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Fighting the “Bog Standard”: Intersectional experiences of gender and disability discrimination within healthcare among women in Scotland 反对“沼泽标准”:苏格兰妇女保健中性别歧视和残疾歧视的交叉经验
IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-06-01 Epub Date: 2026-01-21 DOI: 10.1016/j.ssmqr.2026.100709
Laura Tinner , Ana Alonso Curbelo , Kerry Gillespie
Accumulating evidence highlights that gendered health inequalities are shaped by structural and interpersonal discrimination. Existing research also suggests that disabled people suffer worse healthcare experiences and outcomes than the remainder of the population. Despite women being more likely to have a chronic illness or disability than men, and women more frequently experiencing dismissal and disbelief about their health conditions and pain, there is a scarcity of evidence surrounding the healthcare experiences of disabled and chronically ill women. Through four focus groups (n = 14) and 28 semi-structured interviews, we explored the links between discrimination and health among women in Scotland. We used intersectionality as a theoretical and applied framework to zoom in on the experiences of women with a chronic illness or disability, integrating other axes of inequality where relevant. We argue that these women occupy a particular position of amplified discrimination within healthcare, which is borne out of sexist and ableist framings of what constitutes a ‘healthy’ body. Weight blame is one neoliberal logic used in healthcare contexts that restricts disabled women's access to referrals, diagnosis, treatment, support and respect. To navigate these discriminatory healthcare systems, women advocate for themselves, alter their behaviour and balance sometimes conflicting presentations of self. We articulate how these experiences are likely drivers of entrenched gender and disability inequalities.
越来越多的证据表明,两性健康不平等是由结构性歧视和人际歧视造成的。现有的研究还表明,残疾人的医疗保健经历和结果比其他人群更糟糕。尽管妇女比男子更容易患慢性病或残疾,而且妇女更容易对自己的健康状况和疼痛感到不被重视和怀疑,但关于残疾和慢性病妇女的保健经历的证据却很少。通过四个焦点小组(n = 14)和28个半结构化访谈,我们探讨了歧视与苏格兰妇女健康之间的联系。我们将交叉性作为一个理论和应用框架来放大患有慢性疾病或残疾的女性的经历,并在相关的地方整合其他不平等轴。我们认为,这些妇女在医疗保健中处于被放大歧视的特殊地位,这源于对“健康”身体构成的性别歧视和能力主义框架。体重指责是医疗环境中使用的一种新自由主义逻辑,它限制残疾妇女获得转诊、诊断、治疗、支持和尊重。为了应对这些歧视性的医疗保健系统,妇女为自己发声,改变自己的行为,平衡有时相互矛盾的自我表现。我们阐明了这些经历如何可能成为根深蒂固的性别和残疾不平等的驱动因素。
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引用次数: 0
Longitudinal reflections on family caregiving experiences: Insights from solicited diaries of caregivers of people living with dementia in British Columbia, Canada 对家庭照护经验的纵向反思:来自加拿大不列颠哥伦比亚省痴呆症患者照护者征求日记的见解
IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-06-01 Epub Date: 2025-12-04 DOI: 10.1016/j.ssmqr.2025.100677
Kishore Seetharaman , Lucy Kervin , Koushambhi Khan , Heather Cooke , Jennifer Baumbusch
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引用次数: 0
Sovereignty in the digital age Indigenous perspectives on health data and emerging technologies 数字时代的主权土著人对卫生数据和新兴技术的看法
IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-06-01 Epub Date: 2026-01-07 DOI: 10.1016/j.ssmqr.2025.100698
Samantha Hurst , Kelle Dhein , Joseph Yracheta , Timothy Mackey
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引用次数: 0
Perceptions of age and aging in the context of medical decision-making. A qualitative, case-vignette-based focus group study with physicians, nursing staff and seniors 在医疗决策的背景下对年龄和老龄化的看法。对医生、护理人员和老年人进行定性的、基于个案的焦点小组研究
IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-06-01 Epub Date: 2026-01-13 DOI: 10.1016/j.ssmqr.2026.100703
Laura Mohacsi , Lena Stange , Eva Hummers , Evelyn Kleinert

Background

While interactions between the perception of one's own age and different parameters of health and health behavior are well-researched, only few publications focus on perceptions of old age in the context of medical decision-making. Therefore, we examined how old age is perceived by physicians, nursing staff, and people aged 75 or older in the context of medical decision-making.

