People of South-Asian origin have an increased prevalence of coronary artery disease. Although cardiac rehabilitation (CR) is effective, South Asians are among the least likely people to participate in these programs. Automatic referral increases CR use and may reduce access inequalities. This study qualitatively explored whether CR referral knowledge and access varied among South-Asian patients. Participants were South-Asian cardiac patients receiving treatment at hospitals in Ontario, Canada. Each hospital refers to CR via one offour methods: automatically through paper or electronically, through discussion with allied health professionals (liaison referral), or through referral at the physician's discretion. Data were collected via interviews and analyzed using interpretive-descriptive analysis. Four themes emerged: the importance of predischarge CR discussions with healthcare providers, limited knowledge of CR, ease of the referral process for facilitators of CR attendance, and participants'needs for personal autonomy regarding their decision to attend CR. Liaison referral was perceived to be the most suitable referral method for participants. It facilitated communication between patients and providers, ensuring improved understanding of CR. Automatic referral may not be as well suited to this population because of reduced patient-provider communication.
The United Nations Convention against torture prohibits repatriation of refugees if there is reason to believe they will be tortured on return to their country. A history of torture is therefore an important factor in making a case for asylum. In this study, the results of the medical examinations of 59 torture victims investigated at the Department of Forensic Medicine, University of Aarhus, Denmark, 1996-2002, are presented and discussed. Variables including age, sex, education, health, torture methods, condition of confinement, torture aftereffects, and findings at the forensic examination were registered in a database (Paradox) and analyzed. In 70%, aftereffects of torture could be documented. These included scars after fixation, burns, incisions, or flogging. Symptoms and signs from joints, muscles, and nerves were common in victims who had been suspended. Many of the victims of phalanga had painful feet and signs of walking impairment. A majority of the victims suffered from posttraumatic stress syndrome. An independent medical report offers an opportunity to evaluate and elaborate the story told by the victim and should be used in disputed cases. We have a duty to protect refugees against torture.
The Canadian population is aging and becoming more ethnically diverse. This paper focuses on South Asian immigrant seniors and examines differences in housing and living arrangements among seniors who immigrated at different life stages. We interviewed a convenience sample of 161 immigrant seniors of South Asian descent in Edmonton, Alberta, to assess type of living arrangement, type of housing and dwelling density (measured in persons per room), activity in the neighbourhood, and means of transportation. Overall, those seniors who came to Canada before the end of mid-life were more likely than those who came at an older age to drive a car and, if married, to live in a one- or two-generation family. Women were more likely than men to be widowed, have poorer English-language skills, or live with a three-generation family if unmarried, and less likely to drive a car. Most respondents were satisfied with their living arrangements, housing, and perceived safety at home and in their neighbourhood. Theoretical implications are discussed.
There is concern that a disproportionately high number of people of South Asian origin await transplantation in Canada. The donation rate is low in this population, and it is difficult to obtain good tissue matches.
To explore the values and beliefs regarding organ donation among Indo-Canadian people living in British Columbia.
A naturalistic qualitative study was designed. Individual interviews and focus groups were held to collect data pertaining to beliefs regarding organ donation.
Lower Mainland of British Columbia, Canada.
A total of 40 Indo-Canadian persons participated; a wide range of ages, religions, and backgrounds were represented.
The major themes that emerged from the data related to context (including family/community, religion, trust in the healthcare system, and knowledge about organ donation); and values and beliefs (including intergenerational considerations, death and dying, and the organ donation process). Participants noted that people from their community were reluctant to discuss death and relatedissues such as organ donation. Although there was recognition of the importance of individual decision making pertaining to organ donation, the participants believed that family and community members also should be involved.
Beliefs varied considerably among participants, and one should not make assumptions about the beliefs of any one individual based primarily on that individual's membership in an ethnocultural community.
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.
Othering is a process that identifies those that are thought to be different from oneself or the mainstream, and it can reinforce and reproduce positions of domination and subordination. Although there are theoretical and conceptual treatments of othering in the literature, researchers lack sufficient examples of othering practices that influence the interactions between patients and health care providers. The purpose of this study was to explore the interactions between health care providers and South Asian immigrant women to describe othering practices and their effects. Ethnographic methods were used involving in-depth interviews and focus group discussions. The analysis entailed identifying uses of othering and exploring the dynamics through which this process took place. Women shared stories of how discriminatory treatment was experienced. The interviews with health care professionals provided examples of how views of South Asian women shaped the way health care services were provided. Three forms of othering were found in informants' descriptions of their problematic health care encounters: essentializing explanations, culturalist explanations, and racializing explanations. Women's stories illustrated ways of coping and managing othering experiences. The analysis also revealed how individual interactions are influenced by the social and institutional contexts that create conditions for othering practices. To foster safe and effective health care interactions, those in power must continue to unmask othering practices and transform health care environments to support truly equitable health care.
School of Nursing and Department of Obstetrics and Gynecology, McGill University, and Women's Health Mission, McGill University Health Centre, 3506 University Street, Montréal, Canada. email@example.com
Differences in relationship power dynamics or migration factors may affect knowledge, attitudes, and practices (KAP) towards HIV/AIDS and sexually transmitted infections (STIs) in resettling Migrant women. A sample of 122 women and men born in India, Sri Lanka, Pakistan or Bangladesh and residing in Montreal completed questionnaires on HIV/STI KAP and decision-making power Within sexual relationships. Knowledge gaps and stigmatizing attitudes were found. STI/HIV information available in one's language and other educational strategies that consider women's Power may improve KAP among South Asian migrant women.