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Abstract
This article reports on the findings from a small-scale co-produced qualitative study on experiences of distress caused by the war in Bosnia and Herzegovina (BiH). Inspired by the emerging interdisciplinary field of Mad Studies, the study is novel and unique in two ways. First, it prioritises social understanding and interpretation of madness and distress. Second, an emphasis is placed on experiential knowledge. Beyond interviews with 20 people who experienced distress due to political conflict, this included contextualisation of the study in the knowledge generated through survivor research and within the field of Mad Studies. Study findings highlight the social causes and consequences of distress caused by conflict, such as war-related violence, gender-based violence, experiences of poverty and corruption. Participants stressed the importance of safety and support within their own home, mutual and supportive relationships with their families, friends, other people who experienced distress, the broader community and opportunities to do everyday activities they enjoy. In terms of professional support, the findings suggest that poverty alleviation and protection of people's right to self-determination through access to human rights advocacy and representation may be as relevant as non-coercive community-based services. This indicates that support for distress caused by political conflict need not be different from any other support for people who experience distress. Emphasis should be placed on survivor-run initiatives and non-coercive, community-based support which addresses social causes of distress and enables people to exercise self-determination.
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van Lummel EVTJ, Ietswaard L, Rigter M, Tjan DHT, van Delden JJM, Milota M. Finding the balance between person-centred and treatment-centred discussions in advance care planning-a qualitative analysis of conversations within the MUTUAL (Multidisciplinary Timely Undertaken Advance Care Planning conversations) intervention using a narrative analysis. Age Ageing 2024; 53:afae020. [PMID: 38452194 PMCID: PMC10919783 DOI: 10.1093/ageing/afae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/30/2023] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Advance care planning (ACP) aims to create conditions for more person-centred care. We aimed to explore variations in person-centred care discussions and treatment-centred care discussions within ACP conversations in the Multidisciplinary Timely Undertaken Advance Care Planning (MUTUAL) intervention and how person-centred care discussions could be encouraged. The MUTUAL intervention consists of the following: (i) timely patient selection, (ii) the patient and healthcare professionals preparing for the conversation, (iii) a scripted ACP conversation in a multidisciplinary setting and (iv) documentation. METHODS We conducted a narrative analysis of ACP conversations. A narrative summary template was created and used to analyse 18 audio-recordings. RESULTS We noticed variations in person-centred and treatment-centred focus within the ACP conversations. We identified three important strategies that facilitated person-centred care discussions within ACP conversations. First, healthcare professionals' acceptance that ACP is an individual process. We believe it is important that healthcare professionals recognise and accept where the patient is in his or her individual ACP process; not making decisions right away can also be part of a decisional process. Secondly, exploring the underlying motivation for treatment wishes can give insights into patient's wishes, values and needs. Lastly, healthcare professionals who demonstrated an adaptive, curious and engaged attitude throughout the ACP process achieved more person-centred ACP conversations. This coincided with elaborating on the patient's emotions, fears and worries. CONCLUSION Person-centred and treatment-centred focus varied within the ACP conversations in the MUTUAL intervention. Certain strategies by healthcare professionals facilitated a more person-centred focus.
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Affiliation(s)
- Eline V T J van Lummel
- Department of Intensive Care, Gelderse Vallei Hospital, Ede, Netherlands
- Department of Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Larissa Ietswaard
- Department of Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Marloes Rigter
- Department of Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Dave H T Tjan
- Department of Intensive Care, Gelderse Vallei Hospital, Ede, Netherlands
| | - Johannes J M van Delden
- Department of Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Megan Milota
- Department of Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
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Hamui Sutton A, Sánchez-Guzmán MA. Resident training in psychopathology and uncertainty in a clinical situation. Health (London) 2024; 28:290-312. [PMID: 36245256 DOI: 10.1177/13634593221127821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The central theme of this article is the way in which psychiatry physicians-in-training deal with uncertainty in the discussion of clinical cases in Mexico. Methodologically, it is approached from the field of clinical ethnography and the narrative interpretation of plots in performative actions where there are sequences of communicative exchanges. In this way, it focuses on a detailed description of situations where clinical cases are reviewed to decipher, explain, and understand intersubjective meanings in the face of the emergence of uncertainty, its management, and the implications on decisions and actions. The study finds that limitations within the field of psychiatry lie in the nosographic construction of disease and its translation into the diagnostic hypotheses made by clinicians, where there are wide margins of ambiguity. The strategies implemented in the face of uncertainty are use of drugs, the collegiate review of the case, and utilization of intuition as a spontaneous, preconscious daily practice. The specific case described here provides a microscopic observation of the complex scenarios in which uncertainty occurs in educational and teaching processes, clearly revealing how patient care is articulated. The narratives and their interpretation are materials for training/curriculum and psychiatric clinical practice.
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Gleason K, Martin J, Bernier E. Community narratives on rural homelessness: Tales of terror and tales of compassion. J Prev Interv Community 2024:1-30. [PMID: 38411157 DOI: 10.1080/10852352.2024.2315367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Homelessness is often assumed to be mostly confined to urban spaces, leaving experiences of homelessness in rural contexts largely unexamined. The present study aims to understand the discursive context, or public understanding, of homelessness in rural communities. We examined community narratives related to the idea of "homelessness" in rural spaces. Semi-structured qualitative interviews were conducted with 70 key stakeholders from four rural communities in the U.S. State of Maine. Participants were asked to give their impressions related to homelessness in their community. We conducted a systematic qualitative analysis of these interviews and our analysis was grounded in a critical discourse analysis perspective. Using Rappaport's framework for understanding helpful and harmful community narratives, we identified three community narratives that harm by stereotyping or erasing homelessness in rural communities: Not Here, That One Guy, and Mainly Outsiders. We also examined counter-narratives that worked against each of the three primary narratives: It Looks Different, It's More Hidden, and Local Struggle and Lack of Resources. The counter-narratives tell a different, more compassionate, story of homelessness in rural spaces. Our main goal was to analyze the "work" that each of these narratives were doing in terms of constructing different understandings of "rural homelessness." The implications for policy and practice are discussed.
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Affiliation(s)
- Kristen Gleason
- Psychology Department, University of Southern Maine, Portland, Maine, USA
| | - Jennifer Martin
- Psychology Department, University of New Haven, West Haven, Connecticut, USA
| | - Elizabeth Bernier
- Psychology Department, University of Southern Maine, Portland, Maine, USA
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Parkes J, Datzberger S, Nagawa R, Musenze JB, Kasidi JR, Bhatia A, Naker D, Devries K. Unintended pregnancies in the lives of young people in Luwero, Uganda: a narrative analysis. Cult Health Sex 2024:1-16. [PMID: 38315580 DOI: 10.1080/13691058.2024.2305820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 01/11/2024] [Indexed: 02/07/2024]
Abstract
Using a feminist narrative approach, this article explores how unintended pregnancy can rupture young lives, and how young people respond to and navigate these ruptures. We analyse qualitative data from a longitudinal cohort study in Luwero, Uganda, focusing on narratives of a girl and a boy about their recent experiences of unintended and unwanted pregnancy during COVID-19 school closures. We argue that laws, policies and norms relating to education, sexual and reproductive health, and the family in Uganda position young people in complex and contradictory ways, that create the conditions for unintended pregnancies, and restrict the choices open to them. The analysis traces how pregnancy ruptures their everyday lives, their identities, and relationships. Their narratives reveal gendered ways in which they enact identities to manage the ruptures. Families are sites of contestation, where gender and sexuality are regulated, but are also mobilised by young people to support their efforts to repair the ruptures. Our analysis underscores the importance of working with young people to understand their positionalities, resource environments and social networks as they make and navigate decisions about pregnancy, and of addressing the structural forces that underpin the rupturing effects of pregnancy on teenage lives.
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Affiliation(s)
- Jenny Parkes
- Education, Practice and Society, IOE Faculty of Education and Society, UCL, London, UK
| | - Simone Datzberger
- Education, Practice and Society, IOE Faculty of Education and Society, UCL, London, UK
| | - Rehema Nagawa
- Medical Research Council/Uganda Virus Research Institute, MUL, Entebbe, Uganda
| | | | - Joan Ritar Kasidi
- Medical Research Council/Uganda Virus Research Institute, MUL, Entebbe, Uganda
| | - Amiya Bhatia
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Karen Devries
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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Diefenbach GJ, Stubbing J, Rice TB, Lord KA, Rudd MD, Tolin DF. Uncovering the role of substance use in suicide attempts using a mixed-methods approach. Suicide Life Threat Behav 2024; 54:70-82. [PMID: 37987548 DOI: 10.1111/sltb.13019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Substance use is an established risk factor for suicide attempt. Clarifying the role of substance use in suicide attempts may identify modifiable treatment targets. This study used mixed methods to associate substance use with suicide attempt history and identify pathways through which substance use contributes to attempts. METHODS Study 1 included 213 adult inpatients (n = 127 with substance use disorder [SUD]), who completed assessments of suicide attempt history as well as demographic and clinical suicide risk factors. Study 2 was a narrative analysis of suicide attempt stories described by 20 inpatients diagnosed with SUD. RESULTS In Study 1, patients with co-occurring alcohol and drug use disorders reported more actual lifetime suicide attempts than did those without SUD. In addition, alcohol and drug use disorders were independently associated with lifetime suicide attempts after controlling for demographic and clinical confounders. In Study 2, substance use played a role in all suicide attempts through at least one pathway before, during, or after a triggering stressor, or as suicide attempt method. CONCLUSIONS Substances play a role in suicide attempt baseline risk, acute risk and as means. It is important to target chronic and acute substance use in suicide prevention treatment plans.
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Affiliation(s)
- Gretchen J Diefenbach
- Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut, USA
- Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jessica Stubbing
- Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut, USA
| | - Tyler B Rice
- Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut, USA
| | - Kayla A Lord
- Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut, USA
| | | | - David F Tolin
- Anxiety Disorders Center, The Institute of Living, Hartford, Connecticut, USA
- Yale University School of Medicine, New Haven, Connecticut, USA
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Straus EJ, Brown H, Howard AF, Teachman G. Composing adult lives with a ventilator at the intersection of developmental and neoliberal discourses of time. Health (London) 2024:13634593241226646. [PMID: 38234164 DOI: 10.1177/13634593241226646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
This paper explores temporalities and experiences of time drawn from an analysis of interview data from a critical narrative inquiry of the experiences of young adults living with home mechanical ventilation (HMV). The analysis centers the ideological effects of dominant discourses that shape understandings of time in the Euro-Western world and the ways in which young adults' stories prompt a rethinking of time in health research and praxis. Data generation involved interviews and photo-elicitation with five young adults (ages 18-40). A critical narrative analysis of participants' stories surfaced the influence of ableist, developmentalist, and neoliberal discourses of time and the creative resistance that points to the potential of crip orientations to time in opening up possibilities for living. Implications for practice and research are offered.
