Research In Nursing & Health[JOURNAL]
Sun
40 papers
Social problems, technological solutions? German nursing care experts' perspectives, evaluations, and imaginaries of care robotics research.
Braun M, Breuer S, Müller R
Health (London) · 2026 May · PMID 42153293 · Publisher ↗
Nursing care work in Germany has been facing significant challenges, among them a steadily increasing shortage of nursing care workers. Funding programs promote the use of care robotics to mitigate these challenges' nega...
Nursing care work in Germany has been facing significant challenges, among them a steadily increasing shortage of nursing care workers. Funding programs promote the use of care robotics to mitigate these challenges' negative effects and to support nursing care practice. However, most robotics research on the topic has so far followed a technology-centered approach that hardly considers nursing care experts' distinct experiences, knowledge, or expertise. Drawing on interviews, focus groups, and workshops with nursing scientists, students, and practitioners, this study investigates the perspectives, evaluations, and imaginaries of German nursing care experts regarding care robotics. In their accounts, we found three salient themes that highlight care robotics as an open-ended, empirical concern for the nursing sciences; as a means for delineating between automatable and non-automatable nursing care activities; and as a potential remedy for nurses' assistive and executive responsibilities. Each of these themes highlights a particular set of challenges that nursing care work currently faces in the context of German healthcare from the nursing care experts' perspective and that shapes their perspectives on care robotics. We discuss the nursing care experts' responses as a reference point to re-articulate deep-seated disciplinary and professional concerns along three distinct dimensions: a nursing-as-science, nursing-as-practice, and nursing-as-profession dimension. We further conceptualize these dimensions as matters of care that care robotics research should engage with to generate care for nursing care work and workers. We conclude by suggesting ways for incorporating these dimensions into care robotics research and development.
'Why can't you just be fine?': An autoethnography of self-harm from a lived experience and nursing perspective.
da Cunha Lewin C
Health (London) · 2026 Mar · PMID 40418714 · Full text
Psychiatric discourse problematises self-harm as a psychopathological behaviour indicative of individualistic deficiency. This guides clinical priorities in treatment whilst negating salient components and individual pre...
Psychiatric discourse problematises self-harm as a psychopathological behaviour indicative of individualistic deficiency. This guides clinical priorities in treatment whilst negating salient components and individual preferences. Conversely, survivor-controlled research emphasises underacknowledged aspects of self-harm, such as its embodied emotionality as embedded within sociocultural context. This suggests a need for re-theorisation. Autoethnography (AE) utilises the researcher as the main source of data to elucidate social phenomena. Through AE, I consider my lived and professional experiences, as a registered general nurse, of self-harm by referring to my medical notes, memory reflections and personal diary entries as contextualised to self-harm literature. This lived experience (LE) perspective of self-harm is derived from subjective experience and contemporary literature, framed within survivor epistemology. This novel understanding argues that people with self-harm may experience immersive, aversive embodied emotionality arising from sociocultural and relational conflict. It considers self-harm as supporting the person to (1) be an integrated whole; (2) employ self-care; and (3) connect with oneself and others. This LE perspective directly critiques dominant psychiatric conceptualisations, instead compassionately framing self-harm as socially implicated. This could improve societal understanding, reduce pejorative attitudes and benefit people with LE.
's voyage on to a hospital ward: Expectations, explorations and emergent robocentric nursing care.
Nettleton S, Brown N, Atkin K … +3 more , Dolezal L, Metsäketo S, Robins D
Health (London) · 2025 Jul · PMID 39628366 · Full text
Drawing on ethnographic fieldwork in Finland, we report on the trial of a teleoperated care robot named Välkky introduced onto a fully operational hospital neurological ward. Our data revealed a narrative arc where parti...
Drawing on ethnographic fieldwork in Finland, we report on the trial of a teleoperated care robot named Välkky introduced onto a fully operational hospital neurological ward. Our data revealed a narrative arc where participants' early expectations of the hospital-based trial altered as the project unfolded. Greeted with techno-excitement and experimental enthusiasm about the place of robotics in reshaping roles within clinical care, Välkky became the focus for collaborative in situ learning, adaptation and redesign amongst the roboticists, designers, nurses, patients, and managers. Välkky acted as an 'attractor' provoking thinking about, and a reimagining of, future arrangements of care. Our empirically informed insights seek to pave the way for real-world nuanced thinking that pushes beyond human/non-human and success/failure binaries. Building on debates in STS and feminist posthumanism, we propose a , which encourages us to 'queer' health care robots, and to understand them as fluid, hybrid, distributed and relational figures, rather than purely as inert, mechanical, non-human objects that might replace humans. Nursing care practices by and with robots will generate new meanings and practices of care that will emerge iteratively, as caring relations, relationships and practices develop within the context of operational ward environments. Robots may or may not be able support care, but they will invariably challenge what care is.
