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Kamila A, Widyawati W, Hasanbasri M, Hakimi M. Capturing the HIV-related social exclusion practices experienced by key populations through photovoice: an interpretative phenomenological study. Reprod Health 2024; 21:107. [PMID: 39004733 PMCID: PMC11247771 DOI: 10.1186/s12978-024-01832-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 06/16/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Key populations are defined as groups that are susceptible to HIV, including Men Sex with Men (MSM), Transgender (TG), Persons who Inject Drug (PID), and Female Sex Worker (FSW). These key populations groups are among the fastest-growing populations in Indonesia. These vulnerable groups are ostracized by society and health services, which makes it difficult to get treatment. This project was carried out to investigate the different experiences and perspectives of these key populations in facing and addressing social and spiritual exclusion. METHODS A qualitative phenomenological study using photovoice was carried out from July to December 2022. Key populations comprising MSM, TG, PID, and FSW were recruited from community-based peer groups in West Bandung Regency using snowball sampling. This was followed by the Photovoice stages, from workshops to focus group discussions and interviews with audio recordings. Furthermore, thematic data analysis was carried out by interpretative participant narratives and photographs supported by Atlas.ti software. RESULT Eighteen participants comprising four MSM, five TG, four PIDs, and five FSWs participated in this research. Among these eighteen participants, six were HIV-negative, including 3 PIDs and 3 FSWs, while the remaining were positive. The analysis of the collected data identified four main themes: 1) limited access like unequal treatment, disadvantage, and harassment, 2) social and spiritual impact, 3) coping mechanisms, and 4) self-reflection through photovoice. These results showed that social exclusion occurred in an environment where community values, beliefs, and norms dehumanised these key populations, and where removal of support and care was prominent. Despite these challenges, participant resilience was evidenced by using internal resources and peer support as coping mechanisms. The participants considered photovoice as a tool to foster self-confidence and self-awareness through a reflective process. CONCLUSIONS The findings of this study highlight the emphasis on participants' openness in sharing their experiences, which can build empathy and promote a more inclusive community in HIV prevention efforts. This research findings can be used to inform HIV policy and practice and inclusion of these key populations in the community. We advocate making the photovoice efforts accessible to a wider audience through exhibitions and various media.
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Affiliation(s)
- Ami Kamila
- Doctoral Program, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Faculty of Health Science, Universitas 'Aisyiyah Bandung, Bandung, West Java, Indonesia
| | - Widyawati Widyawati
- Pediatric and Maternity Nursing Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Mubasysyir Hasanbasri
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Mohammad Hakimi
- Obstetrics and Gynecology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Bryant JV, Carcioppolo N, Lun D, Potter J. Entertainment-education to reduce internalized stigma, increase intimate partner status disclosure intentions, and increase antiretroviral medical adherence intentions: A randomized controlled trial targeting black women living with HIV in the Southern U.S. Soc Sci Med 2023; 327:115945. [PMID: 37182297 DOI: 10.1016/j.socscimed.2023.115945] [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: 03/30/2022] [Revised: 04/06/2023] [Accepted: 05/01/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Black women in the Southern U.S. account for 67% of all new HIV diagnoses across women of all races and ethnicities. In comparison to women of other racial and ethnic identities, Black women disproportionately experience internalized stigma, lower levels of disclosure self-efficacy, and lower rates of medical adherence. The disclosure processes model hypothesizes that persons living with HIV can be disclosure avoidance oriented or disclosure approach oriented. Disclosure avoidance is facilitated by various forms of stigma and negative outcome expectations. While disclosure approach orientation is facilitated by factors such as positive disclosure attitudes and disclosure self-efficacy. Despite the important role of disclosure in ending the HIV epidemic, extant interventions are limited. Recent research suggests entertainment-education (EE) may be an effective intervention for HIV status disclosure. Entertainment-education is a persuasive strategy that consists of intentionally embedding health and social messages into entertaining content. METHODS The present study evaluated the comparative efficacy of the 90 DAYS film for improving internalized HIV stigma, disclosure beliefs, positive disclosure attitudes, disclosure self-efficacy, HIV disclosure intentions, and medical adherence intentions. A randomized controlled trial was employed consisting of 130 Black women living with HIV in the Southern U.S. Participants were recruited primarily via a Qualtrics panel and randomly assigned to either view the 90 DAYS film or a standard of care brochure. RESULTS Results indicated the EE condition significantly outperformed the brochure condition on the following outcomes: disclosure beliefs (p = .046), positive disclosure attitudes (p = .008), disclosure self-efficacy (p = .007), and intentions to disclose to an intimate partner (p = .038). Statistically significant differences were not observed for internalized stigma or medical adherence intentions. CONCLUSION Findings suggest that EE is an effective strategy for improving psychosocial influences of disclosure and disclosure intentions. Theoretical and practical implications of this work are discussed.
