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Acceptability of a web-based community reinforcement approach for substance use disorders with treatment-seeking American Indians/Alaska Natives.

https://arctichealth.org/en/permalink/ahliterature270301
Source
Community Ment Health J. 2015 May;51(4):393-403
Publication Type
Article
Date
May-2015
Author
Aimee N C Campbell
Eva Turrigiano
Michelle Moore
Gloria M Miele
Traci Rieckmann
Mei-Chen Hu
Frankie Kropp
Roz Ringor-Carty
Edward V Nunes
Source
Community Ment Health J. 2015 May;51(4):393-403
Date
May-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Alaska
Female
Health Services Accessibility
Humans
Indians, North American - psychology
Internet
Interviews as Topic
Linear Models
Male
Middle Aged
Patient Acceptance of Health Care - ethnology
Qualitative Research
Substance-Related Disorders - ethnology - therapy
Therapy, Computer-Assisted - methods
Young Adult
Abstract
Longstanding disparities in substance use disorders and treatment access exist among American Indians/Alaska Natives (AI/AN). Computerized, web-delivered interventions have potential to increase access to quality treatment and improve patient outcomes. Prior research supports the efficacy of a web-based version [therapeutic education system (TES)] of the community reinforcement approach to improve outcomes among outpatients in substance abuse treatment; however, TES has not been tested among AI/AN. The results from this mixed method acceptability study among a diverse sample of urban AI/AN (N = 40) show that TES was acceptable across seven indices (range 7.8-9.4 on 0-10 scales with 10 indicating highest acceptability). Qualitative interviews suggest adaptation specific to AI/AN culture could improve adoption. Additional efforts to adapt TES and conduct a larger effectiveness study are warranted.
Notes
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PubMed ID
25022913 View in PubMed
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Depression literacy among older Chinese immigrants in Canada: a comparison with a population-based survey.

https://arctichealth.org/en/permalink/ahliterature141072
Source
Int Psychogeriatr. 2010 Dec;22(8):1318-26
Publication Type
Article
Date
Dec-2010
Author
Yvonne Tieu
Candace Konnert
JianLi Wang
Author Affiliation
Department of Psychology, University of Calgary, Calgary, Alberta, Canada. ytieu@ucalgary.ca
Source
Int Psychogeriatr. 2010 Dec;22(8):1318-26
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Asian Continental Ancestry Group - psychology - statistics & numerical data
Canada - epidemiology
Case-Control Studies
Depression - diagnosis - ethnology - psychology - therapy
Emigrants and Immigrants - psychology - statistics & numerical data
Female
Health Literacy - statistics & numerical data
Health Surveys
Humans
Male
Middle Aged
Patient Acceptance of Health Care - ethnology - statistics & numerical data
Prognosis
Questionnaires
Abstract
Investigations of mental health literacy are important because the recognition of a mental health problem is the first step in seeking appropriate mental health care. Lack of recognition is a significant barrier to accessing mental health resources. Older Chinese immigrants are at increased risk for depression; however, there is no research investigating their depression literacy, including their beliefs about treatment, etiology, and prognosis.
This study investigated depression literacy among 53 older Chinese immigrants in Canada (aged 55-87 years) and compared their literacy to Canadian-born participants of the same age who were part of a larger population-based survey. Depression literacy was assessed through interviews using a case vignette and included the following indices: rates of correct identification of depression; perceived efficacy of various people, professions and treatments; and perceptions of etiology and prognosis.
In the Chinese sample, 11.3% correctly identified depression in the case vignette. In contrast, 74.0% of participants in the population-based survey correctly identified depression. Differences in the perceptions of helpful people and interventions, etiology, and prognosis were also noted between the samples. Both samples strongly endorsed physical activity as helpful in the treatment of depression.
In light of these results, it is clear that older Chinese immigrants would benefit from information regarding the symptoms, etiology, and treatment of depression, and that this information may begin to address the serious underutilization of mental health services among this group. Our discussion highlights practice implications and promising interventions.
PubMed ID
20813076 View in PubMed
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Heterogeneity in health status and the influence of patient characteristics across patients seeking musculoskeletal orthopaedic care - a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature115532
Source
BMC Musculoskelet Disord. 2013;14:83
Publication Type
Article
Date
2013
Author
Anthony V Perruccio
Rajiv Gandhi
Y Raja Rampersaud
Author Affiliation
Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network, 1st Floor, East Wing, Room 441, Toronto, ON, Canada.
Source
BMC Musculoskelet Disord. 2013;14:83
Date
2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
African Continental Ancestry Group
Aged
Aged, 80 and over
Asian Continental Ancestry Group
Comorbidity
Cross-Sectional Studies
European Continental Ancestry Group
Female
Health Knowledge, Attitudes, Practice - ethnology
Health Status Disparities
Humans
Male
Mental health
Middle Aged
Musculoskeletal Diseases - diagnosis - ethnology - physiopathology - psychology - therapy
Ontario - epidemiology
Orthopedic Procedures
Pain - diagnosis - ethnology - physiopathology - prevention & control - psychology
Pain Measurement
Patient Acceptance of Health Care - ethnology
Questionnaires
Regression Analysis
Risk factors
Young Adult
Abstract
Health status is an important predictor of patient outcomes. Consequently, identifying patient predictors of health status is essential. In musculoskeletal orthopaedic care, the majority of work examining the association between patient characteristics and health status has been undertaken among hip/knee cohorts. We investigate these associations comparing findings across four musculoskeletal cohorts (hip/knee; foot/ankle; neck/back; elbow/shoulder).
Patients seeking elective musculoskeletal orthopaedic care were recruited prior to consultation. Questionnaires captured health domain status (bodily pain, physical functioning, and mental and general health) and covariates: demographics; socioeconomic characteristics; and comorbidity. Scores were compared across cohorts. Two path regression analyses were undertaken. First, domain scores were simultaneously examined as dependent variables in the overall sample. Subsequently, the model was assessed stratified by cohort.
1,948 patients: 454 neck/back, 767 hip/knee, 378 shoulder/elbow, 349 foot/ankle. From stratified analyses, significant variability in covariate effects was observed. Worse bodily pain scores were associated with increasing age and female sex among hip/knee, low income among foot/ankle, and overweight/obese for foot/ankle and hip/knee. Worse mental health scores were associated with low income across cohorts except elbow/shoulder, low education within neck/back, and compared to Whites, Blacks had significantly worse scores among foot/ankle, better scores among hip/knee. Worse general health scores were observed for Asians among hip/knee, Blacks among foot/ankle, and South-Asians among elbow/shoulder and neck/back.
The substantial heterogeneity across musculoskeletal cohorts suggests that patient- and cohort-specific approaches to patient counsel and care may be more effective for achieving optimal health and outcomes.
Notes
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PubMed ID
23497192 View in PubMed
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Indigenous Elder Insights About Conventional Care Services in Alaska: Culturally Charged Spaces.

