Body symbolics, obstetric practices, and the improvement of maternal health in Cambodia

2020 ◽  
pp. 450-471
Author(s):  
Clémence Schantz
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Professionals ◽  
Participant Observation ◽  
The Body ◽  
Clinical Settings ◽  
Mixed Method Research ◽  
Structured Interviews ◽  
Phnom Penh ◽  
Frequent Use

Cambodia is one of the nine countries worldwide to have reduced its maternal mortality rate by more than 75 per cent between 1990 and 2015. Whilst prior to the 2000s, childbirth in Cambodia used to be a private event, it has now become a biomedical event for women and their families. This chapter describes the findings of mixed-method research challenging the idealized vision of the United Nations regarding maternal health in Cambodia by describing obstetrical practices on the ground, from an empirical study led in several clinical settings in Phnom Penh, through participant observation, semi-structured interviews with health-care professionals and patients, questionnaires with pregnant women, to the examination of medical records from four Phnom Penh maternity wards. The findings demonstrate that the biomedicalization of childbirth in Cambodia has been accompanied by technologized delivery with extremely frequent use of surgical practices. In order to understand the population’s adherence to these practices, the chapter draws out a number of anthropological and demographic arguments. These biomedical practices are part of a symbolism of the body where the body is conceived as a receptacle, where the body humours must be able to circulate appropriately, and where the hot/cold balance must be respected. Childbirth as an opening of the body represents a danger for women because it threatens this equilibrium.

scholarly journals Where else would I look for it? A five-country qualitative study on purposes, strategies, and consequences of online health information seeking

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Nicola Diviani ◽  
Eva Haukeland Fredriksen ◽  
Corine S. Meppelink ◽  
Judy Mullan ◽  
Warren Rich ◽  
...  
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Information ◽  
Health Care Professionals ◽  
Information Seeking ◽  
The Body ◽  
Online Health Information ◽  
Structured Interviews ◽  
Ehealth Literacy ◽  
Digital Divides

Background. Online health information (OHI) is widely available and consulted by many people in Western countries to gain health advice. The main goal of the present study is to provide a detailed account of the experiences among people from various demographic backgrounds living in high-income countries, who have used OHI. Design and methods. Thematic analysis of 165 qualitative semi-structured interviews conducted among OHI users residing in Australia, Israel, the Netherlands, Norway, and Switzerland was performed. Results. The lived experience of people using OHI seem not to differ across countries. The interviews show that searches for OHI are motivated from curiosity, sharing of experiences, or affirmation for actions already taken. Most people find it difficult to appraise the information, leading them to cross-check sources or discuss OHI with others. OHI seems to impact mostly some specific types of health behaviors, such as changes in diet or physical activity, while it only plays a complementary role for more serious health concerns. Participants often check OHI before seeing their GP, but are reluctant to discuss online content with health care personnel due to expected negative reception. Conclusions. This study adds to the body of knowledge on eHealth literacy by demonstrating how OHI affects overall health behavior, strengthens patients’ ability to understand, live with, and prepare themselves for diverse health challenges. The increasing digitalization of health communication and health care calls for further research on digital divides and patient-professional relations. Health care professionals should acknowledge OHI seeking and engage in discussions with patients to enable them to appreciate OHI, and to support shared decision making in health care. The professionals can utilize patient’s desire to learn as a resource for health prevention, promotion or treatment, and empowerment.

scholarly journals Meanings attributed to healthy eating by consumers of a street market

2017 ◽  
Vol 30 (2) ◽  
pp. 261-270 ◽  
Author(s):  
Jasilaine Andrade PASSOS ◽  
Maria do Carmo Soares de FREITAS ◽  
Ligia Amparo da Silva SANTOS ◽  
Micheli Dantas SOARES
Keyword(s):  
Health Care ◽  
Healthy Eating ◽  
Health Care Professionals ◽  
Fruits And Vegetables ◽  
Eating Habits ◽  
Participant Observation ◽  
The Body ◽  
New Meanings ◽  
Media Reports ◽  
Safe Food