Methods

The study employed a qualitative research design, conducting 16 focus group discussions (N = 79): five with physicians (n = 24), five with nursing staff (n = 28), and six with people aged 75 and older (n = 27). Discussions were initiated by two case vignettes stating geriatric decision-making situations. To include the perspectives of people unable to attend group discussions, eight individuals aged 75 or older were interviewed individually. Qualitative content analysis was used to analyze the data.

Results

Four major dimensions of old age were derived from the data: (1) age means freedom and autonomy, (2) age means (risk of) decline, (3) age brings age-related tasks, (4) age means being closer to death. They interrelate and lead to a shift in wishes, perspectives, preferences, and priorities regarding medical treatment.

Conclusion

The four identified dimensions coexist and may contradict one another. Perceptions of age and aging, both among older adults and healthcare professionals, can influence medical decision-making by shaping how priorities and preferences evolve with increasing age. These findings highlight the importance of explicitly exploring and understanding individual patients’ wishes and values, particularly in advanced age, to ensure that medical decisions align with personal perspectives and needs.
虽然对自己年龄的感知与健康和健康行为的不同参数之间的相互作用已经得到了很好的研究,但只有少数出版物关注医疗决策背景下对老年的感知。因此,我们研究了在医疗决策的背景下,医生、护理人员和75岁或以上的人是如何感知年龄的。方法采用质性研究设计,共开展16个焦点小组讨论(N = 79),其中5个与医生(N = 24), 5个与护理人员(N = 28), 6个与75岁及以上老年人(N = 27)。讨论是由两个说明老年人决策情况的案例短文发起的。为了纳入无法参加小组讨论的人的观点,对8位75岁或以上的人进行了单独采访。采用定性内容分析法对数据进行分析。结果从数据中得出老年的四个主要维度:(1)年龄意味着自由和自主;(2)年龄意味着(风险)下降;(3)年龄带来与年龄相关的任务;(4)年龄意味着更接近死亡。它们相互关联,并导致在医疗方面的愿望、观点、偏好和优先事项的转变。结论四个维度是共存的,也可能相互矛盾。老年人和医疗保健专业人员对年龄和老龄化的看法可以通过塑造优先事项和偏好如何随着年龄的增长而演变来影响医疗决策。这些发现强调了明确探索和理解个体患者的愿望和价值观的重要性,特别是在老年患者中,以确保医疗决策与个人观点和需求保持一致。
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引用次数: 0
“Stop acting like a diva”: Responses to sexual violence in young adult romance novels “别装得像个天后”:对青少年言情小说中性暴力的回应
IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-06-01 Epub Date: 2025-11-28 DOI: 10.1016/j.ssmqr.2025.100671
Margaret M. Palmer
Young Adult Literature (YAL) provides adolescents with cultural scripts for understanding gender, sexuality, and power, making it essential to examine portrayals of sexual violence and its aftermath. They can normalize sexual harm by suggesting that girls must manage violence on their own and that institutions will not intervene, or they can challenge rape culture by modeling resistance and accountability. This paper analyzes 20 popular YAL novels published between 2005 and 2013 using iterative inductive content analysis (ICA), an approach involving repeated cycles of reading, coding, and refining categories. I find that characters employ six tactics: saying no, joking, threatening violence, creating space, relocation, and violence, both independently and in combination when responding to sexual violence. Schools are portrayed as failing girls, treating sexual harassment as misunderstandings and dismissing girls as “divas” when they protest; notably, school discipline disproportionately targets Latino boys as perpetrators while excusing white boys, who more frequently commit sexual violence in this sample. Police are almost entirely absent, responding to sexual violence in only two texts. Collectively, these patterns demonstrate how young adult romance novels reproduce central assumptions of rape culture: that sexual violence is an individual rather than institutional issue, that resistance is constrained by gender, and that institutional accountability is not reliable.