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Herland MD. Understanding the Narratives of Child Sexual Abuse. Qual Health Res 2024:10497323231218828. [PMID: 38227892 DOI: 10.1177/10497323231218828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
This qualitative study consisted of in-depth, retrospective interviews with participants over the age of 18 who experienced child sexual abuse. Through narrative analysis, study findings shed light on three overall findings: the perception of memories, the perception of grooming, and the perception of the lived lives of child sexual abuse survivors. Findings suggest that the narratives elicited from the participants included current views but also past experiences and anticipation about the future, including individual and societal levels of meaning. These narratives are furthermore entangled and inexorably linked - temporally, culturally, generationally, materially, and emotionally - and the results are thus presented from a holistic perspective. Study findings help explain the complex dimensions concerning the lived experiences of child sexual abuse. As such, this research speaks to the field of social and health care practitioners working with children and families facing the complex phenomenon of child sexual abuse.
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Ng LHX, Carley KM. Corrigendum: Do you hear the people sing? Comparison of synchronized URL and narrative themes in 2020 and 2023 French protests. Front Big Data 2023; 6:1343108. [PMID: 38149222 PMCID: PMC10750104 DOI: 10.3389/fdata.2023.1343108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 12/28/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fdata.2023.1221744.].
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Affiliation(s)
- Lynnette Hui Xian Ng
- IDeaS, Software and Societal Systems, Carnegie Mellon University, Pittsburgh, PA, United States
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Gilbert KG. Learning journeys - student learning development in the first years of a medical degree: an analysis of student conversations. Front Sociol 2023; 8:1244039. [PMID: 38111907 PMCID: PMC10725972 DOI: 10.3389/fsoc.2023.1244039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/07/2023] [Indexed: 12/20/2023]
Abstract
Introduction Students starting medical school generally come from a learning background that expects them to learn content, which is reproduced to pass an exam. As a part of their learning development, they must adapt and become self-motivated learners who can determine the underlying principles or concepts and use these to problem solve in the uncertainty of real-life clinical practice. Whilst much has been written about designing curricula to promote learning development, there is no one-size fits all approach to facilitating this type of learning, thus an analysis of what helps and hinders learning development is indicated. Methods Student pairs in Y2 and Y3 of an undergraduate Bachelor of Medicine, Bachelor of Surgery (BMBS) programme of a South-West UK medical school, were asked to audio record a conversation about their learning through a facilitated problem-based learning approach during the BMBS course so far. They were provided with a brief to aid them in their discussion in the style of the outside broadcast method of BBC Radio 4s listening project. Using this method, the conversation was unfacilitated and allowed to take its natural course. Conversations were transcribed and coded to determine emerging themes with respect to the developing understanding of the students about what and how they were learning. Results Four student pairs volunteered for the project one from Y2 and three from Y3. Five key themes were identified including: from 'learning it all, to structured learning'; 'developing understanding and the spiral curriculum'; 'working alone versus working with others'; 'integrated learning and understanding context' and 'assessment and resources.' Narrative analysis within these themes suggested that over the course of the first two to three years of study, participants developed a better understanding of how best to learn, although there were differences in both time and order that participants reached a point where learning felt more natural to them. Discussion Analysis of the data suggested that students develop independently towards being self-motivated lifelong learners. There were several key aspects of curriculum design that could be used to facilitate this development, which could easily be incorporated into developing or creating problem- / enquiry-based curricula.
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Affiliation(s)
- Kerry G. Gilbert
- School of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, St Luke’s Campus, Exeter, United Kingdom
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Abstract
Qualitative research provides an in-depth understanding of lived experiences. However, these experiences can be hard to apprehend by using just one method of data analysis. A good example is the experience of resilience. In this paper, the authors describe the chain of the decision-making process in the research of the construct of "resilience". s The authors justify the implications of a multi-method, pluralistic approach, and show how the triangulation of two or more qualitative methods and integration of several qualitative data analysis methods can improve a deeper understanding of the resilience among people with chronic pain. By combining the thematic analysis, narrative analysis, and critical incident technique, lived experiences can be seen from different perspectives.Therefore, the thematic analysis describes the content and answers to "what" regarding resilience, the narrative analysis describes the dynamics of resilience, and answers to "how", while the critical incident technique clarifies the most significant experience and the answers to "why" changes happen. This integrative approach could be used in the analysis of other psychological constructs and can serve as an example of how the rigour of qualitative research could be provided.
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Affiliation(s)
- Elīna Zelčāne
- Department of Health Psychology and Paedagogy, Riga Stradiņš University, Riga, Latvia,CONTACT Elīna Zelčāne Department of Health Psychology and Paedagogy, Riga Stradiņš University, Jāņa Asara street 5, RigaLV-1009, Latvia
| | - Anita Pipere
- Department of Health Psychology and Paedagogy, Riga Stradiņš University, Riga, Latvia
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Bakken AK, Mengshoel AM, Synnes O, Strand EB. Acquiring a new understanding of illness and agency: a narrative study of recovering from chronic fatigue syndrome. Int J Qual Stud Health Well-being 2023; 18:2223420. [PMID: 37307500 DOI: 10.1080/17482631.2023.2223420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/06/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND The condition known as chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is poorly understood. Simplified medical models tend to neglect the complexity of illness, contributing to a terrain of uncertainty, dilemmas and predicaments. However, despite pessimistic pictures of no cure and poor prognosis, some patients recover. PURPOSE This study's purpose is to provide insight into people's experiences of suffering and recovery from very severe CFS/ME and illuminate understanding of how and why changes became possible. METHODS Fourteen former patients were interviewed about their experiences of returning to health. A narrative analysis was undertaken to explore participants' experiences and understandings. We present the result through one participant's story. RESULTS The analysis yielded a common plotline with a distinct turning point. Participants went through a profound narrative shift, change in mindset and subsequent long-time work to actively pursue their own healing. Their narrative understandings of being helpless victims of disease were replaced by a more complex view of causality and illness and a new sense of self-agency developed. DISCUSSION We discuss the illness narratives in relation to the disease model and its shortcomings, the different voices dominating the stories at different times in a clinically, conceptually, and emotionally challenging area.
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Affiliation(s)
- Anne Karen Bakken
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway
| | - Anne Marit Mengshoel
- Department for Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
| | - Oddgeir Synnes
- Department for Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
| | - Elin Bolle Strand
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway
- Dep of Digital Health Research, Oslo University Hospital, Oslo, Norway
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Savage V, Gomez H, Perez M, Donastorg Y, Kerrigan D, Barrington C. Trajectories of HIV management among virally suppressed and unsuppressed female sex workers in the Dominican Republic: A comparative qualitative analysis. Int J Qual Stud Health Well-being 2023; 18:2164947. [PMID: 36681941 PMCID: PMC9869989 DOI: 10.1080/17482631.2023.2164947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
PURPOSE Despite suboptimal HIV outcomes among female sex workers (FSW), limited research has been conducted on factors that impact viral suppression among this population. Examining narratives of HIV management, we examined how experiences of diagnosis, treatment initiation, and ongoing care behaviours shaped viral suppression outcomes over time. METHODS We conducted 20 in-depth interviews with FSW in Santo Domingo, Dominican Republic. Using narrative and thematic qualitative approaches, we developed analytic summaries and matrices to compare trajectories of managing HIV between suppressed and unsuppressed participants. RESULTS Regardless of suppression status, participants described similar narratives of overcoming initial challenges to HIV management through personal resilience and social support. Unsuppressed participants identified more delays in initiating antiretroviral therapy and more lapses in adherence due to less active acceptance of their HIV status and more persistent experiences of economic hardship and HIV stigma. CONCLUSIONS We found that individual, interpersonal and structural factors, including stigma and economic precarity, differentiated trajectories towards viral suppression among FSW indicating the importance of multilevel interventions. Improved access to mental health services and social support could promote greater early acceptance of HIV status and progress towards viral suppression among FSW.
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Affiliation(s)
- Virginia Savage
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- CONTACT Virginia Savage Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, 35 Dauer Drive, CB #7440, Chapel Hill, NC27599, USA
| | - Hoisex Gomez
- HIV Vaccine Trials Research Unit, Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic
| | - Martha Perez
- HIV Vaccine Trials Research Unit, Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic
| | - Yeycy Donastorg
- HIV Vaccine Trials Research Unit, Instituto Dermatologico y Cirugia de la Piel, Santo Domingo, Dominican Republic
| | - Deanna Kerrigan
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, District of Columbia, USA
| | - Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Sunde OS, Alteren J, Ytrehus S. Caring for a home-dwelling older parent with mental health problems: a narrative analysis of family caregivers' experiences. Int J Qual Stud Health Well-being 2023; 18:2236373. [PMID: 37501358 PMCID: PMC10388798 DOI: 10.1080/17482631.2023.2236373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
PURPOSE To gain knowledge regarding family caregivers of home-dwelling older adults with mental health problems and the meaning-making of the caregiver's role. DESIGN An explorative qualitative study involving narrative analysis. METHODS Semi-structured individual interviews were conducted among eight adult children. Interview data were analysed using narrative analysis. The reporting adhered to consolidated criteria for reporting qualitative studies. RESULTS Each participant narrated unique and nuanced stories of the caregiver role, but their stories also revealed prominent themes across participants' experiences and meaning-making. The analysis revealed three themes: family relationships through a long life, a demanding and difficult caregiver role, and reconstructing the caregiver's role by leaving the responsibility to healthcare services. CONCLUSION Family caregivers experienced the role as purposeful and demanding. Mostly, psychological reactions to behaviour symptoms and duration of caregiving were considered difficult and demanding. They described that they lacked knowledge of the illness and how to perform care. Sharing care responsibility with healthcare services had the potential to ease family caregivers' burden. However, based on a long life as caregivers, some experienced difficulties when reconstructing and adjusting the role to their life situation.
