 10). Participants, who were actively engaged in recovery services, participated in one-on-one in-depth interviews that included questions about their perceptions of and direct experiences with substance use and recovery. They were also asked to share their journeys into addiction and subsequent recovery while reflecting on the barriers and facilitators to recovery for women in their community. Our findings support a growing body of research that emphasizes recovery as a relational process. Women in Northeast England and London relied on social networks, particularly through peer meetings, to navigate their recovery. Additionally, key themes included the impact of community and institutional harm, particularly in promoting isolation and emotional distress. This study highlights the significance of social learning and relational resilience in addiction recovery, framed within a sociocultural-ecological model. These findings underscore that recovery is not solely an individual process but one deeply embedded in broader sociocultural and relational dynamics.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100597"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reterritorialising paediatric care in general practice clinics through a GP-paediatrician integrated care model 通过全科医生-儿科医生综合护理模式，在全科诊所重新定位儿科护理

IF 1.8

SSM. Qualitative research in health Pub Date : 2025-06-27 DOI: 10.1016/j.ssmqr.2025.100595

Michael Hodgins , Jenny Sohn , Carmen Crespo-Gonzalez , Tamara Morris , Yvonne Zurynski , Sonia Khano , Lena Sanci , Teng Liaw , Gary Freed , Brendan Goodger , Harriet Hiscock , Raghu Lingam

{"title":"Reterritorialising paediatric care in general practice clinics through a GP-paediatrician integrated care model","authors":"Michael Hodgins , Jenny Sohn , Carmen Crespo-Gonzalez , Tamara Morris , Yvonne Zurynski , Sonia Khano , Lena Sanci , Teng Liaw , Gary Freed , Brendan Goodger , Harriet Hiscock , Raghu Lingam","doi":"10.1016/j.ssmqr.2025.100595","DOIUrl":"10.1016/j.ssmqr.2025.100595","url":null,"abstract":"<div><div>Evidence is building exploring the efficacy of general practitioner (GP)-paediatrician integrated care models in improving the quality of paediatric primary care and reducing GP referrals to outpatient clinics and emergency departments. However, contemporary research has not adequately explored the mechanisms of change within these models to best support their sustainability and scalability. Our analysis involved interviews and focus groups with four paediatricians and 82 GPs across 21 general practices that were enrolled in a trial of a GP-paediatrician integrated care model, Strengthening Care for Children (SC4C). Using Deleuze and Guattari's ontological framing of assemblage deterritorialisation and reterritorialisation, we explored how the SC4C model reterritorialised GPs' scope of practice. We framed our reading of GP-paediatrician roles and responsibilities using material forms of content and immaterial forms of expression to identify how the SC4C model disrupted historical relationships and hierarchies between general practice and paediatric domain of practice. Our analysis revealed that the boundaries of GP-led paediatric assemblages of care were often dictated by system constraints within existing GP models, including limited funding and time available for GPs to deliver comprehensive paediatric care.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100595"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The sociality of walking: A post-phenomenological study on everyday walking among parents in Québec 行走的社会性：曲海地区父母日常行走的后现象学研究

IF 1.8

SSM. Qualitative research in health Pub Date : 2025-06-27 DOI: 10.1016/j.ssmqr.2025.100600