Pediatric oncology caregiving as narrative repair: Restor(y)ing disrupted family biographies and damaged moral identities.
Molinaro ML, Polzer J, Laliberte Rudman D … +1 more , Savundranayagam M
Health (London) · 2025 May · PMID 39099340 · Full text
Drawing on Arthur Frank's conceptualization of narrative repair, we consider how pediatric oncology nurses restore and re-story the narratives of patients and families whose biographies have been thrown off course by the...
Drawing on Arthur Frank's conceptualization of narrative repair, we consider how pediatric oncology nurses restore and re-story the narratives of patients and families whose biographies have been thrown off course by the diagnosis and death of a child from cancer, as well as their own narratives as caregivers. Frank argued that when one's life story is shipwrecked by chronic or life-threatening illness, storytelling is way to reorient one's biography to a new ending, repairing the narrative wreckage created by the illness experience. In this critical narrative study with nine pediatric oncology nurses in Ontario, Canada, we highlight how, through physical, narrative, and moral proximity, nurses become entwined in their patients' and families' illness narratives, and how developing this narrative knowledge provides nurses with opportunities to steer families onto new terrain. As well, we examine how nurses re-story and repair their own identities as "good" caregivers in situations when they are prevented from acting on behalf of their pediatric cancer patients. These findings contribute to literature on illness narratives by considering narrative repair as a relational process enacted as part of pediatric oncology caregiving.
Reflections of a white healthcare professional researching ethnicized and racialized minorities: Autoethnographically explored emotions revealing implicit advantages and consequences.
Halberg N
Health (London) · 2024 Jul · PMID 37391906 · Publisher ↗
Health research is often embedded in biomedicine in which the goal is to remove all bias. However, this is problematic in research on social issues such as social and health inequities. Therefore, there is growing critic...
Health research is often embedded in biomedicine in which the goal is to remove all bias. However, this is problematic in research on social issues such as social and health inequities. Therefore, there is growing criticism of health researchers' positions as neutral and invisible. I explore research-based advantages and consequences following my positionings within whiteness, nursing and healthcare professionality. Drawing on two ethnographic studies conducted in Denmark, one among black Nigerian women working in the streets of Copenhagen, the other following patients, defined in Danish healthcare as 'ethnic minorities', in two hospitals in the greater Copenhagen area, I take the point of departure from autoethnographic emotions of 'doing good', 'discomfort' and 'denial'. As I analyse these emotions as a in the contexts, I show the advantages and consequences of leaving my marked body unmarked. With an intersectional lens, I discuss how health researchers' risk (re)producing social inequalities in health based on for example, avoiding topics of skin colour and experiences of discrimination. Ultimately, what legitimized my access to the people in the field paradoxically also risked delegitimizing their experiences of racialized and ethnicized inequalities. This is not only consequential for the interlocutors but also for the knowledge production, since we as health researchers' risk implicitly avoiding important knowledge if we do not see our own research positionings as a racialized, ethnicized and culturalized matter. Therefore, the need for educational curriculum on racialization and anti-discrimination is imperative within the health professions and as health researchers regardless of profession or research area.
Good care and adverse effects: Exploring the use of social alarms in care for older people in Sweden.
Lydahl D
Health (London) · 2024 Jul · PMID 37391903 · Full text
In Nordic countries, 'welfare technology' is a concept used increasingly by policymakers when discussing the promise of digitalisation in care for older people. In this paper, I draw on data from 14 qualitative ethnograp...
