SSM. Qualitative research in health最新文献

{"title":"Understanding metabolic bariatric surgery stigma through the lived experiences of Dutch women","authors":"Franshelis K. Garcia ,&nbsp;Bob C. Mulder ,&nbsp;Annemarie M.A.E. Wagemakers ,&nbsp;Eric J. Hazebroek ,&nbsp;Kirsten T. Verkooijen","doi":"10.1016/j.ssmqr.2026.100699","DOIUrl":"10.1016/j.ssmqr.2026.100699","url":null,"abstract":"<div><div>Metabolic bariatric surgery (MBS) is an effective treatment for severe obesity, yet patients often face stigma related to both obesity and MBS, complicating their treatment experience. Despite its significance, MBS stigma remains under-theorized in research. This study applies a socio-ecological stigma framework to explore how MBS stigma is experienced by patients in the Netherlands.</div><div>Using qualitative methods, we conducted semi-structured interviews with 16 Dutch women undergoing MBS and employed reflexive thematic analysis to examine how stigma shapes their decision-making, disclosure practices, social relationships, and post-operative adjustment. Four core themes emerged: (1) The Decision-Making Journey, highlighting internal conflicts driven primarily by weight stigma and feelings of personal failure; (2) Disclosure and Reactions, which revealed that sharing MBS decisions often brought social support but also exposed participants to stigma from those outside their immediate circles; (3) Life After Surgery, capturing improvements in health and social engagement alongside ongoing struggles with body image and eating behaviors; and (4) Healthcare Support and Missed Opportunities, reflecting mixed experiences with healthcare professionals and a notable lack of psychological follow-up care.</div><div>Stigma emerged at multiple levels - internalized, interpersonal, and structural - affecting patients’ well-being and access to care. MBS stigma is a pervasive, embedded part of obesity treatment. Our findings emphasize the urgent need for stigma-informed, empathetic healthcare and sustained psychological support throughout patients’ treatment journey. Effectively addressing both weight- and MBS stigma requires change at the institutional level and addressing the moral judgments often tied to obesity treatment to improve patient care and outcomes.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100699"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924975","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}

{"title":"The impact of the strong black woman stereotype on young Black women's breast cancer perceptions","authors":"Brittany Davy ,&nbsp;Tara C. Marshall ,&nbsp;Anne-Marie Livingstone","doi":"10.1016/j.ssmqr.2025.100670","DOIUrl":"10.1016/j.ssmqr.2025.100670","url":null,"abstract":"<div><div>There are significant disparities in health behaviours between young Black women and their peers, highlighting the impact of racial and gender stereotypes such as the Strong Black Woman (SBW). This stereotype, developed during slavery and continuously redefined through societal and cultural shifts, attributes characteristics to Black women such as emotional strength and selflessness to justify their widespread maltreatment. While earlier research has examined the influence of the SBW stereotype on the physical and mental health of Black women, relatively few studies have examined the ways this stereotype specifically influences Black women's understanding and management of their breast cancer-related health behaviors. Using interpretative phenomenological analysis, this study explored young Black women's experiences with the SBW stereotype and its implications for health decisions. An analysis of in-depth interviews conducted with young Black women from Ontario, Canada identified several key themes: (1) The SBW stereotype minimizes sympathy and grace towards Black women and invalidates their concerns, which negatively impacts their health-related behaviour, (2) despite opposing the SBW stereotype, it still pushed them to be self-sacrificing and neglectful of their health, and (3) their multiple employment and educational responsibilities limited preventative health measures. We discuss how these results can inform culturally sensitive healthcare practices and policies, aiming to enhance the support provided to young Black women in managing their health effectively.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100670"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924980","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}

