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1.
Qual Health Res ; 27(5): 727-737, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27055495

RESUMEN

Men experiencing depression may present with externalizing behaviors including avoidance, getting angry, or finding distractions rather than seeking help. General practitioners report that depression is harder to diagnose in men than in women. Research has not typically focused on men's accounts of depression; thus, the current study uses an exploratory design to better understand men's subjectivities of depression. A thematic framework informed the analysis of interviews with 10 men who had experienced high levels of depressive symptoms at least once within the prior 5 years, with two overarching discourses of depression discussed. The first relates to links between depression and health, including comorbid illnesses. The second relates to social contexts in which depression is experienced. These findings extend upon previous research suggesting medical practitioners have difficulty with competing biomedical and social discourses of depression, highlighting the importance of continuing to improve understandings of men's depression discourses.


Asunto(s)
Actitud Frente a la Salud , Trastorno Depresivo/diagnóstico , Trastorno Depresivo/psicología , Conductas Relacionadas con la Salud , Conducta de Búsqueda de Ayuda , Masculinidad , Hombres/psicología , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
2.
Qual Health Res ; 27(7): 983-993, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26984366

RESUMEN

Experiences of cancer are enmeshed with cultural understandings and social discourses around responsibility and causation. A cancer diagnosis can raise questions about its causation-including the role of the individual-whereas the disease and its treatment provide various social markers of illness. We present a sociological study of 81 women's accounts of living with cancer, with a focus on how women interpret their illness, in light of their interpersonal interactions and accounts of social relations. Our analysis reveals women's experiences of cancer diagnosis and treatment, the varied sociocultural meanings of cancer and the responses it elicits, the presence of moral assessments within everyday interactions, and the implications for the support and care they receive. We argue that the experience of cancer should be seen as intimately interwoven with its social reception and cultural sense-making practices, including normative constructs which promote ideas about (in)justice, responsibilization, and shame.


Asunto(s)
Características Culturales , Relaciones Interpersonales , Neoplasias/psicología , Adulto , Anciano , Cuidadores/psicología , Femenino , Culpa , Conductas Relacionadas con la Salud , Humanos , Persona de Mediana Edad , Negociación , Vergüenza , Salud de la Mujer
3.
Qual Health Res ; 27(5): 714-726, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26631675

RESUMEN

Breast cancer, the most common cancer among Arab women in Qatar, significantly affects the morbidity and mortality of Arab women largely because of low participation rates in breast cancer screening. We used a critical ethnographic approach to uncover and describe factors that influence Arab women's breast cancer screening practices. We conducted semistructured interviews with 15 health care practitioners in Qatar. Through thematic analysis of the data, we found three major factors influencing breast cancer screening practices: (a) beliefs, attitudes, and practices regarding women's bodies, health, and illness; (b) religious beliefs and a culturally sensitive health care structure; and (c) culturally specific gender relations and roles. Arab women's health practices cannot be understood in isolation from the sociocultural environment. The problem of low rates of breast cancer screening practices and supportive interventions must be addressed within the context and not be limited to the individual.


Asunto(s)
Árabes/psicología , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/psicología , Detección Precoz del Cáncer/psicología , Conocimientos, Actitudes y Práctica en Salud , Tamizaje Masivo/psicología , Religión , Adulto , Anciano , Anciano de 80 o más Años , Actitud Frente a la Salud , Femenino , Humanos , Persona de Mediana Edad , Qatar
4.
Qual Health Res ; 27(4): 534-546, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26631681

RESUMEN

Persistent, subjective symptoms of unknown etiology following treatment for Lyme disease have been termed post- treatment Lyme disease syndrome or chronic Lyme disease (PTLDS/CLD). The objective of this study was to give primacy to the patient experience of this medically contested condition by eliciting patient illness narratives and identifying emergent issues through semistructured interviews conducted among 29 participants. We used thematic narrative analysis to identify three predominant themes: (a) Physical and social limitations lead to a "new normal" characterized by fundamental shifts of ways of being in the world, (b) disease-specific factors contribute to symptom and illness invisibility that affects social support in nuanced ways, and (c) pervasive medical uncertainty regarding PTLDS/CLD promotes an increased sense of personal responsibility for care. Similar to other contested or medically unexplained syndromes, our findings suggest that the social sequelae of PTLDS/CLD can be equally protracted as the physical effects of this illness.


Asunto(s)
Enfermedad de Lyme/psicología , Enfermedad Crónica , Femenino , Estado de Salud , Humanos , Relaciones Interpersonales , Masculino , Salud Mental , Persona de Mediana Edad , Narración , Apoyo Social
5.
Glob Qual Nurs Res ; 3: 2333393616650082, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-28462340

RESUMEN

We examined the meaning of living with HIV/AIDS among women in Lebanon. Ten women living with HIV/AIDS (WLWHA) described their experiences via semistructured in-depth interviews. They navigated a process of HIV diagnosis acceptance that incorporated six overlapping elements: receiving the news, accessing care, starting treatment, navigating disclosure decisions, negotiating stigma, and maintaining stability. Through these elements, we provide a framework for understanding three major themes that were constructed during data analysis: Stand by my side: Decisions of disclosure; Being "sick" and feeling "normal": Interacting with self, others, and society; and Living day by day: focusing on the present. We contribute to the existing literature by providing a theoretical framework for understanding the process of diagnosis and sero-status acceptance among WLWHA. This was the first study of its kind to examine the meaning of living with HIV/AIDS among women in a Middle Eastern country.

