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Cancer care experiences and the use of complementary and alternative medicine at end of life in Nova Scotia's Black Communities.

https://arctichealth.org/en/permalink/ahliterature144942
Source
J Transcult Nurs. 2010 Apr;21(2):114-22
Publication Type
Article
Date
Apr-2010
Author
Victor J Maddalena
Wanda Thomas Bernard
Josephine Etowa
Sharon Davis Murdoch
Donna Smith
Phyllis Marsh Jarvis
Author Affiliation
Memorial University of Newfoundland, St John's, Nova Scotia, Canada. victor.maddalena@med.mun.ca
Source
J Transcult Nurs. 2010 Apr;21(2):114-22
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Adult
African Continental Ancestry Group
Complementary Therapies - statistics & numerical data
Cultural Competency
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Neoplasms - nursing
Nova Scotia
Oncology Nursing - methods
Palliative Care
Patient Acceptance of Health Care - statistics & numerical data
Patient satisfaction
Program Development
Program Evaluation
Qualitative Research
Residence Characteristics
Abstract
This qualitative study examines the meanings that African Canadians living in Nova Scotia, Canada, ascribe to their experiences with cancer, family caregiving, and their use of complementary and alternative medicine (CAM) at end of life.
Case study methodology using in-depth interviews were used to examine the experiences of caregivers of decedents who died from cancer in three families.
For many African Canadians end of life is characterized by care provided by family and friends in the home setting, community involvement, a focus on spirituality, and an avoidance of institutionalized health services. Caregivers and their families experience multiple challenges (and multiple demands). There is evidence to suggest that the use of CAM and home remedies at end of life are common.
The delivery of palliative care to African Canadian families should consider and support their preference to provide end-of-life care in the home setting.
PubMed ID
20220031 View in PubMed
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Depression: the 'invisible grey fog' influencing the midlife health of African Canadian women.

https://arctichealth.org/en/permalink/ahliterature163287
Source
Int J Ment Health Nurs. 2007 Jun;16(3):203-13
Publication Type
Article
Date
Jun-2007
Author
Josephine Etowa
Barbara Keddy
Julius Egbeyemi
Felicia Eghan
Author Affiliation
Dalhousie University, School of Nursing, Halifax, Nova Scotia, Canada. josephine.etowa@dal.ca
Source
Int J Ment Health Nurs. 2007 Jun;16(3):203-13
Date
Jun-2007
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
African Continental Ancestry Group - psychology
Aged
Depression - ethnology - etiology - psychology
Female
Humans
Middle Aged - psychology
Nova Scotia
Qualitative Research
Abstract
Depression is a topic that is often avoided in discussions among Black women for a myriad of reasons. The purpose of this study was to investigate the midlife health of Black women living in the province of Nova Scotia, Canada. This paper will present one of the key findings of this research; midlife depression. It will examine the factors associated with depression among mid-life African Canadian women and how these women deal with depression. A triangulation of qualitative and quantitative methods guided by the principles of participatory action research (PAR) was used in the study. Data collection methods included 50 in-depth interviews of mid-life African Canadian women aged 40-65, focus groups, and workshops as well as the CES-D structured instrument. Purposive sampling method was the primary recruitment strategy and 113 people participated in the study. Although the women rarely openly discussed depression, they described depression as emotional feelings that range from "feeling blue" to being clinically depressed. Women viewed midlife depression as the consequence of a complex set of circumstances and stressors that they face. At midlife, Black women frequently recognize the importance of greater self-care and the need to pay more attention to their health, but they are reluctant to do so because they have to be "strong" in order to deal with their daily experiences of racism. Racism, among other things, leads to accumulated stress and undermines Black women's ability to cope and make healthy life choices. This signifies the implications of these research findings for clinical practice.
PubMed ID
17535166 View in PubMed
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Determinants of Black women's health in rural and remote communities.

https://arctichealth.org/en/permalink/ahliterature160555
Source
Can J Nurs Res. 2007 Sep;39(3):56-76
Publication Type
Article
Date
Sep-2007
Author
Josephine Etowa
Juliana Wiens
Wanda Thomas Bernard
Barbara Clow
Author Affiliation
School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada. Josephine.Etowa@dal.ca
Source
Can J Nurs Res. 2007 Sep;39(3):56-76
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
African Continental Ancestry Group - ethnology - statistics & numerical data
Attitude to Health - ethnology
Female
Focus Groups
Health Services Accessibility - statistics & numerical data
Health services needs and demand
Health Services Research
Health Status Disparities
Healthcare Disparities - statistics & numerical data
Humans
Medically underserved area
Nova Scotia
Nursing Methodology Research
Poverty
Prejudice
Qualitative Research
Questionnaires
Residence Characteristics
Rural Health - statistics & numerical data
Social Distance
Unemployment - statistics & numerical data
Women - psychology
Women's Health - ethnology
Abstract
The On the Margins project investigated health status, health-care delivery, and use of health services among African-Canadian women residing in rural and remote regions of the province of Nova Scotia. A participatory action research approach provided a framework for the study. Triangulation of data-collection methods--interviews, focus groups, and questionnaires--formed the basis of data generation. A total of 237 in-depth one-on-one interviews were conducted and coded verbatim. Atlas-ti data-management software was used to facilitate coding and analysis. Six themes emerged from the data: Black women's multiple roles, perceptions of health, experiences with the health-care system, factors affecting health, strategies for managing health, and envisioning solutions. The authors focus on 1 of these themes, factors affecting Black women's health, and discuss 3 subthemes: race and racism, poverty and unemployment, and access to health care.
PubMed ID
17970460 View in PubMed
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Gendered and cultured relations: exploring African Nova Scotians' perceptions and experiences of breast and prostate cancer.

