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Negotiating the (bio)medical gaze - Experiences of trans-specific healthcare in Sweden.

https://arctichealth.org/en/permalink/ahliterature289963
Source
Soc Sci Med. 2017 02; 174:9-16
Publication Type
Journal Article
Date
02-2017
Author
Ida Linander
Erika Alm
Anne Hammarström
Lisa Harryson
Author Affiliation
Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Sweden; Umeå Centre for Gender Studies, Umeå University, Sweden. Electronic address: ida.linander@umu.se.
Source
Soc Sci Med. 2017 02; 174:9-16
Date
02-2017
Language
English
Publication Type
Journal Article
Keywords
Attitude of Health Personnel
Delivery of Health Care - manpower - standards
Grounded Theory
Humans
Negotiating - methods
Qualitative Research
Sweden
Transgender Persons - psychology
Abstract
In Sweden as well as in other western countries persons with trans experiences have to go through a clinical evaluation in order to get access to gender-confirming medical procedures. The aim of this study is to analyse care-users' experiences of navigating and negotiating access to gender-confirming medical procedures in Sweden. Biomedicalisation is used as a theoretical framework in order to analyse how technoscientific and neoliberal developments are parts of constructing specific experiences within trans-specific care. Constructivist grounded theory was used to analyse 14 interviews with persons having experiences of, or considering seeking, trans-specific healthcare. The participants experienced trans-specific healthcare as difficult to navigate because of waiting times, lack of support, provider ignorance and relationships of dependency between healthcare-users and providers. These barriers pushed the users to take responsibility for the care process themselves, through ordering hormones from abroad, acquiring medical knowledge and finding alternative support. Based on the participants' experiences, it can be argued that the shift of responsibility from care-providers to users is connected to a lack of resources within trans-specific care, to neoliberal developments within the Swedish healthcare system, but also to discourses that frame taking charge of the care process as an indicator that a person is in need of or ready for care. Thus, access to gender-confirming medical procedures is stratified, based on the ability and opportunity to adopt a charge-taking role and on economic and geographic conditions. Based on the results and discussion, we conclude that trans-specific care ought to focus on supporting the care-seekers throughout the medical process, instead of the current focus on verifying the need for care. There is also a need for increased knowledge and financial resources. A separation between legal and medical gender reassignment could contribute to a better relationship between care-providers and care-users and increase the quality of care.
PubMed ID
27960120 View in PubMed
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American Indian and Alaska Native Cancer Patients' Perceptions of a Culturally Specific Patient Navigator Program.

https://arctichealth.org/en/permalink/ahliterature289968
Source
J Prim Prev. 2017 Apr; 38(1-2):121-135
Publication Type
Journal Article
Date
Apr-2017
Author
Carol Grimes
Jenine Dankovchik
Megan Cahn
Victoria Warren-Mears
Author Affiliation
Northwest Portland Area Indian Health Board, 918 NE Rosa Parks Way, Portland, OR, 97211, USA.
Source
J Prim Prev. 2017 Apr; 38(1-2):121-135
Date
Apr-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Alaska Natives - psychology
Attitude to Health - ethnology
Cultural Competency
Female
Humans
Idaho
Indians, North American - psychology
Interviews as Topic
Male
Middle Aged
Models, organizational
Neoplasms - ethnology - psychology
Oregon
Patient Navigation - methods - organization & administration - standards
Patient Satisfaction - ethnology
Qualitative Research
Young Adult
Abstract
Lack of access to care, funding limitations, cultural, and social barriers are challenges specific to tribal communities that have led to adverse cancer outcomes among American Indians/Alaska Natives (AI/AN). While the cancer navigator model has been shown to be effective in other underserved communities, it has not been widely implemented in Indian Country. We conducted in-depth interviews with 40 AI/AN patients at tribal clinics in Idaho and Oregon. We developed the survey instrument in partnership with community members to ensure a culturally appropriate semi-structured questionnaire. Questions explored barriers to accessing care, perceptions of the navigator program, satisfaction, and recommendations. AI/AN cancer patients reported physical, emotional, financial, and transportation barriers to care, but most did not feel there were any cultural barriers to receiving care. Navigator services most commonly used included decision making, referrals, transportation, scheduling appointments, and communication. Satisfaction with the program was high. Our study provides a template to develop a culturally appropriate survey instrument for use with an AI/AN population, which could be adapted for use with other indigenous patient populations. Although our sample was small, our qualitative analysis facilitated a deeper understanding of the barriers faced by this population and how a navigator program may best address them. The results reveal the strengths and weakness of this program, and provide baseline patient satisfaction numbers which will allow future patient navigator programs to better create evaluation benchmarks.
Notes
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PubMed ID
27838858 View in PubMed
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Breast-cancer-isation explored: Social experiences of gynaecological cancer in a Norwegian context.

