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1.
BMC Public Health ; 19(1): 1452, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690307

RESUMO

BACKGROUND: Physical inactivity is a crucial risk factor for the development of chronic health issues, which have a high incidence among Arabs living in the Gulf Cooperation Council (GCC) countries. The Qatar Stepwise Survey 2012 reported that approximately 44% of young adults 18-44 years of age had insufficient levels of physical activity. Family is a powerful source of information and socialization for adolescents and has a strong influence on their attitudes, decision-making, and behaviors. METHODS: The purpose of this study is to understand how university students' physical activity can be influenced by sociocultural factors, particularly family health values and Muslim Arab culture. Using the criterion sampling strategy, 20 undergraduate Muslim students (Female students =10, Male students = 10) aged from 18 to 23 years who were Qatari or born and also raised in Qatar were recruited and interviewed. Participants were asked if they consider themselves active or not, about their perception of family health values regarding physical activity and the factors shaping these values, and the influence of family values on their physical activity behavior. The interviews were transcribed verbatim, coded, and analyzed following inductive analysis. RESULTS: The majority of the participants were influenced by their family health values, which were shaped by Qatari culture and the culture of origin for non-Qatari and were implicitly shaped by Islam. Participants reported that their role models of physical activity were males (fathers and male siblings), a health condition will motivate their families to be physically active, and families give priority to work and academic achievement over physical activity. A few participants showed that there was explicit influence of Islam on their physical activity, because culture's influence was veiling religion's. Culture was seen as a facilitator for physical activity from the males' perspectives, which was not the case for female participants who reported the negative influence of culture on their physical activity because of the limited choices available for them. Non-Qatari students revealed that their culture of origin (such as Syria, Palestine, Egypt, Somalia, Bangladesh, Sudan, Pakistan and India) was the dominant factor in shaping their family health values. CONCLUSIONS: The findings address gaps in the literature about families' health values regarding physical activity in Qatar, the influence of the different ecologies surrounding these values, and the physical activity behaviors of university students. Knowledge about these factors can aid in the development of family-based interventions designed to motivate adolescents to be physically active, which should be religion- and culture-tailored.


Assuntos
Exercício/psicologia , Islamismo/psicologia , Estudantes/psicologia , Adolescente , Características Culturais , Família/etnologia , Família/psicologia , Feminino , Identidade de Gênero , Humanos , Masculino , Catar , Pesquisa Qualitativa , Estudantes/estatística & dados numéricos , Universidades , Adulto Jovem
2.
BMC Public Health ; 19(1): 981, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337379

RESUMO

BACKGROUND: The goal of adaptation is to maintain the effectiveness of the original intervention by preserving the core elements that account for its success while delivering an intervention that is tailored to the new community and/or cultural context. The current study describes the process of adapting an evidence-based smoke-free homes (SFH) intervention for use in American Indian/Alaska Native (AI/AN) households. METHODS: We followed a systematic adaptation process. We first assessed the community through focus groups coordinated in collaboration with tribal partners. Because our team included the original developers of the intervention, the steps of understanding the intervention, selecting the intervention and consulting with experts were simplified. Additional steps included consulting with stakeholders through a national work group and collaboratively deciding what needed adaptation. RESULTS: A number of key themes pertinent to the adaptation of the SFH intervention were identified in the focus groups. These included the gravity of messaging about commercial tobacco use; respect, familialism, and intergenerationalism; imagery, including significant symbolism, colors, and representative role models; whether and how to address traditional tobacco; and, barriers to a SFH not adequately addressed in the original materials. CONCLUSIONS: Adaptation of an intervention to create smoke-free homes in AI/AN families necessitated both surface structure changes such as appearance of role models and deep structure changes that addressed core values, and beliefs and traditions.