ABSTRACT Objective: To investigate the meanings attributed to healthy eating by consumers of a street market in the region called Recôncavo da Bahia, Bahia, Brazil. Methods: Phenomenology-based ethnography to understand the meanings attributed by those consumers. Information was collected through participant observation documented in a field diary and in-depth interviews. Interviews were conducted with seven people who were visitors and/or worked at the street market. In the analytical process, the following significant concepts related to healthy eating were systematized: "fruits and vegetables represent healthy eating"; "safe food: it has to be clean", and "foods that do the body good". Results: The meanings attributed to healthy eating are revisited daily and are related to individuals' life experiences; new meanings derive from intersubjective constructions. Based on the interviews, it was observed that re-signification was a constant process, marked by events that influence the respondents to change their eating habits such as diseases, aging, information received by health care professionals, and media reports. Healthy eating was also represented by the hygienic-sanitary quality of foods and the lack of strict control over everyday food choices. Conclusion: We highlight the importance of this discussion in the scientific field and governmental bodies, as well as among health care professionals aiming at a better understanding of the different concepts of healthy eating.

scholarly journals Maternal health care for refugee women in Germany: A qualitative approach on the interaction level

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Kasper
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Maternal Health Care ◽  
Structured Interviews ◽  
Childbearing Age ◽  
Individual Level ◽  
Refugee Women ◽  
Challenges And Opportunities

Abstract Background In the recent past, the number of forcibly displaced people increased worldwide. About 1/3 of the persons seeking asylum in Germany are female. The majority of all refugee women who are coming to Germany are currently of childbearing age. Refugee women are considered a highly vulnerable refugee subgroup, as they frequently experience physical strains and psychological burdens while fleeing their home countries and being pregnant at the same time. Moreover, pregnancy and the following period require specialized care and support in order to allow a transition to maternity without complications. The aim of this project is to analyze maternal health care services for refugee women on the level of interaction with maternal health care professionals in Germany. Methods Maternal health care professionals in outpatient and clinical settings with experiences of caring for refugee women were recruited. Semi-structured interviews were conducted. The interviews are currently analyzed following the standards of qualitative thematic analysis. Results Maternal health care professionals experience challenges in executing particular maternal health care actions, such as taking the medical history where there is no communication possible or performing examinations where there is no or little privacy (e.g. in camps). In addition there are changes in tasks, which are no subject to originally maternal health care, such as organizing translation and transportation. Furthermore they face a shortage of resources (e.g. translators, time), which constrains them to find solutions on an individual level. Conclusions Maternal health care professionals provide maternal health care to refugee women under special circumstances (e.g. communication barriers, discontinuity of care). As there are limited resources (e.g. translators, time) they develop solutions and strategies on an individual level. Key messages Challenges and opportunities are disclosed by examining maternal health care professionals’ actions. Maternal health care improves through understanding maternal health care professionals’ strategies.

Maternal health care provision for refugee women

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Kasper
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Professionals ◽  
Maternal Health Care ◽  
Professional Practices ◽  
Health Care Provision ◽  
Care Provision ◽  
Structured Interviews ◽  
Childbearing Age ◽  
Refugee Women

Abstract Background In the recent past, the number of forcibly displaced people increased worldwide. About 1/3 of the persons seeking asylum in Germany are female. The majority of all refugee women who are coming to Germany are currently of childbearing age. Refugee women are considered a highly vulnerable refugee subgroup, as they frequently experience physical strains and psychological burdens while fleeing their home countries and being pregnant at the same time. Moreover, pregnancy and the following period require specialized care and support in order to allow a transition to maternity without complications. The aim of this project is to analyze maternal health care services for refugee women on the level of interaction with maternal health care professionals in Germany. Methods Maternal health care professionals in outpatient and clinical settings with experiences of caring for refugee women were recruited. Semi-structured interviews were conducted. The interviews were analyzed following the standards of qualitative thematic analysis. Results Maternal health care professionals face challenges in implementing and providing maternal health care concerning their professional practices and interventions. Due to a lack of resources (e.g. translators, time) and other conditions, gynaecologists and midwives are forced to find new solutions that maintain (medical care), adapt (vaginal examination) or miss out on (informed consent) ordinary professional practices. Key messages Maternal health care professionals face different barriers when providing maternal health care to migrant/refugee such as communication barriers and problems in relationship building. The identification of challenges and opportunities for professionals in maternal health care provision may contribute to improve maternal health (care) for refugee women.

