Suchergebnisse

There is urgent need to effectively support the well-being of rural palliative family caregivers (FCGs). A mixed method study was conducted with 23 FCGs. Data collection included completion of an assessment questionnaire and semistructured interviews. The most prevalent needs identified by questionnaire were caring for the patient's pain, fatigue, body, and nourishment; FCG's fatigue and need for respite. Yet few FCGs wanted more attention to these needs by healthcare providers. FCGs resisted considering their own personal needs. Instead, they focused on needs related to providing care including to be(come) a palliative caregiver, be skilled and know more, navigate competing wishes, needs, demands, and priorities, and for "an extra pair of hands." Gaps in rural palliative services contributed to low expectations for assistance; reluctance to seek assistance was influenced by FCGs' resourcefulness and independence. Findings suggest that supporting FCGs will most likely be successful when framed in relation to their caregiving role.

The "More doctors smoke camels" advertising campaign ran from 1946 until 1954. The campaign featured a series of advertisements centered around and celebrating the physician in American life. Neatly bookending the demise of the physician was the appearance, in 1955, of the Marlboro Man. The dominant figure in the Marlboro Man campaign was the cowboy. This shift away from the physician to the cowboy will be situated in the context of 1950s fears about smoking and health. The similarities and differences in the masculine virtues of the physician and the cowboy will be analyzed in terms of the relationship between men and health in mid-century America.

The purpose of this study was to examine the influence of family members on immigrant South Asian women's health and health-seeking behavior. This qualitative study was part of a larger study that examined the health-seeking practices of immigrant South Asian women living in the Lower Mainland of British Columbia, Canada. Using ethnographic methods, data were collected through face-to-face interviews with women who had lived in Canada for 10 months to 31 years. Analysis of translated and transcribed data revealed that women made decisions about their health in consultation with family members. Overall, family members were perceived to be supportive and provided direct and indirect assistance to women in ways that influenced their health. Expected roles and responsibilities often had detrimental influences on women's health. Health care for immigrant South Asian women needs to take into account women's relationships with family members and the influence of family on women's health.

Although individuals who are diagnosed with smoking-related disorders are offered smoking cessation programs, little attention has been directed toward reducing tobacco use among healthy relatives who smoke. The purpose of this article is to report smoking relatives' responses to a family member's diagnosis of lung disease, their constructions of smoking in this context, and their interaction patterns with the patient. Interviews with 11 family members where there was a diagnosis of lung cancer and 3 family members where there was another serious smoking-related diagnosis were analyzed. Family members used two strategies to support their continued smoking: distancing themselves from the diagnosis and taking the position that smoking cessation needed to be internally motivated by the "right reason" and initiated at the "right time" to anticipate success. The few participants who chose to quit, did so in support of their ill family member. The findings provide direction for intervening with family members who smoke.

Purpose: The purpose of this study was to explore gender-related factors that motivate and support men's smoking reduction and cessation to inform effective men-centered interventions. Approach or Design: Focus group design using a semi-structured interview guide. Setting: Three communities in British Columbia, Canada. Participants: A total of 56 men who currently smoked and were interested in reducing or quitting or had quit. Intervention: N/A. Methods: Data collected in 6 focus group discussions were transcribed and analyzed in accord with principles of thematic qualitative methods. Results: We report the results across 4 interconnected themes: (1) the fight to quit takes several rounds, (2) the motivation of supportive competition, (3) challenges and benefits of connecting with smoke-free peers, and (4) playing up the physical and financial gains. Conclusions: Masculine-based perspectives positioned quitting alongside fighting for self-control, competing, connecting, physical prowess, and having extra cash as motivating components of programs to engage men in efforts to be smoke-free. It may be worthwhile to consider the inclusion of gain-framed and benefit-focused messaging in programs that support men's tobacco cessation.

