SSM. Qualitative research in health最新文献

{"title":"Dèyè mòn, gen mòn: Qualitative examination of drivers and facilitators of stigma as a barrier to sexual and maternal healthcare in Haiti","authors":"Jasmine Abrams ,&nbsp;Jaleah D. Rutledge ,&nbsp;Elizabeth Raskin ,&nbsp;Alexis Kiyanda ,&nbsp;Joanne Gaillard ,&nbsp;Morgan Maxwell ,&nbsp;Trace Kershaw","doi":"10.1016/j.ssmqr.2025.100556","DOIUrl":"10.1016/j.ssmqr.2025.100556","url":null,"abstract":"<div><div>Haitian women face heightened risk of contracting HIV and encounter challenges in accessing quality care due to sociocultural and economic barriers. Stigma compounds these challenges, especially for pregnant women living with HIV. Globally, HIV-related stigma is a recognized barrier to testing, treatment, and prevention, contributing to low testing rates and substandard treatment and care. This study examines sources and origins of stigma that impact pregnant women's access to and experience with sexual and maternal healthcare. Qualitative data was collected from 85 participants via focus groups with HIV-positive pregnant women (n = 26) and HIV-negative pregnant women (n = 35). We also conducted 24 interviews with maternal health care providers, HIV prevention specialists, and traditional healers. We used thematic analysis to identify key themes related to drivers and facilitators of stigma and its impact on access to healthcare among pregnant women in rural Haiti. Drivers of stigma were: 1) Lack of Knowledge, 2) Stereotypes, Prejudice, &amp; Blaming People Living with HIV (PLHIV), 3) Lack of Hospital Resources and Protocols. Facilitators of stigma were: 1) Underdeveloped Healthcare Infrastructure, 2) Classism, 3) Healthcare as a Commodity, 4) Hospital Policies and Practices, and 5) Patriarchal Society. Each of these facilitators uniquely influence HIV stigma experiences and practices. Our study identified complex multilevel drivers and facilitators of HIV and class related stigma and its impact on sexual and maternal healthcare access in Haiti, emphasizing the need for more comprehensive interventions that address psycho-socio-cultural determinants of health.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"7 ","pages":"Article 100556"},"PeriodicalIF":1.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865044","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":"Medicalizing aesthetics or beautifying illness? Exploring the absence of diagnosis and the centrality of patient autonomy in dermatology","authors":"Dana Alsaialy,&nbsp;Dino Numerato","doi":"10.1016/j.ssmqr.2025.100551","DOIUrl":"10.1016/j.ssmqr.2025.100551","url":null,"abstract":"<div><div>The <em>moment</em> of diagnosis is often regarded as a cornerstone of clinical practice and patienthood. It has mainly been viewed as preceding, and hence profoundly shaping, patients’ constructions of health and illness. However, amidst a rise in patient autonomy, the significance of a diagnosis as the starting point for care and patient identity is diminishing. This shift is particularly evident in dermatology due to its visual nature, the prevalence of alternative experts (e.g., cosmetologists, skincare gurus), and the intersection between its biomedical and cosmetic features. Against this backdrop, our study aims to reconsider the position of diagnosis in the dermatological context by raising the following questions: how is a dermatological condition socially constructed and therapeutically approached by patients, and what role does a diagnosis play? To address these questions, we thematically analyzed in-depth interviews with a heterogeneous sample of culturally diverse subjects diagnosed with seven distinct skin and hair conditions. Our findings reveal that the diagnostic <em>moment</em> is often absent in dermatological settings; instead, multiple agencies contribute to a dermatological diagnosis, with patients, rather than physicians, as the central agency. We situate our results within the broader context of increasing patient autonomy and lay expertise, noting that while the pursuit of “optimal” well-being is justified in the name of health, some skin and hair diseases are minimized, beautified, or embraced in the form of skin positivity.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"7 ","pages":"Article 100551"},"PeriodicalIF":1.