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1.
J Fam Nurs ; : 10748407211053931, 2021 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-34694172

RESUMO

There is a significant gap in understanding the sexual health of Arab Americans. The purpose of this study is to explore family sex communication among Arab American young adults and its association with gender and sexual attitudes. We used a parallel mixed methods design and administered an electronic survey (N = 100); a subsample of 24 participants participated in five focus groups. We observed convergence in the findings. Participants reported rare occurrences of family sex communication, with women reporting less comfort than men. Family sex communication was often "unspoken," and reinforced prevailing social norms. Gender differences were reported based on sex communication topics. The most common source of sex information was peers/friends. Focus group participants perceived their parents to be more conservative and less knowledgeable about sex than they were. Future research on strategies to bridge generational differences is needed to promote family-based sex communication, given the multiple teachable moments at home.

2.
Support Care Cancer ; 29(10): 5915-5925, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33763724

RESUMO

BACKGROUND: Multilevel barriers can arise after a cancer diagnosis, especially in underserved racial/ethnic minority patient populations, raising the need for diverse and contextually adapted interventions. However, limited data exists on Arab American (ArA) cancer patients' needs, partly due to their racial/ethnic misclassification as Whites. This study leveraged the perspectives of cancer survivors and community stakeholders (i.e., healthcare and community leaders) to identify ArA cancer patients' needs, as well as their preferred intervention strategies to address them. METHODS: Using a hybrid inductive-deductive content analysis approach, we analyzed qualitative data from interviews with 18 ArA community stakeholders recruited through community partners in Chicago. RESULTS: Participants associated cancer stigma to ArA patients' concealment of their diagnosis and aversion to cancer support groups. Economic and language barriers to treatment were emphasized. A lack of resources for ArA cancer patients was also noted and was partly attributed to their misclassification as White. In response to these needs, participants suggested peer mentorship programs to overcome privacy concerns, hospital-based patient navigation to address language and economic barriers in healthcare, diversification of the healthcare workforce to overcome language barriers, and community coalitions to recognize ArA as an ethnic group and increase cancer support resources. Such advocacy will be essential to accurately characterize patients' cancer burden and obtain funding to support community programs and resources. CONCLUSION: Our findings suggest that multilevel interventions at the patient, healthcare, and community levels are needed to address ArA cancer patients' needs.


Assuntos
Sobreviventes de Câncer , Neoplasias , Árabes , Humanos , Área Carente de Assistência Médica , Grupos Minoritários , Neoplasias/terapia , Estados Unidos
3.
AIDS Care ; 33(6): 767-785, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33550841

RESUMO

Black youth face significant disparities in HIV/sexually transmitted infection (STI) disease burden. Mental illness and emotion regulation are ontributors to HIV/STI risk, yet many HIV/STI prevention interventions do not address these factors. Project GOLD was a pilot randomized controlled trial of a psychoeducational HIV/STI prevention intervention designed to address the role of mental illness and emotion regulation in HIV/STI risk among heterosexually active Black youth aged 14-17 (N = 108). Participants were recruited from outpatient mental health treatment programs and general community settings via community partner referrals, face-to-face encounters, flyers and social media. Assessments were conducted pretest, immediate posttest, and at 3-, 6-, and 12-month follow-up. Although there were no statistically significant differences in behavior change from baseline, there were practically significant effect sizes among HIV condition participants when compared to the general health condition (e.g., fewer sexual partners at 6 months). An increase in theoretical mediators (e.g., condom use negotiation beliefs) was sustained at 12 months. HIV condition participants also reported lower depressive symptom severity, with statistical significance noted at immediate post and at 3 months. The findings highlight the importance and challenges of engaging Black youth in culturally and contextually relevant, developmentally and psychologically appropriate HIV/STI prevention interventions.


