Estigma en mujeres de peso alto a través de un análisis fenomenológico interpretativo

Tener peso alto es una característica que ha sido devaluada y denigrada socialmente, convirtiendo a las personas de cuerpos grandes en víctimas de estereotipos, prejuicios y discriminación, lo que se ha denominado estigmatización por el peso, fenómeno que ocurre especialmente en mujeres. El objetivo de este estudio fue describir las experiencias de estigma de peso de mujeres con obesidad que viven en el sur de Chile. Participaron seis mujeres entre 20 y 57 años a través de entrevistas semi-estructuradas realizadas de manera remota. Mediante Análisis Fenomenológico Interpretativo se identificaron cuatro supratemas y diversos subtemas, los supratemas son: 1. La obesidad como parte de la persona. 2. Las experiencias de sentirse discriminada. 3. Todo gira en función del peso. 4. Lo que la sociedad piensa de la obesidad, los que en su conjunto permiten caracterizar la experiencia de vivir con obesidad y sufrir el estigma asociado al peso en distintos ámbitos de sus vidas, incluso en contextos sanitarios. Las consecuencias de esta experiencia son diversas y negativas, destacando el impacto que tiene en su autoestima y las constantes emociones negativas que derivan de las situaciones de discriminación. Estos resultados ponen de manifiesto la importancia de avanzar hacia la diversidad y aceptación corporal, lo que supone un desafío a la sociedad en general y en particular a los proveedores de salud, ya que se requiere de intervenciones libres de prejuicios y orientadas a la salud y el bienestar de las personas.

Carrying a high weight is a characteristic that has been devalued and socially denigrated, turning people with large bodies into victims of stereotypes, prejudice, or discrimination, which has been called weight stigmatisation, a phenomenon that occurs especially in women. The aim of this study was to describe the weight stigma experiences of women with obesity who live in southern Chile. Six women between 20 and 57 years of age participated in semi-structured interviews conducted remotely. Through Interpretative Phenomenological Analysis four supra-themes and several sub-themes were identified, the supra-themes are: 1. Obesity as part of the person. 2. Experiences of feeling discriminated. 3. Everything is about weight. 4. what society thinks of obesity, which together allow characterising the experience of living with obesity and suffering the weight stigma in different areas of their lives, including in health contexts. The consequences of this experience are diverse and negative, highlighting the impact it has on their self-esteem and the constant negative emotions that derive from discrimination situations. These results highlight the importance of moving toward body diversity and acceptance, which is a challenge for society in general and health care providers in particular, as it requires interventions free from prejudice and orientated to the health and well-being of individuals.

An interpretive phenomenological analysis of hope in cancer patients: A qualitative study

Background: In positive psychology, increased recognition of the phenomenon of hope among people suffering from cancer, along with alleviating their negative mental states like anxiety, depression, and fear of death is evident and promising. The aim of the study was to explore the lived experience of hope in cancer patients. Materials: Qualitative phenomenological research approach was used. A semi-structured in-depth interview with open-ended questions was administered to explore the patient抯 hope related experiences during the journey of cancer. A purposive sampling technique was used to select a total of 10 participants for the study. The size of the sample was decided on the basis of literature for the interpretive phenomenological study. Results: Results revealed five major common themes related to hope during illness: (1) survival expectation; (2) will to live; (3) prognostic clarification; (4) positivity of health providers; and (5) recovery of other patients: A source of hopefulness. Conclusion: The lived experiences of cancer patients shows that hope is the positive expectation of survival, which is a source of motivation during their journey of illness. It also denotes goal setting behaviour. Thus, hope is the 搘ill to live� which is related to social support, positive communication with healthcare providers, and recovery of fellow patients.

