Navigating the Empty Spaces of Care: A Feminist Political Economy Analysis of the Care Experiences and Work Practices of Women Living with Cancer
Notice bibliographique
Résumé
Advances in cancer treatment are improving survival rates and, in so doing, transforming the nature of cancer from an acute to chronic illness. Within the Canadian health care system, there has been increasing policy acknowledgment of and support for a culture change in care that promotes a stronger chronic care agenda and yet the Canadian health care system continues to operate within a predominantly medical model that favours acute care and treatment. The Princess Margaret Cancer Centre has shown some evidence of their commitment to a chronic care model through the implementation of ELLICSR Health, Wellness and Cancer Survivorship Centre. While this appears promising, understanding how these changes are operationalized in a predominantly acute health care setting remains an underdeveloped area and the implications for patients remain unknown. In this study, I apply critical ethnography and various data collection methods (document analysis, participant observation, semi-structured interviews and photo elicitation) in order to explore the patient experience within this changing health care milieu, paying particular attention to patients care experiences and work practices. As informed and framed by feminist political economy, this project explores the everyday care and work experiences of women diagnosed with cancer as situated within the broader social, political, and economic contexts in which cancer care and work are anchored. Analysis traces key tensions and conflicts between policy directions and the everyday environments where care takes place. The findings illuminate that, in the absence of suitable and sustained institutional and funding support, ideological changes that appear to be in line with improved patient autonomy and control (e.g., person-centeredness, patient involvement and self-management) more closely resemble increased individual responsibility and work for which little choice is given. In the empty spaces between policy promises and care practices, the findings reveal a new responsibility and accountability circuit wherein access to good quality care increasingly rests on patient action/inaction, thus rendering opportunities for care more inequitable. The delivery of psychosocial and supportive care through ELLICSR made a critical difference in the care experiences of study participants; however, the precarity of this space demonstrates the lack of commitment to the proposed goals of reforms. As our health care system changes, we must take up a context-sensitive approach that invites engagement with the messiness and complexity of cancer care as conceptualized, practiced, and lived.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».