Assuntos
Infecções por HIV , Doenças Sexualmente Transmissíveis , Adolescente , Afro-Americanos , Infecções por HIV/prevenção & controle , Humanos , Projetos Piloto , Sexo Seguro , Comportamento Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle
4.
Nurs Manag (Harrow) ; 28(1): 26-30, 2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33377356

RESUMO

Over the past four decades, the number of people aged over 60 years has increased worldwide, and within this population there has been a proportional increase in people with diverse sexual orientations and gender identities. Executive nurses have an important leadership role in challenging heterocisnormative care practices in healthcare environments that affect the well-being of older adults who are lesbian, gay, bisexual, transgender, queer or questioning and others (LGBTQ+). This article reports on the findings of a secondary analysis of data extracted from an earlier scoping review to provide recommendations for executive nurses on how to advocate for LGBTQ+ older adults and create safe and inclusive healthcare environments for them.


Assuntos
Enfermeiras Administradoras , Papel do Profissional de Enfermagem , Defesa do Paciente , Minorias Sexuais e de Gênero/estatística & dados numéricos , Idoso , Humanos , Pessoa de Meia-Idade
5.
Cult Health Sex ; : 1-17, 2020 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-32744471

RESUMO

While the sexual behaviours of different racial and ethnic groups have been studied extensively in the USA, Arab Americans are relatively understudied. The purpose of our study is to describe sexual attitudes and behaviours of Arab American young adults, to explore gender differences and the factors associated with five primary sexual behaviours (solo and partnered masturbation, oral, vaginal and anal sex). We conducted a cross-sectional quantitative study using a self-administered survey, which included measures of Arab ethnic identity, religiosity and sexual attitudes and behaviours. The survey was completed by 100 Arab American young adults (18-25 years old). Almost half of the sample reported being engaged in at least one of the five primary sexual behaviours in the past six months. In bivariate analysis, there were significant gender differences in sexual attitudes and all the primary sexual behaviours except for anal sex. Sexual attitudes and religiosity were significant predictors of partnered masturbation, oral and vaginal sex. Our findings challenge Arab societal assumptions that unmarried Arab American young adults do not engage in sexual behaviours, including risky behaviours, warranting further research to prevent unintended sexual health outcomes.

6.
J Community Health ; 45(4): 761-767, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-31916178

RESUMO

Chicago is among the top five metropolitan areas in the United States where Arab Americans reside; however, we have little available data on their perceptions of personal or community health. We collected 200 community health surveys in collaboration with a community-based organization that serves mainly Arabs in Chicago's southwest suburbs. The survey evaluated perceived community and personal health. In a mostly female, married, and low-income sample, participants identified cancers, diabetes, and high blood pressure/cholesterol as the top three health problems, while alcohol abuse, drug abuse, and overweight/obesity as the top three risky behaviors within the community. Gender differences, age differences, and educational level differences were found on certain determinants of health regarding the health of the community, perceived health problems, and risky behaviors. Our data validates previous findings from the literature highlighting cancer, diabetes, and high blood pressure as health priorities among Arabs, but offers new insights into unidentified issues within the Arab American community in Southwest Chicago such as alcohol, drug abuse, and child neglect/abuse. Furthermore, our findings warrant the need for classifying Arabs as a separate minority population facing health disparities.


Assuntos
Árabes/estatística & dados numéricos , Nível de Saúde , Inquéritos Epidemiológicos , Grupos Minoritários , Adulto , Chicago/etnologia , Criança , Maus-Tratos Infantis , Diabetes Mellitus , Feminino , Humanos , Hipertensão , Masculino , Pessoa de Meia-Idade , Obesidade , Sobrepeso , Pobreza , Assunção de Riscos , Inquéritos e Questionários , Estados Unidos
7.
J Homosex ; 67(13): 1902-1919, 2020 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-31125288

RESUMO

The present cross-sectional descriptive study examined the attitudes and behaviors of health-care providers toward LGBT patients in Lebanon. Participants (N = 141) generally showed positive attitudes and behaviors toward LGBT patients. Mental health providers were significantly less likely to believe that homosexuality is a mental health disorder or that it is unnatural to identify with a gender identity other than one's biological sex when compared to non-mental health providers. Mental health providers were also more likely to be willing to address transgender people by their gender pronouns, and to believe that homosexuality is a natural variation on the sexual orientation spectrum when compared to non-mental health providers. Findings show favorable attitudes and behaviors of health-care providers toward LGBT individuals when compared to previous investigations in Lebanon. Implications on the educational, research, and policy levels are discussed.