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Affiliation(s)
- Olivia Sissil Sunde
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Johanne Alteren
- Health Science, Faculty of Health Sciences and Social Care, Molde University College Specialized University in Logistics, Molde, Norway
| | - Siri Ytrehus
- Health Science, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway
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Grant C, Powell C, Philip G, Blackburn R, Lacey R, Woodman J. 'On paper, you're normal': narratives of unseen health needs among women who have had children removed from their care. J Public Health (Oxf) 2023; 45:863-869. [PMID: 37525519 PMCID: PMC10687599 DOI: 10.1093/pubmed/fdad137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/30/2023] [Accepted: 07/07/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Mothers who have children removed from their care often have complex needs. These women have poor health outcomes and are dying earlier than their peers from preventable and amenable causes. Yet there is little known about how health care services might mitigate these risks. This study aimed to listen to the voices of women who had children removed from their care to understand their experiences of health and healthcare. METHODS We used a narrative approach to collect and analyse interview data with six mothers who had experienced child removal in England. Each participant was asked to reflect on their life and main health challenges. RESULTS Three narrative subplots were developed to consolidate experiences of unmet health need: (i) 'on paper you're normal': narratives of complex need, (ii) 'in my family, everyone had issues': narratives of whole family need and (iii) 'I'm still mummy, no matter where they are': narratives of maternal identity and health. CONCLUSIONS Findings highlight limitations within current systems of support, including a culture of distrust and women falling between the gaps of services. Women's narratives illustrate opportunities for health intervention, especially immediately following child removal.
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Affiliation(s)
- Claire Grant
- Department of Epidemiology and Public Health, University College London, London, WC1E 7HB, UK
| | - Claire Powell
- Great Ormond Street Institute of Child Health, University College London, London, WC1N 1EH, UK
| | - Georgia Philip
- Centre for Research on Children & Families, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Ruth Blackburn
- Great Ormond Street Institute of Child Health, University College London, London, WC1N 1EH, UK
| | - Rebecca Lacey
- Department of Epidemiology and Public Health, University College London, London, WC1E 7HB, UK
| | - Jenny Woodman
- Thomas Coram Research Unit, Social Research Institute, University College London, London, WC1H 0AA, UK
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van Sambeek N, Franssen G, van Geelen S, Scheepers F. Making meaning of trauma in psychosis. Front Psychiatry 2023; 14:1272683. [PMID: 38025479 PMCID: PMC10656619 DOI: 10.3389/fpsyt.2023.1272683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background Finding new meaning and identity in the aftermath of trauma has been identified as a key process of mental health recovery. However, research indicates that this meaning-making process is compromised in people with psychosis. Considering the high prevalence, yet under-treatment of trauma in people with psychosis, it is urgent to gain insight into how their meaning-making process can be supported. Aim To gain insight into how people with psychosis make meaning of trauma and identify barriers and facilitators in their meaning-making process. Methods Qualitative inquiry of N = 21 interviews transcripts from the Dutch Psychiatry Storybank. We included interviews of people who (a) lived through multiple psychotic episodes, and (b) spontaneously addressed traumatic experiences in a low-structured interview. Storyline analysis was performed to gain insight into the meaning-making of trauma within their self-stories. Psychosocial conceptualizations of narrative identity were used to inform the analysis. A data-validation session with four experts-by-experience was organized to check and improve the quality of our analysis. Results We identified four different story types: (1) Psychiatry as the wrong setting to find meaning; (2) The ongoing struggle to get trauma-therapy; (3) Exposure to trauma as a threat to a stable life, and (4) Disclosure as the key to resolving alienation. Each story type comprises a different plot, meaning of trauma withing the self-story, (lack of) integration and barriers and facilitators in the meaning-making process. Overall, barriers in the meaning-making process were mostly situated within mental healthcare and stigma-related. People felt particularly hindered by pessimistic ideas on their capacity to develop self-insight and cope with distress, resulting in limited treatment options. Their process of adaptive meaning-making often started with supportive, non-judgmental relationships with individuals or communities that offered them the safety to disclose trauma and motivated them to engage in a process of self-inquiry and growth. Conclusion The outcomes illuminate the social context of the meaning-making challenges that people with psychosis face and illustrate the devastating influence of stigma. Our outcomes offer guidance to remove barriers to adaptive meaning-making in people with psychosis, and can help clinicians to attune to differences in the meaning-making of trauma.
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Affiliation(s)
- Nienke van Sambeek
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Gaston Franssen
- Faculty of Humanities, University of Amsterdam, Amsterdam, Netherlands
| | | | - Floortje Scheepers
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
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17
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Bennett EV, Hurd L, Pritchard E, Colton T, Crocker PRE. 'You're part of something bigger': interpersonal relationships and older Canadian men's body image. Psychol Health 2023; 38:1553-1571. [PMID: 35072564 DOI: 10.1080/08870446.2022.2030739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/25/2021] [Accepted: 01/11/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE We examined older men's body image, with a focus on the role of interpersonal relationships in shaping their psychological adaptation to age-related body changes to appearance, function, and health. DESIGN Qualitative narrative constructionist study. MAIN OUTCOME MEASURES We conducted semi-structured interviews with 29 men aged 65-83. Data were analysed using thematic narrative analysis; we identified and interpreted patterns in and across the men's stories about their aging bodies. RESULTS Narratives of purpose through meaningful engagement and belonging through connection permeated the men's accounts. Participants mitigated body-related changes and challenges through pleasurable physical, leisure, and community activities. They derived purpose from these activities as they kept them physically, cognitively, and socially engaged and thus relevant with advancing age, particularly post retirement. The men derived a sense of belonging through social connections. Relationships with family, friends, and community members shaped their capacity for meaningful engagement and associated psychological adjustment to age-related body changes. CONCLUSION The findings point to the imperative need to consider how men negotiate their constantly changing, aging bodies within the context of interpersonal relationships, and highlight the role that later life belonging and purpose play in shaping how men experience their bodies as they grow older.
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Affiliation(s)
- Erica V Bennett
- School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada
| | - Laura Hurd
- School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada
| | - Elizabeth Pritchard
- School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada
| | - Tayler Colton
- Department of Education and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, BC, Canada
| | - Peter R E Crocker
- School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada
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18
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Lindström M, Bäckström AC, Henje C, Stenberg G. 'When I use the electric wheelchair, I can be myself' - real-life stories about occupational identity construction. Scand J Occup Ther 2023; 30:1368-1382. [PMID: 35786150 DOI: 10.1080/11038128.2022.2093268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 06/18/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Young and adult users of electric wheelchairs (EWs) describe how EWs have personal, functional, emotional, and symbolic values and are considered by some to be part of the self. AIM The aim of this study was to increase our understanding of how occupational identity is constructed in the daily practices of EW users. MATERIAL AND METHODS Context-based, in-depth oral stories and filmed sequences of daily practice enactments of persons who have used an EW since childhood were the basis for the narrative analysis. FINDINGS The findings elucidate how the informants enact and tell about their identity-development in response to daily and relational practices, and its relevance to the informant's sense of self, belonging, competence, life-prospects, conduct, and awareness of shifting values, and this was likewise demonstrated in different appearances and roles related to social recognition. A model illustrating the findings is proposed. CONCLUSIONS AND SIGNIFICANCE Contextual values and exploring experiences, such as possibilities to develop competences and roles, along with encountering social recognition, but also hindering regulations and adversities, influence the development of occupational identities. Findings in this study can contribute to increased understanding, conscious political decisions, as well as a more person-centred approach within healthcare.
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Affiliation(s)
- Maria Lindström
- Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University, Umeå, Sweden
| | - Ann-Charlotte Bäckström
- Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University, Umeå, Sweden
| | | | - Gunilla Stenberg
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
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19
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Somogyvári L. Violence in the Education: The Post-Revolutionary Situation in Hungary (1956-1957). F1000Res 2023; 12:1244. [PMID: 38099005 PMCID: PMC10719558 DOI: 10.12688/f1000research.140928.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 12/18/2023] Open
Abstract
Background: The author attempts to introduce an unusual approach towards schools, universities, and dormitories, including their users (professors, teachers, parents, and students): How can the educational issues be seen through the lenses of special police forces in a specific historical moment? After the 1956 Hungarian revolution, a brutal pacification process took place all over the country, supported by the Soviet troops and special armed forces, police battalions of the restarting communist power. Methods: In this historical study, I used mainly military archive documents to show the perspective of the communist restauration and confront their viewpoints with party reports and some oral histories by eyewitnesses, who suffered several injuries during the repression. The paper is based on narrative analysis, as the official explanation presented various stories to justify their actions, while the reality in the background might be very different from this. Results: Between November 1956 and May 1957, these soldiers or officers became a familiar image in educational institutions. They blamed teachers and professors for misleading their students and thus creating a narrative of the counter-revolution of October 1956, while they identified themselves as parents or teachers (instead of the real ones, who lost their rights to do this, due to the participation in the revolution). Conversely, physical and verbal aggression was a widespread routine of the army officers. Conclusions: In extraordinary situations, during historical crises violence became suddenly real, allowed, and/or supported by many political actors to achieve their goals. After the consolidation of power, these special army and police forces were released and their activities were stopped by the authorities of the Ministry of National Defence because their presence was realized as an uncomfortable situation for the politicians. Such studies may give lessons us to learn, about how these scenes escalate into a point of no return.
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Affiliation(s)
- Lajos Somogyvári
- Department of Education Sciences, Faculty of Humanities,, University of Pannonia, Veszprém, 8200, Hungary
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20
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Agoff C, Bruno M, Sandberg S. Protecting Parents, Idealizing the Past, Blaming Friends: Life Stories of Men Imprisoned for Violence. Int J Offender Ther Comp Criminol 2023:306624X231198802. [PMID: 37740451 DOI: 10.1177/0306624x231198802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
Life-stories emerge from a wide variety of facts and events in individual lives and weave a selected few of these together to make meaning in the present. They are crucial for constructing identity and influence action by establishing worldviews and a persona that narrators will seek to confirm. In this study we describe three main themes in the life-stories of six incarcerated men in Argentina: a) Protecting family, especially parents; b) reconstructing an ideal past, and contrasting it with a more cynical present; and c) blaming criminal neighborhoods, friends, and girlfriends for their crimes. We discuss how these themes are intertwined, what function they fulfill, and the identities and masculinities they produce. Combining research on life-stories with narrative and psychosocial criminology the analysis reveals how life-stories of incarcerated men can be seen as attempts at countering stigma and defending a self that is under attack. The life-stories portray a believable, 'good', and multifaceted image of the self, but most importantly, create coherence and unity in otherwise chaotic lives.
