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1.
J Health Care Poor Underserved ; 32(1): 90-98, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33678683

RESUMO

African Americans are disproportionately affected by COVID-19-related disease and mortality due to long-standing social, political, economic, and environmental injustice; and COVID-19 inequities are exacerbated by institutional distrust. In the absence of trust, public health authorities have not adequately fulfilled their professional and ethical obligations to protect African American communities from the negative effects of COVID-19. As institutional distrust is shaped by individual and collective experiences of untrustworthiness, we propose a paradigm shift from increasing trust among African Americans to increasing trustworthiness among medical and public health institutions/systems throughout the United States. This narrative review extends the literature describing how social determinants contribute to COVID-19 inequities by demonstrating how institutional distrust develops over time and is reinforced through systems of injustice. Additionally, we illustrate consequences of institutional distrust for COVID-19 inequities and provide recommendations for building trustworthiness through ethical public health practice.


Assuntos
Afro-Americanos/psicologia , Atitude Frente a Saúde/etnologia , Prática de Saúde Pública , Confiança , Humanos , Prática de Saúde Pública/ética , Determinantes Sociais da Saúde , Estados Unidos
3.
BMC Palliat Care ; 20(1): 14, 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33435961

RESUMO

BACKGROUND: China holds one fifth of the world's population and faces a rapidly aging society. In its ambition to reach a health care standard comparable to developed countries by 2030, the implementation of palliative care gains special importance. Until now, palliative care education in China is limited and disparate. This study aims to explore and determine factors that have impeded the development and implementation of palliative care education in China. METHODS: We conducted semi-structured interviews with n=28 medical teachers from seven Chinese universities. Interviews were transcribed, and thematic analysis applied. RESULTS: Three themes with two subthemes were constructed from data analysis. Theme 1 covers the still ambivalent perception of palliative care and palliative care education among participants. The second theme is about cultural attitudes around death and communication. The third theme reflects participants' pragmatic general understanding of teaching. All themes incorporate obstacles to further implementation of palliative care and palliative care education in China. CONCLUSIONS: According to the study participants, palliative care implementation through palliative care education in China is hindered by cultural views of medical teachers, their perception of palliative care and palliative care education, and their understanding of teaching. The study demonstrates that current attitudes may work as an obstacle to the implementation of palliative care within the health care system. Approaches to changing medical teachers' views on palliative care and palliative care education and their cultural attitudes towards death and dying are crucial to further promote the implementation of palliative care in China.


Assuntos
Atitude do Pessoal de Saúde/etnologia , Atitude Frente a Morte/etnologia , Atitude Frente a Saúde/etnologia , Cultura , Docentes de Medicina , Cuidados Paliativos , Medicina Paliativa/educação , China , Comunicação , Feminino , Humanos , Masculino , Pesquisa Qualitativa
5.
Public Health ; 190: 75-81, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33360294

RESUMO

OBJECTIVES: This study was to examine the relationship between health literacy (HL) and health behaviors in the South Bohemia Region in the Czech Republic (CR) and compare them to HL and health behaviors in the Visegrád group countries (Czech Republic, Hungary, Poland, and Slovakia). The paper reports the results from the research in the CR. STUDY DESIGN: A quantitative descriptive study. METHODS: The sample was stratified by sex and age and included a representative sample of 303 adults. The data were collected using the combination of a country-specific questionnaire with the HLS-EU-16 standardized questionnaire. RESULTS: Exercise was significantly associated with perceived health and HL; those with a lower level of HL did not exercise during the previous month. Based only on full answers (N = 251), inadequate HL was identified in 17.5% of the respondents (44), marginal HL in 31.5% (77), and adequate HL in 51% (128) of the respondents. Nearly 49% of the participants evaluated their health as 'good', 25.7% rated their health as 'very good' and 'satisfactory' by 25.7%. But 41.6% experienced one or more chronic diseases, 37.6% had some limitations to their health, and 20.5% smoked. For alcohol consumption, 26% drank weekly and 23% drank two to three times a month. Exercise varied from never (29.7%) to daily (7.9%). CONCLUSION: Based on our results, we conclude that health behavior risk factors are still present in the South Bohemia region of the CR regardless of levels of HL reported on the HLS-EU-16.