Julie Karmann , Sylvie Miaux , Troy Glover , Meghan Winters , Yan Kestens

{"title":"The sociality of walking: A post-phenomenological study on everyday walking among parents in Québec","authors":"Julie Karmann , Sylvie Miaux , Troy Glover , Meghan Winters , Yan Kestens","doi":"10.1016/j.ssmqr.2025.100600","DOIUrl":"10.1016/j.ssmqr.2025.100600","url":null,"abstract":"<div><div>The lack of sociality – or social relationships – has consequences for health, especially for parents for whom raising a child takes a village. Walking has long been credited with promoting sociality. Yet the link between sociality and walking has received insufficient attention. To understand how walking supports sociality among parents in a Quebec context, we conducted a post-phenomenological study focusing on everyday walking. The experience of walking was explored through go-along interviews and follow up interviews with 26 parents. The thematic analysis illuminated that walking fostered sociality via three interrelated processes. Firstly, walking weaved people together via the spatial permeations it promoted and associated relations of familiarities, commonalities and mnemotics. Secondly, walking led participants to relate to their community through encounters, facilitating the emergence of sociality in the form of recognition, alienation, resonance and dissonance. Lastly, walking enabled communions through the social spaces created by the movement such as villages or bubbles. This study illustrates the unique contribution of walking to an underappreciated aspect of health: the social aspect. This work ultimately opens the door to the implementation of mundane interventions that target social heath.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100600"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144516928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

‘You don’t need schooling—just take the pills and don’t stop.’: Pathways between formal education and chronic HIV care in Malawi “你不需要上学——只要吃药，不要停。：马拉维正规教育与慢性艾滋病毒护理之间的途径

IF 1.8

SSM. Qualitative research in health Pub Date : 2025-06-27 DOI: 10.1016/j.ssmqr.2025.100599

Stephanie Chamberlin , Misheck Mphande , Pericles Kalande , Khumbo Phiri , Kathryn Dovel

{"title":"‘You don’t need schooling—just take the pills and don’t stop.’: Pathways between formal education and chronic HIV care in Malawi","authors":"Stephanie Chamberlin , Misheck Mphande , Pericles Kalande , Khumbo Phiri , Kathryn Dovel","doi":"10.1016/j.ssmqr.2025.100599","DOIUrl":"10.1016/j.ssmqr.2025.100599","url":null,"abstract":"<div><div>Research on chronic care management from other settings indicates that people’s formal education (e.g., primary, secondary, and tertiary schooling) may confer important cognitive skills and material resources to help them manage their chronic HIV care and treatment. However, recent population-level findings from southern and eastern Africa suggest no statistical relationship between education and chronic HIV care. To gain additional insight into these puzzling findings, we draw on in-depth interviews with HIV care clients in Malawi to understand how people acquire education-related resources and how they use such resources to support their HIV care. These interviews suggest that education-related cognitive and material resources are central to HIV care management, but such resources are not necessarily gained through formal schooling. Importantly, HIV clients use a variety of strategies to overcome their limited skills and resources, often relying on the literacy and material resources of their family and community to facilitate their HIV care. Taken together, these findings provide new insight into the mechanisms that link or attenuate education-health relationships in different contexts globally. Further, this work informs the development of more equitable chronic care interventions for meeting the needs of people across different education levels.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100599"},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

“Should I continue with this profession or not?”: moral distress during the COVID-19 pandemic among Swiss healthcare workers “我是否应该继续这个职业？”： 2019冠状病毒病大流行期间瑞士医护人员的道德困境

IF 1.8

SSM. Qualitative research in health Pub Date : 2025-06-20 DOI: 10.1016/j.ssmqr.2025.100590

Elisabeth Stock , Andrea Martani , Olga Vinogradova , Fabienne Moser , Bernice S. Elger , Tenzin Wangmo

