Background Prolonged health uncertainty extends beyond diagnostic processes and clinical encounters into everyday life, reshaping work, relationships, self-understanding, and the capacity to imagine a stable future. Yet the occupational and relational burden of living under uncertainty often remains hidden when outward functioning is preserved. Method This analytic autoethnography examined how prolonged health uncertainty was lived and negotiated across work, family life, and selfhood. The analysis drew on a curated archive of self-authored materials, including contemporaneous written reflections, retrospective accounts, and selected self-narrative documents. Materials were interpreted thematically through the lens of biographical disruption. Results Four interrelated themes were identified: 1) health uncertainty beyond the clinic, 2) carrying competence under strain, 3) silence, disclosure, and institutional vulnerability, and 4) rebuilding a livable future. The findings show that uncertainty became embedded in the ordinary structure of life rather than remaining a purely medical issue. Continued functioning at work depended on self-monitoring, emotional containment, selective silence, and repeated efforts to preserve a coherent professional self. Uncertainty remained unresolved, but was incorporated into a more fragile, still livable continuity. Conclusions Prolonged health uncertainty should be understood as both a medical problem awaiting clarification and a disruptive occupational and relational condition. This article highlights the hidden labor involved in remaining apparently functional while living and working through uncertainty.
Background:Positionality is central to ethnographic research because knowledge is produced through situated and relational encounters. Clinician-ethnographers occupy complex insider-outsider positions, as their professional identity may shape access, behavior, disclosure, and interpretation within the field. In this article, I explore the multiple positionalities of the physician-ethnographer in acute hospital settings and argue that professional identity should not be perceived as bias to be neutralized, but as an interpretive resource. Methods:I draw on reflexive episodes from ethnographic fieldwork examining non-invasive advanced respiratory support. I consider moments of intervention and restraint, emotional steadiness, and shifting self-presentation to examine how professional identity and authority are experienced and negotiated in practice. Results:The withholding and expression of professional authority made visible how positionality reshaped interlocutor behavior, disclosure, and the stabilization of knowledge. When I was recognized as a physician, interactions were often organized around clinical credibility and technical knowledge. When positioned as a student or outsider, interlocutors more readily articulated uncertainty, emotional labor, and the relational dimensions of care. Professional authority persisted even when unexercised, and both intervention and restraint reorganized interactions within the field. Holding multiple positionalities revealed hierarchies and moral negotiations that structure acute care. Conclusion:The physician-ethnographer's multiple positionalities should not be understood as a methodological liability to be minimized. By reframing clinician positionality as analytically generative, I demonstrate how reflexive practice can reveal the relational and symbolic organization of clinical care. Professional identity is not external to ethnographic data, but forms part of the conditions through which knowledge is produced.
Aims This study aimed to gain perspectives of clinicians and academics from multiple disciplines in Ireland and internationally on multifactorial falls risks, attitudes towards falls prevention, the existence of standardization, and opinion on the ideal screening tool. Methods Braun and Clarke’s (2006) thematic analysis was conducted on 15 expert interview transcripts from 10 disciplines. Results The following themes emerged: falls risk factors, proactive versus reactive culture, standardization, and logistics of the ideal tool. Discussion This study found a need for a nationally standardized, multidisciplinary falls screening tool for community-dwelling older adults which would proactively identify and stratify risk and streamline toward appropriate interventions to improve Irish primary falls prevention. Implications include potentially decreasing fall-related admissions, alleviating healthcare burden, as per Irish and international policies that aim to proactively recognize risk for the prevention of common causes of harm.
