Identifying coping strategies used by patients at a transgender health clinic through analysis of free-text autobiographical narratives.


Journal

Health expectations : an international journal of public participation in health care and health policy
ISSN: 1369-7625
Titre abrégé: Health Expect
Pays: England
ID NLM: 9815926

Informations de publication

Date de publication:
04 2021
Historique:
revised: 20 01 2021
received: 21 07 2020
accepted: 23 01 2021
pubmed: 26 2 2021
medline: 2 10 2021
entrez: 25 2 2021
Statut: ppublish

Résumé

This paper presents an analysis of 32 narratives written by patients waiting for assessment at a transgender health clinic (THC) in England. Narratives are autobiographical free texts, designed to allow patients to describe in their own words their experiences of their gender identity and/or transition prior to a clinic appointment, as part of the assessment process. Narratives were analysed to identify actions prospective patients had taken to manage their (usually lengthy) waiting times, so that these 'coping strategies' could be shared with future patients. Corpus linguistic methodology was utilized to identify common patterns across the whole corpus of text-based data, augmented with more detailed sociolinguistic analysis of individual narratives. There are broad commonalities in the way the transition experience is described across the corpus in terms of presentation of key experiences and feelings. There are specific descriptions of a number of recurring coping strategies, both positive and negative. The empowerment value of writing these narratives may be limited; the existence of recurring key features suggests that patients may feel they have to present their experiences in certain ways to be accepted for treatment. However, dissemination of some positive coping strategies may help future clients of THCs to better cope with waiting times, as well as assisting practitioners in THCs in supporting their patients during this wait. The clinic's Service Users' Research Advisory Group contributed to formulating the objective and design of the study. Results were presented at the clinic's annual PPI conference.

Sections du résumé

BACKGROUND
This paper presents an analysis of 32 narratives written by patients waiting for assessment at a transgender health clinic (THC) in England. Narratives are autobiographical free texts, designed to allow patients to describe in their own words their experiences of their gender identity and/or transition prior to a clinic appointment, as part of the assessment process.
OBJECTIVE
Narratives were analysed to identify actions prospective patients had taken to manage their (usually lengthy) waiting times, so that these 'coping strategies' could be shared with future patients.
DESIGN
Corpus linguistic methodology was utilized to identify common patterns across the whole corpus of text-based data, augmented with more detailed sociolinguistic analysis of individual narratives.
RESULTS
There are broad commonalities in the way the transition experience is described across the corpus in terms of presentation of key experiences and feelings. There are specific descriptions of a number of recurring coping strategies, both positive and negative.
CONCLUSION
The empowerment value of writing these narratives may be limited; the existence of recurring key features suggests that patients may feel they have to present their experiences in certain ways to be accepted for treatment. However, dissemination of some positive coping strategies may help future clients of THCs to better cope with waiting times, as well as assisting practitioners in THCs in supporting their patients during this wait.
PATIENT/PUBLIC CONTRIBUTION
The clinic's Service Users' Research Advisory Group contributed to formulating the objective and design of the study. Results were presented at the clinic's annual PPI conference.

Identifiants

pubmed: 33629441
doi: 10.1111/hex.13222
pmc: PMC8077074
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

719-727

Informations de copyright

© 2021 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Références

Health Expect. 2021 Apr;24(2):719-727
pubmed: 33629441
Health Expect. 2015 Oct;18(5):1508-18
pubmed: 24102959
J Sex Med. 2015 Mar;12(3):756-63
pubmed: 25612159
Int Rev Psychiatry. 2012 Dec;24(6):568-77
pubmed: 23244612
Sociol Health Illn. 2019 Mar;41(3):517-532
pubmed: 30484870
Int J Transgend. 2019 Jul 18;20(2-3):138-154
pubmed: 32999602
Int J Transgend. 2019 Jul 25;20(2-3):119-125
pubmed: 32999599
Int Rev Psychiatry. 2016;28(1):1-4
pubmed: 26769232
Qual Health Res. 2008 Oct;18(10):1345-55
pubmed: 18832767
Int J Transgend. 2018 May 25;20(2-3):155-168
pubmed: 32999603

Auteurs

Angela Zottola (A)

School of English, University of Nottingham, University Park, Nottingham, United Kingdom.

Lucy Jones (L)

School of English, University of Nottingham, University Park, Nottingham, United Kingdom.

Alison Pilnick (A)

School of Sociology and Social Policy, University of Nottingham, University Park, Nottingham, United Kingdom.

Louise Mullany (L)

School of English, University of Nottingham, University Park, Nottingham, United Kingdom.

Walter Pierre Bouman (W)

Nottingham National Centre for Transgender Health, Nottingham, United Kingdom.

Jon Arcelus (J)

Nottingham National Centre for Transgender Health, Nottingham, United Kingdom.
Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom.

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