A vida perto da morte: relatos de uma médica sobre amor e perda / Life close to death: a doctor's accounts of love and loss

Como especialista em cuidados paliativos, a dra. Rachel Clarke escolheu trabalhar em um lugar que muita gente considera trágico demais para estar. Todos os dias ela tenta levar cuidado e conforto àqueles que chegam ao fim de suas vidas, para ajudar a tornar a morte mais suportável. Sua capacidade de lidar com o fim, no entanto, foi posta à prova quando teve que enfrentar o câncer do próprio pai e aprender que nada, nem mesmo os melhores cuidados paliativos, pode amenizar a dor de perder alguém que você ama. Ainda assim, ela argumenta que é no hospice ­ como é chamada a unidade de cuidados paliativos ­ que se encontram as coisas mais importantes da vida, como a bondade, o afeto e a alegria. Com seus relatos vibrantes, cheios de coragem e ternura, A vida perto da morte é a carta de amor de Clarke ao seu pai, à sua profissão e à vida em si.

Conversations about sexual activity within Haitian families: implications for HPV vaccine uptake.

Objective: Parents play an integral role in young adults' sexual health including human papillomavirus (HPV) vaccine decision-making. The objective of this study was to explore conversations regarding sexual activity in Haitian households and the influence of such conversations on young Haitian women's HPV vaccine discussion with their parents.Methods: From a large university in the southeastern United States, 30 Haitian-American college women (ages 17-26) were recruited for semi-structured in-depth interviews. The interviews were recorded and transcribed verbatim. Interview transcripts were analyzed using thematic analysis.Results: Most participants stated that they either did not have conversations regarding sexual activity or the conversations that they had were described as 'uncomfortable' or 'awkward'. Many participants stated that once parents knew that HPV is sexually transmitted, their discussions about the vaccine would be considered an announcement of their sexual debut or sexual activity. Hence, many decided to not discuss the HPV vaccine with their parents.Conclusion: Findings have important implications for HPV vaccine uptake. Results showed that a lack of conversations about sexual activity within Haitian households led to limited discussions about the HPV vaccine among young Haitian-American college women and their parents. Future HPV vaccine uptake efforts should integrate familial and cultural beliefs about female sexuality, while focusing on cervical cancer prevention.

Barriers to HPV Vaccination Among Unvaccinated, Haitian American College Women.

Background: Haitian women residing in the United States are disproportionately affected by cervical cancer. Human papillomavirus (HPV) vaccine has been licensed in the United States since 2006. Vaccination rates are less than optimal overall, and the rates are particularly low among young black women. We investigated barriers to HPV vaccination in a sample of Haitian American college women. Methods: Thirty self-identified Haitian American women, aged 17-26 years, were recruited from a large university campus in southeastern United States (n=30). They completed in-depth face-to-face interviews. The research team analyzed the transcripts using thematic analysis. Results: More than half of the participants (n=18) had not yet initiated the HPV vaccine series. Most of the unvaccinated participants stated that they had received a provider recommendation for the vaccine. Lack of provider recommendation, negative vaccine perception and attitudes, and side effect concerns constituted barriers to vaccination. Conclusions: Haitian American college women at high risk of cervical cancer have cited several barriers to HPV vaccination, with the most prominent being lack of physician recommendation. Healthcare providers should continue recommending the vaccine to college women as many of them may not have received a recommendation. When recommending the HPV vaccine, discussions should be framed with the intent to positively influence HPV vaccine perceptions and ultimately vaccine attitudes.