Assuntos
Atitude do Pessoal de Saúde , Homossexualidade , Minorias Sexuais e de Gênero , Adulto , Estudos Transversais , Feminino , Humanos , Líbano , Masculino , Pessoa de Meia-Idade , Pessoas Transgênero
8.
Vulnerable Child Youth Stud ; 14(2): 151-165, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687041

RESUMO

Sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), continue to disproportionately affect Black adolescents. Those experiencing the psychological sequelae of mental illnesses are at increased risk. Here, we outline the development of an HIV/STI prevention intervention for heterosexually-active Black adolescents with mental illnesses. This research was guided by a psychosocial expansion of the Theory of Planned Behavior, nested within a broader social determinants of health framework. A youth community advisory board provided study oversight. Heterosexually-active Black adolescents aged 14 to 17 were recruited from community-based outpatient mental health providers for focus groups, surveys and two "dress rehearsals" of the intervention protocol (N = 68). The qualitative and quantitative findings indicated that knowledge, attitudes and skills related to consistent condom use, reduced number of sexual partners, routine HIV/STI testing, abstinence and emotion regulation were important areas to target. These elicitation data provided insight on the context of HIV/STI risk for the study population, and were used to develop the intervention content. "Project GOLD: We are Kings and Queens" was designed to be delivered over two days (three hours per day), with eight, 45-minute modules. The activities address behaviors, as well as cognitive, emotional, psychological and social processes associated with HIV/STI risk. Alongside evidence-based HIV/STI prevention strategies (e.g., sexual partner communication skills), the intervention activities are rooted in principles of Cognitive Behavioral Therapy. Dress rehearsal participants were in favor of the intervention and provided feedback on activity length, gender and cultural relevance, and strategies to sustain attention; this information was used to finalize the curriculum. In partnership with the community, we developed a theoretically-driven, gender and culturally relevant, developmentally and psychologically appropriate HIV/STI prevention program. Our ultimate goal is to standardize sexual health assessment and intervention in outpatient mental health treatment settings to meet sexual health needs in this underserved population.

9.
Am J Public Health ; 109(11): 1580-1583, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31536397

RESUMO

In response to the Institute on Minority Health and Health Disparities' (NIMHD) new health disparities research framework, we call on the National Institutes of Health (NIH) to acknowledge Arabs in the United States as a health disparity population. Arab classification as White leads to their cultural invisibility and perpetuates a cycle of undocumented health disparities.We provide examples of how this contested identity reinforces challenges associated with identifying this population and contributes to enactments of structural violence and undocumented health disparities. Decades of research with Arabs in the United States provides consistent evidence that their health does not fit the health profile of White Americans and that Arabs do not benefit from Whiteness and White privilege associated with their White racial categorization. On the contrary, Arabs in the United States experience discrimination and health disparities that require urgent attention; this can be achieved only by identifying the population with a racial category other than White.We conclude with recommendations to NIH and NIMHD to revise their definition of health disparity populations to include Arabs in the United States.


Assuntos
Árabes/classificação , Grupos Minoritários/classificação , Saúde das Minorias/classificação , Grupo com Ancestrais do Continente Europeu , Disparidades nos Níveis de Saúde , Humanos , Estados Unidos
10.
Health Soc Care Community ; 27(6): 1430-1437, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31338949

