“We’re all in an abusive relationship with the health-care system”: Collective memories of transgender health care

2021 ◽  
pp. e20210013
Author(s):  
Charlie Davis ◽  
Corey W. Johnson ◽  
Ashley Flanagan ◽  
Washington Silk

Collective memory work allows participants to recall, examine, and analyze their memories and experiences within a broader cultural context to see how their individual experiences link to collective, shared experiences of similar and/or different groups. This study utilized collective memory work to engage six trans participants in an examination of their individual experiences with health care. During a four-hour focus group, participants engaged in this process of discourse analysis and came to collective agreements about the meaning of their stories, the intentions of the author, and the intentions of others in their shared lived experience. In this paper, we will provide a thorough and rich description of the participants’ memories and their collective analysis, which highlights the interconnection between perceptions of oneself and their experiences with the health-care system. Our analysis revealed participants felt they had a toxic relationship with the health-care system. In particular, they discussed how health-care professionals left trans people tremulously asking for services, uncertain if they would receive care, what the quality of the care would be, and whether they would be treated respectfully. When discussing positive health-care experiences, participants highlighted when fears and anxieties were not realized, but all instances reflected some inappropriate actions. The results from this study will contribute to research on trans health care by providing a nuanced understanding of how health-care experiences impact trans communities collectively, as well as the ways in which health practices can be improved.

2009 ◽  
Vol 29 (4) ◽  
pp. 162-168
Author(s):  
AL Dewar ◽  
K Gregg ◽  
MI White ◽  
J Lander

A new framework is needed for patients with chronic pain and their primary care physicians that acknowledges the individual’s experiences and provides evidence-informed education and better linkages to community-based resources. This study describes the experience of 19 chronic-pain sufferers who seek relief via the health care system. Their experiences were recorded through in-depth semistructured interviews and analyzed through qualitative methods. The participants reported early optimism, then disillusionment, and finally acceptance of living with chronic pain. Both individuals with chronic pain and their health care professionals need evidence-informed resources and information on best practices to assist them to manage pain. Empathetic communication between health care professionals and individuals with chronic pain is crucial because insensitive communication negatively affects the individual, reduces treatment compliance and increases health care utilization.


2021 ◽  
Vol 11 (33) ◽  
pp. 14-26
Author(s):  
Teila Ceolin ◽  
Rita Maria Heck ◽  
Renata Menasche ◽  
Maria-Antonia Martorell-Poveda

O objetivo foi compreender o sistema de cuidado à saúde entre famílias rurais ao Sul do Rio Grande do Sul. Constituiu-se de uma pesquisa qualitativa, com orientação etnográfica, realizada em 2014, com 25 interlocutores, residentes em um território rural. Os dados foram analisados por meio de uma abordagem hermenêutica antropológica. As práticas de cuidado à saúde, para essas famílias rurais, envolvem diferentes saberes, tanto os oriundos do sistema formal, quanto do sistema informal de saúde. Essas práticas transitam pelo cuidado familiar, serviços biomédicos, religiosidade, não ocorrendo um fluxo único, mas utilizando-se dos diferentes espaços e serviços, de acordo com suas necessidades. Nesse sentido, para realização de um cuidado integral à saúde dos indivíduos e das suas famílias, os profissionais necessitam conhecer o contexto cultural da comunidade acompanhada, entender e valorizar as práticas e as dinâmicas de cuidado que integram seu sistema de cuidado à saúde.Descritores: População Rural, Família, Cultura, Enfermagem. Health care system of rural familiesAbstract: The aim was to comprehend the health care system of rural families in the south of Rio Grande do Sul. Qualitative research with etnographic orientation, developed in 2014, with 25 interlocutors, residents of a rural territory. Data were analyzed through antropological hermeneutic approach. Health care practices, for these rural families, involve different knowledge, those from the formal system and those from the informal system of health. These practices transit through family care, biomedical systems and services, religiosity, not a single flow, but using different spaces and services, according to their needs. Thus, the realization of an integral health care of the individuals and their families requires professionals that know the community’s cultural context, understand it and value practices and care dybamics that integrate their health care system.Descripstors: Rural Population, Family, Culture, Nursing. Sistema de atención de salud a familias ruralesResumen: El objetivo era comprender el sistema de atención de salud entre las familias rurales en el sur de Rio Grande do Sul. Consistió en una investigación cualitativa, con orientación etnográfica, realizada en 2014, con 25 interlocutores, residentes en un territorio rural. Los datos se analizaron utilizando un enfoque hermenéutico antropológico. Las prácticas de atención médica para estas familias rurales implican diferentes tipos de conocimiento, tanto de los sistemas de salud formales como informales. Estas prácticas se mueven a través de la atención familiar, los servicios biomédicos, la religiosidad, no un solo flujo, sino que utilizan diferentes espacios y servicios, de acuerdo con sus necesidades. En este sentido, para brindar atención médica integral a las personas y sus familias, los profesionales necesitan conocer el contexto cultural de la comunidad que se sigue, comprender y valorar las prácticas y dinámicas de atención que integran su sistema de atención de salud.Descriptores: Población Rural, Família, Cultura, Enfermería.