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Affiliation(s)
- Jazmyne V Bryant
- Division of Health Science, Florida A&M University, 334 Palmer Avenue, Tallahassee, FL, 32307, USA.
| | - Nick Carcioppolo
- Dept of Communication Studies, University of Miami, 5100 Brunson Dr, Coral Gables, FL, 33146, USA
| | - Di Lun
- Dept of Health Disparities Research, University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030, USA
| | - JoNell Potter
- Dept of Obstetrics and Gynecology, University of Miami, 8932 SW 97th Ave, Miami, FL, 33176, USA
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Ruiz-Burga E, Tariq S, Touloumi G, Gill J, Nicholls EJ, Sabin C, Mussini C, Meyer L, Volny Anne A, Carlander C, Grabar S, Jarrin I, Van der Valk M, Wittkop L, Spire B, Pantazis N, Burns FM, Porter K. CASCADE protocol: exploring current viral and host characteristics, measuring clinical and patient-reported outcomes, and understanding the lived experiences and needs of individuals with recently acquired HIV infection through a multicentre mixed-methods observational study in Europe and Canada. BMJ Open 2023; 13:e070837. [PMID: 37169505 DOI: 10.1136/bmjopen-2022-070837] [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] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Despite the availability of pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART), 21 793 people were newly diagnosed with HIV in Europe in 2019. The Concerted action on seroconversion to AIDS and death in Europe study aims to understand current drivers of the HIV epidemic; factors associated with access to, and uptake of prevention methods and ART initiation; and the experiences, needs and outcomes of people with recently acquired HIV. METHODS AND ANALYSIS This longitudinal observational study is recruiting participants aged ≥16 years with documented laboratory evidence of HIV seroconversion from clinics in Canada and six European countries. We will analyse data from medical records, self-administered questionnaires, semistructured interviews and participatory photography. We will assess temporal trends in transmitted drug resistance and viral subtype and examine outcomes following early ART initiation. We will investigate patient-reported outcomes, well-being, and experiences of, knowledge of, and attitudes to HIV preventions, including PrEP. We will analyse qualitative data thematically and triangulate quantitative and qualitative findings. As patient public involvement is central to this work, we have convened a community advisory board (CAB) comprising people living with HIV. ETHICS AND DISSEMINATION All respective research ethics committees have approval for data to contribute to international collaborations. Written informed consent is required to take part. A dissemination strategy will be developed in collaboration with CAB and the scientific committee. It will include peer-reviewed publications, conference presentations and accessible summaries of findings on the study's website, social media and via community organisations.
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Affiliation(s)
- Elisa Ruiz-Burga
- Institute for Global Health, University College London, London, UK
| | - Shema Tariq
- Institute for Global Health, University College London, London, UK
- Central and Northwest London NHS Foundation Trust, Mortimer Market Centre, London, UK
| | - Giota Touloumi
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - John Gill
- Southern Alberta HIV Clinic, Calgary, Alberta, Canada
| | | | - Caroline Sabin
- Institute for Global Health, University College London, London, UK
| | - Cristina Mussini
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, University of Modena and Reggio Emilia, Modena, Italy
| | - Laurence Meyer
- INSERM CESP U1018, APHP Hôpital de Bicêtre, Le Kremlin-Bicêtre, Paris-Saclay University, Gif-sur-Yvette, France
| | | | - Christina Carlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Sophie Grabar
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, AP-HP, Hôpital St Antoine, Paris, France
| | - Inma Jarrin
- National Centre of Epidemiology, Carlos III Health Institute, Madrid, Spain
- Centro de Investigación Biomédica en Red Enfermedades Infecciosas, Madrid, Spain
| | - Marc Van der Valk
- Department of Infectious Diseases, Amsterdam Infection & Immunity Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands
- HIV Monitoring Foundation, Amsterdam, Netherlands
| | - Linda Wittkop
- INSERM, BPH, U1219, CIC-EC 1401, Universite Bordeaux, Bordeaux, France
- INRIA SISTM Team, Talence, France
| | - Bruno Spire
- Inserm, IRD, SESSTIM, ISSPAM, Aix-Marseille Université, Marseille, France
