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Fomiatti R, Shaw F, Fraser S. 'It's a different way to do medicine': Exploring the affordances of telehealth for hepatitis C healthcare. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 110:103875. [PMID: 36257085 DOI: 10.1016/j.drugpo.2022.103875] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
Abstract
While the use of telehealth was common in hepatitis C healthcare in Australia in remote and regional areas prior to the COVID-19 pandemic, it has been used more broadly to improve access to hepatitis C heathcare during the pandemic. Despite its widespread uptake, little research has explored how telehealth shapes hepatitis C healthcare. In this article, we draw on the concept of affordances (Latour, 2002) and interviews with 25 healthcare practitioners to explore the emergent possibilities for hepatitis C care that take shape through telehealth. Despite suggestions that telehealth is comparable to in-person care, healthcare practitioners' accounts suggest that telehealth significantly changes the nature of their experience of providing healthcare for hepatitis C. According to these service practitioners, while it increased access to hepatitis C healthcare during the pandemic, it also afforded narrower, less personal healthcare encounters, with a focus on simple and singular issues, and reduced opportunities for communication and rapport. These affordances also discouraged the use of interpreters and by extension the inclusion of patients from non-English speaking backgrounds. However, the data collected also suggest that telehealth has the potential to afford more informal and relaxed healthcare environments and dispositions between healthcare practitioners and patients, potentially disrupting classic practitioner-patient power dynamics. In concluding, the article considers how telehealth models of care might better afford quality hepatitis C healthcare and care beyond COVID-19 pandemic conditions.
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Affiliation(s)
- Renae Fomiatti
- School of Humanities and Social Sciences, Deakin University; Australian Research Centre in Sex, Health and Society, La Trobe University.
| | - Frances Shaw
- ARC Centre of Excellence for Automated Decision-Making and Society, Swinburne University of Technology
| | - Suzanne Fraser
- Australian Research Centre in Sex, Health and Society, La Trobe University; Centre for Social Research in Health, University of New South Wales
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Velasco RAF, Slusser K, Coats H. Stigma and healthcare access among transgender and gender-diverse people: A qualitative meta-synthesis. J Adv Nurs 2022; 78:3083-3100. [PMID: 35689393 DOI: 10.1111/jan.15323] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/13/2022] [Accepted: 05/14/2022] [Indexed: 11/29/2022]
Abstract
AIM To describe the experience of stigma among transgender and gender-diverse (TGD) people accessing care. DESIGN A qualitative meta-synthesis. DATA SOURCES CINAHL, Medline, PubMed and PsycINFO were used to retrieve English-language, peer-reviewed qualitative studies from September 2016 to September 2021. REVIEW METHODS The methods for this qualitative meta-synthesis included four steps. Step 1: Form the clinical question and purpose of synthesis to define and refine search terms. Step 2: Evaluate the literature using PRISMA. Step 3: Appraise the literature using Lett's Critical Review Form. Step 4: Conduct a reciprocal translation to synthesize the results. RESULTS Of the 12 articles that met the inclusion criteria, 3 were from nursing journals. The articles included were studies conducted in U.S.A., Brazil, Canada, Colombia, Mozambique, Sweden, Uganda and United Kingdom, and most recruited transfeminine-identifying participants. Three main themes emerged: stigma experienced within the individual, interpersonal and structural socio-ecological levels among TGD people accessing care. CONCLUSION Stigma is a significant public health issue as it limits healthcare access among TGD people. Stigma experienced at various socio-ecological levels contributes to health disparities. Nurses must create and implement interventions informed by the lived experiences of TGD people. IMPACT Extant literature on this topic is limited in the nursing literature. This qualitative meta-synthesis illuminates TGD identity stigma-related experiences using a socio-ecological framework. While stigma is often experienced at the individual and interpersonal levels, oppressive systems that value cisgender cultural norms over other gender identities allow structural-level stigma to occur. Nurses are morally, ethically and professionally responsible for challenging systems that create and sustain stigma. Understanding how stigma is experienced when accessing care can help deliver critical information needed to improve healthcare access among TGD people and other historically oppressed communities.
