AIM: The aim was to analyse the construction of masculinities among men aged 85 and older. BACKGROUND: All societies have a gender order, constructed from multiple ideas of what is seen as feminine and masculine. As the group of men aged 85 and older is increasing in size and their demand for care will increase, we must recognize the importance of studying these men and various discourses of masculinities. DESIGN: Qualitative explorative. METHODS: Qualitative content analysis was used to analyse thematic narratives. Masculinity theories provided the point of departure for the analysis. RESULTS: The analysis coalesced into three masculinities. 'Being in the male centre', developed from subthemes as: taking pride in one's work and economic situation; being in the centre in relation to others; regarding women as sexual objects; and belonging to a select group. 'Striving to maintain the male facade' developed from subthemes as: emphasizing 'important' connections; having feelings of loss; striving to maintain old norms and rejecting the fact of being old. 'Being related' was formulated from subthemes as: feeling at home with domestic duties; being concerned; accepting one's own aging; and reflecting on life. CONCLUSIONS: Our study indicates the importance of being aware of the existence of multiple masculinities, in contrast to the generally unproblematic and unsubtle particular healthcare approaches which consider men as simply belonging to one masculinity. Relevance to clinical practice. Diverse masculinities probably affect encounters between men and healthcare providers and others who work with an older population and therefore our results are of importance in a caring context.
In this article, we share words spoken by Aboriginal elders from Saskatchewan, Canada, in response to the research question, "What would you like non-Aboriginal health care providers to know when providing end-of-life care for Aboriginal families?" Our purpose in publishing these results in a written format is to place information shared by oral tradition in an academic context and to make the information accessible to other researchers. Recent theoretical work in the areas of death and dying suggests that cultural beliefs and practices are particularly influential at the end of life; however, little work describing the traditional beliefs and practices of Aboriginal peoples in Canada exists to guide culturally appropriate end-of-life care delivery. Purposive sampling procedures were used to recruit five elders from culturally diverse First Nations in southern Saskatchewan. Key informant Aboriginal elder participants were videotaped by two Aboriginal research assistants, who approached the elders at powwows. Narrative analysis of the key informant interview transcripts was conducted to identify key concepts and emerging narrative themes describing culturally appropriate end-of-life health care for Aboriginal families. Six themes were identified to organize the data into a coherent narrative: realization; gathering of community; care and comfort/transition; moments after death; grief, wake, funeral; and messages to health care providers. These themes told the story of the dying person's journey and highlighted important messages from elders to non-Aboriginal health care providers.
The objective of this study was to examine factors associated with HIV testing among Aboriginal peoples in Canada who live off-reserve. Data were drawn for individuals aged 15-44 from the Aboriginal Peoples Survey (2001), which represents a weighed sample of 520,493 Aboriginal men and women living off-reserve. Bivariable analysis and logistic regression were used to identify factors associated with individuals who had received an HIV test within the past year. In adjusted multivariable analysis, female gender, younger age, unemployment, contact with a family doctor or traditional healer within the past year, and "good" or "fair/poor" self-rated health increased the odds of HIV testing. Completion of high-school education, rural residency, and less frequent alcohol and cigarette consumption decreased the odds of HIV testing. A number of differences emerged when the sample was analyzed by gender, most notably females who self-reported "good" or "fair/poor" health status were more likely to have had an HIV test, yet males with comparable health status were less likely to have had an HIV test. Additionally, frequent alcohol consumption and less than high-school education was associated with an increased odds of HIV testing among males, but not females. Furthermore, while younger age was associated with an increased odds of having an HIV test in the overall model, this was particularly relevant for females aged 15-24. These outcomes provide evidence of the need for improved HIV testing strategies to reach greater numbers of Aboriginal peoples living off-reserve. They also echo the long-standing call for culturally appropriate HIV-related programming while drawing new attention to the importance of gender and age, two factors that are often generalized under the rubric of culturally relevant or appropriate program development.