| | - Nikos Pantazis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Fiona M Burns
- Institute for Global Health, University College London, London, UK
| | - Kholoud Porter
- Institute for Global Health, University College London, London, UK
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Earnshaw VA, Cox J, Wong PL, Saifi R, Walters S, Azwa I, Omar SFS, Collier ZK, Hassan AA, Lim SH, Wickersham J, Haddad MS, Kamarulzaman A, Altice FL. Acceptability and Feasibility of Online, Asynchronous Photovoice with Key Populations and People Living with HIV. AIDS Behav 2022; 27:2055-2069. [PMID: 36463390 PMCID: PMC9734619 DOI: 10.1007/s10461-022-03938-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 12/07/2022]
Abstract
Photovoice is an action-oriented qualitative method involving photography and story-telling. Although photovoice yields a powerful form of data that can be leveraged for research, intervention, and advocacy, it has arguably been underutilized within HIV research. Online, asynchronous photovoice methods represent a promising alternative to traditional in-person methods, yet their acceptability and feasibility with key populations and people living with HIV (PLWH) have yet to be explored. The current study describes the methods and evaluation of an online, asynchronous photovoice project conducted with 34 members of key populations and PLWH in Malaysia in 2021. A HIPAA-compliant website incorporating a series of instructional videos was created to facilitate participant engagement and data collection. Quantitative and qualitative indicators suggest that participants found the project to be highly acceptable and feasible. Online, asynchronous photovoice methods hold potential for increasing the scale of this powerful and versatile qualitative research method with key populations and PLWH.
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Affiliation(s)
- Valerie A Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, 111 Alison Hall West, Newark, DE, 19716, USA.
| | - Jon Cox
- Department of Art and Design, University of Delaware, Newark, DE, USA
| | - Pui Li Wong
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Rumana Saifi
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Centre of Excellence for Research in AIDS, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Suzan Walters
- School of Global Public Health, New York University, New York, NY, USA
| | - Iskandar Azwa
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | | | - Asfarina Amir Hassan
- Centre of Excellence for Research in AIDS, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sin How Lim
- Department of Social and Preventive Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Marwan S Haddad
- Center for Key Populations, Community Health Center, Inc., New Britain, CT, USA
| | - Adeeba Kamarulzaman
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Centre of Excellence for Research in AIDS, Universiti Malaya, Kuala Lumpur, Malaysia
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Musiimenta A, Campbell JI, Tumuhimbise W, Burns B, Atukunda EC, Eyal N, Haberer JE. Electronic Adherence Monitoring May Facilitate Intentional HIV Status Disclosure Among People Living with HIV in Rural Southwestern Uganda. AIDS Behav 2021; 25:2131-2138. [PMID: 33389324 DOI: 10.1007/s10461-020-03143-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 10/22/2022]
Abstract
HIV status disclosure remains one of the major challenges to effective HIV prevention. Given the complexities and low rates of disclosure, new innovative strategies are needed. Since electronic adherence monitoring (EAM) are unique mobile devices that light up when transmitting data, those who see them often want to know more about them, which can potentially result in HIV status disclosure. We conducted a qualitative study to explore patient experiences with EAM for antiretroviral therapy (ART) in Uganda with a goal of understanding potential ethical concerns, including disclosure. Unexpectedly, several participants reported intentionally using EAM to facilitate HIV status disclosure to others in order to get social support, encourage HIV testing, and create awareness about HIV. Although researchers and clinicians need to be mindful of the potential for unintended HIV status disclosure through the use of EAM, they should also recognize the potential of this approach to support intended disclosure.
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Affiliation(s)
- Angella Musiimenta
- Mbarara University of Science and Technology, P.O. Box 653, Mbarara, Uganda.
- Angels Compassion Organisation (ACO), Mbarara, Uganda.