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Affiliation(s)
- Carolina Agoff
- National Autonomous University of Mexico (UNAM), Ciudad de Mexico, Mexico
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21
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Faccio E, Fonte C, Smania N, Neri J. (Re)constructing identity following acquired brain injury: The complex journey of recovery after stroke. Health Expect 2023; 27:e13874. [PMID: 37731198 PMCID: PMC10726149 DOI: 10.1111/hex.13874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/01/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION People with poststroke acquired brain injury (ABI) face a complex and often troubled identity reconstruction journey. The literature is rich with studies related to the psychological and neuropsychological components involved in rehabilitation, but it is lacking with respect to the investigation of the existential dimensions and the challenges associated with finding new senses and meanings for one's identity and future perspectives, body and interpersonal relationships. METHODS The aim of this study is to investigate the narrative processes of identity reconstruction after brain damage. Through a qualitative approach, 30 autobiographical narratives about self, body and the relationships with others were collected and analyzed. Semistructured interviews were used for the data collection. Narrative and positioning analysis were applied. RESULTS Four main positionings emerged: sanctioning a radical break with one's previous life; assuming a sense of salvation and compulsory as well as irreversible adaptation to the limitations associated with one's condition; feeling different and disabled; and considering new possibilities and active constructions of self-being in relationship with others. These results underline the narrative processes of construction of the injury and the identity and delineate possible resources and instruments to improve the clinical practice for health practitioners. They are also valuable for other professionals who deal with neurological services and rehabilitation, such as psychological counselling and support for persons who have experienced ABI and their families. PATIENT OR PUBLIC CONTRIBUTION This work resulted from a close collaboration between two universities and a hospital neurological rehabilitation department in the Veneto Region (Northern Italy). Three associations of people with stroke and their families living in the same area contributed to designing the research on the basis of the needs expressed by their members with the aim to identify strategies and devices to be implemented in the public service to improve the care pathway. They also participated in the interpretation of the data.
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Affiliation(s)
- Elena Faccio
- Department of Philosophy, Sociology, Education and Applied PsychologyUniversity of PaduaPaduaItaly
| | - Cristina Fonte
- Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Nicola Smania
- Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Jessica Neri
- Department of Philosophy, Sociology, Education and Applied PsychologyUniversity of PaduaPaduaItaly
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22
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Karlsson AW, Lundsgaard HH, Janssens A. Mothers' Views on the Storage and Usage of Their Children's Biological Material Under the Danish Biobanking Model: A Narrative Approach Using Epistemic Injustice. Value Health 2023; 26:1308-1313. [PMID: 37187237 DOI: 10.1016/j.jval.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/14/2023] [Accepted: 05/04/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES To investigate the knowledge and attitudes of mothers living in Denmark on the storage and usage of their children's biological material. The Danish Neonatal Screening Biobank contains blood from the Phenylketonuria-screening test. Legal, ethical, and moral concerns have been raised in several countries of how consent is obtained best in pediatric biobank governance. Research on knowledge and attitudes of Danish parents on the usage of their children's biological material is scarce. METHODS A coproduced study between a mother and 2 researchers. We analyzed 5 online focus group interviews using Ricoeur's hermeneutical narrative analysis. RESULTS Mothers have very little knowledge on the storage and usage of their children's biological material. They consider the Phenylketonuria-screening test to be part of a birth package, which leaves very little option of choice. They accept donating the material as a token of appreciation in an act of altruism toward the wider society but are only comfortable supporting Danish research. CONCLUSIONS An exploration of the communal narrative build in the interviews reveal an overall feeling of duty to help benefit society, an overwhelming trust toward the health system, and epistemic unjust storage information practices.
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Affiliation(s)
- Anne Wettergren Karlsson
- Department of Public Health, University of Southern Denmark, Odense, Denmark; Centre for Research with Patients and Relatives, Odense University Hospital, Odense, Denmark.
| | | | - Astrid Janssens
- Department of Public Health, University of Southern Denmark, Odense, Denmark; Utrecht University Medical Center, Utrecht University, The Netherlands; Centre for Research with Patients and Relatives, Odense University Hospital, Odense, Denmark; University of Exeter Medical School, Exeter, England, UK
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23
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Maldonado L, Hamid G, Deatrick JA, Bradway C, Moriarty H. Narrative Analysis of Urban-Dwelling Pregnant Puerto Rican Women: Fuerza y Tenacidad. West J Nurs Res 2023; 45:815-825. [PMID: 37395494 DOI: 10.1177/01939459231186055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Among Latina subgroups residing in the mainland United States, Puerto Rican women have the highest infant mortality rates when compared to all Latinas. Despite this, little is known about their daily lives in urban settings. This narrative analysis describes the stories regarding the life course of 21 pregnant Puerto Rican women living in an urban area in the mainland United States to identify plot types and underlying dimensions of their social ecology. Holistic form analysis was used to identify the structure of the narratives with graphical representations of the three identified types of plots (series of events that make up a story). Holistic content analysis was used to describe the major components of the narratives. Three primary plot types emerged from the narratives: Progressive, Neutral, and Circular. The women exhibited strength and tenacity to survive within a challenging urban setting often complicated by social pressures of their culture. The findings show the diversity of their lives and their social contexts even though from the viewpoint of being pregnant, Puerto Rican women who lived in a single neighborhood they may seem remarkably similar to an outsider.
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Affiliation(s)
- Linda Maldonado
- Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
| | - Gwendolyn Hamid
- Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
| | - Janet A Deatrick
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Christine Bradway
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Helene Moriarty
- Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
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24
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Liu XY, To SM. Narrative analysis of parents' experiences with participating in the intervention of children on the autism spectrum in mainland China. Disabil Rehabil 2023; 45:3070-3078. [PMID: 36073849 DOI: 10.1080/09638288.2022.2120098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 08/22/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Although the challenges encountered by parents of children on the autism spectrum during the intervention process have garnered scholarly attention, how parents subjectively review those challenges and construct meanings of their experiences remained underexamined. By applying the narrative analysis framework, we investigated the lived experiences of parents of children on the autism spectrum regarding challenges they faced in the intervention process, along with the meanings of those experiences that they constructed in the sociocultural context of mainland China. METHODS We purposively sampled 16 parents to narrate their experiences following semistructured interviews. Each participant had one child who had participated in autism intervention for more than two years. RESULT The narrative analysis revealed that parents experienced a series of challenges imposed by structural barriers in the intervention process, which resulted in psychological distress and negative perceptions of their parental identities. Albeit susceptible to those adversities, the parents actively constructed new meanings of parenthood and their children's situations through reflexive dialogues. CONCLUSION Our results indicate the essential role of meaning-oriented coping in helping parents with children on the autism spectrum to mitigate the negative influence of challenges on their parental identity, strengthen their parent-child relationships, and readjust their priorities for intervention.IMPLICATIONS FOR REHABILITATIONThe role of encouraging new meanings through reflexive dialogues was found to be particularly important among parents with children on the autism spectrum to cope with the challenges they faced in the intervention process.New meanings assigned can mitigate the negative impact of challenges on parents' parental identity, strengthening their parent-child relationships, and readjusting their priorities for intervention within the Chinese socio-cultural context.It is crucial for social workers and other practitioners to support parents in mainland China by facilitating them to assign new meanings to the challenging situations.It is important for social workers and other practitioners to encourage parents to cultivate inner strengths and self-value to support their children on the autism spectrum.
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Affiliation(s)
- Xiao-Yu Liu
- Rainbow Lutheran Centre, Hong Kong Lutheran Social Service, Hong Kong
| | - Siu-Ming To
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
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25
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Grimm CJ, de Terte I, Hodgetts D, Kearney S. Narratives of holistic mental health recovery in New Zealand Defence Force personnel. Mil Psychol 2023:1-11. [PMID: 37643328 DOI: 10.1080/08995605.2023.2250708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Abstract
Research on military mental health recovery has tended to focus on therapy outcomes while backgrounding the role of diverse healing influences. The New Zealand Defence Force (NZDF) is a bicultural military integrated with Māori customs and cultural perspectives on holistic health and wellbeing. This study used narrative analysis to examine the semi-structured interviews of 21 active duty NZDF personnel who had accessed mental healthcare to understand what factors contributed to their return to wellness. Narratives described an orientation toward recovery as a process, where many interrelated wellbeing and social factors together supported the return to health. Culturally available Māori wellbeing metaphors were adopted as heuristics by service members in their storying of growth and healing. Findings are considered in terms of how wellbeing and recovery are conceptualized and promoted within militaries with diverse cultures. Discussion focuses on how narratives within military institutions can promote resilience and support service member recovery from mental distress.
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Affiliation(s)
- Carsten James Grimm
- Directorate of Health, New Zealand Defence Force, Wellington, New Zealand
- School of Psychology, Manawatu Campus, Massey University, Palmerston North, New Zealand
| | - Ian de Terte
- School of Psychology, Wellington Campus, Massey University, Wellington, New Zealand
| | - Darrin Hodgetts
- School of Psychology, Albany Campus, Massey University, Auckland, New Zealand
| | - Stephen Kearney
- Directorate of Health, New Zealand Defence Force, Wellington, New Zealand
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26
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Ng LHX, Carley KM. Do you hear the people sing? Comparison of synchronized URL and narrative themes in 2020 and 2023 French protests. Front Big Data 2023; 6:1221744. [PMID: 37693848 PMCID: PMC10483998 DOI: 10.3389/fdata.2023.1221744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction France has seen two key protests within the term of President Emmanuel Macron: one in 2020 against Islamophobia, and another in 2023 against the pension reform. During these protests, there is much chatter on online social media platforms like Twitter. Methods In this study, we aim to analyze the differences between the online chatter of the 2 years through a network-centric view, and in particular the synchrony of users. This study begins by identifying groups of accounts that work together through two methods: temporal synchronicity and narrative similarity. We also apply a bot detection algorithm to identify bots within these networks and analyze the extent of inorganic synchronization within the discourse of these events. Results Overall, our findings suggest that the synchrony of users in 2020 on Twitter is much higher than that of 2023, and there are more bot activity in 2020 compared to 2023.
