Qualitative Research in Medicine and Healthcare 2019-09-09T09:31:26+00:00 Francesca Savio Open Journal Systems <p><strong>Qualitative Research in Medicine and Healthcare</strong> is an interdisciplinary and international forum for qualitative research in healthcare settings. The journal is conceived as a site for dialogues between researchers, academics, and healthcare practitioners; it allows an exchange between multiple parties in the health and social service professions, patients and clients as well as senior and junior researchers who believe in the ethos of qualitative approaches. Qualitative research is reflexive. It takes into account that the empirical insights and theoretical propositions it produces are ontologically consequential for all those involved in the research process. This journal publishes research that use many methods of data collection and numerous approaches to data analysis, ranging from systematic coding to mostly inductive, phenomenological and narrative approaches. Submissions can be either theoretical, empirical, or present state of the art reviews of important subject matter in the field, but they have to advance scholarly knowledge, and contribute to research practice in an original way. Each issue of <strong>Qualitative Research in Medicine and Healthcare</strong> provides readers with peer-reviewed articles that examine: the illness experience from multiple and varied perspectives; constructions of health, illness and healthcare that highlight relational and global contexts; healthcare policies in various organizational and institutional settings; the pressures of neoliberalism on healthcare; attention to the communicative dynamics of the patient-provider relationship; narrative approaches to health.</p> <p>As a promotional activity, this journal does <strong>not apply charge</strong> for publication to Authors.</p> Editor’s introduction: qualitative research and the epistemics of experience 2019-09-09T09:31:20+00:00 Mariaelena Bartesaghi <p>Not available.</p> 2019-09-06T09:52:17+00:00 ##submission.copyrightStatement## The role of standardized patient assessment forms in medical communication skills education 2019-09-09T09:31:26+00:00 Grace Peters <p>Communication skills training is a routine practice in medical education designed to instruct and evaluate future physicians in matters of patient-provider interaction. Based on the United States Medical Licensing Examination Step 2 Clinical Skills (CS), medical schools across the United States hire and train standardized patients (SPs) to act as patients in and evaluators of simulated interactions with medical students (MSs). Using discourse analysis, I examine how a computerized assessment form creates a particularized version of communication skills with implications for future practice. The 39-item checklist is completed by SPs following a simulated interaction designed to prepare third-year MSs for the Step 2 CS. Specifically, I analyze how the form is structured to make recognizable specific communication skills tasks, who should complete said tasks, and what varying degrees of communication skills competency are within the realm of task completion. By analyzing the form, I consider the agency of texts in medical education, the implications of technologizing communication as an institutional skill, and the limitations of enlisting SPs to evaluate communication skills competency under the guise of a patient perspective.</p> 2019-08-23T17:06:11+00:00 ##submission.copyrightStatement## Advantages and challenges of using mobile ethnography in a hospital case study: WhatsApp as a method to identify perceptions and practices 2019-09-09T09:31:25+00:00 Thomas Bjørner Morten Schrøder <p>The focus of this article is to provide the reader with reflexivity and a framework for using mobile ethnography. Based on a case study with an ethnographic approach (including mobile ethnography using WhatsApp), we identified perceptions and practices for improved workflows and procedures related to nurses’ introduction and implementation of self-catheterization at the National Spinal Injuries Centre in Great Britain. We offer detailed procedures, advantages, and challenges in using mobile ethnography. The ethnographic approach consisted of four phases, including initial workshops, go-along observations, interviews, and a mobile ethnographic approach using WhatsApp as a mobile diary for six nurses. Within the case study, three major themes were revealed by the ethnographic approach, with the conclusion that nurses have positive attitudes towards self-catheterization, but these nurses are becoming less influential and the practices around this technique are consequently disappearing. The main result is that use of WhatsApp as a self-tracking tool can extend the methodological toolbox, but reflexivity and preliminary work are required to make the practice beneficial.</p> 2019-08-23T17:08:43+00:00 ##submission.copyrightStatement## Assisted living in rural areas: aging in blurred landscapes 2019-09-09T09:31:24+00:00 Bodil H. Blix Torunn Hamran <p>Here, we explore the experiences and practices of care in the context of assisted living facilities (ALFs) in rural areas from the perspectives of family members, health care professionals, and senior citizen interest group representatives. Specifically, we focus on the potential for ALFs to safeguard and unify the health care policy ambitions of equity, quality, and aging in place. Focus group interviews with health care professionals and interest group representatives and individual interviews with family members were conducted in largely rural Norwegian municipalities. Providing high-quality health care services in people’s homes remains challenging, particularly in rural areas. ALFs have been introduced as a compromise, <em>a home away from home</em>. In rural areas, ALFs are typically localized in community centers. ALFs are neither homes nor nursing homes, and residents possess varying and changing care needs. Several parties experience challenges with respect to safety, evolving care needs, and responsibilities. Moreover, the service allocation and user payment systems may undermine equity. This study indicates that health care authorities should evaluate whether prioritizing assisted living is still suitable for the aging population in rural areas and beyond.</p> 2019-08-26T15:51:06+00:00 ##submission.copyrightStatement## It doesn’t make sense, but we do: framing disease in an online metastatic breast cancer support community 2019-09-09T09:31:26+00:00 Ariane B. Anderson <p>Using Weick’s sensemaking as a conceptual framework to investigate online discussions between members of a Facebook group of metastatic breast cancer patients, and using thematic analysis to examine textual threads between group members, this research examines participants’ framing of cancer survivorship. Participants in peer-to-peer disease support groups, which are not led by medical experts, communicate differently among themselves in order to cope with chronic and terminal illness. Perceptions of survivorship of late stage patients versus early stage patients differ for a variety of reasons, with late stage patients understanding their illness trajectory more often as chronic and declining. This analysis identified three properties of sensemaking used by members to manage their disease: identity, retrospective, and enactment. Results indicate that peer-to-peer online support group communication engenders distinct framing logics that members draw upon for group support as they manage a chronic and terminal disease.</p> 2019-08-23T00:00:00+00:00 ##submission.copyrightStatement## There’s just huge anxiety: ontological security, moral panic, and the decline in young people’s mental health and well-being in the UK 2019-09-09T09:31:24+00:00 Jo Bell Marie Reid Judith Dyson Annette Schlosser Tim Alexander <p>This study aims to critically discuss factors associated with a recent dramatic rise in recorded mental health issues amongst UK youth. It draws from interviews and focus groups undertaken with young people, parents and professionals. We offer valuable new insights into significant issues affecting young people’s mental health and well-being that are grounded in their lived experiences and in those who care for and work with them. By means of a thematic analysis of the data, we identified an increase in anxiety related to: future orientation, social media use, education, austerity, and normalization of mental distress and self-harm. We apply the notion of ontological security in our interpretation of how socio-cultural and political changes have increased anxiety amongst young people and consequent uncertainty about the self, the world and the future, leading to mental health problems. There are also problems conceptualizing and managing adolescent mental health, including increased awareness, increased acceptance of these problems, and stigmatisation. We relate this to the tendency for moral panic and widespread dissemination of problems in a <em>risk society</em>. In our conclusion, we highlight implications for future research, policy and practice.</p> 2019-08-26T15:58:24+00:00 ##submission.copyrightStatement##