Masculinities and culture are intertwined and have significant implications for men's mental health. This study aimed to explore influences of Australian masculinities and culture on men's mental health. Five focus groups were conducted with men ( N = 43) living in New South Wales, Australia. Three overarching themes were identified: (1) a history of strength and self-reliance: taketh as we are, she'll be right, (2) social and geographical divides: surrounded by men but never actually connecting, and (3) male socialisation and generational dissidence: not getting the wisdom from the men that have gone before me. Participants' perspectives and experiences offer a reference point and lens for understanding challenges and enhancing efforts to promote Australian men's mental health. Gender transformative program strategies are proposed to promote men's mental health and help-seeking.

Background: Indigenous women in Canada have been hyper-visible in research, policy and intervention related to substance use during pregnancy; however, little is known about how the social determinants of health and substance use prior to, during, and after pregnancy intersect. The objectives of this study were to describe the social contexts of pregnant-involved young Indigenous women who use substances and to explore if an Indigenous-Specific Determinants of Health Model can predict substance use among this population. Methods: Using descriptive statistics and hierarchical logistic regression guided by mediation analysis, the social contexts of pregnant-involved young Indigenous women who use illicit drugs' lives were explored and the Integrated Life Course and Social Determinants Model of Aboriginal Health's ability to predict heavy versus light substance use in this group was tested (N = 291). Results: Important distal determinants of substance use were identified including residential school histories, as well as protective factors, such as sex abuse reporting and empirical evidence for including Indigenous-specific determinants of health as important considerations in understanding young Indigenous women's experiences with pregnancy and substance use was provided. Conclusions: This analysis provided important insight into the social contexts of women who have experiences with pregnancy as well as drug and/or alcohol use and highlighted the need to include Indigenous-specific determinants of health when examining young Indigenous women's social, political and historical contexts in relation to their experiences with pregnancy and substance use. ; Health and Social Development, Faculty of (Okanagan) ; Medicine, Faculty of ; Non UBC ; Nursing, School of (Okanagan) ; Obstetrics and Gynaecology, Department of ; Population and Public Health (SPPH), School of ; Reviewed ; Faculty

It has been over 20 years since the inception of predictive testing for Huntington disease (HD), yet the social implications of knowing one's genetic risk for HD have not been fully explored. Genetic discrimination (GD) is a potential risk associated with predictive testing. Although anecdotal reports of GD have been documented, there is a paucity of research on the nature and experiences of GD in the context of HD. The purpose of this study was to describe the concerns and experiences of GD in the HD community. Semistructured interviews were conducted with 45 genetically tested and 10 untested individuals and analyzed using grounded theory methods. Our findings demonstrate that a majority of individuals were concerned about (37/55) and experienced GD (32/55) across a variety of contexts that extend beyond the traditionally examined contexts of insurance and employment to include family, social, government, and health-care domains. We describe a process of engagement with GD in which individuals formed meaningful interpretations of GD and personalized its risk and consequences in their lives. Our findings provide an insight into some of the specific processes and factors influencing engagement with GD. These results help identify areas where more education and support is needed and provide direction to genetic professionals supporting their clients as they confront issues of GD and genetic testing.

Purpose: To estimate program effectiveness regarding physical activity (PA), diet, and social connectedness as part of a feasibility study. Design: Pre-post quasi-experimental. Setting: HAT TRICK was delivered in collaboration with a Canadian semi-professional ice hockey team and offered at the arena where they trained and played games. Participants: Participants (N = 62) at baseline were overweight (BMI >25kg/m2) and inactive (<150 minutes of MVPA/week) men age 35+ years. Intervention: Gender-sensitized 12-week intervention for men targeting PA, healthy eating and social connectedness. Method: Baseline, post-intervention (12 weeks) and 9-month follow-up self-report and accelerometer data were collected. Multi-level modeling assessed growth trajectories of outcome measures across time. Results: Accelerometer measured weekly/min. of moderate PA showed significant linear trends (95%CI: 42.9 – 175.3) from baseline (147.0 ± 104.6), 12-week (237.7 ± 135.5) and 9-month follow-up (204.89 ± 137.7) qualified with a quadratic trend. Self-reported weekly/min of moderate and vigorous PA showed significant linear trends (95%CI: 94.1, 264.1; 95%CI: 35.1, 109.6) from baseline (52.6 ± 83.8, 22.42 ± 44.9), 12 week (160.1 ± 157.4, 66.6 ± 74.4) and 9-month follow-up (118.6 ± 104.6, 52.2 ± 59.2) qualified with quadratic trends. DINE measured fat score rating showed linear trends over time (95%CI -14.24, -6.8), qualified with a quadratic trend. DINE fibre score and social connectedness showed no trends. Conclusion: Findings yield valuable information about the implementation of gender-sensitized lifestyle interventions for men and demonstrate the importance of male-specific strategies for reaching and engaging overweight, physically inactive men.