青少年文学(YAL)为青少年提供了理解性别、性和权力的文化脚本,因此审视性暴力及其后果的描述至关重要。他们可以通过暗示女孩必须自己处理暴力,机构不会干预,使性伤害正常化,或者他们可以通过树立抵制和问责的榜样,挑战强奸文化。本文使用迭代归纳内容分析(ICA)分析了2005年至2013年间出版的20本YAL流行小说,这是一种涉及阅读、编码和精炼类别的重复循环的方法。我发现角色在应对性暴力时使用了六种策略:拒绝、开玩笑、暴力威胁、创造空间、搬迁和暴力,这些策略既可以单独使用,也可以结合使用。学校被描绘成失败的女孩,将性骚扰视为误解,并在女孩抗议时将其视为“天后”;值得注意的是,学校纪律不成比例地将拉丁裔男孩作为施暴者,而原谅白人男孩,后者在本样本中更频繁地实施性暴力。警察几乎完全缺席,只有两条短信回应性暴力。总的来说,这些模式表明了年轻成人浪漫小说是如何再现强奸文化的核心假设的:性暴力是个人问题,而不是制度问题,反抗受到性别的限制,制度责任不可靠。
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引用次数: 0
“Do you belong in my circle?” – a retrospective reflexive thematic analysis of the particularity and price of solidarity for socioculturally diverse communities in Switzerland during the COVID-19 pandemic “你属于我的圈子吗?”-对2019冠状病毒病大流行期间瑞士社会文化多样性社区团结的特殊性和代价进行回顾性反思性专题分析
IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-06-01 Epub Date: 2025-12-23 DOI: 10.1016/j.ssmqr.2025.100697
Gia Thu Ly , Cristopher I.Kobler Betancourt , Balthasar L. Hug , Annika Frahsa
During the COVID-19 pandemic, calls for solidarity were widespread, yet its practice proved fragile and uneven. This study explores how individuals from socio-culturally diverse and often marginalized communities in the canton of Bern (Switzerland) experienced and enacted solidarity. Drawing on the conceptual works by Prainsack & Buyx and Komter, we conducted reflexive thematic analysis of seven focus group discussions with 53 participants and identified two central themes: (1) “Commonality, gratitude and reciprocity as particularities of solidarity”, highlighting how shared values and mutual recognition shaped solidaristic practices; and (2) “Barriers, challenges and costs: the ticket to enter solidarity”, capturing affective labour, limitations of institutional solidarity, and conditions under which solidarity was withheld. Focusing on participants' lived experiences, findings concentrate on three key insights: first, participants experienced positive aspects of solidarity—such as shared purpose and commonality—but these were often offset by emotional and social burdens; second, sociocultural and socioeconomic contexts fundamentally shaped who could afford the costs asscociated with solidaristic engagement; and third, institutional appeals to solidarity were insufficient to sustain collective action, failing to meet participants’ diverse needs and capacities. Solidarity was thus enacted in deeply situated and contingent ways, motivated by ethical and emotional imperatives, yet constrained by structural inequalities. The study underscores the need to consider both affective and socio-structural dimensions when fostering solidaristic practices, offering insights for developing context-specific and culturally responsive strategies to support collective action and social cohesion in times of crisis.