| | | | - Wilson Tumuhimbise
- Mbarara University of Science and Technology, P.O. Box 653, Mbarara, Uganda
| | - Bridget Burns
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
| | - Esther C Atukunda
- Mbarara University of Science and Technology, P.O. Box 653, Mbarara, Uganda
| | - Nir Eyal
- School of Public Health and Philosophy, Rutgers University, New Brunswick, NJ, USA
| | - Jessica E Haberer
- Center for Global Health, Massachusetts General Hospital, Boston, MA, USA
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Chan C. Digital Story Retelling - Evaluation of a Story-reading Workshop Promoting Open-mindedness in the Community. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2019; 16:652-668. [PMID: 32459156 DOI: 10.1080/26408066.2019.1684410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Digital storytelling (DST), broadly speaking, is a storytelling method that is interwoven with digital media. It is commonly used in educational settings or human services to support various sorts of social advocacy. While many of these DST practices have devised methods to engage marginalized groups to express their voices, they lack parallel initiatives to enable audiences to understand those voices. This study examined a story-retelling workshop model called StoryAd, which utilizes productions from DST activities to facilitate face-to-face contact. The workshop itself is also a lite version of DST activity. METHOD A pilot study was conducted in Hong Kong in 2019. Participants enrolled online, met offline, and their advertisement ideas might go online and contribute back to the stories. The workshop model was evaluated using a one-group pretest-posttest design. The participants were 45 Hong Kong Chinese, aged 18-60. RESULTS Participants' critical thinking disposition, self-esteem, perspective-taking, and curiosity toward new information increased, while their need for cognitive-closure decreased. DISCUSSION AND CONCLUSION This study has proved the feasibility and acceptability of the workshop model. It also opens the discussion about extending DST pedagogy to engage and influence story-readers.
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Affiliation(s)
- Chitat Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Cristancho SM, Helmich E. Rich pictures: a companion method for qualitative research in medical education. MEDICAL EDUCATION 2019; 53:916-924. [PMID: 31037744 DOI: 10.1111/medu.13890] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/04/2019] [Accepted: 03/20/2019] [Indexed: 05/20/2023]
Abstract
CONTEXT Within the social sciences, researchers increasingly build on visual methods to explore complex phenomena and understand how people experience and give meaning to this complexity. Amongst the variety of visual methods available, rich pictures are beginning to gain traction in health professions education (HPE) research. APPROACH A rich picture is a pictorial representation of a particular situation, including what happened, who was involved, how people felt, how people acted, how people behaved, and what external pressures they acted upon. Rich pictures expand our perspective; they may highlight connections, illuminate the big picture and reveal unexpected emotions. Although new methods bring excitement to the field, it is our responsibility to also be cautious and insightful about their limitations. Rich pictures are a method in evolution in HPE research, with many unknowns about what is possible and what is optimal. PURPOSE In the current paper, we aim to map out the background, describe the process and share some reflective insights of using rich pictures as a data collection method.
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Affiliation(s)
- Sayra M Cristancho
- Department of Surgery, Faculty of Education, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Esther Helmich
- CEDAR, University Medical Center Groningen, Groningen, the Netherlands
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Sun CJ, Nall JL, Rhodes SD. Perceptions of Needs, Assets, and Priorities Among Black Men Who Have Sex With Men With HIV: Community-Driven Actions and Impacts of a Participatory Photovoice Process. Am J Mens Health 2018; 13:1557988318804901. [PMID: 30296869 PMCID: PMC6440064 DOI: 10.1177/1557988318804901] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Black men who have sex with men (MSM) with HIV experience significant health inequities and poorer health outcomes compared with other persons with HIV. The primary aims of this study were to describe the needs, assets, and priorities of Black MSM with HIV who live in the Southern United States and identify actions to improve their health using photovoice. Photovoice, a participatory, collaborative research methodology that combines documentary photography with group discussion, was conducted with six Black MSM with HIV. From the photographs and discussions, primary themes of discrimination and rejection, lack of mental health services, coping strategies to reduce stress, sources of acceptance and support, and future aspirations emerged. After the photographs were taken and discussed, the participants hosted a photo exhibition and community forum for the public. Here, 37 community attendees and influential advocates collaborated with the participants to identify 12 actions to address the men's identified needs, assets, and priorities. These included making structural changes in the legal and medical systems, encouraging dialogue to eliminate multiple forms of stigma and racism, and advocating for comprehensive care for persons with HIV. As a secondary aim, the impacts of photovoice were assessed. Participants reported enjoying photovoice and found it meaningful. Results suggest that in addition to cultivating rich community-based knowledge, photovoice may result in positive changes for Black MSM with HIV.