Assuntos
Nativos do Alasca/psicologia , Família/etnologia , Habitação , Índios Norte-Americanos/psicologia , Política Antifumo , Grupos Focais , Humanos
3.
BMC Public Health ; 19(1): 759, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200685

RESUMO

BACKGROUND: Due to multiple and interacting factors, Latino children are disproportionately at risk for overweight and obesity in the United States. Childhood obesity increases the risk for adverse physical and psychosocial outcomes throughout the lifespan. Intensive behavioral interventions recommended in primary care settings may not conform to current practices, and the most vulnerable populations are often unable to access these services. Community Health Workers (CHWs) offer a promising approach to bridging the gap between vulnerable communities and culturally competent services. La Vida Buena (The Good Life) is an 8-week family-focused intervention for Latino children 5-8 years old and their parents or caregivers who are patients at a Federally-Qualified Community Health Center (FQHC). It is a culturally and linguistically appropriate curriculum, facilitated by CHWs, that targets family behaviors to foster a healthy lifestyle in order to prevent and mitigate childhood overweight and obesity. METHODS: The primary objective is to test the effectiveness of the La Vida Buena (LVB) childhood obesity program among Latino children 5-8 years old and their families as compared with a single educational session. This study uses a parallel two-arm quasi-experimental design. The intervention group receives the 8-week La Vida Buena intervention and the comparison group receives a single educational session. The primary outcome is the change in the child's BMI z-score from baseline to 6 months. DISCUSSION: The implementation and evaluation of La Vida Buena may inform research and practice for linking Latino patients in FQHCs to culturally responsive community-based childhood obesity interventions. It will also contribute to the literature about CHWs as facilitators of behavior change for families underserved by health services and preventive programs. La Vida Buena can serve as a culturally and linguistically appropriate early intervention curriculum that will foster a healthy home environment for childhood obesity mitigation and prevention. TRIAL REGISTRATION: The trial was retrospectively registered on December 18, 2018. The ClinicalTrials.gov Identifier is NCT03781856.


Assuntos
Agentes Comunitários de Saúde , Família/etnologia , Hispano-Americanos/psicologia , Obesidade Pediátrica/etnologia , Programas de Redução de Peso/organização & administração , Criança , Pré-Escolar , Família/psicologia , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , México , Obesidade Pediátrica/prevenção & controle , Avaliação de Programas e Projetos de Saúde , Estados Unidos
4.
BMC Public Health ; 19(1): 652, 2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31138165

RESUMO

BACKGROUND: Colorectal cancer (CRC) screening, such as fecal occult blood test (FOBT), is an effective way to prevent CRC, one of the most common cancers worldwide. However, studies found that South Asian ethnic minorities tend not to utilize CRC screening, whose importance on CRC prevention shall be educated among those from ethnic minorities, especially older adults. The purpose of this study is to develop and implement a family-based, multimedia intervention to augment the knowledge of CRC prevention among older South Asian adults in Hong Kong and enhance their motivation for undergoing FOBT. The acceptability and effectiveness of the intervention will be assessed using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. METHODS: A cluster randomized controlled trial will be carried out. Three hundred and twenty South Asian dyads, comprising an older adult aged between 50 and 75 and a younger family member aged between 18 and 49, will be recruited in ten districts in Hong Kong through community organizations that provide support services for South Asians in local communities. Dyads will be randomly allocated to either the intervention or wait-list control group. Intervention dyads will receive intervention, whose contents are based on the health belief model, via multiple forms of media including PowerPoint presentation, video clip and health information booklet. Control dyads will receive intervention after post-intervention data are collected. For dyads in both groups, an appointment with a family doctor will be arranged for those willing to undergo FOBT. Outcomes will be assessed at baseline and post-intervention. Data will be analysed using the Generalised Linear Models Procedure in an intention-to-treat manner. DISCUSSION: Findings of this study will provide evidence of the benefits of utilizing multimedia and family-based approaches in intervention development to enhance the effectiveness of health promotion interventions for ethnic minorities. Further, the findings would provide reference to the potential incorporation of the intervention in the existing support services for South Asian ethnic minorities in local communities. TRIAL REGISTRATION: This trial is registered at the ISRCTN Registry ( ISRCTN72829325 ) on 19th July 2018.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Neoplasias Colorretais/etnologia , Detecção Precoce de Câncer/estatística & dados numéricos , Família/etnologia , Promoção da Saúde/métodos , Grupos Minoritários/psicologia , Multimídia , Adolescente , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Protocolos Clínicos , Neoplasias Colorretais/prevenção & controle , Feminino , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Sangue Oculto , Adulto Jovem
5.
Transcult Psychiatry ; 56(4): 599-619, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31092130