在2019冠状病毒病大流行期间,人们普遍呼吁团结一致,但事实证明,团结一致的做法是脆弱和不平衡的。本研究探讨了来自伯尔尼州(瑞士)社会文化多样性和边缘化社区的个人如何经历和实施团结。借鉴Prainsack & Buyx和Komter的概念性作品,我们对53名参与者参与的7个焦点小组讨论进行了反思性主题分析,确定了两个中心主题:(1)“共性、感恩和互惠作为团结的特殊性”,突出了共同的价值观和相互认可如何塑造了团结的实践;(2)“障碍、挑战和成本:进入团结的门票”,抓住了情感劳动、制度团结的局限性,以及阻碍团结的条件。关注参与者的生活经历,研究结果集中在三个关键见解上:首先,参与者经历了团结的积极方面——比如共同的目标和共性——但这些往往被情感和社会负担所抵消;其次,社会文化和社会经济背景从根本上决定了谁能够承担与团结参与相关的成本;第三,机构对团结的呼吁不足以维持集体行动,未能满足参与者的不同需求和能力。因此,团结是以深刻的情境和偶然的方式实现的,受到道德和情感需求的推动,但受到结构性不平等的制约。该研究强调,在促进团结实践时,需要考虑情感和社会结构两个方面,为制定针对具体情况和文化的战略提供见解,以支持危机时期的集体行动和社会凝聚力。
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引用次数: 0
Exploring young fathers’ roles and decision-making regarding childhood vaccination in Tajikistan: A focus group study 探讨塔吉克斯坦年轻父亲在儿童疫苗接种方面的角色和决策:焦点小组研究
IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-06-01 Epub Date: 2025-11-22 DOI: 10.1016/j.ssmqr.2025.100669
Giyoung Lee , Brandy Joe Milliron , Mutribjon Bahruddinov , Allison K. Groves , Ann C. Klassen
Father involvement is an important factor in childhood vaccination. Despite Tajikistan's significant efforts to improve vaccination coverage, vaccine hesitancy persists, with parents exhibiting signs of mistrust towards vaccinations due to misinformation. This study aims to examine how fathers describe their role in their child's vaccination plans and to explore their beliefs and attitudes regarding childhood vaccinations through thematic analysis of data from seven focus groups. Focus group discussions aimed to understand influences on immunization and potential communication channels, messages, and behavior change goals for future campaigns. Our analysis categorized fathers based on their attitudes towards vaccines (supportive or hesitant) and on their level of engagement in vaccine decisions (active or passive). Fathers in the focus groups reported seeing themselves as protectors, particularly given their cultural role as primary decision-makers for their children's health. Our findings indicate that, although many fathers are supportive of childhood vaccines, vaccine hesitancy due to misinformation remains a concern. Current gender norms, as well as employment logistics, also pose barriers for fathers to become more involved in their children's vaccination process. Fathers expressed a desire for more opportunities to learn about health issues in their communities. These insights offer opportunities for public health campaigns to educate and engage fathers as partners in advocating for childhood vaccinations. Future interventions should focus on promoting father involvement, both in terms of attitude and agency, while remaining sensitive to cultural gender norms.
父亲的参与是儿童接种疫苗的一个重要因素。尽管塔吉克斯坦在提高疫苗接种覆盖率方面作出了重大努力,但对疫苗的犹豫仍然存在,由于错误信息,家长表现出对疫苗接种不信任的迹象。本研究旨在研究父亲如何描述他们在孩子接种疫苗计划中的作用,并通过对七个焦点小组的数据进行专题分析,探讨他们对儿童接种疫苗的信念和态度。焦点小组讨论旨在了解对免疫的影响以及未来运动的潜在沟通渠道、信息和行为改变目标。我们的分析根据父亲对疫苗的态度(支持或犹豫)和参与疫苗决策的程度(主动或被动)对父亲进行了分类。焦点小组中的父亲报告称,他们将自己视为保护者,特别是考虑到他们作为子女健康主要决策者的文化角色。我们的研究结果表明,尽管许多父亲支持儿童接种疫苗,但由于错误信息导致的疫苗犹豫仍然是一个问题。目前的性别规范以及就业后勤也对父亲更多地参与其子女的疫苗接种过程构成了障碍。父亲们表示希望有更多的机会了解他们社区的健康问题。这些见解为公共卫生运动提供了机会,使父亲们成为倡导儿童接种疫苗的伙伴,并对他们进行教育。今后的干预应侧重于促进父亲在态度和能动性方面的参与,同时对文化性别规范保持敏感。
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引用次数: 0
“I'm staying as informed as I can and trying to make nutritional & lifestyle amendments”: COVID long-haulers’ strategies for managing uncertainty and assessing the trustworthiness of COVID-19-related information “我尽我所能了解情况,并试图改变营养和生活方式”:COVID长途运输公司管理不确定性和评估COVID-19相关信息可信度的策略
IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-06-01 Epub Date: 2025-12-04 DOI: 10.1016/j.ssmqr.2025.100681
Beth St. Jean , Katherine F. Raymond , Brooke Fisher Liu , Duli Shi , Miranda Downey , Twanna Hodge , Jane Behre , Nicole Miller
