RESUMEN
OBJECTIVES: To identify and describe threats to informed decision-making at key junctures of the Down syndrome (DS) determination experience. METHODS: We conducted 32 narrative interviews with 42 participants (10 couples and 22 individuals). Participants relayed their stories of receiving their child's or a prospective child's DS determination. Interviews were recorded, transcribed verbatim, and analyzed thematically. RESULTS: We identified the following 5 threats to informed decision-making: routinization of screening, screening for reassurance's sake, equating an openness to screening with an openness to testing and termination, misunderstanding and miscommunicating about probability, and a lack of up-to-date, accurate, neutral information. CONCLUSIONS: The results contribute to an existing body of literature on the DS determination experience with a uniquely Canadian lens. The threats outline how well-intended counselling can ultimately undermine reproductive autonomy and informed decision-making. With knowledge of how these seemingly harmless behaviours threaten informed decision-making and reproductive autonomy, care providers can modify their counselling to lessen their impact.
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Síndrome de Down , Niño , Femenino , Humanos , Embarazo , Canadá , Toma de Decisiones , Síndrome de Down/diagnóstico , Diagnóstico PrenatalRESUMEN
BACKGROUND: As the popularity and demonstrated effectiveness of Health and Wellness Coaching (HWC) continue to grow to address chronic disease prevalence worldwide, delivery of this approach in a group format is gaining traction, particularly in healthcare. Nonetheless, very little empirical work exists on group coaching and there are currently no published competencies for Group Health and Wellness Coaching (GHWC). METHODS: We used a well-established two-phase (Development and Judgment) process to create and validate GHWC competencies with strong content validity. RESULTS: Seven highly qualified Subject Matter Experts systematically identified and proposed the GHWC competencies, which were then validated by 78 National Board Certified Health and Wellness Coaches (NBC-HWCs) currently practicing GHWC who rated the importance and use frequency of each one. The validation study led to 72 competencies which are organized into the structure and process of GHWC. CONCLUSIONS: GHWC requires not only coaching skills, but significant group facilitation skills to guide the group process to best support members in maximizing health and well-being through self-directed behavioral change. As the presence of HWC continues to grow, it is imperative that GHWC skill standards be accepted and implemented for the safety of the public, the effectiveness of the intervention, and the value analysis of the field. Such standards will guide curriculum development, allow for a more robust research agenda, and give practical guidance for health and wellness coaches to responsibly run groups. High quality standards for GHWC are particularly needed in health care, where a Level III Current Procedural Terminology (CPT®) code for GHWC has been approved in the United States since 2019 and reimbursement of such has been approved by the Centers for Medicare and Medicaid for 2024.
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Tutoría , Anciano , Humanos , Estados Unidos , Medicare , Promoción de la Salud , Procesos de Grupo , CertificaciónRESUMEN
Parents of children with Down syndrome (DS) were interviewed about if their experiences raising their children matched their initial assumptions about parenting a child with DS. A dominant narrative was identified, wherein most parents described initially having negative assumptions, which did not come to fruition; parenting their child was not very different from parenting a typical child. There was also a sub-group of participants who disputed the dominant narrative; parenting their child was challenging and the dominant narrative marginalizes that experience. The findings indicate that although for many parents, having a child with DS is like "taking the scenic route" (i.e., it involves a few more hurdles, but often more rewards), this framing is not always applicable. Therefore, health care providers and support organizations should promote a narrative that encompasses the diversity of parenting a child with DS.
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Síndrome de Down , Discapacidad Intelectual , Humanos , Padres , Responsabilidad Parental , Grupo SocialRESUMEN
OBJECTIVE: This study provides a theory-based snapshot of the processes involved in women's fertility intention formation and decisions regarding the timing of motherhood. BACKGROUND: The trend to defer childbearing is linked with both empowering and challenging outcomes for women. The cognitive-social (C-S) model suggests that deliberative thinking regarding reproduction occurs following fertility-relevant life transitions, which results in fluctuations in motherhood schemas and fertility intentions. This framework was applied to explore fertility intention formation. METHODS: Semi-structured interviews were conducted with twelve women who either had children or desired children. RESULTS: Two overarching themes central to the C-S model are discussed: (a) passive expectations and (b) deliberative intentions. Women's motherhood schemas were often underpinned by schematic structures (e.g. group norms and scripts) and material structures (e.g. observational influences). Life transitions and personal experiences tended to prompt deliberative thinking about motherhood plans. CONCLUSION: The results were generally consistent with the C-S model, but highlight complexities to consider when investigating fertility expectations and intentions.
