To explore the cancer information preferences of immigrant women by their level of acculturation we conducted interviews with 34 Spanish-speaking English-as-a-second-language (ESL) women. Chi-square and Fisher's exact tests were used to look for differences by acculturation. Four themes were identified: What is prevention? What should I do; sources of my cancer information, strategies I use to better understand, and identifying and closing my health knowledge gaps. Acculturation did not differentiate immigrant women's cancer information sources, preferences, or strategies used to address language barriers. We suggest the effect of acculturation is neither direct nor simple and may reflect other factors including self-efficacy.
The relationships of personal acculturation and of personal-family acculturation match to depressive symptoms were investigated in a sample of 68 Muslim university students. Two dimensions of personal and family acculturation were assessed: heritage and mainstream culture identification. Participants completed the Vancouver Index of Acculturation (Ryder, Alden, & Paulhus, 2000 ) and the depressive disorder subscale of the Psychiatric Diagnostic Screening Questionnaire (Zimmerman & Mattia, 1999 ). For personal acculturation, individuals with high personal heritage culture identification reported fewer lifetime (but not past-year) depressive symptoms. In contrast, individuals with high personal mainstream culture identification reported more past-year (but not lifetime) depressive symptoms. The hypothesis that a match between personal and family acculturation orientation would be associated with fewer depressive symptoms was supported for heritage culture identification only. For past-year depression, the two match conditions (low or high personal and family heritage culture identification) were associated with significantly fewer depressive symptoms than a low personal/high family mismatch but did not differ from a high personal/low family mismatch. For lifetime depression, a high personal/high family match was associated with significantly fewer depressive symptoms than all other conditions. Findings suggests that, for Muslims, a match of high personal and high family heritage culture identification may act as a protective factor for the experience of depressive symptoms both in the short term (past year) and in the long term (lifetime).
Conscience is an important concept in ethics, having various meanings in different cultures. Because a growing number of healthcare professionals are of immigrant background, particularly within the care of older people, demanding multiple ethical positions, it is important to explore the meaning of conscience among care providers within different cultural contexts.
The study aimed to illuminate the meaning of conscience by enrolled nurses with an Iranian background working in residential care for Persian-speaking people with dementia.
A phenomenological hermeneutical method guided the study. Participants and research context: A total of 10 enrolled nurses with Iranian background, aged 33-46 years, participated in the study. All worked full time in residential care settings for Persian-speaking people with dementia in a large city, in Sweden. Ethical considerations: The study was approved by the Regional Ethical Review Board for ethical vetting of research involving humans. Participants were given verbal and written study information and assured that their participation was voluntary and confidential.
Three themes were constructed including perception of conscience, clear conscience grounded in relations and striving to keep a clear conscience. The conscience was perceived as an inner guide grounded in feelings, which is dynamic and subject to changes throughout life. Having a clear conscience meant being able to form a bond with others, to respect them and to get their confirmation that one does well. To have a clear conscience demanded listening to the voice of the conscience. The enrolled nurses strived to keep their conscience clear by being generous in helping others, accomplishing daily tasks well and behaving nicely in the hope of being treated the same way one day.
Cultural frameworks and the context of practice needed to be considered in interpreting the meaning of conscience and clear conscience.
To describe the experiences of public health nurses (PHNs) in counseling immigrant parents on food and feeding practices at child health centers (CHCs).
In this study employing a qualitative description (QD) approach, the participants (n = 26) were PHNs from five CHCs in the greater Oslo region of Norway.
Data were collected through five focus group interviews and examined using qualitative content analysis.
Counseling on food and feeding practices was an important topic in most consultations with immigrant parents. The PHNs were concerned that the child should eat ordinary, healthy food regularly. Immigrant families were often experienced as a "generic group" and the PHNs disclosed that they rarely adjusted their counseling strategy based on enquiries about families' food culture or parents' level of education or knowledge. Time constraints and language and cultural barriers were common challenges. The PHNs suggested that culturally adapted information materials and visual aids from health authorities could improve communication.
Counseling immigrant parents on food and feeding at CHCs is often challenging for PHNs. The study findings could be used in the development of guidelines to assist PHNs in delivering culturally competent counseling about food and feeding practices.
The purpose of this study is to describe cultural beliefs and coping strategies related to dealing with childhood cancer identified through a qualitative study of the caregiving experiences of first-generation South Asian immigrant parents of children with cancer. A constructivist grounded theory approach was employed. Families with a child at least 6 months postdiagnosis were recruited from 5 Canadian pediatric oncology centers. In-depth semistructured interviews were conducted in English, Hindi, Punjabi, or Urdu with a sample of 25 South Asian parents. Analysis of interviews involved line-by-line coding and using the constant comparison method. The following 2 central themes related to culture and coping emerged: (a) cultural beliefs about childhood cancer being incurable, rare, unspeakable, and understood through religion and (b) parental coping strategies included gaining information about the child's cancer, practicing religious rituals and prayers, trusting the health care professionals, and obtaining mutual support from other South Asian parents. These cultural beliefs and coping strategies have important implications for health care providers to understand the variations in the perceptions of childhood cancer and coping in order to implement culturally sensitive health care services.
We investigated the role of anger expression and cultural framework in predicting Russian immigrant women's physical and psychological health status. One hundred Russian immigrant women between the ages of 30 and 65 completed questionnaires assessing anger expression, cultural framework, and health status. All research questions were addressed using hierarchical regression procedures. The results are discussed in terms of implications for understanding immigration experiences of Russian women who migrate from countries that are more collectivistic and less individualistic than the United States.