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865155","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":"Pharmacists' role, beliefs and attitudes to contraception in West Africa","authors":"Rokhaya Cissé ,&nbsp;Ndèye Sokhna Cissé ,&nbsp;Rhiana Mills ,&nbsp;Paula Baraitser","doi":"10.1016/j.ssmqr.2025.100554","DOIUrl":"10.1016/j.ssmqr.2025.100554","url":null,"abstract":"","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100554"},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189491","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":"“Kind of backed into this corner:” exploring gendered interpretations and responses to violence in long-term residential care","authors":"Kirsten J. Brooks ,&nbsp;Rachel V. Herron ,&nbsp;Dale Spencer ,&nbsp;Sheila Novek ,&nbsp;Laura M. Funk ,&nbsp;Katie Aubrecht ,&nbsp;Christine Kelly ,&nbsp;Douglas A. Brownridge ,&nbsp;Lori E. Weeks","doi":"10.1016/j.ssmqr.2025.100555","DOIUrl":"10.1016/j.ssmqr.2025.100555","url":null,"abstract":"<div><div>Violence in long-term residential care (LTRC) is primarily directed at women who make up a disproportionate share of residents and staff, yet gender has been relatively understudied and undertheorized in research on violence in this setting. In this paper we draw together the concept of gender structure and Pierre Bourdieu's concepts of habitus and field to explore staff perspectives on violent situations and learn about gendered power dynamics in LTRC. Our analysis of interviews with 29 staff in two Canadian provinces explored how gender infused the ways in which staff interpreted, experienced, and responded to violence in LTRC. Gendered perceptions and assumptions manifested in how participants spoke of orienting to the importance of body size, strength, speed, and perceived capability when anticipating who might perpetrate violence. Likewise, gender and gendered bodily characteristics also appeared to shape work roles (e.g., who was expected to provide ‘back-up’ in violent situations). Staff accounts also provided insight into how past experiences of gender-based violence and gendered power dynamics outside of LTRC shaped violent situations and power dynamics inside LTRC. Lastly, in response to violent situations, staff routinely minimized, downplayed, and trivialized violence to cope with their positions within these situations, illuminating a gendered duty to care. Our findings advance understandings of gendered interpretations and strategies employed in response to violence in LTRC, raising questions about the consequences for both residents and staff.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"7 ","pages":"Article 100555"},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800102","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":"Acceptance and implementation of evidence-based practices in delivery room resuscitation: A qualitative study","authors":"Cecelia L. Corson ,&nbsp;Ingrid M. Nembhard ,&nbsp;Christopher P. Bonafide ,&nbsp;Elizabeth E. Foglia ,&nbsp;Henry C. Lee ,&nbsp;Sara C. Handley","doi":"10.1016/j.ssmqr.2025.100557","DOIUrl":"10.1016/j.ssmqr.2025.100557","url":null,"abstract":"<div><h3>Background</h3><div>Variation persists in the implementation of evidence-based practices (EBPs) for delivery room resuscitation associated with high-quality care. To date, research has often studied leaders and rarely focused on the perspectives of delivery room resuscitation team members. We investigated team member perspectives on facilitators and barriers to accepting and implementing EBPs in delivery room resuscitation.</div></div><div><h3>Methods</h3><div>This is a qualitative analysis of responses to open-ended questions in a twice-administered survey of delivery room resuscitation team members from a 16-hospital network. We conducted a two-phase content analysis, I) inductive conventional content analysis and II) deductive directed content analysis, to map response themes onto the three elements of the Promoting Action on Research Implementation in Health Services (PARIHS) framework – evidence, facilitation, and context.</div></div><div><h3>Results</h3><div>There were 569 responses from 322 individuals representing all delivery room resuscitation team member roles. We identified five main themes that influence acceptance and implementation of EBPs: evidence, education, process characteristics, leadership, and change mindset. These themes aligned with the PARIHS framework elements of Evidence, Facilitation (occurring through education and process characteristics), and Context (determined by leadership and change mindset). We identified 12 sub-themes; 9 applied to both acceptance and implementation of EBPs, 1 applied only to acceptance of EBPs, and 2 applied only to implementation of EBPs.</div></div><div><h3>Conclusions</h3><div>While many facilitators and barriers are consistent for both acceptance and implementation, some differ. To optimize EBPs in delivery room resuscitation, organizations may benefit from tailoring interventions to incorporate facilitators and address barriers that influence EBP acceptance and/or implementation.