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Affiliation(s)
- Roque Anthony F Velasco
- College of Nursing, University of Colorado Denver, University of Colorado Denver, Aurora, Colorado, USA
| | - Kim Slusser
- College of Nursing, University of Colorado Denver, University of Colorado Denver, Aurora, Colorado, USA
| | - Heather Coats
- College of Nursing, University of Colorado Denver, University of Colorado Denver, Aurora, Colorado, USA
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Balfe M. The sociological imagination for mental health nursing: A framework and some reflections. J Psychiatr Ment Health Nurs 2022; 29:374-380. [PMID: 34228860 DOI: 10.1111/jpm.12783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/06/2021] [Accepted: 07/01/2021] [Indexed: 11/27/2022]
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Velasco RAF. Stigma among transgender and gender-diverse people accessing healthcare: A concept analysis. J Adv Nurs 2021; 78:698-708. [PMID: 34524708 DOI: 10.1111/jan.15040] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/12/2021] [Accepted: 09/05/2021] [Indexed: 12/21/2022]
Abstract
AIM To provide a timely analysis around the concept of stigma among transgender and gender-diverse people accessing healthcare. BACKGROUND While research on stigma has been prolific in other disciplines, the literature on stigma-especially among transgender and gender-diverse people-have been limited in nursing. A clear definition of stigma among transgender/gender-diverse people is also lacking in the nursing literature. DESIGN Walker and Avant's method of concept analysis. DATA SOURCES PubMed and CINAHL databases were used to retrieve English language records from February 2016 to February 2021. Influential literature from sociology and psychology and an online dictionary and thesaurus were also used to clarify the concept. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used to search the scientific literature to clarify and describe the antecedents, defining attributes, consequences and empirical referents of stigma among transgender/gender-diverse people accessing healthcare. RESULTS A clear definition of stigma was identified. The defining attributes of stigma-labelling, stereotype, separation, status loss and discrimination-reflect its definition. Without asymmetrical power relationships, stigma will not exist. The consequences of stigma include negative and positive outcomes. CONCLUSION While this concept analysis provides clarification of stigma, further exploration of the concept is needed. Furthermore, this concept analysis illustrates how nurses are strategically positioned to disrupt the power structures that allow stigma to operate. Understanding the concept of stigma also enables nurses to create equitable and multifaceted inventions to improve healthcare access among transgender and gender-diverse people.
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Ardissone A. From loyalty to resignation: Patient-doctor figurations in type 1 diabetes. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:1388-1404. [PMID: 34050536 PMCID: PMC8453939 DOI: 10.1111/1467-9566.13304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 04/17/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023]
Abstract
This paper contributes to the debate on the patient-doctor relationship by focussing on a specific chronic disease: type 1 diabetes. This field is characterised by an increasing use of technology, specifically therapeutic devices and a significant requirement of patient self-management. This paper presents the main findings of research conducted in Italy in 2018. It is argued that this relationship is more properly described as an interdependent figuration of actors characterised by a dynamic process of power balances, which recalls Elias' (What is sociology? Columbia University Press, 1978) figurational-processual and relational sociology. In this theoretical context, patients may manage their (dis)satisfaction with their diabetologists by choosing different behaviours that stem from Hirschman's archetype (Exit, voice, and loyalty. Responses to decline firms, organizations, and states. Harvard University Press, 1970): voice, exit, loyalty and, we would add, resignation. These categories are fluid, and all of them can be experienced by patients over time, depending on the quality of the figurations built among these transactors.
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Coleman-Minahan K, Stevenson AJ, Obront E, Hays S. Judicial bypass attorneys' experiences with abortion stigma in Texas courts. Soc Sci Med 2021; 269:113508. [PMID: 33358022 PMCID: PMC7924962 DOI: 10.1016/j.socscimed.2020.113508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/27/2020] [Accepted: 11/05/2020] [Indexed: 11/16/2022]
Abstract
Texas requires pregnant young people under 18 (i.e., minors) seeking abortion without parental consent to go to court with an attorney to petition a judge for permission to obtain abortion. There is a lack of empirical data on the process through which abortion laws stigmatize abortion and on the actors involved. We use data from in-depth qualitative interviews with 19 attorneys who participated in a collective 800 judicial bypass cases to explore what's at stake for multiple actors within a shared social space and how interactions between those actors reproduce stigma. We extend stigma theory to explain how structural abortion restrictions produce stigma at the individual level. We find that to protect their interests in "keeping pregnant minors in," the Texas court system constrains attorneys' ability to represent minors through politicization and stigmatization; attorneys face logistical and emotional challenges, including navigating hostile or ill-informed courts, witnessing court actors humiliate their clients without means of recourse, and experiencing stigma themselves. Although what's most at stake for their clients becomes most at stake for attorneys- helping young people obtain a judicial bypass so they can access abortion and protecting them from humiliation and trauma- they must reconcile their own violation of norms stigmatizing abortion with their consciences' motivation to represent bypass clients and protect their professional identity and career advancement from being "tainted" by taking judicial bypass cases. In order to protect what is at stake for their clients in the context of the highly stigmatized Texas courts, attorneys rationally make trade-offs that protect some stakes while undermining others. Moreover, attorneys' management of experienced stigma and their violation of norms stigmatizing abortion leads some to reproduce abortion stigma in their interactions with minors.