A culturally adapted lifestyle intervention addressing a Middle Eastern immigrant population at risk of diabetes, the MEDIM (impact of Migration and Ethnicity on Diabetes In Malmö): study protocol for a randomized controlled trial.
Department of Clinical Sciences, Center for Primary Health Care Research, Lund University/Region Skåne, Skåne University Hospital, Building 60, floor 12 Jan Waldenströms gata 37, 205 02 Malmö, Sweden. Louise.Bennet@med.lu.se.
Studies have shown that lifestyle interventions are effective in preventing or delaying the onset of type 2 diabetes in high-risk patients. However, research on the effectiveness of lifestyle interventions in high-risk immigrant populations with different cultural and socioeconomic backgrounds is scarce. The aim was to design a culturally adapted lifestyle intervention for an immigrant population and to evaluate its effectiveness and cost-effectiveness.
In this randomized controlled trial, 308 participants (born in Iraq, living in Malmö, Sweden and at high risk of type 2 diabetes) will be allocated to either a culturally adapted intervention or a control group. The intervention will consist of 10 group counseling sessions focusing on diet, physical activity and behavioral change over 6 months, and the offer of exercise sessions. Cultural adaptation includes gender-specific exercise sessions, and counseling by a health coach community member. The control group will receive the information about healthy lifestyle habits provided by the primary health care center. The primary outcome is change in fasting glucose level. Secondary outcomes are changes in body mass index, insulin sensitivity, physical activity, food habits and health-related quality of life. Measurements will be taken at baseline, after 3 and 6 months. Data will be analyzed by the intention-to-treat approach. The cost-effectiveness during the trial period and over the longer term will be assessed by simulation modeling from patient, health care and societal perspectives.
This study will provide a basis to measure the effectiveness of a lifestyle intervention designed for immigrants from the Middle East in terms of improvement in glucose metabolism, and will also assess its cost-effectiveness. Results from this trial may help health care providers and policy makers to adapt and implement lifestyle interventions suitable for this population group that can be conducted in the community.
This article discusses factors that affect the exclusion of older immigrants in Finland. The meaning of intergenerational relationships to older immigrants in an everyday life context is versatile and comprises support, commitment and expectations between generations. The second and third generations are doing their best to cope with their own everyday life and integration process while being under the pressure to meet the varied expectations of the first generation. The topic is explored using qualitative data drawn from interviews with three-generation families from the former Soviet Union. The study found that satisfying factors of everyday life, such as housing or activities offered by society and the possibility to live close to the children and grandchildren reflect the feeling of inclusion to the host society. Dissatisfying feelings such as hostile attitudes, deficient language acquisition and a longing for the former home country, people and places there, affect the feelings of social and emotional exclusion. The exclusion faced by older immigrants in the Finnish society seems to be more complicated and sensitive than is generally recognized; it is illustrated through the emotions of immigrant elders rather than through their active actions or participation.
AIMS: To compare belief in own effort to stay healthy, health behaviour and body mass index (BMI) among non-Western immigrants with Danish citizenship and citizens with Danish background. METHODS: Based on the National Health Interview Survey 2005, logistic regression analyses were used to examine differences in belief in own effort to stay healthy, in health behaviour and in BMI between 136 non-Western immigrants with Danish citizenship and 9,901 citizens with Danish background in the age group 25-64 years. RESULTS: Non-Western immigrants had lower odds for reporting that own effort is very important to maintain good health (odds ratio (OR) 0.45; 95% confidence interval (CI) 0.32-0.62) and for reporting consuming more alcohol on a weekly basis than recommended by the Danish National Board of Health (OR 0.21, 95% CI 0.09-0.51). The odds were higher for non-Western immigrants for than citizens with Danish background for reporting sedentary spare-time activities (OR 2.96, 95% CI 1.96-4.17), daily consumption of boiled vegetables (OR 2.50, 95% CI 1.77-3.53), and daily consumption of salad/raw vegetables (OR 2.84, 95% CI 2.02-3.99). We found no differences in daily smoking, daily fruit consumption, BMI> or =25 or BMI> or =30. CONCLUSIONS: The non-Western immigrants are healthier in terms of alcohol and vegetable consumption and unhealthier with regard to leisure-time physical activity. The non-Western immigrants are less likely to report that their own effort is important in maintaining good health.
The prevalence of Type 2 diabetes (T2D) among Pakistani women in Norway is remarkably high. This study aims to assess how they live with the disease and their response to lifestyle and medical information. 120 Pakistani women living in Norway (mean age: 55.7 years) were personally interviewed about their T2D using a structured questionnaire (response rate: 95%). The participants were first-generation immigrants (mean residence time: 28.7 years) of whom 27% were illiterates. Poor health was reported by one-third, and 71% had developed macrovascular comorbidities. A majority reported physical inactivity and an unhealthy diet included religious fasting. One-third was not able to self-measure their blood glucose. There was a great variation in antidiabetic drug regimens and one-fourth had to use insulin in addition to tablets. Pakistani women in Norway showed suboptimal control of their T2D in terms of lifestyle habits, comorbidities and drug use. Low literacy and cultural factors seem to challenge adherence to lifestyle and medical information.