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"7 ","pages":"Article 100557"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783986","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 don't know if I'm a dad, I don't know if I'm a mom, I think I'm both”: Gender identity, parenting desires, and pregnancy among transgender, nonbinary, and gender expansive adults","authors":"Kaleb Masterson ,&nbsp;Alison H. Norris ,&nbsp;Marta Bornstein","doi":"10.1016/j.ssmqr.2025.100552","DOIUrl":"10.1016/j.ssmqr.2025.100552","url":null,"abstract":"<div><div>Many transgender and gender expansive (trans∗) people assigned female at birth retain the capacity for pregnancy and want to become parents, through pregnancy or otherwise. We explored the role of gender in parenting and pregnancy desires among gender minorities theoretically capable of pregnancy. We conducted in-depth, open-ended interviews with 12 trans∗ adults (18–35 years) from July–August 2023 in the US. Interviews focused on gender identity, parenting, and pregnancy decisions. We recorded, transcribed, and analyzed interviews using a combination of thematic and inductive methods. Two related themes emerged: (1) the relationship between gender identity development and parenting and pregnancy desires, and (2) how the gendered nature of pregnancy and obstetric care shaped feelings about pregnancy. Participants had complex feelings about parenting, and some realized they wanted to become a parent only after more fully understanding their gender. Others felt becoming a parent would help them better understand their gender identity. Participants were keenly aware of the gendered nature of parenting and pregnancy, and how their experiences and presentation conflicted with social and gender norms. Gender identity was salient in how participants experienced and made decisions about parenting and pregnancy. Healthcare providers should prioritize providing trans-competent reproductive and obstetric care to ensure trans∗ populations are supported in reaching their reproductive goals. Importantly, broader social and structural changes that allow for expansive gender identity expression in both pregnancy and parenthood are necessary to create safe and healthy environments for trans∗ people to make parenting and pregnancy decisions and pursue parenthood.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"7 ","pages":"Article 100552"},"PeriodicalIF":1.8,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776956","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":"“In the end … I got pregnant. And that wasn't what the plans were”: Threats to reproductive health and rights for migrant women intending to seek safety in the U.S.","authors":"Kaylee Ramage ,&nbsp;Emma Stirling-Cameron ,&nbsp;Nicole Ramos ,&nbsp;Isela Martinez SanRoman ,&nbsp;Arianna Spata ,&nbsp;Shira Goldenberg","doi":"10.1016/j.ssmqr.2025.100553","DOIUrl":"10.1016/j.ssmqr.2025.100553","url":null,"abstract":"<div><h3>Background</h3><div>Reproductive health and rights for migrant women intending to seek safety in the U.S. are shaped by the risk environments through which they migrate, including policy, social, economic, and physical factors. We examined migrant women's lived experiences of reproductive health and rights resulting from and perpetuated by these risk environments across migration phases.</div></div><div><h3>Methods</h3><div>As part of a larger study examining maternal and reproductive health among U.S.-bound pregnant and parenting migrant women seeking safety at the Mexico-U.S. border, we analyzed qualitative, semi-structured interviews of the lived experiences of threats to reproductive health and rights in relation to policies and practices experienced across phases of migration by migrant women intending to seek safety in the U.S.</div></div><div><h3>Results</h3><div>Among 38 migrant women, threats to reproductive health and rights were pervasive and strongly shaped by the risk environments and unsafe humanitarian conditions experienced during migration and at the Mexico-U.S. border. These included: i) experiences of <em>pervasive sexual violence and exploitation;</em> (ii) <em>unplanned pregnancy, disruptions to family planning,</em> and <em>threats to perinatal health;</em> and (iii) <em>experiences of violence pre- and during migration</em>, and <em>border experiences</em> that increased threats to the health and safety of women and their families.</div></div><div><h3>Conclusion</h3><div>Migrant women seeking safety in the U.S. face significant threats to reproductive health and rights during migration, perpetuated by the risk environments experienced in transit and at the Mexico-U.S. border. There is a need to shift existing migration policies towards sustainable immigration reforms that allow for safe, orderly, and timely migration.