Social Positioning Theory as a lens for exploring health information seeking and decision making

Infection prevention and control in neonatal units: An ethnographic study of social and clinical interactions among healthcare providers and mothers in Ghana

INTRODUCTION

Healthcare-associated infections (HAIs) are a global health challenge, particularly in low- and middle-income countries (LMICs). Infection prevention and control (IPC) remains an important strategy for preventing HAIs and improving the quality of care in hospital wards. The social environment and interactions in hospital wards are important in the quest to improve IPC. This study explored care practices and the interactions between healthcare providers and mothers in the neonatal intensive care units (NICU) in two Ghanaian hospitals and discusses the relevance for IPC.

METHODOLOGY

This study draws on data from an ethnographic study using in-depth interviews, focus group discussions involving 43 healthcare providers and 72 mothers, and participant observations in the wards between September 2017 and June 2019. The qualitative data were analysed thematically using NVivo 12 to facilitate coding.

FINDINGS

Mothers of hospitalized babies faced various challenges in coping with the hospital environment. Mothers received sparse information about their babies' medical conditions and felt intimidated in the contact with providers. Mothers strategically positioned themselves as learners, guardians, and peers to enable them to navigate the clinical and social environment of the wards. Mothers feared that persistent requests for information might result in their being labelled "difficult mothers" or might impact the care provided to their babies. Healthcare providers also shifted between various positionings as professionals, caregivers, and gatekeepers, with the tendency to exercise power and maintain control over activities on the ward.

CONCLUSION

The socio-cultural environment of the wards, with the patterns of interaction and power, reduces priority to IPC as a form of care. Effective promotion and maintenance of hygiene practices require cooperation, and that healthcare providers and mothers find common grounds from which to leverage mutual support and respect, and through this enhance care for mothers and babies, and develop stronger motivation for promoting IPC.

Exploring the multidimensional relationships between social media support, social confidence, perceived media credibility and life attitude during the COVID-19 pandemic

Previous literature mainly focuses on the impact of social media support on social trust, emotional effect and life attitude, and affirmed the social governance value of social media support. However, the multidimensional relationship between social media support and social confidence, perceived media credibility and life attitude during the COVID-19 pandemic is an important, yet less explored, research issue. The present research aimed to fill in this gap by a survey of 1343 participants who are permanent residents aged 18 and above in a city through WeChat social networking platform. The results showed that: (1) social media support exerted direct influence on social confidence, perceived media credibility and life attitude; (2) perceived media credibility positively influenced social confidence; (3) social media support not only directly promoted social confidence, but also indirectly influenced social confidence through public’s perceived media credibility. These findings suggested that strengthening social media support during the COVID-19 pandemic is not only helpful to reconstitute the public’s confidence in prevailing against the pandemic, but also is able to help promote the diversification of the power of public network autonomy. This study highlighted social media support as an effective path to improve the ability of social governance.

Social Positioning Analysis as a Qualitative Methodology to Study Identity Construction in People Diagnosed With Severe Mental Illnesses

Severe mental illnesses (SMI) in general, and schizophrenia in particular, have been characterized as alterations of the experience of self and identity. When first diagnosed with SMI, the subjective experiences and specific narrative challenges faced by this population are particularly important. Therefore, qualitative approaches which allow to analyze these subjective experiences should be developed. This article presents in detail a specific method, called Social Positioning Analysis, which makes the complexity of narratives and life stories with multiple turning points understandable. To develop this methodological proposal, it has been taken into account the performative aspects of social interaction in which narratives are constructed. The methodology has previously been used in other health contexts and is innovative in the field of mental health. Linguistic criteria, definitions, and multiple examples are included to facilitate its application, as well as some reflections about its potential and possible benefits.

Wikipedia: an unexplored resource for understanding consumer health information behaviour in library and information science scholarship

Purpose

To date, health information behaviour (HIB) models have not been applied to an exploration of Wikipedia as a consumer health information resource. Wikipedia has been situated and is well established as a valuable resource for the general layperson wishing to learn more about their health or the health of a loved one. This paper aims to identify an approach to exploring the role of Wikipedia in consumer health information behaviour (CHIB) that is grounded in a conceptual framework from the library and information science (LIS) discipline.

Design/methodology/approach

The author draws on current HIB models and relevant theories from existing LIS literature and applies them to propose a new definition of CHIB. The author uses this definition to frame Wikipedia as an unexplored consumer health information resource in the LIS scholarship and suggests future directions for placing such investigations within a conceptual framework from LIS.

Findings

The paper finds that Longo's expanded conceptual model of health information-seeking behaviour (ECMHISB) could be valuable and useful for the exploration of CHIB in relation to Wikipedia's health and medical content. Due to Wikipedia's online nature, research framed by these models must acknowledge and take under consideration the digital divide phenomenon and various factors that influence an individual's place within it.

Research limitations/implications

This work builds a foundation upon which future research into the role of Wikipedia's health and medical content in CHIB can be grounded. Using Longo's model, future research might provide insight into who Wikipedia is helping and who it has left behind. LIS scholars, practicing health librarians and perhaps health workers stand to gain a deeper understanding of the potential influence of Wikipedia's health information on its consumers.