RESUMO

This article explores the pragmatic sensibilities that are implicit in idioms of distress among family caregivers for Alzheimer's disease in Teotitlán del Valle, a rural Zapotec-speaking community in Oaxaca, Mexico. Through analysis of caregivers' perceptions of progressive memory loss and related etiological understandings, this article emphasizes the pragmatism inherent to local health perspectives. In so doing, the article revisits Nichter's earliest formulation of idioms of distress as providing an alternative epistemological framework to appreciate how illness is varyingly understood. Such a framework is useful for understanding how idioms of distress are not aimed towards attaining accuracy about what illness is in an objective sense, but rather put into focus how such descriptions are both constitutive of-and themselves pragmatic responses to-broader social circumstances. This article concludes with a consideration of how idioms of distress empower individuals as agents of action.


Assuntos
Doença de Alzheimer/etnologia , Cuidadores , Família/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Índios Norte-Americanos/etnologia , Linguagem , Estresse Psicológico/etnologia , Adulto , Idoso , Doença de Alzheimer/enfermagem , Feminino , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Pesquisa Qualitativa
6.
J Cross Cult Gerontol ; 34(2): 131-148, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31134463

RESUMO

Native American grandparents by tradition are expected to play a role in rearing grandchildren. However, in many Native grandfamilies, grandparents are rearing grandchildren not by choice or tradition, but as the result of family crises that necessitated grandparent intervention. European American grandparents have likewise been called to rear their grandchildren when their adult children are unable or unwilling to perform parental duties. Less is known about these custodial grandparents' resilience pathways, particularly among rural grandfamilies. Guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation, this study examined the relationships between stressors, resources, and resilience among rural Native and European American custodial grandparents. Correlates of resilience were economic stress and stress management. Significant interactions were found between economic stress and government assistance and economic stress and stress management, indicating complex resilience pathways. Implications of study findings for research and intervention are discussed.


Assuntos
Adaptação Psicológica , Custódia da Criança , Educação Infantil/etnologia , Família/psicologia , Avós/psicologia , Relação entre Gerações/etnologia , Resiliência Psicológica , Adulto , Cuidadores , Criança , Educação Infantil/psicologia , Família/etnologia , Feminino , Humanos , Índios Norte-Americanos , Masculino , Pessoa de Meia-Idade , Poder Familiar , População Rural , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia
7.
BMC Cardiovasc Disord ; 19(1): 82, 2019 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-30943893

RESUMO

BACKGROUND: Ferritin is one of the key proteins that regulate iron homeostasis and is widely available clinical biomarker of iron status. This study aimed to discuss the influence of serum ferritin (SF) on cardiovascular risk factors in the first-degree relatives with family history of type 2 diabetes (FHD). METHODS: This cross-sectional study included 232 men. Anthropometric measurements and blood samples were analyzed. The people were divided into four groups according to median SF (102.8 ng/ml) and people with or without FHD. Group A (FHD-and low SF), group B (FHD-and high SF), group C (FHD+ and low SF), and group D (FHD+ and high SF). RESULTS: The subjects in different categories of SF concentrations showed significant differences in BMI (SF main effect: P = 0.010), WC (P = 0.030), SBP (P < 0.001), FPG (P < 0.001), PPG-2 h (P < 0.001), FINS (P < 0.001), and HOMA-IR (P = 0.015; all: 2-way ANOVA). There was a significant difference in SBP (FHD main effect: P = 0.003), DBP (P = 0.006), and FINS (P = 0.013, all: 2-way ANOVA) between the groups with or without FHD. The interaction term between SF and FHD was significant for SBP (P = 0.011), DBP (P = 0.012), and PPG-2 h (P = 0.022). Logistic analysis showed that accumulation of CVD risk factors, which were ≥ 2 items and ≥ 3 items in group D were 7.546 and 3.343 times higher compared with group A (P < 0.05). CONCLUSIONS: The increased SF levels increased the risk of cardiovascular risk factors and the occurrence of insulin resistance in first-degree relatives with FHD.