Background: This study examined the formulation, adoption, and implementation of a ban on smoking in the parks and beaches in Vancouver, Canada. Methods: Informed by Critical Multiplism, we explored the policy adoption process, support for and compliance with a local bylaw prohibiting smoking in parks and on beaches, experiences with enforcement, and potential health equity issues through a series of qualitative and quantitative studies. Results: Findings suggest that there was unanimous support for the introduction of the bylaw among policy makers, as well as a high degree of positive public support. We observed that smoking initially declined following the ban's implementation, but that smoking practices vary in parks by location. We also found evidence of different levels of enforcement and compliance between settings, and between different populations of park and beach users. Conclusions: Overall success with the implementation of the bylaw is tempered by potential increases in health inequities because of variable enforcement of the ban; greatest levels of smoking appear to continue to occur in the least advantaged areas of the city. Jurisdictions developing such policies need to consider how to allocate sufficient resources to enhance voluntary compliance and ensure that such bylaws do not contribute to health inequities. ; Other UBC ; Non UBC ; Reviewed ; Faculty

<i>Objective:</i> To investigate the knowledge, professional involvement and confidence of Canadian nurses and physicians in providing genetic services for adult onset hereditary disease. <i>Methods:</i> 1,425 physicians and 1,425 nurses received a mailed questionnaire with reminders. The response rates were 50% (n = 543) and 79% (n = 975), respectively. <i>Results:</i> Forty-eight percent of physicians and 31% of nurses lacked formal education in genetics. Respondents reported being involved in caring for people at risk for adult onset hereditary disease. Their levels of confidence that they could perform tasks, such as counselling about predictive genetic tests, however, were lower than their levels of expectation that it would be important for them to provide these services. <i>Conclusions:</i> The expected roles and educational needs of Canadian nurses and physicians have broad areas of overlap suggesting the possibility of combined professional education programs and multiple ways of organizing teams to provide genetic services to people at risk for adult onset hereditary disease.

Objective: To explore published empirical literature in order to identify factors that facilitate or inhibit collaborative approaches for health promotion using a scoping review methodology. Data Source: A comprehensive search of MEDLINE, CINAHL, ScienceDirect, PsycINFO, and Academic Search Complete for articles published between January 2001 and October 2015 was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study Inclusion and Exclusion Criteria: To be included studies had to: be an original research article, published in English, involve at least 2 organizations in a health promotion partnership, and identify factors contributing to or constraining the success of an established (or prior) partnership. Studies were excluded if they focused on primary care collaboration or organizations jointly lobbying for a cause. Data Extraction: Data extraction was completed by 2 members of the author team using a summary chart to extract information relevant to the factors that facilitated or constrained collaboration success. Data Synthesis: NVivo 10 was used to code article content into the thematic categories identified in the data extraction. Results: Twenty-five studies across 8 countries were identified. Several key factors contributed to collaborative effectiveness, including a shared vision, leadership, member characteristics, organizational commitment, available resources, clear roles/responsibilities, trust/clear communication, and engagement of the target population. Conclusion: In general, the findings were consistent with previous reviews; however, additional novel themes did emerge.