{"title":"“Should I continue with this profession or not?”: moral distress during the COVID-19 pandemic among Swiss healthcare workers","authors":"Elisabeth Stock , Andrea Martani , Olga Vinogradova , Fabienne Moser , Bernice S. Elger , Tenzin Wangmo","doi":"10.1016/j.ssmqr.2025.100590","DOIUrl":"10.1016/j.ssmqr.2025.100590","url":null,"abstract":"<div><div>The COVID-19 pandemic led to an extraordinary situation of resource scarcity and pushed healthcare to its limits. Consequently, healthcare professionals (HCPs) faced moral and ethical challenges that served as potential triggers for moral distress. The purpose of this study was to identify moral distress experiences of HCPs during the COVID-19 pandemic. We conducted 30 semi-structured interviews with HCPs working in the German part of Switzerland. We utilized thematic analysis to examine the data and oriented within the relativist/constructionist framework. We identified four themes: 1) The burden of moral distress explores examples of morally distressing situations; 2) Precipitating factors encompass the underlying conditions that contributed to moral distress; 3) Mitigating factors refer to the elements that helped reduce the intensity of moral distress or, in some cases, prevented it from arising altogether; 4) Coping strategies capture how participants actively managed or adapted to experiences of moral distress. Our findings relay that the level of experienced moral distress is linked to the nature of the work as it was more commonly experienced by those with greater direct contact with patients and residents. Frontline HCPs found team support interventions – such as availability of low-threshold supervision – to be especially helpful in coping with moral distress. Participants in leadership positions expressed that teamwork in decision-making alleviated their moral burdens. Our findings highlight the need to address moral distress through national policies and pandemic preparedness plans, to protect healthcare workers and ensure healthcare system resilience in future crises.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100590"},"PeriodicalIF":1.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Media exposure to maternal health trauma: A qualitative study on its effects on Black women's mental health 媒体接触对孕产妇健康创伤：对黑人妇女心理健康影响的定性研究

IF 1.8

SSM. Qualitative research in health Pub Date : 2025-06-20 DOI: 10.1016/j.ssmqr.2025.100592

Diane B. Francis , Nadia Kyeremeh , Nia F. Mason , Soroya Julian McFarlane , Kallia O. Wright

{"title":"Media exposure to maternal health trauma: A qualitative study on its effects on Black women's mental health","authors":"Diane B. Francis , Nadia Kyeremeh , Nia F. Mason , Soroya Julian McFarlane , Kallia O. Wright","doi":"10.1016/j.ssmqr.2025.100592","DOIUrl":"10.1016/j.ssmqr.2025.100592","url":null,"abstract":"<div><div>Black women experience disproportionately higher rates of death, illness, and mental health issues during and after pregnancy. The recent surge in avoidable maternal deaths in the U.S. has alarmed national and local media. Despite the media's responsibility to inform, its coverage of traumatic events may negatively affect mental health. This research examined if and how exposure to media narratives regarding maternal healthcare experiences affected the mental health of Black women. Between June and September 2020, we interviewed thirty Black women who had given birth within the prior 18 months. The data were analyzed using thematic analysis. The main themes were: 1) sources of and experiences with traumatic maternal health narratives, 2) the stressful effects of media, and 3) the media's role in fostering positive communication. We found that traumatic maternal health narratives in the media affect the mental health of Black women. However, such narratives also facilitated valuable discussions between the women, their partners, family, and healthcare providers. Thus, despite being a potential source of stress, media exposure can cultivate positive communication patterns.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100592"},"PeriodicalIF":1.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of stigma in impeding implementation of harm reduction services in San Francisco 耻辱感在阻碍旧金山实施减少伤害服务方面的作用

IF 1.8

SSM. Qualitative research in health Pub Date : 2025-06-20 DOI: 10.1016/j.ssmqr.2025.100593

Christopher F. Akiba , Cariné E. Megerian , Esther O. Chung , Terry Morris , Lynn D. Wenger , Leslie W. Suen , Barrot H. Lambdin , Alex H. Kral

