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An embodied geography of disablement: chronically ill women's struggles for enabling places in spaces of health care and daily life.

https://arctichealth.org/en/permalink/ahliterature170167
Source
Health Place. 2006 Sep;12(3):345-52
Publication Type
Article
Date
Sep-2006
Author
Valorie A Crooks
Vera Chouinard
Author Affiliation
School of Geography and Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1. crooksva@mcmaster.ca
Source
Health Place. 2006 Sep;12(3):345-52
Date
Sep-2006
Language
English
Publication Type
Article
Keywords
Arthritis
Chronic Disease
Demography
Disabled Persons - psychology
Female
Fibromyalgia
Humans
Interviews as Topic
Ontario
Abstract
Using data gathered from 18 interviews with women who have developed arthritic illnesses we illustrate how becoming a chronically ill woman is a geographically uneven process. By examining changes in the spatial configuration of everyday life, performances of the ill female self in places, and relations with places of life important to these women, such as the health care clinic and workplace, we show how women's capacities to struggle effectively for enabling identities are challenged. Further, we argue that embodying illness involves women and others, including doctors, assigning meanings to their changing material, lived and represented places in the world.
PubMed ID
16546699 View in PubMed
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Motivation, justification, normalization: talk strategies used by Canadian medical tourists regarding their choices to go abroad for hip and knee surgeries.

https://arctichealth.org/en/permalink/ahliterature104935
Source
Soc Sci Med. 2014 Apr;106:93-100
Publication Type
Article
Date
Apr-2014
Author
Keri Cameron
Valorie A Crooks
Vera Chouinard
Jeremy Snyder
Rory Johnston
Victoria Casey
Author Affiliation
School of Geography and Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada. Electronic address: camerkl@mcmaster.ca.
Source
Soc Sci Med. 2014 Apr;106:93-100
Date
Apr-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Arthroplasty, Replacement, Hip
Arthroplasty, Replacement, Knee
Canada
Choice Behavior
Female
Humans
Male
Medical Tourism - psychology
Middle Aged
Motivation
Narration
Qualitative Research
Abstract
Contributing to health geography scholarship on the topic, the objective of this paper is to reveal Canadian medical tourists' perspectives regarding their choices to seek knee replacement or hip replacement or resurfacing (KRHRR) at medical tourism facilities abroad rather than domestically. We address this objective by examining the 'talk strategies' used by these patients in discussing their choices and the ways in which such talk is co-constructed by others. Fourteen interviews were conducted with Canadians aged 42-77 who had gone abroad for KRHRR. Three types of talk strategies emerged through thematic analysis of their narratives: motivation, justification, and normalization talk. Motivation talk referenced participants' desires to maintain or resume physical activity, employment, and participation in daily life. Justification talk emerged when participants described how limitations in the domestic system drove them abroad. Finally, being a medical tourist was talked about as being normal on several bases. Among other findings, the use of these three talk strategies in patients' narratives surrounding medical tourism for KRHRR offers new insight into the language-health-place interconnection. Specifically, they reveal the complex ways in which medical tourists use talk strategies to assert the soundness of their choice to shift the site of their own medical care on a global scale while also anticipating, if not even guarding against, criticism of what ultimately is their own patient mobility. These talk strategies provide valuable insight into why international patients are opting to engage in the spatially explicit practice of medical tourism and who and what are informing their choices.
PubMed ID
24556288 View in PubMed
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Understanding, embracing, rejecting: Women's negotiations of disability constructions and categorizations after becoming chronically ill.

https://arctichealth.org/en/permalink/ahliterature155404
Source
Soc Sci Med. 2008 Dec;67(11):1837-46
Publication Type
Article
Date
Dec-2008
Author
Valorie A Crooks
Vera Chouinard
Robert D Wilton
Author Affiliation
Department of Geography, Simon Fraser University, RCB 7123, Burnaby, British Columbia, Canada. crooks@sfu.ca
Source
Soc Sci Med. 2008 Dec;67(11):1837-46
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Adaptation, Psychological
Adult
Aged
Attitude to Health
Cohort Studies
Disabled Persons - psychology
Female
Fibromyalgia - psychology
Humans
Interviews as Topic
Middle Aged
Ontario
Sick Role
Abstract
The purpose of this article is to elucidate the various responses women have to being, or not being, categorized as disabled within specific spheres (e.g., medical, state) or places (e.g., doctor's office, work) after developing a contested chronic illness. Drawing on interviews conducted with 55 women living with fibromyalgia syndrome in Ontario, Canada, we examine how they come to understand various constructions of disability and whether or not they reflect their sense of self, and how and why they either embrace or reject external categorizations of themselves as disabled by the state or medical professionals. In doing so we contribute to the limited geographic literature which stresses the importance of spatiality and ways of being in place to ill and impaired persons' negotiations of the self and relationships with others. We find that negotiating disability was, for many, an emotionally charged and complex process, drawing on one or more strategies: reluctantly employing some meanings associated with 'being disabled' to achieve material ends, creating an understanding of disability that is most in keeping with one's sense of self, embracing other meanings to the extent that they offer a legitimate basis for identity, and/or rejecting disability in the interests of sustaining an existing identity. For those women in need of forms of state assistance such as income support and health care, state institutions exert powerful pressures to come to terms with what disability means in one's life - particularly as medical and state authorities classify people as 'disabled enough' or 'not disabled enough' for entitlement to state resources.
PubMed ID
18760870 View in PubMed
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Use of medical tourism for hip and knee surgery in osteoarthritis: a qualitative examination of distinctive attitudinal characteristics among Canadian patients.