Assuntos
Doenças Cardiovasculares/sangue , Diabetes Mellitus Tipo 2/sangue , Família , Ferritinas/sangue , Resistência à Insulina , Síndrome Metabólica/sangue , Adulto , Grupo com Ancestrais do Continente Asiático/genética , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/genética , China/epidemiologia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/genética , Família/etnologia , Predisposição Genética para Doença , Hereditariedade , Humanos , Resistência à Insulina/etnologia , Resistência à Insulina/genética , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/etnologia , Síndrome Metabólica/genética , Pessoa de Meia-Idade , Linhagem , Prognóstico , Medição de Risco , Fatores de Risco , Fatores Sexuais , Regulação para Cima
8.
Health Psychol ; 38(4): 306-317, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30896217

RESUMO

OBJECTIVE: African Americans and Latinos make up the two largest minority groups in the United States, and compared with Whites, these ethnic minority groups face disproportionate risk for certain physical health problems. However, factors that may protect these groups against early risk for poor health are not entirely understood. Familism, which emphasizes family interdependence and commitment, and is more prevalent among Latino and African American families, may be one such factor. The current study examined whether values and behaviors related to familism were differentially associated with inflammatory processes among White, African American, and Latino youth. METHOD: Participants were 257 youth who completed measures of familism values and behaviors and whose parents reported on their ethnicity. Participants also provided blood samples for the assessment of proinflammatory cytokine responses to bacterial challenge and of sensitivity to anti-inflammatory features of cortisol and interleukin (IL)-10. RESULTS: Significant familism values and behaviors by ethnicity interactions were observed. For Latino and African American youth but not for White youth, more familism values were associated with greater sensitivity to IL-10. Additionally, for African American youth, more familism behaviors were associated with decreased cytokine responses to bacterial challenge and greater sensitivity to cortisol and IL-10. By contrast, familism behaviors were associated with lower sensitivity to cortisol in White youth and were not associated with any inflammatory outcomes in Latino youth. CONCLUSION: This pattern of findings suggests that for African American youth and to some extent for Latino youth, familism values and behaviors may be protective against the elevated risk for poor health they face. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Família/etnologia , Inflamação/etnologia , Adolescente , Afro-Americanos , Grupo com Ancestrais do Continente Europeu , Feminino , Hispano-Americanos , Humanos , Masculino , Estados Unidos
9.
Int J Ment Health Nurs ; 28(4): 879-887, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30848012

RESUMO

The purpose of this qualitative study was to explore the meaning of acceptance (Thum-jai) as a culturally embedded coping strategy in the lives of Thai people who have experienced adversity that caused suffering. Thematic analysis was used to examine the responses of 47 participants to written, open-ended questions or face-to-face interviews. The EQUATOR's COREQ checklist for qualitative research was followed. Participants came from diverse religious' traditions and geographic regions throughout Thailand. Findings revealed seven themes: circumstance and emotion; thought and action; time, experience, and effort; social and moral support; religious and spiritual ethos; acceptance and hope; and survive and thrive. The adverse circumstance is central to the concept of acceptance. Before acceptance, there is often hope; yet Thai people reach an existential point whether to accept the reality of the situation or continue in distress. Purposeful approaches to deal with the event flow from the cultural contexts of spirituality and social support. Drawing upon psychological strength, Thai people undertake purposive thought and action to facilitate redirecting their lives for better mental health. Thum-jai brings release and peace of mind. Clinicians may find that people experiencing adverse life events are best served by nondirective approaches. Acceptance and change in thoughts and behaviours may come from meditation and therapeutic mindfulness practices that allow those in Western and non-Western cultures to use their own values, expressions, and societal expectations to cope with suffering and formulate effective decisions.


Assuntos
Adaptação Psicológica , Cultura , Estresse Psicológico/etnologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Educação , Emoções , Família/etnologia , Família/psicologia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Religião e Psicologia , Apoio Social , Espiritualidade , Estresse Psicológico/psicologia , Tailândia , Adulto Jovem
10.
Eur J Oncol Nurs ; 38: 57-64, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30717937