https://arctichealth.org/en/permalink/ahliterature288183
Source
J Gerontol Soc Work. 2016 May-Jun;59(4):296-315
Publication Type
Article
Author
Jean E Balestrery
Source
J Gerontol Soc Work. 2016 May-Jun;59(4):296-315
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alaska - ethnology
Alaska Natives - ethnology - psychology
Anthropology, Cultural - methods
Cultural Competency
Female
Humans
Male
Middle Aged
Patient Acceptance of Health Care - ethnology - psychology
Qualitative Research
Racism - psychology
Rural Population
Abstract
Indigenous peoples around the world endure health and social disparities. In the United States, such disparities are typically ameliorated through conventional care services and organizations.
To examine points of tension that characterize culturally pluralistic care services in the United States, specifically Alaska, within context of Indigenous colonial histories.
The research design is ethnographic and multisited, comprising 12 months of fieldwork across urban, rural and remote village sites in Alaska. A conceptual lens that accounts for culturally diverse social spaces where relations of power are at stake frames research presented here. This work incorporates relational and participatory action research principles with Alaska Native Elders. Ethnographic evidence was collected through multiple methods, including field notes, documents, and interviews, with ethnographic analysis involving atlas.ti.
Alaska Native Elders describe salient points of tension characterizing Alaska's conventional care services through the following insights: generational curses--a pain, prejudice on both sides-wounded, and value-systems clash-fighting.
This article concludes with discussion about collective anxieties and implications for care services.
PubMed ID
27359337 View in PubMed
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Is there equity in access to health services for ethnic minorities in Sweden?