6.
Qual Health Res ; 26(4): 490-503, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25652196

RESUMEN

Cancer and cancer treatments can cause significant changes to women's sexual well-being. We explored how women construct a sense of their bodies and sexual "selves" in the context of cancer. Sixteen women, across a range of ages (20-71 years), cancer types, and cancer stages, took part in in-depth semistructured interviews. We conducted a thematic discourse analysis, drawing on feminist poststructuralist theory, identifying "the abject body" as a dominant theme. Participants constructed abject bodies as being "beyond abnormality," "outside idealized discourses of embodied femininity," and "out of control." The women's accounts varied in management and resistance of the abject body discourse, through bodily practices of concealment, resisting discourses of feminine beauty, and repositioning the body as a site of personal transformation. The corporeality of the cancerous body can be seen to disrupt hegemonic discourses of femininity and sexuality, with implications for how women practice and make meaning of embodied sexual subjectivity.

7.
Qual Health Res ; 26(3): 377-86, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25656416

RESUMEN

Amid growing concern about the graying population, an emerging theme in public health discourse is that of "successful aging." In this article, we use a governmentality lens to analyze a Canadian health promotion video, titled "Make Health Last: What Will Your Last 10 Years Look Like?" and viewers' responses to its message. The video presents starkly different scenarios of the last decade of life, conveying a neo-liberal rationality in which health in old age is positioned as a matter of individual choice. Our analysis suggests that while viewers generally support the video's message of personal responsibility for health, some are uneasy about implied claims that age-related illness can be prevented by choosing to be healthy. We argue that the video's simplistic messaging about health in later life raises disturbing questions about health promotion campaigns that deny the "normal" aging body and blame the elderly for "deciding" not to remain youthful and healthy.


Asunto(s)
Envejecimiento/fisiología , Envejecimiento/psicología , Promoción de la Salud/métodos , Educación del Paciente como Asunto , Pacientes/psicología , Autocuidado/métodos , Grabación en Video , Anciano , Anciano de 80 o más Años , Canadá , Organizaciones de Beneficencia , Femenino , Humanos , Masculino , Persona de Mediana Edad
8.
Qual Health Res ; 25(5): 622-35, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25829509

RESUMEN

Achieving equitable access to health care is an important policy goal, with access influenced by affordability, availability, and acceptability of specific services. We explore patient narratives from a 5-year program of research on health care access to examine relationships between social constructions of illness and the acceptability of health services in the context of tuberculosis treatment and antiretroviral therapy in South Africa. Acceptability of services seems particularly important to the meanings patients attach to illness and care, whereas-conversely-these constructions appear to influence what constitutes acceptability and hence affect access to care. We highlight the underestimated role of individually, socially, and politically constructed healthworlds; traditional and biomedical beliefs; and social support networks. Suggested policy implications for improving acceptability and hence overall health care access include abandoning patronizing approaches to care and refocusing from treating "disease" to responding to "illness" by acknowledging and incorporating patients' healthworlds in patient-provider interactions.


Asunto(s)
Infecciones por VIH/psicología , Conocimientos, Actitudes y Práctica en Salud , Accesibilidad a los Servicios de Salud , Tuberculosis/psicología , Adulto , Antirretrovirales/uso terapéutico , Enfermedad Crónica , Femenino , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Política de Salud , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Narración , Política , Embarazo , Relaciones Profesional-Paciente , Sudáfrica , Tuberculosis/diagnóstico , Tuberculosis/tratamiento farmacológico , Adulto Joven
9.
Qual Health Res ; 25(3): 320-35, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25192764

RESUMEN

Cancer experiences are sites of transition and struggle that are made meaningful through communication with others. As such, they are events in which communal coping might occur as survivors and families deal with cancer collectively. I conducted 64 interviews with family members who had coped with breast cancer. Using relational dialectics theory, I analyzed data for discursive struggle and competition via a contrapuntal analysis. Thematic and discourse analyses revealed that communal coping was not highly prevalent in family member talk of their experiences. Individual coping by female breast cancer survivors typified the experience, and family members depicted coping as an individual identity disruption as opposed to a communal experience. This article contributes to a more comprehensive theoretical understanding of communal coping within a context of cancer. I offer suggestions for a reconceptualization of communal coping to benefit health practitioners and researchers.


Asunto(s)
Adaptación Psicológica , Neoplasias de la Mama/psicología , Familia/psicología , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/terapia , Comunicación , Femenino , Identidad de Género , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Apoyo Social , Factores de Tiempo
10.
Qual Health Res ; 24(1): 6-17, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24259535

RESUMEN

Research has shown that social representations of HIV can constitute barriers to health workers' willingness to provide HIV care. Considering a growing shortage in the HIV primary workforce in Western countries, we examine how HIV is perceived today by doctors involved in its care. In 1989 Sontag predicted that once the virus became better understood and treatable, the dehumanizing meanings that defined the early epidemic would vanish and HIV would turn into an ordinary illness. However, research shows that HIV still carries stigma, including in the health care sector. Drawing on qualitative interviews, we found that HIV doctors in Australia perceived HIV as a far-from-ordinary chronic illness because of its extraordinary history and its capacity to extend in multiple clinical and social directions. These rarely explored perspectives can contribute to the social reframing of HIV and to strategies to build a dedicated HIV workforce in Australia and elsewhere.


Asunto(s)
Actitud del Personal de Salud , Médicos Generales/psicología , Infecciones por VIH/psicología , Percepción , Adulto , Australia , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Estigma Social
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