Difference Within and Without: Health Care Providers' Engagement With Disability Arts

Misfits Meet Art and Technology: Cripping Transmethodologies

This article thinks with disability theory and artistic praxis to explore how disabled artists repurpose and invent technologies in artistic processes designed to enact care and access, extend embodiment, satiate the senses, and create crip culture. Drawing on four examples, we claim that disabled artists are creative technologists whose non-normative culture-making practices approach accessibility as a transmethodological process that requires and generates new forms of interconnected technology and artfulness. Disabled artists, as "creative users," change the uses and outcomes of technology, dis-using technologies in ways that lead to a more dynamic understanding of access and with it, of crip cultures as processual, artful, and political.

Critical reflection in team-based practice: A narrative review

INTRODUCTION

Research on critical reflection (a process of recognising and challenging assumptions that frame health care practice) has demonstrated strong potential for making health care more collaborative and equitable, yet its enactment within team-based health care remains underexplored. We conducted a narrative review to advance understanding of how critical reflection develops, occurs in and impacts team-based practice and care.

METHODS

We searched three databases (Medline, CINAHL and Scopus) for articles related to the concepts of critical reflection and/or critically reflective practice in the context of team-based health care and examined how teams engage with those theoretical concepts, to inform ideas for a new approach to support critically reflective practice.

FINDINGS

The search identified 974 citations of which nine articles showed elements of critical reflection in team-based practice. However, since only one of the nine included articles explicitly used the term 'critical reflection' in their research, critical reflection as a theoretical concept was found to be largely missing from the current team-based health care literature. Instead, aspects of critical reflection were evident in terms of challenging power hierarchies and questioning practice assumptions through dialogue, with a goal of collaborative practice. This sharing of knowledge and skills allowed teams to push boundaries and innovate together in practice. The included articles also emphasised the importance of creating a purposeful environment for open dialogue and practice change to occur.

CONCLUSION

To support equitable care through collaborative practices, we suggest dialogue as and for critical reflection should be explicitly developed and researched within team-based health care.

Dementia as a material for co-creative art making: Towards feminist posthumanist caring

This article generates new understandings of dementia through feminist posthumanist and performative engagements with co-creative artmaking practices during a six-month study in a residential care home in Norway. Dementia emerges within multisensorial entanglements of more-than-human materials in three different artmaking sessions, which first materialized in the form of collective photographs and vignettes and culminated in a final exhibition, Gleaming Moments, in the care home. Drawing on these photographs, vignettes, and the author's engagement as a research artist in the sessions, this analysis examined how dementia was enacted as a spark of inspiration, felted warm seat pads, and a friendly more-than-human touch, that is, a touch of human and nonhuman art materials. These findings suggest new ontologies of dementia within multisensorial artmaking practices, in which dementia functions as a material for co-creative artmaking rather than a disease. These findings disrupt dominant biomedical ontologies of Alzheimer's disease and other dementias, as well as humanist person-centered practices in dementia care, which have concretized an individual, rather than relational, focus on dementia. In contrast, this study explores dementia as a phenomenon within the entanglements of human and nonhuman intra-active agencies. By highlighting the significance of these agencies (i.e., sponge holder-painting, wool-felting, choir-singing, chick-making) for different worlds-making with dementia, this study provides an entry point for imagining feminist posthumanist caring. Thus, dementia becomes a matter in life that is not to be managed and defeated to achieve successful aging, but to be interrogated and embraced.

Medical invalidation in the clinical encounter: a qualitative study of the health care experiences of young women and nonbinary people living with chronic illnesses

BACKGROUND

Medical invalidation is a well-documented phenomenon in the literature on chronic illnesses, yet there is a paucity of research capturing the perspectives of young adults living with chronic illnesses, and especially of those who are gender diverse or from groups that face broader societal marginalization. Our study sought to answer the following question: How do young women and nonbinary adults living with chronic illnesses characterize their experiences of medical invalidation and its impact on their health and well-being?

METHODS

This was a patient-oriented qualitative study informed by feminist disability theory. Eligibility requirements included self-identifying as having a chronic illness, self-identifying as a woman or nonbinary person receiving health care in Manitoba, and being between the ages of 18 and 35 years. Participants took part in online arts-based workshops and subsequent focus group discussion in November 2021.

RESULTS

Eight women and 2 nonbinary individuals participated. Medical invalidation was experienced by all of the participants at different points in their illness journeys and took a variety of forms depending on their social location and their particular illness, positioning invalidation as an issue of in/visibility. We identified several consequences of medical invalidation, including internalizing invalidation, overcompensating for their illness, avoiding care and, ultimately, symptom intensification. We also present participants' recommendations to avoid medical invalidation.

INTERPRETATION

This study provides insight into the phenomenon of medical invalidation, understood as the act of dismissing, minimizing or otherwise not taking patient concerns seriously. We suggest person-centred care may not be enough, and critical reflexivity may help avoid unintentionally invalidating patient experiences.

Data for all: Tactile graphics that light up with picture-perfect resolution

People who are blind do not have access to graphical data and imagery produced by science. This exclusion complicates learning and data sharing between sighted and blind persons. Because blind people use tactile senses to visualize data (and sighted people use eyesight), a single data format that can be easily visualized by both is needed. Here, we report that graphical data can be three-dimensionally printed into tactile graphics that glow with video-like resolution via the lithophane effect. Lithophane forms of gel electropherograms, micrographs, electronic and mass spectra, and textbook illustrations could be interpreted by touch or eyesight at ≥79% accuracy (n = 360). The lithophane data format enables universal visualization of data by people regardless of their level of eyesight.

