B. Ann Hilton

Beliefs related to breast health practices: the perceptions of South Asian women living in Canada.

Breast cancer is becoming a major concern for many South Asian women. Clinical observations of women from a South Asian community living in Canada revealed an under use of early detection strategies. The purpose of this qualitative ethnoscience study was to examine breast health practices from the perspective of South Asian women to provide a foundation for the development of culturally suitable breast health services for this group. Open-ended interviews were conducted with a convenience sample of 50 South Asian women over the age of 30 who had not been diagnosed with breast cancer. Adequate representation of the main religious groups (i.e. Sikh, Hindu, Muslim and Christian) was ensured through sampling techniques. Analysis of translated interviews involved identification of themes and the development of a taxonomy to represent relationships among emerging cultural themes and domains. Four central domains of beliefs related to breast health practices were identified: beliefs about a womans calling, beliefs about cancer, beliefs about taking care of your breasts and beliefs about accessing services. These beliefs hold important implications for how health promotion strategies should be structured and offered, In particular, attention must be paid to the language that is used to talk about breast cancer, the importance of the role of the family in womens health decisions and traditions related to using narratives to share information and advice.

The relationship of uncertainty, control, commitment, and threat of recurrence to coping strategies used by women diagnosed with breast cancer

The purpose of this descriptive correlational study was to investigate the relationship between commitments, uncertainty about the cancer situation, threat of recurrence, and control of the cancer situation and the set of coping strategies used by women to cope with their breast cancer diagnosis. Lazarus and Folkmans theory of psychological stress provided the framework. The sample consisted of 227 nonhospitalized women who had had a diagnosis of breast cancer. Two sets of canonical variate sets were significant at the .001 level with canonical correlations of .52 and .47. The first canonical set indicated that the use of escape-avoidance and accepting responsibility but not positive reappraisal strategies were characteristics of those women who had low commitment and low control together with high uncertainty and high threat of recurrence. The second set indicated that seeking social support, as well as the use of planful problem solving, escape-avoidance, positive reappraisal, and self-controlling strategies was adopted by women who had high threat of recurrence and high control.The purpose of this descriptive correlational study was to investigate the relationship between commitments, uncertainty about the cancer situation, threat of recurrence, and control of the cancer situation and the set of coping strategies used by women to cope with their breast cancer diagnosis. Lazarus and Folkmans theory of psychological stress provided the framework. The sample consisted of 227 nonhospitalized women who had had a diagnosis of breast cancer. Two sets of canonical variate sets were significant at the .001 level with canonical correlations of .52 and .47. The first canonical set indicated that the use of escape-avoidance and accepting responsibility but not positive reappraisal strategies were characteristics of those women who had low commitment and low control together with high uncertainty and high threat of recurrence. The second set indicated that seeking social support, as well as the use of planful problem solving, escape-avoidance, positive reappraisal, and self-controlling strategies was adopted by women who had high threat of recurrence and high control.

The Influence of Family on Immigrant South Asian Women’s Health

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.

Issues, problems, and challenges for families coping with breast cancer

There is a scarcity of research that examines the adaptation of the family to breast cancer from the familys perspective. This study analyzed 12 families from the time of diagnosis to 12 months later. Issues, problems, and challenges that partnered families faced during the initial year were identified through five interview points. Frequency of the problems identified and the challenges encountered shifted over time.

The desi ways: traditional health practices of South Asian women in Canada.

Although many South Asian immigrants have made their homes in Canada, little research has examined health behaviors in this population and fewer studies have examined the use of traditional health practices. As part of a larger study on health-seeking patterns of South Asian women living in Western Canada, an analysis was done on the use of traditional health practices. Using critical ethnographic methods, data were collected through face-to-face individual interviews ( n = 50), focus group discussions ( n = 12), and community meetings with a cross section of women in the South Asian community. Interviews were conducted in the language of each participants choice. Thematic analysis was done on the transcribed interviews. Womens descriptions of traditional health practices varied and consisted of home remedies, dietary regimens, prayers, rituals, and consultation with hakims, veds, babajis, pundits, homeopaths, and jyotshis. Choosing to use traditional health practices was influenced by family members, the nature and severity of problems, beliefs and prior experiences, and the feasibility of using these practices. Traditional health practices were used on a daily or episodic basis. Women rarely used traditional health practices exclusively. Traditional health practices were used for small problems or when conventional medicines did not work. For women to meet their health needs, health care providers must be culturally sensitive and respect womens choices to use traditional health practices.Although many South Asian immigrants have made their homes in Canada, little research has examined health behaviors in this population and fewer studies have examined the use of traditional health practices. As part of a larger study on health-seeking patterns of South Asian women living in Western Canada, an analysis was done on the use of traditional health practices. Using critical ethnographic methods, data were collected through face-to-face individual interviews (n = 50), focus group discussions (n = 12), and community meetings with a cross section of women in the South Asian community. Interviews were conducted in the language of each participants choice. Thematic analysis was done on the transcribed interviews. Womens descriptions of traditional health practices varied and consisted of home remedies, dietary regimens, prayers, rituals, and consultation with hakims, veds, babajis, pundits, homeopaths, and jyotshis. Choosing to use traditional health practices was influenced by family members, the nature and severity of problems, beliefs and prior experiences, and the feasibility of using these practices. Traditional health practices were used on a daily or episodic basis. Women rarely used traditional health practices exclusively. Traditional health practices were used for small problems or when conventional medicines did not work. For women to meet their health needs, health care providers must be culturally sensitive and respect womens choices to use traditional health practices.

Voices of Immigrant South Asian Women: Expressions of Health Concerns

Health care concerns, health issues, and illness are defined within a social, cultural, political, and economic context.1 When health care practitioners and patients share a common culture, it is not always necessary to negotiate an understanding of the health problem. The distinctive ways that health problems are discussed and treated are often taken for granted when cultures are shared.2 Immigrants to North America may bring a set of beliefs and expectations to health care interactions that differ from those held by Western health care providers trained in biomedicine. Differences in explanatory models between professionals and their patients have the potential to create mismatches that can lead to problems, including misunderstandings and unmet expectations and needs. Explicating explanatory models in health care interactions can provide an effective device for identifying the sources of clinical miscommunications and misrecognitions.3 The concept of explanatory models is based on a distinction between illness (the patients perceptions of symptoms and disability) and disease (the biomedical practitioners perspective). While authors such as Kleinman have extensively explored the nature of these explanatory models, Kleinman has cautioned that they are easily misapplied when a patients perceptions and beliefs are treated as distinct entities to be identified and recorded.4

Psychometric assessment of the Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQOL-HIV) in a sample of HIV-infected women.

Since the late 1980s, several HIV-specific quality of life instruments have been developed; however, little testing has been done in terms of their validity and reliability for HIV-infected women. The purpose of this study was to test the content validity, concurrent validity, internal consistency, and test–retest reliability of the Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQOL-HIV) in a sample of 85 HIV-infected women. The MQOL-HIV is a 40-item scale comprised of 10 dimensions. Most of the items and all of the domains were determined content valid but revision of some of the items and domains is recommended. Concurrent validity was measured between the MQOL-HIV and the MOS-HIV and ranged from 0.51–0.81 between similar domains. 7 Of the 10 domains and the entire instrument, had a Cronbachs α over 0.70 (range 0.43–0.92). Eight domains and the entire instrument achieved test–retest correlation coefficients over 0.70 (range 0.60–0.96). Although some revision may make the scale more content-valid for HIV-infected women, given due care in the interpretation of results, the MQOL-HIV can be used with female populations in its current form.