Sepali Guruge

Postoperative Patient Education: A Systematic Review

Introduction: Knowledge of the effects of the specific approach, mode of delivery, and dose of educational interventions is essential to develop and implement effective postoperative educational interventions. Understanding the relationships of patient characteristics to outcomes is important for educational interventions. Purpose and method: The purpose of this systematic review was to examine who would most benefit from postoperative education, given in what type of approach and mode, and at what dose? The sample included 58 studies involving 5,271 participants. Major results: Findings indicate that delivery of postoperative patient education through the individualization of content, use of combined media for delivery, provision of education on a one-on-one basis, and in multiple sessions is associated with improvement in educational/health outcomes. Samples that contained individuals younger than 50 years and higher percentages of males showed benefits in outcomes of moderate magnitude. Application: The results highlight the importance of attending to the characteristics of both the elements of postoperative educational interventions and the individual patients in the design and delivery of patient education.

Cultural adaptation and translation of measures: An integrated method

Differences in the conceptualization and operationalization of health-related concepts may exist across cultures. Such differences underscore the importance of examining conceptual equivalence when adapting and translating instruments. In this article, we describe an integrated method for exploring conceptual equivalence within the process of adapting and translating measures. The integrated method involves five phases including selection of instruments for cultural adaptation and translation; assessment of conceptual equivalence, leading to the generation of a set of items deemed to be culturally and linguistically appropriate to assess the concept of interest in the target community; forward translation; back translation (optional); and pre-testing of the set of items. Strengths and limitations of the proposed integrated method are discussed.

The experiences of professional nurses who have migrated to Canada: cosmopolitan citizenship or democratic racism?

This interpretive research analyses the discourse of nurses who migrated to Canada and experienced racism. They also experienced reprisals when they formally complained about racism in a context of denial of the problem of racism by colleagues and employers. The present work focuses on two issues arising from the data: the problem of how to make racism visible among those who have a vested interest in denying its existence and the emotional cool of those filing grievances or complaints in contrast with the hot reaction of those being challenged when racism is named. We introduce two theoretical perspectives to address these phenomena called democratic racism and cosmopolitan citizenship, respectively. The former, as defined by Henry et al. (The Colour of Democracy: Racism in Canadian Society. Harcourt Brace, Canada, Toronto, 1996), describes the coexistence of both democratic values and practices that discount people of colour advertently or inadvertently. We outline the notion of cosmopolitan citizenship that is argued by Turner (Politics of the Global City. Routledge, London, 2000) to be an orientation resulting from global microcosms in cities teeming with diversity. The characteristic orientations of cool and stewardship are useful for describing some of the discourse expressed by each participant in our study all of whom challenged racism practices, not on nationalistic grounds, but rather out of concern for universal human rights. Their characteristics qualify them for cosmopolitan citizenship under Turners perspective. We suggest that anti-racist activists have been cosmopolitan citizens for decades and argue that while cosmopolitan citizenship may have taken root in neo-liberal movements, it appears to have tactical attributes in the struggle with democratic racism. In conclusion, we advocate for a cosmopolitan citizenship ethic to facilitate a rational move toward racial integration in the profession through the sharing of power and privilege. One goal in confronting racism is the accountability for whiteness: immunity from responsibility or apology.

Primary prevention of violence against women

The best mechanisms to prevent violence against women were reviewed in a critical appraisal conducted by the University Health Network Womens Health Program. Several promising primary interventions were identified. These included: educational and policy-related interventions to change social norms, early identification of abuse by health and other professionals, programs and strategies to empower women, safety and supportive resources for victims of abuse, and improved laws and access to the criminal justice system. The policy recommendations emerging from this analysis are presented.