https://arctichealth.org/en/permalink/ahliterature289973
Source
Sociol Health Illn. 2016 11; 38(8):1258-1271
Publication Type
Journal Article
Date
11-2016
Author
Kari Nyheim Solbraekke
Geir Lorem
Author Affiliation
Department of Health Science, University of Oslo, Norway. k.n.solbrakke@medisin.uio.no.
Source
Sociol Health Illn. 2016 11; 38(8):1258-1271
Date
11-2016
Language
English
Publication Type
Journal Article
Keywords
Adaptation, Psychological
Adult
Breast Neoplasms - psychology
Female
Genital Neoplasms, Female - diagnosis - therapy
Humans
Norway
Qualitative Research
Social capital
Social Stigma
Survivors - psychology
Abstract
This article's point of departure is recent claims that breast cancer survivorship displaying positivity and self-growth represents the gold standard for all forms of cancer survivorship in English-speaking Western cultures. An interview study of Norwegian women regarding gynaecological cancer followed by hysterectomy is used to explore whether this process is taking place beyond this setting. Results show that the women's experiences of having to display survivorship in this manner are not as notable as found in English-speaking Western countries, neither is their experience of social othering. Reasons for this may be strong norms of social egalitarianism marking Norwegian culture and breast cancer informational campaigns that have not yet totally defined Norwegian norms for how to survive cancer. At the clinic and in the public sphere, however, the women experience gynaecological cancer as clearly having lower status than breast cancer, leading to a strong sense that the bodily site of their disease is taboo. Hence, as found in English-speaking cultures, the complex embodied nature of having gynaecological cancer and life beyond treatment seems to be silenced by the media and medical institutions. Finally, implications for future research and health care related to cancer survivorship are also discussed.
PubMed ID
27461035 View in PubMed
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Negotiating the care-giving role: family members' experience during critical exacerbation of COPD in Norway.

https://arctichealth.org/en/permalink/ahliterature289999
Source
Health Soc Care Community. 2017 Mar; 25(2):612-620
Publication Type
Journal Article
Date
Mar-2017
Author
Gunvor Aasbø
Jorun Rugkåsa
Kari N Solbraekke
Anne Werner
Author Affiliation
Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.
Source
Health Soc Care Community. 2017 Mar; 25(2):612-620
Date
Mar-2017
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Caregivers
Female
Geriatric Nursing - standards
Home Care Services
Humans
Interviews as Topic
Male
Norway
Patient satisfaction
Pulmonary Disease, Chronic Obstructive - physiopathology
Qualitative Research
Quality of Health Care
Abstract
Healthcare policies often state that complex conditions are to be treated outside hospital in various forms of public-private partnership. Chronic obstructive pulmonary disease (COPD) is a progressive illness that includes episodes of serious acute exacerbations characterised by extreme breathlessness. There is limited knowledge about COPD exacerbations from the perspective of family caregivers and implications of the changing boundary between hospital care and care at home. In this paper, we explore how caregivers negotiate their role as caregivers with patients and healthcare professionals during acute exacerbations. We conducted 10 qualitative interviews with family caregivers of COPD patients in 2011, all were spouses over the age of 60. The participants were recruited through the patient pool of ambulatory pulmonary services of two hospitals in Oslo, Norway. Data were interpreted using thematic analysis. The caregivers described a lack of understanding and support from health professionals in some situations. They shouldered considerable responsibility, but were not always acknowledged as competent carers by professionals. Caregivers had to balance their involvement. They noted that they could lose the professionals' co-operation if their involvement was perceived as interfering or preventing the professionals from exercising their expertise. However, by not sharing their personalised knowledge about the patients, they risked that the professionals would not understand the severity of the exacerbation, which could undermine their own ability to maintain a sense of safety and control. The negotiations caregivers participated in and the uncertainty they experienced shed new light on the complexity of their role, and the discrepancy between practice and ideals in healthcare policy regarding collaboration of care. It is crucial to develop further knowledge about structural, interactional and communicational facilitators and barriers for reaching shared understandings and facilitating mutual trust in these demanding situations.
PubMed ID
27103468 View in PubMed
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Building COPD care on shaky ground: a mixed methods study from Swedish primary care professional perspective.