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Affiliation(s)
- Lynnette Hui Xian Ng
- IDeaS, Software and Societal Systems, Carnegie Mellon University, Pittsburgh, PA, United States
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27
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White BK, Gombert A, Nguyen T, Yau B, Ishizumi A, Kirchner L, León A, Wilson H, Jaramillo-Gutierrez G, Cerquides J, D'Agostino M, Salvi C, Sreenath RS, Rambaud K, Samhouri D, Briand S, Purnat TD. Using Machine Learning Technology (Early Artificial Intelligence-Supported Response With Social Listening Platform) to Enhance Digital Social Understanding for the COVID-19 Infodemic: Development and Implementation Study. JMIR Infodemiology 2023; 3:e47317. [PMID: 37422854 PMCID: PMC10477919 DOI: 10.2196/47317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Amid the COVID-19 pandemic, there has been a need for rapid social understanding to inform infodemic management and response. Although social media analysis platforms have traditionally been designed for commercial brands for marketing and sales purposes, they have been underused and adapted for a comprehensive understanding of social dynamics in areas such as public health. Traditional systems have challenges for public health use, and new tools and innovative methods are required. The World Health Organization Early Artificial Intelligence-Supported Response with Social Listening (EARS) platform was developed to overcome some of these challenges. OBJECTIVE This paper describes the development of the EARS platform, including data sourcing, development, and validation of a machine learning categorization approach, as well as the results from the pilot study. METHODS Data for EARS are collected daily from web-based conversations in publicly available sources in 9 languages. Public health and social media experts developed a taxonomy to categorize COVID-19 narratives into 5 relevant main categories and 41 subcategories. We developed a semisupervised machine learning algorithm to categorize social media posts into categories and various filters. To validate the results obtained by the machine learning-based approach, we compared it to a search-filter approach, applying Boolean queries with the same amount of information and measured the recall and precision. Hotelling T2 was used to determine the effect of the classification method on the combined variables. RESULTS The EARS platform was developed, validated, and applied to characterize conversations regarding COVID-19 since December 2020. A total of 215,469,045 social posts were collected for processing from December 2020 to February 2022. The machine learning algorithm outperformed the Boolean search filters method for precision and recall in both English and Spanish languages (P<.001). Demographic and other filters provided useful insights on data, and the gender split of users in the platform was largely consistent with population-level data on social media use. CONCLUSIONS The EARS platform was developed to address the changing needs of public health analysts during the COVID-19 pandemic. The application of public health taxonomy and artificial intelligence technology to a user-friendly social listening platform, accessible directly by analysts, is a significant step in better enabling understanding of global narratives. The platform was designed for scalability; iterations and new countries and languages have been added. This research has shown that a machine learning approach is more accurate than using only keywords and has the benefit of categorizing and understanding large amounts of digital social data during an infodemic. Further technical developments are needed and planned for continuous improvements, to meet the challenges in the generation of infodemic insights from social media for infodemic managers and public health professionals.
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Affiliation(s)
- Becky K White
- Department of Epidemic and Pandemic Preparedness and Prevention, World Health Organization, Geneva, Switzerland
| | | | - Tim Nguyen
- Department of Epidemic and Pandemic Preparedness and Prevention, World Health Organization, Geneva, Switzerland
| | - Brian Yau
- Department of Epidemic and Pandemic Preparedness and Prevention, World Health Organization, Geneva, Switzerland
| | - Atsuyoshi Ishizumi
- Department of Epidemic and Pandemic Preparedness and Prevention, World Health Organization, Geneva, Switzerland
| | | | | | | | | | - Jesus Cerquides
- Artificial Intelligence Research Institute, Spanish Council for Scientific Research, Cerdanyola, Spain
| | - Marcelo D'Agostino
- Information Systems for Health, Evidence and Intelligence for Action in Health, Pan American Health Organization and World Health Organization Regional Office for the Americas, Washington DC, DC, United States
| | - Cristiana Salvi
- Risk Communication and Community Engagement Unit, Health Emergencies Division, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Ravi Shankar Sreenath
- Risk Communication and Community Engagement Unit, Health Emergencies Division, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Kimberly Rambaud
- Risk Communication and Community Engagement Unit, Health Emergencies Division, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Dalia Samhouri
- Country Health Emergency Preparedness and International Health Regulations (2005), World Health Organization Regional Office for Eastern Mediterranean, Cairo, Egypt
| | - Sylvie Briand
- Department of Epidemic and Pandemic Preparedness and Prevention, World Health Organization, Geneva, Switzerland
| | - Tina D Purnat
- Department of Epidemic and Pandemic Preparedness and Prevention, World Health Organization, Geneva, Switzerland
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Aurén-Møkleby M, Thoresen L, Mengshoel AM, Solbrække KN, Aasbø G. 'It's not just about me': a qualitative study of couples' narratives about home death when one of the partners is dying of cancer. Palliat Care Soc Pract 2023; 17:26323524231189517. [PMID: 37545874 PMCID: PMC10399270 DOI: 10.1177/26323524231189517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/05/2023] [Indexed: 08/08/2023] Open
Abstract
Background Most cancer patients state a preference for home death. Care and support from primary caregivers are important to enable dying at home. A preference for home death from the perspective of couples has rarely been investigated. Objectives To explore how a preference for home death is understood and enacted in couples where one of the partners is dying of cancer. Design A qualitative interview research design with a narrative approach was used. Methods Five couples participated in dyad interviews. During the analysis, two interviews that particularly illuminated couples' shared and individual views were chosen as the primary cases. Results The interviews show, in two highly different ways, how a preference for home death is a significant relational matter. The interviews are presented as two cases: 'Struggles in an Unknown Terrain' and 'Reliance at the Kitchen Table'. They show how a preference for home death can be understood and enacted as a struggle or as reliance based on the couple's shared biography and the partner's ability to care for the partner during the end-of-life phase. The analysis highlighted the negotiations that underpin a preference for home death. In these negotiations, the couples drew on idealised understandings of home death. These ideas were supported by cultural values related to autonomy and independence as well as participation and citizenship. Thus, in the negotiations about being cared for and caring, legitimate dependency and the maintenance of a reciprocal relationship were balanced. The presence of healthcare professionals and medical devices in the home had to be balanced with the need to maintain a sense of self and an authentic home. Conclusion A relational perspective on a preference for home death made us attentive to couples' negotiations. These negotiations give couples the opportunity to re-evaluate and reconfirm individual and mutual needs in the end-of-life phase.
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Affiliation(s)
| | - Lisbeth Thoresen
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | | | | | - Gunvor Aasbø
- Institute of Health and Society, University of Oslo, Oslo, NorwayDepartment of Research, Cancer Registry of Norway, Oslo, Norway
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Lian OS, Nettleton S, Grange H, Dowrick C. 'My cousin said to me . . .' Patients' use of third-party references to facilitate shared decision-making during naturally occurring primary care consultations. Health (London) 2023:13634593231188489. [PMID: 37519043 DOI: 10.1177/13634593231188489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
In this paper, we explore the ways in which patients invoke third parties to gain decision-making influence in clinical consultations. The patients' role in decision-making processes is often overlooked, and this interactional practice has rarely been systematically studied. Through a contextual narrative exploration of 42 naturally occurring consultations between patients (aged 22-84) and general practitioners (GPs) in England, we seek to fill this gap. By exploring how and why patients invoke third parties during discussions about medical treatments, who they refer to, what kind of knowledge their referents possess, and how GPs respond, our main aim is to capture the functions and implications of this interactional practice in relation to decision-making processes. Patients refer to third parties during decision-making processes in most of the consultations, usually to argue for and against certain treatment options, and the GPs recognise these utterances as pro-and-contra arguments. This enables patients to counter the GPs' professional knowledge through various knowledge-sources and encourage the GPs to target their specific concerns. By attributing arguments to third parties, patients claim decision-making influence without threatening the GPs' authority and expertise, which their disadvantaged epistemic position demands. Thereby, patients become able to negotiate their role and their epistemic position, to influence the agenda-setting, and to take part in the decision-making process, without being directly confrontational. Invoking third parties is a non-confrontational way of proposing and opposing treatment options that might facilitate successful patient participation in decision-making processes, and so limit the risk of patients being wronged in their capacity as knowers.
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Affiliation(s)
| | - Sarah Nettleton
- UiT The Arctic University of Norway, Norway
- University of York, UK
| | - Huw Grange
- UiT The Arctic University of Norway, Norway
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Singh S. Supporting an Invisible Workforce: The Case for the Creation of the Home Healthcare Workers Support Act. Am J Law Med 2023; 49:349-358. [PMID: 38344783 DOI: 10.1017/amj.2023.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
This Article seeks to synthesize academic research on home healthcare workers during the COVID-19 pandemic to understand how their workplace challenges were magnified. Crisis communication researchers note that a crisis provides both opportunities and threats for growth. This Article argues that many of the issues that have impacted home healthcare workers have always been present, but the pandemic allows policy makers the ability to see them clearly because the pandemic brought a spotlight to the issues that home healthcare workers face on a daily basis. Consequently, the author employed a narrative analysis of the literature concerning home healthcare workers during the pandemic to understand how the pandemic exacerbated structural issues that led to an increase in mental health difficulties for this population. By understanding how the pandemic exacerbated mental health issues, policy makers can craft solutions that can withstand the next public health crisis which will undoubtedly impact the most disenfranchised.
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Affiliation(s)
- Sabrina Singh
- School of Communication & Information, Rutgers University, New Brunswick, NJ, USA
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31
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Alshibani A, Alharbi M, Conroy S. Frailty Identification in Prehospital Care: A Scoping Review of the Literature. Open Access Emerg Med 2023; 15:227-239. [PMID: 37337614 PMCID: PMC10276993 DOI: 10.2147/oaem.s409083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/22/2023] [Indexed: 06/21/2023] Open
Abstract
The proportion of older adults is increasing worldwide. Frailty assessment in prehospital care was suggested to improve triage decisions and paramedics' judgment. This study aimed to assess the scope and nature of available evidence around frailty identification in prehospital care. A systematic search of the literature was performed using MEDLINE, SCOPUS, CINHAL, and Web of Science to identify relevant articles published from January 2022 downwards. A list of indexed terms and their associated alternatives were pre-determined. Of the 71 identified and reviewed articles after removing duplicates, six articles were included in the review. Due to the heterogeneity of the included articles, the findings were described narratively. The findings of this review showed that the available evidence is limited and heterogenic. Two themes emerged from the findings of the included articles: 1) Paramedics' Perceptions about Frailty Assessment in Prehospital Care and 2) Frailty Scores for Application in Prehospital Care. Paramedics recognised frailty assessment in pre-hospital care to be feasible and important. They highlighted the need for a simple and clear frailty score that could be used and mentioned to other healthcare professionals when handing over patients. Six frailty scores were reported to be used in prehospital care. The evidence around each frailty score is very limited. Overall, frailty assessment in prehospital care was shown to be important and feasible. Different frailty scores have been assessed for use in prehospital care. Further research investigating frailty identification in prehospital care is needed.
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Affiliation(s)
- Abdullah Alshibani
- Emergency Medical Services Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
| | - Meshal Alharbi
- Emergency Medical Services Department, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Simon Conroy
- MRC Lifelong Health & Ageing Unit, University College London, London, UK
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Jacobs G, Schuhmann C, Wierstra I. Healthcare chaplains' conflicting and ambivalent positions regarding meaning in life and worldview. J Health Care Chaplain 2023:1-15. [PMID: 37163214 DOI: 10.1080/08854726.2023.2210026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Western society is increasingly a spiritual society, but not so much a society that draws on clearly delineated religious or worldview pillars anymore. Within healthcare, there's a growing attention to the spiritual dimension of health and the collaborative spiritual care that is needed for person-centered care. This changing religious/worldview and healthcare landscape is influencing healthcare chaplaincy. In this case study in-depth interviews were conducted with a chaplaincy team within a large healthcare organization in The Netherlands. Dialogical Self Theory was used as the theoretical framework in the narrative analysis of these stories. This provided insights into how these chaplains negotiate their professional identity within a changing healthcare landscape. It is concluded that there are multiple and often contradictory and conflicting positions within and between chaplains and that it is a challenge for healthcare chaplains to integrate the "old" and "new" representations of chaplaincy.
