The impacts and implications of the community face mask use during the Covid-19 pandemic: A qualitative narrative interview study.

INTRODUCTION: A range of nonpharmaceutical public health interventions has been introduced in many countries following the rapid spread of Covid-19 since 2020, including recommendations or mandates for the use of face masks or coverings in the community. While the effectiveness of face masks in reducing Covid-19 transmission has been extensively discussed, scant attention has been paid to the lived experience of those wearing face masks. METHOD: Drawing on 40 narrative interviews with a purposive sample of people in the United Kingdom, with a particular focus on marginalised and minoritized groups, our paper explores experiences of face mask use during the pandemic. RESULTS: We find that face masks have a range of societal, health and safety impacts, and prompted positive and negative emotional responses for users. We map our findings onto Lorenc and Oliver's framework for intervention risks. We suggest that qualitative data offer particular insights into the experiences of public health interventions, allowing the potential downsides and risks of interventions to be more fully considered and informing public health policies that might avoid inadvertent harm, particularly towards marginalised groups. PATIENT OR PUBLIC CONTRIBUTION: The study primarily involved members of the public in the conduct of the research, namely through participation in interviews (email and telephone). The conception for the study involved extensive discussions on social media with a range of people, and we received input and ideas from presentations we delivered on the preliminary analysis.

The pregnancy experiences of amputee women: a qualitative exploration of online posts.

BACKGROUND: This paper seeks to explore the pregnancy experiences of amputee women. Relatively little is known about pregnancy for amputees, but the wider literature on disability and pregnancy shows that the disabled pregnant body is often viewed as 'high risk'. The majority of amputations (90%) involve lower limb amputations; whilst our analytical interest was not limited to lower limb amputations, the sources we explored reflected the prevalence of lower limb amputees. METHODS: Using online blogs and first-person accounts from 6 different sources (3 authors of blogs, 2 authors of websites and 1 author of an information page on a general amputation website), we thematically analyse amputee women's own narratives around their experiences of pregnancy. FINDINGS: Four key themes were identified, which we describe as: The lack of information for the pregnant amputee; Managing risks; The embodied experience of suffering; and 'It's all worth it in the end'. Women amputees faced trade-offs between risks to self and the unborn child and reported physical discomforts due to pregnancy-related bodily changes impacting their prosthesis or residual limb. The challenges of pregnancy as an amputee were, however, all seen to be outweighed by the safe arrival of a healthy baby. CONCLUSIONS: The lack of information on pregnancy for amputees may affect women's resilience to the adaptation challenges they face. Research should further explore the experiences of amputee mothers to ensure adequate information is available to them and their caring professionals, and that the needs of women with more challenging experiences are also addressed.

Experiences of face mask use during the COVID-19 pandemic: A qualitative study.

The use of face masks and coverings has been a central component of efforts to mitigate the impact of the COVID-19 pandemic and has been legally mandated in some countries. Most academic studies to date, however, have focussed primarily on its effectiveness in reducing SARS-CoV-2 transmission, largely neglecting the social dimensions of mask mandates. In this narrative interview-based study, we consider experiences of face masks, with a particular focus on groups considered to be at a potential disadvantage from compulsory masking. Drawing on 40 telephone, video-call and e-mail interviews, we highlight the impact of inconsistent communication and the notion of mask wearing as an act of altruism on participants' experiences. In particular, we show how intolerance towards individuals who did not wear masks could result in stigma and exclusion, regardless of the legitimacy of their reasons. We suggest that more is needed to mitigate the 'dark side' of discourses of collective effort and altruism at a time of societal stress and fracture, and to account for the needs and interests of groups for whom compulsory masking may result in further marginalisation.

Understanding amputation care in England and Scotland: a qualitative exploration of patient stories posted on an online patient feedback site.

PURPOSE: Undergoing an amputation is a life-altering experience that can involve a protracted and intensive period of care from a range of healthcare professionals. Amputation care within the NHS has historically been criticised. Here we seek to understand how patients are experiencing care by exploring their stories and identifying features of both high- and low-quality care. MATERIALS AND METHODS: We analysed patient stories posted on the patient feedback site Care Opinion during the period 2018-2020 to examine how amputee patients (and their families) experience NHS care. Using thematic analysis, we identified four key themes. RESULTS: We found that patients' stories of undergoing an amputation as posted on Care Opinion give overwhelmingly positive feedback on their experiences. Patients report feeling well-supported by empathetic staff, and that the outcomes, in terms of quality of life and restoration of mobility, are beneficial. Time was a common feature within the posts we examined and negative experiences of care often related to untimeliness in a variety of ways. CONCLUSIONS: Care Opinion provides a useful and accessible resource for understanding how patients experience amputation care; analysis of stories posted there provides preliminary ideas of the features of "good care" from a patient-centred perspective.IMPLICATIONS FOR REHABILITATIONPatients undergoing amputations view professionalism of staff as important for good care.Timeliness is important to patients in seeing care in positive terms, ensuring patients are supported in their care during and after amputation in a timely manner is therefore important for achieving good rehabilitation care.Rehabilitation and related services supporting patients who have undergone amputations could usefully patient feedback sites as a means for further understanding the experiences of their patients and for improving services where necessary.

