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1.
BMC Public Health ; 19(1): 1146, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31429735

RESUMO

BACKGROUND: UK African and Caribbean (AfC) communities are disproportionately burdened by type 2 diabetes (T2D). Promoting healthy eating and physical activity through structured education is the cornerstone of T2D care, however cultural barriers may limit engagement in these communities. In addition, changes in lifestyle behaviour are shaped by normative influences within social groups and contextual factors need to be understood to facilitate healthful behaviour change. The Behaviour Change Wheel (BCW) and associated COM-B framework offer intervention designers a systematic approach to developing interventions. The aim of this study was to apply the BCW in the design of a culturally sensitive self-management support programme for T2D in UK AfC communities. METHODS: An intervention development study was conducted. Focus groups were held with 41 AfC patients with T2D to understand healthful weight-management, diet and physical activity behaviours. The COM-B framework and BCW were used to evaluate the qualitative data, identify appropriate behaviour change techniques and specify the intervention components. RESULTS: Participants were motivated to avoid diabetes-related consequences although did not always understand the negative impact of their current health behaviours on long-term diabetes outcomes. Barriers to healthful behaviour included gaps in knowledge related to diet, physical activity and weight management guidance. In addition, motivation and social opportunity barriers included an acceptance of larger body sizes, rejection of body mass index for weight guidance and cultural identity being strongly linked to consumption of traditional starches. There was a lack of social opportunity to perform moderate to vigorous physical activity, although walking and dance were culturally acceptable. The resulting Healthy Eating & Active Lifestyles for Diabetes (HEAL-D) intervention uses social support, social comparison, credible sources and demonstration as key behaviour change techniques. CONCLUSION: Use of COM-B and the BCW highlighted the need for an intervention to address motivational and social opportunity barriers to engaging in healthful behaviours, as well as addressing key gaps in knowledge. This framework facilitated the linkage of theoretical behaviour constructs with evidence-based behaviour change techniques, which will enable us to evaluate operationalisation of our chosen BCTs and their impact on behaviour change in a future feasibility study.


Assuntos
Terapia Comportamental/educação , Assistência à Saúde Culturalmente Competente/métodos , Diabetes Mellitus Tipo 2/etnologia , Dieta para Diabéticos/métodos , Educação de Pacientes como Assunto/métodos , Autogestão/educação , Adulto , Grupo com Ancestrais do Continente Africano/educação , Terapia Comportamental/métodos , Região do Caribe/etnologia , Diabetes Mellitus Tipo 2/terapia , Dieta para Diabéticos/etnologia , /métodos , Exercício , Feminino , Grupos Focais , Comportamentos Relacionados com a Saúde/etnologia , Estilo de Vida Saudável , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Avaliação de Programas e Projetos de Saúde , Autogestão/métodos , Apoio Social , Reino Unido
2.
Infant Ment Health J ; 40(5): 659-672, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31318444

RESUMO

Despite recognition that immigrant women face significant health challenges, addressing the healthcare needs of immigrants is a source of debate in the United States. Lack of adequate healthcare for immigrants is recognized as a social justice issue, and other countries have incorporated immigrants into their healthcare services. Oslo, the fastest growing capital in Europe, is rapidly shifting to a heterogeneous society prompting organizational action and change. The New Families Program serves first-time mothers and their infants in an Oslo district serving 53% minorities from 142 countries. Anchored in salutogenic theory, the program aims to support the parent-child relationship, children's development and social adaptation, and to prevent stress-related outcomes. Formative research has informed the successful program development and implementation within the existing maternal and child healthcare service. Implications for addressing maternal and child health needs of an immigrant population are presented.


Assuntos
Assistência à Saúde Culturalmente Competente , Emigrantes e Imigrantes , Serviços de Saúde Materno-Infantil/organização & administração , Adulto , Diversidade Cultural , Assistência à Saúde Culturalmente Competente/métodos , Assistência à Saúde Culturalmente Competente/organização & administração , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Lactente , Noruega , Inovação Organizacional , Desenvolvimento de Programas , Estados Unidos
3.
Infant Ment Health J ; 40(5): 742-756, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31291015