Qualitative research on digital cognitive behavioral therapy for insomnia in patients with insomnia combined with depressive and/or anxious symptoms / 中华行为医学与脑科学杂志

Objective:To investigate the physical and mental experience, treatment compliance and use barriers of patients with insomnia in using digital cognitive behavioral therapy for insomnia (dCBT-I) in order to provide qualitative evidence for the development and application optimization of the dCBT-I technology paradigm.Methods:From July to November 2021, a semi-structured interview outline was used to conduct in-depth interviews with the dCBT-I users ( n=10) to record their original feelings about the use of dCBT-I. Interpretative phenomenology's text analysis was used to explore the participants' experience and cognition of dCBT-I. Results:Text analysis and key information calibration were carried out on the verbatim transcripts of semi-structured interview recordings, and three core themes were extracted, namely stickiness factor, use barrier and optimization direction, as well as eight sub-themes, namely professionalism, accessibility, benefit experience, difficulty in task execution, instruction generalization, difficulty in software operation, enrich treatment content and personalized guidance.Conclusion:The present study showed that participants were receptive to the dCBT-I intervention and would be benefited from it.However, dCBT-I still needs to be optimized and improved to reduce the operating difficulty and explore more appropriate timing of manual intervention.

Experiences of caregivers of boys with Duchenne Muscular Dystrophy: "When I look at him, my world falls apart" / Experiencias de cuidadoras de niños con Distrofia Muscular de Duchenne: "Cuando lo volteo a mirar, se me une el cielo con la tierra"

Resumen La Distrofia Muscular de Duchenne (DMD) es una enfermedad neuromuscular, clasificada como una enfermedad huérfana o rara, transmitida por la madre, y que conlleva al deterioro físico progresivo y fatal de quienes la desarrollan, que en su mayoría son hombres. Aun con los tratamientos farmacológicos disponibles, el pronóstico de vida de los pacientes sigue siendo desalentador. Los niños van perdiendo progresivamente la movilidad y funcionalidad hasta que fallecen. En consecuencia, el progreso de esta enfermedad requiere de cuidados frecuentes o permanentes que implican altos niveles de exigencia para las cuidadoras de niños y de jóvenes que han desarrollado la DMD. El apoyo proveniente del sistema de salud es escaso para ambos, lo que se traduce en una intensa sobrecarga para las madres y mujeres de la familia que son quienes, habitualmente, cuidan a la persona diagnosticada con DMD durante su vida. Este estudio cualitativo de tipo fenomenológico tuvo como objetivos analizar el significado de la experiencia de ser cuidadora de niños y jóvenes que viven con DMD en Colombia, develando el sentido que tiene para las mujeres familiares asumir el rol de cuidadora. Se entrevistaron siete mujeres entre los 25 y los 64 años encargadas de cuidar, por lo menos, a un niño o joven con diagnóstico de DMD, previo consentimiento informado. Adicionalmente, los cuidadores desarrollaron un ejercicio de asociaciones libres. Para el análisis de datos se realizó un análisis temático de las narrativas, encontrando tres temas fundamentales alrededor de los cuales se le da sentido a esta experiencia: (1) descubrir la enfermedad, (2) vivir en función del paciente y (3) reconstruir el sentido de vida. Así, en un momento inicial las cuidadoras se enfrentan al diagnóstico de la enfermedad brindado por los médicos, quienes les explican su curso y su naturaleza. La cuidadora inicia un proceso de duelo, en el que la tristeza, la negación y la resignación tienen lugar, y emociones como la frustración y la impotencia se presentan en su máxima expresión. La manera en la que es comunicado el diagnóstico es evaluada por las cuidadoras como poco sensible. De hecho, ninguna de las participantes en el estudio recibió apoyo psicológico durante el proceso. En segundo lugar, ser la figura de cuidado implicó cambios a nivel personal, familiar y social, para lograr responder a las necesidades de los niños con DMD. En este sentido, algunas debieron renunciar a sus empleos, alejarse de amistades e incluso algunas manifestaron que se han separado de su pareja o han vivido experiencias de deterioro en las relaciones con su pareja y familia extensa. Además, junto con sus hijos han vivenciado experiencias de discriminación, vulneración de derechos y escaso apoyo social, experiencias que son factores de riesgo para la salud mental. Finalmente, la enfermedad termina por constituirse en el elemento vinculante entre ellas y sus niños. Los hallazgos de la presente investigación permiten identificar que, en el proceso de enfermedad, se produce una reconstrucción del sentido de vida. Así, las estrategias de afrontamiento se dirigen a lograr una transformación espiritual. La presencia de la enfermedad es interpretada como una manera de ser probadas y desarrollar sus cualidades como mujer y como madre. Entonces, el cuidado y la relación madre-hijo, son componentes motivacionales que transforman y dan sentido a la vida. En conclusión, los resultados muestran que el significado de la DMD está fuertemente vinculado a un proceso de intenso sufrimiento y estrés psicológico, con alta carga negativa. En particular, durante los primeros años después del diagnóstico, que debe ser asimilado y elaborado para aprender a convivir con la DMD y la certeza de la muerte prematura de un hijo.