https://arctichealth.org/en/permalink/ahliterature71928
Source
Eur J Public Health. 2001 Jun;11(2):147-52
Publication Type
Article
Date
Jun-2001
Author
A. Hjern
B. Haglund
G. Persson
M. Rosén
Author Affiliation
Centre for Epidemiology, National Board of Health and Welfare, 106 30 Stockholm, Sweden. anders.hjern@sos.se
Source
Eur J Public Health. 2001 Jun;11(2):147-52
Date
Jun-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Chile - ethnology
Comparative Study
Ethnic Groups - statistics & numerical data
Female
Health Care Surveys
Health Services Accessibility - statistics & numerical data
Health status
Humans
Interviews
Iran - ethnology
Logistic Models
Male
Middle Aged
Minority Groups - statistics & numerical data
Multivariate Analysis
Patient Acceptance of Health Care - ethnology
Poland - ethnology
Research Support, Non-U.S. Gov't
Sex Distribution
Social Justice
Socioeconomic Factors
Sweden - epidemiology
Turkey - ethnology
Abstract
BACKGROUND: This paper addresses the extent to which equity of treatment according to need, as defined by self-reported health status, is received by members of ethnic minorities in Swedish health services. METHODS: The study was based on a multivariate analysis of cross-sectional data from the Swedish Survey of Living Conditions and Immigrant Survey of Living Conditions in 1996 on use of health services, morbidity and socioeconomic indicators. The study population consisted of 1,890 Swedish residents aged 27-60 years born in Chile, Poland, Turkey and Iran and 2,452 age-matched, Swedish-born residents. MAIN RESULTS: Residents born in Chile, Iran and Turkey were more likely to have consulted a physician during the 3 months prior to the interview compared to Swedish-born residents; odds ratios (ORs) 1.4 (95% CI: 1.2-1.7), 1.3 (95% CI: 1.1-1.7) and 1.5 (95% CI: 1.3-1.9) respectively. The higher consultation rate in these ethnic minorities was primarily explained by a less satisfactory, self-reported health status compared to Swedish-born residents. Thirty-eight percent of the minority study groups reported exposure to organised violence in their country of origin, which was associated with a higher level of use of consultations with a physician (OR 1.3, 95% CI: 1.1-1.6). CONCLUSIONS: This study did not indicate any gross pattern of inequity in access to care for ethnic minorities in Sweden. Systems for allocating resources to health authorities need to consider the possibility that ethnic minorities in Sweden and in particular victims of organised violence, use health services more than is suggested by socioeconomic indicators only.
PubMed ID
11420800 View in PubMed
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Men and women managing coronary artery disease risk: urban-rural contrasts.

https://arctichealth.org/en/permalink/ahliterature173243
Source
Soc Sci Med. 2006 Mar;62(5):1091-102
Publication Type
Article
Date
Mar-2006
Author
Kathryn M King
Elizabeth Thomlinson
Julianne Sanguins
Pamela LeBlanc
Author Affiliation
Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada T2N 1N4. kingk@ucalgary.ca
Source
Soc Sci Med. 2006 Mar;62(5):1091-102
Date
Mar-2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Alberta - epidemiology
Coronary Disease - ethnology - prevention & control
Cultural Characteristics
European Continental Ancestry Group - psychology
Female
Health Behavior - ethnology
Health Knowledge, Attitudes, Practice
Humans
Life Style - ethnology
Male
Middle Aged
Patient Acceptance of Health Care - ethnology
Questionnaires
Rural Health - statistics & numerical data
Socioeconomic Factors
Urban Health - statistics & numerical data
Abstract
People's beliefs about health and making lifestyle changes associated with risk reduction and disease prevention can vary based on their gender and ethnocultural affiliation. Our objective was to describe and explain how gender and ethnocultural affiliation influence the process that people undergo when faced with making lifestyle changes related to their coronary artery disease (CAD) risk. A series of grounded theory studies were undertaken in Alberta, Canada, with men and women from five ethnocultural groups diagnosed with CAD. Here, we describe the cultural aspects associated with urban- and rural-living in 42 Euro-Celtic men and women. Data were collected through semi-structured, audio-recorded interviews and analysed using constant comparative methods. The core variable that emerged through the process was 'meeting the challenge'. There were three phases to the process of managing CAD risk: pre-diagnosis/event, liminal self, and living with CAD. Intra-personal, inter-personal, extra-personal, and socio-demographic factors influenced the participants' capacity to meet the challenge of managing their CAD risk. The influence of these factors was either direct or indirect through the intertwined elements of the participants' knowledge about CAD and perceived extent of necessary change. Each element of this process was influenced by the participants' gender and culture (urban- versus rural-living). When healthcare providers understand and work with the gender- and ethnoculturally based components that influence people's appraisal of their cardiac health and their decision-making, appropriate secondary prevention interventions and positive health outcomes are more likely to follow.
PubMed ID
16115710 View in PubMed
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Othering and being othered in the context of health care services.

