Sex, Sexuality, and Intimate Relationships Among Afghan Women and Men of Refugee Background Living in Melbourne, Australia: Experiences, Opportunities, and Transcultural Tensions.

Over the last two decades, Afghanistan has been a leading country of origin for asylum seekers and refugees arriving in Australia. It is widely recognized that humanitarian migrants experience poorer sexual and reproductive health than the broader population. In turn, a body of research has emerged exploring the sexual and reproductive health of the local Afghan community. However, this has predominantly focused on youth or perinatal experiences, and less attention has been given to the broader relational and social dimensions of sexuality. Accordingly, this research aimed to explore the perspectives and experiences of married Afghan women and men as they navigate and negotiate sex, sexuality, and intimate relationships following settlement in Melbourne, Australia. A total of 57 Afghan women and men participated in six focus group discussions and 20 semi-structured interviews. Male participants described the ways that having increased access to sex and sexually explicit materials in Australia is creating opportunities for them to establish more fulfilling sex lives. Many women also described a growing awareness of sexuality, although often expressed difficulty prioritizing and claiming more pleasurable sexual encounters for themselves. However, concerns about sexual freedom are also creating new challenges for the Afghan community living in Australia in relation to sex and relationships. For example, men expressed fears about women exercising sexual liberties outside of the home, and this appeared to place women's everyday behavior under increased scrutiny. Women also voiced concerns about how easily men can access sex outside of marriage within Australia, and described how this amplified their sense of obligation to be sexually compliant and meet their husband's desires. This study provides new insights into the ways that Afghan community members are moving between societies, and how their understandings of sexual participation, pleasure, desire, health, consent, and capacity for self-determination are being challenged, reshaped, and reconstructed throughout this process.

Family planning and Afghan refugee women and men living in Melbourne, Australia: new opportunities and transcultural tensions.

This research aimed to explore the family planning perspectives and experiences of Afghan women and men living in Melbourne. A total of 57 Afghan women and men participated in six focus groups and 20 semi-structured interviews. The majority of participants indicated a preference for two or three children and were open to using modern contraception. However, many women described experiencing negative side effects when using hormone-based contraception and expressed difficulty negotiating condom use with their husbands as an alternative. Some women described how these difficulties resulted in inconsistent contraceptive practices and, at times, unintended pregnancy. Participants recognised that health professionals have an important role in addressing their family planning needs. This study highlights the ways in which Afghan women and men are changing in relation to their family planning beliefs and practices, and the opportunities, challenges and transcultural tensions they experience as they navigate these issues in Australia.

The cultural politics of mining and natural disaster in Indonesia: by fire and sword.

Natural disasters are inevitably the outcome of cultural agonisms. The cultural politics of natural disasters are shaped by competing claims and conceptions of 'nature'. Recent disasters in Indonesia are directly linked to these contending conceptions and the ways in which different social groups imagine risk and reward. The Sidoarjo volcanic mudflow of 2006 represents a volatile and violent exemplar of contending cultural and economic claims. Like other disasters in Indonesia and elsewhere in the developing world, this 'natural' disaster is characterised by differing conceptions of 'nature' as cultural tradition, divine force, and natural resource. A new extractive project in East Java is exhibiting similar economic and cultural agonisms, particularly around the notion of development, environment, self-determination, and tradition. This paper examines the 'disputes over meaning' associated with natural disasters in contemporary societies, and the ways in which they are related to human culture, social organisation, and hierarchical systems of violence.

A qualitative exploration of the emotional wellbeing and support needs of new mothers from Afghanistan living in Melbourne, Australia.

BACKGROUND: The Afghan community is a priority population for many health and social services within the southeast region of Melbourne, which is home to the largest population of Afghanistan-born people within the state of Victoria. The majority of Afghan women arriving in Australia are of childbearing age, and evidence suggests that they are at increased risk of emotional challenges following birth as a result of the refugee and migration experience. This research aimed to explored the experiences of Afghan women living in Melbourne throughout pregnancy, birth, and early motherhood, and gain insight into the aspects of their experiences that they perceive as positively and negatively impacting their emotional wellbeing. METHODS: This qualitative study collected data through two focus group discussions (conducted in Dari) and 10 in-depth interviews (conducted in Dari or English). Thirty-eight Afghanistan-born women aged 18 years and older, who recently migrated to Australia and have at least one Australian-born child, were purposively selected to participate. A trained bicultural worker assisted in recruitment, data collection and translation. Thematic analysis was performed, and findings were confirmed with a subgroup of participants prior to being included within reporting. RESULTS: Participants consistently discussed experiencing emotional challenges following birth, identifying symptoms commonly associated with postnatal depression. Women largely attributed this emotional state to separation from family and culture, leading to loneliness, isolation, and disconnection. Participants expressed resistance towards professional support due to cultural stigma associated with mental illness. Partner support was seen to be positive but difficult to negotiate. Religion, strong relationship with child, forming friendships, education, and utilising childcare were identified as positive influences on the emotional wellbeing of women. CONCLUSIONS: This study highlighted social and cultural factors contributing towards the emotional wellbeing of Afghan mothers. Findings confirm the need for innovative community-based models to support the mental health of Afghan women. This is particularly pertinent given the identified resistance towards discussing emotional wellbeing with healthcare professionals. Further research and investment is required in this area.