RESUMO

Effecting a paradigm shift from "reproductive health" to "reproductive justice" within the perinatal field requires changes simultaneously at the levels of the individual healthcare provider and the system of care. The Infant-Parent Program at the University of California, San Francisco (UCSF) has extended its pioneering infant and early childhood mental health consultation to perinatal service systems applying an infant mental health approach to programs caring for expecting and new parents. In partnership with two nursing programs, UCSF consultants direct their efforts at supporting reflective practice capacities and use-of-self in patient-provider relationships. Both nursing programs serve vulnerable groups of expectant and new parents who grapple with challenges to health and well-being stemming from structural racism. As reflective capacities are supported within the consultation case conferences, providers spontaneously identify the need for tools to effectively address issues of race, class, and culture and to combat structural racism throughout the healthcare system. Policies and procedures that uphold structural racism cease to be tolerable to providers who bring their full selves to the work that they are trained to do. Using these nurse consultation partnerships as organizational case studies, this article describes a range of challenges that arise for providers and delineates steps to effective engagement toward reproductive justice.


Assuntos
Assistência à Saúde Culturalmente Competente , Pessoal de Saúde , Relações Profissional-Paciente/ética , Racismo/prevenção & controle , Encaminhamento e Consulta , Diversidade Cultural , Assistência à Saúde Culturalmente Competente/métodos , Assistência à Saúde Culturalmente Competente/organização & administração , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/normas , Humanos , Lactente , Saúde do Lactente/etnologia , Saúde Mental/etnologia , Pesquisa em Avaliação de Enfermagem , Gravidez , Encaminhamento e Consulta/ética , Encaminhamento e Consulta/normas , Estados Unidos , Populações Vulneráveis/etnologia
4.
Sultan Qaboos Univ Med J ; 19(1): e11-e14, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31198589

RESUMO

Female patients in Oman face a certain amount of pressure from their families when making high-stakes decisions regarding personal healthcare. In fact, some women waive their right to make decisions, typically giving that responsibility to their husbands or fathers. This article highlights the need to empower females in decision-making when it comes to their own well-being. Moreover, informed consent should not be signed by anyone but the patient herself if the patient is deemed competent by a medical professional.


Assuntos
Cultura , Consentimento Livre e Esclarecido/normas , Assistência à Saúde Culturalmente Competente/métodos , Tomada de Decisões , Feminino , Humanos , Omã , Relações Médico-Paciente
6.
Comput Inform Nurs ; 37(5): 243-249, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31094913

RESUMO

This paper aims to discuss the challenges faced during a pilot study that tested a technology-based cancer pain management program among Asian American survivors of breast cancer and provide directions for future technology-based interventions for racial and ethnic minorities. Data consisting of research diaries and meeting minutes underwent content analysis to extract themes that reflected the challenges. The challenges included those related to (1) diversities within the population of Asian American survivors of breast cancer; (2) survivors' treatment and healing process; (3) Internet resources from the participants' countries of origin; (4) building trust between researchers and participants/gatekeepers; (5) fidelity of the intervention; and (6) cultural sensitivity. Future design and implementation of technology-based programs for racial and ethnic minorities must consider these challenges.


Assuntos
Sobreviventes de Câncer/psicologia , Manejo da Dor/métodos , Mídias Sociais/tendências , Americanos Asiáticos/psicologia , Americanos Asiáticos/estatística & dados numéricos , Neoplasias da Mama/complicações , Neoplasias da Mama/psicologia , Sobreviventes de Câncer/estatística & dados numéricos , Assistência à Saúde Culturalmente Competente/métodos , Feminino , Humanos , Internet , Pessoa de Meia-Idade , Manejo da Dor/tendências , Projetos Piloto
7.
Plast Surg Nurs ; 39(2): 35-40, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31136555

RESUMO

Orofacial clefts are one of the most common global birth defects. Orofacial clefts may be part of a syndrome or an isolated birth defect, and affect approximately 1-1.5 per 1,000 live births worldwide with noted inequalities across geographical areas and cultures. In the United States, Asian American populations have a substantially higher incidence of cleft lip with or without cleft palate (2/1,000 live births). Orofacial clefts are a key health issue with substantial health care costs, and associated medical, psychological, and social ramifications. It has been estimated that the health care costs within the United States are approximately $697 million over a child's lifetime. In disorders like orofacial clefts, because of the complexity of the condition and subsequent medical interventions, as well as the cultural intricacies of the Asian culture, it requires significant knowledge and understanding by the health care providers. In order to provide optimal and safe cleft care, reduce health care costs, and improve the outcomes for the Asian American population, a culturally sensitive, multidisciplinary, and coordinated approach is needed. Increased culturally specific education, early access to prenatal care, and ongoing infant and pediatric health care are essential.


