Healthcare choice: Discourses, perceptions, experiences and practices

Policy discourse shaped by neoliberal ideology, with its emphasis on marketisation and competition, has highlighted the importance of choice in the context of healthcare and health systems globally. Yet, evidence about how so-called consumers perceive and experience healthcare choice is in short supply and limited to specific healthcare systems, primarily in the Global North. This special issue aims to explore how choice is perceived and utilised in the context of different systems of healthcare throughout the world, where choice, at least in policy and organisational terms, has been embedded for some time. The articles are divided into those emphasising: embodiment and the meaning of choice; social processes associated with choice; the uncertainties, risks and trust involved in making choices; and issues of access and inequality associated with enacting choice. These sociological studies reveal complexities not always captured in policy discourse and suggest that the commodification of healthcare is particularly problematic

The shifting nature of women’s experiences and perceptions of ductal carcinoma in situ

Aim: This paper is a report of a descriptive qualitative study of the evolution of women’s perceptions and experiences of ductal carcinoma in situ from the period near to diagnosis to one year later. Background: Ductal carcinoma in situ is a non-invasive breast condition where cancer cells are detected but confined to the ducts of the breast. With treatment, the condition has a positive prognosis but ironically patients undergo treatment similar to that for invasive breast cancer. There is a lack of longitudinal qualitative research studying women’s experiences of ductal carcinoma in situ, especially amongst newly diagnosed patients and how experiences change over time. Methods: Forty-five women took part in an initial interview following a diagnosis of ductal carcinoma in situ and twenty-seven took part in a follow-up interview 9-13 months later. Data were collected between January 2007 and October 2008. Transcripts were analysed using a hybrid approach to thematic analysis. Findings: Women’s early perceptions of ductal carcinoma in situ merged and sometimes conflicted with their lay beliefs of breast cancer. Perceptions and experiences of the condition shifted over time. These overriding aspects were evident within four themes identified across the interviews: 1) perceptions of DCIS versus breast cancer, 2) from paradox to acceptance, 3) personal impact, and 4) support and interactions with others. Conclusion: This study represents one of the few longitudinal qualitative studies with newly diagnosed patients, capturing women’s initial and shifting experiences and perceptions of the condition. The issues identified need to be recognised in clinical practice and supported appropriately

The inter-experiential field: Perceptions and metaperceptions in person-centered and experiential psychotherapy

How can we understand the complex nexus of interpersonal relationships from a phenomenological, experiential standpoint? Drawing on theory and research from R. D. Laing's interpersonal phenomenology, social psychology, and Interpersonal Psychotherapy, this paper examines the disjunctions that may arise in people's perceptions of each other, and the highly destructive consequences that such disjunctions can have. It explores the questions of how people perceive, and misperceive, other people's experiences; how people perceive, and misperceive, others' perceptions of their experiences ('metaperceptions'); and the implications that such an analysis has for the practice of person-centered and experiential psychotherapy and counseling

Children and young people’s experiences and perceptions of self-management of type 1 diabetes: A qualitative meta-synthesis

The aim of this review was to conduct a meta-synthesis of the experiences and perceptions of self-management of type 1 diabetes of children and young people living with type 1 diabetes (CYPDs). Six databases were systematically searched for studies with qualitative findings relevant to CYPDs’ (aged 8–18 years) experiences of self-management. A thematic synthesis approach was used to combine articles and identify analytical themes. Forty articles met the inclusion criteria. Two analytical themes important to CYPDs’ experiences and perceptions of self-management were identified: (1) negotiating independence and (2) feeling in control. The synthesis contributes to knowledge on contextual factors underpinning self-management and what facilitates or impedes transition towards autonomous self-management for CYPDs

