Reproductive autonomy encompasses one\'s ability to make decisions around contraceptive use, pregnancy, and childbirth. An individual\'s geographic location affects access to a wide range of information and care related to reproductive choice. Individuals in rural areas face additional barriers to reproductive health and decision-making than those in urban areas. This phenomenological qualitative study examined the experiences with and perceptions of reproductive decision-making among women in rural Appalachian communities in the United States. Four themes emerged from the data: autonomy tied to choice, role of religion and church on autonomy and decision-making, navigating limited access to care, and shame. Women should be supported in making reproductive health decisions, and efforts are needed to increase autonomy within reproductive health care and decisions. Sexual health programming within school and other community settings should address shame that often occurs around reproductive health topics, particularly among religious communities.

In this commentary, I consider how geographers narrating speculative futures might risk disempowering their research participants. Reflecting on my work with community cultural organizations, I discuss the importance of centering participants and their geographical imaginations of their own futures in qualitative research projects. I then consider restructuring researcher-participant voice in the narration of speculative futures, and my use of future-focused questioning.

Hypertensive disorders of pregnancy are a leading cause of pregnancy-related morbidity and mortality. The primary objective of this study was to compare the frequency of documentation of postpartum blood pressure through remote blood pressure monitoring with text-message delivered reminders versus office-based follow-up 7-10 days postpartum. The secondary objective was to examine barriers and facilitators of both care strategies from the perspectives of individuals who experienced a hypertensive disorder of pregnancy. We conducted a randomized controlled trial at a tertiary care academic medical center in the southeastern US with 100 postpartum individuals (50 per arm) from 2018 to 2019. Among 100 trial participants, blood pressure follow-up within 7-10 days postpartum was higher albeit not statistically significant between postpartum individuals randomized to the remote assessment intervention versus office-based standard care (absolute risk difference 18.0%, 95% CI -0.1 to 36.1%, p = 0.06). Patient-reported facilitators for remote blood pressure monitoring were maternal convenience, clarity of instructions, and reassurance from the health assessments. These positive aspects occurred alongside barriers, which included constraints due to newborn needs and the realities of daily postpartum life.

BACKGROUND: Neonatal care is complex, involving multiple people and technologies within a community of care. When preterm babies are cared for far from home and/or transferred between units, the whole community of care (and particularly parent participation) is disrupted. Although previous studies have captured subjective experiences of parents, there has been little research exploring the material practices undertaken by parents as a consequence of place-of-care decisions, or the social organisation of those practices.
METHODS: As part of a wider study exploring optimal place-of-care, semistructured interviews were conducted between July 2018 and October 2019 with 48 parents (36 families) with one or more preterm babies (born at 27-31 weeks gestation) cared for in a neonatal unit in the last 12 months.
RESULTS: We highlight parents\' labour-intensive and stressful work to: (1) parent in the neonatal care community (an oversight role that goes beyond contemporary notions of \'involvement\'); (2) create continuity amid place-of-care disruptions; and (3) adapt to the managerial logics of neonatal care settings. Our analysis focuses on the work generated by managerial systems that organise place-of-care decision-making and other efficiency-focused practices. Parents are absorbed into negotiating institutional systems and diverted from routine parenting activities.
CONCLUSIONS: Those involved in the organisation and management of neonatal care should take account of how managerial systems impact parents\' workload, ability to participate in their baby\'s community of care and, ultimately, on the wellbeing and development of babies and their families.
UNASSIGNED: The OPTI-PREM study embedded parents\' experiences of neonatal care into the research, through a discrete workstream that employed qualitative methodology to capture parents\' experiences-as reported in this paper. The OPTI-PREM project was also supported by a Bliss volunteer parent panel, which was involved in designing and overseeing the research. Bliss \'champion[s] the right for every baby born premature or sick to receive the best care by supporting families, campaigning for change and supporting professionals and enabling life-changing research\' (https://www.bliss.org.uk/about-us/about-bliss). A representative of Bliss is a co-author of this manuscript, and a parent representative (named in the Acknowledgements) provided feedback during its preparation.

UNASSIGNED: Chronic pain is a highly prevalent long-term condition, experienced unequally, impacting both the individual living with pain, and wider society. \'Acceptance\' of chronic pain is relevant to improved consultations in pain care, and navigating an approach towards evidence-based, long-term management and associated improvements in health. However, the concept proves difficult to measure, and primary qualitative studies of lived experiences show complexity related to our socio-cultural-political worlds, healthcare experiences, and difficulties with language and meaning. We framed acceptance of chronic pain as socially constructed and aimed to conceptualise the lived experiences of acceptance of chronic pain in adults.
UNASSIGNED: We conducted a systematic search and screening process, followed by qualitative, interpretive, literature synthesis using Meta-ethnography. We included qualitative studies using chronic pain as the primary condition, where the study included an aim to research the acceptance concept. We conducted each stage of the synthesis with co-researchers of differing disciplinary backgrounds, and with lived experiences of chronic pain.
UNASSIGNED: We included 10 qualitative studies from Canada, Sweden, The Netherlands, Ireland, UK, Australia and New Zealand. Our \'lines of argument\' include a fluid and continuous journey with fluctuating states of acceptance; language and meaning of acceptance and chronic pain, a challenge to identity in a capitalist, ableist society and the limits to individualism; a caring, supportive and coherent system. The conceptual framework of the meta-ethnography is represented by a rosebush with interconnected branches, holding both roses and thorns, such is the nature of accepting life with chronic pain.
UNASSIGNED: Our findings broaden conceptualisation of \'acceptance of chronic pain\' beyond an individual factor, to a fluid and continuous journey, interconnected with our socio-cultural-political worlds; an ecosystem.