https://arctichealth.org/en/permalink/ahliterature290073
Source
BMC Health Serv Res. 2017 07 10; 17(1):467
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
07-10-2017
Author
Sara Lundell
Malin Tistad
Börje Rehn
Maria Wiklund
Åsa Holmner
Karin Wadell
Author Affiliation
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, 901 87, Umeå, Sweden. sara.lundell@umu.se.
Source
BMC Health Serv Res. 2017 07 10; 17(1):467
Date
07-10-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Communication
Cost-Benefit Analysis
Delivery of Health Care - organization & administration
Female
Health Knowledge, Attitudes, Practice
Health Personnel - psychology
Humans
Interviews as Topic
Male
Middle Aged
Primary Health Care
Pulmonary Disease, Chronic Obstructive - therapy
Qualitative Research
Quality of Health Care
Surveys and Questionnaires
Sweden
Abstract
Chronic obstructive pulmonary disease (COPD) is a public health problem. Interprofessional collaboration and health promotion interventions such as exercise training, education, and behaviour change are cost effective, have a good effect on health status, and are recommended in COPD treatment guidelines. There is a gap between the guidelines and the healthcare available to people with COPD. The aim of this study was to increase the understanding of what shapes the provision of primary care services to people with COPD and what healthcare is offered to them from the perspective of healthcare professionals and managers.
The study was conducted in primary care in a Swedish county council during January to June 2015. A qualitatively driven mixed methods design was applied. Qualitative and quantitative findings were merged into a joint analysis. Interviews for the qualitative component were performed with healthcare professionals (n = 14) from two primary care centres and analysed with qualitative content analysis. Two questionnaires were used for the quantitative component; one was answered by senior managers or COPD nurses at primary care centres (n = 26) in the county council and the other was answered by healthcare professionals (n = 18) at two primary care centres. The questionnaire data were analysed with descriptive statistics.
The analysis gave rise to the overarching theme building COPD care on shaky ground. This represents professionals driven to build a supportive COPD care on 'shaky' organisational ground in a fragmented and non-compliant healthcare organisation. The shaky ground is further represented by uninformed patients with a complex disease, which is surrounded with shame. The professionals are autonomous and pragmatic, used to taking responsibility for their work, and with limited involvement of the management. They wish to provide high quality COPD care with interprofessional collaboration, but they lack competence and are hindered by inadequate routines and lack of resources.
There is a gap between COPD treatment guidelines and the healthcare that is provided in primary care. To facilitate implementation of the guidelines several actions are needed, such as further training for professionals, additional resources, and improved organisational structure for interprofessional collaboration and patient education.
Notes
Cites: Eur Respir J. 2015 Apr;45(4):879-905 PMID 25829431
Cites: COPD. 2013 Aug;10(4):425-35 PMID 23537344
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PubMed ID
28693473 View in PubMed
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Telephone advice nursing: parents' experiences of monitoring calls in children with gastroenteritis.

https://arctichealth.org/en/permalink/ahliterature290163
Source
Scand J Caring Sci. 2015 Jun; 29(2):333-9
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
Jun-2015
Author
Elisabeth Kvilén Eriksson
Susanna Sandelius
Anna Carin Wahlberg
Author Affiliation
Health Care Call Center, Västra Götaland, Uddevalla, Sweden.
Source
Scand J Caring Sci. 2015 Jun; 29(2):333-9
Date
Jun-2015
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Counseling
Female
Gastroenteritis - therapy
Humans
Interviews as Topic
Male
Parents
Pediatric Nursing - standards
Qualitative Research
Self Care
Sweden
Telenursing - standards
Young Adult
Abstract
A common reason for calling a telephone advice nurse is gastroenteritis symptoms in children. A monitoring call is a follow-up call from the telephone nurse to the care seeker in order to follow up on given advice and make a new assessment. The aim of the study was to describe the parents' experiences of monitoring calls in telephone advice nursing in children with gastroenteritis. A qualitative interview method was chosen and data were analysed inductively with a qualitative latent content analysis. Ten parents, nine mothers and one father were interviewed. Four main categories and 13 subcategories were identified and described as useful, and the main categories were convenience - parents found it convenient to get access to self-care advice at home, confirmation - the interaction between the telephone nurse and the parent seemed to become deeper and closer as a result of the monitoring call, support - in a vulnerable situation receiving further information and an opportunity to let the telephone nurse monitor the sick child and guidance - to be guided through the most acute phase in the child's gastroenteritis symptoms. Monitoring calls seemed to be experienced as a security enhancing, positive opportunity and a robust complement to seeking care at a healthcare facility. The results of the study indicate how inhabitants can receive expert advice, support and guidance for care and provide a useful basis for Swedish Healthcare Direct (SHD) to develop the modalities for monitoring calls.
PubMed ID
25236581 View in PubMed
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"Men don't think that far" - Interviewing men in Sweden about chlamydia and HIV testing during pregnancy from a discursive masculinities construction perspective.

