Sukhdev Grewal

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 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.

Perinatal Beliefs and Practices of Immigrant Punjabi Women Living in Canada

OBJECTIVE To describe new immigrant Punjabi womens perinatal experiences and the ways that traditional beliefs and practices are legitimized and incorporated into the Canadian health care context. DESIGN Naturalistic qualitative descriptive. PARTICIPANTS/SETTING Fifteen first-time mothers who had immigrated in the past 5 years to Canada from Punjab, India, and had given birth to a healthy infant in the past 3 months in a large urban center in British Columbia, Canada. Five health professionals and community leaders also took part in a focus group to confirm the study findings and to offer recommendations. RESULTS Three major categories emerged: the pervasiveness of traditional health beliefs and practices related to the perinatal period (e.g., diet, lifestyle, and rituals), the important role of family members in supporting women during the perinatal experiences, and the positive and negative interactions women had with health professionals in the Canadian health care system. CONCLUSIONS Change is required at the levels of the health professional, the heath care system, and the community to ensure that culturally safe care is provided to immigrant Punjabi women and their families during the perinatal period, which is an important and sensitive period of interaction with the Canadian health care system.

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

Writing reflexively to illuminate the meanings in cultural safety

With the introduction of cultural safety into nursing curricula, educators are grappling with ways to take their own understanding of the concept to create culturally safe places in their educational environments. The purpose of this paper is to share a process of writing as inquiry to surface new meanings in what might ontologically be understood as culturally safe environments. The writing illuminates individual and collective meanings of cultural safety from the perspectives of eight Canadian nurse educators. Using aesthetic texts and hermeneutic approaches, the meaning of cultural safety is exposed. Fluid depictions of the self as other, along with politicized taken for granted practices and multiple fields of meaning, bring clarity to a view that knowledge is always partial. Since knowledge is co-constructed, situated and socially produced, the representations of our evolving stories and cycles of reflection hold to an element of partiality in epistemological privilege The various texts shared offer insight into thinking about culturally safe spaces as horizons of new meaning. The implications for nursing education are in recognizing locations for both the educators and the learners. These writing and interpretive processes can be integrated into curricula to strengthen reflexive and relational practice.