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Affiliation(s)
- Kate Coleman-Minahan
- College of Nursing, University of Colorado Anschutz Medical Campus, USA; University of Colorado Population Center (CUPC), University of Colorado Boulder, 1440 15th Street, CO, 80302, Boulder, USA.
| | - Amanda Jean Stevenson
- University of Colorado Population Center (CUPC), University of Colorado Boulder, 1440 15th Street, CO, 80302, Boulder, USA; Department of Sociology, University of Colorado Boulder, UCB 327 Ketchum 195, CO, 80309, Boulder, USA.
| | - Emily Obront
- Reproductive Psychiatry Clinic of Austin, Austin, TX, USA.
| | - Susan Hays
- Law Office of Susan Hays, P.C., Austin, TX, USA.
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Haslam SA, Haslam C, Jetten J, Cruwys T, Bentley SV. Rethinking the nature of the person at the heart of the biopsychosocial model: Exploring social changeways not just personal pathways. Soc Sci Med 2020; 272:113566. [PMID: 33303292 DOI: 10.1016/j.socscimed.2020.113566] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/20/2020] [Accepted: 11/26/2020] [Indexed: 10/22/2022]
Abstract
Karunamuni et al.'s (2020) biopsychosocial-pathways (BPS-P) model provides an important framework for elaborating on Engel's (1977) biopsychosocial (BPS) model of health. In particular, the BPS-P model improves on Engel's by articulating and evidencing the multiple pathways between biological, psychological, and social influences on health and identifying mechanisms that might be implicated in these pathways. Yet its analytic treatment of these influences as "separate systems" means that, as with Engel's model, the BPS-P model is more a list of ingredients than an integrated whole. In this commentary, following Haslam et al.'s (2019) specification of a sociopsychobio model, we underscore the value of a synthetic appreciation of biology, psychology, and society as dynamically interdependent aspects of an integrated whole which is more than just the sum of its parts and the pathways between them. In particular, our alternative framework centres on an appreciation of people as social beings whose group memberships and associated social identities open up 'changeways' (not just pathways) that, as we have seen during the COVID-19 pandemic, can fundamentally restructure biology, psychology and society.
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Fraser S, Fomiatti R, Moore D, Seear K, Aitken C. Is another relationship possible? Connoisseurship and the doctor–patient relationship for men who consume performance and image-enhancing drugs. Soc Sci Med 2020; 246:112720. [DOI: 10.1016/j.socscimed.2019.112720] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 10/28/2019] [Accepted: 12/03/2019] [Indexed: 01/06/2023]
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Haslam SA, Haslam C, Jetten J, Cruwys T, Bentley S. Group life shapes the psychology and biology of health: The case for a sociopsychobio model. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2019. [DOI: 10.1111/spc3.12490] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Joslyn MR, Haider-Markel DP. Perceived causes of obesity, emotions, and attitudes about Discrimination Policy. Soc Sci Med 2019; 223:97-103. [PMID: 30718009 DOI: 10.1016/j.socscimed.2019.01.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 12/13/2018] [Accepted: 01/12/2019] [Indexed: 01/09/2023]
Abstract
RATIONALE Although obesity represents a potential public health crisis, our understanding of public perceptions of obesity, emotional responses to the obese, and related policy preferences is limited. OBJECTIVE We employed Weiner's attribution theory of controllability (Weiner, 1988, 2011) to examine perceived causes of obesity, emotional responses, and related policy implications. If the perceived cause is controllable (eating and lifestyle habits), we expected less sympathy and greater anger toward obese people and support for prejudicial hiring policies based on weight. If the cause is perceived as uncontrollable (genetic), sympathy is anticipated as well as opposition to such hiring policies. METHOD We conducted multivariate analyses with data from two nationally representative surveys of U.S. adults. CONCLUSION Our findings supported the hypotheses, showing that sympathy and lack of anger toward obese people are strongly determined by a genetic attribution for obesity. Moreover, sympathy and the genetic attribution are significant predictors of opposition to hiring policies that discriminate against obese people. Finally, in a second study, chief among several causal attributions for obesity-lack of will power, lack of exercise, marketing of foods, and genetics-we discovered biological attribution functions as the key predictor of perceptions that obese people are frequent targets of discrimination. We suggest governments and the food industry should be more attuned to the underlying beliefs of the public about the causes of obesity when formulating programs and policies to address the issue.
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Affiliation(s)
- Mark R Joslyn
- Department of Political Science, 1541 Lilac Lane, 504 Blake Hall, University of Kansas, Lawrence, KS, 66044, USA
| | - Donald P Haider-Markel
- Department of Political Science, 1541 Lilac Lane, 504 Blake Hall, University of Kansas, Lawrence, KS, 66044, USA.
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Bell K. Whatever happened to the ‘social’ science in Social Science & Medicine? On golden anniversaries and gold standards. Soc Sci Med 2018; 214:162-166. [DOI: 10.1016/j.socscimed.2018.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 03/24/2018] [Accepted: 04/09/2018] [Indexed: 01/12/2023]
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