UNASSIGNED: To describe how Qualitative Meaning Analysis (QMA), based on a lifeworld theoretical approach, can be made accessible to students and researchers not well-versed in the philosophy of science or qualitative research. Additionally, to demonstrate that it is a more rigorous approach than qualitative content analysis in guiding healthcare inquiries.
UNASSIGNED: In recent years, qualitative approaches in nurse education and research have increasingly relied on various content analytical procedures. Liberated from clear philosophical underpinnings, they offer a seemingly pragmatic stance to nursing inquiries. However, by prioritizing \'sorting content\' over the exploration of meaning, there\'s a risk of adopting a mechanistic approach to qualitative analysis. This is problematic because we contend that the search for meaning lies at the heart of qualitative inquiry in nursing and healthcare research, dealing with existential phenomena surrounding health, illness, and care.
UNASSIGNED: This paper explores the search for meaning in health care research, particularly in nursing, and introduces key epistemological aspects. It also discusses practical considerations to further familiarize and encourage the use of QMA in graduate nursing education and research.
UNASSIGNED: Qualitative inquiry with a focus on meaning is a powerful means when the intention is to develop person-centered care, and the relationship between the professionals and patients is in focus. Such an approach has the potential to illuminate existential suffering as well as innate health capacities in patients.

BACKGROUND: Loneliness among nursing home residents is an increasing public health issue and consists of a combination of social, emotional, and existential loneliness. Cycling Without Age (CWA) involves taking nursing home residents on trishaw rides pedaled by trained volunteer \'pilots\'. This study aims to explore nursing home residents\' lived experiences of CWA and whether participation in CWA can mitigate experiences of loneliness.
METHODS: A qualitative phenomenological design was used. We conducted three observations and eight interviews: semi-structured interviews (n = 5) and informal interviews (n = 3) with passengers in CWA. Data were analyzed using reflexive thematic analysis.
RESULTS: Three themes were developed: 1. creating meaningful communities (related to the social mechanism connected to participating in CWA), 2. breaking the monotony of everyday life (related to how the passengers experience CWA as a meaningful activity), and 3. reconnecting to oneself (related to the meaningful experience the passengers have when they are connected to their local communities and reminiscence).
CONCLUSIONS: Taking part in CWA may mitigate loneliness, as passengers perceive it as being meaningful. These results strengthen the notion that participating in meaningful activities hold the potential to mitigate feelings of loneliness among nursing home residents.

OBJECTIVE: Information about social determinants of health (SDOH) is essential for primary care clinicians in the delivery of equitable, comprehensive care, as well as for program planning and resource allocation. SDOH are rarely captured consistently in clinical settings, however. Artificial intelligence (AI) could potentially fill these data gaps, but it needs to be designed collaboratively and thoughtfully. We report on a codesign process with primary care clinicians to understand how an AI tool could be developed, implemented, and used in practice.
METHODS: We conducted semistructured, 50-minute workshops with a large urban family health team in Toronto, Ontario, Canada asking their feedback on a proposed AI-based tool used to derive patient SDOH from electronic health record data. An inductive thematic analysis was used to describe participants\' perspectives regarding the implementation and use of the proposed tool.
RESULTS: Fifteen participants contributed across 4 workshops. Most patient SDOH information was not available or was difficult to find in their electronic health record. Discussions focused on 3 areas related to the implementation and use of an AI tool to derive social data: people, process, and technology. Participants recommended starting with 1 or 2 social determinants (income and housing were suggested as priorities) and emphasized the need for adequate resources, staff, and training materials. They noted many challenges, including how to discuss the use of AI with patients and how to confirm their social needs identified by the AI tool.
CONCLUSIONS: Our codesign experience provides guidance from end users on the appropriate and meaningful design and implementation of an AI-based tool for social data in primary care.

暂无摘要。

UNASSIGNED: To design an educational intervention on sexual dysfunction for patients suffering from schizophrenia and diabetes based on patients\' and other relevant stakeholders\' preferences, and to offer transparency into the basic decision-making process behind a final design.
UNASSIGNED: We conducted a three-part investigation to explore theory, preferences, and feasibility based on literature searches and interviews with patients, healthcare professionals, heads of Assertive Community Treatment Centres and experts. Based on a content analysis of this material, a draft of the intervention was developed. The draft was quality-checked by involvement of stakeholder representatives and refined to its final design.
UNASSIGNED: The intervention evolved into having two components: One intervention for patients and one for healthcare professionals. In patient education, meeting peers and predictability were important factors. For healthcare professionals, daily clinical activities were prioritised.
UNASSIGNED: We present a framework for an educational intervention about sexual dysfunction, schizophrenia and diabetes targeting both patients and healthcare professionals.
UNASSIGNED: The transparency of the design process underlying the interventions allows for reproduction and eases further refinement, extension, and adjustment if implemented in other contexts.