COVID long-haulers face a great deal of uncertainty and information-related challenges that can impede their ability to cope with and manage this serious chronic health condition. We conducted an explanatory sequential mixed-methods study involving an online survey (n = 135) and follow-up interviews (n = 29) to investigate the information-related experiences of COVID long-haulers. In this paper, we share the strategies they used to navigate uncertainty and to assess the trustworthiness of COVID-19-related information. We found that participants experienced a great deal of uncertainty, often relating to the fear, anxiety, and depression they felt as they were unsure whether they would ever recover. Nearly all participants shared strategies they used to deal with uncertainty, which included seeking, sharing, and/or avoiding information; using information to manage one's health; taking control of what they can and/or giving up control over things they cannot; and accepting their situation. With specific regard to information management, participants shared several strategies they used to assess the trustworthiness of COVID-19-related information. These included looking into the source and/or authors of the information, making sure that the authors provided evidence and citations for their claims, investigating why the information was being shared, making sure that the source/authors acknowledged remaining gaps or uncertainty in our knowledge, and checking multiple sources to cross-verify the information they had found. Our findings have important implications for the design of optimal approaches that can help to support and facilitate COVID long-haulers’ uncertainty management and information assessment efforts.
COVID - 19长途航空公司面临着大量不确定性和与信息相关的挑战,这些挑战可能会阻碍他们应对和管理这一严重慢性健康状况的能力。我们进行了一项解释性顺序混合方法研究,包括在线调查(n = 135)和随访访谈(n = 29),以调查COVID - 19长途运输人员的信息相关经历。在本文中,我们分享了他们用于应对不确定性和评估covid -19相关信息可信度的策略。我们发现,参与者经历了大量的不确定性,通常与他们感到的恐惧、焦虑和抑郁有关,因为他们不确定自己是否会康复。几乎所有的参与者都分享了他们用来处理不确定性的策略,包括寻找、分享和/或避免信息;利用信息管理个人健康;控制他们能控制的和/或放弃他们不能控制的;接受他们的处境。在信息管理方面,与会者分享了他们用来评估covid -19相关信息可信度的几种策略。这些措施包括调查信息的来源和/或作者,确保作者为他们的主张提供证据和引用,调查信息被共享的原因,确保来源/作者承认我们的知识中仍存在差距或不确定性,并检查多个来源以交叉验证他们发现的信息。我们的研究结果对设计最佳方法具有重要意义,这些方法有助于支持和促进COVID长途运输公司的不确定性管理和信息评估工作。
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引用次数: 0
Beyond access: Racial and socioeconomic disparities in device use among youth with type 1 diabetes 超越获取:1型糖尿病青少年设备使用中的种族和社会经济差异
IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-06-01 Epub Date: 2025-12-19 DOI: 10.1016/j.ssmqr.2025.100690
Cassidy Puckett , Jenise C. Wong , Berty D.C. Arreguín , Jennifer K. Raymond , Stephanie S. Crossen , Kevin Yen
Racial and socioeconomic disparities in medical device use among youth with type 1 diabetes (T1D) are well documented. Inequities in access can arise in the unequal prescription of insulin pumps and continuous glucose monitoring (CGM) devices. Once prescribed, challenges to device use can also create inequities, but less is known about racial and socioeconomic disparities in post-access challenges such as barriers to use at school. Using focus group data from three mixed-method studies of youth with T1D (N = 50) and their caregivers (N = 56), we compare the experiences of higher-income and majority White youth to lower-income and predominantly Latinx and Black youth. We find many similarities, along with two striking differences. First, lower-income and majority Latinx and Black youth express more fear and victimization from bullying at school, which can lead to device discontinuation. Second, these youth and their caregivers report few connections to other families managing T1D but many connections to those with T2D. This social network configuration promotes the typicality assumption that these youth have T2D, which carries significant stigma and limits diabetes-related social capital that might otherwise support device use. Overall, our findings extend health inequities research by identifying unique challenges faced by lower-income and majority Latinx and Black youth with T1D in utilizing medical innovation.