{"title":"The role of stigma in impeding implementation of harm reduction services in San Francisco","authors":"Christopher F. Akiba , Cariné E. Megerian , Esther O. Chung , Terry Morris , Lynn D. Wenger , Leslie W. Suen , Barrot H. Lambdin , Alex H. Kral","doi":"10.1016/j.ssmqr.2025.100593","DOIUrl":"10.1016/j.ssmqr.2025.100593","url":null,"abstract":"<div><div>The United States continues to face an epidemic of drug overdose deaths among people who use drugs (PWUD). Harm reduction services are efficacious interventions that reduce overdose deaths and improve the health of PWUD. For decades, San Francisco has remained at the vanguard of the adoption, implementation, and sustainability of harm reduction programs. During a time of national urgency in 2023, we conducted a qualitative study interviewing leaders, managers, and frontline staff at 10 community-based organizations providing harm reduction services in San Francisco. We analyzed in-depth interview data using Reflexive Thematic Analysis. Participants described feeling that PWUD, providers of harm reduction services, and the services themselves became highly stigmatized at the political and community levels. Multi-level stigma was exacerbated by the city's social and economic conditions including extreme income inequality and gentrification, giving rise to public drug use and open-air drug markets. Multi-level stigma was upheld by a system of anti-harm reduction rhetoric and misinformation from public officials, leading to its politicization and insufficient funding for organizations providing harm reduction services. These barriers resulted in harm reduction worker self-censorship and staff trauma, burnout, and turnover, leading to program implementation challenges and ultimately harming organizations' abilities to improve the health of PWUD. Organizations mitigated barriers through mutual aid but only to a degree. Targeting stigma directly may help to address implementation challenges over the long term and lead to additional, sufficient, and sustained funding needed to ensure adequate and stable service provision.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100593"},"PeriodicalIF":1.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disentangling COVID-19 vaccine hesitancy: the role of social imaginaries of epidemics in northern Sierra Leone 解开COVID-19疫苗犹豫：塞拉利昂北部对流行病的社会想象的作用

IF 1.8

SSM. Qualitative research in health Pub Date : 2025-06-20 DOI: 10.1016/j.ssmqr.2025.100591

Yara Alonso , Abu Bakarr Jalloh , Kwabena Owusu-Kyei , Augustin E. Fombah , Clara Menéndez , Mohamed Samai , Cristina Enguita-Fernàndez

{"title":"Disentangling COVID-19 vaccine hesitancy: the role of social imaginaries of epidemics in northern Sierra Leone","authors":"Yara Alonso , Abu Bakarr Jalloh , Kwabena Owusu-Kyei , Augustin E. Fombah , Clara Menéndez , Mohamed Samai , Cristina Enguita-Fernàndez","doi":"10.1016/j.ssmqr.2025.100591","DOIUrl":"10.1016/j.ssmqr.2025.100591","url":null,"abstract":"<div><div>The WHO identified vaccine hesitancy as a threat to global health in 2019, but it was the COVID-19 pandemic that brought it to the fore of public discussions. Despite efforts to account for context in public health frameworks, these fail to translate into analyses that meaningfully capture the local dynamics forging vaccine hesitancy, while dominant public narratives continue to offer decontextualized and monolithic portrayals of this multifaceted phenomenon. Drawing on ethnographic insights from fieldwork conducted in northern Sierra Leone, we propose the notion of ‘social imaginaries of epidemics’ as a socio-historical lens through which to understand how people made sense of the COVID-19 pandemic and the ensuing response, thereby disentangling the shared meanings that enabled vaccine hesitancy in this setting. We do this by reconstructing three key narratives that shaped how COVID-19 was being socially imagined: epidemic memories, mistrust in the governance of epidemics, and diverging health priorities. The social imaginary of COVID-19 as a disease that was ‘deadly’, ‘harmless’, ‘invisible’ or ‘fake’ continuously shifted, yet always in dialogue with shared memories of the last Ebola epidemic. The social imaginary of the COVID-19 response was shaped by existing mistrust in the state's governance of epidemics, whereby the response was underfunded or weak as the result of the government ‘eating COVID money’ or pursuing electoral advantages. The immunisation response was socially imagined as responding to foreign instead of local priorities by disregarding food insecurity in favour of vaccines. Together, this social imaginary rendered COVID-19 vaccines useless, harmful or unimportant to many.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100591"},"PeriodicalIF":1.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The impact of collective trauma on mental health psychology practitioners' wellbeing: Insights gained from Covid-19 集体创伤对心理健康心理学从业者福祉的影响：从Covid-19中获得的见解

