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EN
This paper explores a range of health care seeking actions adopted by Polish migrants living in London. It is based on the in-depth interviews with 62 Polish migrants who resided in London in 2007 and 2008. The study reflects experiences of a diverse group of participants encompassing individuals of different ages, family circumstances and employment statuses. It uncovered a number of actions such as avoiding contact with any health services, self-medication, utilising Polish private doctors in London, and accessing public health services in Poland and London. These services and strategies were often used successively, concurrently or interchangeably depending on individual’s assessment of their situation and circumstances at the time of experiencing a particular medical need. The research uncovered a prominence of transnational health care seeking practices as most participants continued to access at least some form of health care in Poland. It also noted the impact of the length of stay, knowledge of English and labour market position on patterns of health care use. Engagement with the British National Health Service (NHS) was characterised initially by lack of knowledge of the system resulting in meandering between different institutions. There was also a sense of cultural unease and mismatch of expectations characterising doctor-patient encounters. However, the pathways of access and attitudes towards the NHS began to change as migrants learned their way through the English health care system. This underlines an importance of taking into account a longitudinal dimension in studies of migrant health care seeking behaviour.
PL
Celem artykułu jest zaprezentowanie charakterystyki i wyzwań projektowania partycypacyjnego w opiece zdrowotnej, umożliwiającego ewaluację procesu wykorzystanego w projekcie „Pacjenci Pacjentom” Fundacji Ludzie i Medycyna. Projektowanie partycypacyjne wykorzystano do stworzenia nowej przestrzeni w aplikacji mobilnej Pacjenci Pacjentom. Ewaluacja miała sprawdzić: (1) na ile zaimplementowany proces spełnił kryteria projektowania partycypacyjnego; (2) na ile doświadczenie projektowania partycypacyjnego rzeczywiście emancypuje osoby uczestniczące i zaprasza je do decyzyjności. Wyniki sugerują, że implementacja była udana, ukazując jednocześnie nowe zagadnienia istotne dla metody, niewystarczająco reprezentowane w literaturze skutecznie wprowadzonych projektów z tego nurtu. Aspektami tymi są dostępność cyfrowa i wynikająca z kondycji osób uczestniczących, a także waga procesu grupowego.
EN
The goal of this article is to present the characteristics and challenges of the participatory design (PD) process in healthcare, in connection with an evaluation of the PD process in the People and Medicine Foundation’s project – Patients4Patients. The main objective was to design and implement a new module in the Patients4Patients mobile app. The evaluation tried to answer the questions of (1) to what degree the proposed participatory process aligned with participatory design principles, and (2) to what degree the participants felt empowered and engaged in the designing and decision-making process. The results suggest that the implementation of PD was successful. At the same time, new aspects were revealed that have not been widely discussed in the literature on successful PD projects in e-healthcare, namely digital and conditional accessibility, and the importance of the group process
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EN
Objective. Breast cancer (BC) diagnosis is considered as a traumatic and life changing moment. Throughout the illness, women often need support from their close family. However, before receiving any support, women must navigate the challenging process of disclosing their diagnosis, which may bring about difficulties and reservations. This qualitative study explores the disclosure process in female patients with breast cancer, focusing on understanding reasons for hesitation, expectations related to parents’ reactions, the act of disclosure, and its outcomes. Methods. In-depth interviews were structured into two parts. The narrative part was followed by a semi-structured interview. The research population was recruited to meet the conditions of a maximum variation sample (different regions of the country, different age categories, education, stage of the disease, and treatment modality). 53 interviews were collected and transcribed verbatim. The age of participants at the time of the interview was 28–76 years, mean age was 48.61 (SD=13.12). Data from which categories were created were managed in NVivo10 software and were open coded. The codes were then grouped into themes for thematic analysis. Results. Three main themes emerged for delaying disclosure to parents: a) protecting parents, b) fear of reactions, and c) fear of changes in the parent-child relationship. Each theme contained specific subthemes contributing to the disclosure hesitation. Conclusion. Women with BC greatly benefit from the support offered by their parents. However, disclosing the diagnosis to them is often challenging. As a result, it is crucial to provide support to women with BC as they prepare to share their diagnosis. Medical staff should also consider including family members in the treatment and care process for patients with BC, recognizing the significance of family support in the overall well-being and coping of patients.
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