Assuntos
Americanos Asiáticos/psicologia , Fenda Labial/cirurgia , Fenda Labial/epidemiologia , Assistência à Saúde Culturalmente Competente/etnologia , Assistência à Saúde Culturalmente Competente/métodos , Humanos , Fatores de Risco , Estados Unidos/epidemiologia , Estados Unidos/etnologia
8.
Rev Bras Enferm ; 72(2): 314-320, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31017191

RESUMO

OBJECTIVE: To translate and adapt the Patient Perceptions of Hemodialysis Scale (PPHS) to the Brazilian context. METHOD: A methodological study, in which the stages of initial translation, synthesis of translations, back translation, evaluation by an expert committee and pre-test of the PPHS were performed. RESULTS: Two initial translations by independent translators, experienced in the health area and fluent in English. Subsequently, the synthesis of the translations was carried out, and this synthesis was back translated to the original language (American English).The translated and back-translated versions were evaluated by an expert committee made up of six PhD experts from the health area. The judges' evaluations resulted in content validity indexes for each item of the scale, and 7 of the 36 items had to be revised. Subsequently, a pretest was carried out with 20 participants, who considered the instrument intelligible. CONCLUSION: The PPHS is adequately translated and adapted to Brazilian Portuguese.


Assuntos
Pacientes/psicologia , Percepção , Psicometria/normas , Diálise Renal/normas , Adulto , Brasil , Assistência à Saúde Culturalmente Competente/métodos , Assistência à Saúde Culturalmente Competente/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Diálise Renal/métodos , Diálise Renal/psicologia , Reprodutibilidade dos Testes , Inquéritos e Questionários , Tradução
9.
Drug Alcohol Depend ; 199: 18-26, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-30981045

RESUMO

BACKGROUND: Current models of HIV prevention intervention dissemination involve packaging interventions developed in one context and training providers to implement that specific intervention with fidelity. Providers rarely implement these programs with fidelity due to perceived incompatibility, resource constraints, and preference for locally-generated solutions. Moreover, such interventions may not reflect local drug markets and drug use practices that contribute to HIV risk. PURPOSE: This paper examines whether provider-developed interventions based on common factors of effective, evidence-based behavioral interventions led to reduction in drug-related HIV risk behaviors at four study sites in Ukraine. METHODS: We trained staff from eight nongovernmental organizations (NGOs) to develop HIV prevention interventions based on a common factors approach. We then selected four NGOs to participate in an outcome evaluation. Each NGO conducted its intervention for at least N = 130 participants, with baseline and 3-month follow-up assessments. RESULTS: At three sites, we observed reductions in the prevalence of both any risk in drug acquisition and any risk in drug injection. At the fourth site, prevalence of any risk in drug injection decreased substantially, but the prevalence of any risk in drug acquisition essentially stayed unchanged. CONCLUSIONS: The common factors approach has some evidence of efficacy in implementation, but further research is needed to assess its effectiveness in reducing HIV risk behaviors and transmission. Behavioral interventions to reduce HIV risk developed using the common factors approach could become an important part of the HIV response in low resource settings where capacity building remains a high priority.


Assuntos
Assistência à Saúde Culturalmente Competente/métodos , Infecções por HIV/etnologia , Infecções por HIV/prevenção & controle , Abuso de Substâncias por Via Intravenosa/etnologia , Abuso de Substâncias por Via Intravenosa/prevenção & controle , Adolescente , Adulto , Assistência à Saúde Culturalmente Competente/tendências , Feminino , Seguimentos , Humanos , Masculino , Uso Comum de Agulhas e Seringas/efeitos adversos , Uso Comum de Agulhas e Seringas/tendências , Organizações/tendências , Fatores de Risco , Ucrânia/etnologia , Adulto Jovem
10.
Perm J ; 232019.
Artigo em Inglês | MEDLINE | ID: mdl-30939290