RESUMO

PURPOSE: Behavioral interventions targeting cancer survivors often fail to address the clustering of unhealthy behaviors among family members and friends, and the impact of close relationships on behavior change. The study's aim was to identify factors associated with receptivity and preferences for lifestyle behavior change among family members of African-American survivors of lung cancer. METHODS: Principles of social cognitive theory guided the design. A descriptive, qualitative study recruited 26 African-American family members of lung cancer survivors from two teaching hospitals in the southeastern United States. A 20-item Information Form collected demographic, health status, and health behavior information. Family members participated in one of three semi-structured focus group discussions. RESULTS: Four major themes emerged: family members and survivors both resisted the caregiver role; dramatic changes evoked by the diagnosis of lung cancer were facilitators and barriers to lifestyle choices; leaning on faith was the primary source of support; and these families live with a constant threat of multiple cancers. Findings emphasize the importance of meaningful conversations among health-care providers, survivors, and family members during the time of diagnosis, treatment, and recovery, so that family members are better prepared to cope with anticipated changes. CONCLUSIONS: This study highlights the stressors that affect family members and sheds light on their unique needs. The stressors limit their ability to change health behaviors. Family members need basic education, skills training, and support related to the lung cancer diagnosis and other cancers. Current methods to provide these services are limited in their accessibility, availability, and effectiveness.


Assuntos
Afro-Americanos/psicologia , Sobreviventes de Câncer/psicologia , Família/psicologia , Comportamentos Relacionados com a Saúde/etnologia , Neoplasias Pulmonares/etnologia , Neoplasias Pulmonares/psicologia , Adaptação Psicológica , Adulto , Idoso , Cuidadores/psicologia , Família/etnologia , Feminino , Amigos/psicologia , Humanos , Estilo de Vida/etnologia , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Apoio Social
11.
J Cross Cult Gerontol ; 34(1): 51-65, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30666497

RESUMO

The purpose of this study is to explore the cultural context of family religiosity/spirituality among Korean-American elderly families, and how this changed after families immigrated to the USA. Fifty one first-generation Korean-Americans participated in one or two hour, in-depth interviews in Korean at a participant's home or church. These included 27 older adults and 24 family members living together or within a radius of one-hour transit time from their elders, residing in the Southeastern United States. A thematic and interpretive method was used to analyze transcribed interviews. Three themes were identified that explained the cultural context of family religiosity/spirituality: (a) traditional family religious rituals, (b) church oriented routines, and (c) family collectivism. The participants did not distinguish 'religiosity' and 'spirituality' during the interviews. The findings suggest that the family religiosity/spirituality of the participants was influenced by the traditional family religious values, which were shaped by Korean culture. The traditional religions of Shamanism, Buddhism, and Confucianism are prevalent in Asian countries. Thus, the findings of this study may help healthcare professionals identify the cultural contexts of spirituality/religiosity of Asian immigrant families in order to provide holistic care.


Assuntos
Família , Religião , Espiritualidade , Idoso , Americanos Asiáticos/psicologia , Diversidade Cultural , Emigrantes e Imigrantes/psicologia , Família/etnologia , Família/psicologia , Relações Familiares/etnologia , Relações Familiares/psicologia , Feminino , Nível de Saúde , Humanos , Masculino , Estados Unidos
12.
Soc Work Public Health ; 34(1): 102-112, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30646824

RESUMO

Over time, groundbreaking changes in societies' views and treatment of persons with disabilities, along with significant legislative and policy changes, have impacted the quality of life of African-American families raising children with disabilities. This article presents some of the challenges and inequities faced by African-American families that impact their quality of life using critical race theory (CRT). Also, it reviews results obtained by a study of 123 African-American families raising children with disabilities. The article offers implications for policy and practice and discusses the role for social workers in addressing disparities in healthcare and other areas.


Assuntos
Afro-Americanos , Crianças com Deficiência , Família/etnologia , Família/psicologia , Qualidade de Vida , Criança , Efeitos Psicossociais da Doença , Feminino , Humanos , Masculino , Teoria Social
13.
Med Anthropol ; 38(3): 195-209, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30468087

RESUMO

In this article, I trace the most salient features of Mexican families' complex journeys as they coped with the "predicament" of childhood deafness. Framing support seeking through the theoretical lens of pilgrimage brings into focus family introspection and captures their tenacity while facing culture-specific obstacles. Ultimately, families realized their quests were not about "fixing" their children's hearing, but finding more reliable communication in sign language. Pilgrimage, as a metaphor for the journeys described by participants, helps us understand families' realizations that the biomedical options most commonly available in Mexico City were of limited efficacy, and reveals collective desire for alternatives to these options.