The social construction of male infertility: a qualitative questionnaire study of men with a male factor infertility diagnosis.

Although recent research has highlighted the distressing impact of infertility for men, fertility issues are still routinely seen as a 'women's issue' - even when male factor infertility is highlighted. This article reports findings from a qualitative questionnaire study focusing on a sample of men with a male factor infertility diagnosis; an under-researched and marginalised group in the context of reproductive medicine. Our analysis suggests that male factor infertility is viewed by men as a failure of masculinity, as stigmatising and silencing, and as an isolating and traumatic experience. It is also clear that these themes are shaped by wider societal discourses which present men as (unproblematically) fertile, uninvested in parenthood and stoic in their approach to emotional distress. Such norms also ensure that reproduction continues to be presented as a 'women's issue' which burdens women and marginalises men. In understanding male factor infertility experiences, the damaging nature of the social construction of male fertility is then more clearly illuminated.

Morbid curiosity? Discussion of the disposal of amputated limbs on online question and answer sites.

Amputation is a growing health issue with implications for the corporeal form and sense of bodily identity. Disposal of the removed limb (the amputate) has historically been suggested to impact on patient adaptation to amputation, although understandings of limb disposal are scarce within existing research. The growth of online question and answer sites has created opportunities for social actors to post and respond to a vast array of topic areas, including those that are seen as morbid or taboo. This paper then explores the discussion of amputate disposal within threads from two popular question and answer sites. Using thematic analysis, the paper examines how perceived ownership of limbs, understanding of the amputate as 'waste' and recourse to grotesque humour are key means by which limb disposal is discussed within these sites. Posters then create a new knowledge around the disposal of limbs, albeit one framed by uncertainty.

Ethics of limb disposal: dignity and the medical waste stockpiling scandal.

We draw on the concept of dignity to consider the ethics of the disposal of amputated limbs. The ethics of the management and disposal of human tissue has been subject to greater scrutiny and discussion in recent years, although the disposal of the limbs often remains absent from such discourses. In light of the recent UK controversy regarding failures in the medical waste disposal and the stockpiling of waste (including body parts), the appropriate handling of human tissue has been subject to further scrutiny. Although this scandal has evoked concern regarding procurement and supply chain issues, as well as possible health and safety risks from such a 'stockpile', the dignity of those patients' implicated in this controversy has been less widely discussed. Drawing at Foster's (2014) work, we argue that a dignity framework provides a useful lens to frame consideration of the disposal of limbs after amputation. Such a framework may be difficult to reconcile with the logic of business and the 'biovalue' of the medical waste, but would we argue afford more patient-centred approaches towards disposal. It may also facilitate better practices to help mitigate future stockpiling incidences.

Extending the Comfort Zone: Building Resilience in Older People With Long-Term Conditions.

This article examines how a 6-week mental health resilience course for people with long-term conditions (LTCs; diabetes, heart disease, and arthritis) increased perceived resilience of older participants. This article examines how peer support assisted participants to develop resilience, considers gender issues, examines the importance of course activities, and explores how resilience enhances quality of life. A mixed methods approach was used. A before-and-after questionnaire was administered 3 times, including 3-month follow-up. Interviews were held with 24 program participants, aged 45 to 80 years. Diaries were kept by participants over 3 months. Survey findings showed significant gains in perceived resilience, at the end of the course, with no significant drop-off after 3 months. Interview and diary narratives highlighted positive experiences around well-being, condition management, and social engagement. Peer support was key to effective processes. Challenges concern ongoing support in communities, and considering age and gender variables when researching what improved resilience means to older people with LTCs.

Fit to father? Online accounts of lifestyle changes and help-seeking on a male infertility board.

The reproductive realm is routinely viewed as a feminised space requiring women's commitment and labour. By contrast, men's procreative contributions and 'reproductive masculinity' is represented as unproblematic, with men assumed to be fertile across the lifespan. Recent scientific research has, however, cast doubt over these longstanding assumptions, suggesting that a link does exist between 'lifestyle' factors and male fertility. The notion that fertility can be improved with effort (for both women and men) can be located within wider cultural and political shifts which construct individuals as increasingly responsible for acting on health messages and engaging in self-disciplining body projects. Through an exploration of 'lifestyle changes' within a men's online infertility discussion forum board, this paper examines how discourses of individualisation healthism and masculinity are reproduced and interlinked. Our thematic analysis indicates that 'lifestyle work' is construed as crucial for achieving conception - and as a means to demonstrate men's commitment to the dyadic goal of parenthood, which in turn may challenge and extend previous notions of 'reproductive masculinity'.

Searching for help online: An analysis of peer-to-peer posts on a male-only infertility forum.

