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Voswinkel MM, Hanegraaff SM, Mares SHW, Wezenberg E, van Delden JJM, van Elburg AA. Ethical implications of defining longstanding anorexia nervosa. J Eat Disord 2024; 12:77. [PMID: 38863013 PMCID: PMC11165790 DOI: 10.1186/s40337-024-01040-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/04/2024] [Indexed: 06/13/2024] Open
Abstract
The label severe and enduring anorexia nervosa (SE-AN) is widely used in the literature on longstanding anorexia nervosa (AN). However, the process of constructing the criteria and the use of the label SE-AN has ethical implications that have not been taken into account. Through combining existing literature and lived experience perspective, this paper addresses to what extent the current criteria do and do not reflect the lived experience. Arguments are presented on why the process of constructing the criteria for SE-AN and the application of the label can be both identified as, and give rise to, epistemic injustice. Epistemic injustice is an injustice that is done to a person as an individual with the capacity of acquiring and sharing knowledge. This type of injustice can occur at any stage of an interaction between people in which knowledge is shared with one another. The paper concludes by giving suggestions on how to pursue epistemic justice in the process of defining longstanding AN.
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Affiliation(s)
- Marthe M Voswinkel
- Department of Eating Disorders (Amarum), GGNet Mental Health, Vordenseweg 12, Warnsveld, 7231 PA, The Netherlands.
- Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, Utrecht, 3584 CS, The Netherlands.
| | - Simone M Hanegraaff
- Department of Eating Disorders (Amarum), GGNet Mental Health, Vordenseweg 12, Warnsveld, 7231 PA, The Netherlands
| | - Suzanne H W Mares
- Department of Eating Disorders (Amarum), GGNet Mental Health, Vordenseweg 12, Warnsveld, 7231 PA, The Netherlands
| | - Elke Wezenberg
- Department of Eating Disorders (Amarum), GGNet Mental Health, Vordenseweg 12, Warnsveld, 7231 PA, The Netherlands
| | - Johannes J M van Delden
- Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, Utrecht, 3584 CG, The Netherlands
| | - Annemarie A van Elburg
- Department of Eating Disorders (Amarum), GGNet Mental Health, Vordenseweg 12, Warnsveld, 7231 PA, The Netherlands
- Department of Clinical Psychology, Utrecht University, Heidelberglaan 1, Utrecht, 3584 CS, The Netherlands
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Chapman K, Dixon A, Kendall E, Clanchy K. Defining dignity at the intersection of disability: a scoping review. Disabil Rehabil 2024:1-11. [PMID: 38265032 DOI: 10.1080/09638288.2024.2302582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/27/2023] [Indexed: 01/25/2024]
Abstract
PURPOSE This scoping literature review aimed to determine the definition of dignity in relation to disability. It also examined the extent to which inclusive research methods have been used to develop working definitions. MATERIALS AND METHODS A comprehensive search was conducted in five electronic databases, using a modified framework by Arksey and O'Malley. Narrative synthesis and qualitative content analysis were employed to examine definitions of dignity and the use of inclusive research methods. RESULTS 22 peer-reviewed studies were included. The majority of the studies were qualitative (72.72%) and examined various disability populations in diverse settings. Although 19 studies offered a definition of dignity, there was no clear consensus. Dignity was frequently defined from a utilitarian perspective, emphasising affordances and barriers. However, engagement with theoretical constructs was superficial and limited. Further, no studies mentioned the use of inclusive research methods. CONCLUSIONS The absence of inclusive research methods hinders the development of a comprehensive definition of dignity that is accepted by and relevant to people with disability. Engaging with both theoretical and empirical perspectives of dignity is crucial to develop a meaningful and inclusive definition, which can inform interventions and policies that enhance dignity for people with disability across diverse settings and contexts.