Assuntos
Atitude Frente a Saúde/etnologia , Exercício Físico/psicologia , Comportamentos Relacionados com a Saúde/etnologia , Letramento em Saúde/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , República Tcheca , Exercício Físico/fisiologia , Feminino , Humanos , Hungria , Masculino , Pessoa de Meia-Idade , Polônia , Eslováquia , Determinantes Sociais da Saúde , Fatores Socioeconômicos , Inquéritos e Questionários
6.
J Cross Cult Gerontol ; 35(4): 455-478, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33064233

RESUMO

Successful aging is a concept that has gained popularity and relevance internationally among gerontologists in recent decades. Examining lay older adults' perspectives on successful aging can enhance our understanding of what successful aging means. We conducted a systematic review of peer reviewed studies from multiple countries published in 2010-2020 that contained qualitative responses of lay older adults to open-ended questions such as "What does successful aging mean to you?" We identified 23 studies conducted in 13 countries across North America, Western Europe, the Middle East, Asia, and Oceania. We identified no studies meeting our criteria in Africa, South America, Eastern Europe, North Asia, or Pacific Islands. Across all regions represented in our review, older adults most commonly referred to themes of social engagement and positive attitude in their own lay definitions of successful aging. Older adults also commonly identified themes of independence and physical health. Least mentioned were themes of cognitive health and spirituality. Lay definitions of successful aging varied by country and culture. Our findings suggest that gerontology professionals in fields including healthcare, health psychology, and public health may best serve older adults by providing services that align with older adults' priority of maintaining strong social engagement as they age. Lay perspectives on successful aging acknowledge the importance of positive attitude, independence, and spirituality, in addition to physical and cognitive functioning.


Assuntos
Envelhecimento/etnologia , Atitude Frente a Saúde/etnologia , Comparação Transcultural , Envelhecimento Saudável/etnologia , Adaptação Psicológica , Idoso , Idoso de 80 Anos ou mais , Ásia , Cognição , Europa (Continente) , Feminino , Geriatria , Nível de Saúde , Humanos , Masculino , Oriente Médio , América do Norte , Oceania , Pesquisa Qualitativa , Apoio Social , Espiritualidade
7.
J Cross Cult Gerontol ; 35(4): 353-366, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32949318

RESUMO

There has been a noticeable increase in the number of studies assessing perceptions regarding depression (illness representations) among people diagnosed with the disorder. However, these studies have examined mainly younger adults (ages 18 to 65), and very little is known about older adults. This study examined illness representations among younger and older Israeli Arabs with depression based on the Self-Regulation Model (SRM). A total of 12 Israeli Arabs (six younger adults aged 18-64 and six older adults aged 65+) diagnosed with depression took part in semi-structured, in-depth interviews. The majority of the participants in the younger group were female and married, compared to the older group which has a gender equal ratio, half of which are married. The data were analyzed thematically, guided by the SRM illness representations' dimensions (identity; timeline; cause; consequences; control/cure; cyclical and coherence; and emotional representations). Differences between younger and older adults were found in some of the illness representations. Older adults described depression as a chronic illness associated with somatic symptoms, and did not believe in psychological treatment. Younger adults did not perceive depression as chronic, reported cognitive and emotional symptoms, and believed in the efficacy of psychological treatment. Our findings indicated that participants' perceptions about depression appeared to be associated with their age, along with their unique cultural background as they are traditional but undergoing processes of modernization. This study stress the importance of illness representations in intervention programs tailored for different age groups, and considering their specific cultural needs.


Assuntos
Árabes/psicologia , Atitude Frente a Saúde/etnologia , Depressão/etnologia , Transtorno Depressivo Maior/etnologia , Adulto , Idoso , Cultura , Feminino , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
9.
J Infect Dis ; 222(10): 1607-1611, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-32860499

RESUMO

We investigated individual behaviors taken by white, African American, and Latino United States (US) households in response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and likelihood of using digital tools for symptom surveillance/reporting. We analyzed cross-sectional week 1 data (April 2020) of the coronavirus disease 2019 (COVID-19) Impact Survey in a large, nationally representative sample of US adults. In general, all groups engaged in the same prevention behaviors, but whites reported being more likely to use digital tools to report/act on symptoms and seek testing, compared with African Americans and Latinos. Individual behaviors may not explain COVID-19 case disparities, and digital tools for tracking should focus on uptake among race/ethnic minorities.