https://arctichealth.org/en/permalink/ahliterature173024
Source
Res Theory Nurs Pract. 2005;19(3):257-73
Publication Type
Article
Date
2005
Author
Joan Evans
Lorna Butler
Josephine Etowa
Iona Crawley
Daniel Rayson
David G Bell
Author Affiliation
Dalhousie University, Halifax, NS, Canada. joan.evans@dal.ca
Source
Res Theory Nurs Pract. 2005;19(3):257-73
Date
2005
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
African Continental Ancestry Group - psychology
Breast Neoplasms - ethnology - psychology
Female
Focus Groups
Gender Identity
Humans
Male
Nova Scotia
Prostatic Neoplasms - ethnology - psychology
Socioeconomic Factors
Abstract
Although breast and prostate cancer are those most frequently diagnosed in Canada, information about the ways in which gender, class, race, culture, and other social determinants impact the experience of African Canadians living with cancer is lacking. This study began to address this gap by exploring cultured and gendered dimensions of African Nova Scotians' experiences of these two cancers. Using a participatory action research approach, data were collected in two phases of focus group discussions in five African Nova Scotian communities from a total of 57 people, including those with breast or prostate cancer and their families and associates. Findings provide insight into how gender and meanings of masculinity and femininity in the African Nova Scotian community unavoidably interact with other social structures such as race and class to affect women and men's perceptions and experiences of these two cancers. These insights point to the need for culturally appropriate and meaningful health interventions. As a prerequisite, health care professionals need to have an understanding of the overlapping and contextualized nature of gender, class, and race and be willing and able to work in partnership with African Nova Scotian communities to identify and develop strategies that reflect the realities of peoples' lives.
PubMed ID
16144243 View in PubMed
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Health-care access as a social determinant of health.

https://arctichealth.org/en/permalink/ahliterature154706
Source
Can Nurse. 2008 Sep;104(7):22-7
Publication Type
Article
Date
Sep-2008
Author
Elizabeth McGibbon
Josephine Etowa
Charmaine McPherson
Author Affiliation
School of Nursing, St Francis Xavier University, Antigonish , Nova Scotia.
Source
Can Nurse. 2008 Sep;104(7):22-7
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Canada
Health Services Accessibility
Health Status Disparities
Humans
Nursing
Social Justice
Abstract
The social determinants of health (SDH) are recognized as important indicators of health and well-being. Health-care services (primary, secondary, tertiary care) have not until recently been considered an SDH. Inequities in access to health care are changing this view. These inequities include barriers faced by certain population groups at point of care, such as the lack of cultural competence of health-care providers. The authors show how a social justice perspective can help nurses understand how to link inequities in access to poorer health outcomes, and they call on nurses to break the cycle of oppression that contributes to these inequities.
PubMed ID
18856224 View in PubMed
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The impact of everyday racism on the occupations of African Canadian women.

https://arctichealth.org/en/permalink/ahliterature147549
Source
Can J Occup Ther. 2009 Oct;76(4):285-93
Publication Type
Article
Date
Oct-2009
Author
Brenda L Beagan
Josephine Etowa
Author Affiliation
School of Occupational Therapy, Dalhousie University, Halifax NS, Canada. bbeagan@dal.ca
Source
Can J Occup Ther. 2009 Oct;76(4):285-93
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Adult
African Continental Ancestry Group
Aged
Canada
Employment
Female
Humans
Interviews as Topic
Leisure Activities
Middle Aged
Parenting
Prejudice
Race Relations
Schools
Abstract
Occupational therapy has increasingly explored the impact of cultural differences on occupations but has not yet begun to explore the impact of racism on human occupation.
This study with 50 African Canadian women used mixed methods to explore the effects of racism on their occupational experiences.
Women aged 40-65 were interviewed in-depth about everyday experiences with racism and overall well-being. Three standardized instruments assessed frequency and stressfulness of race-related experiences.
Everyday racism had subtle, almost intangible, impacts, shaping women's engagement with and the meaning of leisure, productive, and caring occupations.
As occupational therapy increasingly attends to issues of cultural difference, it is critical to also attend to racism. This means learning to ask thoughtful questions about how racism may shape clients' occupations. Attention to this aspect of the social environment will enhance practice with African-heritage clients and clients from other racial minority groups.
PubMed ID
19891298 View in PubMed
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6 records – page 1 of 1.