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Intención , Conducta Reproductiva , Niño , Femenino , Humanos , Conocimientos, Actitudes y Práctica en Salud , Fertilidad , ReproducciónRESUMEN
OBJECTIVE: Apply Weiner's attribution-affect-action (AAA) model to the context of societal support for access to assisted reproductive technology (ART). METHODS: Five hundred and fifty-four Canadians were randomly assigned to 1 of 4 vignette conditions describing reproductively challenged women differentiated by the root cause of their need for ART. Following this, participants completed an online questionnaire measuring the components of the AAA model. RESULTS: The overall expected relationships among the AAA framework variables were found. Participants were least willing to support access to ART for women perceived as relatively more responsible for their fertility issues and who elicited lower levels of sympathy, whereas participants were most willing to support access for women viewed as less responsible and who elicited more sympathy. Additionally, participants were most supportive of general access to ART and least supportive when asked to offer personal funds to assist the women with access. CONCLUSION: These findings have potential implications for Canadian health care policy decisions on funding fertility treatments through the universal health care system. Further research on this issue, as well as the development and testing of interventions aimed at addressing beliefs around equitable and inclusive access to ART, are warranted.
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Fertilización In Vitro , Infertilidad/terapia , Opinión Pública , Técnicas Reproductivas Asistidas , Apoyo Social , Actitud Frente a la Salud , Canadá , Femenino , Fertilidad , Conocimientos, Actitudes y Práctica en Salud , Accesibilidad a los Servicios de Salud , Conducta de Ayuda , HumanosRESUMEN
OBJECTIVE: The present study explores the content of abortion provider stigma. BACKGROUND: Abortion stigma extends beyond women who have abortions to abortion providers. Previous analyses of anti-abortion bills and rhetoric have revealed stereotypes of abortion providers as dangerous and less trustworthy than other health professionals. METHODS: We present a thematic analysis of one-on-one interviews about attitudes toward abortion providers with Canadian individuals (N = 21) holding an anti-abortion stance. RESULTS: We found participants held two kinds of beliefs about abortion providers: (1) providers are agentic and intentional actors and (2) providers are non-agentic victims of a larger system. While the former subtype of provider was viewed with hostility and disgust, the latter was viewed with pity, with participants suggesting that restriction of abortion would be beneficial for provider well-being. CONCLUSION: We document a new component of abortion provider stigma: the belief that abortion providers are harmed by abortion and that they are to be pitied for this. This 'abortion harms providers' attitude parallels recent anti-abortion arguments that abortion harms women. These stigmatising attitudes both construct the provider as untrustworthy and unable to properly care for women.
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Aborto Inducido/legislación & jurisprudencia , Actitud , Personal de Salud/psicología , Estigma Social , Canadá , Femenino , Humanos , Masculino , Embarazo , Investigación CualitativaRESUMEN
OBJECTIVES: Malnutrition during infancy has long-term adverse consequences for both physical and psychological development. Early detection of malnutrition among hospitalized infants is essential to provide optimal nutrition support. The primary aim of the present study was to investigate the nutritional status of hospitalized infants using 2 methods: the Subjective Global Nutritional Assessment (SGNA) and anthropometric measurement. We also investigated diagnostic category associated with nutritional status, the mean anthropometric z scores, and explored the association between malnutrition and nutrition focused variables. METHODS: Nutritional status of 110 hospitalized infants ages 31 days to 12 months was investigated using the SGNA and anthropometric measurements converted to z scores. RESULTS: Utilizing the SGNA, 78 (70.9%) infants were classified as having normal nutritional status, 30 (27.3%) were moderately malnourished, and 2 (1.8%) were severely malnourished. The proportion of infants with acute malnutrition (weight-for-length z score <-2) was 16.4%, and chronic malnutrition (length-for-age z score <-2) was 3.6%. The mean anthropometric z scores of infants were significantly lower in infants identified as moderately and severely malnourished using the SGNA. Decrease in serial weight (odds ratio [OR] 44.4; 95% confidence interval [CI]: 4.3-451.5), having prolonged gastrointestinal symptoms (OR 18.8; 95% CI: 1.5-234.7), and reduced nutrition-related functional capacity (OR 27.6; 95% CI 2.5-301.7) were associated with malnutrition after adjusting for sex, age, and length of hospital stay. CONCLUSIONS: Regardless of the method applied, cases of malnutrition amongst hospitalized infants were identified. The SGNA is a comprehensive approach to identifying malnutrition in hospitalized infants.