Assuntos
Surdez/etnologia , Família/etnologia , Antropologia Médica , Criança , Surdez/terapia , Humanos , Medicalização , México/etnologia , Línguas de Sinais , Viagem
14.
J Appl Res Intellect Disabil ; 32(2): 413-426, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30353627

RESUMO

BACKGROUND: This study investigated the psychocultural perspectives concerning family quality of life among Brazilian families with children who have severe or profound intellectual disability. METHODS: Individual in-depth semi-structured interviews conducted with 15 mothers, selected by convenience, were analysed using a categorical thematic analysis technique. The themes were examined to allow for an interpretative approach of the results. RESULTS: Mothers revealed that their children with disabilities had insufficient access to services and support related to health care, transportation and recreation. Family quality of life was negatively affected by financial restrictions and social interaction difficulties. Caring for a child with disabilities seemed to be centred on the mother and religious coping appeared as a common psychological adjustment strategy. CONCLUSIONS: Improving emotional and psychological cares, as well as social and practical measures comprising income support and access to appropriate health care, were inferred to be the mothers' priorities to improve their families' quality of life.


Assuntos
Adaptação Psicológica , Família/psicologia , Acesso aos Serviços de Saúde , Deficiência Intelectual/enfermagem , Qualidade de Vida/psicologia , Adulto , Brasil/etnologia , Criança , Estudos Transversais , Família/etnologia , Feminino , Humanos , Deficiência Intelectual/etnologia , Masculino , Pessoa de Meia-Idade , Mães/psicologia , Pesquisa Qualitativa , Índice de Gravidade de Doença , Adulto Jovem
16.
Death Stud ; 43(4): 270-279, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29757095

RESUMO

In this qualitative study, we explored how Chinese rural elders narrate death-related issues and death preparation. Adopting a phenomenological approach, we interviewed 14 participants regarding the particular actions they employ to prepare for death. The findings revealed a death preparation system for rural Chinese elders that is instrumental in how they converse about death, wish for a good death, make objects and symbols, and anticipate an afterlife as a worshiped ancestor rather than a wandering ghost. Family and family honor provide the context for death preparation. We discuss implications and the need for the death preparation education of younger generations.


Assuntos
Envelhecimento/etnologia , Atitude Frente a Morte/etnologia , Família/etnologia , População Rural , Idoso , China/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
17.
Patient Educ Couns ; 102(2): 352-359, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30170824

RESUMO

OBJECTIVE: There is limited number of studies from Arabic countries on the participation of family members in Treatment decision-making (TDM) process. The aim of this study is to evaluate the role of family members in the TDM process among adult Omani women diagnosed with breast cancer. METHODS: A cross-sectional study has been conducted with women diagnosed with breast cancer and their nominated family members. RESULTS: A total of 79 patients and their nominated family members participated. The family members who were most engaged in the TDM were more likely to be young, male, employed and first-degree relative. The following characteristics of patients associated with more family-controlled the TDM: being older (crude odds ratio [OR] = 7.71; 95% confidence interval [CI]: 2.28-22.20), no formal education (OR = 0.18; 95% CI: 0.54) and diagnosed at stage IV (OR = 6.55; 95% CI: 1.89-22.65). The family members who dominate communication with the oncologists were more likely to control the TDM (OR = 6.03; 95% CI: 1.78-20.42). CONCLUSION: Several factors influence the TDM process including age, gender, employments status, educational level and capability of communication. PRACTICE IMPLICATIONS: The TDM process is heavily involves family members. This should be taking in consideration by oncologists during counselling in order to reach the best treatment.


Assuntos
Neoplasias da Mama/terapia , Comunicação , Tomada de Decisões , Família , Preferência do Paciente/psicologia , Adulto , Idoso , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/etnologia , Estudos Transversais , Família/etnologia , Família/psicologia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Omã , Participação do Paciente , Fatores Socioeconômicos , Adulto Jovem
18.
Curr Opin Support Palliat Care ; 13(1): 3-8, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30431459