Originality/value

For LIS scholars, this paper is novel in the fact that a HIB model has not yet been applied to the study of Wikipedia's health content. This paper provides a foundation for this research.

Shared Dilemmas in the Management of Bipolar Disorder

A hermeneutic phenomenological analysis reveals the complexity of bipolar disorder. Operating at biological, psychological, and social levels this phenomenon creates dilemmas and people must account for their choices in a moral order. Two participants suffer from the condition, whereas a third is employed to deliver mental health treatment. Three themes are identified showing that all the participants struggle to feel they are competent and consistent decision makers. They feel exposed, fearing that others will impose interpretations on their behavior. They resist the imposition of a medical model, wanting to believe that choices are personal and related to life experiences. This person-centered interpretation is favored because it offers the potential for learning, for achieving autonomy, and growth. By attending to the interpersonal aspects of emotion and subjectivity, this analysis challenges the idea that autonomy can be undermined by a disease process in a simple manner. It is suggested that mental health care systems need to deliver services in which the personal and interpersonal aspects of recovery are adequately managed.

Clinical Positioning Space: Residents' Clinical Experiences in the Outpatient Oncology Clinic

In this article, we present a case study of residents' clinical experiences and communication in outpatient oncology consultations. We apply positioning theory, a dynamic alternative to role theory, to investigate how oncology residents and patients situate themselves as persons with rights and duties. Drawing from seven qualitative interviews and six days of observation, we investigate the residents' social positioning and their conversations with patients or supervisors. Our focus is on how (a) relational shifts in authority depend on each situation and its participants; (b) storylines establish acts and positions and narratively frame what participants can expect from a medical consultation viewed as a social episode; and (c) the positioning of rights and duties can lead to misunderstandings and frustrations. We conclude that residents and patients locate themselves in outpatient conversations as participants who jointly produce and are produced by patients' and nurses' storylines about who should take responsibility for treatment.

A feminist information engagement framework for gynecological cancer patients

Purpose

– The purpose of this paper is to present a three-part framework of information engagement for situated gynecological cancers. These particular cancers intertwine with medicalization of sexuality and gender power dynamics, situating information behaviors and interactions in women’s socio-health perceptions. Using Kavanagh and Broom’s feminist risk framework, the framework establishes functional and temporal parameters for sense-making and information engagement.

Design/methodology/approach

– This paper employs a structured, reiterative literature review with emergent thematic analysis. Nine indices from medicine, information studies, and sociology were searched using combinations of five terms on cervical cancer (CC) and 14 terms on information engagement in the title, abstract, and subject fields. Results were examined on a reiterative basis to identify emergent themes pertaining to knowledge development and information interactions.

Findings

– Environmentally, social stigma and gender roles inhibit information seeking; normalizing CC helps integrate medical, moral, and sexual information. Internally, living with the dichotomy between “having” a body and “being” a body requires high-trust information resources that are presented gradually. Actively, choosing to make or cede medical decision-making requires personally relevant information delivered in the form of concrete facts and explanations.

Research limitations/implications

– The study covers only one country.

Originality/value

– This study’s information framework and suggestions for future research encourage consideration of gender power dynamics, medicalization of sexuality, and autonomy in women’s health information interactions.

Women's experiences of planning a vaginal breech birth in Australia

Background

In many countries, planned vaginal breech birth (VBB) is a rare event. After the Term Breech Trial in 2000, VBB reduced and caesarean section for breech presentation increased. Despite this, women still request VBB. The objective of this study was to explore the experiences and decision-making processes of women who had sought a VBB.

Methods

A qualitative study using descriptive exploratory design was undertaken. Twenty-two (n = 22) women who planned a VBB, regardless of eventual mode of birth were recruited. The women had given birth at one of two maternity hospitals in Australia that supported VBB. In-depth, semi-structured interviews using an interview guide were conducted. Interviews were analysed thematically.

Results

Twenty two women were interviewed; three quarters were primiparous (n = 16; 73%). Nine (41%) were already attending a hospital that supported VBB with the remaining women moving hospitals. All women actively sought a vaginal breech birth because the baby remained breech after an external cephalic version – 12 had a vaginal birth (55%) and 10 (45%) a caesarean section after labour commenced. There were four main themes: Reacting to a loss of choice and control, Wanting information that was trustworthy, Fighting the system and seeking support for VBB and The importance of ‘having a go’ at VBB.

Conclusions

Women seeking a VBB value clear, consistent and relevant information in deciding about mode of birth. Women desire autonomy to choose vaginal breech birth and to be supported in their choice with high quality care.

"I think about Oprah": social class differences in sources of health information

Health information influences an individual's health outcomes. Indeed, researchers have found that communication inequalities contribute to health inequalities. We do not have a clear understanding of why and how the communication disparities exist, however, particularly the social forces behind such differences. The qualitative nature of this article reveals the nuances of health information seeking using the case of infertility. Through 58 in-depth interviews, I demonstrate how differences in social and cultural capital between women of low and high socioeconomic status (SES) result in different ways of learning about health. Women of high SES have access to support groups, physicians, and the Internet, whereas women of low SES do not discuss their health problems with their peers, and lack access to and distrust physicians. I explore how these differences in health information shape the illness experience. I conclude with policy implications.