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Affiliation(s)
- Christina J Sun
- 1 Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Jennifer L Nall
- 2 Forsyth County Department of Public Health, Winston-Salem, NC, USA
| | - Scott D Rhodes
- 3 Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Division of Public Health Sciences, Winston-Salem, NC, USA
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Woda A, Haglund K, Belknap R, Cleek E. Photovoice: A Research Method and Intervention to Engage Older Adults. J Gerontol Nurs 2018; 44:43-49. [PMID: 29969139 DOI: 10.3928/00989134-20180614-07] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 04/23/2018] [Indexed: 11/20/2022]
Abstract
The purpose of the current article is to describe the use of photovoice with individuals from vulnerable population groups. Ten African American men and women ages 66 to 72 with heart failure from three different low income public housing facilities were recruited for participation in a qualitative photovoice project. Participants were given 5 weeks to take photographs of images that represented facilitators of and barriers to engaging in self-care behaviors. Each week, participants met as a group to discuss the photographs and their meanings to other participants. The photovoice method was empowering to participants, easy to use, and shown to be appropriate within African American older adults with heart failure. The photovoice method assisted in providing the opportunity for this vulnerable population to share their personal beliefs and perspectives. Use of this method assisted in identification of themes that represented facilitators of and barriers to engaging in self-care and was effective in meeting the specific aims of the research project. Findings from the current study support photovoice as a valuable method to use with vulnerable individuals with chronic conditions. [Journal of Gerontological Nursing, 44(7), 43-49.].
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Helmich E, Diachun L, Joseph R, LaDonna K, Noeverman-Poel N, Lingard L, Cristancho S. 'Oh my God, I can't handle this!': trainees' emotional responses to complex situations. MEDICAL EDUCATION 2018; 52:206-215. [PMID: 29044675 DOI: 10.1111/medu.13472] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 05/12/2017] [Accepted: 09/04/2017] [Indexed: 05/28/2023]
Abstract
CONTEXT Dealing with emotions is critical for medical trainees' professional development. Taking a sociocultural and narrative approach to understanding emotions, we studied complex clinical situations as a specific context in which emotions are evoked and influenced by the social environment. We sought to understand how medical trainees respond to emotions that arise in those situations. METHODS In an international constructivist grounded theory study, 29 trainees drew two rich pictures of complex clinical situations, one exciting and one frustrating. Rich pictures are visual representations that capture participants' perceptions about the people, situations and factors that create clinical complexity. These pictures were used to guide semi-structured, individual interviews. We analysed visual materials and interviews in an integrated way, starting with looking at the drawings, doing a 'gallery walk', and using the interviews to inform the aesthetic analysis. RESULTS Participants' drawings depicted a range of personal emotions in response to complexity, and disclosed unsettling feelings and behaviours that might be considered unprofessional. When trainees felt confident, they were actively participating, engaged in creative problem-solving strategies, and emphasised their personal involvement. When trainees felt the situation was beyond their control, they described how they were running away from the situation, hiding themselves behind others or distancing themselves from patients or families. CONCLUSIONS A sense of control seems to be a key factor influencing trainees' emotional and behavioural responses to complexity. This is problematic, as complex situations are by their nature emergent and dynamic, which limits possibilities for control. Following a social performative approach to emotions, we should help students understand that feeling out of control is an inherent property of participating in complex clinical situations, and, by extension, that it is not something they will 'grow out of' with expertise.
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Affiliation(s)
- Esther Helmich
- University Medical Center Groningen, Groningen, the Netherlands
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Abstract
Photovoice is a practical method to allow at-risk youth to express the environmental influences in their lives at school, at home, and in their community. This project emerged from an interprofessional collaboration between social work and nursing that focused on school health. The purpose was to explore the factors influencing the mental and emotional health using photographs by students in a largely Hispanic middle school. Ten students were recruited and consented but only eight completed the project. The SHOWeD method was used to assist the students to formally reflect upon their photographs. Data analysis was conducted using content analysis to identify themes presented the students' reflections. The themes were staying healthy, stress dealing with anger/frustration, maintaining friendships and communication, recognizing bullying, and planning for the future. Reflections aided students to provide rich details about how the school environment influences their mental and emotional health. The use of Photovoice is a reasonable method for at-risk youth to explore and describe their environment. Nurses, social workers, parents, and school leaders can use the new knowledge about how the school environment influences the health of students to develop tools to support a healthy school and community environment.
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Affiliation(s)
- Lisa Bashore
- 1 Harris College of Nursing, Texas Christian University, Fort Worth, TX, USA
| | - Gina K Alexander
- 1 Harris College of Nursing, Texas Christian University, Fort Worth, TX, USA
| | - D Lynn Jackson
- 2 Department of Social Work, Texas Christian University, Fort Worth, TX, USA
| | - Paige Mauch
- 2 Department of Social Work, Texas Christian University, Fort Worth, TX, USA
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