{"title":"The continuity of care paradox in paediatric primary care: understanding parental vaccine hesitancy","authors":"Zuzana Kotherová,&nbsp;Jaroslava Hasmanová Marhánková,&nbsp;Dino Numerato","doi":"10.1016/j.ssmqr.2026.100717","DOIUrl":"10.1016/j.ssmqr.2026.100717","url":null,"abstract":"<div><div>This article explores how continuity of care - understood as long-term relationships between parents and paediatric general practitioners (PGPs) shaped by healthcare system characteristics – affects parental vaccine hesitancy (VH).</div><div>Qualitative data from the Czech Republic were collected through interviews with PGPs (N = 15), nurses (N = 4) and parents (N = 30) who had intentionally delayed or refused at least one mandatory childhood vaccination. Moreover, 60 h of ethnographic observation were carried out in three paediatric practices in Prague. Thematic analysis identified patterns in how continuity of care influences vaccination decisions.</div><div>The study revealed four ways in which continuity of care can both mitigate and reinforce VH. First, continuity enables mutual selection strategies of PGPs and parents, creating homogenous practices that limit exposure to diverse perspectives. Second, it provides opportunities for communication, allowing open dialogue to develop or distrust to deepen over time. Third, continuity shapes how disagreement is negotiated within parent-PGP relationships, where trust can be strengthened and challenged by the vaccination agenda. Finally, system-level constraints, such as time pressure and limited capacity, reduce the potential of continuity to support informed decision-making.</div><div>While continuity of care is often assumed to foster trust and promote vaccine adherence, our findings highlight the paradoxical nature of continuity of care: the same continuity that supports cooperation can also entrench doubt, reduce flexibility, and limit PGPs’ ability to engage with hesitant families. The study underscores the need to address not only interpersonal communication but also the structural conditions within which continuity of care operates when tackling VH.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100717"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077369","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}

{"title":"Empowering people and communities? The power of stories in asset-based approaches to health inequalities","authors":"Simon J. Armour ,&nbsp;Gemma Yarwood ,&nbsp;Hugh McLaughlin ,&nbsp;Julia Robinson","doi":"10.1016/j.ssmqr.2026.100720","DOIUrl":"10.1016/j.ssmqr.2026.100720","url":null,"abstract":"<div><div>In response to the global impacts of the Covid-19 pandemic, many national governments have implemented ‘fiscal consolidation’ measures, invoking long-standing neoliberal discourses which advocate reduction in public services and state welfare support. Meanwhile, assets-based approaches to health, including voluntary welfare provision, have gained traction internationally, proposed as a means to reduce health inequalities by ‘empowering’ people and communities. Presenting evidence from an ethnographic psycho-social study of volunteer experiences within two voluntary organisations, working within disadvantaged communities in northern England, this paper interrogates the notion of community empowerment, examining how power dynamics emerge in everyday practices and discourses. We identify two different narratives within these settings: <em>redemption stories</em> and <em>collective victimhood</em>. While these may offer some psychological refuge from dominant discourses which blame and shame people experiencing poverty, they also serve to reinforce perceptions of individual responsibility, failure, and powerlessness.</div><div>We conclude that assets-based approaches can only fulfil their potential if they are resourced and delivered in ways that are sensitive and responsive to the reproduction of power relations within the organisational setting and in the wider contexts of people's lives. This requires critical attention to the underlying values and paradigms underpinning such interventions.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100720"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173462","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}

{"title":"U.S. men's views about women's and men's agency in the abortion decision-making process","authors":"Xiana Bueno ,&nbsp;Lucrecia Mena-Meléndez ,&nbsp;Brandon L. Crawford ,&nbsp;Ronna C. Turner ,&nbsp;Wen-Juo Lo ,&nbsp;Kristen N. Jozkowski","doi":"10.1016/j.ssmqr.2025.100673","DOIUrl":"10.1016/j.ssmqr.2025.100673","url":null,"abstract":"<div><div>Research examining men's public opinion on women's and men's roles in abortion is limited but increasingly important as access to abortion has shifted dramatically in the U.S. In this study, we examined U.S. men's views of women's and men's agency in abortion decision-making. We explored 72 in-depth interviews on abortion attitudes conducted with men in 2021 and identified three main narratives. First, most men indicated that abortion is exclusively a women's decision. Several men noted wanting men's opinions to at least be heard in the decision-making process, while still maintaining that women should be the decision-makers. We identified subtle nuances, including <em>paternalistic</em> and <em>sexist attitudes</em>. Second, several interviewees envisioned the abortion decision as a default joint non-confrontational decision couples make together while dismissing possible tensions that may arise from discrepant views. Third, some interviewees argued that both women and men should have equal agency, claiming there should be a greater role for men than currently exists and disregarding how reproduction inherently falls on women. As the abortion landscape continues to shift post-<em>Dobbs</em>, and the issue of abortion legality is brought directly to voters via ballot initiatives, it is most important to understand people's opinions regarding abortion.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100673"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737543","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}