Abstract Duchenne muscular dystrophy (DMD) is a neuromuscular disease that leads to progressive and fatal physical deterioration. The progression of this disease requires frequent or permanent care that implies high levels of demand for the caregivers of children who have developed DMD. Certainly, this disease affects diagnosed children and their caregivers as well. The support from the health system is scarce for both, which translates into an intense burden for the mothers and women of the family who care the person diagnosed with DMD during their lifetime. This qualitative study with phenomenological approach aimed to analyze the meaning of the experience of being a caregiver for boys and young men living with DMD in Colombia. After obtaining their informed consent, caregivers were interviewed and a thematic analysis of their narratives was performed to determine three key topics that endow their experiences with meaning: (1) finding out about the disease, (2) living according to the needs of boys and young men, and (3) providing a new meaning to life. The results show that the meaning of DMD is strongly associated with intense suffering and psychological stress, with a high negative burden, especially during the initial years after diagnosis. The study suggests that it is important to assimilate and process these experiences and findings to learn how to live with DMD and identify the certainty of a child's premature death.

Exploration of the Factors in Treatment Adherence to Coronary Heart Diseases Diagnosis Among the Multi-Ethnic Patients: A Qualitative Study

Abstract@#Introduction: Introduction: Coronary heart disease (CHD) is the leading cause of death in Malaysia. This study aims to explore the treatment experiences of patients with recurrent coronary heart disease during hospital admission and after discharge. This research also attempts to understand patients’ adherence to the prescribed treatment. Method: The main sample for this study includes inpatients and outpatients with recurrent CHD who have undergone secondary prevention treatment at certain tertiary hospitals which were purposively sampled. The transcripts of one-to-one semi-structured interviews (N=22) were analyzed using the Interpretative Phenomenological Analysis (IPA). Results: Three themes emerged in the analysis of treatment adherence among multi-ethnic patients with CHD: (i) doctor-patient relationships; (ii) information-seeking behaviour; and (iii) psychosocial beliefs. Other factors that influence treatment adherence include patients’ cultural, religious, or spiritual beliefs-based complementary alternative medicines (CAM), if these factors were inadequately addressed by their respective heath professional. Conclusion: The results demonstrate that for future cardiac rehabilitation program development, health professionals must not only focus on the patient’s care improvement but must also be knowledgeable on the patient’s preferred alternative treatment.

Phenomenological Analysis of Barrier Factors Affecting Nutrition Education Jobs of Nutrition Teachers

The purpose of this study was to understand barrier factors affecting nutrition education jobs and determining priorities according to frequency of occurrence of obstacles. Focus group interview (FGI) was conducted on 11 nutrition teachers, and the result are summarized by the phenomenological analysis method. The barriers of nutrition education consisted of three categories, seven themes, and 10 sub-themes. The three categories were divided into work burden, recognition of nutrition education, and limitations of the nutrition education environment. Recognition of nutrition education was further divided into internal recognition from nutrition teachers and individual and external recognition from students and staff. The results showed that the most frequent barrier experienced by nutrition teachers in the work burden category was heavy work loads of foodservice management, followed by irrational working environment. In addition, limitations of the nutrition education environment consisted of absence of standard curriculum and textbooks, inadequate education infrastructure, and inadequate class time. To improve this, it is necessary to reduce nutrition teacher's food service management and develop standard curriculum and educational materials for nutrition education.

O caso de August Strindberg: (re)visitando a patografia de Jaspers e a análise fenomenológica de Binswanger / The case of August Strindberg: (re)visiting Jaspers’ pathography and Binswanger’s phenomenological analysis / El caso de August Strindberg: (re)visitando la patografía de Jaspers y el análisis fenomenológico de Binswanger