https://arctichealth.org/en/permalink/ahliterature180509
Source
Health Commun. 2004;16(2):255-71
Publication Type
Article
Date
2004
Author
Joy L Johnson
Joan L Bottorff
Annette J Browne
Sukhdev Grewal
B Ann Hilton
Heather Clarke
Author Affiliation
School of Nursing, University of British Columbia, Canada. johnson@nursing.ubc.ca
Source
Health Commun. 2004;16(2):255-71
Date
2004
Language
English
Publication Type
Article
Keywords
Adult
Africa, Eastern - ethnology
Aged
Aged, 80 and over
Asia, Western - ethnology
Asian Continental Ancestry Group - classification - ethnology
Attitude of Health Personnel - ethnology
British Columbia
Emigration and Immigration
Female
Fiji - ethnology
Humans
Interviews as Topic
Middle Aged
Patient Acceptance of Health Care - ethnology
Prejudice
Professional-Patient Relations
Social Identification
Women's Health Services - standards
Abstract
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.
PubMed ID
15090288 View in PubMed
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Perspectives of homeless people on their health and health needs priorities.

https://arctichealth.org/en/permalink/ahliterature163815
Source
J Adv Nurs. 2007 May;58(3):273-81
Publication Type
Article
Date
May-2007
Author
Isolde Daiski
Author Affiliation
School of Nursing, York University, Toronto, Ontario, Canada. idaiski@yorku.ca
Source
J Adv Nurs. 2007 May;58(3):273-81
Date
May-2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Female
Health Services Needs and Demand - ethics - organization & administration - standards
Homeless Persons - psychology - statistics & numerical data
Humans
Male
Middle Aged
Nurse-Patient Relations - ethics
Ontario - epidemiology
Patient Acceptance of Health Care - ethnology - psychology - statistics & numerical data
Prevalence
Social Problems - ethics - statistics & numerical data
Abstract
This paper is a report of a study of the perspectives of homeless individuals on their health and healthcare needs.
Many studies show the high incidence and severity of diseases, physical and mental, amongst the homeless populations. However, the views of homeless people themselves are usually omitted. In order to provide appropriate care, healthcare professionals need to be aware of these perspectives.
A descriptive, exploratory design, using semi-structured interviews and observational field notes, was chosen for this qualitative study. A convenience sample of 24 participants experiencing homelessness was recruited in one Canadian city in 2005.
Participants described their health and healthcare needs in a holistic sense. They reported concerns about physical illnesses, mental health, addictions and stress. Shelter life promoted spread of diseases and lacked privacy. Violence was rampant in shelters and on the streets, leading to constant fear. There was emotional distress over social exclusion and depersonalization. Participants wanted to work and to be housed, yet felt trapped in a dehumanizing system.
The recommendations are (a) elimination or mitigation of most health problems of the homeless through safe, affordable housing; (b) reintegration into the community through job counselling, treatment of addictions and employment. Negative societal attitudes towards these clients need to change. Healthcare professionals, particularly community nurses, have opportunities to collaborate respectfully with these clients and work for changes in public policies, such as national housing and addiction treatment policies, and for streamlined, humanized services to smooth the processes of social reintegration.
PubMed ID
17474916 View in PubMed
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Punjabi Sikh patients' cardiac rehabilitation experiences following myocardial infarction: a qualitative analysis.