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Hospitalización , Desnutrición/diagnóstico , Evaluación Nutricional , Estado Nutricional , Femenino , Humanos , Lactante , Modelos Logísticos , Masculino , Análisis Multivariante , Índice de Severidad de la EnfermedadRESUMEN
PURPOSE: In recent years, anti-choice dialog has shifted from a focus on the fetus to a focus on the woman. This new movement constructs itself as positive and pro-woman, while perpetuating harmful stereotypes about women and the effects of abortion. Research has shown a relationship between benevolent sexism (beliefs that women are morally pure creatures in need of protection and nurturing) and restrictive attitudes towards abortion, although no research has qualitatively explored this relationship. METHOD: The present study seeks to explore this by interpreting the content of one-on-one interviews with Canadian individuals holding an anti-choice stance through the theoretical framework of benevolent sexism. RESULTS: Thematic analysis of the interviews revealed three main themes: (1) protective paternalism, (2) complementary gender differentiation, and (3) the categorization of women. CONCLUSION: These themes connect strongly with benevolent sexism, providing evidence that abortion is still a stigmatized procedure. This stigma has shifted from viewing women who have abortions in an overtly negative way to viewing them as pitiable and poor decision makers.
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Aborto Inducido/psicología , Derechos Sexuales y Reproductivos/psicología , Adulto , Actitud , Beneficencia , Canadá , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sexismo , Adulto JovenRESUMEN
BACKGROUND: The pressing need to manage burgeoning chronic disease has led to the emergence of job roles such as health and wellness coaches (HWCs). As use of this title has increased dramatically, so has the need to ensure consistency, quality and safety for health and wellness coaching (HWC) provided in both practice and research. Clear and uniform role definitions and competencies are required to ensure appropriate scope of practice, to allow best practices to emerge, and to support the implementation of well-designed, large scale studies to accumulate a rigorous evidence base. Since the nascent field is replete with heterogeneity in terms of role delineations and competencies, a collaborative volunteer non-profit organization, the National Consortium for Credentialing Health and Wellness Coaches (NCCHWC), has been built over the past six years to support professionalization of the field. METHODS: In 2014, a professionally led Job Task Analysis (JTA) was conducted with 15 carefully selected subject matter experts (SMEs) with diverse education and professional backgrounds who were practicing HWC in a wide variety of settings. After establishing a thorough list of specific tasks employed during HWC, the expert panel discussed the knowledge and skills necessary to competently perform the tasks. Subsequently, a large validation survey assessed the relative importance and frequency of each identified job task in conducting HWC. RESULTS: The JTA identified 21 job tasks as essential to HWC. In the subsequent validation survey, 4026 practicing health and wellness coaches were invited to rate each of the 21 job tasks in terms of their importance and frequency. A response rate of 25.6 % provided a diverse sample (n = 1031) in terms of background, and represented a wide variety of training programs from academia, industry, the private sector and associations. Per best practices, the subset of practicing HWCs (n = 885) provided importance and frequency ratings to be used to calculate task and domain weights that can serve as a foundation for a NCCHWC national certification examination. CONCLUSIONS: This JTA provides a significant step forward in the building of a clear and consistent definition of HWC that will allow for uniform practice standards and enable more stringent methodology to evaluate this promising approach within evidence-based medicine.
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Empleos Relacionados con Salud , Educación en Salud , Perfil Laboral , Análisis y Desempeño de Tareas , Empleos Relacionados con Salud/normas , Certificación , Práctica Clínica Basada en la Evidencia , Humanos , Organizaciones sin Fines de Lucro , Competencia ProfesionalRESUMEN
BACKGROUND: Health coaching interventions aim to identify high-risk enrollees and encourage them to play a more proactive role in improving their health, improve their ability to navigate the health care system, and reduce costs. OBJECTIVES: Evaluate the effect of health coaching on inpatient, emergency room, outpatient, and prescription drug expenditures. RESEARCH DESIGN: Quasiexperimental pre-post design. Health coaching participants were identified over the 2-year time period 2009-2010. Propensity scores facilitated matching eligible participants and nonparticipating controls on a one-to-one basis using nearest kernel techniques. Difference in differences logistic and generalized linear models addressed the impact of health coaching on the probability of incurring costs and levels of inpatient, emergency room, outpatient, and prescription drug expenditures, respectively. MEASURES: Administrative claims data were used to analyze health services expenditures preparticipation and post health coaching participation time periods. RESULTS: Of the 6940 health coaching participants, 1161 participated for at least 4 weeks and had a minimum of 6 months of claims data preparticipation and postparticipation. Although the probability of incurring costs and expenditure levels for emergency room services were not affected, the probability of incurring inpatient expenditures and levels of outpatient and total costs for health coaching participants fell significantly from preparticipation to postparticipation relative to controls. Estimated outpatient and total cost savings were $286 and $412 per person per month, respectively. CONCLUSIONS: Health coaching led to significant reductions in outpatient and total expenditures for high-risk plan enrollees. Future studies analyzing both health outcomes and claims data are needed to assess the cost-effectiveness of health coaching in specific populations.