The relationship between care providers’ relational behaviors and residents mood and behavior in long-term care settings

Background: Care providers’ interactions with residents are an important element in long-term care settings. This study aimed at examining the association between care providers’ relational behaviors and affect and mood of residents with dementia over different caregiving situations and with different residents. Methods: This study utilized a repeated-measures design. Thirty-eight residents with a diagnosis of dementia and 35 care providers from three nursing homes in Ontario, Canada, participated in the study. Care providers’ relational behaviors and residents’ mood and affect were assessed using direct observation methods and self-rating scales. Results: The care providers’ relational behavior varied according to the caregiving situation, with the most effective relational behaviors observed during interpersonal interactions and the least effective during mealtimes. Less effective relational behaviors were observed between care providers and residents that were perceived as more resistive to care. In addition, effective relational behaviors were associated with positive mood and affect of the residents. Conclusion: These findings emphasize the importance of acknowledging and enhancing care providers’ relational behaviors when caring for persons with dementia living in long-term care settings.

“Violence Is an International Language”: Tamil Women's Perceptions of Intimate Partner Violence

Research on intimate partner violence (IPV) across populations is challenging because of the multiplicity of definitions and lack of clarity about the behaviors that constitute IPV. The purpose of this study was to examine the ways in which Sri Lankan Tamil women in Toronto understand, define, and experience IPV. Focus group interviews were conducted with women representing different ages and stages of life. Findings suggest that definitions of IPV were not culturally specific. Rather, the Tamil women defined IPV broadly and recognized different forms of coercive control. However, psychologically abusive behaviors were identified that held particular meanings for this community.

Improving Immigrant Populations’ Access to Mental Health Services in Canada: A Review of Barriers and Recommendations

Abstract This article emerges from a scoping review of over two decades of relevant literature on immigrants’ access to mental health services in Canada. Key online databases were searched to explore the gaps and opportunities for improving access to mental health services using a review framework provided by Arksey and O’Malley (Int J Soc Res Methodol 8:19–32, 2005). Immigrants and refugees came from diverse religious and cultural backgrounds and had complex mental health-related concerns that were not currently being adequately addressed by existing services. The major barriers to the utilization of mental health services included: those related to the uptake of existing health information and services; those that were related to the process of immigrant settlement; and barriers related to availability of appropriate services. A thematic analysis of the range of recommendations that emerge from these studies for improvement of research, practice and policy is provided.

Perceptions of Factors Contributing to Intimate Partner Violence Among Sri Lankan Tamil Immigrant Women in Canada

In this article we explore Sri Lankan Tamil immigrant womens views on factors contributing to intimate partner violence (IPV). We conducted eight focus groups with young, midlife, and senior women and women who experienced IPV. Three main themes emerged: postmigration sources of stress and conflict, patriarchal social norms that dictated gendered behavior, and individual male attributes and behaviors. Study participants recognized gender inequality and financial dependence as contributing factors and the role of women in promoting marital harmony. Findings suggest that pre- and postmigration factors need to be considered in the prevention of IPV in newcomer communities.

Sri Lankan Tamil Immigrants in Toronto: Gender, Marriage Patterns, and Sexuality

‘Our culture is so deep, and so traditional, and so ancient, that I would feel that only another person that shares those values and has been moulded from that culture would be able to understand.’

Patient Demographics and Learning Needs: Examination of Relationship

Background: Limited research has examined differences in patients’ learning needs in relation to demographic characteristics, such as age, gender, level of education, and culture. Yet such knowledge is essential to develop postoperative educational interventions that are tailored to patients’ needs. Study purpose: The purpose of this study was to examine the relationship between learning needs and the demographic characteristics of patients who have undergone coronary artery bypass graft (CABG) surgery. Method: A descriptive design was used.The sample of convenience included 38 patients who met eligibility criteria. Major results: Statistically significant relationships were found between the patients’ age, gender, and cultural background, and learning needs (p < .05) and not between the learning needs and level of education. Application: These preliminary highlight the importance of attending to learning needs of patients with different backgrounds in order to improve self-management following CABG surgery.