Penetrating the dark silence

The Subjective Experience of Using Medications: What We Know and the Paths Forward

Medications can cause bodily changes, where the associated benefits and risks are carefully assessed based on the changes experienced in the phenomenal body. For this reason, the phenomenology of Merleau-Ponty is an important theoretical framework for the study of experience related to the daily use of medications. The aim of this study was to discuss the contribution of a recently developed framework of the general ways people can experience the daily use of medications—resolution, adversity, ambiguity, and irrelevance—and present reflections about the little-understood aspects of this experience. However, some issues raised throughout this article remain open and invite us to further exploration, such as (1) the coexistence of multiple ways of experiencing the use of medications, by the same individual, in a given historical time; (2) the cyclical structure of this experience; (3) the impact of habit and routine on the ways of experiencing the daily use of medications; and (4) the contribution of the concept of existential feelings to this experience and its impact on patients’ decision-making. Therefore, the experience with the daily use of medications is a complex and multifaceted phenomenon that directs the decision-making process of patients, impacting health outcomes.

[Narrative as a strategy for understanding the experience of chronic illness: a literature review]

This article aims to explore, in available literature, the use of narrative in studies of chronic illness. It is hoped that this study in addition to knowing how to have been the use of narrative in studies, contribute to the care of people with chronic illness. Methodologically, the study consists of a literature review of qualitative nature, focusing on articles with the Virtual Health Library descriptors (VHL). In terms of results, three stand out meanings attributed to the use of narrative by the authors: technique to get testimonies, research method and specific type of testimony; and in terms of the main results attributed by the authors with the use of narrative, are evident two themes: the experience of chronic illness in the subject ill perspective, highlighting the search for meaning, reframing the chronicity and coping strategies; and the possibility of understanding chronic illness, by professionals from the experience of the subject ill. It is verified, in the analyzed studies, that the use of the narrative itself or the narration process can make possible the resignification of the process of illness by the subjects and point out strategies for care management in chronic illness.

Experiences with the daily use of medications among chronic hepatitis C patients

BACKGROUND

Subjective experiences with medication use are individual experiences that can impact health outcomes by contributing to problems related to such use.

OBJETIVES

The aim of the present study was to understand the experiences of chronic hepatitis C patients who were taking chronic medications, based on the phenomenology proposed by Merleau-Ponty and connection among this experience with the essential structures of the experience.

METHODS

Data were gathered from interviews conducted with ten individuals taking long-term medications at the Viral Hepatitis Outpatient Clinic of the Alfa Gastroenterology Institute of the Hospital das Clínicas, Federal University of Minas Gerais, Brazil. The content of field diaries kept during the interviews were also used. Thematic analysis was employed, enabling the identification of the ways in which individuals experienced their medication routines, which were then reorganized to encompass the essential structures of the experience.

RESULTS

The researchers identified four ways patients experience daily medication use, all anchored in corporeality: resolution, adversity, ambiguity, and irrelevance. The first three were based on the perspective that daily medication use is more than a mere mechanical action, involving changes in the phenomenal body, relieving, eliminating or causing symptoms in the physical body, normalizing life and symbolizing the disease.

FINAL CONSIDERATIONS

The present study allowed the researchers to infer that the same individual can even simultaneously experience daily medication use in different ways, depending on the disease and the medication in question. It also allowed for the understanding of the cyclical nature of experience with daily medication use, being that the introduction of a new medication can give rise to a new experience. The results point to the complexity of this experience, which requires formal education and places health professionals as responsible for this aspect of care.

Young adult women's experiences of body image after bariatric surgery: a descriptive phenomenological study

AIM

To understand the lived experience of body image in young women after obesity surgery.

BACKGROUND

Quantitative studies have documented that health-related quality of life and body image are improved after bariatric surgery, probably due to significant weight loss. Female obesity surgery candidates are likely to be motivated by dissatisfaction regarding physical appearance. However, little is known about the experience of the individual woman, leaving little understanding of the association between bariatric surgery and changes in health-related quality of life and body image.

DESIGN

A qualitative descriptive phenomenological study.

METHODS

Data were collected over 4 months during 2010. Selection for interview was carried out through purposeful sampling. The participants were five young women who underwent bariatric surgery (range: 1-12 months). In-depth, semi-structured interviews were analysed by systematic text condensation influenced by Giorgi's phenomenological method and supplemented by elements from narrative analysis.

FINDINGS

The analysis revealed three concepts: solution to an unbearable problem, learning new boundaries and hopes of normalization. These revelatory concepts were synthesized into one major theme: on the edge of control, that is describing these women's feelings of being on the edge of balance between control and loss of control.

CONCLUSION

Perception of control may be an essential aspect of body image and the key to understanding these young women's feelings of empowerment and quality of life through body control postbariatric surgery. Future studies should focus on how body control is an essential aspect of body image, which may contribute to long-term weight loss maintenance and improve quality of life.

Challenging nurses' cultural competence of disability to improve interpersonal interactions

Worldwide, at least 6.9 billion people have an impairment-producing health condition. Insensitive encounters with healthcare providers (HCPs) can result in negative appraisals, fear, and avoidance, but little is known about what things are commonly perceived as insensitive. A review of published narratives describing negative encounters with HCPs was conducted. Narrative analysis was used to compare, contrast, and synthesize six themes describing the common negative encounters: (a) ignoring or minimizing their knowledge, (b) detached interpersonal interactions, (c) placing a negative skew on their life quality, (d) lack of HCP knowledge related to their complete needs, (e) assuming they should be asexual and childless, and (f) an inherent power differential. The medical model of disability is perceived by individuals with impairment-producing health conditions to inform negative encounters perceived as insensitive. This preliminary knowledge is important so we can address educational needs, plan future research questions, and establish clinical practice improvements.

Real food matters for health

Human health, an enigma that has been a part of human existence from its origins, is founded on the intake of food. Holistic health is concerned with issues of the body, soul/mind, and spirit. Using concepts from ecology, this article explores the relationships between food, nutrients, whole food diets, and health. An analysis of studies linking whole food to health and depressive disorders are presented in an attempt to move food and diets into mainstream mental health discussions. The purpose of this article is to demonstrate that real food matters for the health of all and is of vital consequence for improving the chronic conditions plaguing modern society's mental health.