RESUMO

INTRODUCTION: Latinos face unique challenges engaging with their health care providers for risk management of cardiovascular disease (CVD). OBJECTIVE: To better understand differences in how Latinos and non-Latino whites (NLWs) experience CVD care. METHODS: We examined self-reported activation, engagement, confidence, and communication comparing Latinos (n = 194) and NLWs (n = 208). Data were taken from baseline survey assessments of participants in the CREATE Wellness Study (NCT02302612), designed to help patients with poorly controlled CVD risk factors more actively engage in their care. The groups were compared using χ2 tests and separate logistic regression models adjusting for age, age and income, and age and educational attainment. RESULTS: Latinos in this cohort were younger, were less educated, and had lower incomes than did NLWs. In age-adjusted models, Latinos were significantly less likely to report knowing how to ask good questions about their health (71.1% vs 83.7% for NLW, p < 0.01; adjusted odds ratio = 0.49, 95% confidence interval = 0.29-0.83). Further adjustment by educational attainment or income did not attenuate this association. Latinos were also significantly more likely to report positive experiences and confidence with several measures of chronic illness care (adjusted odds ratio range = 1.57-2.01). Further adjustment by educational attainment eliminated these associations. CONCLUSION: We found notable differences between Latinos and NLWs in their experience of health care. These results provide insights into how CVD risk management programs can be tailored for Latinos. Interventions to improve patient activation and engagement for Latinos with CVD should emphasize question-asking skills.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Assistência à Saúde Culturalmente Competente/métodos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Comunicação em Saúde/métodos , Hispano-Americanos/estatística & dados numéricos , Fatores Etários , Atitude Frente a Saúde , California , Doenças Cardiovasculares/psicologia , Estudos de Coortes , Escolaridade , Grupo com Ancestrais do Continente Europeu/psicologia , Feminino , Hispano-Americanos/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Autorrelato , Fatores Socioeconômicos
11.
Rev Bras Enferm ; 72(suppl 1): 299-306, 2019 Feb.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30942376

RESUMO

OBJECTIVE: To describe and analyze the national and international scientific production on Nursing care for the transgender or gender-variance population. METHOD: Integrative review of the literature, conducted throughout  the Virtual Health Library, Cumulative Index to Nursing and Allied Health Literature, Public Medline and Web of Science databases, without pre-established periods of time and using the descriptors "Transgender AND 'Nursing Assistance'" and "Transgender AND 'Nursing care'". RESULTS: We included 11 articles, published between 2005 and 2016, broadly North American with only one Brazilian, so categorized: I- Fragility in the care of transgender people; II - Health of the transgender population: general and specific demands; III- Public health policies for transgender people. Transgender people have not found yet answers to their health demands; they are victims of prejudices and violence in services and seek care in extreme cases of sickness. FINAL CONSIDERATIONS: Understanding their needs is primordial to build knowledge and practices that support nursing care.


Assuntos
Cuidados de Enfermagem/normas , Percepção , Pessoas Transgênero/psicologia , Assistência à Saúde Culturalmente Competente/métodos , Assistência à Saúde Culturalmente Competente/normas , Humanos , Cuidados de Enfermagem/tendências , Prática Profissional/tendências , Sexismo/psicologia
12.
Nurs Womens Health ; 23(2): 163-171, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30844366

RESUMO

Women who are in the sexual minority or are gender nonconforming experience more physical and mental health disparities compared with those in the sexual majority. Individuals in the minority have reported a fear of being judged or a feeling of being invisible to health care providers. Many nurses believe that they treat all patients the same, but they may be unaware of the special cultural needs of individuals in the minority. In this article, we describe health disparities experienced by lesbian, gay, bisexual, transgender, questioning/queer, and intersex (LGBTQI) populations; explain definitions and terms to improve communication; and discuss best practices to provide inclusive environments for these individuals. We also discuss the process of coming out and how nurses can best meet the needs of individuals in the different stages of coming out.