https://arctichealth.org/en/permalink/ahliterature290241
Source
Sex Reprod Healthc. 2017 Jun; 12:107-115
Publication Type
Journal Article
Date
Jun-2017
Author
Monica Christianson
Jens Boman
Birgitta Essén
Author Affiliation
Department of Nursing, Umeå University, SE-901 85 Umeå, Sweden. Electronic address: monica.christianson@umu.se.
Source
Sex Reprod Healthc. 2017 Jun; 12:107-115
Date
Jun-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Chlamydia Infections - diagnosis - psychology - transmission
Emotions
Fathers - psychology
Female
HIV Infections - diagnosis - psychology - transmission
Health Knowledge, Attitudes, Practice
Humans
Male
Masculinity
Pregnancy
Pregnancy Complications, Infectious - diagnosis
Qualitative Research
Sexual Health
Shame
Sweden
Young Adult
Abstract
We used qualitative research design to discursively explore expectant fathers' perceptions of chlamydia and HIV, and their masculinity constructions about testing, and explored how they talked about their potential resistance towards testing and their pre-test emotions.
Twenty men were offered chlamydia and HIV testing at the beginning of their partner's pregnancy. Those who agreed to be tested were interviewed in-depth; those who declined testing were also interviewed. The interviews were tape recorded and transcribed verbatim. The analysis was inspired by discourse analysis on masculinity.
Three discursive themes: Men prefer to suppress their vulnerability to STIs, Body and biology differ between men and women and Men have mixed emotions around STI testing underscore the informants' conversations and sometimes conflicting thoughts about STI testing.
The majority of men talked about pregnancy as a feminine territory, raised uncertainties about men's roles in the transmission of STIs, and talked about women's and men's essentially different bodies and biology, where few men realised that they could infect both their partner and the unborn child. This knowledge gap that men have must become apparent to healthcare providers, and policy makers must give men equal access to the reproductive arena.
PubMed ID
28477922 View in PubMed
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Meal box schemes a convenient way to avoid convenience food? Uses and understandings of meal box schemes among Danish consumers.

https://arctichealth.org/en/permalink/ahliterature290430
Source
Appetite. 2017 Jul 01; 114:232-239
Publication Type
Journal Article
Date
Jul-01-2017
Author
Frej Daniel Hertz
Bente Halkier
Author Affiliation
Department of Communication and Arts (DCA), Roskilde University, Office Location: 40.03.06, Aboretvej 1, 4000 Roskilde, Denmark. Electronic address: fdhertz@ruc.dk.
Source
Appetite. 2017 Jul 01; 114:232-239
Date
Jul-01-2017
Language
English
Publication Type
Journal Article
Keywords
Activities of Daily Living
Adult
Consumer Behavior - economics
Cooking - economics
Denmark
Family
Fast Foods - adverse effects - economics
Feeding Behavior
Feeding Methods - economics
Female
Focus Groups
Food Preferences
Health Knowledge, Attitudes, Practice
Healthy Diet - economics
Humans
Male
Meals
Patient compliance
Qualitative Research
Terminology as Topic
Abstract
The term convenience food is subject to diversification, lack of clarity and moral ambiguity. In this paper we address these issues and critically discuss convenience food by using empirical findings from a Danish study that deals with practitioners' uses of meal box schemes. The methodological design consists of thirteen individual interviews, four focus groups and some observations of cooking practices. We combine the empirical findings with a particular definition of convenience food by Brunner et al. (2010) and selected practice theoretical concepts. This particular combination enables us to categorize meal box schemes as a new form of convenience food called convenient food. In addition, results suggest that meal box schemes reduce leftovers from dinner. Meal boxes also influence dinner related activities such as planning ahead in time and grocery shopping, which require less physical and mental effort.
PubMed ID
28315421 View in PubMed
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Leisure-time youth centres as health-promoting settings: Experiences from multicultural neighbourhoods in Sweden.