种族和社会经济差异在医疗器械使用的青少年1型糖尿病(T1D)是有证可循的。胰岛素泵和连续血糖监测(CGM)设备的不平等处方可能导致获取不公平。一旦规定,对设备使用的挑战也会造成不平等,但对使用后挑战(如在学校使用障碍)的种族和社会经济差异知之甚少。利用三项针对T1D青年(N = 50)及其照顾者(N = 56)的混合方法研究的焦点小组数据,我们比较了高收入和大多数白人青年与低收入和以拉丁裔和黑人为主的青年的经历。我们发现了许多相似之处,但也有两个显著的不同之处。首先,低收入和大多数拉丁裔和黑人青年对学校欺凌表现出更多的恐惧和受害,这可能导致设备停产。其次,这些年轻人和他们的照顾者报告说,他们与其他患有T1D的家庭联系很少,但与患有T2D的家庭联系很多。这种社会网络结构促进了典型假设,即这些年轻人患有糖尿病,这带来了显著的耻辱,限制了糖尿病相关的社会资本,否则可能会支持设备的使用。总体而言,我们的研究结果通过确定低收入和大多数拉丁裔和黑人青年T1D在利用医疗创新方面面临的独特挑战,扩展了健康不平等研究。
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引用次数: 0
Do-it-yourself hormones: constructing credible knowledge in an online transgender forum 自己动手的荷尔蒙:在一个在线跨性别论坛上构建可信的知识
IF 2.5 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2026-06-01 Epub Date: 2025-12-23 DOI: 10.1016/j.ssmqr.2025.100692
Natasa Stoli, Klasien Horstman, Olga Zvonareva
On the continuum of patient participation between ‘‘informed patients'’ and ‘‘patients in control’‘, DIY pharmaceuticals are considered the most radical because they are produced outside regular medical professional and regulatory contexts. While some see DIY pharmaceuticals as an important contribution to making pharmaceuticals more accessible, others are concerned because they circumvent established procedures for assessing safety and efficacy. We studied a particular case of DIY pharmaceuticals: citizen drug developers who enable access to hormone therapy in transgender health care through the home production of hormones. By studying an online community of DIY hormone producers, we aimed to gain insight into how they strive to develop knowledge practices that are credible and safe. Theoretically, we drew from science and technology studies scholarship on knowledge credibility and patient participation in knowledge production. We relied on a qualitative study of an online forum to generate our data. The analysis shows how citizen drug developers constructed and performed standards of safety and efficacy in sharing knowledge within their community and how these standards were ensured. DIY pharmaceuticals can be an unconventional but important pathway for citizen participation in biomedical knowledge production, employing strategies for performing credible knowledge outside formal laboratory spaces and in the absence of external supervision.
在“知情患者”和“受控患者”之间患者参与的连续性方面,DIY药品被认为是最激进的,因为它们是在常规医疗专业和监管环境之外生产的。虽然一些人认为DIY药品是对使药品更容易获得的重要贡献,但另一些人则感到担忧,因为它们绕过了评估安全性和有效性的既定程序。我们研究了一个DIY药物的特殊案例:公民药物开发人员通过家庭生产激素,使跨性别医疗保健能够获得激素治疗。通过研究一个DIY激素生产商的在线社区,我们旨在深入了解他们如何努力发展可信和安全的知识实践。从理论上讲,我们借鉴了科学技术研究中关于知识可信度和患者参与知识生产的研究成果。我们依靠对在线论坛的定性研究来生成我们的数据。分析显示了公民药物开发人员如何构建和执行在社区内分享知识的安全性和有效性标准,以及如何确保这些标准。DIY药品可以成为公民参与生物医学知识生产的非常规但重要的途径,采用在正式实验室空间之外和缺乏外部监督的情况下执行可信知识的策略。
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引用次数: 0
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SSM. Qualitative research in health
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