Assuntos
Assistência à Saúde Culturalmente Competente/métodos , Minorias Sexuais e de Gênero/psicologia , Adulto , Assistência à Saúde Culturalmente Competente/normas , Feminino , Homossexualidade/psicologia , Humanos , Cuidados de Enfermagem/métodos , Cuidados de Enfermagem/normas , Comportamento Sexual/psicologia
13.
Aust J Prim Health ; 25(2): 118-124, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30721646

RESUMO

Resettled refugees in Australia have been shown to exhibit a high prevalence of limited health literacy and are at greater risk of mismanaging their medication and not being able to access the healthcare services they need. The aim of the current study is to explore the barriers to accessing medicines and pharmacy services in Queensland, Australia, among resettled refugees from Africa; this research was conducted from the perspectives of healthcare professionals and people who help the refugees to resettle in their adopted country (resettlement workers). A 'generic qualitative' approach was used in this study. In-depth interviews were conducted among healthcare professionals (two GPs, nine pharmacists and three nurse practitioners) and resettlement workers. Participants were recruited via a purposive snowball sampling method in the cities of Brisbane and Townsville, Queensland, Australia. Twenty-four in-depth interviews were conducted; 14 with healthcare professionals. Three key themes emerged from the data: (1) Communication Barriers; (2) Navigating the Health System; and (3) Belief Systems and Culture. Perceptions of those 'at the coalface' - healthcare professionals and people who are responsible for assisting refugees to resettle in Australia - provide insight into the language and cultural challenges experienced by resettled refugees from Africa regarding access to the Australian health system, including medicines and pharmacy services.


Assuntos
Assistência à Saúde Culturalmente Competente/métodos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Farmácias/estatística & dados numéricos , Refugiados/estatística & dados numéricos , África/etnologia , Atitude do Pessoal de Saúde , Austrália , Barreiras de Comunicação , Assistência à Saúde Culturalmente Competente/estatística & dados numéricos , Cultura , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Alfabetização em Saúde/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Masculino , Queensland
14.
BMC Palliat Care ; 18(1): 21, 2019 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-30764810

RESUMO

BACKGROUND: There is little scholarship on culturally safe approaches to palliative care, especially for rural Indigenous clients. Thus, it is important to articulate how cultural safety can be enacted to support rural Indigenous Peoples and communities at end of life. We sought to identify strategies described in existing literature that have potential to deepen our understanding of culturally safe approaches to palliative care within rural and small-town settings in Canada. METHODS: We searched for peer-reviewed and grey literature about Indigenous palliative care in rural and small-town settings in Canada, United States, New Zealand, and Australia. Medline, CINAHL, and Embase were searched. We thematically analyzed 22 resulting articles to address our interest in culturally safe approaches to palliative care in rural/small-town and on-reserve contexts. RESULTS: The following themes were extracted from the literature: symbolic or small gestures; anticipating barriers to care; defer to client, family and community; shared decision-Making; active patient and family involvement; respectful, clear, and culturally appropriate communication; community ownership of services; empower cultural identity, knowledge, and traditions; and, policy. DISCUSSION: Culturally competent practices can improve Indigenous palliative care services; however, they do not result in decolonized care. Strategies include: symbolic or small gestures; anticipating barriers to access; deferring to the client, family, and community members; and, collective decision making and family involvement. Culturally safe approaches contribute to institutional or organizational change and decolonized care. Strategies include: involvement of patient and family in service planning; reflection about individual and systemic racism; community ownership of services and; recognizing distinct Worldviews that shape care. CONCLUSIONS: Culturally safe strategies invite decolonization of care through awareness of colonialism, racism, and discrimination. They invite commitment to building partnerships, power sharing, and decision-making in the delivery of care. Culturally competent activities may catalyze the adoption of a cultural safety framework; however, mislabeling of cultural competency as cultural safety may contribute to organizational inaction and a watering down of the spirit of cultural safety.


Assuntos
Assistência à Saúde Culturalmente Competente/normas , Cuidados Paliativos/métodos , Grupos Populacionais/psicologia , Competência Cultural , Assistência à Saúde Culturalmente Competente/métodos , Humanos , Cuidados Paliativos/psicologia , Cuidados Paliativos/normas , Grupos Populacionais/etnologia , População Rural , Determinantes Sociais da Saúde/etnologia
15.
Fam Process ; 58(1): 34-52, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30786004

RESUMO

Low-income Latinas/os are exposed to widespread mental health disparities in the United States. Most recently, a resurgence of anti-immigration narratives has led vulnerable Latina/o immigrants to experience considerable contextual stressors with multiple deleterious consequences for their overall well-being, including significant disruptions to their parenting practices. Within this context of adversity and despite the multiple benefits associated with parent training (PT) prevention interventions, the availability of contextually and culturally relevant PT interventions remains limited in underserved Latina/o communities. This paper constitutes a contribution to this gap in knowledge by presenting a model of intervention delivery utilized in the dissemination of culturally adapted versions of the evidence-based intervention known as GenerationPMTO.© The proposed model also describes a process of change that we have documented in empirical research with low-income Latina/o immigrant parents who have been exposed to the adapted interventions. The manuscript is organized in four sections. First, an overview of the model is discussed, along with a brief summary of major theories. Next, the core components of the model are described, complemented by the presentation of a case study. Finally, implications for prevention and clinical intervention are discussed.