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Ahorro de Costo/economía , Atención a la Salud/economía , Gastos en Salud , Promoción de la Salud/economía , Servicios de Salud/economía , Educación del Paciente como Asunto/economía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Análisis Costo-Beneficio , Servicio de Urgencia en Hospital/economía , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Costos de la Atención en Salud , Humanos , Masculino , Persona de Mediana Edad , Minnesota , Medicamentos bajo Prescripción , Estudios Retrospectivos , Teléfono , Adulto JovenRESUMEN
OBJECTIVE: Infertility is an issue of current concern across North America. The Society of Obstetricians and Gynaecologists of Canada advocates for public education regarding infertility issues. Public education is supposed to be a fundamental objective of news media. However, it is uncertain whether the media are acting as good partners to the medical profession in this objective of educating the public, and young women in particular. Recent findings suggest that print news tends to present infertility using high-alarm framing strategies; however, the impact of this framing on news consumers is unknown. The purpose of this study was to understand the effects of high- versus low-alarm frames on consumers of infertility-related news. METHODS: In this experiment, 131 undergraduate students were randomly assigned to read infertility-focused news articles judged to employ either high- or low-alarm framing strategies in presenting infertility. Participants subsequently completed various psychological, emotional, and knowledge measures to gauge the impact of the news exposure. RESULTS: The participants exposed to the high-alarm framing showed higher levels of perceived personal susceptibility to infertility, marginally higher levels of worry about infertility, and significantly lower levels of infertility-related knowledge than those exposed to the low-alarm framing. CONCLUSION: The manner in which the news media report on infertility has repercussions on how individuals think and feel about infertility. The findings of this study can inform health care providers about how the media are shaping perceptions of infertility, and can assist professional bodies interested in undertaking public education initiatives.
Objectif : L'infertilité suscite bien des préoccupations de nos jours en Amérique du Nord. La Société des obstétriciens et gynécologues du Canada préconise la mise en Åuvre d'efforts visant la sensibilisation du public à l'égard des questions entourant l'infertilité. Bien que la sensibilisation du public constitue, en principe, l'un des objectifs fondamentaux des médias d'information, la question de savoir si ces derniers collaborent de façon efficace avec la profession médicale à cet égard (et plus particulièrement en ce qui concerne la sensibilisation des jeunes femmes) demeure trouble. De récentes études semblent indiquer que la presse écrite tend à utiliser des stratégies grandement alarmistes en ce qui concerne la communication des nouvelles traitant de l'infertilité; cependant, les effets de ces stratégies sur le public demeurent inconnus. Cette étude avait pour objectif de comparer et de comprendre les effets des stratégies de communication grandement alarmistes et peu alarmistes sur le public visé par les nouvelles traitant de l'infertilité. Méthodes : Dans le cadre de cette expérience, 131 étudiants de premier cycle ont été affectés au hasard à un groupe devant lire des articles de journaux qui, à notre avis, utilisaient des stratégies de communication grandement alarmistes pour aborder le sujet de l'infertilité ou à un groupe devant lire des articles de journaux qui, à notre avis, utilisaient des stratégies peu alarmistes pour aborder ce sujet. Les participants ont par la suite rempli un questionnaire mesurant divers paramètres psychologiques, affectifs et liés aux connaissances, et ce, pour nous permettre d'évaluer les effets de l'exposition à chacun de ces types de nouvelles. Résultats : Les participants qui ont été exposés à des stratégies de communication grandement alarmistes ont présenté des taux accrus de sensibilité personnelle perçue à l'infertilité, des taux légèrement accrus d'inquiétude envers l'infertilité et des niveaux considérablement moindres de connaissances à l'égard de l'infertilité, par comparaison avec les participants ayant été exposés à des stratégies de communication peu alarmistes. Conclusion : La façon dont les médias d'information traitent de la question de l'infertilité exerce une influence sur la façon dont les gens perçoivent les renseignements qui leur sont fournis à ce sujet. Les résultats de cette étude pourraient renseigner les fournisseurs de soins de santé quant à la façon dont les médias influencent les perceptions en ce qui concerne l'infertilité et pourraient s'avérer utiles pour les organismes professionnels qui souhaitent mettre en Åuvre des initiatives d'éducation publique.