Given the magnitude of the diabetes epidemic among Canadian Aboriginals and the corresponding need to develop physical activity interventions, the aims of this study were to: 1) examine the meaning of physical activity; 2) assess physical activity behavior levels; and 3) examine the association of key Social Cognitive Theory (SCT) constructs with physical activity behavior. Thirty-four Aboriginals with diabetes completed a survey composed of questions regarding: 1) the perceived meaning of physical activity; 2) physical activity behavior; and 3) SCT constructs. An emerging theme revealed that some participants perceived physical activity leisure-time activities as appropriate across the lifespan, while the majority perceived leisure-time activities to be only for youth. Based on the reported energy expenditure estimates, 61.5% of participants were categorized as sedentary. However, when occupational and household activities were taken into account, 33.0% were categorized as sedentary. Bivariate correlations revealed that no SCT constructs were significantly associated with energy expenditure scores. Results suggest that specific SCT construct items may help understand physical activity behavior change.
This paper describes the portrayal of HIV/AIDS in 14 mass print newspapers directed towards the Canadian Aboriginal population and published between 1996 and 2000. Based on qualitative content analysis the research examines both manifest and latent meanings. Manifest results of this study indicate that women and youth are under represented as persons with HIV/AIDS. The latent results note the frequent references to Aboriginal culture, and the political and economic position of Aboriginal Canadians when discussing the disease, the person with the disease, the fear of the disease and the reaction of the community to the person with the disease. Unlike mainstream media where the medical frame is dominant, HIV/AIDS are here contextualized by culture, identity, spirituality and political-economic issues.
This paper reports on the first wave of results from a study exploring the views and experiences of community-based stakeholders on improving care for pregnant and parenting Aboriginal people in Canada. The issue of poor access to prenatal care by Aboriginal women and families is viewed through a post-colonial lens within a historical and social location. This case study was guided by participatory research principles. Data were collected through exploratory interviews and small-group discussions. The sample comprised purposively selected community leaders, providers, and community members affiliated with 2 Aboriginal health-care organizations in a mainly rural region. Participants from all 3 stakeholder groups expressed the view that care should be based on an understanding of the priorities and experiences of the pregnant and parenting Aboriginal women and families themselves. Therefore the research question What are Aboriginal parents' views of the importance of pregnancy and parenting? was added to highlight the views and life experiences of Aboriginal parents. "Turning around" the intergenerational impact of residential schools was identified as pivotal to care. The results suggest that pregnancy and parenting must be understood as reflecting both the unique individual and family experiences of Aboriginal people and the intergenerational impact of residential schools as an instrument of collective violence and as a key factor in Aboriginal Canadians' inequitable health status and access to health services.
Data from the Québec Longitudinal Study of Child Development were used to examine factors associated with postnatal depression and the links between self-rated health (SRH) and depressive symptoms in mothers 5 months after giving birth, according to immigration status. Postnatal depressive symptoms were measured using the 12-item Center for Epidemiologic Studies Depression Scale (CES-D). Immigrant mothers were classified according to their ethnocultural (majority or minority) group and compared with Canadian-born mothers. Logistic regression was used to evaluate the association between SRH and depressive symptoms. The prevalence of high depressive symptoms was larger among immigrants from minority groups (24.7%) than among immigrants from majority groups (8.3%) and Canadian-born mothers 11.2%). SRH was associated with depressive symptoms among Canadian- born mothers, but not among minority immigrant mothers. Canadian- born mothers integrated mental health into their assessment of overall health status, however, depressive symptoms among minority immigrant mothers were common, and their determinants warrant further research.
This study examined the relationships between culture and the health status of older Chinese in Canada. Data were collected through face-to-face interviews with a cross-sectional, randomly selected sample of 2,272 older Chinese between 55 and 101 years of age in seven Canadian cities. Health status was assessed by the number of chronic illnesses, by limitations in ADL and IADL, and by information on the Medical Outcome Study Short Form SF-36. Although cultural variables explained only a small proportion of variance in health status, having a stronger level of identification with traditional Chinese health beliefs was significant in predicting physical health, number of illnesses, and limitations on IADL. Other cultural variables, including religion, country of origin, and length of residence in Canada, were also significant in predicting some health variables. Interventions to improve health should focus on strategies to enhance cultural compatibility between users and the health delivery system.