Assuntos
Afro-Americanos/psicologia , Atitude Frente a Saúde/etnologia , Betacoronavirus , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/epidemiologia , Grupo com Ancestrais do Continente Europeu/psicologia , Hispano-Americanos/psicologia , Pneumonia Viral/etnologia , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Fatores Etários , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Estudos Transversais , Características da Família , Feminino , Disparidades nos Níveis de Saúde , Humanos , Controle de Infecções/métodos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Probabilidade , Inquéritos e Questionários , Estados Unidos/epidemiologia , Estados Unidos/etnologia , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-32664696

RESUMO

Although participating in regular physical activity has many benefits, female Korean college students tend to have much lower participation rates than their male counterparts. An effective means of increasing physical activity among female college students is sport participation. The purpose of this study is to incorporate three types of psychological needs from self-determination theory as precursor background variables into the theory of planned behavior to predict sport participation among female Korean college students. Our dataset consisted of 494 female undergraduate students attending Kyung Hee University in South Korea. Using structural equation modeling, the direct and indirect effects of attitude, subjective norm, perceived behavioral control, and psychological needs satisfaction such as competency, relatedness, and autonomy were examined. Although attitude towards and perceived behavioral control over sport participation were significantly associated with intention in all three models, subjective norm was not significantly associated with intention in any model. Satisfaction of the psychological needs for competency, relatedness, and autonomy had positive indirect effects on sport participation. This study underscores the importance of addressing the satisfaction of these three basic psychological needs when designing future sport promotion interventions for female college students.


Assuntos
Intenção , Esportes/psicologia , Estudantes/psicologia , Grupo com Ancestrais do Continente Asiático , Atitude Frente a Saúde/etnologia , Feminino , Humanos , Masculino , Modelos Psicológicos , República da Coreia , Inquéritos e Questionários , Universidades
11.
N Z Med J ; 133(1516): 33-46, 2020 06 12.
Artigo em Inglês | MEDLINE | ID: mdl-32525860

RESUMO

AIM: An understanding of patients' healthcare experiences and perceptions is essential for developing new health services. In Aotearoa New Zealand, inequities in health outcomes exist, with Maori experiencing worse health outcomes than non-Maori. This includes poorer access to, and quality of, prescribed medicines. This study aims to explore kaumatua (Maori older adults') experiences of medicines and medicine-related services in New Zealand. METHOD: This qualitative research applied kaupapa Maori theory and explored Maori older adults' experiences of medicines and medicine-related services in New Zealand. Ten kaumatua from Auckland, New Zealand participated in semi-structured interviews. Reflexive thematic analysis was used to analyse data. RESULTS: Three themes were generated: 1. diverse, multi-dimensional realities of medicine-taking for Maori with ageing; 2. medicines supply as a business transaction; and 3. self-determined agency of kaumatua supported by authentic healthcare partnerships. Kaumatua expressed their ability to retain power and control over their medicine therapy and their desire for this to occur within a supportive, authentic partnership model that involves them and their multiple healthcare providers. CONCLUSION: Maori older adults have the ability, desire and right to control their medicines journey in a way that is relevant to their experiences of medicines. They value support from authentic healthcare partnerships in enabling this.


Assuntos
Idoso , Atitude Frente a Saúde/etnologia , Comunicação , Grupo com Ancestrais Oceânicos , Medicamentos sob Prescrição , Idoso/psicologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etnologia , Feminino , Humanos , Masculino , Nova Zelândia , Farmacêuticos , Relações Médico-Paciente , Medicamentos sob Prescrição/efeitos adversos , Relações Profissional-Paciente , Pesquisa Qualitativa
12.
BMC Womens Health ; 20(1): 100, 2020 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-32393248

RESUMO

BACKGROUND: Female genital mutilation (FGM) has been a longstanding tradition in Egypt and until recently the practice was quasi-universal. Nevertheless, there are indications that the practice has been losing support and that fewer girls are getting cut. This study analyzes the prevalence of FGM in different birth cohorts, to test whether the prevalence declined over time. The study also examines whether such a decline is occurring in all segments of society or whether it is limited mostly to certain more modernized segments of society. METHODS: This study pooled data from the 2005, 2008 and 2014 waves of the Egypt Demographic and Health Surveys (EDHS). The women participating in the EDHS provided data on 62,507 girls born to them between 1987 and 2014, including whether they were cut and at what age. Kaplan-Meier and Weibull proportional hazard survival analyses were used to examine trends in the prevalence and hazards of FGM across birth cohorts. Controls for region, religion and socioeconomic status of the parents were included in the Weibull regression. RESULTS: The results show a steady decline in FGM across the birth cohorts studied. The base hazard for the 2010 birth cohort is only 30% that of the 1987 one. Further analyses show that the decline in FGM occurred in all segments of Egyptian society in a fairly similar manner although differences by region, religion and socioeconomic status persisted. CONCLUSIONS: This study confirms that FGM is declining in Egypt. The proportion of girls getting cut has declined rapidly over the past few decades. This decline is not limited to the more modernized segments of society, but has spread to the more traditional segments as well. The latter increases prospects for the eventual eradication of the practice.