In Nordic countries, 'welfare technology' is a concept used increasingly by policymakers when discussing the promise of digitalisation in care for older people. In this paper, I draw on data from 14 qualitative ethnographic interviews with employees in municipal eldercare in Sweden, as well as observations carried out at a nursing home, to suggest the importance of studying how good care is enacted through welfare technology, whilst simultaneously attending to the adverse effects sometimes consequent from these practices. In this article, I explore what values are supported when doing care with welfare technology, and what values are neglected in this process. The theoretical starting point for this article takes its inspiration from recent discussions of care within Science and Technology Studies (STS). Employing a , the article argues for the importance of understanding how good care is enacted with technology, while also attending to what these care practices exclude and neglect. Focusing on the use of , the article shows that when doing care with such technology, values such as independence, safety and some forms of togetherness and availability were enhanced; while other values such as other forms togetherness and availability, a stress-free working environment and functionality were neglected.
Involuntary psychiatric treatment and the erosion of consent: A critical discourse analysis of mental health legislation in British Columbia, Canada.
Kolar M, Varcoe C, Brown H … +1 more , Einboden R
Health (London) · 2023 Nov · PMID 35531879 · Full text
The Mental Health Act (1996) is legislation that directs voluntary and involuntary psychiatric treatment for people experiencing mental health issues in British Columbia (BC), Canada. This critical discursive analysis ex...
The Mental Health Act (1996) is legislation that directs voluntary and involuntary psychiatric treatment for people experiencing mental health issues in British Columbia (BC), Canada. This critical discursive analysis explores how BC's Mental Health Act (1996) and the Guide to the Mental Health Act (2005) structure involuntary psychiatric treatment and illustrates how the discourses within these texts constitute people experiencing mental health issues as passive recipients of care. Understandings of people experiencing mental health issues as pathological, incapable, vulnerable and dangerous justify their need for protection and the protection of others. Protection is identified as a central legitimising discourse in the use of involuntary psychiatric treatment. Further, these texts define the roles and responsibilities of police, physicians and nurses in authorising and implementing involuntary psychiatric treatment. This analysis describes how this legislation erodes consent and entrenches social marginalisation. Alternatively, discourses of equity have potential to transform health care practices and structures that reproduce discourses of deficit, vulnerability and dangerousness, shifting towards promotion of the rights and safety of people experiencing mental health issues and crises.
From domestication to imperial patronage: Deconstructing the biomedicalisation of occupational therapy.
Turcotte PL, Holmes D
Health (London) · 2023 Sep · PMID 34949100 · Full text
Occupational therapy knowledge emerged in the 19th century as reformist movements responded to the industrialisation of society and capitalist expansion. In the Global North, it was institutionalised by State apparatuses...
Occupational therapy knowledge emerged in the 19th century as reformist movements responded to the industrialisation of society and capitalist expansion. In the Global North, it was institutionalised by State apparatuses during the First and Second World Wars. Although biomedicine contributed to the rapid expansion and establishment of occupational therapy as a health discipline, its domestication by the biomedical model led to an overly regulated profession that betrays its reformist ideals. Drawing on the work of Deleuze and Guattari, our aim in this article is to deconstruct the biomedicalisation of occupational therapy and demonstrate how resistance to this process is critical for the future of this discipline. The use of arts and crafts in occupational therapy may be conceptualised as a 'nomad science' aesthetically resisting the domination of industrialism and medical reductionism. Through the war efforts, a coalition of progressive nurses, social workers, teachers, artisans and activists metamorphosed into occupational therapists. As it did with nursing, biomedicine proceeded to domesticate occupational therapy through a form of 'imperial' patronage subsequently embodied in the evidence-based movement. 'Occupational' jargon is widely used today and may be viewed as the product of a profession trying to establish itself as an autonomous discipline that imposes its own regime of truth. Given the symbolic violence underlying this patronage, the future of occupational therapy should not mean behaving according to biomedicine's terms. As a discipline, occupational therapy must resist the appropriation of its 'war machine' and craft its own terms through the release of new creative energy.
An auto-ethnographic reflection on the nature of nursing in the UK during the Covid-19 pandemic.
Allan HT
Health (London) · 2023 Sep · PMID 34894800 · Full text
In this article I discuss the effects on the patient experience of isolation nursing during the CoronaVirus Disease (COVID)-19 pandemic. An unintended consequence of isolation nursing has been to distance patients from n...