RESUMO

Iraqi refugees in the US experience a high prevalence of non-communicable diseases. In this article, we explore how cultural and structural realities intersect to influence utilisation of preventative healthcare and cancer screening with the aim of understanding health disparities in this population. We conducted three focus group discussions with a total of 14 Iraqi refugee women living in a northeastern US city in 2016 and analysed the qualitative data using a thematic analysis. Eight themes emerged from our data: (a) 'prevention is better than cure:' Iraqi refugee women maintain wellness; (b) physical and mental health are interrelated in causing and curing ill-health; (c) Iraqi refugee women embrace both biomedical and other healing practices; (d) God contributes to healing; (e) cancer is caused by dangerous environments. Three of the eight themes related to barriers to care; (f) multi-level problems within hospitals and clinics prevent the delivery of care; (g) financial barriers prevent access to care and good health; (h) competing priorities are a barrier to good health. We argue that understanding refugee health requires critical analysis of both culturally informed understandings of health and illness as well as the structural aspects of health disparities that result in limited access to life opportunities, racism and inequality for refugees and their communities.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Islamismo/psicologia , Refugiados/psicologia , Religião e Medicina , Fatores Socioeconômicos , Adulto , Características Culturais , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pesquisa Qualitativa , Estados Unidos
11.
J Racial Ethn Health Disparities ; 6(4): 790-798, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30877505

RESUMO

Severe maternal morbidity (SMM) is 50 to 100 times more common than maternal death, and has increased disproportionately among ethnic/racial minority women in the United States. However, specific knowledge about how the types and timing of severe maternal morbidities deferentially affect ethnic/racial minority women is poorly understood. This study examines racial/ethnic disparities in severe maternal morbidity during antepartum (AP), intrapartum (IP), and postpartum (PP) hospital admissions in the United States (US) for 2002-2014. We identified AP, IP, and PP hospitalizations in the National Inpatient Sample. Distribution of sociodemographic, behavioral and hospital characteristics, insurance, comorbidities, and SMM occurrence was summarized using descriptive statistics. Through Joinpoint regression, temporal SMM trends of hospitalizations were examined and stratified by race. Multivariate logistic regression assessed the association between race and SMM. We found black women have the highest proportion of SMM across all pregnancy intervals with a 70% greater risk of SMM during AP after adjusting for all cofactors. In the PP period, Hispanic women's risk of SMM is 19% less when compared to white women. Racial/ethnic disparities in SMM vary in timing and SMM type. Systematic investigation is needed to understand risks to black women and the protective factors associated with Hispanic women in the PP. Addressing racial disparities in maternal morbidity and mortality requires national policies and initiatives tailored to black women that address the specific types and timings of life-threatening obstetric complications.


Assuntos
Grupos Étnicos/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Complicações na Gravidez/etnologia , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Comorbidade , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde , Hispano-Americanos/estatística & dados numéricos , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Gravidez , Características de Residência , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
12.
Cult Health Sex ; 21(10): 1103-1116, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30646837

RESUMO

People interpret virginity in a variety of ways with different implications for sexual identity and behaviour. In Arab societies, heterosexuality and compulsory virginity before marriage are traditionally understood as ideals for a 'good' Arab girl, a 'good' Arab family and, consequently, a 'good' Arab society. In this study, our goal was to gain an in-depth understanding of the enactment of sexual agency and decision-making around virginity from the perspectives of Arab women living in the USA. We conducted a qualitative phenomenological study involving interviews with ten women whose accounts could be grouped into three distinct types: 'For me, it's the person you marry that you will be doing these things with'; 'I want to wait until marriage but I know there might be a possibility where I'm not'; and 'I started dating this guy, and I did lose my virginity to him'. The life stories of the women illustrate different ways of enacting sexual agency that are strongly influenced by socio-cultural norms and contexts. Our findings have important implications for future research to better understand decisions and behaviours about virginity and how Arab women in the USA enact their sexuality.