Assuntos
Atitude Frente a Saúde/etnologia , Circuncisão Feminina/etnologia , Circuncisão Feminina/tendências , Empoderamento , Saúde da Mulher/etnologia , Circuncisão Feminina/efeitos adversos , Estudos de Coortes , Egito/epidemiologia , Feminino , Comportamentos Relacionados com a Saúde/etnologia , Inquéritos Epidemiológicos , Humanos , Prevalência , Religião , Saúde Reprodutiva
13.
AIDS Behav ; 24(10): 2927-2934, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32239358

RESUMO

Uptake of pre-exposure prophylaxis (PrEP) among Black women living in the US is suboptimal. We sought to determine the association between HIV-related medical mistrust (or belief in HIV conspiracy theories) and willingness to use PrEP among Black women. We analyzed data from the 2016 National Survey on HIV in the Black Community (NSHBC), a nationally representative cross-sectional survey. Among NSHBC participants, 522 were women and 347 (69.0%) reported HIV risk factors. Only 14.1% were aware that PrEP exists; 30.8% reported willingness to use PrEP. HIV-related medical mistrust was reported by 60.4% of women. In multivariable analysis, controlling for income, education, marital status and health care engagement, belief in conspiracy theories was significantly associated with higher willingness to use PrEP. The HIV-Related Medical Mistrust Scale item: "there is a cure for HIV, but the government is withholding it from the poor" was independently associated with higher PrEP willingness. This finding speaks to the need for an improved understanding of the role of HIV-related medical mistrust among Black women to improve uptake of biomedical HIV prevention.


Assuntos
Afro-Americanos/psicologia , Fármacos Anti-HIV/uso terapêutico , Atitude Frente a Saúde/etnologia , Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Profilaxia Pré-Exposição/métodos , Confiança/psicologia , Adulto , Estudos Transversais , Feminino , Infecções por HIV/etnologia , Humanos , Intenção , Estados Unidos/epidemiologia
14.
PLoS One ; 15(4): e0231490, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32287286

RESUMO

INTRODUCTION: Many infants with possible serious bacterial infections (PSBI) do not receive inpatient treatment because hospital care may not be affordable, accessible, or acceptable for families. In 2015, WHO issued guidelines for managing PSBI in young infants (0-59 days) with simpler antibiotic regimens when hospital care is not feasible. Bangladesh adopted WHO's guidelines for implementation in outpatient primary health centers. We report results of an implementation research study that assessed caregiver acceptability of the guidelines in three rural sub-districts of Bangladesh during early implementation (October 2015-August 2016). METHODS: We included 19 outpatient primary health centers involved in the initial rollout of the infection management guidelines. We extracted data for all PSBI cases (N = 192) from facility registers to identify gaps in referral feasibility, simplified antibiotic treatment, and follow-up. Focus group discussions (FGD) and in-depth interviews (IDI) were conducted with both caregivers (6 FGDs; 23 IDIs) and providers (2 FGDs; 28 IDIs) to assess caregiver acceptability of the guidelines. RESULTS: Referral to the hospital was not feasible for many families (83.3%; N = 160/192) and acceptance varied by infection severity. Barriers to referral feasibility included economic and household factors, and previous experiences with poor quality of care at the sub-district hospital. Conversely, providers and caregivers indicated high acceptability of simplified antibiotic treatment. 80% (N = 96/120) of infants with clinical severe infection for whom referral was not feasible returned to the facility for the second antibiotic injection. Some providers reported developing local solutions-including engaging informal providers in treatment of the infant-to address organizational barriers and promote treatment compliance. Follow-up of young infants receiving simplified treatment is critical, but only 67.4% (N = 87/129) of infants received fourth day follow-up. Some providers' reported deviations from the guidelines that shifted responsibility of follow-up to the caregiver, which may have contributed to lapses. CONCLUSION: Caregivers' perception of trust and communication with providers were influential in caregiver acceptability of care. Few caregivers accepted referral to the sub-district hospital, suggesting low acceptability of this option. When referral was not feasible, many caregivers reported satisfaction with simplified antibiotic treatment. Local solutions described by providers require further examination in this context to assess the safety and potential value of these strategies in outpatient treatment. Our findings suggest strengthening providers' interpersonal skills could improve caregiver acceptability of the guidelines.