RESUMO

PURPOSE OF REVIEW: This article provides an informed perspective on cardiovascular disease (CVD) and palliative care need among Maori New Zealanders. High Maori CVD risk factors will contribute to a sharp increase in older Maori deaths which has implications for health and palliative care service provision. RECENT FINDINGS: CVD is New Zealand's leading cause of premature deaths and disability among Maori. A projected rise in older Maori deaths within the next 30 years will require increased palliative care. However, accessing palliative care and obtaining and understanding information can be challenging for families who are already often overburdened with high social and economic disadvantages. Meeting the high financial costs associated with end-of-life care make living with CVD challenging. Engaging with the health system's biomedical approach when holistic care is preferable can be a major barrier. SUMMARY: Maori families provide the bulk of care at end-of-life, but they can become fatigued with the challenges that accompany long-term progressive illnesses, such as CVD. They are also burdened by the financial costs associated with end-of-life. It is often difficult for Maori to access palliative care and to obtain and understand information about the illness and treatment. Navigating an unfamiliar and complex health system, low health literacy among Maori and poor relationship building and communication skills of health professionals are significant barriers. Cultural safety training would help to increase health and cardiovascular professionals' cultural understanding of Maori and their holistic end-of-life preferences; this could go some way to strengthen rapport building and communication skills necessary for effective engagement and informational exchanges. Increasing the Maori palliative care workforce and introducing cultural safety training among health professionals could help to bridge the gap. A current study to gather traditional care customs and present these to whanau and the health and palliative care sectors in the form of an online resource could contribute to this decolonizing objective.


Assuntos
Doenças Cardiovasculares/etnologia , Grupo com Ancestrais Oceânicos , Cuidados Paliativos/estatística & dados numéricos , Assistência Terminal/estatística & dados numéricos , Envelhecimento , Cuidadores/psicologia , Doenças Transmissíveis , Competência Cultural , Família/etnologia , Comportamentos Relacionados com a Saúde/etnologia , Alfabetização em Saúde , Acesso aos Serviços de Saúde , Disparidades nos Níveis de Saúde , Humanos , Nova Zelândia/epidemiologia , Cuidados Paliativos/economia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Fatores de Risco , Fatores Socioeconômicos , Assistência Terminal/economia
19.
Health Promot Int ; 34(2): 291-299, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-29149271

RESUMO

Rangatahi Tu Rangatira (R2R) is a national health promotion programme in Aotearoa New Zealand which aims to promote cultural and physical wellbeing for rangatahi (young people) and their whanau (family). Grounded in tikanga Maori, the programme focuses on total wellbeing, leadership and cultural awareness providing rangatahi opportunities to increase their participation in physical activity and cultural knowledge through nga taonga takaro (Maori ancestral games). This paper focuses on an evaluation of this innovative health promotion programme focussing on the delivery of R2R by a local iwi provider in a rural area. Kanohi ki te kanohi (face-to-face) interviews and focus groups were used to collect data from a range of stakeholders including rangatahi, whanau, programme developers, and collaborating community organizations. A whanau ora (holistic) framework incorporating five core outcomes and key indicators specific to the programme was developed to assess the impact of delivery. Results demonstrated that rangatahi and their whanau were living healthier lifestyles through being more physically active; had gained an increased desire to succeed in their education and extra curriculum activities; and felt more connected to their community and te ao Maori. This demonstrates the importance of incorporating cultural elements to support improved lifestyle changes for rangatahi and their whanau and the connection between enhanced cultural identity and good health.


Assuntos
Promoção da Saúde/métodos , Serviços de Saúde do Indígena , Grupo com Ancestrais Oceânicos , Saúde Pública/métodos , Adolescente , Adulto , Cultura , Exercício , Família/etnologia , Grupos Focais , Humanos , Entrevistas como Assunto , Nova Zelândia , Pesquisa Qualitativa
20.
J Lesbian Stud ; 23(1): 119-139, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30560725

RESUMO

In this essay, we offer our stories of family and migration under a Donald Trump presidency. We are a lesbian couple; one of us is a citizen of the United States while the other is a citizen of a Muslim country. We use autoethnographic methods to explore and interrogate our "messy and fabulous" journey of liminality; our journey of belonging and exclusion, where we grapple with issues related to sexuality, family, career, and citizenship. Our "voices" are used both individually and in unison, to highlight our intersectional and relational selves. We intend this work to contribute to the many ways we can better understand and appreciate the bountiful and colorful vistas of lesbian families' migrant experiences.


Assuntos
Emigração e Imigração , Minorias Sexuais e de Gênero , Escolha da Profissão , Família/etnologia , Feminino , Empregados do Governo , Humanos , Casamento , Política , Estados Unidos
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