Men's experiences of infertility help seeking are under-researched and thus less widely understood than women's experiences, with men's needs for support often missing from reproductive research knowledge. This article presents a thematic analysis of peer-to-peer posts within the context of a UK men-only online infertility forum. The key themes demonstrate that men value male support from those with experience, and that masculinity influences help-seeking requests and men's accounts more broadly. We highlight the value of such online communities in offering support to men in need while recognising the importance of further research across other online settings in order to inform practice around supporting men in the reproductive realm.

Successful mental health promotion with men: the evidence from 'tacit knowledge'.

There remains significant concern about men's mental health, particularly in terms of personal and societal barriers to help-seeking, negative coping mechanisms and high suicide rates. This article presents findings from a multi-phase study looking at 'what works' in mental health promotion for men. Work here reports the collection and analysis of the tacit knowledge of those working within mental health promotion interventions for men. A 'multiple hub and spoke' approach was used to assist data collection. Thirteen key players, active in the men's mental health field, half from the UK and half beyond, formed an Investigative Network collecting data, mainly through interviews, from wider geographical and professional community contexts where they had networks. The focus of data collection was on 'what works' in mental health promotion for men. Data was analysed using thematic analysis techniques. Findings suggest that settings which created safe male spaces acted to promote trust, reduce stigma and normalize men's engagement in interventions. Embedding interventions within the communities of men being engaged, fully involving these men, and holding 'male-positive' values engendered familiarity and consolidated trust. Using 'male-sensitive' language and activity-based approaches allowed for positive expressions of emotions, facilitated social engagement, and provided a base for open communication. Appropriate partnerships were also seen as a necessary requirement for success and as crucial for maximizing intervention impact. The importance of gender and 'masculinity' was apparent throughout these findings and taking time to understand gender could facilitate positive ways of working alongside men, increasing levels of engagement and successful outcomes.

Evaluating a community-led project for improving fathers' and children's wellbeing in England.

Although under-researched and under-theorized compared to other settings, there is potential for the family setting to be harnessed to support the development of healthy children and societies and to reduce health inequalities. Within this setting, the role of fathers as health facilitators has yet to be fully understood and considered within health promotion. This paper draws on a two year evaluation of a community embedded intervention for fathers and children in an area of multiple deprivation in North West England. The evaluation integrated a variety of qualitative methods within a participatory evaluation framework to help understand the development and impact of a programme of work co-created by a social enterprise and fathers from within the community. Findings suggest that allowing fathers to define their own concerns, discover solutions to these and design locally appropriate ways to share these solutions can result in significant change for them, their children and the wider community. The key to this process is the provision of alternative spaces where fathers feel safe to share the substantial difficulties they are experiencing. This improved their confidence and had a positive impact on their relationships with their children and with significant others around them. However, this process required patience, and a commitment to trusting that communities of men can co-create their own solutions and generate sustainable success. We suggest that commissioning of services delivered 'to' people could be replaced, or supplemented, by commissioning appropriate organisations to work with communities to co-create solutions to the needs they themselves have recognized.

Men's accounts of infertility within their intimate partner relationships: an analysis of online forum discussions.

OBJECTIVE: This article aims to provide insights into men's accounts of infertility in the context of their intimate partnerships. BACKGROUND: Although we are beginning to understand that men experience the emotions of infertility acutely, little is known about how such emotions impact on men's intimate partner relationships. Evidence suggests that infertility can impact intimate partner relationships (both positively and negatively), but there is a paucity of research around how men talk about such relationship impacts, and how they share their stories with other men. Men are often viewed as the silent supporting partner within infertility contexts, with women narrated as taking the burden within the relationship. METHODOLOGY: The paper draws on data from a general discussion board on an online men-only forum. Inductive thematic analysis was utilised to identify key themes across the men's online posts. RESULTS: Men's posts demonstrate that infertility challenges relationships, and that men use the forum examined to offer each other advice on coping with infertility in their relationships. Men highlighted a sense of having less agency than their female partners in relation to infertility and that they were less able to access support for themselves as a result. CONCLUSION: We argue that infertility can be a challenging and complex time within intimate partner relationships and that men construct this situation with reference to gendered norms and constraints within their online accounts. Consideration of both parties in couples experiencing infertility is important for supporting relationships during any diagnosis and treatment processes for infertility.

Emoting infertility online: A qualitative analysis of men's forum posts.

Relatively little research on infertility focuses exclusively or significantly on men's experiences, particularly in relation to emotional aspects. Evidence that does exist around male infertility suggests that it is a distressing experience for men, due to stigma, threats to masculinity and the perceived need to suppress emotions, and that men and women experience infertility differently. Using thematic analysis, this article examines the online emoting of men in relation to infertility via forum posts from a men-only infertility discussion board. It was noted that men 'talked' to each other about the emotional burdens of infertility, personal coping strategies and relationships with others. Three major themes were identified following in-depth analysis: 'the emotional rollercoaster', 'the tyranny of infertility' and 'infertility paranoia'. This article then offers insights into how men experience infertility emotionally, negotiate the emotional challenges involved (especially pertaining to diagnosis, treatment outcomes and their intimate relationships) and how they share (and find value in doing so) with other men the lived experience of infertility.