Assuntos
Atitude Frente a Saúde/etnologia , Cuidadores/psicologia , Cooperação do Paciente/psicologia , Adulto , Assistência Ambulatorial/métodos , Assistência Ambulatorial/tendências , Instituições de Assistência Ambulatorial , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/terapia , Bangladesh/epidemiologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Atenção Primária à Saúde , População Rural , Organização Mundial da Saúde
15.
Transplant Proc ; 52(4): 1036-1041, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32173592

RESUMO

BACKGROUND: Transplantation depends on a donation from a living or deceased donor, with the latter ideally involving a multiorgan transplant. The objective of this study was to determine the factors that influence the attitudes of the population in Mexico toward being a donor. METHODS: We conducted an observational, cross-sectional study with a survey on the attitudes toward donation in the population of Mexico. The survey had 33 items on it regarding sociodemographic aspects and people's positions on the issues of organ and tissue donation. We used central tendency and dispersion averages and calculated the difference between groups using chi squares or the Student t test. We also used the statistical program SPSS version 25. RESULTS: The perception of respondents regarding organ and tissue donation (with 1064 people or 65.1% in favor) points to a lack of knowledge in Mexico. People do not talk about organ donation with their relatives and especially do not discuss their wishes in case of death (only 660 people indicated they had or 40.4%). There is a better attitude toward donation among younger respondents, women, single people, health personnel, people with higher incomes, Catholics, and those who do not have a hospitalized family member. CONCLUSIONS: It is necessary to provide more information about organ donation to people in Mexico. The opinion toward donation is generally favorable; however, there are multiple factors that influence opinions. Family members of patients in intensive care are the least willing to donate themselves or donate a relative's organs.


Assuntos
Atitude Frente a Saúde , Transplante de Órgãos/psicologia , Doadores de Tecidos/psicologia , Adulto , Atitude Frente a Saúde/etnologia , Estudos Transversais , Família , Feminino , Pessoal de Saúde , Humanos , Masculino , México , Pessoa de Meia-Idade , Inquéritos e Questionários
16.
Ann Epidemiol ; 43: 66-70, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32094041

RESUMO

PURPOSE: Although stroke survivors who continue smoking face increased risk for subsequent strokes, little is known about U.S. poststroke smoking patterns. We examined smoking prevalence in U.S. stroke survivors and what sociodemographic factors are associated with continuation of smoking in these individuals. METHODS: We determined the prevalence of smoking in U.S. stroke survivors (n = 56,523) using 2016-2018 Behavioral Risk Factor Surveillance System data. A logistic regression was created to identify associations between sociodemographic factors and poststroke smoking continuation. RESULTS: 20.4% of stroke survivors continued to smoke after their stroke (14.7% smokes every day, 5.7% smokes some days). Older age, being male (OR: 1.15, 95% CI: 1.05-1.27), Asian (OR: 2.79, 95% CI: 1.52-5.11) or Hispanic (OR: 1.31, 95% CI: 1.06-1.63) ethnicity, higher income, higher educational attainment, and access to health care (OR: 1.27, 95% CI: 1.02-1.59) and a personal doctor (one doctor OR: 1.51, 95% CI: 1.25-1.83; more than one doctor OR: 1.59, 95% CI: 1.27-1.99) corresponded with increased odds of smoking continuation after a stroke. CONCLUSIONS: A greater push for smoking cessation by clinicians and support programs to aid with cessation in U.S. stroke survivors is needed to decrease the high prevalence of poststroke smoking in this population.


