MAPS OF MARGINALIZATION: EXPLORING THE HEALTHCARE EXPERIENCES OF MEN AND WOMEN WITH FIBROMYALGIA

This qualitative study explored the retrospective and ongoing healthcare experiences of men and women who have a diagnosis of fibromyalgia (FM), a contested, chronic, and gendered condition of unknown origin. The research question was: How do men and women who have a diagnosis of FM experience interactions with healthcare providers? The study, which was epistemologically rooted in the critical theories of feminist poststructuralism and intersectionality, blended constructivist grounded theory with a participatory component, an arts-based research methodology called body-map storytelling. Thirty-five participants were recruited from the Greater Toronto Area and Kitchener-Waterloo. Ten participants completed in-depth interviews while 25 participants completed body maps within a series of focus group sessions. Through analysis of the verbal and visual data, four key findings emerged. First, participants experienced compromised healthcare due to structural barriers and unsupportive attitudes of healthcare providers. Second, participants’ experiences of compromised healthcare were impacted by systems of embodied differences. Third, participants resisted the system of compromised healthcare through strategies of self-management. Finally, participants described their experiences of helpful clinical practices, as well as their suggestions for improving FM healthcare services. The study contributes crucial information for the transformation of healthcare policies, programs and clinical practices for the FM population. As a form of applied research, the study has also helped give voice to and empower a marginalized population

Practice-based Qualitative Research: Participant Experiences of Walk-in Counselling and Traditional Counselling

Walk-in single session counselling is becoming a more widely used model for delivering mental health services across Ontario. This paper reports findings from the qualitative phase of a mixed method study, exploring the experiences of those attending walk-in counselling (WIC) model compared to the traditional service delivery model employing a wait list. We used a comparative case study design for the qualitative phase. Findings reveal that participant outcomes of the walk-in counselling model is influenced by accessibility, how a participant makes sense of the service, and the degree to which a participant is motivated and able to engage in counselling. WIC supports the mental health system by reducing wait lists associated with traditional service delivery models, and meeting the needs many people identify for immediate consultation. Other participants still perceive themselves as requiring ongoing counselling over time and involving in-depth exploration. This research supports health systems providing access to both models