Young Women's Perceptions and Experiences of Becoming a Research Physicist

The research presented here focuses on young women's (under 30 years of age) views of their future careers in physics research and the barriers and constraints they have already experienced and those they anticipate in the future. This research is timely because of girls' increasing success in educational achievement throughout school and university levels. Our initial survey of female members of the Institute of Physics showed that only 15% of young women under 30 said they encountered barriers in their careers compared to 45% of women over 30 years. However the young women described situations that clearly were barriers and were gender related, but they didn–t recognize them as such. The initial survey detected a drift away from research careers in the over 30s and so this research sought explanations for this by examining the younger women's perceptions of future careers

Physiotherapy students\u27 perceptions and experiences of clinical prediction rules

Objectives: Clinical reasoning can be difficult to teach to pre-professional physiotherapy students due to their lack of clinical experience. It may be that tools such as clinical prediction rules (CPRs) could aid the process, but there has been little investigation into their use in physiotherapy clinical education. This study aimed to determine the perceptions and experiences of physiotherapy students regarding CPRs, and whether they are learning about CPRs on clinical placement. Design: Cross-sectional survey using a paper-based questionnaire. Participants: Final year pre-professional physiotherapy students (n=371, response rate 77%) from five universities across five states of Australia. Results: Sixty percent of respondents had not heard of CPRs, and a further 19% had not clinically used CPRs. Only 21% reported using CPRs, and of these nearly three-quarters were rarely, if ever, learning about CPRs in the clinical setting. However most of those who used CPRs (78%) believed CPRs assisted in the development of clinical reasoning skills and none (0%) was opposed to the teaching of CPRs to students. The CPRs most commonly recognised and used by students were those for determining the need for an X-ray following injuries to the ankle and foot (67%), and for identifying deep venous thrombosis (63%). Conclusions: The large majority of students in this sample knew little, if anything, about CPRs and few had learned about, experienced or practiced them on clinical placement. However, students who were aware of CPRs found them helpful for their clinical reasoning and were in favour of learning more about them

Interpersonal perceptions of adverse peer experiences in first-grade students

Aim: The aim of this study was to identify which adverse peer experiences better predict perceived negative peer relationships among elementary school first graders according to sex. The peer experiences examined were peer rejection, peer victimization, and mutual antipathy; the interpersonal perceptions studied were perceived peer victimization, dyadic meta-perception of peer disliking, and loneliness. Methods: The participants were 809 children (Mage = 6.4 years, SD = 0.32; ngirls = 412, 50.9%) enrolled in 35 first-grade classes from 15 schools in 4 Spanish regions: Valencia, n = 276, 34.1%; Balearic Islands, n = 140, 17.3%; Andalusia, n = 199, 24.6%; Castile-Leon, n = 194, 24%. We calculated sex differences in peer experiences and interpersonal perceptions by means of one-way ANOVA for means differences and Fisher’s r-to-z transformation for correlations differences. We used a multilevel regression analysis (nesting variables: class and region) to determine whether the associations between each peer experiences and each perception were unique. Results: Each adverse peer relationship predicted each interpersonal perception differentially. Peer victimization was a good predictor of the three interpersonal perceptions, and the only predictor of perceived peer victimization. Peer rejection predicted loneliness, whereas mutual antipathies predicted dyadic meta-perception of peer disliking, although more so among girls. A significant effect at region level was found but not at class level. Conclusion: Our findings suggest that research should take into account the different levels of the social peer system when analyzing peer experiences within the classroom context. The study contributes to sensitize teachers about the greater responsiveness of 6-year-old girls to adverse peer experiences, and it could be useful for designing interventions that would help children oppose rejection and empower active bystanders to fight against peer mistreatment.Ministerio de Economía y Competitividad de España EDU2012-35930Universitat Jaume I P1-1A2012-0

"This isn't the road I want to go down" Young people's perceptions and experiences of secure care

The consultation sought to map young people's secure journey ie. their experiences and views of secure care from admission through to final discharge, including the transition from secure care and the services they received to assist them in that transition. It centred on four broad themes intended to elicit young people's individual experiences and perceptions regarding: admission to secure care, time in secure care, exit from secure care, and reflections once left secure care