Objective(s) Lyme disease is the most common vector-borne illness in the United States, with an estimated 476,000 cases diagnosed and treated annually. Although incidence is highest among White individuals, people of color are more likely to experience severe or disseminated manifestations. This study explored factors contributing to this disparity by examining experiences of people of color diagnosed with Lyme disease. Setting Participants resided in high-incidence U.S. states. Participants Self-identified people of color diagnosed with Lyme disease within the past 12 months. Methods Fifteen participants completed in-depth interviews analyzed using inductive and deductive qualitative content analysis. Follow-up focus groups supported consensus-building and thematic refinement. Results Key themes included limited awareness that people of color are at risk for Lyme disease, perceived discrimination in health care encounters, diagnostic delays attributed to the characteristic erythema migrans (EM) rash being less visible on darker skin, and insufficient physician knowledge regarding diverse clinical presentations. Participants also expressed a preference for racially concordant providers. Lyme disease affected physical health, emotional well-being, social relationships, and engagement in outdoor activities. Conclusions People of color may face distinct challenges in Lyme disease recognition and management, contributing to disparities in outcomes. Findings underscore the need for targeted education for at-risk populations, patients and providers and for equitable prevention and diagnostic strategies.
Purpose: Prolonged digital screen exposure among university educators has led to increased cases of digital eye strain (DES), a growing occupational health concern in the academic sector. This study explored the lived experiences and coping strategies of faculty members facing moderate-to-severe DES at a Philippine university. Methods: A descriptive phenomenological approach guided this qualitative inquiry. Nine faculty members were purposively selected based on moderate-to-severe DES scores from a prior university-wide quantitative survey. Semi-structured interviews were conducted, transcribed verbatim, and analyzed using phenomenological analysis following Creswell’s descriptive phenomenological steps, including identification of significant statements, formulation of meaning units, and synthesis of themes describing the essence of the experience. Results: The findings revealed four major themes: digital health and resilience, workstation and environmental ergonomics, work-life integration, and health services, policy supports, and system-level enablers. Participants described the paradox of digital tools that enhance teaching while contributing to physical strain and technostress. Conclusions: This study underscores the urgency for educational institutions to integrate ocular health and ergonomic practices into workplace policies. Targeted interventions, such as regulated screen breaks, eye care programs, and digital wellness education, are essential. The findings contribute to sustainable development goals (SDGs) and advocate for a safer, health-conscious academic environment.
Background:Worldwide, women, particularly younger and middle-aged (≤65 years), are disproportionately affected by stroke. Although the adoption of healthy lifestyle habits is integral for stroke risk factor modification, little is known about younger adult women who had a stroke or are at high risk of stroke-their lifestyle-related knowledge, behaviors, associated and influencing facilitators, and barriers to support brain health, which this study aimed to address. Methods:A qualitative interpretivist design was employed that was part of a larger quality improvement mixed-methods study. Data was collected through virtual, semi-structured focus groups. Inductive thematic analysis was performed and analyzed using the intersectionality framework. Results:A total of 11 women comprised the study sample who were of high stroke risk or had a stroke (mean age 53 years, 54.5 % stroke). A total of six themes emerged from the analysis: (1) lifestyle habits supporting holistic post-stroke recovery, (2) parenting-not being the same mother as before, (3) professional expectations-having to leave career behind and pressures to return, (4) societal expectations of women and permission to self-care, (5) psychological safety and comfort from women-centered interventions, and (6) experience in the healthcare system-not feeling seen, heard, or considered as a woman. Conclusions:Study findings have implications on three levels: 1) micro, through the development of intensive, long-term educational, behavioral, peer-led, group-based and theory-informed interventions that focus on holistic and incremental lifestyle changes and involve family and social support; 2) meso, through the use of practical tools in clinical practice, integration of motivational interviewing and health coaching, and services for children in health care and school systems, and 3) macro, through the incorporation of case management and psychosocial support in the current model of stroke care.
