SSM. Qualitative research in health最新文献

{"title":"“Not all bathrooms are created Equal”: Moral experiences of maneuvering in inaccessible infrastructure with physical disability","authors":"Abby Arthur Smith","doi":"10.1016/j.ssmqr.2025.100561","DOIUrl":"10.1016/j.ssmqr.2025.100561","url":null,"abstract":"<div><div>How do people with physical disabilities characterize their encounters with inaccessible infrastructure? I draw on interviews and focus groups with older adults with spinal cord injuries from the Midwestern United States to argue that participants experienced inaccessible space as morally harmful, damaging their sense of worth and dignity. They developed strategic bodily “<em>maneuvers</em>” to squeeze through narrow corridors, scale ledges, navigate the back of rooms and buildings, and avoid filth and garbage–resulting in situations of exclusion and marginalized inclusion. Maneuvering established inaccessible spaces and disabled bodies as “<em>denied”</em> and “<em>undignifying,”</em> two stigmatizing classifications which participants experienced as hurtful and unfair. Denied space was exclusionary and associated participants’ disabilities with what they could not do. Undignifying space facilitated a sidelined, dirty, burdensome sense of inclusion. These were moral experiences: they made participants feel less whole and welcome. While denied space offered fewer mobility opportunities, participants felt most stigmatized by undignifying space, precisely because they had greater opportunity to encounter its degrading features by navigating through it. Participants articulated forceful moral judgments toward degrading and exclusionary infrastructure. In instances when opportunities for maneuvering <em>through</em> space were totally unavailable or too degrading to bear, most participants maneuvered <em>away</em> from it. Through such embodied micro-protests against marginalizing spaces, participants constructed themselves as moral agents worthy of inclusion and dignity. This process developed out of encounters between the body and the material forms of inaccessible space, speaking to literature that indicates the relevance of material things–like infrastructure and the body–to sociologists of morality and disability.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"7 ","pages":"Article 100561"},"PeriodicalIF":1.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874875","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":"Social Context and Public Health Compliance: Mask wearing during the COVID-19 pandemic","authors":"James W. Shockey","doi":"10.1016/j.ssmqr.2025.100564","DOIUrl":"10.1016/j.ssmqr.2025.100564","url":null,"abstract":"<div><div>As medical science worked to understand how the coronavirus is transmitted and how it can be controlled, public health professionals have been faced with the challenge of translating medical science recommendations into actions that support community health. These actions must be effective, but also adopted by individuals within the community. During the coronavirus pandemic, most people appeared to comply with guidelines for wearing face masks. On the other hand, a significant fraction of the population has consistently avoided wearing masks.</div><div>This paper explores the factors involved in an individual's decision to wear a mask, looking also at the relationships among a wider range of actions recommended as part of the CDC's COVID- 19 public health strategy. Using national panel data collected beginning in March 2020, we analyze the interaction among self-reported measures of adherence to public health recommendations, individual perceptions of the effectiveness of mask wearing as a mitigation strategy, and indicators of individual attitudes toward political aspects of coronavirus mitigation. Results from a Qualitative Comparative Analysis (QCA) suggest that compliance with wearing a face mask is associated with other protective behaviors, such as avoiding public places (APUBLIC); believing that wearing a mask helps to keep oneself and others safe from coronavirus infection (MESAFE, OTHERSAFE); and not believing that mask wearing is a political statement and that individuals should not be forced to wear facemasks since the U.S. is a free country (POL, FREE).</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"7 ","pages":"Article 100564"},"PeriodicalIF":1.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895011","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":"Living in the shadows: the persistence of secrecy in young people living with HIV on antiretroviral therapy, a qualitative study of the BREATHER Plus trial","authors":"Tamlyn Carmin Seunanden ,&nbsp;Nothando Ngwenya ,&nbsp;Stella Namukwaya ,&nbsp;Londiwe Shandu ,&nbsp;Moherndran Archary ,&nbsp;Cissy Kityo Mutuluuza ,&nbsp;Sarah Lilian Pett ,&nbsp;Adeodata Rukyalekere Kekitiinwa ,&nbsp;Sarah Bernays ,&nbsp;Janet Seeley","doi":"10.1016/j.ssmqr.2025.100560","DOIUrl":"10.1016/j.ssmqr.2025.100560","url":null,"abstract":"","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"7 ","pages":"Article 100560"},"PeriodicalIF":1.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868389","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":"When structure creates strain: Physician perspectives on work-home interference, professional relationships, and organizational resilience","authors":"Karen S. Schaepe ,&nbsp;Tait D. Shanafelt ,&nbsp;Liselotte N. Dyrbye ,&nbsp;Natasha Matt-Hensrud ,&nbsp;Colin P. West","doi":"10.1016/j.ssmqr.2025.100558","DOIUrl":"10.1016/j.ssmqr.2025.100558","url":null,"abstract":"<div><div>Despite widespread recognition of work-home interference (WHI) as a key driver of physician burnout, the day-to-day realities of how physicians navigate these challenges remain underexplored. This study examines how WHI shapes physicians’ professional and personal lives, with a particular focus on its impact on relationships and organizational resilience.</div><div>Through seven focus groups with 64 physicians across specialties and career stages at Mayo Clinic in Rochester, Minnesota, we identified key sources of WHI, including inflexible work schedules and the persistent mental burden of balancing multiple roles. Physicians described resorting to unsustainable coping strategies that, over time, became entrenched. They also expressed frustration with institutional efforts to mitigate WHI, which emphasized personal resilience and time management while overlooking deeper structural issues.</div><div>A critical finding from the study was the often-underappreciated role of professional relationships in buffering against WHI and sustaining both individual and organizational resilience. Physicians described how efficiency-driven interventions—such as workflow changes and increased productivity demands—unintentionally eroded collegial connections, leaving them feeling increasingly isolated and unsupported. This loss of professional community exacerbated the emotional toll of WHI and arguably weakens the adaptive capacity of most healthcare organizations.</div><div>These findings suggest that WHI and burnout cannot be addressed solely through individual-level interventions or efficiency measures. Instead, healthcare institutions must acknowledge the social dimensions of physician well-being and foster work environments that prioritize connection alongside productivity. By reassessing the trade-offs between efficiency and relational cohesion, organizations can better support physicians and promote a more sustainable, resilient workforce.</div></div>","PeriodicalId":74862,"journal":{"name":"SSM. Qualitative research in health","volume":"7 ","pages":"Article 100558"},"PeriodicalIF":1.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848634","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":"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}