In this article I discuss the effects on the patient experience of isolation nursing during the CoronaVirus Disease (COVID)-19 pandemic. An unintended consequence of isolation nursing has been to distance patients from nurses and emphasise the technical side of nursing while at the same time reducing the relational or affective potential of nursing. Such distanced forms of nursing normalise the distal patient in hospital. I consider ways in which this new form of distanced nursing has unwittingly contributed to the continued commodification of nursing care in the British NHS. Autoethnography is used to describe and reflect on the illness experience, the experiences of caregivers and the sociocultural organisation of health care. The findings discuss three areas of the illness experience: intimate nursing care; communication; the 'distanced' patient experience.
Medical assistance in dying and the meaning of care: Perspectives of nurses, pharmacists, and social workers.
Mills A, Bright K, Wortzman R … +2 more , Bean S, Selby D
Health (London) · 2023 Jan · PMID 33685263 · Full text
Medical Assistance in Dying (MAiD) was legalized in Canada in 2016. While it has generated significant academic interest, the experiences of healthcare workers other than physicians remain understudied. This paper report...
Medical Assistance in Dying (MAiD) was legalized in Canada in 2016. While it has generated significant academic interest, the experiences of healthcare workers other than physicians remain understudied. This paper reports on a qualitative study of interprofessional Healthcare Providers (HCPs) involved in the provision of MAiD in order to: (1) characterize providers' views about the care they offer in general; (2) examine whether or not they consider MAiD a form of care; and (3) explore their reasons for viewing or not viewing MAiD as care. Semi-structured qualitative interviews were conducted with ten nurses, eight social workers, and three pharmacists with firsthand experience delivering MAiD at an academic hospital in Toronto, Canada. The study was approved by the hospital's REB. Written informed consent was obtained prior to participation. Codebook thematic analysis and template analysis generated four themes: (1) care as advocacy, (2) care as easing suffering, (3) care as psychosocial, and (4) care as relational. Every participant viewed MAiD as a form of care and drew on these four themes to authenticate MAiD as care. Participants consider MAiD a form of care for patients, families, other healthcare workers, and even themselves. In alternating and composite fashion, they describe MAiD in terms of autonomy, easing suffering, and a kind death for the dying (and those entrusted with their care)-a complex choreography of social discourses and moral logics that refuse to settle into a simple dichotomy of "choice versus care." Participants depict MAiD in many of the same terms and imagery they use to describe the care they offer in general. In light of ongoing social controversies surrounding MAiD, HCPs utilize a range of logics strategically to repel negative attention and enable their participation in what they see as a caring end for their patients.
Doing nothing? An ethnography of patients' (In)activity on an acute stroke unit.
Costa A, Jones F, Kulnik ST … +3 more , Clarke D, Honey S, Robert G
Health (London) · 2022 Jul · PMID 33426969 · Full text
Health research has begun to pay increasing attention to inactivity in its broadest sense as lack of meaningful activity and boredom. Few studies however have taken a critical look at this phenomenon. We explore (in)acti...
Health research has begun to pay increasing attention to inactivity in its broadest sense as lack of meaningful activity and boredom. Few studies however have taken a critical look at this phenomenon. We explore (in)activity drawing on ethnographic data from observations in an acute stroke unit and post-discharge interviews with stroke survivors and their families. Four themes emerged that explain patients' (in)activity: (i) planned activities; (ii) 'doing nothing', (iii) the material environment of the unit; (iv) interactions with staff. Considering these themes, we seek to problematise received conceptual and methodological approaches to understanding (in)activity. We argue that (in)activity is best conceived not as lack of action or meaning, but as a situated practice encompassing both bodily and mental activities that reflect and reproduce the way in which life is collectively organised within a specific healthcare setting.
'Should it fit? Yes. Does it fit? No': Exploring the organisational processes of introducing a recovery-oriented approach to mental health in Australian private health care.
Dawson L, River J, McCloughen A … +1 more , Buus N
Health (London) · 2021 May · PMID 31773989 · Publisher ↗
This article explores the implementation of an innovative approach to mental health care in a private health setting. Open Dialogue is a recovery-oriented approach to mental health that emerged in Finland, which emphasis...