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Infertilidad/psicología , Medios de Comunicación de Masas , Estudiantes/psicología , Adulto , Canadá , Estudios Transversales , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
OBJECTIVE: To examine the impact of providing fertility information on personal levels of fertility knowledge and intentions to delay childbearing. METHODS: Participants (n=69 young childless women) were randomly assigned to either an experimental (fertility-related) or control (alcohol-related) informational intervention group. Subsequent to the exposure to information, participants completed a questionnaire measuring fertility knowledge and intentions for reproduction. We predicted that the provision of fertility-related information would result in greater fertility knowledge and less intention to delay childbearing among young childless women. RESULTS: The young women exposed to the brief fertility information intervention were significantly more likely to respond correctly to questions testing their fertility knowledge, and reported less intention to delay childbearing than the young women in the control group. CONCLUSION: This study provided evidence that providing fertility-related information contributes to greater reproductive knowledge and may affect childbearing intentions. Future research is warranted to examine the influence of fertility information on reproductive decision-making within a theoretical framework in order to ensure that subsequent information interventions maximize their effectiveness.
Objectif : Examiner les effets de l'offre de renseignements en matière de fertilité sur les niveaux personnels de connaissances au sujet de la fertilité et sur les intentions de différer la grossesse. Méthodes : Les participantes (n = 69 jeunes femmes sans enfants) ont été affectées au hasard à un groupe d'intervention informationnelle expérimental (traitant de fertilité) ou témoin (traitant d'alcool). À la suite de leur exposition aux renseignements, les participantes ont rempli un questionnaire mesurant les connaissances en matière de fertilité et les intentions en matière de procréation. Nous avions prédit que l'offre de renseignements traitant de fertilité entraînerait une amélioration des connaissances au sujet de la fertilité et une atténuation de l'intention de reporter la grossesse chez les jeunes femmes sans enfants. Résultats : Les jeunes femmes exposées à une brève intervention informationnelle traitant de fertilité ont été considérablement plus susceptibles de répondre correctement aux questions visant leurs connaissances au sujet de la fertilité; de plus, elles étaient moins susceptibles de signaler une intention de reporter la grossesse que les jeunes femmes du groupe témoin. Conclusion : Les données issues de cette étude indiquent que l'offre de renseignements traitant de fertilité contribue à l'amélioration des connaissances au sujet de la procréation et pourrait influencer les intentions en ce qui concerne la grossesse. La tenue d'autres recherches s'avère justifiée pour examiner l'influence des renseignements traitant de fertilité sur le processus décisionnel en matière de procréation dans un cadre théorique, de façon à ce que l'on puisse s'assurer que les interventions informationnelles subséquentes maximisent leur efficacité.
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Toma de Decisiones , Conocimientos, Actitudes y Práctica en Salud , Educación del Paciente como Asunto , Conducta Reproductiva , Femenino , Fertilidad , Humanos , Intención , Encuestas y Cuestionarios , Adulto JovenRESUMEN
This project aimed to explore the experiences of perceived mistrust and stigma by the LGBTQ+ members while accessing healthcare services in Saskatchewan, Canada. In partnership with local organization, a community-based participatory research (CBPR) approach was employed and, semi structured descriptive interviews were conducted. Sixteen participants ranging from age 20-60 were recruited and interviewed. Inductive coding method with thematic data analysis was performed, and descriptive comprehensive results were produced. The LGBTQ+ community reported negative experiences within the context of four emerging themes: (a) perceived stigma and discrimination in healthcare settings, (b) practitioners' LGBTQ+-specific healthcare knowledge, (c) the need for LGBTQ+-specific cultural sensitivity and inclusion, and (d) a call for changes in healthcare policy. Each theme and its corresponding experiences serve as a baseline of information to demonstrate the need for improved access to safe healthcare and increased sustainable health for the LGBTQ+ community members. This calls for training and education, establishing cultural sensitivity, and mandating policy changes could improve the experiences of the LGBTQ+ community members.