Levels of empathy in undergraduate nursing students.

Empathy and absence of prejudice and stigma are instrumental in facilitating effective nurse-patient relations. This study assessed empathy levels and regard for specific medical conditions in undergraduate nursing students. A cross-sectional study was undertaken using paper-based versions of the Jefferson Scale of Physician Empathy (JSPE) and Medical Condition Regard Scale (MCRS), along with a brief set of demographic questions. Participants reported good empathy levels on JSPE. Attitudes towards intellectual disability, chronic pain, acute mental illness and terminal illness rated well on MCRS. Attitudes towards substance abuse, however, were lower. There were no significant differences between age groups, gender or year level of study. Overall results of this study were positive. Nursing students demonstrated acceptable empathy levels. Attitudes towards patients who abuse substances highlight an area that needs both further exploration and addressing. Attitudes towards mental health diagnoses were particularly favourable given that these often attract stigma and negative attitudes.

Attitudes of undergraduate health science students towards patients with intellectual disability, substance abuse, and acute mental illness: a cross-sectional study.

BACKGROUND: There is a long history of certain medical conditions being associated with stigma, stereotypes, and negative attitudes. Research has shown that such attitudes can have a detrimental effect on patients presenting with stigmatised medical conditions and can even flow on to impact their family. The objective of this study was to measure the attitudes of undergraduate students enrolled in six different health-related courses at Monash University toward patients with intellectual disability, substance abuse, and acute mental illness. METHODS: A convenience sample of undergraduate students enrolled in six health-related courses in first, second and third years at Monash University were surveyed. The Medical Condition Regard Scale--a valid and reliable, self-report measure of attitudes--was administered to students along with a brief demographic form. Mean scores, t-tests, and ANOVA were used to analyse student attitudes. Ethics approval was granted. RESULTS: 548 students participated. Statistically significant differences were found between the courses (p = 0.05), year of the course (p = 0.09), and gender (p = 0.04) for the medical condition of intellectual disability. There was no statistically significant difference between the courses, year of the course, gender, and age group for substance abuse or acute mental illness conditions. CONCLUSION: The findings suggest that students in undergraduate health-related courses, as a group, have a strong regard for patients with intellectual disability and some regard for patients with acute mental illness, but not for patients presenting with substance abuse problems.

Mothers reframing physical activity: family oriented politicism, transgression and contested expertise in Australia.

Mothers of young children are a population sub-group with one of the lowest levels of physical activity. This paper presents the findings from a qualitative study with 40 Australian mothers of children under school age. The research aimed to understand the tensions, dilemmas and trade-offs which women experience around physical activity within the contexts of their everyday lives as mothers of young children. The analysis shows that, in contrast to health promotion messages which frame physical activity as a positive and healthy behaviour, mothers of young children perceive activity as being both enhancing and threatening to their health and social relationships. Restrictive stereotypes of the 'good' mother make it difficult for many women to prioritise their own physical activity needs over their childrearing and domestic responsibilities. Nevertheless, women's involvement in physical activity is often underpinned by the maternal 'ethic of care' as something which can help them cope better with the challenges of being a mother and contribute to the wellbeing of the family. This article takes as its departure point the notion that the maternal 'ethic of care' creates previously unrecognised opportunities in relation to physical activity. For many mothers, physical activity can also be a way of challenging hegemonic discourses and extending what it means to be a good mother in contemporary society. Although largely overlooked by contemporary health promotion, it is women's family-oriented politicism and resistance to dominant meanings about motherhood, health and the 'ideal' body which create alternative possibilities for their participation and enjoyment of physical activity during early motherhood.

Levels of empathy in undergraduate midwifery students: an Australian cross-sectional study.