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Affiliation(s)
- Gaby Jacobs
- University of Humanistic Studies, Utrecht, Netherlands
| | | | - Iris Wierstra
- University of Humanistic Studies, Utrecht, Netherlands
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Sund M, Hanisch H, Fjetland KJ. Activistic citizenship in nursing homes: co-ownership in the mundane. Dementia (London) 2023; 22:594-609. [PMID: 36716355 PMCID: PMC10009321 DOI: 10.1177/14713012231155307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The traditional narrative of dementia, focused on cognition as constructive of personhood, has been challenged by person-centred care as well as a rights-based citizenship lens. However, reports of everyday discrimination leading to occupational deprivation and pathologising interpretations of people living with dementia in nursing homes highlight the need for further investigation. The purpose of this study was to investigate the transformative power of mundane and relational enactments of citizenship in nursing homes, exploring the potential of adding an activistic lens of citizenship to our interpretive practices. Through an ethnographic study in Norwegian nursing homes, a narrative analysis of fieldnotes and interview transcripts was conducted. Narratives were interpreted using narrative theory, occupational perspectives and theories of citizenship. Findings reveal a phenomenon of shared ownership between residents and staff, and a vulnerable balance between silence and active social and occupational engagement in the nursing homes. Further, they shed light on how group-based assessments of residents' abilities or occupational needs may constrain opportunities, and staffs' options, to facilitate co-ownership. We suggest that a lens of activistic citizenship implies interpreting residents' behaviours as mundane forms of subtle resistance. A professional and ethical responsibility building on such interpretive practices may turn attention towards structures that constrain residents' expressions of citizenship.
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Affiliation(s)
- Marianne Sund
- Centre of Diaconia and Professional Practice/Faculty of Health studies, 87446VID Specialized University, Stavanger, Norway
| | - Halvor Hanisch
- Work Research Institute, 60499Oslo Metropolitan University, Oslo, Norway
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May B, Milne R, Shawyer A, Meenaghan A, Ribbers E, Dalton G. Identifying challenges to critical incident decision-making through a macro-, meso-, and micro- lens: A systematic synthesis and holistic narrative analysis. Front Psychol 2023; 14:1100274. [PMID: 37057142 PMCID: PMC10086351 DOI: 10.3389/fpsyg.2023.1100274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/13/2023] [Indexed: 03/30/2023] Open
Abstract
It is predicted that emergency responses to critical incidents will increase over the next few decades, as society faces unique and dynamic challenges (e.g., pandemics, migrant crises, and terrorism). As such, it is necessary to breakdown, identify, and evaluate the unique barriers associated with decision-making in the context of critical incident responses. The aim of the current study was to synthesize the bibliographic characteristics of the research on decision making and present a holistic narrative analysis of the multi-layered factors. Additionally, the systematic synthesis of evidence facilitated a critical appraisal of the quality and distribution of evidence across macro-, meso-, and micro- levels. Results suggested that research was moderately heterogeneous, as evidence captured diverse narrative factors. However, micro-centric characteristics (e.g., cognitive-related factors) were not well represented. Instead, research primarily focused toward intermediate meso-level characteristics, capturing factors such as "interoperability" and "organization policy and procedure" as critical challenges to decision-making. Six key narratives were also identified and discussed. Both the quality appraisal and narrative findings suggested that research should seek opportunities to experimentally assess, evaluate and validate decision-making. Whilst this has previously appeared ethically and practically problematic, advances in technology, research and analysis have allowed high-fidelity simulation experimentation to recreate critical incidents.
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Abstract
BACKGROUND Humans are occupational beings. Our occupational choices depend on the opportunities available to us, and within nursing homes, institutional rules or structures may limit occupational engagement. An everyday citizenship lens acknowledges the importance of people's rights as citizens as well as engagement in mundane aspects of the everyday, highlighting diverse expressions of agency. AIMS/OBJECTIVES To show how older residents living with dementia in nursing homes can realize their everyday citizenship. METHODS A phenomenologically inspired ethnographic study was conducted in nursing home units in Norway, exploring everyday citizenship through narrative analysis. RESULTS Within everyday environments of care, the narratives of May, Janne and Camilla tell stories of spontaneous initiatives towards contribution and responsibilities, highlighting their continuous occupational natures. CONCLUSION Becoming can be seen as constitutive of self and identity, through residents' actions and contributions within the mundane and ordinary of everyday life, as an essential part of everyday citizenship. SIGNIFICANCE FOR PRACTICE A citizenship of becoming presupposes that institutional perceptions of activities being offered ought to be broadened towards supporting residents' natural desires to do and act within the mundane and ordinary of everyday life.
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Affiliation(s)
- Marianne Sund
- Centre of Diaconia and Professional Practice/Faculty of Health Studies, VID Specialized University, Stavanger, Norway
| | | | - Halvor Hanisch
- Faculty of Health Studies, VID Specialized University, Stavanger, Norway.,Work Research Institute, Oslo Metropolitan University, Oslo, Norway
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36
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Kaufmann J, Gould O, Lloyd V. Seeking Care for Long COVID: A Narrative Analysis of Canadian Experiences. J Patient Exp 2023; 10:23743735231151770. [PMID: 36710996 PMCID: PMC9880455 DOI: 10.1177/23743735231151770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The goal of this study was to explore the experiences of individuals seeking care for long COVID-19 in the Canadian healthcare system. Recorded virtual interviews were carried out with 8 participants and narrative analysis was used to examine the stories produced and identify the central narratives that defined participants' experiences. Care-seeking experiences were characterized by (1) often debilitating multi-system symptoms for which little information about prognosis was available and no effective treatments were provided, (2) compounded by the frustration of trying to convince family, friends, and health care practitioners of the legitimacy of their illness, (3) access to medical care was severely limited by the global pandemic and associated higher thresholds for care, (4) like others suffering from complex, multi-system conditions, people with long COVID are often struggling with a health-care system ill-suited for dealing with long-term and possibly chronic conditions. To make system-level improvements to better serve those with chronic conditions, it is critical that we understand the care-seeking experiences of chronic illness patients, including the unique experiences of those with long COVID.
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Affiliation(s)
- Julia Kaufmann
- Department of Psychology, Mount Allison University, Sackville, NB, Canada
| | - Odette Gould
- Department of Psychology, Mount Allison University, Sackville, NB, Canada,Odette Gould, Department of Psychology,
Mount Allison University, 49A York Street, Sackville, NB E4L 1C7.
| | - Vett Lloyd
- Department of Biology, Mount Allison University, Sackville, NB, Canada
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Abstract
BACKGROUND Physical restraints are routinely employed to ensure patient safety in Japanese acute care. Little is known about nursing students' perspectives and how they begin to question their value and knowledge in the face of restraint experiences in clinical practice. OBJECTIVE To investigate nursing students' questions about patient restraints and how they understand the ethics of the use of restraints in nursing. RESEARCH DESIGN Qualitative descriptive research using narrative analysis. PARTICIPANTS AND RESEARCH CONTEXT Experiential data were generated and thematically analyzed from semi-structured interviews with 16 nursing students who had completed their bachelor's degree program requirements. ETHICAL CONSIDERATIONS The study was approved by academic and clinical ethics agencies. Participants provided written informed consent. RESULTS Physical restraints were encountered in 16 incidents, 3 with children and 13 with older patients with dementia. Students struggled to comprehend the policies and protocols of restraint use and worried their use was primarily for security rather than therapeutic purposes. Five themes were identified: (1). Questioning the tension between person-centered care, patient autonomy, and restraints, (2). Questioning the nature of restraints in which participants analyzed the policies and protocols around restraint use, (3). Questioning the professional nursing self whereby students reflected on how restraint use challenged their nursing values, and (4). Questioning professional nursing practice, in which students explored how restraints fit within a nursing perspective and positioned themselves as patient advocates. Students encountering physical restraints should ask questions based on values of patient-centeredness, autonomy, and advocacy. There is a need for education that facilitates reflection and questioning so that it informs students' ethical thinking which may enhance nurse advocacy to reduce restraint use. CONCLUSIONS Restraints provide contexts in which students must face tensions between nursing values and clinical reality. Further research on nursing education strategies within non-psychiatric settings is needed to reduce physical restraints.
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Abstract
This paper endeavors to portray the narratives of a group of female undergraduate students, in Saudi Arabia, studying during the Covid-19 pandemic. Data collection occurred in March 2021, at which time students had been in online classes for a year and had experienced several curfews as well as a total lockdown. Students answered open-ended questions and wrote a reflection about how they experienced the pandemic. The majority of the participants reported sleep disturbances, depression, anxiety, and social isolation, identifying their family as the most important source of support during this time. Others tried to cope using their own resources. The study highlighted the need for increased awareness among faculty, education leaders and policy-makers about the psychological effects of lockdown and social isolation. There is a requirement for more support services for those affected by anxiety, depression, and regular follow-up after the pandemic ends to explore the long-term consequences.
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Affiliation(s)
- Carmen Winkel
- Core Curriculum Department, College of Sciences & Human Studies, Prince Mohammad Bin Fahd University, Al-Khobar, Saudi Arabia,Carmen Winkel, Core Curriculum Department, College of Sciences & Human Studies, Prince Mohammad Bin Fahd University, Al-Khobar, Saudi Arabia.
| | - Beverley McNally
- Core Curriculum Department, College of Sciences & Human Studies, Prince Mohammad Bin Fahd University, Al-Khobar, Saudi Arabia
| | - Siddiqua Aamir
- Core Curriculum Department, College of Sciences & Human Studies, Prince Mohammad Bin Fahd University, Al-Khobar, Saudi Arabia
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Givati A, Berlinsky S. The 'disenchantment' of traditional acupuncturists in higher education. Health (London) 2023; 27:20-40. [PMID: 33611969 PMCID: PMC9742634 DOI: 10.1177/1363459321990725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Efforts of traditional acupuncturists in the UK to regulate their practice and standardise their training, led, from the mid-1990s, to the launch of acupuncture undergraduate programmes within, or validated by, universities. It appeared as if by so doing acupuncturists were on course to align themselves with 'scientifically plausible', state-regulated, allied health professionals, a remarkable development considering the marginality of acupuncture practice outside East Asia, and its paradigmatic tensions with biomedicine. But was it really to be? Based on in-depth interviews with higher education acupuncture educators and an analysis of educational documents published by the leading professional body, we explore the way in which this paradigmatic tension is negotiated within a framework that is dominated by biomedicine. By critically revisiting sociology of professions and anti-colonial analysis, we examine an over two decades long journey of acupuncture educators in academic institutions in the UK. Based on this analysis, we point at some of the challenges that acupuncturists faced in higher education that may have restricted the academic legitimisation of acupuncture and that left them in a position of academic marginality and greater exposure to scrutiny, leading to their academic and mainstreaming 'disillusionment'. At the same time, by positioning themselves as 'professional academics' within higher education institutions and demonstrating professionalism, acupuncture educators were able to demonstrate academic and professional 'credibility' and therefore distance themselves from the continuous scrutiny over their 'biomedical fragility'.