Healthcare Barriers Among Working-Age Persons with Disabilities in Trinidad

Even though easily accessible and cost-effective healthcare is a fundamental human right, many persons with disabilities experience healthcare barriers and poor health outcomes. We explore the healthcare barriers among working-age persons with disabilities in Trinidad using a qualitative descriptive approach. Semi-structured interviews with 26 participants reveal barriers at the personal, healthcare facility, and societal levels. The findings indicate the need for a nation-wide integrated digitalized system and increased intersectoral collaborations to support adequate healthcare among persons with disabilities in Trinidad. Increased consultation with persons with disabilities and transformation of the disability discourses within the healthcare system and at the national level are also recommended as part of the humanisation of their care.

What a body can do: Rethinking body functionality through a feminist materialist disability lens

A burgeoning body of literature shows a positive relationship between body functionality and positive body image. Although still nascent, research centring experiences of people with disabilities and bodily differences develops this literature. In this article, we offer directions for this research, bringing body functionality into dialogue with feminist materialist disability theory to examine relations between people's bodily perceptions and the socio-material worlds they occupy. Feminist disability theory re-imagines difference through an affirmative lens, conceptualising body image as relational and processual, and approaching difference through four orientations: difference is basic to the world; difference is not deficiency; difference is not the problem, our inhospitable and ableist world is; and centring difference exposes the mythical norm. We apply this lens to body functionality research, and outline implications for research, practice, and theory, arguing that building a bridge between these frameworks offers a stepping off point for exciting directions for body image research.

Healthcare providers' engagement with eating disorder recovery narratives: opening to complexity and diversity

Interdisciplinary healthcare providers (HCPs) receive only minimal training in identifying, referring for and treating eating disorders and may feel ill-prepared to manage them. There is a need for brief interventions that prepare HCPs for work with people with eating disorders, particularly when they do not fit stereotypes about who might experience an eating disorder. One method for enacting brief interventions that make change in this realm is using digital stories (short videos) to generate awareness and knowledge. In this article, we discuss the results of a pilot study exploring the impact of viewing digital stories created by people in eating disorder recovery and their supporters on an interdisciplinary group of HCPs. We showed five stories to 22 HCPs who filled out qualitative prequestionnaires and postquestionnaires about their experiences of viewing the films and how they conceptualised recovery. Providers found the stories evocative; the stories appear to have complexified their perspectives on recovery. HCPs desired more diverse, detailed and lengthy stories, indicating that pursuing digital storytelling for HCP education and awareness may hold promise. Through centring the voices of people with eating disorders and in recovery, digital stories may also provide new ways of talking about recovery that open up possibilities for embracing difference.

Elements of a counter-exhibition: Excavating and countering a Canadian history and legacy of eugenics

Into the Light, a recently mounted collectively curated museum exhibition, exposed and countered histories and legacies of 20th-century "race betterment" pedagogies taught in Ontario's postsecondary institutions that targeted some groups of people, including Anishinaabe, Black, and other racialized populations, and disabled and poor people, with dehumanizing ideas and practices. This article advances understandings of the transformative potential of centralizing marginalized stories in accessible and creative ways to disrupt, counter, and draw critical attention to the brutal impacts of oppressive knowledge. The "counter-exhibition" prioritized stories of groups unevenly targeted by such oppression to contest and defy singular narratives circulating in institutional knowledge systems of what it means to be human. The authors draw on feminist, decolonial and disability scholarship to analyze the exhibition's curation for the ways it collectively and creatively: (1) brought the past to the present through materializing history and memory in ways that challenged archival silences; and (2) engaged community collaboration using accessible, multisensory, multimedia storytelling to "speak the hard truths of colonialism" (Lonetree) while constructing a new methodology for curating disability and access (Cachia). The authors show how the exhibition used several elements, including counter-stories, to end legacies of colonial eugenic violence and to proliferate accounts that build solidarity across differences implicated in and impacted by uneven power (Gaztambide-Fernández).

Difference-attuned witnessing: Risks and potentialities of arts-based research

In this paper, we interrogate notions of affect, vulnerability and difference-attuned empathy, and how they relate to bearing witness across difference—specifically, connecting through creativity, experiencing the risks and rewards of vulnerability, and witnessing the expression of difficult emotions and the recounting of affect-imbued events within an arts-based process called digital/multi-media storytelling (DST). Data for this paper consists of 63 process-oriented interviews conducted before and after participants engaged with DST in a research project focused on interrogating negative concepts of disability that create barriers to healthcare. These retrospective reflections on DST coalesce around experiences of vulnerability, relationality, and the risks associated with witnessing one’s own and others’ selective disclosures of difficult emotions and affect-laden aspects of experiences of difference. Through analysing findings from our process-oriented interviews, we offer a framework for understanding witnessing as a necessarily affective, difference-attuned act that carries both risk and transformative potential. Our analysis draws on feminist Indigenous (Maracle), Black (Nash) and affect (Ahmed) theories to frame emerging concepts of affective witnessing across difference, difference-attuned empathy, and asymmetrical vulnerability within the arts-based research process.