Why Health and Social Care Support for People with Long-Term Conditions Should be Oriented Towards Enabling Them to Live Well

This research was funded by The Health Foundation (a charity working to improve the quality of healthcare in the UK) via (a) a commission on conceptualising collaborative care, (b) an Open Insight initiative project on re-conceptualising support for self-management (reference 7209), and (c) a contribution towards salary funding for Alan Cribb. At the University of Aberdeen, Vikki Entwistle works within the Health Services Research Unit, which is core funded by the Chief Scientist Office of the Scottish Government’s Health and Social Care Directorates. Health Foundation and Scottish Government staff are among those who have participated in knowledge exchange events related to the two projects. The views expressed in the paper are those of the authors and are not necessarily shared by funders or workshop participants. The authors accept full responsibility for this paper. Open access via Springer Compact AgreementPeer reviewedPublisher PD

Chapter 22 FEMINIST BIOETHICS AND EMPIRICAL RESEARCH

The Routledge Handbook of Feminist Bioethics is an outstanding resource for anyone with an interest in feminist bioethics, with chapters covering topics from justice and power to the climate crisis. Comprising forty-two chapters by emerging and established scholars, the volume is divided into six parts: I Foundations of feminist bioethics II Identity and identifications III Science, technology and research IV Health and social care V Reproduction and making families VI Widening the scope of feminist bioethics The volume is essential reading for anyone with an interest in bioethics or feminist philosophy, and will prove an invaluable resource for scholars, teachers and advanced students

Empirical relationships between health literacy and treatment decision making : A scoping review of the literature

Copyright © 2014 Elsevier Ireland Ltd. All rights reserved. Acknowledgements This research was supported by a Joseph Armand Bombardier Doctoral Scholarship awarded to Leslie J. Malloy-Weir by the Social Sciences and Humanities Research Council of Canada. The authors would like to thank Maureen Rice for her help with the literature search strategy and Dr. Malcolm Weir for his help with the relevance screening.Peer reviewedPostprin

Primary goals, information-giving and men\u27s understanding: A qualitative study of Australian and UK doctors\u27 varied communication about PSA screening

Objectives: (1) To characterise variation in general practitioners’ (GPs’) accounts of communicating with men about prostate cancer screening using the prostate-specific antigen (PSA) test, (2) to characterise GPs’ reasons for communicating as they do and (3) to explain why and under what conditions GP communication approaches vary. Study design and setting: A grounded theory study. We interviewed 69 GPs consulting in primary care practices in Australia (n=40) and the UK (n=29). Results: GPs explained their communication practices in relation to their primary goals. In Australia, three different communication goals were reported: to encourage asymptomatic men to either have a PSA test, or not test, or alternatively, to support men to make their own decision. As well as having different primary goals, GPs aimed to provide different information (from comprehensive to strongly filtered) and to support men to develop different kinds of understanding, from population-level to ‘gist’ understanding. Taking into account these three dimensions (goals, information, understanding) and building on Entwistle et al’s Consider an Offer framework, we derived four overarching approaches to communication: Be screened, Do not be screened, Analyse and choose, and As you wish. We also describe ways in which situational and relational factors influenced GPs’ preferred communication approach. Conclusion: GPs’ reported approach to communicating about prostate cancer screening varies according to three dimensions—their primary goal, information provision preference and understanding sought—and in response to specific practice situations. If GP communication about PSA screening is to become more standardized in Australia, it is likely that each of these dimensions will require attention in policy and practice support interventions

Ethical Justifications for Access to Unapproved Medical Interventions : An Argument for (Limited) Patient Obligations

Peer reviewedPostprin

Risk, Overdiagnosis and Ethical Justifications

Wendy Rogers was supported by Future Fellowship (FT130100346) from the Australian Research Council and a 2018 Residency from the Brocher Foundation. Stacy Carter was supported by National Health and Medical Research Council Centre for Research Excellence 1104136 and a 2018 Residence from the Brocher Foundation. This study was funded by FT130100346 from the Australian Research Council (Rogers) and CRE 1104136 from the National Health and Medical Research Council (Carter), and Rogers and Carter both received support in the form of a 2018 month-long residency at the Brocher Foundation, Switzerland.Peer reviewedPublisher PD

The ethical and epistemic roles of narrative in person-centred healthcare

Acknowledgements The first author was supported by the Australian Research Council (CE140100012). The third author was part supported by the Wellcome Trust (209811). Our thanks to participants at the European Society for Philosophy of Medicine and Health Care 32nd annual conference for comments and questions on an earlier version of some of the paperPeer reviewedPostprin

Vaginal birth after caesarean section : why is uptake so low? Insights from a meta-ethnographic synthesis of women’s accounts of their birth choices

Funding MB is a research training fellow funded by The Wellcome Trust.Peer reviewedPublisher PD

Revisiting the equity debate in COVID-19 : ICU is no panacea

Copyright information No commercial re-use. See rights and permissions. Published by BMJ. This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained. https://bmj.com/coronavirus/usagePeer reviewedPostprin

How the stigma of low literacy can impair patient-professional spoken interactions and affect health: Insights from a qualitative investigation

BackgroundLow literacy is a significant problem across the developed world. A considerable body of research has reported associations between low literacy and less appropriate access to healthcare services, lower likelihood of self-managing health conditions well, and poorer health outcomes. There is a need to explore the previously neglected perspectives of people with low literacy to help explain how low literacy can lead to poor health, and to consider how to improve the ability of health services to meet their needs.MethodsTwo stage qualitative study. In-depth individual interviews followed by focus groups to confirm analysis and develop suggestions for service improvements. A purposive sample of 29 adults with English as their first language who had sought help with literacy was recruited from an Adult Learning Centre in the UK.ResultsOver and above the well-documented difficulties that people with low literacy can have with the written information and complex explanations and instructions they encounter as they use health services, the stigma of low literacy had significant negative implications for participants’ spoken interactions with healthcare professionals.Participants described various difficulties in consultations, some of which had impacted negatively on their broader healthcare experiences and abilities to self-manage health conditions. Some communication difficulties were apparently perpetuated or exacerbated because participants limited their conversational engagement and used a variety of strategies to cover up their low literacy that could send misleading signals to health professionals.Participants’ biographical narratives revealed that the ways in which they managed their low literacy in healthcare settings, as in other social contexts, stemmed from highly negative experiences with literacy-related stigma, usually from their schooldays onwards. They also suggest that literacy-related stigma can significantly undermine mental wellbeing by prompting self-exclusion from social participation and generating a persistent anxiety about revealing literacy difficulties.ConclusionLow-literacy-related stigma can seriously impair people’s spoken interactions with health professionals and their potential to benefit from health services. As policies increasingly emphasise the need for patients’ participation, services need to simplify the literacy requirements of service use and health professionals need to offer non-judgemental (universal) literacy-sensitive support to promote positive healthcare experiences and outcomes