This article explores the implementation of an innovative approach to mental health care in a private health setting. Open Dialogue is a recovery-oriented approach to mental health that emerged in Finland, which emphasises family involvement, interdisciplinary collaboration and a flexible, needs-adapted approach. Early research is promising; however, little research has explored Open Dialogue outside Finland. This study aimed to explore the introduction of this approach at a private, inpatient young-adult mental health unit in Australia. Drawing on data from a long-term ethnographic field study that included 190 hours of observation and qualitative interviews, the findings show that despite staff members being inspired by and supportive of Open Dialogue, the existing ideology and organisational structures of the unit conflicted with the integration of Open Dialogue principles. Dialogical ways of working were challenged by medical dominance and emphasis on economic efficiencies. This study emphasises the importance of a 'good' fit between organisational cultures and innovations. It also highlights the challenges of moving towards recovery-oriented and family-focused models of care in the Australian neoliberal health care context. There is a need for organisational and ideological change in health services that is receptive to, and meaningfully supports, efforts to implement recovery-oriented care.
Challenging care work: General practitioners' perspectives on caring for young adults with complex psychosocial problems.
Andersen JH, Tjørnhøj-Thomsen T, Reventlow S … +1 more , Davidsen AS
Health (London) · 2021 Mar · PMID 31495235 · Publisher ↗
The international literature shows that primary care is well placed to address mental health problems in young people, but that primary care professionals experience a range of challenges in this regard. In Denmark, youn...
The international literature shows that primary care is well placed to address mental health problems in young people, but that primary care professionals experience a range of challenges in this regard. In Denmark, young adults who have complex psychosocial problems, and who are not in education or work, cause political and academic concern. They are also in regular contact with their general practitioners, the Danish municipalities and psychiatric services. However, little is known about general practitioners' perspectives on caring for this vulnerable group of patients. In this article, we investigate how general practitioners' care work is shaped by the bureaucratic management of care in a complex infrastructure network comprising the general practitioners, psychiatry, the municipalities and the young adults. The analysis is based on interviews and focus groups with general practitioners, psychiatric nurses and social workers. We employ Tronto's concept of care and the concept of boundary work as a theoretical framework. We argue that general practitioners strive to provide care, but they are challenged by the following: contested diagnostic interpretations and the bureaucratic significance of diagnoses for the provision of care from psychiatry and the municipalities, systemic issues with handling intertwined social and mental health problems, and the young adults' difficulties with accessing and receiving available care.
Love and incomprehensibility: The hermeneutic labour of caring for and understanding a loved one with psychosis.
Luderowski A, Boden ZV
Health (London) · 2020 Nov · PMID 30935237 · Publisher ↗
Informal carers are increasingly involved in supporting people with severe and enduring mental health problems, and carers' perceptions impact the wellbeing of both parties. However, there is little research on how carer...
Informal carers are increasingly involved in supporting people with severe and enduring mental health problems, and carers' perceptions impact the wellbeing of both parties. However, there is little research on how carers actually make sense of what their loved one is experiencing. Ten carers were interviewed about how they understood a loved one's psychosis. Data were analysed using a hermeneutic-phenomenological approach. Three themes described the carers' effortful quest to understand their loved one's experiences while maintaining their relational bonds. Carers described psychosis as incomprehensible, seeing their loved one as incompatible with the shared world. To overcome this, carers developed hermeneutic 'mooring points', making sense of their loved one's unusual experiences through novel accounts that drew on material or spiritual explanations. The findings suggest that informal carers resist biomedical narratives and develop idiosyncratic understandings of psychosis, in an attempt to maintain relational closeness. We suggest that this process is effortful - it is - done in the service of maintaining the caring relationship. Findings imply that services should better acknowledge the bond between carers and care-receivers, and that more relationally oriented approaches should be used to support carers of people experiencing severe mental health problems.
Nurses' knowledge and deliberations crucial to Barcoded Medication Administration technology in a Dutch hospital: Discovering nurses' agency inside ruling.
Boonen M, Rankin J, Vosman F … +1 more , Niemeijer A
Health (London) · 2020 May · PMID 30230356 · Publisher ↗
This article shows how Barcoded Medication Administration technology institutionally organizes and rules the daily actions of nurses. Although it is widely assumed that Barcoded Medication Administration technology impro...