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"7 ","pages":"Article 100553"},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760373","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":"Integrating portable air purifiers in German daycare centers during the COVID-19 pandemic – A qualitative exploration of usage, maintenance and impact on prevention behaviors","authors":"Hannah Stephan,&nbsp;Felix Droop,&nbsp;Thomas Kistemann,&nbsp;Nico T. Mutters,&nbsp;Timo Falkenberg","doi":"10.1016/j.ssmqr.2025.100548","DOIUrl":"10.1016/j.ssmqr.2025.100548","url":null,"abstract":"<div><div>During the COVID-19 pandemic portable air purifiers with high-efficiency particulate air (HEPA) filters were suggested as a supplement to other prevention measures. Our previous study in German daycare centers did, however, not show a reduction in COVID-19 prevalence. The current study investigates possible reasons for the absence of preventive effects and examines confounding factors and particularities of the daycare setting. Prevention measures employed in the daycare centers, changes in prevention behavior as well as operation and maintenance of the purifiers were qualitatively assessed. The study follows an interventional design with the intervention group utilizing air purifiers. It was conducted in 29 daycares in three districts of the German federal state of Rhineland-Palatinate. Semi-structured qualitative interviews with the daycare heads were conducted between November 2022 and April 2023. The results show no major differences in prevention behavior between the intervention and control groups, thus inadequate prevention measures cannot explain the absence of the preventive effect of the air purifiers. The effectiveness of the air purifiers is more likely to be influenced by the type and duration of their use. Exploration of the usage behavior revealed inconsistencies in the frequency of usage, cleaning and maintenance, which are likely confounding factors. Further, thermal and acoustic emissions of the purifiers induced inadequate use. The findings indicate that the use of air purifiers must be compatible with the particular environment, otherwise the preventive effect is not realized. The daycare setting has not shown to be ideal for the adequate use of portable air purifiers.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"7 ","pages":"Article 100548"},"PeriodicalIF":1.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705027","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":"The sexual abuse of adolescent boys in humanitarian emergencies: A qualitative study of the Rohingya refugee crisis","authors":"Shane Harrison ,&nbsp;Richard Dean Chenhall ,&nbsp;Karen Block ,&nbsp;Sabina Faiz Rashid ,&nbsp;Cathy Vaughan","doi":"10.1016/j.ssmqr.2025.100549","DOIUrl":"10.1016/j.ssmqr.2025.100549","url":null,"abstract":"<div><div>An increasing amount of evidence indicates that adolescent boys may be exposed to child sexual abuse in humanitarian emergencies. However, there is currently limited understanding of risk factors for adolescent boys' exposure to sexual abuse in emergency settings and how humanitarian organisations are responding. In this study, we examined sexual abuse against adolescent boys in the 2017 Rohingya refugee crisis and potential risk factors in this context. We collected data from the emergency response in Cox's Bazar, Bangladesh between 2018 and 2019. This included six and a half months of participant observation, 23 semi-structured interviews and 12 informal ethnographic interviews with humanitarian staff, and 10 focus group discussions with a total of 52 child protection caseworkers. Our results showed that younger adolescent boys aged 9–14 were more at risk in the camp environment compared to older adolescent boys. Perpetrators were primarily older Rohingya and Bangladeshi males, with abuse taking place in public places and at home. In the main, the humanitarian response was limited to case management support and referrals to services of varying quality. Our findings suggest that adolescent boys may be at heightened risk of sexual abuse due to their social location and environment. Moreover, our data indicates that adolescent survivors may have been an oversight in the initial crisis response. We believe that public health actors should improve the overall response to adolescent survivors of sexual abuse in the onset of a humanitarian crisis and carefully adapt interventions to account for the needs of adolescent boys.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"7 ","pages":"Article 100549"},"PeriodicalIF":1.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705028","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 was being true to myself”: Listening to young people talk about gender identity and transition","authors":"Dr Kathy McKay ,&nbsp;Dr Eilis Kennedy ,&nbsp;Dr Talen Wright ,&nbsp;Professor Bridget Young","doi":"10.1016/j.ssmqr.2025.100550","DOIUrl":"10.1016/j.ssmqr.2025.100550","url":null,"abstract":"","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"7 ","pages":"Article 100550"},"PeriodicalIF":1.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684035","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}