{"title":"Bureaucratic violence: Professionals’ views of the financial experiences of terminally ill migrants","authors":"Tim Sedgley ,&nbsp;Joanne Alexander ,&nbsp;Laurence Lessard-Phillips ,&nbsp;Aisha Macgregor ,&nbsp;Liz Forbat","doi":"10.1016/j.ssmqr.2025.100680","DOIUrl":"10.1016/j.ssmqr.2025.100680","url":null,"abstract":"<div><h3>Background</h3><div>Having a terminal illness is associated with an increased risk of living in poverty and destitution at end of life. This is more pronounced for migrants who may not have the same social and cultural capital, or local family support, that established citizens have. This paper explores the financial challenges for migrants with a terminal illness.</div></div><div><h3>Methodology</h3><div>Qualitative interviews were conducted with healthcare staff, and legal and migration specialists supporting migrants with a terminal illness in the UK. A total of 22 people were interviewed, comprising 14 working within health/palliative care settings, four in legal/policy settings, and four in migrant support.</div></div><div><h3>Findings</h3><div>Thematic analysis identified that having a terminal illness as a migrant accompanies severe financial and material challenge. Migrants continued to work while receiving chemotherapy and used unregulated money lenders to stave off poverty. The expense of visa applications, insecure visa terms, and exclusion from statutory and healthcare support combined to produce enormous financial, emotional and physical strain on terminally ill migrants. Interviewees situated these challenges as both impediments to their work supporting migrants, and as constituting a form of bureaucratic violence.</div></div><div><h3>Conclusion</h3><div>Financial precarity for migrants with terminal illness was exacerbated by bureaucratic systems and processes (e.g., immigration policy and welfare exclusion). There is urgent need for systemic reform to ensure that good quality of living and dying is not a privilege of the financially secure. However, this is predicated on a political will and interest to improve the lives and deaths of migrants with terminal illness.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100680"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737544","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}

{"title":"“You're not necessarily pregnant”: Confusion about emergency contraception","authors":"Jennifer Mueller ,&nbsp;Alicia VandeVusse ,&nbsp;Laura D. Lindberg","doi":"10.1016/j.ssmqr.2025.100678","DOIUrl":"10.1016/j.ssmqr.2025.100678","url":null,"abstract":"<div><div>Misconceptions about what emergency contraception does are common and have resulted in policy efforts to restrict access. Understanding the beliefs and reasoning behind people's uncertainty and lack of knowledge about emergency contraception helps shed light on key misconceptions and how advocates, providers, and researchers can improve clarity. We conducted a secondary analysis using previously collected qualitative data from card sort and vignette activities focused on scenarios related to emergency contraception and if participants considered these scenarios abortions (N = 64). We identified three major themes related to participants' classification of emergency contraception: uncertainty and pregnancy liminality; timing and mechanism of action; and the role of intention and overlap with medication abortion. Our study demonstrates that people lack a consistent, coherent understanding of what emergency contraception does, which has implications for contraceptive access and service provision. Furthermore, these misconceptions can become politicized and undergird the rationale for restrictions on sexual and reproductive health care.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100678"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790730","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}

{"title":"Bridging work: Community health workers’ role as a continuum of building, guiding, sustaining and transforming the path to health equity","authors":"Melina Michelen ,&nbsp;John Billimek ,&nbsp;Salvador Zarate ,&nbsp;Patricia J. Cantero ,&nbsp;Noraima Chirinos ,&nbsp;Rocio Salazar ,&nbsp;Mary Anne Foo ,&nbsp;Samantha Peralta ,&nbsp;Gloria I. Montiel ,&nbsp;Brittany N. Morey ,&nbsp;Sora P. Tanjasiri ,&nbsp;Alana M.W. LeBrón","doi":"10.1016/j.ssmqr.2025.100693","DOIUrl":"10.1016/j.ssmqr.2025.100693","url":null,"abstract":"<div><div>Community Health Workers (CHW) are commonly conceptualized as a ‘bridge’ that connects the community to health-related systems and resources for which they have historically and contemporarily experienced systemic barriers to accessing. Nonetheless, the nuances of the bridge role remain underexamined. The bridge metaphor, by the static nature of a bridge, can overlook the dynamic and relational aspects of CHWs' work beyond simple liaison functions. This qualitative study shows CHWs' work goes beyond liaison roles, expanding on the bridge metaphor. We evaluated narratives from CHWs from Orange County, California and across California (n = 77), as well as Orange County institutional representatives and policy makers (n = 15) regarding CHWs roles as bridges through interviews and focus groups conducted between February 2023–January 2024. Interviews and focus group discussions were recorded, transcribed, and analyzed following a flexible coding approach. Participants provided nuanced details to expand on the CHW role as bridges, well beyond liaising or connecting. Their narratives illuminate the full arc of CHW bridging work, highlighted in three themes: 1) Building: involving working with the community to identify the need for a bridge and building responsive and adaptable bridges accessible to the community, 2) Guiding: encompasses accompanying and guiding the community to access and cross these bridges, and 3) Sustaining and transforming: comprising maintaining a responsive and accessible bridge while working to reduce the structural gaps necessitating such bridges. Such an understanding of CHW roles can provide insights into the efforts needed to sustain this workforce, critical to public health and community wellbeing.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100693"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924982","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}