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Affiliation(s)
- Kelsey Chapman
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
- The Hopkins Centre, Griffith University, Nathan, Queensland, Australia
| | - Angel Dixon
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
| | - Elizabeth Kendall
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
- The Hopkins Centre, Griffith University, Nathan, Queensland, Australia
| | - Kelly Clanchy
- Inclusive Futures, Griffith University, Nathan, Queensland, Australia
- The Hopkins Centre, Griffith University, Nathan, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
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Chapman K, Dixon A, Ehrlich C, Kendall E. Dignity and the Importance of Acknowledgement of Personhood for People With Disability. QUALITATIVE HEALTH RESEARCH 2024; 34:141-153. [PMID: 37902052 PMCID: PMC10714705 DOI: 10.1177/10497323231204562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Exploring the intricate relationship between individual and collective experiences, this study explores dignity from the perspectives of people with disability. Using an extreme citizen science approach, we engaged people with disability as active partners in gathering data through qualitative surveys and focus groups. Framework Analysis was employed to ensure the validity of findings while privileging the voices of people with lived experience of disability. Dignity was contingent on the acknowledgement of personhood and the delivery of human rights. Our research identified five key aspects to maintain and protect dignity: (1) acknowledging personhood; (2) recognising people with disability as decision-makers of their lives; (3) realising the right to access information; (4) maintaining the right to privacy; and (5) eliminating or minimising barriers to accessibility and inclusion. Undignified experiences that resulted from a lack of acknowledgement negatively affected participants' wellbeing, and healthcare settings were identified as particularly challenging environments for dignity. These findings have significant implications for healthcare systems and services within an international and interdisciplinary context. They emphasise the need for adaptable, flexible services, co-designed with people with lived experience of disability. Addressing organisational constraints, resource limitations, and expectations is paramount to ensuring dignity is maintained through the acknowledgement of personhood and safeguarding of human rights.
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Affiliation(s)
- Kelsey Chapman
- The Hopkins Centre: Research for Rehabilitation and Resilience, Griffith University, Nathan, QLD, Australia
- Inclusive Futures: Reimagining Disability, Griffith University, Southport, QLD, Australia
| | - Angel Dixon
- Inclusive Futures: Reimagining Disability, Griffith University, Southport, QLD, Australia
| | - Carolyn Ehrlich
- The Hopkins Centre: Research for Rehabilitation and Resilience, Griffith University, Nathan, QLD, Australia
| | - Elizabeth Kendall
- The Hopkins Centre: Research for Rehabilitation and Resilience, Griffith University, Nathan, QLD, Australia
- Inclusive Futures: Reimagining Disability, Griffith University, Southport, QLD, Australia
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Geraghty TJ, Foster MM, Burridge LH. Moving from Interest to Engagement-Understanding the Research Capacity Building Needs of Rehabilitation Doctors. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 44:112-119. [PMID: 37493439 DOI: 10.1097/ceh.0000000000000521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Doctors working in rehabilitation settings have specialized clinical skills and experience, but research activity may be constrained by time pressures and inadequate current skills. This means missed opportunities to contribute to the evidence-base for better clinical practice and outcomes for people living with disabling, chronic complex conditions. This research aimed to understand rehabilitation doctors' research needs, experience, and aspirations to enable future training initiatives that are tailored to their practice context. METHODS This exploratory sequential mixed-method study comprised a survey followed by focus groups. Rehabilitation doctors from three health services in south-east Queensland, Australia completed an online survey incorporating the Research Spider to explore their research experience, confidence, interest, opportunity, and intent. Focus groups explored the survey results and participants' views regarding strategies to build research capacity. RESULTS The major findings were the gap between high research interest and low experience, confidence and opportunity; and fundamental research skills were identified as priority training topics. These findings support previous research. However, rehabilitation doctors may also have a self-expectation that, as competent clinicians, they should necessarily also be research-competent, and hold misperceptions regarding the shared nature of health services research. DISCUSSION Protected time and funding may enhance engagement with research to generate specialty-relevant evidence for practice. To this end, a research capacity building initiative in the form of a series of self-directed learning packages has been developed and implemented. A tailored workshop to strengthen rehabilitation doctors' research skills and engagement has also been developed for implementation.
