Qualitative health research
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Active and sensitively managed patient involvement in medical education is vital in the drive toward the development of tomorrow's doctors' patient-centered professionalism. Bedside teaching encounters (BTE) involve clinicians, medical students, and patients, and comprise a formative and focused activity through which students learn both the "whats" and "hows" of physicianship. ⋯ Although patients sometimes participated as team members, even taking the role of director, they were commonly positioned in less active roles: as audience, nonperson, and prop. In this article we discuss critically this commonality across the BTEs: the patient role as passive object at the point at which the serious act of teaching physical examination begins, even when patients actively reject this passive role.
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In this article, we report on qualitative findings pertaining to low-income people's perceptions of and responses to "poverty stigma," a key component of social exclusion with important implications for health and well-being. Our findings are drawn from a multimethod study designed to investigate experiences of social exclusion and social isolation among people living on low incomes. We conducted semistructured individual interviews (n = 59) and group interviews (total n = 34) with low-income residents of two large Canadian cities. ⋯ Participants overwhelmingly thought that other members of society tend to view them as a burden to society-as lazy, disregarding of opportunities, irresponsible, and opting for an easy life. Low-income people responded to perceived stigma with a variety of cognitive and behavioral strategies that reflected their efforts to reconcile their perceived "social" and "personal" identities. These strategies included confronting discrimination directly, disregarding responses from others, helping other low-income people, withdrawing and isolating themselves from others, engaging in processes of cognitive distancing, and concealing their financial situation.
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The primary responsibility of prehospital emergency personnel at out-of-hospital cardiac arrests (OHCA) is to provide lifesaving care. Ethical considerations, decisions, and actions should be based in the patient's beliefs about health and well-being. In this article, we describe patients' experiences of surviving OHCA. ⋯ Survival means a search for coherence with distressing and joyful understanding, as well as existential insecurity exposed by feelings of vulnerability. Well-being is found through a sense of coherence and meaning in life. The study findings show survivors' emotional needs and a potential for prehospital emergency personnel to support them as they try to make sense of what has happened to them.
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In this article, I explore what happens when specialist palliative care staff meet together to discuss patients under their care. Many studies (e.g., Atkinson) have discussed how health care practitioners in various settings use rhetorical strategies when presenting cases in situations such as ward rounds and team meetings. ⋯ The context of specialist palliative care is an interesting place for research, as there is a history of patient-centered holistic approaches to care, within a multidisciplinary context, that is interdisciplinary in its focus, structure, and practice (e.g., Saunders). This article examines the rhetorical accomplishment of teamwork in specialist palliative care settings.
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In this study, I examined interpreters' self-perceived roles and their corresponding communicative goals and strategies. Twenty-six professional interpreters (of 17 languages), 4 patients, and 12 health care providers were recruited for this study, which involved participant observation of medical encounters and in-depth interviews. ⋯ Interpreters' desire to maintain neutrality during the medical encounters influences the communicative strategies they adopt when assuming other roles. I conclude the article with the theoretical and practical implications of interpreters' self-perceived roles.