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Minorías Sexuales y de Género , Humanos , Adulto Joven , Adulto , Persona de Mediana Edad , Saskatchewan , Motivación , Identidad de Género , Disparidades en Atención de SaludRESUMEN
This study examines the societal perceptions and judgements made towards HIV-positive pregnant women when compared with those targeting pregnant women with other medical conditions. One hundred and sixty participants (124 female) were randomly assigned to one of four experimental conditions defined by specific medical condition of the pregnant woman in the vignette (HIV/AIDS, obesity, lung cancer or diabetes). Participants were asked to respond to a variety of items gauging their reaction to the woman and her pregnancy subsequent to reading the scenario. As expected, participants were least approving of the pregnancy of the woman with HIV/AIDS, and they rated her as a less fit parent than the women with the other medical conditions. Subsequent analyses revealed that concern for the health of the child and attributions of responsibility/blame for the medical condition did not account for the differential reactions to the pregnant woman with HIV/AIDS. These findings corroborate the felt stigma and prejudicial attitudes reported by HIV-positive mothers.
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Infecciones por VIH/psicología , Responsabilidad Parental/psicología , Mujeres Embarazadas/psicología , Prejuicio , Estigma Social , Actitud Frente a la Salud , Femenino , Humanos , Masculino , Madres/psicología , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Complicaciones Infecciosas del Embarazo/psicología , Mujeres/psicología , Adulto JovenRESUMEN
The COVID-19 pandemic adversely affected the wellbeing of university students and adults in general, emphasizing the need for mental health programming that was compliant with physical distancing mandates. The present evaluation investigated mental health and social connection within the context of COVID-19 by remotely evaluating a virtual animal-assisted activity at the University of Saskatchewan - PAWS Your Stress. The purpose of this article is to outline our evaluation methods and findings, while calling specific attention to the collaborative strategies that were implemented within a remote, time-sensitive context. The evaluation findings revealed that remote animal-assisted programming can facilitate connections with humans and animals, and promote multiple mental health benefits, despite the lack of physical interaction with the animals. Our lessons learned indicate that remote program logic modelling workshops are feasible when suited to audience demographics. Further, our experience suggests that the Most Significant Change technique (a qualitative, participatory, storytelling method that elicits outcome data) can be useful in time-restricted evaluations, and the necessity of central steps in the process may vary depending on evaluation goals. This project has implications for future evaluation work, by demonstrating the effective use of remote methods that allowed for successful stakeholder collaboration.
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COVID-19 , Adulto , Humanos , Animales , Perros , Animales para Terapia , Evaluación de Programas y Proyectos de Salud , PandemiasRESUMEN
OBJECTIVE: To examine the information about Down syndrome (DS) provided to pregnant women in Canada through a content analysis of prenatal screening information pamphlets. METHODS: Prenatal screening information pamphlets were requested from Canadian prenatal testing centres. In total, 17 pamphlets were received (response rate = 65%). Statements presenting information descriptive of DS were identified from the pamphlets, and a content analysis was carried out. Specifically, each statement was analyzed with respect to both the content and the valence of the information presented on the basis of predetermined decision rules. To enhance reliability, four independent raters reviewed each statement, and any differences in coding were resolved through discussion. RESULTS: In total, 158 statements descriptive of DS were extracted from the pamphlets. The categorical analysis revealed that 91% of the extracted statements emphasized medical or clinical information about DS, whereas only 9% of the statements relayed information pertaining to psychosocial issues. The valence analysis revealed that nearly one half of the statements portrayed a negative message pertaining to DS, while only 2.4% of the statements conveyed a positive image of DS. CONCLUSION: The pamphlets provided to pregnant women do not appear to present a comprehensive, balanced portrayal of DS, which may serve to limit informed decision-making.
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Síndrome de Down/diagnóstico , Difusión de la Información/métodos , Folletos , Educación del Paciente como Asunto/métodos , Diagnóstico Prenatal , Canadá , Toma de Decisiones , Femenino , Humanos , EmbarazoRESUMEN
Mindfulness-based stress reduction (MBSR) is an approach to health and wellness that an increasing number of health care providers are practicing and recommending to their patients. This article describes MBSR, its use in health care, and its benefits for patients with conditions such as anxiety, depression, chronic pain syndromes, and insomnia. It also offers advice about how physicians can incorporate elements of MBSR into their daily practices in order to reduce stress in their lives and prevent burnout.
