SSM. Qualitative research in health最新文献

{"title":"The role of stigma in impeding implementation of harm reduction services in San Francisco","authors":"Christopher F. Akiba ,&nbsp;Cariné E. Megerian ,&nbsp;Esther O. Chung ,&nbsp;Terry Morris ,&nbsp;Lynn D. Wenger ,&nbsp;Leslie W. Suen ,&nbsp;Barrot H. Lambdin ,&nbsp;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}

{"title":"Disentangling COVID-19 vaccine hesitancy: the role of social imaginaries of epidemics in northern Sierra Leone","authors":"Yara Alonso ,&nbsp;Abu Bakarr Jalloh ,&nbsp;Kwabena Owusu-Kyei ,&nbsp;Augustin E. Fombah ,&nbsp;Clara Menéndez ,&nbsp;Mohamed Samai ,&nbsp;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}

{"title":"The impact of collective trauma on mental health psychology practitioners' wellbeing: Insights gained from Covid-19","authors":"Annita Ventouris ,&nbsp;Agata Wezyk ,&nbsp;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}

{"title":"Examining access to gender-affirming surgery: A community-based thematic analysis of structural and systemic barriers and supports","authors":"Braveheart Gillani ,&nbsp;Amine Sahmoud ,&nbsp;Daniel Hamilton ,&nbsp;Erika Kelley ,&nbsp;Shubham Gupta ,&nbsp;Gulnar Feerasta ,&nbsp;Swagata Banik ,&nbsp;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}