Assuntos
Fumar Cigarros/psicologia , Grupos Étnicos/estatística & dados numéricos , Acidente Vascular Cerebral/etnologia , Sobreviventes/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Atitude Frente a Saúde/etnologia , Sistema de Vigilância de Fator de Risco Comportamental , Fumar Cigarros/efeitos adversos , Fumar Cigarros/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Prevalência , Fatores Sexuais , Fatores Socioeconômicos , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/mortalidade , Reabilitação do Acidente Vascular Cerebral , Sobreviventes/psicologia , Estados Unidos/epidemiologia
17.
Nephrol Nurs J ; 47(1): 53-65, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32083437

RESUMO

Understanding African-American families' experiences with treatment for kidney failure is necessary for informing the delivery of family-centered care and the design of appropriate interventions. This qualitative study explored treatment-related questions, concerns, and family impacts among African-American family members of patients with pre-kidney failure and kidney failure. Thirty-five family members participated in focus groups stratified by patients' treatment experiences (pre-kidney failure, in-center hemodialysis, peritoneal dialysis, awaiting living-donor kidney transplantation, or post-transplantation). Family members raised questions and concerns about the psychological, lifestyle, and practical aspects of treatment. Similarly, discussions about family impacts emphasized psychosocial effects, lifestyle consequences, and the provision and receipt of support. Efforts to address these questions, concerns, and perceived family impacts through additional research, early and tailored education, and supportive interventions are needed.


Assuntos
Afro-Americanos/psicologia , Atitude Frente a Saúde/etnologia , Família/etnologia , Insuficiência Renal/etnologia , Insuficiência Renal/terapia , Família/psicologia , Humanos
18.
BMC Complement Med Ther ; 20(1): 60, 2020 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-32070348

RESUMO

BACKGROUND: Traditional medicine serves as a form of primary health care for more than 80% of African populations. Currently, there is no research documenting if and how African migrant communities engage with their traditional health practices and beliefs after they resettle in Western countries. The aim of this study was to examine African migrant women's experiences and perspectives about traditional and complementary medicine use in relation to their maternal health and wellbeing in Australia. METHODS: We conducted a mixed method study between December 2016 and October 2017. Questionnaires were completed by 319 women and 15 in-depth interviews were conducted among African migrant women residing across the Sydney metropolitan area, Australia. Survey data were analysed using SPSS (version 23) and logistic regression model was used to test associations. Qualitative data were analysed thematically using NVivo 11 software to identify themes and conceptual categories in the participants' responses. The study was informed by Andersen's Socio-behavioural model of health service utilisation. RESULTS: The findings indicated that use of traditional and complementary medicine was high and continued to be well used following African women's resettlement in Australia. The survey found that 232 (72.7%) women use some form of traditional and complementary medicine for maternal health and wellbeing purposes. Most women (179, 77.2%) reported that maintaining their maternal health and wellbeing was the most common reason for use. The interview findings indicated that access to traditional medicine included making requests from relatives and friends who travelled to Africa looking for a similar medicinal plant in Australia and preparing home remedies with advice from family members and healers back in Africa. Age ≥ 35 years (OR, 16.5; 95%CI, 6.58-41.5; p < 0.001), lower education (OR, 24; 95%CI, 8.18-71.1; p < 0.001), parity (OR, 7.3; 95%CI, 1.22-42.81; p = 0.029), and lower income (OR, 2.7; 95%CI, 1.23-5.83; p = 0.013) were strong predictors of traditional medicine use. CONCLUSION: Use of traditional and complementary medicine among African migrant women in Sydney remained high following resettlement in Australia. As noted in Andersen's sociobehavioural model of health service utilisation, specific predisposing and enabling factors including age, education and income were associated with use of traditional and complementary medicine.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Atitude Frente a Saúde/etnologia , Terapias Complementares/estatística & dados numéricos , Saúde Materna/estatística & dados numéricos , Migrantes , Adolescente , Adulto , África/etnologia , Austrália , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
19.
BMC Health Serv Res ; 20(1): 24, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31914997