Assuntos
Assistência à Saúde Culturalmente Competente/métodos , Educação não Profissionalizante/métodos , Emigrantes e Imigrantes/psicologia , Hispano-Americanos/psicologia , Poder Familiar/psicologia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Pobreza/psicologia , Estados Unidos
16.
J Nurs Educ ; 58(2): 117-120, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30721314

RESUMO

BACKGROUND: Cultural consciousness is a central element of purposeful and appropriate health care delivery. Research suggests that cultural consciousness is strengthened through self-reflection, dialogue about race, and experience within other cultures. METHOD: Two cohorts of senior-level nursing students participated in a 1-week cultural immersion service-learning (CISL) experience in an isolated, rural American Indian community. Student reflections and White Racial Identity Attitude Scale (WRIAS) data were collected and analyzed. RESULTS: The CISL experience facilitated culturally conscious care in two thirds of the participating nursing students. Differences in WRIAS scores were statistically significant (p < .0001) with an effect size of 1.9. CONCLUSION: Implementing CISL experiences into the undergraduate curriculum may help nursing students recognize societal privilege and improve cultural consciousness. Recommendations are provided to assist nurse educators to develop partnerships with indigenous nations, which make CISL experiences possible. [J Nurs Educ. 2019;58(2):117-120.].


Assuntos
Competência Cultural/educação , Assistência à Saúde Culturalmente Competente/métodos , Bacharelado em Enfermagem/métodos , Autoeficácia , Estudos de Coortes , Currículo , Humanos , Pesquisa em Educação de Enfermagem , População Rural , Estudantes de Enfermagem
17.
Transcult Psychiatry ; 56(2): 379-397, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30663935

RESUMO

Crash-landings are a recurrent theme in Ghanaian witchcraft discourse. In the society's witchcraft lore, these are inadvertently aborted flights of maleficent witches en route to secret nocturnal witches' assemblies or to carry out diabolical deeds. While those accused of being witches who have crash-landed invariably face severe mistreatment, no study has systematically explored this purported phenomenon. In this article, I describe the results of an analysis of 10 cases of alleged crash-landings of witches that were reported in the Ghanaian media over a 12-year period. In addition to identifying the common characteristics associated with the alleged crash-landings, I provide a summary description of each case. The results show that the alleged witches were overwhelmingly female, elderly, and poor, and suffered from grave psychopathological conditions. Policy implications of the findings are discussed.


Assuntos
Assistência à Saúde Culturalmente Competente/métodos , Transtornos Mentais/psicologia , Bruxaria , Adulto , Idoso , Feminino , Gana , Humanos , Masculino , Transtornos Mentais/enfermagem , Pessoa de Meia-Idade , Religião e Psicologia
18.
Home Healthc Now ; 37(1): 36-43, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30608466

RESUMO

Over nine million people living in the United States are military Veterans over the age of 65. Many utilize civilian care providers, creating a need for civilian providers to have an understanding of the unique healthcare issues of this population. This article describes the qualitative results of a mixed-methods study of nine home care nurses' experiences caring for Veterans. Three themes emerged from the data: Challenges Coordinating Care, Building a Rapport Takes More Time, and Recognizing Impact of Military Service on Patient's Worldview. As demonstrated in this study, home care nurses care for Veterans every day. Although similarities exist, nurses readily described differences in caring for Veterans compared with non-Veterans that can impact patient outcomes. It is imperative for the nursing workforce to not only assess for military/Veteran status but to also have some knowledge of military culture and Veteran-specific healthcare issues.