https://arctichealth.org/en/permalink/ahliterature118780
Source
BMC Health Serv Res. 2012;12:417
Publication Type
Article
Date
2012
Author
Valorie A Crooks
Keri Cameron
Vera Chouinard
Rory Johnston
Jeremy Snyder
Victoria Casey
Author Affiliation
Department of Geography, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada. crooks@sfu.ca
Source
BMC Health Serv Res. 2012;12:417
Date
2012
Language
English
Publication Type
Article
Keywords
Arthroplasty, Replacement, Hip - psychology
Arthroplasty, Replacement, Knee - psychology
Attitude to Health
Canada
Female
Humans
Interviews as Topic
Male
Medical Tourism - psychology
Middle Aged
Osteoarthritis, Hip - surgery
Osteoarthritis, Knee - surgery
Patient satisfaction
Abstract
Medical tourism is the term that describes patients' international travel with the intention of seeking medical treatment. Some medical tourists go abroad for orthopaedic surgeries, including hip and knee resurfacing and replacement. In this article we examine the findings of interviews with Canadian medical tourists who went abroad for such surgeries to determine what is distinctive about their attitudes when compared to existing qualitative research findings about patients' decision-making in and experiences of these same procedures in their home countries.
Fourteen Canadian medical tourists participated in semi-structured phone interviews, all of whom had gone abroad for hip or knee surgery to treat osteoarthritis. Transcripts were coded and thematically analysed, which involved comparing emerging findings to those in the existing qualitative literature on hip and knee surgery.
Three distinctive attitudinal characteristics among participants were identified when interview themes were compared to findings in the existing qualitative research on hip and knee surgery in osteoarthritis. These attitudinal characteristics were that the medical tourists we spoke with were: (1) comfortable health-related decision-makers; (2) unwavering in their views about procedure necessity and urgency; and (3) firm in their desires to maintain active lives.
Compared to other patients reported on in the existing qualitative hip and knee surgery literature, medical tourists are less likely to question their need for surgery and are particularly active in their pursuit of surgical intervention. They are also comfortable with taking control of health-related decisions. Future research is needed to identify motivators behind patients' pursuit of care abroad, determine if the attitudinal characteristics identified here hold true for other patient groups, and ascertain the impact of these attitudinal characteristics on surgical outcomes. Arthritis care providers can use the attitudinal characteristics identified here to better advise osteoarthritis patients who are considering seeking care abroad.
Notes
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PubMed ID
23170924 View in PubMed
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Women with disabilities' experiences of government employment assistance in Canada.

https://arctichealth.org/en/permalink/ahliterature150014
Source
Disabil Rehabil. 2010;32(2):148-58
Publication Type
Article
Date
2010
Author
Vera Chouinard
Author Affiliation
School of Geography and Earth Sciences, McMaster University, Hamilton, Ontario, Canada. chouinar@mcmaster.ca
Source
Disabil Rehabil. 2010;32(2):148-58
Date
2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Canada
Disabled Persons - rehabilitation
Employment, Supported - statistics & numerical data
Female
Government
Humans
Middle Aged
Public Policy
Questionnaires
Rehabilitation, Vocational
Abstract
The purpose of this article is to explore women with disabilities' experiences of government employment assistance in Canada.
The article draws on the results of an online survey conducted in 2006. Data were coded and analysed according to key themes.
The results indicate that many of the women with disabilities who responded to the survey regarded the employment assistance they have received as of very limited importance to their abilities to find and keep paid work. Their comments suggest that existing forms of government employment assistance, such as the provision of wage subsidies to employers, may be of limited effectiveness in enabling at least some women with disabilities to find and keep paid work. The women's comments point to the limitations of existing employment assistance strategies including the need to shift program emphases away from individualistic models aimed at 'reforming the worker' and toward systemic barriers to employment.
The article concludes by discussing the implications of survey results for future research and strategies for improving the types of employment assistance available to women with disabilities.
PubMed ID
19562587 View in PubMed
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