RESUMO

BACKGROUND: Community Health Representatives (CHRs) overcome health disparities in Native communities by delivering home care, health education, and community health promotion. The Navajo CHR Program partners with the non-profit Community Outreach and Patient Empowerment (COPE), to provide home-based outreach to Navajo clients living with diabetes. COPE has created an intervention (COPE intervention) focusing on multiple levels of improved care including trainings for CHRs on Motivational Interviewing and providing CHRs with culturally-appropriate education materials. The objective of this research is to understand the participant perspective of the CHR-COPE collaborative outreach through exploring patient-reported outcomes (PROs) of clients who consent to receiving the COPE intervention (COPE clients) using a qualitative methods evaluation. METHODS: Seven COPE clients were selected to participate in semi-structured interviews one year after finishing COPE to explore their perspective and experiences. Qualitative interviews were recorded, transcribed, and coded to identify themes. RESULTS: Clients revealed that health education delivered by CHRs facilitated lifestyle changes by helping them understand key health indicators and setting achievable goals through the use of accessible material and encouragement. Clients felt comfortable with CHRs who respected traditional practices and made regular visits. Clients also appreciated when CHRs educated their family members, who in turn were better able to support the client in their health management. Finally, CHRs who implemented the COPE intervention helped patients who were unable to regularly see a primary care doctor for critical care and support in their disease management. CONCLUSION: The COPE-CHR collaboration facilitated trusting client-CHR relationships and allowed clients to better understand their diagnoses. Further investment in materials that respect traditional practices and aim to educate clients' families may foster these relationships and improve health outcomes. TRIAL REGISTRATION: clinicaltrials.gov: NCT03326206. Registered 9/26/2017 (retrospectively registered).


Assuntos
/psicologia , Atitude Frente a Saúde/etnologia , Serviços de Saúde Comunitária/organização & administração , Diabetes Mellitus/etnologia , Índios Norte-Americanos/psicologia , /estatística & dados numéricos , Agentes Comunitários de Saúde/psicologia , Relações Comunidade-Instituição , Comportamento Cooperativo , Diabetes Mellitus/terapia , Feminino , Humanos , Índios Norte-Americanos/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Organizações sem Fins Lucrativos/organização & administração , Participação do Paciente , Relações Profissional-Paciente , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Estados Unidos
20.
BMC Pregnancy Childbirth ; 20(1): 51, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31973693

RESUMO

BACKGROUND: Migration to another country has a potential influence on breastfeeding practices. A significant difference in breastfeeding rates between Irish nationals and non-nationals has been reported. This study was conducted to explore breastfeeding practices of the Chinese in Ireland, one of the largest Irish ethnic groups, and to explore the influence of living in Ireland on breastfeeding practices. This is the first and the only migration study so far on breastfeeding practices among the Chinese in Ireland. METHODS: A sequential explanatory mixed methods approach was adopted. The first phase was a cross-sectional self-administered retrospective mailed survey, to explore breastfeeding practices and determinants of breastfeeding among a convenience sample of Chinese mothers living in Ireland (n = 322). Recruitment was conducted in the Dublin metropolitan area, with the application of the snowball technique to increase sample size. The second phase consisted of seven semi-structured focus groups (n = 33) conducted in Dublin, to explore the influence of living in Ireland on breastfeeding among Chinese mothers who had given birth in Ireland. Quantitative data were analyzed by univariate and multivariate logistic regression analyses, and informed the qualitative data collection. Qualitative data were analyzed by thematic content analyses, to explain and enrich the qualitative results. RESULTS: The breastfeeding initiation rate among Chinese immigrants to Ireland who gave birth in Ireland (CMI) (75.6%) was high and close to that of Chinese immigrant mothers who gave birth in China (CMC) (87.2%). However, giving birth in Ireland was independently associated with a shorter duration of breastfeeding (< 4 months) among Chinese immigrants. Qualitative results explained that a shorter breastfeeding duration among CMI than that of CMC was mainly due to cultural conflicts, a lack of family support, language barriers, immigrants' low socioeconomic status, and mothers' preference for infant formula on the Irish market. Both quantitative and qualitative data revealed a strong cultural belief in the efficacy of the traditional Chinese postpartum diet for breast milk production for both CMC and CMI. Antenatal feeding intention was a strong determinant for breastfeeding initiation and duration among CMI. CONCLUSION: Migration to Ireland was found to be associated with a shorter duration of breastfeeding of the Chinese. Culturally sensitive and language-specific education and support of breastfeeding is needed for the Chinese mothers living in Ireland. The mixed methods design presented here might serve as a template for future migration research on breastfeeding.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Atitude Frente a Saúde/etnologia , Aleitamento Materno/etnologia , Desmame/etnologia , Adulto , China/etnologia , Estudos Transversais , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Promoção da Saúde , Humanos , Lactente , Cuidado do Lactente/métodos , Irlanda , Relações Mãe-Filho/etnologia , Mães , Fatores Socioeconômicos
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