Bombak Andrea E, Chinho Norma, Thomson Lisa, Burk Courtney, Akhter Sumaiya, O'Keefe Kathleen, Turner Lee
University of New Brunswick, Canada.
Health (London). 2025 Mar;29(2):236-257. doi: 10.1177/13634593241238869. Epub 2024 Mar 19.
The lived experiences of higher-weight people vary; homogenous samples may fail to capture this diversity. This study develops an in-depth understanding of the lived experiences of higher-weight (Body Mass Index ⩾ 30) older adults (⩾60 years of age) in a Canadian Atlantic province. Participants ( = 11) were interviewed face-to-face using a semi-structured interview guide twice at 2-to-3-month intervals regarding their perceived treatment in social and health situations; how positive and negative healthcare experiences affected their health, lifestyles and healthcare seeking-behaviour; and recommendations in terms of patient experiences, access and inclusion. Participants infrequently reported negative experiences; however, participants' experiences were informed by uptake of moralistic, neoliberal discourses. Thematic content analysis identified two major themes: (participants demonstrated internalisation of the imperative for weight loss, healthy lifestyles and active ageing) and (participants expressed that a positive attitude could prevent/help cope with stigma). Results suggest that individualistic, rather than collective, political solutions to health and stigma have been taken up by higher-weight older adults in a Canadian Atlantic province, which may hinder attempts at structural reforms addressing stigma.
体重较高人群的生活经历各不相同；同质化样本可能无法体现这种多样性。本研究深入了解了加拿大一个大西洋省份中体重较高（体重指数⩾30）的老年人（⩾60岁）的生活经历。研究人员采用半结构化访谈指南，以面对面的方式对11名参与者进行了两次访谈，访谈间隔为2至3个月，内容涉及他们在社会和健康状况下所感受到的待遇；积极和消极的医疗经历如何影响他们的健康、生活方式和就医行为；以及关于患者体验、就医机会和包容性的建议。参与者很少报告负面经历；然而，参与者的经历受到道德主义、新自由主义话语影响。主题内容分析确定了两个主要主题：（参与者表现出对减肥、健康生活方式和积极老龄化必要性的内化）和（参与者表示积极的态度可以预防/帮助应对耻辱感）。结果表明，加拿大一个大西洋省份中体重较高的老年人采取了针对健康和耻辱感的个人主义而非集体主义政治解决方案，这可能会阻碍旨在解决耻辱感的结构性改革尝试。