Author(s):  
Tiffany D. Joseph

Tiffany D. Joseph’s chapter examines how stratification of access by immigration status effectively undermined a “universal” health policy. While the ACA only extended coverage to U.S. citizens and eligible documented immigrants, Massachusetts pursued a universal health care system at the state level and offered coverage to all residents, regardless of documentation status. Despite this policy that aimed for inclusion, immigrants in Massachusetts were still more likely than non-immigrants to remain uninsured. Joseph interviewed Brazilian and Dominican immigrants, health care professionals, and immigrant/health organization employees to find out why immigrants remained uninsured. She identified immigration-related, health care system, and bureaucratic barriers that prevented individuals from effectively accessing care. Massachusetts serves as both a model and a cautionary tale for ACA implementation, with barriers exacerbated for immigrant, low-income, and minority populations.


2019 ◽  
Vol 35 (3) ◽  
pp. 185-191 ◽  
Author(s):  
David A. Agom ◽  
Stuart Allen ◽  
Sarah Neill ◽  
Judith Sixsmith ◽  
Helen Poole ◽  
...  

Background: There is a dearth of research focusing on identifying the social complexities impacting on oncology and palliative care (PC), and no study has explored how the health-care system in Nigeria or other African contexts may be influencing utilization of these services. Aim: This study explored how social complexities and the organization of health-care influenced the decision-making process for the utilization of oncology and PC in a Nigerian hospital. Methods: This qualitative study used an interpretive descriptive design. Data were collected using semistructured interview guides with 40 participants, comprising health-care professionals, patients, and their families. Thematic analysis was conducted to generate and analyze patterns within the data. Findings: Three themes were identified: dysfunctional structural organization of the health-care delivery system, service-users’ economic status, and the influence of social networks. The interrelationship between the themes result in patients and their family members decisions either to present late to the hospital, miss their clinical appointments, or not to seek oncological health care and PC. Conclusion: This article offers insights into the role of the health-care system, as organized currently in Nigeria, as “autoinhibitory” and not adequately prepared to address the increasing burden of cancer. We therefore argue that there is a need to restructure the Nigerian health-care system to better meet the needs of patients with cancer and their families as failure to do so will strengthen the existing inequalities, discourage usage, and increase mortality.


Author(s):  
Luc Legris ◽  
Michel Préville

ABSTRACTFive semi-structured interviews were conducted, using the psychological autopsy method, in order to document the causes of geriatric suicide and to describe the interaction among suicidal elderly persons, their personal and social environments, and health care professionals. The results of this study support our hypothesis that elderly persons view suicide as a means of alleviating the psychological suffering associated with the frustration they experience on account of their inability to satisfy their basic needs. Three types of basic needs that affect the suicidal tendency of elderly persons were identified: the need to self-actualize, the need to belong, and the need to feel safe. The results also show that the people who make up the social and personal environment of elderly persons have a limited role in the prevention of suicide. This is due to their unfamiliarity with the problems surrounding the fulfilment of the basic needs of the suicidal elderly. Furthermore, as revealed in the cases studied here, the intervention of the health care system has centred mainly on the use of medication as a treatment for symptoms of psychological distress. The health care system pays little attention to the dissonance associated with the frustration suicidal elderly persons experience on account of their inability to satisfy their basic needs. Finally, the outcome of this qualitative study suggests that understanding the basic needs of the elderly can be very useful in understanding geriatric suicide.


2010 ◽  
Vol 34 (4) ◽  
pp. 441 ◽  
Author(s):  
Haylee J. Weaver ◽  
Grant A. Blashki ◽  
Anthony G. Capon ◽  
Anthony J. McMichael

Climate change will affect human health, mostly adversely, resulting in a greater burden on the health care system, in addition to any other coexistent increases in demand (e.g. from Australia’s increasingly ageing population). Understanding the extent to which health is likely to be affected by climate change will enable policy makers and practitioners to prepare for changing demands on the health care system. This will require prioritisation of key research questions and building research capacity in the field. There is an urgent need to better understand the implications of climate change for the distribution and prevalence of diseases, disaster preparedness and multidisciplinary service planning. Research is needed to understand the relationship of climate change to health promotion, policy evaluation and strategic financing of health services. Training of health care professionals about climate change and its effects will also be important in meeting long-term workforce demands.


2020 ◽  
Vol 5 (2) ◽  
pp. 54-60
Author(s):  
Mathias Tiedemann Svendsen ◽  
Steven R. Feldman ◽  
Sylvia Naiga Tiedemann ◽  
Anne Sofie Stochholm Sørensen ◽  
Cecilie Marie Ringgaard Rivas ◽  
...  