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Affiliation(s)
- Assaf Givati
- Assaf Givati, School of Population Health & Environmental Sciences, King’s College London, Addison House, London, WC2R 2LS, UK.
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Johnson IM, Light MA, Perry TE, Moore M, Lewinson T. Understanding the Ephemeral Moment of COVID Avoidance Hotels: Lessons Learned from Acknowledging Housing as Central to Dignified Later Life. J Gerontol Soc Work 2023; 66:3-28. [PMID: 35695062 PMCID: PMC9744961 DOI: 10.1080/01634372.2022.2087129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/31/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
Place and health are intricately bound. COVID has amplified system burdens and health risks within the housing care continuum, in which older adults with chronic illnesses are disproportionately represented. The paper identifies the health experiences of older adults with severe conditions living in and moving through temporary avoidance hotels during the COVID-19 pandemic. An interpretive descriptive approach was taken with qualitative chart data and provider observation to represent the experiences of 14 older avoidance hotel residents living with serious illnesses. Through provider documentation, we illustrate trends pre-pandemic, in the first nine months of the pandemic, and the second nine months. Such trends include strengths and opportunities such as the health-affirming nature of avoidance hotels, their potential in generating continuity of care and permanent housing, and synergy between harm reduction approaches and palliative care. Challenges were also identified in catering to the diverse medical, behavioral, and psychosocial-spiritual needs of older and seriously ill residents and the consequences of geographic dispersion on health care, health behaviors, and informal care networks. Through these strengths and challenges, avoidance hotels present essential lessons in considering future housing and healthcare intervention and implementation that addresses the needs of older seriously ill people facing homelessness and housing precarity.
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Affiliation(s)
- Ian M Johnson
- Dept of Social Work, University of Tennessee College of Social Work, Knoxville, Tennessee, USA
| | - Michael A Light
- Dept of Social Work, Palliative Care Training Center, University of Washington, Seattle, Washington, USA
| | - Tam E Perry
- Wayne State University School of Social Work, Detroit, Michigan, USA
| | - Megan Moore
- Dept of Social Work, University of Washington, Seattle, Washington, USA
| | - Terri Lewinson
- Dartmouth College Institute for Health Policy & Clinical Practice Lebanon, New Hampshire, USA
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Gaveras EM, Fabbre VD, Gillani B, Sloan S. Understanding Past Experiences of Suicidal Ideation and Behavior in the Life Narratives of Transgender Older Adults. Qual Soc Work 2023; 22:159-175. [PMID: 37387722 PMCID: PMC10306254 DOI: 10.1177/14733250211051783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Transgender people (collectively referred to here as trans) experience disproportionate rates of suicidal ideation and behavior (plans and attempts) attributed to complex constellations of structural and individual factors. Interpretive methods in suicide research elucidate and contextualize intricate patterns of risk factors and strategies for recovery. The life narratives of trans older adults offer unique insights into past suicidal behavior and recovery after distress has diminished and perspective has been gained. This study aimed to illuminate the lived experiences of suicidal ideation and behavior in the biographical interviews of 14 trans older adults as part of the project To Survive on This Shore (N=88). Data analysis was conducted using a two-phase narrative analysis. Trans older adults contextualized suicide attempts, plans, ideation, and recovery as navigating impossible to possible paths. Impossible paths were seen as hopelessness in their life direction, often after a significant loss. Possible paths were described as pathways to recovery from crises. Transitions from impossible to possible paths were narrated as a turning point or moment of strength combined with outreach to family, friends, or mental health professionals. Narrative approaches hold the potential to illuminate pathways to well-being among trans persons with lived experiences of suicidal ideation and behavior. For social work practitioners, therapeutic narrative work around past suicidal ideation and behavior with trans older adults holds promise for suicidal prevention by identifying important supportive resources and previously used coping skills in crises.
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Affiliation(s)
- Eleni M Gaveras
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130
| | - Vanessa D Fabbre
- Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO, 63130
| | | | - Steff Sloan
- University of Kansas, Center for Public Partnerships and Research, St. Andrews Research Building, 1617 St. Andrews Drive, Lawrence, Kansas 66047
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Lian OS, Nettleton S, Grange H, Dowrick C. 'It feels like my metabolism has shut down'. Negotiating interactional roles and epistemic positions in a primary care consultation. Health Expect 2022; 26:366-375. [PMID: 36385430 PMCID: PMC9854284 DOI: 10.1111/hex.13666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/07/2022] [Accepted: 11/06/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Our aim is to explore the ways in which a patient and a general practitioner (GP) negotiate knowledge claims stemming from different epistemic domains while dealing with a mismatch between experiential and biomedical knowledge during the clinical consultation. We interpret their interaction in relation to the sociocultural context in which their negotiation is embedded and identify factors facilitating their successful negotiation (a medical error is avoided). METHODS Based on a narrative analysis of a verbatim transcript of a complete naturally occurring primary care consultation, we explore the moment-to-moment unfolding of talk between the patient and the GP (two women). FINDINGS The patient experiences symptoms of what she interprets as a thyroid condition, and indirectly asks for medication. She presents her case by drawing on experiential knowledge ('it feels like my metabolism has shut down') and biomedical knowledge (while suggesting a diagnosis and a diagnostic test). The GP informs her that her thyroid blood tests are normal and uses biomedical knowledge to explain why she turns down the patient's request. This stages a potential conflict between the patient's embodied experiential knowledge and the doctor's biomedical knowledge. However, during their encounter, the patient and the GP manage to co-construct the patient's illness story and make shared decisions about further actions. CONCLUSION The transition from potential conflict to consensus is a result of the mutual efforts of two parties: a patient who persistently claims experiential as well as biomedical knowledge while at the same time deferring to the GP's professional knowledge, and a GP who maintains her epistemic authority while also acknowledging the patient's experiential and biomedical knowledge. PATIENT AND PUBLIC CONTRIBUTION Our empirical data are sourced from a data archive and patients were not involved in the design or conduct of the study, but our study is based on a naturally occurring clinical consultation with a patient.
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Affiliation(s)
- Olaug S. Lian
- Department of Community Medicine, Faculty of Health SciencesUiT—The Arctic University of NorwayTromsøNorway
| | | | - Huw Grange
- Department of Community Medicine, Faculty of Health SciencesUiT—The Arctic University of NorwayTromsøNorway
| | - Christopher Dowrick
- Department of Primary Care and Mental HealthUniversity of LiverpoolLiverpoolUK
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Avruscio G, Ragazzo S, Ceccato D, Adamo A, Napoli C, Cacco L, Scalzotto F, Canciani M, Cognolato M, Fedele A, Scipioni A, Tocco Tussardi I. Implementation of a quality management system according to ISO 9001:2015 standards in an Angiology Unit: an Italian experience. Ann Ig 2022; 34:627-634. [PMID: 35107122 DOI: 10.7416/ai.2022.2501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND The International Standardization Organization operates the world's most widely recognized quality management system standard, the ISO 9001:2015. In the healthcare sector, the adoption of this standard within an organization helps to improve the overall performance and provides a foundation for development and continuous progress. Our study aims to describe the implementation process of a quality management system according to the ISO 9001:2015 standards in an Angiology Unit of an Italian Univer-sity hospital. METHODS The project was structured in 5 operational phases, which were carried out during a time frame of 14 months (March 2018-May 2019) and entailed several improvement actions associated with quality and safety outputs such as clinical management, clinical practice, safety, and patient-centeredness. RESULTS Implementation of the quality management system led to the improvement of many aspects of the processes performed in the Angiology Unit, both in the outpatient and day hospital setting. Overall, the project positively impacted on systems for patient safety, particularly in communication and data transmis-sion, and clinical leadership. CONCLUSIONS The implementation of the ISO 9001 certification is a process that apparently may seem ex-pensive in terms of resources used, commitment, work, comparison, but it leads to substantial and always progressive improvements in the offer of Services to the user, safety both for the users and for the healthcare personnel involved, in addition to the care processes that translate into significant benefits in terms of quality of care for patients, as well as management savings for the organization.
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Affiliation(s)
- G Avruscio
- Angiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padua, Italy
| | - S Ragazzo
- Angiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padua, Italy
| | - D Ceccato
- Angiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padua, Italy
| | - A Adamo
- Angiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padua, Italy
- Department of Neurosciences, University of Padua, Italy
| | - C Napoli
- Angiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padua, Italy
| | - L Cacco
- Angiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padua, Italy
| | - F Scalzotto
- Quality Innovation and Organizational Development Service, University Hospital of Padua, Italy
| | - M Canciani
- "Learn to Lead" - Management consulting, organization and training, Milan, Italy
| | - M Cognolato
- Quality Innovation and Organizational Development Service, University Hospital of Padua, Italy
| | - A Fedele
- Quality and Environment Research Centre (CESQA), Department of Industrial Engineering, University of Padua, Italy
| | - A Scipioni
- Quality and Environment Research Centre (CESQA), Department of Industrial Engineering, University of Padua, Italy
| | - I Tocco Tussardi
- Department of Diagnostics and Public Health, University of Verona, and Risk Management Unit, Integrated University Hospital of Verona, Italy
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Zietz S, Kajula L, Martin S, Moracco B, Shanahan M, Maman S. "Mtoto Wa Nyoka Ni Nyoka," The Child of a Snake is a Snake: A Narrative Analysis of Adverse Childhood Experiences and Perpetration of Interpersonal Violence Among Men in Dar es Salaam, Tanzania. J Interpers Violence 2022; 37:NP12040-NP12065. [PMID: 33666115 PMCID: PMC8418622 DOI: 10.1177/0886260521997443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Childhood exposure to adversity, including abuse and neglect, is consistently found to be a predictor of intimate partner violence (IPV) and peer violence (PV) perpetration in adulthood. The purpose of this study is to qualitatively examine factors that may facilitate or impede the use of violence among those who have been exposed to adversity early in life. We are particularly interested in protective experiences or environments for these participants. The qualitative data were analyzed through thematic coding and narrative analysis of participant life histories.We found three salient themes: (a) parental acceptance and early attachment is protective for coping with stress with intimate partners in adulthood; (b) certain key life turning points can provide a protective context against violent behavior in adulthood; and (c) poverty in adulthood compromises one's ability to cope with stress and anger in adulthood.Our findings contextualize the different factors that may affect the behavior of perpetration of interpersonal violence among high-risk men in Dar es Salaam who have been exposed to adversity in childhood. These findings provide important information on the risk and protective factors for interpersonal violence spanning from childhood to adulthood. This study highlights the importance of child development interventions in this situation, both for the primary prevention of child adversity and for promoting resilience and mitigating the effects of childhood adversity that put men at risk for perpetration of interpersonal violence in adulthood.