{"title":"Rethinking participation and knowledge: Reflections on qualitative research in technology development for dementia care","authors":"Nora Weinberger","doi":"10.1016/j.ssmqr.2025.100664","DOIUrl":"10.1016/j.ssmqr.2025.100664","url":null,"abstract":"<div><div>The past two decades have seen an intensification of research and development in assistive technologies for people living with dementia. While many of these projects emphasize inclusion, participation often takes place under restrictive conditions: through structured evaluations, usability testing, or proxy-based design feedback. This paper argues that such frameworks limit what kinds of knowledge are recognized as valid and what forms of expression are rendered legible. Drawing on multi-site participatory research projects, the author reflects on moments in which inherited benchmarks of coherence, reliability, and evidence strain against the realities of the field. In these spaces of epistemic friction, where memory fragments, timelines collapse, silences carry meaning, names shift, or questions fail to land, what emerges is not less knowledge but knowledge of another kind. These claims are illustrated through four scenes of epistemic friction drawn from the author's fieldwork. The paper develops a methodology of shared presence: a research stance grounded in attunement and epistemic reciprocity, valuing responsiveness over analytic control and relation over extraction. By treating repetition, silence, ambiguity, and reframing as epistemic resources, this orientation contributes to the rethinking of qualitative inquiry in technology development for dementia care. It also addresses technology development more directly, arguing that when such forms of knowledge are ignored, the results are often technically sophisticated but socially unanchored unusable products. The article thus speaks to broader debates about voice, vulnerability, and epistemic responsibility in the context of health, care, and innovation.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100664"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737542","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}

{"title":"Migrants' and refugees’ experiences of healthcare access in Egypt: An exploratory qualitative study","authors":"Eman Elafef ,&nbsp;Hassan Edries ,&nbsp;Shaimaa Abdelrahman ,&nbsp;Wessam Elnahry ,&nbsp;Samir Hadjiabduli ,&nbsp;Adel Abdelkhalek ,&nbsp;Asad Adam ,&nbsp;Mahmoud Hilali ,&nbsp;Ahmed Hamed Arisha ,&nbsp;Ibrahim Bani ,&nbsp;Farah Seedat ,&nbsp;Sally Hargreaves ,&nbsp;Stella Evangelidou ,&nbsp;Ana Requena-Méndez ,&nbsp;MENA Migrant Health Working Group","doi":"10.1016/j.ssmqr.2025.100672","DOIUrl":"10.1016/j.ssmqr.2025.100672","url":null,"abstract":"<div><h3>Background</h3><div>In Egypt, migrants and refugees are formally entitled to access public healthcare services under the same conditions as Egyptian citizens. However, they continue to face barriers. This qualitative study explores migrants’ perceptions of healthcare access and service provision in Egypt.</div></div><div><h3>Method</h3><div>We conducted six focus group discussions with 23 migrant men and 25 women in vulnerable situations, grouped by sex and language, and 15 individual semi-structured interviews with ten migrant community leaders and six non-governmental organisation staff. Participants were recruited using purposive and snowball sampling at the International Organisation for Migration- Migration Health Assessment Centre. Data were analysed using a hybrid thematic approach, combining deductive coding from Levesque's framework with inductive emergent themes.</div></div><div><h3>Result</h3><div>Participants identified several social determinants that negatively affect their health, including insecurity, social isolation, limited employment opportunities, and poor working conditions. The participants reported complex health needs, including infectious diseases and non-communicable conditions. Key barriers to accessing healthcare included low health literacy, cultural and religious beliefs, limited awareness of the healthcare system, inadequate documentation, language barriers, health misconceptions and mistrust of public healthcare facilities. They encountered perceived poor service quality, financial limitations, and insufficient coordination among service providers. Additional obstacles included high transportation costs, geographic isolation, limited availability of medical services, and prolonged waiting times.</div></div><div><h3>Conclusion</h3><div>In Cairo's urban context, migrants and refugees in vulnerable situations often face barriers to accessing healthcare. Achieving health for all requires targeted policies that expand access to culturally competent healthcare services, empower migrant communities, and regularise migrants' legal status.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"9 ","pages":"Article 100672"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610369","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}