OBJECTIVE: This exploratory study investigated empathy and attitudes towards specific medical conditions, two important aspects of the midwife-woman relationship, amongst undergraduate midwifery students at one university. METHOD: Fifty-two Bachelor of Midwifery students across three years of the course completed questionnaires, the Jefferson Scale of Physician Empathy-Health Professional (JSPE-HP) version and the Medical Condition Regard Scale (MCRS). Both the JSPE-HP and the MCRS are standardised, self-report questionnaires with established reliability and validity. FINDINGS: An overall respectable level of empathy was measured, which was shown to increase consistently and substantially with each year level of the student undergraduate program. Attitudes to selected diagnoses were very good with the exception being substance abuse, which received a significantly lower mean. CONCLUSION: The results of this study indicate that the Bachelor of Midwifery course, or studying midwifery, has a positive effect on students' empathy. Low results in participants' attitudes towards patients presenting with substance abuse raises concern that students may harbour prejudice that could impinge upon their professional practice and the way in which they care for these mothers. Hence, this aspect in particular may need further development within midwifery curriculum development. Further research around other conditions may extend on our understandings of empathy and attitudes in midwifery students and practitioners.

DVD-based stories of people with developmental disabilities as resources for inter-professional education.

PURPOSE: The use of DVD stories about people with developmental disabilities within inter-professional education (IPE) across healthcare disciplines was evaluated. METHODS: First year healthcare students (n = 241) from an IPE unit responded to an attitude scale before and after viewing and discussing a DVD portraying the life and healthcare needs of an adult with cerebral palsy; a third round of data collection occurred later. Qualitative data were obtained from four first year and six second year tutors who discussed student reactions to the DVD. Six first year and four second year students participated in focus groups following viewing of a second DVD, about a young girl with developmental disabilities and complex health needs. RESULTS: ANOVA of the attitude scores did not show significant differences from pre- to post-viewing and discussion of the DVD, nor at a third round of data collection. Qualitative analysis revealed that the DVDs did cause students to shift assumptions, perceptions and understanding of the disabilities depicted, and to learn about their own and other professions. CONCLUSIONS: DVD scenarios of real people with developmental disabilities in real settings offer a means of providing IPE opportunities. The data also point to the need and directions for the development of a new attitudinal measure.

Communication styles of undergraduate health students.

BACKGROUND: Few empirical studies have been undertaken on the communication styles of specific health-related disciplines. The objective of this study is to identify the communication styles of undergraduate health students at an Australian university. METHODS: A cross-sectional study using a paper-based version of the Communicator Style Measure (CSM) was administered to a cohort of students enrolled in eight different undergraduate health-related courses. There were 1459 health students eligible for inclusion in the study. RESULTS: 860 students (response rate of 59%) participated in the study. Participants overall preferred the Friendly and Attentive communicator styles and gave least preference to the Contentious and Dominant styles. There was considerable similarity between participants from each of the health-related courses. There was no statistical difference in relation to communicator styles between the age of the participant or the year level they were enrolled in. CONCLUSION: These results show a preference for communicator styles which are facilitative of a client-centred approach, empathetic, and positive with interpersonal relationships. The lack of significant difference in communicator styles by year level further suggests that people disposed to such communicator styles are drawn to these health-related courses, rather than the specific field of study affecting their style.

Levels of empathy in undergraduate occupational therapy students.

Empathy is an important attribute for occupational therapists in establishing rapport and in better understanding their clients. However, empathy can be compromised by high workloads, personal stressors and pressures to demonstrate efficacy. Occupational therapists also work with patients from a variety of diagnostic groups. The objective of this study was to determine the extent of empathy and attitudes towards clients amongst undergraduate occupational therapy students at one Australian University. A cross-sectional study was undertaken using a written survey of the Jefferson Scale of Physician Empathy (JSPE) and the Medical Condition Regard Scale. Overall, a strong level of empathy was reported amongst students. Four medical conditions that occupational therapists work with (stroke, cerebral palsy, traumatic brain injury and depression) were held in high regard. Substance abuse, however, was held in comparatively low regard. Overall, the year of study appeared to have no significant impact on the students' empathy. Despite having a lower reported empathy level than found in health professions from other studies using the JSPE, occupational therapy students were found to have a good level of empathy. Of concern, however, was the bias reported against the medical condition of substance abuse, highlighting that the there may be a need to reinforce that patients from this diagnostic group are equally deserving of quality care irrespective of their clinical condition. Recommendations for future research include completing a longitudinal study of occupational therapy students' empathy levels and investigating the empathy levels of occupational therapists working with different client groups. Limitations of the study include the convenience sampling of occupational therapy students enrolled at one university which limits the generalizability of the results to groups of participants with similar characteristics.