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Participatory health research (PHR) and the use of arts-based methods continues to grow in popularity. Many scholars acknowledge the importance of (visual) ethics, especially in the dissemination of photographs in a digital age, but ethical issues that arise in relation to contact with the press and social media are not well documented. This article presents second-person action research of a critical case of photovoice in which ethical issues arose when a newspaper report reinforced stigma and was widely disseminated via social media. Press and social media can rapidly engage people for social change, but this also presents risks. What is the potential to de-stigmatize in such situations? The context of the case in this article is the participatory KLIK project, a Dutch initiative which aims to improve the health and resilience of school children aged 8-11 years in a deprived neighbourhood. Awareness of the possibility of political listening and viewing is fundamental for an ethical practice. This article shows the importance of co-ownership, media literacy and collaborative learning about ethics in PHR.

The popularity of Participatory Action Research (PAR) increases the risk of tokenism and blurring the boundaries of what might be considered 'good' PAR. This became a pressing issue when we were invited by the City of Amsterdam to conduct PAR on digital inequality with vulnerable citizens in Amsterdam, within serious constraints of time and budget. We decided to take up the challenge to offer citizens an opportunity to share their needs. This paper aims to increase the transparency of the complex reality of a PAR process in order to help new researchers learn about the challenges of PAR in real-life situations, and to open up the discussion on the quality and boundaries of PAR. Though we managed to implement some core ethical principles of PAR in this project, two were particularly under pressure: democratic participation and collective action. These jeopardized collective learning and might unintentionally feed stereotypes regarding people's capabilities. Nevertheless, this small and local study did manage to create ripples for change.

BACKGROUND: The health of care workers in residential long-term care (LTC) is under pressure. Scholars emphasize the importance of gender-sensitive and intersectional approaches to occupational health. OBJECTIVE: To unravel how the health of nurses and nursing aides is shaped by gender, class, age, sexuality and race. METHODS: A qualitative participatory study. A participatory research team, consisting of academic scholars and nursing aides, conducted semi-structures interviews (N = 20) and one natural group discussion (N = 8 participants) to validate our findings. Thematic data-analysis was guided by gender and intersectionality theory. RESULTS: Empirical findings suggest that gendered norms limit possibilities for self-care for female nurses and nursing aides. Feeling uncared for by society and LTC organizations, paid care workers describe how they take care of each other. These relational health strategies require a feeling of sameness, limiting space for diversity and disability within care teams. Care workers seen as 'cultural other', or those who experienced (chronic) health issues, financial struggles or informal caregiving, risked being excluded from relational care within care teams, which negatively impacted their health. CONCLUSIONS: Care workers' relational health strategies are a gendered and care ethical response to the lack of societal and political care for LTC, but can become mechanisms of exclusion within care teams. This can be understood as a sign of exhaustion, shaped by adverse working conditions and leading to moral stress. The lack of societal appreciation needs to be addressed by occupational health physicians and LTC organizations, to counter mechanisms of exclusion among paid care workers. [ABSTRACT FROM AUTHOR]

Background: Implementing person-centred care (PCC) in nursing homes is challenging due to a gap between theory and practice. Bridging this gap requires suitable education, which focuses on learning how to attune care to the values and preferences of residents and take moral, relational, and situational aspects into account. Staff's stories about the care they provide (i.e. caring stories) may deliver valuable insights for learning about these aspects. However, there is limited research on using staff's narratives for moral learning. Objective: This study aims to provide insight into the perspectives of nursing staff on using their caring stories to learn about PCC. Research design: In this qualitative research, we conducted two rounds of interviews with 17 participants working in nursing homes. We wanted to obtain nursing staff's perceptions of working with their caring stories and the impact on PCC. Ethical considerations: Participation was voluntary, and participants provided written consent. The study protocol is approved by The Institutional Review Board of the Medical Ethical Committee Leiden-Den Haag-Delft. Findings: Working with caring stories enables nursing staff to provide PCC and improves job satisfaction. It increases awareness of what matters to residents, fosters information rich in context and meaning, and enhances voice and vocabulary. Through in-depth team reflections, nursing staff discussed the significant moments for residents, which centralizes the discussions on the moral quality of care. Discussion: Working with caring stories fosters dialogue on PCC and enhances reflection on ethical situations in daily encounters, contributing to the moral development of nursing staff. Putting nursing staff's narratives at the centre of learning suits their daily practice and intrinsic motivation. Therefore, the outcomes of this study are an addition to the existing literature about using narratives in long-term care. Conclusion: Using nursing staff's narratives contributes to PCC and positively impacts nursing staff. We recommend using staff's caring stories as a vehicle for moral learning in the transition to PCC. [ABSTRACT FROM AUTHOR]

While some areas of care work show increased recruitment of men, the care‐gap remains, especially in low paid occupations. Questions arise how masculinities play a part in this, and if caring masculinities obscure gender inequities while at the same time perpetuating them. This qualitative study focusses the negotiation of hegemonic and caring masculinities of men working in residential long‐term care in the Netherlands, and its consequences for health. Semi‐structured interviews (N = 16) were analyzed thematically, drawing upon gender and intersectionality theory to understand inequities between respondents. Findings describe how men move through long‐term care. On entry, men negotiated hegemonic and caring masculinities to gain access, with black men having to work harder. Once inside, men experienced status‐loss and performed hegemonic masculinity, materializing in financial and sexual rewards, especially for white heterosexual men. In time, this performance of hegemonic masculinity backlashed with respect to their own health; herein racialized and homosexual men were hit harder. Consequently, all the men in this study aspired to move out or up from low‐paid care work, with white heterosexual men doing so more successfully. Our study illustrates the importance of an intersectional perspective on caring masculinities at work, showing how caring masculinities perpetuate male privilege for some men more than for others, creating health and labor market inequities among men. In terms of health, this study shows that gender, racism and sexual discrimination need be on the occupational health agenda. [ABSTRACT FROM AUTHOR]

Responsive evaluation honors democratic and participatory values and intends to foster dialogues among stakeholders to include their voices and enhance mutual understandings. The question explored in this article is whether and how responsive evaluation can offer a platform for moral learning ("Bildung") in the interference zone between system and lifeworld. A case example from Dutch psychiatry is presented. Policy makers aimed to develop a "monitoring instrument" for closed psychiatric wards to protect patient rights and prevent incidents. Tensions arose between strategic action and system values (accountability, efficiency, control, safety) and the search for meaning and morality. Several dynamics were set in motion. Through the creation of communicative spaces in which there was room for expression of emotions and stories, the "colonization" by system values was countered. Another dynamic called "culturalization" started simultaneously, that is, adoption of lifeworld values in the system world, which resulted in constructive dialogues on the meaning of good care and moral learning.