August Strindberg (1849-1912), famoso escritor sueco, deixou como legado dezenas de obras que, além da qualidade literária, forneceram um retrato fiel de sua doença mental. Tais descrições chamaram atenção de diversos psiquiatras, principalmente no que tange à relação entre a psicose e a criação estética. Neste artigo, revisitamos a patografia de Strindberg, apresentada por Jaspers, e a análise fenomenológica, realizada por Binswanger, apresentando suas principais características e como esse caso ilustra as diferentes concepções desses autores. Jaspers se interessava pelos escritos autobiográficos de Strindberg por se tratar de um exemplo daquilo que apresenta acerca da inacessibilidade a uma compreensão psicológica da psicose e da compreensão processual do adoecimento. Binswanger, retornando à fenomenológica genética, realiza a análise da experiência delirante de Strindberg a partir de questões egológicas e corporais. Para Jaspers, o mundo pré-mórbido de Strindberg diferenciava-se de seu mundo delirante posterior. Já Binswanger identifica, primariamente, o anúncio do que viria a ser o delírio de Strinberg. São percursos distintos que, para além da distinção, refletem marcas da utilização inicial de uma lente fenomenológica por Jaspers que se efetivam posteriormente através de autores da psicopatologia fenomenológica, como o próprio Binswanger.

August Strindberg (1849-1912), famous Swedish writer, left a legacy of dozens of works, which, besides literary quality, produced a faithful portrait of his mental disease. Such descriptions have drawn the attention of diverse psychiatrists, especially when it comes to the relation between psychosis and esthetic creation. In this article, we have revisited Strindberg’s pathology, presented by Jaspers, and phenomenological analysis, realized by Binswanger, presenting its main characteristics and how this case illustrates the different conceptions by these authors. Jaspers was interested in the autobiographical writings of Strindberg because it consisted of an example of what is presented concerning the inaccessibility to a psychological understanding of psychosis and of the process involved in falling sick. Binswanger, returning to genetic phenomenology, realizes Strindberg’s delirious experience from egological and bodily issues. To Jaspers, Strindberg’s pre-morbid world was different from his posterior delirious world. Binswanger, on the other hand, primarily identifies the announcement of what came to be Strindberg’s delirium. These are distinct trajectories that, beyond distinction, reflect marks of the initial employment of a phenomenological lens by Jaspers which become effective later on by means of Phenomenological Psychopathology authors, such as Binswanger.

August Strindberg (1849-1912), afamado escritor sueco, dejó como legado decenas de obras que, además de la cualidad literaria, encajaron un retrato fiel de su enfermedad mental. Tales descripciones llamaron la atención de varios psiquiatras. En esto artículo revisitamos la patografía de Strindberg, presentada por Jaspers, y el análisis fenomenológico, realizada por Binswanger, presentando sus principales características y como este caso ilustra las diferentes concepciones psicológicas de estos autores. Jaspers se interesaba por los escritos autobiográficos de Strindberg por ser un ejemplo de lo que se presenta sobre la inaccesibilidad a una comprensión psicológica de la psicosis y de la comprensión del proceso de la enfermedad. Binswanger, de volta a la fenomenología genética, realiza el análisis de la experiencia de delirio de Strindberg empezadas en cuestiones egologicas y corporales. Para Jaspers, el mundo pre-mórbido de Strindberg se diferenciaba de su mundo delirante posterior. Ya Binswanger identificaba primariamente el prenuncio de lo que iba a ser el delirio de Strinberg. Son caminos distintos que, además de la distinción, reflejen marcas de la utilización inicial de una lente fenomenológica por Jaspers que se efectiva posteriormente por medio de la Psicopatología Fenomenológica, como el propio Binswanger.

Atuação do psicólogo no CRAS: uma análise fenomenológico-empírica / Actuación del psicólogo en el CRAS: un analisis fenomenológico-empirico / Psychology practice in the CRAS: a phenomenological empirical analysis