Assuntos
Árabes , Casamento/etnologia , Abstinência Sexual/etnologia , Sexualidade , Adulto , Cultura , Feminino , Humanos , Relações Interpessoais , Entrevistas como Assunto , Líbano/etnologia , Pennsylvania , Pesquisa Qualitativa , Comportamento Sexual/etnologia , Síria/etnologia
14.
Cancer Causes Control ; 29(10): 927-936, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30120642

RESUMO

BACKGROUND: Overall, foreign-born women are less likely than U.S.-born women to have initiated human papillomavirus (HPV) vaccination. However, foreign-born women are a racially/ethnically diverse population, and race/ethnicity is an independent predictor of HPV vaccination. METHODS: Using 2011-2015 National Health Interview Survey data, we used multivariable logistic regression to estimate odds ratios for foreign-born black, Latina, and Asian women compared to foreign-born white women and U.S.-born white women, adjusting for sociodemographic factors. We added socioeconomic factors followed by health care access indicators, which we conceptualized as potential mediators, to each model to assess whether they helped explain observed disparities. RESULTS: Foreign-born Asian ([odds ratio=] 0.43; [95% confidence interval:] 0.29-0.65) and Latina (0.46; 0.32-0.68) women had significantly lower adjusted odds of initiating HPV vaccination compared to foreign-born white women. Foreign-born white (0.64; 0.45-0.90), black (0.44; 0.29, 0.67), Latina (0.29; 0.24-0.35), and Asian (0.28; 0.21-0.38) women had significantly lower adjusted odds of HPV vaccination initiation compared to U.S.-born white women. Socioeconomic factors only explained HPV vaccination initiation disparities between foreign-born Latina women and foreign-born and U.S.-born white women. Health care access indicators modestly explained disparities between foreign-born white, black, and Latina women and U.S.-born white women only. CONCLUSIONS: We observed pronounced HPV vaccination initiation disparities among foreign-born women in relation to race/ethnicity and between foreign-born women from minoritized racial/ethnic backgrounds and U.S.-born white women. Research on nativity disparities in HPV vaccination should take into account race/ethnicity, and vice versa. Interventions that seek to facilitate HPV vaccination among foreign-born women are needed and should address the unique needs of those from minoritized racial/ethnic backgrounds to promote cancer equity.


Assuntos
Disparidades em Assistência à Saúde/etnologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Afro-Americanos/estatística & dados numéricos , Idoso , Grupos de Populações Continentais , Grupos Étnicos , Feminino , Acesso aos Serviços de Saúde , Hispano-Americanos/estatística & dados numéricos , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados Unidos , Adulto Jovem
15.
Oncol Nurs Forum ; 44(1): E20-E33, 2017 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-27991600

RESUMO

PROBLEM IDENTIFICATION: Arab American women are an ethnic minority and immigrant population in the United States with unique and nuanced sociocultural factors that influence preventive health behaviors. The aims of this article are to evaluate and synthesize the existing evidence on cervical cancer screening behaviors, as well as determine factors that influence these behaviors, among Arab American women.
. LITERATURE SEARCH: Extensive literature searches were performed using PubMed, CINAHL®, Scopus, Embase, and Cochrane databases; articles published through October 2015 were sought. 
. DATA EVALUATION: Of 17 articles, 14 explicitly identified Arab and/or Muslim women and cervical cancer screening in either the title or the abstract; the remaining three focused on cancer attitudes and behaviors in Arab Americans in general but measured cervical cancer screening. Eleven articles reported different aspects of one intervention. Because of methodologic heterogeneity, the current authors synthesized results narratively.
. SYNTHESIS: Key factors influencing cervical cancer screening were identified as the following. CONCLUSIONS: Cervical cancer screening rates among Arab American women are comparable to other ethnic minorities and lower than non-Hispanic White women. Findings are inconsistent regarding factors influencing cervical cancer screening behaviors in this underrepresented group. 
. IMPLICATIONS FOR RESEARCH: Significant need exists for more research to better understand cervical cancer prevention behaviors in this group to inform culturally relevant interventions. Healthcare providers play a crucial role in increasing cervical cancer screening awareness and recommendations for Arab American women.