Background: Topical therapy is first-line treatment for patients with mild-to-moderate psoriasis, but low adherence to topical drugs is a barrier to treatment success. Health-care system resources are considered to have an impact on adherence of patient with psoriasis to topical drugs. Objective: To investigate dermatology nurses’ perception of the impact of health-care system resources on topical therapy adherence in patients with psoriasis. Methods: A semistructured focus group study was performed with 6 dermatology nurses and 2 student nurses. Participants were recruited from a dermatology outpatient hospital clinic. The study focused on the dermatology nurses’ perception of the effect health-care system resources (including health-care services provided to patients, how clinics are organized, and how the health-care personnel communicate) have on adherence of patients with psoriasis to topical treatment. The focus group discussion was divided into 3 areas: communication with patients and intercollegial communication, follow-up visits and admissions to consultations by other health-care professions, and how to establish consultations to support adherence of patients with psoriasis to topical drugs. Data were analyzed by a systematic text condensation method based on a phenomenological–hermeneutic approach. Results: Nurses identified a number of health-care system resources that may affect adherence of patients with psoriasis, primarily professional collaboration and communication, continuity of care, and the establishment of nurse consultations. Conclusion: Adherence may by negatively affected by contradictory information about topical drugs due to inadequate interprofessional collaboration among health-care professionals. Improving communication between health-care professionals and patients, ensuring continuity of care, and establishing nurse consultations may improve topical therapy outcomes.


2021 ◽  
Author(s):  
Maja Bertram ◽  
Urs Steiner Brandt ◽  
Rikke Klitten Hansen ◽  
Gert Tinggaard Svendsen

Abstract Background: Does higher health literacy lead to higher trust in public hospitals? Existing literature suggests that this is the case since a positive association between the level of health literacy and the level of trust in physicians and the health care system has been shown. This study aims to challenge this assumption. Methods: Based on theoretical arguments from game theory and analysis of empirical data, we argue that the association is better described as an inversely u-shaped curve, suggesting that low and high levels of health literacy lead to a lower level of trust than a medium level of health literacy does. The empirical analysis is based on a study of the Danes’ relationship to the overall health care system. More than 6,000 Danes have been asked about their overall expectations of the health service, their concrete experiences and their attitudes to a number of change initiatives. Results: Game theory analysis show that the combined perceived cooperation and benefit effects can explain an inversely u-shaped relationship between social groups and trust in the health care system. Based on quantitative, binary regression analyses of empirical data, the lowest degree of trust is found among patients from the lowest and highest social groups, while the highest degree of trust is found in the middle group. The main driver for this result is that while patients having low health literacy perceive that the health care system is not cooperative, patients with a high level of health literacy have high expectations about the quality, which the health care system might not be able to provide. This reduces the perceived benefit from their encounter with the health care system. Conclusion: It is important that health care professionals understand that some patient groups have a higher chance of cooperation (e.g., agreeing on the choice of treatment) or defection (e.g. passing a complaint) than others. In perspective, future research should undertake further qualitative examinations of possible patient types and their demands in relation to different health care sectors, focusing specifically on the opportunities to improve the handling of different patient types.


2020 ◽  
Vol 8 (2) ◽  
pp. 59-64
Author(s):  
W Sunitha

The present study deals with A Study on Users’ Perception of Ayurvedic Medicine. This topic helps us to know the knowledge, merits, and demerits of using Ayurvedic medicine. This study focuses on the opinion of the betterment of Ayurvedic medicine among people. Ayurvedic medicine is the traditional medicine used in the early days. In earlier days, ancient men used this medicine to cure various diseases. Ayurveda is derived from two Sanskrit root words: Ayu, which means Life, and Veda, which means Knowledge. Thus it would be safe to call Ayurveda as the ‘Science of life’ more than a mere system of treating an illness. Ayurveda is a holistic Indian system of medicine that uses a constitutional model. It works to prove flexible guidance to attain a state of positive health. Ayurvedic medicine is India’s primary health care system. Ayurvedic medicine is considered to be the world’s older health care system.


Author(s):  
Architha Aithal ◽  
Ateendra Jha

Many developing countries are facing a crisis in human health resources due to a critical shortage of health workers. Despite of many trained health care professionals our health care system is struggling to provide optimum services to the patients. Gaps still exist with respect to patient care, which are unevenly delivered. The data collected from 228 subjects reveals that only 7.01% of the subjects have received counseling always, 59.65% think that counseling should be given and only 41.66% are satisfied with current health care system while 56.57% are not satisfied. Our study shows that there is a huge burden on health care professionals due to a high number of the patient load which leads to the hindrance in optimum patient care and finally leads to the degradation in the quality of health care services. Now time has approached when the term task shifting should be taken seriously especially in the health care sectors. Pharmacists, an ignored profession in the health care sector have a crucial role for optimum patient care. It is the demand of the scenario that pharmacist should be taken as a key role player between the patient and prescriber. A proper communication between the patient and prescriber can be established only if all health care professionals will start working to assist each other not to compete with each other.


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