Background:Qualitative healthcare research often involves emotionally charged topics, such as trauma, illness, loss, moral injury, that profoundly affect researchers as well as participants. Yet the personal and emotional experiences of researchers are frequently excluded from formal training, ethical oversight, and methodological discourse. Objective:This commentary explores emotional reflexivity as a core methodological, ethical, and pedagogical dimension of qualitative research in health care. It asserts that researcher emotions are vital sources of insight, ethical awareness, and relational depth, particularly in clinical, psychological, and trauma-informed research settings. Methods:Drawing from feminist standpoint theory, affect theory, and post-qualitative inquiry, this paper synthesizes conceptual literature, cross-disciplinary insights, and a personal fieldwork vignette from qualitative research with Ukrainian military healthcare professionals. Finally, it presents a framework for emotional engagement throughout the research process. Results and key insights:Emotions shape every stage of qualitative research. When unacknowledged, emotions may contribute to researcher distress or burnout. This commentary highlights the need for emotionally responsive training models, research team practices, and IRB protocols that address participant and researcher vulnerability. It also offers pedagogical strategies and draws parallels to emotionally intensive fields such as counseling, chaplaincy, and medicine. Conclusion:Emotionally reflexive practice enhances ethical clarity, deepens qualitative rigor, and promotes long-term sustainability in health research careers. As qualitative inquiry continues to shape healthcare policy, education, and practice, researcher emotional engagement must be reimagined as an ethical and methodological asset.
Organizational causes of burnout among mental health providers (MHPs) are extensively documented in the literature. Additionally, several studies have established a relationship between higher burnout rates and poorer patient care. However, it remains unclear whether worse patient care results from organizational causes of burnout, MHP burnout itself, or a combination of both. Therefore, an in-depth qualitative exploration of MHPs’ experiences with organizational causes of burnout and their perceptions of how these causes may affect patient care was conducted. Fifty-four MHPs (i.e., social workers, psychologists and psychiatrists) across nine Veteran Health Administration (VA) medical centers participated in semi-structured interviews. Content analysis was used to analyze the data. Findings revealed a complex relationship between organizational factors and individual behaviors influenced by burnout, and their potential impact on patient care. MHPs’ acknowledged that their burnout could impact the quality of care provided to Veterans. The behaviors associated with burnout, such as disengagement, lack of empathy, distraction, lack of preparedness, and procrastination, may inadvertently compromise the therapeutic alliance and the overall efficacy of treatment. Findings also indicated that MHP experienced moral distress from the dissonance between the desire to provide high-quality care and the reality of institutional constraints. Additionally, MHP burnout impacted Veterans’ trust and engagement with the VA mental health care system. Therefore, addressing burnout requires a multifaceted approach including organizational reforms, support and resources for MHPs, and dedicated support for MHPs to deliver high quality care. Our findings emphasize the critical need for organizational-level interventions that prioritize clinical care over bureaucratic demands.
Background Uncertainty is pervasive in healthcare and permeates every clinical encounter between patients and medical professionals. Patients with specifically uncertain diagnoses or treatments such as multiple sclerosis (MS) are more likely to respond negatively to a lack of clear information. Research into MS has a narrow focus on scientific issues of uncertainty, such as causal explanations or treatment recommendations. Inquiry into the interplay between various dimensions, contexts, and subjects of uncertainty in a relational practice and institutional context, is scarce.The objective of this research is to investigate the phenomenon of uncertainty as it appears in hospital practice surrounding outpatient care for people with relapsing-remitting multiple sclerosis (RRMS). Methods This study followed a phenomenological research design, inspired by the work of Les Todres on embodied enquiry. Fifteen people with a recent (less than one year) diagnosis of RRMS were included and prospectively shadowed during hospital appointments over the course of two years. Results The phenomenon of uncertainty is captured as occurring in four different spheres: 1) precarious spaces, 2) elusive technology, 3) hidden expectations, and 4) unsure communication. The image of spheres points to their varied and sometimes opposing (sur)faces when rotated around their axis. The spheres can increase or decrease a sense of doubt, confusion, restlessness, or anxiety in both patients and healthcare providers. Conclusion The four different spheres never seem to fully surface, making uncertainty a masked phenomenon. The findings imply a need for an “unveiling” of uncertainty through 1) examining and debating the course of action at the outpatient clinic, 2) reconsidering the promises and perils of technology, and 3) through metacommunication with patients.