Assuntos
Árabes/psicologia , Árabes/estatística & dados numéricos , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Programas de Rastreamento/psicologia , Programas de Rastreamento/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Detecção Precoce de Câncer/psicologia , Detecção Precoce de Câncer/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados Unidos/etnologia , Neoplasias do Colo do Útero/etnologia
16.
Nurse Educ Today ; 50: 8-11, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28002756

RESUMO

BACKGROUND: Situated in a research-intensive School of Nursing, the Advanced Qualitative Collective (AQC) provides an innovative educational forum for the study of qualitative research by doctoral and postdoctoral scholars. This long-standing collective is guided by a faculty facilitator using a collaborative co-learning approach to address individual and group needs, from the conception of research projects through dissemination of completed qualitative research. This article describes the dynamics of the AQC and the ways a co-created pedagogical entity supports professional development among its diverse members. The informal, participatory style, and dynamic content used by the AQC resists a course structure typical of doctoral education in health sciences, and promotes engagement and self-direction. The AQC provides opportunities for members to examine theoretical frameworks and methodologies rarely addressed within a positivism-dominant learning environment while simultaneously serving as an alternative exemplar for the pedagogy of research.


Assuntos
Docentes/psicologia , Aprendizagem , Pesquisa Qualitativa , Projetos de Pesquisa , Comportamento Cooperativo , Currículo , Educação de Pós-Graduação em Enfermagem , Humanos , Pesquisa em Educação de Enfermagem , Estudantes de Enfermagem
17.
Mol Ecol Resour ; 17(4): 721-729, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27768245

RESUMO

The inclusion of next-generation sequencing technologies in population genetic and phylogenetic studies has elevated the need to balance time and cost of DNA extraction without compromising DNA quality. We tested eight extraction methods - ranging from low- to high-throughput techniques - and eight phyla: Annelida, Arthropoda, Cnidaria, Chordata, Echinodermata, Mollusca, Ochrophyta and Porifera. We assessed DNA yield, purity, efficacy and cost of each method. Extraction efficacy was quantified using the proportion of successful polymerase chain reaction (PCR) amplification of two molecular markers for metazoans (mitochondrial COI and nuclear histone 3) and one for Ochrophyta (mitochondrial nad6) at four time points - 0.5, 1, 2 and 3 years following extraction. DNA yield and purity were quantified using NanoDrop absorbance ratios. Cost was estimated in terms of time and material expense. Results show differences in DNA yield, purity and PCR success between extraction methods and that performance also varied by taxon. The traditional time-intensive, low-throughput CTAB phenol-chloroform extraction performed well across taxa, but other methods also performed well and provide the opportunity to reduce time spent at the bench and increase throughput.


Assuntos
DNA/isolamento & purificação , Animais , Anelídeos , Artrópodes , Cordados , Cnidários , Equinodermos , Sequenciamento de Nucleotídeos em Larga Escala , Moluscos , Filogenia , Reação em Cadeia da Polimerase , Poríferos , Análise de Sequência de DNA
18.
J Clin Nurs ; 25(23-24): 3533-3544, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27272932

RESUMO

AIMS AND OBJECTIVES: To describe prevalence of reproductive coercion, sexual risk behaviours and mental health symptoms among women reporting lifetime sexual experiences with men and women compared to peers reporting sex exclusively with men. BACKGROUND: Reproductive coercion, a global public health problem, is understudied among sexual minority women. Violence against women remains high among women who have sex with women and men. Rates of sexual and physical violence among this population are higher than women reporting exclusive sexual partnerships with either men or women. Nurses and other healthcare providers often do not conduct comprehensive sexual histories; assumptions related to a sex partner's gender may provide indications of broader health implications. DESIGN: Cross-sectional survey of low-income Black women ages 18-25 recruited from six community-based sites for a parent study focused on intimate partner violence and health. METHODS: We analysed survey data from participants who reported lifetime sexual experiences with men and women (N = 42) and compared their outcomes to those of women reporting sexual experiences with men only (N = 107). RESULTS: A greater proportion of women who have sex with women and men reported experiencing reproductive coercion. Women who have sex with women and men also reported a greater number of lifetime intimate partner physical and sexual violence experiences, traded sex for resources, and had post-traumatic stress disorder symptoms. CONCLUSIONS: Findings provide vital information that can inform nursing clinical practice, specifically related to history-taking, screening protocols and counselling strategies for intimate partner violence and mental health among women who have sex with women and men. RELEVANCE TO CLINICAL PRACTICE: Strategies for addressing reproductive coercion and intimate partner violence as well as the health consequences among women who have sex with women and men in clinical and community-based settings should include a longitudinal understanding of sexual behaviour and gender of sex partners.


