PURPOSE: To identify factors that influence American and Icelandic parents' health perceptions among families of infants or young children with asthma. DESIGN: A cross-sectional research design of 76 American families and 103 Icelandic families. Data were collected mainly in the Midwest of the United States (US) and in Iceland from August 1996 through January 2000. METHOD: Parents in these two countries who had children aged 6 or younger with chronic asthma completed questionnaires regarding family demands, caregiving demands, family hardiness, sense of coherence, and health perceptions. Descriptive statistics, chi-square tests and t tests were compiled. Multiple regression analysis was used to test path models and for mediation. FINDINGS: American parents differed from their Icelandic counterparts in family hardiness. In both countries, significant differences were found in caregiving demands and health perceptions between mothers and fathers. Illness severity and caregiving demands affected health perceptions of both mothers and fathers. Sense of coherence mediated the relationship between family demands and parents' perceptions for both parents. For mothers only, family hardiness mediated the relationship between family demands and health perceptions. CONCLUSIONS: The Resiliency Model of Family Stress, Adjustment, and Adaptation was useful for building knowledge on parents' health perceptions in two Western cultures for families of young children with asthma. Interventions emphasizing family and individual resiliency and strengths have the potential to affect parents' views of their children's health.
PURPOSE: The aim of the present investigation was to perform an international multicenter comparison of dental appearance as evaluated by dentists, dental technicians, and nondental subjects. MATERIALS AND METHODS: The participants were drawn from three groups: 203 dentists, 197 dental technicians and 254 nondental subjects. The methods developed in a previous study in Sweden were applied again in seven centers located in six countries. A questionnaire, accompanied by five sets of computer-manipulated images portraying one man and one woman, was used to prompt and record responses to different aspects of dental appearance and function. RESULTS: The questionnaire revealed that both the dental appearance and function of teeth were important to most of the participants, but three quarters of the participants did indicate that good dental function was more important that esthetics. More women (30%) than men (18%), however, placed greater importance on appearance. Age or gender did not influence judgments of the computer-manipulated images, although judgments did vary greatly within the three groups and between the centers. Nonetheless, highly colored teeth were preferred more often by nondental subjects than by dentists or dental technicians. CONCLUSION: Computer-aided image manipulation shows promise as a method for investigating the significance of dental-related beliefs, especially those relating to esthetics, in different population groups. The evaluation of dental appearance and function in this study indicated that dental function is held in greater regard, and that the significance of dental appearance varies widely among dentists, dental technicians, and nondental subjects.
To describe the attitudes and subjective norms of female adolescents toward breastfeeding, and to determine whether these are influenced by age, education level, mother tongue, place of birth, exposure to breastfeeding and intention to breastfeed their children.
236 female adolescents, from four schools randomly selected among those offering education levels from secondary 1 to V 4, answered a questionnaire based on the theory of reasoned action.
Female adolescents showed overall positive attitudes towards breastfeeding, but negative subjective norms. Older girls who were breastfed as infants and who originated from foreign countries showed the most positive attitudes towards breastfeeding.
Even though adolescent girls showed overall positive attitudes, several were unable to make up their mind. This result could be attributed to a lack of knowledge and low exposure to breastfeeding mothers. The school system plays an important role in health promotion and should expose all students to the art of breastfeeding through its health classes.
Ethnic minorities may constitute vulnerable groups within Western health care systems as their ability to master severe chronic diseases could be affected by barriers such as different culture and health/illness beliefs, communication problems and limited educational background. An intervention focusing on immigrant families with children with type 1 diabetes is described. The intervention included the development of adapted educational material and guidelines, and a subsequent re-education of children, adolescents and parents from 37 families. The study demonstrated that it was possible to improve health outcome. During the study, the knowledge of diabetes increased, but with considerable differences between the families. HbA(1c) also decreased significantly during the intervention, but increased during follow-up. The paper discusses possible explanations and suggestions for optimising education and calls for new projects where ethnic minorities are active participants in the development of appropriate educational programs and material.
Refugees needing long-term health care must adapt to new healthcare systems. The aim of this study was to examine the viewpoints of nine refugees in a county in Sweden, with a known chronic disease or functional impairment requiring long-term medical care, on their contacts with care providers regarding treatment and personal needs.
Semi-structured interviews with nine individuals and/or their next of kin. Inductive content analysis was used to identify experiences.
''Care organisations/resources'' and ''professional competence'' were the categories extracted. Participants felt cared for due to accessibility to and regular appointments with the same care provider. Visiting different clinics contributed to a negative experience and lack of trust. The staff 's interest in participants' lives and health contributed to a sense of professionalism. Most participants said the problems experienced were not related to their backgrounds as refugees. Many patients did not fully understand which clinic they were attending or the purpose of the care that the specific clinic provided. Some lacked knowledge of their disease.
Health care was perceived as equal to other Swedish citizens and problems experienced were not explained by refugee backgrounds. Lack of information from care providers and being sent to various levels of care created feelings of a lack of overall medical responsibility.
The realities of doing field research with high-risk, minority, or indigenous populations may be quite different than the guidelines presented in research training. There are overlapping and competing demands created by cultural and research imperatives. A National Institute on Drug Abuse (NIDA)-funded study of American Indian youth illustrates competing pressures between research objectives and cultural sensitivity. This account of the problems that were confronted and the attempts made to resolve them will hopefully fill a needed gap in the research literature and serve as a thought-provoking example for other researchers. This study built cross-cultural bridges. Researchers worked as a team with stakeholders to modify the instruments and methods to achieve cultural appropriateness. The researchers agreed to the communities' demands for increased service access and rights of refusal for all publications and presentations. Data indicate that these compromises did not substantially harm the first year of data collection completeness or the well-being of the youth. To the contrary, it enhanced the ability to disseminate results to those community leaders with the most vested interests. The conflicts between ideal research requirements and cultural demands confronted by the researchers and interviewers in the American Indian community were not necessarily different from issues faced by researchers in other communities. Of major import is the recognition that there are no easy answers to such issues within research.
Cites: J Am Acad Child Adolesc Psychiatry. 2000 Aug;39(8):1032-910939232
BACKGROUND: Tobacco dependence interventions developed for Alaska Natives are virtually nonexistent. Alaska Natives residing on the Yukon-Kuskokwim (Y--K) Delta in southwestern Alaska use a unique form of smokeless tobacco (ST) known as Iqmik. This study employed focus group methodology to explore attitudes toward tobacco use and tobacco dependence interventions among Alaska Natives residing on the Y-K Delta. METHODS: Twelve focus groups of former and current tobacco users were conducted in four villages in the Y-K Delta. Participants were 35 adults (83% female) and 22 adolescents (27% female). Participants completed a brief demographic and tobacco use history form. Statements from the focus groups were transcribed for content coding and analysis of the major themes. RESULTS: Use of Iqmik in the villages is thought to be ubiquitous. Y-K Delta Alaska Natives are introduced to Iqmik at a very young age. Iqmik is mostly used and prepared by young Alaska Natives and adult women. There are few perceived adverse health effects of Iqmik or other tobacco use. Although there is interest in stopping, there is a perceived lack of availability of tobacco dependence interventions. The major barriers to preventing the initiation of and stopping tobacco use are the social acceptance and widespread use and availability of tobacco. CONCLUSION: The attitudes toward tobacco and identified barriers to stopping will be useful in developing tobacco dependence interventions for Alaska Natives.