Physician assistants play a major role in healthcare delivery in the United States, yet what we know about how patients perceive the care they receive from PAs is limited. Prior research on patients’ impressions of PAs has focused primarily on survey data, limiting the scope of what we can learn about patient impressions to predetermined, quantifiable categories, and has focused on post-visit impressions of a single encounter. In an attempt to better understand patient impressions, we conducted open-ended, semi-structured interviews with 30 participants prior to their medical visit, focusing on general impressions of PAs. Through an analytic process of reflexive thematic analysis, we identified three themes from the interview data: patients are confident in PAs, patients feel valued by PAs, and patients appreciate the openness that PAs create. Through exploration of these themes, we uncovered the ways in which interviewees described PAs as engendering trust and enacting multiple aspects of patient-centered care.
Background:Global stroke incidence has been rising among adults 65 years of age or younger. A dearth of research exists exploring and understanding younger and middle-aged adults' lifestyle-related knowledge and habits along with associated facilitators and/or barriers with the adoption, maintenance, and support needs for development of new brain health interventions, which this study sought to address. Methods:A qualitative study was conducted, followed by virtual, semi-structured focus groups. Data collection and analysis were performed using Goffman's dramaturgical theory to guide the inductive thematic data analysis. Results:A total of 12 participants comprised the sample. Four themes emerged: 1) Front stage: Life 2.0, 2) Back stage: Unseen and invisible challenges, 3) Scripts and audience reaction: Dualism of social influence; and 4) Setting: Standard of care, but to who's standard? Conclusion:Findings contributed to a deeper understanding of factors influencing the adoption of healthy habits and approaches to reconceptualize and re-design brain health interventions that meet the needs, preferences, and priorities of this population.
There is a growing emphasis on involving patients and the public in healthcare research. This is especially true in qualitative healthcare research, where partnerships are encouraged between patients with lived experiences and researchers with academic expertise. The rationale is that collaboration can enhance the study's relevance to healthcare users and improve the research quality. However, establishing partnerships can be complex and challenging, requiring negotiation and alignment of expectations. In a qualitative study exploring communication in clinical encounters at a Danish university hospital, we invited patients and relatives to become involved in research. This commentary discusses the challenges, insights, and adjustments to our research design that emerged from the process. Through continuous dialogues with various patients and relatives, we, as researchers, gained a deeper understanding of how to make our research relevant to patients and relatives and how to approach involving patients and relatives in our research. By emphasizing the significance of these dialogues, we aim to demonstrate how aligning expectations and building partnerships with patients and relatives resulted in valuable learning experiences for the researchers and considerably impacted the study's design. Furthermore, we want to highlight that building partnerships requires time, flexibility, and a mutual learning approach to negotiate and align expectations effectively. In this commentary we first review the practice of involving patients and the public in healthcare research and provide an overview of the study's context. Next, we outline our efforts to negotiate and align expectations with patients and relatives, highlighting how new insights led to adjustments to the research design. Finally, we address challenges and the requirements researchers face when involving patients and the public in research partnerships.
Nail technicians are artists and storytellers. Adapting the arts-based health research (ABHR) methodology of body-map storytelling (Gastaldo et al., 2018) and in partnership with the Parkdale Queen West Community Health Centre, 19 Toronto-based nail technicians of varying levels of expertise visualized their reflections on their work and health on life-sized body-maps. Rather than a harm-centered narrative common to some occupational health work, their embodied and experiential knowledges center joys, strengths, pains, stressors, supports, and hopes. Participants’ narratives highlight multiple layers of emotion—in the framing of their work experiences, in their labor as beauty service workers, and in their body-map creation processes. In addition, body-maps have the potential to evoke empathy in audiences and observers. Nail technicians’ stories extend narratives of health and wellbeing beyond the worksite, as their work conditions and experiences are consequential to other aspects of their lives, such as their social health. As a counter-hegemonic, justice-oriented, and community-generated approach, body-map storytelling and related ABHR approaches can upend knowledge hierarchies, centering the perspectives—and, particularly, emotional knowledges—of nail technicians from racialized, newcomer, and immigrant communities.