https://arctichealth.org/en/permalink/ahliterature290650
Source
Scand J Public Health. 2018 Feb; 46(20_suppl):72-79
Publication Type
Journal Article
Date
Feb-2018
Author
Ingela Fredriksson
Susanna Geidne
Charli Eriksson
Author Affiliation
Faculty of Medicine and Health, School of Health Sciences, Örebro University, Sweden.
Source
Scand J Public Health. 2018 Feb; 46(20_suppl):72-79
Date
Feb-2018
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Child
Cultural Diversity
Female
Health Promotion - organization & administration
Humans
Leisure Activities
Male
Program Evaluation
Qualitative Research
Residence Characteristics - statistics & numerical data
Surveys and Questionnaires
Sweden
Abstract
The aim of this paper is to advocate for the importance of meaningful leisure time for young people from a health-promotion perspective using experiences from two youth centres in multicultural neighbourhoods in Sweden.
In this practice-based study, data were collected between 2012 and 2014 at two youth centres in multicultural, socially deprived suburbs in Sweden using surveys with 12- to 16-year-old adolescents ( n?=?207), seven individual interviews with staff and three cooperation partners in the neighbourhoods, and six group interviews with adolescents (50% girls). Quantitative, qualitative and mixed methods were used for analysis.
As part of the youth centres' strategies, they are open and inclusive, foster supportive relationships, emphasise youth empowerment, and integrate family, school and community in their work. The youth centres are health-promoting settings with regard to four of the action areas in the Ottawa Charter: build healthy public policy, create supportive environments, strengthen community actions and develop personal skills.
There is a need for a variety and a combination of various structured and unstructured leisure-time activities because young people's background and life situation plays a role for their participation in leisure-time activities. We conclude that youth centres are well placed to be or to become health-promoting settings if the activities takes place in a structured environment.
PubMed ID
29552968 View in PubMed
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Challenges and demands in the population-based work of public health nurses.

https://arctichealth.org/en/permalink/ahliterature290656
Source
Scand J Public Health. 2018 Feb; 46(20_suppl):53-58
Publication Type
Journal Article
Date
Feb-2018
Author
Berit Misund Dahl
Author Affiliation
NTNU-Norwegian University of Science and Technology, Norway.
Source
Scand J Public Health. 2018 Feb; 46(20_suppl):53-58
Date
Feb-2018
Language
English
Publication Type
Journal Article
Keywords
Attitude of Health Personnel
Curriculum
Female
Health Promotion - organization & administration
Humans
Norway
Nurse's Role
Nurses, Public Health - psychology - statistics & numerical data
Public Health Nursing - education
Qualitative Research
Abstract
Government programs and the Norwegian Directorate of Health give public health nurses in Norway an explicit role in population-based health promotion and disease-prevention work. The aim of this paper is to explore Norwegian public health nurses' experiences with population-based work.
A phenomenological hermeneutic approach was adopted, involving face-to-face interviews with a purposeful sample of 23 public health nurses from urban and rural districts in two counties in Norway.
Three themes were identified: the predominance of work at the individual level, a lack of resources, and adherence to administrative directives. The interviews revealed that the public health nurses were mostly occupied with individual problem-solving activities. Population-based work was hardly prioritized, mostly because of a lack of resources and a lack of recognition of the population-based role of public health nurses.
The study indicates contradictions between the public health nursing practice related to population-based work and the direction outlined by the government and the public health nursing curriculum, which may mean that the public health nursing role is not sufficiently clarified. The implementation of practice models and administrative directives and resources, as well as an explicit emphasis on population health in public health nursing education, can contribute to increased population-based interventions. Greater knowledge of and emphasis on population-based work in public health nursing are needed.
PubMed ID
29552958 View in PubMed
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3182 records – page 1 of 319.