This article shows how Barcoded Medication Administration technology institutionally organizes and rules the daily actions of nurses. Although it is widely assumed that Barcoded Medication Administration technology improves quality and safety by reducing the risk of human error, little research has been done on how this technology alters the work of nurses. Drawing on empirical and conceptual strategies of analysis, this qualitative study used certain tools of institutional ethnography to provide a view of how nurses negotiate Barcoded Medication Administration technology. The approach also uses elements from practice theory in order to discern how technology operates as a player on the field instead of being viewed as a 'mere' tool. A literature review preceded participant observation, whereby 17 nurses were followed and data on an orthopaedic ward were collected over a period of 9 months in 2011 and 2012. Barcoded Medication Administration technology relies on nurses' knowledge to mediate between the embedded logics of its design and the unpredictable needs of patients. Nurses negotiate their own professional logic of care in the form of moment-to-moment deliberations which subvert the ruling frame of the barcoded system and its objectified model of patient safety. The logic of Barcoded Medication Administration technology differs from the logic of nursing care, as this technology presumes medication distribution to be linear, even though nurses follow another line of actor-bound safety practices that we characterize as 'deliberations'.
Informal use of restraint in nursing homes: A threat to human rights or necessary care to preserve residents' dignity?
Øye C, Jacobsen FF
Health (London) · 2020 Mar · PMID 30207186 · Publisher ↗
Use of restraint in nursing homes is highly controversial and fundamentally transgresses human rights and freedom of movement and choice. While different forms of formal restraint use in nursing homes are broadly delinea...
Use of restraint in nursing homes is highly controversial and fundamentally transgresses human rights and freedom of movement and choice. While different forms of formal restraint use in nursing homes are broadly delineated, the use of informal restraint is less understood. The aim of this article is to identify different kinds of informal restraint, and how staff use informal restraint under which circumstances. This article illuminates informal restraint use based on an ethnographic study in four nursing homes in the Western part of Norway. We have identified five different forms of informal restraint use which are as follows: (1) diversion of residents' attention; (2) white lies; (3) persuasion and interpersonal pressure; (4) offers and finally (5) threats. These different forms of informal restraint are actions by staff against residents' will, limiting residents' freedom of movement and their personal preferences. In addition, we have identified 'grey-zone restraint' which comprises actions by staff towards residents which lie in-between formal and informal restraint. The use of informal restraint can be explained by institutional circumstances such as location, architecture and institutional collectivist constraints in relation to care work. Moreover, and paradoxically, informal restraint can be explained as a consequence of neo-liberal policies with establishment of extended premises for freedom of movement and practices of resident preferences in nursing homes. Informal restraint practices call into question whether these practices are compatible with fundamental human rights and the preservation of residents' dignity.
Facilitating resident community in nursing homes: a slippery slope? An analysis on collectivistic and individualistic approaches.
Ågotnes G, Øye C
Health (London) · 2018 Sep · PMID 28537093 · Publisher ↗
Residents in nursing homes are old and frail and are dependent on constant care, medical, or otherwise, by trained professionals. But they are also social beings, secluded in an institutional setting which is both total...
Residents in nursing homes are old and frail and are dependent on constant care, medical, or otherwise, by trained professionals. But they are also social beings, secluded in an institutional setting which is both total and foreign. In this setting, most of the residents most of the time must relate to other residents: other residents are the nursing home residents' peers, companions, and perhaps even significant others. In this article, we will discuss how resident communities in nursing homes are influenced by the approaches of nursing home staff. Two nursing homes have been included in this article-one from Canada and one from Norway. Participant observation was conducted at these two nursing homes, predominantly focusing on everyday-life activities. The cases from Norway and Canada are illustrative of two very different general approaches to residents: one collectivistic and one individualistic. These general approaches produce different contexts for the formation and content of resident communities, greatly affecting nursing home residents. The significance of these approaches to resident community is profound and also somewhat unanticipated; the approaches of staff provide residents with different opportunities and limitations and also yield unintended consequences for the social life of residents. The two different general approaches are, we suggest, "cultural expressions," conditioned by more than official preferences and recommendations. The difference between the institutions is, in other words, anchored in ideas and ideologies that are not explicitly addressed.
Social ecology of resilience and Sumud of Palestinians.
Marie M, Hannigan B, Jones A
Health (London) · 2018 Jan · PMID 28177266 · Full text
The aim of this article is to provide an overview of theoretical perspectives and practical research knowledge in relation to 'resilience', the resilience of Palestinians in particular and the related concept of 'Sumud'....