Assuntos
Coerção , Transtorno Depressivo/epidemiologia , Minorias Sexuais e de Gênero/psicologia , Maus-Tratos Conjugais/psicologia , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano , Baltimore/epidemiologia , Aconselhamento , Estudos Transversais , Transtorno Depressivo/enfermagem , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
19.
Heart Lung ; 45(1): 70-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26702503

RESUMO

OBJECTIVES: To explore whether patient's personal beliefs about inhaled corticosteroid (ICS) and integrative medicine (IM) are discussed at routine primary care visits for asthma. BACKGROUND: Negative medication beliefs and preferences for IM can be salient barriers to effective asthma self-management. METHOD: A qualitative analysis of transcripts from 33 audio-recorded primary care visits using conventional content analysis techniques. RESULTS: Four themes emerged when providers had knowledge of patient's beliefs: negative ICS beliefs, IM use for asthma, decision-making and healthy lifestyles. Two themes were identified when providers did not have this knowledge: asthma self-management and healthy lifestyles. CONCLUSION: When providers had knowledge of their patient's IM endorsement or negative ICS beliefs, they initiated conversations about these modifiable beliefs. Without training in IM and in effective communication techniques, it is unlikely that providers will be able to effectively engage in shared decision-making aimed at improving asthma self-management.


Assuntos
Corticosteroides/administração & dosagem , Asma/tratamento farmacológico , Comunicação , Administração por Inalação , Corticosteroides/uso terapêutico , Adulto , Idoso , Tomada de Decisões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autocuidado/métodos
20.
J Clin Nurs ; 24(21-22): 3318-26, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26249817

RESUMO

AIMS AND OBJECTIVES: The purpose of this study was to explore perceptions of cardiac self-care among Lebanese family caregivers of cardiac patients. The specific aims were to describe the cultural context of cardiac care-giving in Lebanon and to explore the roles of family caregivers in enhancing self-care practices in patients with cardiac diseases. BACKGROUND: The role of family caregivers in Lebanon, a country in the Middle East, is assumed to extend beyond care-giving to making decisions on behalf of the patient and assuming responsibility for patient care. To date, there has been no study done to empirically validate this impression. DESIGN: The design of the study is qualitative descriptive that used semi-structured individual interviews with family caregivers of Lebanese cardiac patients. METHOD: Thirteen family caregivers of cardiac patients were recruited from a referral medical centre in Lebanon. The participants were designated by their patients and interviewed in a place of their choice. RESULTS: One overarching and three themes emerged from data analysis describing roles of family care givers in cardiac self-care. The overarching theme was: Family caregivers of Lebanese cardiac patients were unfamiliar with the term, concept and meaning of Self-Care. The moral and emotional duty to care for the family member stemmed from obligation and responsibility towards patients (theme I). Interdependent care (theme II) between cardiac patients and their families emerged as a significant cultural role. Family members play multiple supportive roles in care-giving namely emotional, informational and instrumental role (theme III). CONCLUSION: In this study, family caregiver role is shown to be based in the sense of obligation and duty towards the sick family member who collectively provide different types of supportive care. RELEVANCE TO CLINICAL PRACTICE: Nurses have to give significant importance to the family caregiver role as an integral part of any culturally sensitive patient/family intervention.


Assuntos
Cuidadores/psicologia , Família , Conhecimentos, Atitudes e Prática em Saúde , Autocuidado , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Entrevistas como Assunto , Líbano , Masculino , Pessoa de Meia-Idade
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