O Sistema Único de Assistência Social (SUAS) foi implantado no Brasil mediante a necessidade de atender as famílias que vivem em situação de vulnerabilidade social, tendo no nível básico o Centro de Referência de Assistência Social (CRAS). Esse trabalho, desenvolvido a partir da pesquisa de iniciação cientifica (2012-2013), visa identificar a atuação do psicólogo no CRAS da cidade de Uberlândia/MG. A partir do método fenomenológico empírico de Amedeo Giorgi foram realizadas entrevistas com as psicólogas dos CRAS, cuja finalidade foi identificar os significados dessa atuação. O método fenomenológico empírico utilizado divide-se em quatro passos: 1) estabelecer o sentido geral; 2) determinação das unidades de significado; 3) transformação das unidades de significado em expressões de caráter psicológico; 4) determinação da estrutura geral de significados psicológicos. A partir da obtenção dos relatos de experiência encontraram-se os aspectos comuns em todas as entrevistas: todas as colaboradoras apreciam trabalhar no CRAS; percebem que o trabalho tem limitações e dificuldades; descrevem a rotina de trabalho dando ênfase na visita domiciliar; identificam as suas atuações como atendimento individual, psicossocial e em grupo; têm consciência que não é possível realizar atendimentos psicoterapêuticos; identificam o atendimento psicológico como psicossocial; percebem que o trabalho em grupo apresenta muitas dificuldades; e por fim, sentem a necessidade de uma sistematização do trabalho.

The Social Assistance System (ITS) was implemented in Brazil by the need to meet the families living in social vulnerability situation, having at the basic level the Centre of reference of Social Assistance (CRAS). This work, developed from the research of scientific initiation (2012-2013) aims to identify the role of the psychologist at CRAS city of Uberlândia/MG. From the empirical phenomenological method of Amedeo Giorgi were carried out interviews with the psychologists of the CRAS, whose purpose was to identify the meanings of this Act. The empirical phenomenological method used is divided into four steps: 1) establish the general sense; 2) determination of units of meaning; 3) transformation of units of meaning in expressions of psychological character; 4) determination of the general structure of psychological meanings. From the obtaining of reports from experience met the commonality in all the interviews: all employees enjoy working in the CRAS; realize that the work has limitations and difficulties; describe the daily routine of work giving emphasis on home visit; identify your performances as individual assistance, psychosocial and group; are you aware that you cannot perform psychotherapy sessions; identify the psychological care and psychosocial; realize that the group work presents many difficulties; and finally, feel the need for a systematization of labor.

El Sistema Único de Asistencia Social (SUAS) fue implantado en Brasil por la necesidad de atender a las familias que viven en situaciones de vulnerabilidad social, teniendo en el nivel básico el Centro de Referencia de Asistencia Social (CRAS). Ese trabajo intenta identificar la actuación del psicólogo en el CRAS de la ciudad de Uberlândia/MG. Partiendo del método fenomenológico empírico de Amedeo Giorgi fueran hechas entrevistas com as psicólogos de los CRAS, cuya intención fue identificar los significados de la actuación. El método fenomenológico empírico usando está dividido en cuatro etapas: 1) establecer el sentido general; 2) determinación de las unidades de significado; 3) trasformación de las unidades de significado en expresiones de carácter psicológico; 4) determinación de la estructura general de significados psicológicos. Partiendo de la obtención de los relatos de experiencia se encuentran los aspectos comunes en todas las entrevistas: todas las colaboradoras aprecian trabajar en el CRAS; perciben que el trabajo tiene límites y dificultades; describen la rutina de trabajo y ponen énfasis en la visita domiciliar; apuntan sus actuaciones como atendimiento individual, psicosocial y en grupo; tiene consciencia que no es posible realizar atendimientos psicoterapéuticos; apuntan el atendimiento psicológico como psicosocial; perciben que el trabajo en grupo presenta muchas dificultades; y por último, sienten como necesidad una sistematización del trabajo.

Family and love as the ontological foci of the kalinga (caring) ethic in the Filipino worldview

This paper is part of a larger study by the same author entitled Kalinga (Caring): The Lived Experience of Filipino Cancer Survivors (Sasa, 2012), which utilized interpretative phenomenologic analysis (IPA) to capture the essence of the Filipino's epistemologic and ontologic concepts of care. Eight (8) Filipino cancer survivors were interviewed regarding their experiences about giving and receiving care. Their narratives were encoded, introspected and analyzed utilizing Interpretative Phenomenological Analysis (IPA) to arrive at an understanding of what caring means and how caring is conveyed. As a result of the study, a Filipino caring model was developed and was dubbed as the Kalinga model (Sasa, 2012). At the core of the model are family and love, which are the overwhelmingly dominating themes in the study based on the length and depth of narratives of the co-participants. This paper expounds on the inextricability of the concepts of family and love in the Kalinga (caring) ethic. Family and love as ontological foci of caring is in harmony with extant literature, and new insights on the same were explicated.