The aim of this article is to provide an overview of theoretical perspectives and practical research knowledge in relation to 'resilience', the resilience of Palestinians in particular and the related concept of 'Sumud'. 'Sumud' is a Palestinian idea that is interwoven with ideas of personal and collective resilience and steadfastness. It is also a socio-political concept and refers to ways of surviving in the context of occupation, chronic adversity, lack of resources and limited infrastructure. The concept of 'resilience' has deep roots, going back at least to the 10th century when Arabic scholars suggested strategies to cope with life adversity. In Europe, research into resilience extends back to the 1800s. The understanding of resilience has developed over four overlapping waves. These focus on individual traits, protective factors, ecological assets and (in the current wave) social ecological factors. The current wave of resilience research focuses on the contribution of cultural contextualisation and is an approach that is discussed in this article, which draws on Arabic and English language literature located through a search of multiple databases (CINAHL, British Nursing Index, ASSIA, MEDLINE, PsycINFO and EMBASE). Findings suggest that 'Sumud' is linked to the surrounding cultural context and can be thought of as an innovative, social ecological, approach to promoting resilience. We show that resilience is a prerequisite to 'Sumud', meaning that the individual has to be resilient in order to stay and not to leave their place, position or community. We close by pressing the case for studies which investigate resilience especially in underdeveloped countries such as Palestine (occupied Palestinian territories), and which reveal how resilience is embedded in pre-existing cultural contexts.
When choice becomes limited: Women's experiences of delay in labour.
Armstrong N, Kenyon S
Health (London) · 2017 Mar · PMID 26655326 · Full text
Choice and patient involvement in decision-making are strong aspirations of contemporary healthcare. One of the most striking areas in which this is played out is maternity care where recent policy has focused on choice...
Choice and patient involvement in decision-making are strong aspirations of contemporary healthcare. One of the most striking areas in which this is played out is maternity care where recent policy has focused on choice and supporting normal birth. However, birth is sometimes not straightforward and unanticipated complications can rapidly reduce choice. We draw on the accounts of women who experienced delay during labour with their first child. This occurs when progress is slow, and syntocinon is administered to strengthen and regulate contractions. Once delay has been recognized, the clinical circumstances limit choice. Drawing on Mol's work on the logics of choice and care, we explore how, although often upsetting, women accepted that their choices and plans were no longer feasible. The majority were happy to defer to professionals who they regarded as having the necessary technical expertise, while some adopted a more traditional medical model and actively rejected involvement in decision-making altogether. Only a minority wanted to continue active involvement in decision-making, although the extent to which the possibility existed for them to do so was questionable. Women appeared to accept that their ideals of choice and involvement had to be abandoned, and that clinical circumstances legitimately changed events.
Patient Participation in Communication about Treatment Decision-Making for Localized Prostate Cancer during Consultation Visits.
Song L, Toles MP, Bai J … +4 more , Nielsen ME, Bailey DE, Sleath B, Mark B
Health N Hav · 2015 Nov · PMID 34296220 · Full text
OBJECTIVES: To describe the communication behaviors of patients and physicians and patient participation in communication about treatment decision-making during consultation visits for localized prostate cancer (LPCa). M...
OBJECTIVES: To describe the communication behaviors of patients and physicians and patient participation in communication about treatment decision-making during consultation visits for localized prostate cancer (LPCa). METHODS: This is a secondary analysis of data from 52 men enrolled in the usual care control group of a randomized trial that focused on decision-making for newly diagnosed men with LPCa. We analyzed the patient-physician communication using the transcribed audio-recordings of real-time treatment consultations and a researcher-developed coding tool, including codes for communication behaviors (information giving, seeking, and clarifying/ verifying) and contents of clinical consultations (health histories, survival/mortality, treatment options, treatment impact, and treatment preferences). After qualitative content analysis, we categorized patient participation in communication about treatment-related clinical content, including "none" (content not discussed); "low" (patient listening only); "moderate" (patient providing information or asking questions); and "high" (patient providing information and asking questions). RESULTS: Physicians mainly provided information during treatment decision consultations and patients frequently were not active participants in communication. The participation of patients with low and moderate cancer risk typically was: 1) "moderate and high" in discussing health histories; 2) "low" in discussing survival/mortality; 3) "low and moderate" in discussing treatment options; 4) "none and low" in discussing treatment impacts; and 5) "low" in discussing treatment preferences. CONCLUSIONS: Findings suggest opportunities for increasing patient participation in communication about treatment decision-making for LPCa during clinical consultations.
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