{"title":"‘A little bit of support really, that's all I was looking for’ a qualitative study of the biographical disruption of fibromyalgia at work in the UK","authors":"Martin J. Stevens ,&nbsp;Louise Locock ,&nbsp;Stefanie Doebl ,&nbsp;Zoe C. Skea ,&nbsp;Debra Dulake ,&nbsp;Gary J. Macfarlane ,&nbsp;Rosemary J. Hollick","doi":"10.1016/j.ssmqr.2025.100577","DOIUrl":"10.1016/j.ssmqr.2025.100577","url":null,"abstract":"<div><div>Fibromyalgia is a chronic condition which can have a detrimental impact on a person's interaction with work. Biographical disruption is a lens through which people's experiences of many chronic conditions have been described. We applied this lens to experiences of work amongst people with fibromyalgia to better understand what support they required to continue to work. We conducted semi-structured interviews in 2019/20 with 31 people who have fibromyalgia. Data were analysed using reflexive thematic analysis. In our study people often experienced fibromyalgia at work as a biographical disruption which can include a non-specific decline in work ability. Diagnosis of fibromyalgia and/or the symptoms becoming less compatible with their job role can further disrupt, creating additional challenges as managing a chronic, often invisible condition conflicts with workplace systems such as sickness absence policies. As the person responds to the disruption, they may feel they either need to move on from their current role or continue with appropriate modifications/support. An overarching theme indicates declining self-esteem because of disruption to working lives. Biographical disruption experienced by workers with fibromyalgia can be mitigated or repaired, however even if resolved it does not follow that work outcomes are positive. Disruptions may be more fully repaired if people with fibromyalgia are able to access support earlier to remain in work. Employers should consider the impact of fibromyalgia and how its fluctuating and contested nature can conflict with workplace systems. Early, symptom-focused work support is essential to help people with fibromyalgia stay in work and navigate challenges.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100577"},"PeriodicalIF":1.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491984","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":"Anything I missed out↑: Pre-briefing in ad hoc trauma emergency teams","authors":"Jo Angouri ,&nbsp;Polina Mesinioti ,&nbsp;Chris Turner","doi":"10.1016/j.ssmqr.2025.100580","DOIUrl":"10.1016/j.ssmqr.2025.100580","url":null,"abstract":"<div><div>Team briefings constitute a core interactional event in healthcare contexts, as they are directly linked to higher clinical performance and enhanced patient safety. In emergency settings, there is strong evidence suggesting that successful briefings reduce the time to critical team tasks, leading to reduced mortality. Despite their role, however, they are still not systematised in organisational practice, and when they are conducted, their content and structure significantly vary (inter)nationally.</div><div>In this article, we draw on a recently completed project to discuss patterns associated with (in)effective pre-briefings in our data and we proposal an overarching framework for pre-briefings in the context of trauma emergencies. Through the use of interactional analysis, an established theoretical and methodological approach, we unpack the form and function of pre-briefings, showing the stages and features that are systematically emergent in our data. Particular attention is paid to the team leader, who holds a central role in bringing the team together during the pre-briefing stage and throughout the episode. We close the paper with the implications of our findings and suggestions for further research.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100580"},"PeriodicalIF":2.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145094610","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":"Reframing labour companionship: gender representations in maternity wards of Argentina","authors":"Carmen Rauh Garrido ,&nbsp;Mercedes Vila Ortiz ,&nbsp;Celina Gialdini ,&nbsp;Alexandre Dumont ,&nbsp;Claudia Hanson ,&nbsp;Mølsted Alvesson Helle","doi":"10.1016/j.ssmqr.2025.100586","DOIUrl":"10.1016/j.ssmqr.2025.100586","url":null,"abstract":"<div><div>Labour companionship positively shapes childbirth experiences, offering continuous emotional and practical support to birthing people. In Argentina, companionship is protected by law, though implementation challenges remain. Gender norms and expectations can act as barriers to quality care. Addressing a gap in companionship literature, this paper explores gender representations perceived by male and female companions and health care providers at two public hospitals in Buenos Aires. This qualitative study involved 27 semi-structured interviews with birthing companions and healthcare workers in maternity wards, including nine male partners, three female companions, and 15 health care providers. Transcript data were analysed following a reflexive thematic approach. Two themes were developed: male companions idealise traditional masculinity values yet embrace femininity at birth, and female companions are stereotyped as “natural” companions. These themes underpinned a third theme, conceptualised as a paradox, regarding proper engagement, support, and preparation of companions during birth. Companions and health care providers engaged with each other while holding biologist constructs of men and women's ability to support a birthing woman as a companion. The findings contribute to a broader discourse on gendered labour experiences, aiming to inform policy and practice of integration of male and female companions, namely, to foster a more equitable birth environment.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100586"},"PeriodicalIF":1.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144312796","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":"Choosing wisely? A frame analysis of the evolution and adoption of shared decision making in the UK","authors":"Gemma Hughes ,&nbsp;Sara E. Shaw ,&nbsp;Jonathan Bowley ,&nbsp;Julie L. Darbyshire ,&nbsp;Timothy J. Stephens","doi":"10.1016/j.ssmqr.2025.100579","DOIUrl":"10.1016/j.ssmqr.2025.100579","url":null,"abstract":"","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100579"},"PeriodicalIF":1.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321998","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":"“Do we perceive the same reality?” Truth telling and persuasion techniques in Red Pilling narratives about the COVID-19 vaccine","authors":"K. Grailey ,&nbsp;R. Gerrard ,&nbsp;M. Kihanga ,&nbsp;A. Buttenheim","doi":"10.1016/j.ssmqr.2025.100588","DOIUrl":"10.1016/j.ssmqr.2025.100588","url":null,"abstract":"<div><div>Despite widespread public health campaigns, lower than desired COVID-19 vaccine uptake was seen across the USA. Vaccine hesitancy can be driven by the proliferation of misinformation online, shaping beliefs and vaccine acceptance. This study explored motivated reasoning and its role in the development of such beliefs, specifically using narratives about “red pilling” – a popular concept originating from the 1999 film ‘”The Matrix”.</div><div>Comments responding to an online blog post by Steve Kirsch, requesting red pilling stories from his followers were analysed in a stepwise process, creating a codebook based on existing typologies for logical fallacies and persuasion techniques. Coded content were thematically analysed using a framework approach.</div><div>The 1472 comments posted by June 22nd^, 2022 were analysed. Fifty-three initial codes were created, condensed into a thematic framework with three overarching domains – “How did you get red pilled”, “Have you been able to red pill others” and “Living red pilled”. These domains contained 11 themes and 14 additional sub-themes. Commenters shared insights into becoming red-pilled, the significance of persuasive sources and how they went on to “red-pill” others. Data also illustrated an isolated life once “red-pilled”, whilst simultaneously being a member of a global network.</div><div>Our analysis provides a rich insight into the strategies and scenarios that inspire red-pilling narratives and their consequences, particularly for public health initiatives such as vaccination programmes. Understanding the ideology that underpins the initiation and spread of misinformation can be utilised to pre-empt and minimise it, building trust across a broad range of world views.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100588"},"PeriodicalIF":1.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307413","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":"Digital assistive technologies to support community-dwelling older adults: an interpretative synthesis of experienced benefits and harms","authors":"Kasper Kruithof ,&nbsp;Rebecca C. Ruehle ,&nbsp;Vivianne Dörenberg ,&nbsp;Faridi van Etten-Jamaludin ,&nbsp;Brenda Frederiks","doi":"10.1016/j.ssmqr.2025.100584","DOIUrl":"10.1016/j.ssmqr.2025.100584","url":null,"abstract":"<div><h3>Background</h3><div>Digital assistive technology (DigAT) holds promise for reducing healthcare costs, improving access to care, and supporting independent living for older adults. However, realizing these benefits remains challenging as seemingly effective and cost-efficient forms of DigAT often fail in real-world settings due to misalignment with users’ needs, values and practices. With the ultimate aim of contributing to more effective DigAT use among community-dwelling older adults, we explored the benefits and harms they experienced using DigAT.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, CINAHL, Philosopher's Index, and PsycINFO for qualitative studies on community-dwelling older adults' experiences with DigAT, and conducted an interpretative synthesis of thirty-one studies.</div></div><div><h3>Results</h3><div>As intended, DigAT resulted in experienced benefits related to health, safety, self-reliance, wellbeing, motivation, empowerment, and access to care. Autonomy and independence were mostly framed as aspirational benefits, dependent on maintaining health and safety to age-in-place. Unexpected benefits of DigAT included self-confidence, feeling cared for, and social inclusion. However, users also reported various harms, including perceived unsafety, burdening others or being burdened, privacy concerns, feeling controlled and judged, alienation, powerlessness, loneliness, stigma, and emotional distress. When DigAT did not align with users' needs, values, or practices, it resulted in misuse, non-use, or adapted use.</div></div><div><h3>Conclusions</h3><div>Our synthesis highlights the need for an intentional and person-centered approach to DigAT design and implementation, ensuring alignment with older adults' needs, values, and practices. Such an approach could enhance DigAT's perceived value, and thereby support the realization of its promise to increase healthcare accessibility and support independent living.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"8 ","pages":"Article 100584"},"PeriodicalIF":1.8,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307414","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}