https://arctichealth.org/en/permalink/ahliterature139644
Source
J Clin Nurs. 2010 Nov;19(21-22):3134-42
Publication Type
Article
Date
Nov-2010
Author
Paul M Galdas
H Bindy K Kang
Author Affiliation
University of British Columbia, School of Nursing, Vancouver, BC, Canada. paul.galdas@ubc.ca
Source
J Clin Nurs. 2010 Nov;19(21-22):3134-42
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Attitude to Health - ethnology
British Columbia
Communication
Female
Follow-Up Studies
Humans
India - ethnology
Male
Middle Aged
Myocardial Infarction - diagnosis - ethnology - rehabilitation
Nurse-Patient Relations
Patient Acceptance of Health Care - ethnology - statistics & numerical data
Patient Participation - statistics & numerical data
Physician-Patient Relations
Qualitative Research
Risk assessment
Sampling Studies
Treatment Outcome
Abstract
To explore the cardiac rehabilitation experiences of Punjabi Sikh patients post myocardial infarction.
Punjabi Sikh people are at significantly higher risk of mortality from myocardial infarction compared with those of European descent. Punjabi Sikh patients' participation in cardiac rehabilitation post myocardial infarction is therefore likely to yield considerable benefits. However, uptake of cardiac rehabilitation by South Asian people has been reported to be modest. Previous investigators have seldom provided insight into experiences of Punjabi Sikh patients post myocardial infarction and the steps that can be taken to improve the appropriateness of cardiac rehabilitation programmes for this at-risk patient group.
Interpretive qualitative design.
In-depth interviews, based on the McGill Illness Narrative Interview schedule, with 15 Punjabi Sikh patients post myocardial infarction attending a cardiac rehabilitation programme in British Columbia, Canada, were conducted; thematic analysis using grounded theory methods of coding and constant comparative analysis was employed.
Four mutually exclusive themes emerged relating to the salient aspects of participants' cardiac rehabilitation experience: 'making sense of the diagnosis', 'practical dietary advice', 'ongoing interaction with peers and the multi-disciplinary team' and 'transport and attendance'.
The themes identified point towards some of the ingredients necessary for providing culturally appropriate cardiac rehabilitation interventions for Punjabi Sikh patients following myocardial infarction. The findings highlight the importance of providing culturally relevant rehabilitation advice about diet and lifestyle changes and providing time for ongoing dialogue with support from health care professionals and peers. The findings from this study also illustrate the need to avoid generalisations about the impact religious beliefs may have on South Asian individuals' willingness to adhere to cardiac rehabilitation advice and make lifestyle adjustments.
This study raises awareness of some of the salient features of experiences of Punjabi Sikh patients with post myocardial infarction that can help guide nurses to provide culturally appropriate cardiac rehabilitation and coronary health promotion.
Notes
Comment In: J Clin Nurs. 2011 Apr;20(7-8):1210-121385253
PubMed ID
21040018 View in PubMed
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Use of emergency care services by immigrants—a survey of walk-in patients who attended the Oslo Accident and Emergency Outpatient Clinic.

https://arctichealth.org/en/permalink/ahliterature269206
Source
BMC Emerg Med. 2015;15:25
Publication Type
Article
Date
2015
Author
Sven Eirik Ruud
Ruth Aga
Bård Natvig
Per Hjortdahl
Source
BMC Emerg Med. 2015;15:25
Date
2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Ambulatory Care Facilities - statistics & numerical data - utilization
Child
Child, Preschool
Cross-Sectional Studies
Emergency Medical Services - statistics & numerical data - utilization
Emigrants and Immigrants - statistics & numerical data
Female
General Practice - statistics & numerical data
Health Care Surveys
Humans
Infant
Infant, Newborn
Male
Middle Aged
Norway
Pakistan - ethnology
Patient Acceptance of Health Care - ethnology - statistics & numerical data
Poland - ethnology
Primary Health Care - statistics & numerical data - utilization
Self Report
Somalia - ethnology
Sweden - ethnology
Young Adult
Abstract
The Oslo Accident and Emergency Outpatient Clinic (OAEOC) experienced a 5-6% annual increase in patient visits between 2005 and 2011, which was significantly higher than the 2-3% annual increase among registered Oslo residents. This study explored immigrant walk-in patients' use of both the general emergency and trauma clinics of the OAEOC and their concomitant use of regular general practitioners (RGPs) in Oslo.
A cross-sectional survey of walk-in patients attending the OAEOC during 2 weeks in September 2009. We analysed demographic data, patients' self-reported affiliation with the RGP scheme, self-reported number of OAEOC and RGP consultations during the preceding 12 months. The first approach used Poisson regression models to study visit frequency. The second approach compared the proportions of first- and second-generation immigrants and those from the four most frequently represented countries (Sweden, Pakistan, Somalia and Poland) among the patient population, with their respective proportions within the general Oslo population.
The analysis included 3864 patients: 1821 attended the Department of Emergency General Practice ("general emergency clinic"); 2043 attended the Section for Orthopaedic Emergency ("trauma clinic"). Both first- and second-generation immigrants reported a significantly higher OAEOC visit frequency compared with Norwegians. Norwegians, representing 73% of the city population accounted for 65% of OAEOC visits. In contrast, first- and second-generation immigrants made up 27% of the city population but accounted for 35% of OAEOC visits. This proportional increase in use was primarily observed in the general emergency clinic (42% of visits). Their proportional use of the trauma clinic (29%) was similar to their proportion in the city. Among first-generation immigrants only 71% were affiliated with the RGP system, in contrast to 96% of Norwegians. Similar finding were obtained when immigrants were grouped by nationality. Compared to Norwegians, immigrants from Sweden, Pakistan and Somalia reported using the OAEOC significantly more often. Immigrants from Sweden, Poland and Somalia were over-represented at both clinics. The least frequent RGP affiliation was among immigrants from Sweden (32%) and Poland (65%).
In Norway, immigrant subgroups use emergency health care services in different ways. Understanding these patterns of health-seeking behaviour may be important when designing emergency health services.
Notes
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