scholarly journals Admission Decision-Making in Hospital Emergency Departments: The Role of the Accompanying Person

2020 ◽  
Vol 7 ◽  
pp. 233339362093002
Author(s):  
Susanna Rance ◽  
Debra Westlake ◽  
Heather Brant ◽  
Ingrid Holme ◽  
Ruth Endacott ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Emergency Departments ◽  
Participant Observation ◽  
Structured Interviews ◽  
Discharge Care ◽  
Conversational Skills ◽  
Hospital Emergency Departments

In resource-stretched emergency departments, people accompanying patients play key roles in patients’ care. This article presents analysis of the ways health professionals and accompanying persons talked about admission decisions and caring roles. The authors used an ethnographic case study design involving participant observation and semi-structured interviews with 13 patients, 17 accompanying persons and 26 health care professionals in four National Health Service hospitals in south-west England. Focused analysis of interactional data revealed that professionals’ standardization of the patient–carer relationship contrasted with accompanying persons’ varied connections with patients. Accompanying persons could directly or obliquely express willingness, ambivalence and resistance to supporting patients’ care. The drive to avoid admissions can lead health professionals to deploy conversational skills to enlist accompanying persons for discharge care without exploring the meanings of their particular relationship with the patients. Taking a relationship-centered approach could improve the attention to accompanying persons as co-producers of health care and participants in decision-making.

scholarly journals Women, Exercise, and Eating Disorder Recovery: The Normal and the Pathological

2021 ◽  
pp. 104973232199204
Author(s):  
Hester Hockin-Boyers ◽  
Megan Warin
Keyword(s):  
Health Care ◽  
Eating Disorder ◽  
Affect Regulation ◽  
Health Care Professionals ◽  
Value Systems ◽  
Structured Interviews ◽  
Data Set ◽  
The United Kingdom ◽  
Theoretical Frame ◽  
Intensity Of Exercise

The appropriate form, regularity, and intensity of exercise for individuals recovering from eating disorders is not agreed upon among health care professionals or researchers. When exercise is permitted, it is that which is mindful, embodied, and non-competitive that is considered normative. Using Canguilhem’s concepts of “the normal and the pathological” as a theoretical frame, we examine the gendered assumptions that shape medical understandings of “healthy” and “dysfunctional” exercise in the context of recovery. The data set for this article comes from longitudinal semi-structured interviews with 19 women in the United Kingdom who engaged in weightlifting during their eating disorder recovery. We argue that women in recovery navigate multiple and conflicting value systems regarding exercise. Faced with aspects of exercise that are pathologized within the eating disorder literature (such as structure/routine, body transformations, and affect regulation), women re-inscribe positive value to these experiences, thus establishing exercise practices that serve them.

scholarly journals Leadership assumptions on implementation of patient involvement methods

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrine Håland Jeppesen ◽  
Kirsten Frederiksen ◽  
Marianne Johansson Joergensen ◽  
Kirsten Beedholm
Keyword(s):  
Health Care ◽  
Organizational Learning ◽  
Health Care Professionals ◽  
Large Scale ◽  
Patient Involvement ◽  
Hospital Setting ◽  
Implementation Process ◽  
University Hospital ◽  
Structured Interviews ◽  
Implementation Processes

Abstract Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process.

scholarly journals Spontaneous harm reduction: a barrier for substance-dependent individuals seeking treatment?