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Affiliation(s)
- Timothy J Geraghty
- Prof. Geraghty: Co-Director, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Australia, and Medical Chair, Division of Rehabilitation, Princess Alexandra Hospital, Metro South Health Hospital and Health Service, Brisbane, Australia. Prof. Foster: Adjunct Professor, Policy Innovation Hub, Griffith Business School, Griffith University, Nathan, Queensland, Australia, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Australia, and School of Health Sciences and Social Work, Griffith University, Brisbane, Australia. Dr. Burridge: Research Fellow, The Hopkins Centre: Research for Rehabilitation and Resilience, Menzies Health Institute Queensland, Griffith University, Nathan, Brisbane, Australia, and School of Health Sciences and Social Work, Griffith University, Brisbane, Australia
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Cox R, Molineux M, Kendall M, Tanner B, Miller E. 'Learning and growing together': exploring consumer partnerships in a PhD, an ethnographic study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:8. [PMID: 36918951 PMCID: PMC10014401 DOI: 10.1186/s40900-023-00417-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Consumer and community involvement (CCI) in health research is increasingly recognised as best practice and is closely linked with calls for epistemic justice and more transparent university collaborations with consumers. Given doctoral candidates play a key role in the future of co-production, examination of consumer partnerships in PhDs is important. This study aimed to describe and evaluate consumer partnerships in a PhD from the perspective of the consumer co-researchers, the PhD candidate, and the academic supervisors including optimal approaches, impacts, and benefits and challenges. METHODS This prospective, co-produced ethnographic study was conducted over 33 months. Data collection included field notes, a monthly online log of partnership experiences and time spent, interviews or a focus group every six months, and a PhD student reflexive diary. Qualitative data were analysed using reflexive thematic analysis. RESULTS The student, two academics, and four consumer co-researchers were involved. A mean of 11.10 h per month were spent on CCI. The student spent the most time (mean 15.86 h per month). Preparation for dissemination of findings was the most frequent partnership activity. The two overarching themes emphasised that a PhD promotes a rich partnership ethos with the student at the centre and that the partnership was a worthwhile but challenging process. The four sub-themes highlighted that developing a collegial and supportive environment with regular meetings combined with a multi-faceted and responsive co-learning approach were core to success. Additionally, there were benefits for individuals, research processes and outcomes, and for driving change in consumer-academic research partnerships. Recruiting to and forming the partnership, maintaining the collaboration through inevitable changes and challenges, and an ethical and supportive closure of the research team were critical. CONCLUSIONS This longitudinal ethnographic study demonstrated that doctoral research can create a rich ethos for research and knowledge co-production which evolved over time. Equalising power dynamics through relationship building and co-learning was critical. Additionally, a focus on supportively ending the partnership was essential, and CCI may reduce PhD student isolation and procrastination. Enhanced university incentivisation of co-production in health research is recommended to address gaps in consumer remuneration and student support.
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Affiliation(s)
- Ruth Cox
- Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Corner Kessels and Troughton Roads, Coopers Plains, QLD, 4108, Australia.
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia.
| | - Matthew Molineux
- Discipline of Occupational Therapy, School of Health Sciences and Social Work, Griffith University, Queensland, Australia
| | - Melissa Kendall
- Acquired Brain Injury Outreach Service and Transitional Rehabilitation Program, Princess Alexandra Hospital, Buranda, QLD, Australia
- School of Health Sciences and Social Work, Griffith University, Meadowbrook, QLD, Australia
| | - Bernadette Tanner
- Consumer Co-Researcher C/O Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, QLD, Australia
| | - Elizabeth Miller
- Consumer Co-Researcher C/O Occupational Therapy Department, Queen Elizabeth II Jubilee Hospital, Coopers Plains, QLD, Australia
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Slattery M, Ehrlich C, Norwood M, Amsters D, Allen G. Disability Research in Australia: Deciding to Be a Research Participant and the Experience of Participation. J Empir Res Hum Res Ethics 2023; 18:37-49. [PMID: 36683436 DOI: 10.1177/15562646221147350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Little is known about why people with disability choose to take part in disability research and what their experience is like. Knowledge of this may help researchers and research ethics committees improve the empowered and ethical participation of people with disability in disability, healthcare, and human service focussed research. This cross-sectional mixed-methods study explored the perspectives and experiences of a group of Australian adults with disability regarding their involvement in research. Online surveys (N = 29) and follow-up interviews (N = 15) were conducted. The study found the decision to participate was a complex appraisal of benefit to self and others, research relevance, value, comfort, convenience, safety and risk. The attitudes and behaviours of researchers in cultivating trust by adopting an empathic approach to the conduct of disability research appear to be an important aspect of participant experience. Research ethics committees may benefit from knowledge of the 'microethical' moments that occur in such research.
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Affiliation(s)
- Maddy Slattery
- School of Health Sciences and Social Work, 5723Griffith University, Meadowbrook, QLD, Australia
- The Hopkins Centre, Griffith University, Australia
| | - Carolyn Ehrlich
- Menzies Health Institute Queensland, Griffith University, Australia
| | | | - Delena Amsters
- The Hopkins Centre, Griffith University, Australia
- Spinal Outreach Team, Metro South Health, Woolloongabba, QLD, Australia
| | - Gary Allen
- Office for Research, Griffith University, Queensland, Australia
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