Effective strategies to closing the knowledge gap on cervical cancer and pap screening are needed to increase screening rates and create a greater demand for services in Nigeria. Using the PEN-3 Cultural Model, this paper facilitates understanding of cultural influences on women's decision to screen for cervical cancer. The study draws on qualitative interviewing to explore women's experiences with pap testing and to describe how cervical cancer prevention is perceived, communicated, and utilized in the population. Data consisted of interviews generated from a purposeful sample of 63 adult female participants. An iterative approach was used to abductively synthesize data to identify themes. Analyses produced three themes: knowledge and relational motivation, risk and barrier perceptions, and getting the word out. Findings highlight the potential in applying culturally centered approaches to promoting cervical cancer prevention in underserved populations.
Veterinarians are expected to care for animals while managing clients' emotions and dealing with stress, depression, burnout, anxiety, suicidal ideation, and other mental health struggles that accompany their profession. Through an open-ended qualitative survey of 124 alumni of a southeastern U.S. vet school, this study was designed to provide a rich, holistic examination regarding veterinarians' management of emotional labor. The investigation found that although veterinarians felt overwhelmed, frustrated, powerless, and fearful, they were institutionally expected to suppress these feelings, which they did by focusing on logic and facts over emotions and by reframing negatives into positives. The study also showcases how participants, by staying neutral and strong for themselves and clients, engaged in double-faced emotion management, newly applying this concept to veterinary medicine. Participants coped with emotional labor demands by turning backstage, where they sought support, allowed themselves to get emotional, engaged in self-care, and decided to enact tangible changes. Some participants were unable to truly find peace backstage, however, due to an entrenched veterinarian identity, lack of communication skills, or preexisting mental health struggles that made it difficult to disengage from their emotions. This study largely supports the claim that emotional labor may be worsening some vets' preexisting stressors and mental health struggles and recommends that veterinary programs universally incorporate training that targets development of interpersonal communication competence, emotional labor, and wellbeing and their ability to decompress backstage.
Background:The United Kingdom has recruited Filipino nurses since the late 1990s to meet the country's healthcare needs. Currently, over 40,000 Filipinos are working in the National Health Service, and it is suggested that 36 % of all known healthcare worker (HCW) deaths from COVID-19 within the first two-month period (March and April 2020) were Filipinos, despite accounting for 8 % of the NHS nursing workforce. There was a clear disparity in social media exposure between the celebrated heroism of Filipino HCW and the coverage of disproportionate death rates within the Filipino HCW community in the UK. This study aimed to explore the lived experiences of Filipino nurses in the UK during the COVID-19 pandemic. Methods:A qualitative study was conducted using interpretative phenomenological approach (IPA). Six nurses were recruited using purposive and snowball sampling, and interviews were transcribed verbatim and analyzed using IPA. Findings:Drawing on interview data, two themes are presented: inescapability and relentlessness of COVID-19 and "It's sink or swim": psychological welfare. Interpretation:Filipino nurses experienced the COVID-19 pandemic as an all-consuming phenomenon, as they were perceived as the embodiment of threat and placed at disproportionate risk perpetuated by racial, systemic, and political factors. Despite this, they had no choice but to battle through, engaging in culturally specific ways of coping.
Change can be frightening. Or maybe it’s better to say that the thought of change can be frightening. Qualitative Research in Medicine & Healthcare is about to see a major change as it shifts publishers from PAGEPress to KeAi Publishing. This will be the last issue published by PagePress, where it began in 2017 under the leadership of founding editor, Mariaelena Bartesaghi. I became editor in 2021. My time spent with QRMH has easily been the most fulfilling of my 25+ years in academia. I have had the support of an editorial board consisting of dedicated scholars who find the service of working on QRMH as rewarding as I do. And QRMH reviewers are unwaveringly generous, writing detailed, thoughtful reviews that balance fair critique with concrete, encouraging suggestions. [...]