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Adaptación Psicológica , Meditación/psicología , Curación Mental , Rol del Médico/psicología , Estrés Psicológico/complicaciones , Humanos , MinnesotaRESUMEN
INTRODUCTION: Housing instability and homelessness are significant barriers to medical treatment for people living with HIV/AIDS. For these individuals, lack of stable housing and stigma is associated with insufficient access to care, poor adherence to medication and higher cost burdens to the healthcare system. This protocol reports on the efforts to evaluate Sanctum V.1.0, a hospice and transitional care home for adults with HIV/AIDS in Saskatoon, Saskatchewan, Canada. The current project was developed out of a need to identify how Sanctum V.1.0 produces varying programme outcomes to assist in endeavours to replicate the programme in other geographic locations. METHODS AND ANALYSIS: A realist evaluation will be conducted to explore how and why Sanctum V.1.0 is successful or unsuccessful, in which circumstances and for whom. Rather than explore the degree to which a programme is effective, realist evaluations seek to uncover mechanisms that explain processual links between programme inputs and outcomes. The completed first phase of the project involved the development of an initial realist programme theory. Phases 2 and 3 will consist of methods to test, refine and validate the initial theory using various data sources. ETHICS AND DISSEMINATION: Ethics approval was obtained from the institutional review board at the University of Saskatchewan on 2 July 2020. Results will be disseminated according to stakeholders' desires.
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Infecciones por VIH , Vivienda , Adulto , Atención a la Salud , Humanos , Proyectos de Investigación , SaskatchewanRESUMEN
OBJECTIVE: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder that affects 6% to 10% of reproductive aged women. It is a poorly understood and often undiagnosed condition that has implications for the health of affected women. We assessed changes in knowledge, feelings, and daily health practices related to PCOS in clinical research study participants. METHODS: Sixty-eight women who had received counselling and education about PCOS while participating in a clinical research study were invited to complete an online survey that assessed levels of concern, knowledge, healthy dieting, active living, and health care satisfaction before and after the study. Differences and associations between scores were analyzed by paired t tests and Pearson correlation. RESULTS: Forty-three women (63%) completed the survey. After taking part in a clinical research study, participants believed they had increased knowledge of (P < 0.001) and concern about (P = 0.029) the etiology and health consequences of PCOS, better lifestyle practices (P < 0.001), and improved health care satisfaction (P = 0.045). Enhanced knowledge of PCOS was positively associated with changes in concern (P = 0.045), healthy dietary habits (P = 0.04), activity levels (P = 0.003), and health care satisfaction (P < 0.001). After the study, women felt empowered to participate in the management of their condition and communicate with their primary care providers. CONCLUSION: Women with PCOS felt that they had more knowledge and motivation to implement preventive health strategies after participating in a clinical research study. Education about how PCOS affects their immediate and long-term health enabled women with PCOS to feel physical and psychological benefits and to engage more with their health care providers.
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Conocimientos, Actitudes y Práctica en Salud , Síndrome del Ovario Poliquístico/psicología , Síndrome del Ovario Poliquístico/terapia , Sujetos de Investigación , Adolescente , Adulto , Femenino , Humanos , Estilo de Vida , Encuestas y CuestionariosRESUMEN
One potential barrier facing sexual assault survivors is that prejudicial attitudes and perceptions of victim appearance can influence the amount of blame, sympathy, and help that they receive from others. Using Weiner's (1980) attribution-affect-action theory as a guide, the present study investigated the relation between observer attitudinal characteristics (rape myth acceptance [RMA] and antifat attitudes [AFA]), victim weight, and specific judgments regarding a hypothetical sexual assault case. Female undergraduate participants (N=173) were presented with a sexual assault scenario and asked to complete a series of self-report questionnaires. Consistent with past research, attributions of victim fault were positively associated with adherence to rape myths and were higher toward thin victims than overweight victims. Further, the relation between the rater attitudinal variables and sentencing recommendations was found to be dependent on victim weight. When the victim was presented as thin, neither RMA nor AFA emerged as a predictor of sentencing recommendations. In contrast, both RMA and AFA were positively related to sentencing recommendations when the victim was presented as overweight. Theoretical and practical implications of these findings are discussed.