Assuntos
Distúrbios de Guerra/enfermagem , Assistência à Saúde Culturalmente Competente/métodos , Enfermagem Domiciliar/métodos , Papel do Profissional de Enfermagem , Veteranos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Competência Clínica , Feminino , Humanos , Masculino , Militares/estatística & dados numéricos , Conforto do Paciente/métodos , Estados Unidos
19.
BMC Psychol ; 7(1): 2, 2019 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-30621791

RESUMO

BACKGROUND: Incidence of end stage kidney disease (ESKD) for Indigenous Australians is especially high in remote and very remote areas of Australia (18 and 20 times the rate of comparable non-Indigenous people). Relocating away from family and country for treatment, adjusting to life with a chronic condition and time lost to dialysis cause grief and sadness which have immense impact on quality of life and challenges treatment adherence. We describe the first randomised controlled trial to address both chronic disease and mental health in Indigenous people with ESKD, which is the first to test the effectiveness of a culturally adapted e-mental health intervention in this population. It builds on an existing program of mental health research with demonstrated efficacy - the Aboriginal and Islander Mental Health Initiative (AIMhi) - to test the newly developed electronic motivational care planning (MCP) therapy - the AIMhi Stay Strong App. METHODS: This is a 3-arm, waitlist, single-blind randomised controlled trial testing the efficacy of the Stay Strong App in improving psychological distress, depressive symptoms, quality of life and treatment adherence among Indigenous clients undergoing haemodialysis for ESKD in Alice Springs and Darwin with follow up over two periods of 3 months (total of 6 months observation). The study compares the efficacy of MCP using the AIMhi Stay Strong App with two control groups (control app intervention and treatment as usual) on participant-reported psychological distress (the primary outcome) using the Kessler Distress Scale (K10); depressive symptoms using the adapted Patient Health Questionnaire (PHQ-9); quality of life using the EuroQoL instrument (EQ5D) and adherence to dialysis treatment planning through file audit. Participants are randomised to receive MCP either at baseline (early treatment) or after 3 months (delayed treatment). The study also examines the cost effectiveness of this therapy in this setting through examination of health care service utilisation across groups during the first 3 months. DISCUSSION: This project will contribute much needed evidence on the efficacy of an electronic wellbeing intervention for Indigenous people with ESKD - a group in which distress is likely to be unacceptably high, yet relatively untreated. TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry; ACTRN12617000249358 ; Date registered: 17/02/2017.


Assuntos
Assistência à Saúde Culturalmente Competente/métodos , Promoção da Saúde/métodos , Serviços de Saúde do Indígena , Diálise Renal/psicologia , Insuficiência Renal Crônica/psicologia , Telemedicina/métodos , Cooperação e Adesão ao Tratamento/psicologia , Atitude Frente a Saúde , Austrália , Feminino , Humanos , Masculino , Motivação , Grupos Populacionais , Qualidade de Vida/psicologia , Insuficiência Renal Crônica/terapia , Projetos de Pesquisa , Método Simples-Cego , Resultado do Tratamento
20.
Aust J Prim Health ; 25(1): 72-81, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30630588

RESUMO

A Masterclass Program was developed to strengthen the research capacity of staff within Aboriginal Community-Controlled Health Organisations (ACCHOs) and featured three Masterclasses delivered across Australia, including Understanding Research, Undertaking Research and Research Evaluation. A mixed-method process and impact evaluation of the Masterclass Program was undertaken. The process evaluation examined the reach of the Program and the impact evaluation comprised an online survey (n=45) and semi-structured interviews (n=21) with Masterclass participants. During 2014-17, 27 Masterclasses were delivered to 260 people, including predominantly ACCHO personnel but also Indigenous doctors and research institute staff who work closely with the ACCHO sector. Most survey respondents felt the Masterclasses improved their understanding of research and their willingness to participate in and undertake research. The qualitative analysis confirmed this and suggested that Masterclasses were implemented in a supportive learning environment which led to increased research capacity (increased research awareness, changed perceptions, increased understanding, critical thinking and new confidence) and ultimately enhanced research engagement (willingness to participate, motivating others, empowered critique of research partners and proposals, interest in further research training). Barriers to research engagement and areas for improvement of the Masterclass Program before, during and after Masterclasses were also identified.


Assuntos
Fortalecimento Institucional/métodos , Serviços de Saúde Comunitária/métodos , Assistência à Saúde Culturalmente Competente/métodos , Serviços de Saúde do Indígena/normas , Avaliação de Programas e Projetos de Saúde/métodos , Saúde Pública/educação , Adolescente , Adulto , Idoso , Austrália , Serviços de Saúde Comunitária/normas , Assistência à Saúde Culturalmente Competente/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos , Adulto Jovem
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