2005 ◽  
Vol 27 (4) ◽  
pp. 272-277 ◽  
Author(s):  
Bruno José Barcellos Fontanella ◽  
Egberto Ribeiro Turato
Keyword(s):  
Harm Reduction ◽  
Health Care Professionals ◽  
Alcoholic Beverage ◽  
Clinical Settings ◽  
Structured Interviews ◽  
Source Type ◽  
Quantitative Studies ◽  
Open Questions ◽  
Substance Dependent ◽  
Family Variables

OBJETIVE: Greater information regarding motivations and treatment barriers faced by substance-dependent individuals has clinical and public health implications. This study aimed to formulate hypotheses regarding psychological, social and family variables that can be constructed as motivations or subjective barriers for the early seeking of formal treatment. METHODS: A qualitative study was conducted in an intentional sample (selected through saturation and variety of types) of 13 substance-dependent individuals who sought treatment. In-depth, semi-structured interviews were conducted using open questions, and the transcribed data were subjected to qualitative analysis. RESULTS: Four types of spontaneous harm reduction measures were identified, according to the subjective logic of each participant: having some periods at rest (not using and recovering from adverse effects); caretaking by close acquaintances (relatives, partners, drug dealers and alcoholic beverage sellers); selectivity regarding substance source, type and means of administration; establishing "healthy" limits of ingestion. CONCLUSIONS: The measures identified might represent barriers to the early seeking of treatment but might also represent spontaneous learning of abilities beneficial to future treatment. Health care professionals should take into consideration their existence and should address them in clinical settings. Issues representative of the formulated categories should be presented in structured questionnaires used in future quantitative studies of barriers to treatment in this population.

scholarly journals Surveillance, anticipation and firefighting: Perspectives of patient safety from a New Zealand case study

2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
New Zealand ◽  
Health Care Professionals ◽  
Nuclear Power ◽  
High Reliability ◽  
Health Care Systems ◽  
Tertiary Hospital ◽  
Structured Interviews

© 2018 John Wiley & Sons Ltd Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety. Background: Despite health care systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by health care professionals with concerns raised about clinician engagement. Design: Instrumental, embedded case study design using qualitative methods. Methods: The study used purposeful sampling, and data was collected using focus groups and semi-structured interviews with doctors (n = 31); registered nurses (n = 19); and senior organisational managers (n = 3) in a New Zealand tertiary hospital. Results: Safety was described as a core organisational value. Clinicians appreciated proactive safety approaches characterized by anticipation and vigilance, where they expertly recognized and adapted to safety risks. Managers trusted evidence-based safety rules and approaches that recorded, categorized and measured safety. Conclusion and Implications for Nursing Management: It is important that nurse managers hold a more refined understanding about safety. Organisations are more likely to support safe patient care if cultural complexity is accounted for. Recognizing how different occupational groups perceive and respond to safety, rather than attempting to reinforce a uniform set of safety actions and responsibilities, is likely to bring together a shared understanding of safety, build trust and nurture safety culture.

Achieving shared understanding in chronic care interactions: the role of caregivers

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sarah Bigi
Keyword(s):  
Health Care ◽  
Elderly Patients ◽  
Health Care Professionals ◽  
Chronic Care ◽  
Second Step ◽  
Original Research ◽  
Clinical Settings ◽  
Shared Understanding ◽  
Content Type

Purpose Within the context of a research program on the most relevant discourse types in chronic care medical encounters, this contribution reports on a qualitative study on the role caregivers play within the process of shared understanding occurring between health-care professionals and elderly patients. The purpose of the paper is to highlight one dimension of such complexity, by bringing to light the challenges connected to the achievement of shared understanding between health-care professionals and elderly patients when caregivers are involved in the conversation. Design/methodology/approach The paper reports on a two-step analysis of a corpus of transcripts of interactions in diabetes and hypertension settings. In the first step, caregivers’ contributions to deliberative sequences have been analyzed. In the second step, the analysis was extended to caregivers’ contributions to the whole encounter. Findings The results show that professionals’ ability to engage caregivers in deliberations during the encounter and, more generally, to assign a role to caregivers as legitimate participants in the consultation may favor the smooth development of the interaction and an effective process of shared understanding among all participants. Originality/value The paper further develops original research about the functions of the argumentative component in dialogues occurring in clinical settings.

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