IF 1.8

SSM. Qualitative research in health Pub Date : 2025-06-19 DOI: 10.1016/j.ssmqr.2025.100585

Annita Ventouris , Agata Wezyk , Constantina Panourgia

{"title":"The impact of collective trauma on mental health psychology practitioners' wellbeing: Insights gained from Covid-19","authors":"Annita Ventouris , Agata Wezyk , Constantina Panourgia","doi":"10.1016/j.ssmqr.2025.100585","DOIUrl":"10.1016/j.ssmqr.2025.100585","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed at investigating how the pandemic, a collective trauma experience, affected the mental health and wellbeing of Mental Health Psychology Practitioners (MHPPs), along with the strategies employed to maintain positive wellbeing.</div></div><div><h3>Method</h3><div>An exploratory, qualitative research approach was taken, and semi-structured interview data was collected from nine MHPPs and analysed thematically.</div></div><div><h3>Results</h3><div>Three main themes were identified, consisting of two subthemes each, ranging from experiences of vicarious traumatisation, personal vs. professional identity issues, through to the strategies participants employ to maintain their wellbeing.</div></div><div><h3>Conclusion</h3><div>The need for training focusing on collectively traumatic experiences was highlighted by this study’s results. The development of targeted interventions and comprehensive training programmes are essential, including modules on self-care, resilience-building, and maintaining professional boundaries, as they can help this group of practitioners be less susceptible to occupational risks, resulting in better outcomes for both practitioners and their clients.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100585"},"PeriodicalIF":1.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Examining access to gender-affirming surgery: A community-based thematic analysis of structural and systemic barriers and supports 审查获得性别确认手术的机会：基于社区的结构性和系统性障碍和支持的专题分析

IF 1.8

SSM. Qualitative research in health Pub Date : 2025-06-18 DOI: 10.1016/j.ssmqr.2025.100589

Braveheart Gillani , Amine Sahmoud , Daniel Hamilton , Erika Kelley , Shubham Gupta , Gulnar Feerasta , Swagata Banik , Rachel Pope

{"title":"Examining access to gender-affirming surgery: A community-based thematic analysis of structural and systemic barriers and supports","authors":"Braveheart Gillani , Amine Sahmoud , Daniel Hamilton , Erika Kelley , Shubham Gupta , Gulnar Feerasta , Swagata Banik , Rachel Pope","doi":"10.1016/j.ssmqr.2025.100589","DOIUrl":"10.1016/j.ssmqr.2025.100589","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify and explore the barriers and facilitators to accessing gender-affirming surgery (GAS) for transgender and gender-diverse individuals (TGDI) using a community-based participatory research (CBPR) approach. This study aims to assess the impact of structural, social, and systemic factors on the accessibility of GAS and to highlight key facilitators that improve healthcare access and overall well-being for TGDI individuals.</div></div><div><h3>Methods</h3><div>Thematic analysis of focus groups was performed to identify barriers and facilitators experienced by the participants in accessing this care.</div></div><div><h3>Results</h3><div>35 TGDI (9 Trans Women, 8 Trans Men, 5 Non-binary individuals, and one person identifying as other) were <strong>included.</strong> The primary facilitators of GAS were community support, access to healthcare, and respectful and affirming care providers, while barriers were insurance difficulties, World Professional Association for Transgender Health (WPATH) criteria, medical gatekeeping, negative experiences with medical personnel, and lack of representation.</div></div><div><h3>Conclusion</h3><div>This study highlights how TGDI face compounded barriers to GAS, including the emotional burden of navigating insurance and WPATH criteria, gatekeeping, and identity erasure. Community networks—especially chosen families and peer knowledge-sharing—emerged as critical facilitators. Beyond increasing representation, findings point to the need for reforming eligibility pathways, provider training in trauma-informed care, and investment in community-based infrastructures that already support access.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100589"},"PeriodicalIF":1.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0