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Affiliation(s)
| | - Lusajo Kajula
- UNICEF Office of Research-Innocenti, Florence, Italy
| | - Sandra Martin
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Beth Moracco
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Meghan Shanahan
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Suzanne Maman
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Garrett TM, Sementelli AJ. COVID-19, asylum seekers, and migrants on the Mexico-U.S. border: Creating states of exception. Polit Policy 2022; 50:POLP12484. [PMID: 35941865 PMCID: PMC9349377 DOI: 10.1111/polp.12484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/29/2021] [Accepted: 02/15/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic illuminates possibilities for creating states of exception while simultaneously destabilizing the Mexico-U.S. border through the politics of fear. Specifically, the Migrant Protection Protocols (MPP), Zero Tolerance Policy (ZTP), COVID-19 CAPIO, Asylum Cooperative Agreements (ACA), and Title 42-using the pandemic under an arcane section of U.S. law to immediately expel asylum seekers and refugees, in particular-highlight the formation of a state of exception consistent with the work of Agamben. They also document how the politics of fear is used to reinforce hegemonic narratives targeting asylum seekers while attempting to reinforce political agendas that lean toward a specific brand of nationalism using the lens of public health as a context. The U.S. government under the Trump administration, and the Biden administration to a lesser extent, constructed these policies aimed primarily at refugees and asylum seekers from El Salvador, Guatemala, Honduras, and Mexico, thereby violating laws and international treaty obligations. Related Articles Correa-Cabrera, Guadalupe. 2013. "Security, Migration, and the Economy in the Texas-Tamaulipas Border Region: The 'Real' Effects of Mexico's Drug War." Politics & Policy 41(1): 65-82. https://doi.org/10.1111/polp.12005.Duman, Yoav H. 2014. "Reducing the Fog? Immigrant Regularization and the State." Politics & Policy 42(2): 187-220. https://doi.org/10.1111/polp.12065.Garrett, Terence M. 2020. "The Security Apparatus, Federal Magistrate Courts, and Detention Centers as Simulacra: The Effects of Trump's Zero Tolerance Policy on Migrants and Refugees in the Rio Grande Valley." Politics & Policy 48(2): 372-35. https://doi.org/10.1111/polp.12348.
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Affiliation(s)
- Terence M. Garrett
- Department of Political ScienceThe University of Texas Rio Grande ValleyBrownsvilleTexasUSA
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Paoli B, Giubilei R, De Gregorio E. Tears of Joy as an Emotional Expression of the Meaning of Life. Front Psychol 2022; 13:792580. [PMID: 35350731 PMCID: PMC8957987 DOI: 10.3389/fpsyg.2022.792580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 02/03/2022] [Indexed: 01/10/2023] Open
Abstract
This article describes a research project in which a qualitative research was carried out consisting of 24 semi-structured interviews and a subsequent data analysis using the MAXQDA software in order to investigate a particular dimorphic emotional expression: tears of joy (TOJ). The working hypothesis is that TOJ are not only an atypical expression due to a "super joy," or that they are only an attempt by the organism to self-regulate the excess of joyful emotion through the expression of the opposite emotion (sadness), but that it is an emotional experience in its own right-not entirely overlapping with joy-with a specific adaptive function. Through the interviews, conducted in a cross-cultural context (mainly in India and Japan), we explored the following possibility: what if the adaptive function of crying for joy were to signal, to those experiencing it, the meaning of their life; the most important direction given to their existence? The material collected provided positive support for this interpretation.
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Carvalho Machado R, Kindl Da Cunha S. From urban waste to urban farmers: Can we close the agriculture loop within the city bounds? Waste Manag Res 2022; 40:306-313. [PMID: 34967238 DOI: 10.1177/0734242x211068248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
As urbanisation intensifies in Brazilian cities, life quality in urban centres becomes a challenge for policymakers, and transitioning urban systems to sustainability is required. Circular economy concepts may contribute to face them, especially those owing to municipal solid waste (MSW) management. Curitiba, a Brazilian municipality known for its innovative initiatives towards sustainability. Despite a long tradition in recycling inert waste, MSW system struggles to promote composting even considering a decade in force national law. Decentralised composting through the Urban Agriculture Program (UAP) is the city's strategy to tackle this struggle. This strategy faces difficulties as, even if urban agriculture facilities seem to be a promising context, closing the agricultural loop within the city bounds was not possible in the 24 urban farmers communities trained in composting techniques. The literature has shown difficulties in government experiments to promote practices in the long run and several experiences in Brazil are already described. This study reveals cultural barriers that influence adoption of domestic composting, by following a secondary data review on past experiences with interviewing and observing participatively urban farms communities. From the fieldwork, cultural perspectives from four different relevant actor roles in the UAP were elaborated and conflicts between them revealed cultural barriers hindering composting practices adoption. Recommendations based on these barriers argue for bottom-up approaches for transition experiments and recognising the sense material and technical support makes to practitioners.
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Nygaard AM, Haugdahl HS, Laholt H, Brinchmann BS, Lind R. Professionals' narratives of interactions with patients' families in intensive care. Nurs Ethics 2022; 29:885-898. [PMID: 35196935 PMCID: PMC9289990 DOI: 10.1177/09697330211050995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: ICU patients’ family members are in a new, uncertain,
and vulnerable situation due to the patient’s critical illness and complete
dependence on the ICU nurses and physicians. Family members’ feeling of being
cared for is closely linked to clinicians’ attitudes and behavior. Aim: To explore ICU nurses’ and physicians’ bedside interaction with
critically ill ICU patients´ families and discuss this in light of the ethics of
care. Research design: A qualitative study using participant observation,
focus groups, and thematic narrative analysis. Participants and research context: Data were gathered from July 2017
to August 2019, in four ICUs in Norway through 270 h of fieldwork and seven
focus groups with ICU nurses and physicians. Ethical considerations: The Regional Committee for Medical and
Health Research Ethics and the Norwegian Centre for Research Data approved the
study. Findings: Quality of ICU family care depends on nurses’ and
physicians’ attitudes, behavior, and personality traits. Three main themes were
identified: being attentive, an active
approach, and degree of tolerance. Discussion: The findings are discussed in light of the ethics of
care and empirical research from the intensive care environment. Conclusions: This study shows that attentive, active, and tolerant
clinicians represent a culture of ethical care that gives families greater
freedom of action and active participation in patient care. Clinicians must not
bear sole responsibility for this culture; it must have a firm basis in the
hospital and ICU and be established through training, interprofessional
reflection, and support of clinicians.
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Affiliation(s)
- Anne M Nygaard
- Department of Health and Care Sciences, 60482UiT, The Arctic University of Norway, Tromso, Norway
| | - Hege S Haugdahl
- Department of Public Health and Nursing, Levanger Hospital, 60500Nord-Trøndelag Hospital Trust and NTNU Norwegian University of Science and Technology, Levanger, Norway
| | - Hilde Laholt
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Troms, Norway
| | | | - Ranveig Lind
- Department of Health and Care Sciences, UiT The Arctic University of Norway and Research Nurse at Intensive Care Unit, University Hospital of North Norway, Harstad, Norway
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LoGiudice JA. A Narrative Analysis of the In Vitro Fertilization Experiences of Survivors of Sexual Abuse. Nurs Womens Health 2022; 26:107-115. [PMID: 35219687 DOI: 10.1016/j.nwh.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/06/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To explore the lived experience of in vitro fertilization (IVF) from the perspective of survivors of sexual abuse. DESIGN In this qualitative study, narrative analysis provided the framework to understand participants' IVF experiences. SETTING Participants were recruited through a regional support group for women with infertility. PARTICIPANTS Three women (mean age = 33.3 years) who self-identified as a survivor of sexual abuse and had at least one IVF experience participated in this study. MEASUREMENTS Each participant wrote a narrative text of her experience. Burke's method was followed for analysis of the narratives. RESULTS The most frequent imbalance was between what is happening (i.e., IVF procedures) and how the health care team provided the care. The repercussion was a negative experience for survivors, stemming from an insensitive manner in which their physical and verbal care was delivered by health care teams. These women were also deeply protective of their oocytes (eggs), embryos, and children. CONCLUSION Health care providers may use these findings to better meet the physical and psychological needs of survivors of sexual abuse who are coping with infertility. Providers can have a more positive effect on the IVF experience of survivors by ensuring that the procedures they perform and the information they share are explained fully and delivered in a trauma-informed manner.
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Qiao G, Ding L, Xiang K, Prideaux B, Xu J. Understanding the Value of Tourism to Seniors' Health and Positive Aging. Int J Environ Res Public Health 2022; 19:1476. [PMID: 35162499 DOI: 10.3390/ijerph19031476] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023]
Abstract
The value of tourism has been included in studies of active aging, and the existing public health implications of the physical and mental health effects of tourism among seniors are recognized as important issues. This study uses a mixed methods research approach to explore the effects of tourism value on the health and mortality risk of older adults, referred to in this paper as seniors. Survival analysis and cohort analysis are combined with the narrative analysis of in-depth interviews with eight convenience-sampled seniors to construct a narrative framework of seniors' active aging tourism and its intrinsic drivers. The study found that the intrinsic framework of active aging tourism values for seniors has a three-stage continuum, an interaction, and orientation characteristics. There are six intrinsic key value drivers of tourism value and public health for seniors. In addition, this study identifies the personal characteristics and strengths of seniors as important influences on tourism value practices for active aging and public health. This study provides a positive psychological and behavioral research direction for existing research on the value of tourism in active aging. It provides an empirical basis for exploring the intrinsic mechanisms of tourism and public health.
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