Sylvia Abonyi

Aboriginal peoples, health and healing approaches: The effects of age and place on health

For demographic reasons and as a result of a number of high profile health incidents in recent years, much of the health research and policy focus is on the younger cohorts of Aboriginal peoples in Canada. A critical examination of recent demographic trends reveals, however, that older cohorts of the Aboriginal population are increasing at a faster rate than younger cohorts, primarily due to improvements in life expectancy and declining fertility rates. Yet, there are surprisingly few health studies that have recognized the aging of the Aboriginal population. The overall goal of this paper is to examine differences in health status, use of conventional health care and traditional approaches to healing between older and younger cohorts of the Aboriginal population as well as to examine the importance of age as a determinant of health and health care use. Using data from the 2001 Statistics Canada Aboriginal Peoples Survey and contingency tables and logistic regression, the results demonstrate that older Aboriginal people face unique challenges - e.g. loss of traditional approaches to healing, geographic isolation, identity politics, constitutional and legal divisions within the Aboriginal community - with respect to their health and access to health services. These outcomes result from a colonial past and contemporary policies that affect all Aboriginal people.

Aging and Health: An Examination of Differences between Older Aboriginal and non-Aboriginal People

La population autochtone au Canada, beaucoup plus jeune que la population générale, a connu une tendance au vieillissement depuis les dix dernières années. Utilisant les données de l’Enquete auprès des peuples autochtones de 2001 (EAPA) et l’Enquête sur la santé dans les collectivités canadiennes (ESCC) de 2000/2001, cet article examine les différences dans l’état de santé et les déterminants de la santé et l’utilisation de soins de santé entre la population autochtone de 55 ans et plus et la population non-autochtone. Les résultats montrent que la population plus âgée autochtone est plus malsaine que la population non-autochtone parmi tous les groupes d’âge; cependant, les différences dans l’état de santé entre les groupes d’âge semblent converger avec l’augmentation de l’âge. Parmi personnes âgées de 55 à 64 ans, 7 pour cent de la population autochtone rapport trois ou plusieurs conditions chroniques par rapport à 2 pour cent de la population non-autochtone. Pourtant, parmi personnes âgées de 75 et plus, 51 pour cent de la population autochtone rapport trois ou plusieurs conditions chroniques par rapport à 23 pour cent de la population non-autochtone.

Recommendations for action on the social determinants of health: a Canadian perspective

we are now well positioned to understand and address health disparities at the global, national, and local levels. The global resurgence of interest in addressing health disparities in the 1990s and 2000s through various movements, such as the WHO Commission on the Social Determinants of Health and their fi nal report with evidence-based recommendations,

Gender, Division of Unpaid Family Work and Psychological Distress in Dual-Earner Families

Introduction: Epidemiological studies have only recently begun to address the consequences of unpaid family work (ie., housework and child rearing) for mental health. Although research is suggestive of an association between the division of unpaid family work and psychological health, especially for women, additional research is required to clarify the conditions under which such a relationship holds. The purpose of the present study was to examine more nuanced relationships between the division of family work and psychological distress by disaggregating the family work construct according to type (housework/child rearing), control over scheduling, and evaluations of fairness. Methods: Analysis of data obtained from a cross-sectional telephone survey conducted in a Canadian city. Analyses were based on 293 employed parents (182 mothers and 111 fathers), with at least one preschool child, living in dual-earner households. Several multiple linear regression models were estimated with psychological distress as the outcome, adjusting for confounders. Results: For mothers, more perceived time spent in child rearing (particularly primary child care) and high-schedule-control housework tasks (e.g. yard work) relative to one’s partner, were associated with greater distress. For fathers, perceived unfairness in the division of housework and child rearing were associated with greater distress. Conclusion: Although methodological limitations temper firm conclusions, these results suggest that the gendered nature of household work has implications for the psychological well-being of both mothers and fathers of preschool children in dual-earner households. However, more longitudinal research and the development of theoretically-informed measures of family work are needed to advance the field.

Research utilization and evidence-based practice among Saskatchewan massage therapists

Abstract While massage therapy (MT) is an increasingly used health care service with a growing evidence base, there is insufficient information about the extent to which MT practice is evidence-based. The purpose of this study was to provide a comprehensive view of Saskatchewan MT’s research utilization to inform the development of evidence-based massage therapy practice. The main objectives of the study were to describe MT’s perceptions of research, their appraised self-efficacy in research literacy and to identify the characteristic of practitioners who use research. Using a survey design all 815 registered members of the Massage Therapist Association of Saskatchewan were invited to complete a mail-out questionnaire. A total of 333 questionnaires were completed and returned for a 41% response rate. Univariate and logistic regression analysis was conducted using SPSS 17.0. While overall perceptions of research were positive, self-efficacy in research literacy was low and research utilization was limited. Characteristics associated with research use included referring to online research databases and peer-reviewed journals, belief that practice should be based on research, and 20 or greater hours per week of practice. Provincial regulatory status may be the first step to quality service delivery and research literacy training and support is needed for practitioners.

Policy, Community and Kin: Interventions That Support Rural Healthy Aging

This study examines the interventions that enable rural seniors to remain within their homes and communities as they age. Through semi-structured interviews with 40 rural seniors, the findings reveal a number of actions that facilitate rural aging. This study has important implications for a range of stakeholders from policy makers to community leaders by identifying policy, community, and kin-level interventions that support rural healthy aging in place. In identifying interventions that support rural seniors’ needs, this study provides a fundamental basis to better allocate resources, plan programs, and develop policies that reflect the needs of an aging population.

Ear Infection and Its Associated Risk Factors in First Nations and Rural School-Aged Canadian Children.

Background. Ear infections in children are a major health problem and may be associated with hearing impairment and delayed language development. Objective. To determine the prevalence and the associated risk factors of ear infections in children 6–17 years old residing on two reserves and rural areas in the province of Saskatchewan. Methodology. Data were provided from two rural cross-sectional children studies. Outcome variable of interest was presence/absence of an ear infection. Logistic regression analysis was conducted to examine the relationship between ear infection and the other covariates. Results. The prevalence of ear infection was 57.8% for rural Caucasian children and 43.6% for First Nations children living on-reserve. First Nations children had a lower risk of ear infection. Ear infection prevalence was positively associated with younger age; first born in the family; self-reported physician-diagnosed tonsillitis; self-reported physician-diagnosed asthma; and any respiratory related allergy. Protective effect of breastfeeding longer than three months was observed on the prevalence of ear infection. Conclusions. While ear infection is a prevalent condition of childhood, First Nations children were less likely to have a history of ear infections when compared to their rural Caucasian counterparts.

A case study of healthcare providers’ goals during interprofessional rounds

ABSTRACT Daily interprofessional rounds enhance collaboration among healthcare providers and improve hospital performance measures. However, it is unclear how healthcare providers’ goals influence the processes and outcomes of interprofessional rounds. The purpose of this case study was to explore the goals of healthcare providers attending interprofessional rounds in an internal medicine ward. The second purpose was to explore the challenges encountered by healthcare providers while pursuing these goals. Three focus groups were held with healthcare providers of diverse professional backgrounds. Focus group field notes and transcripts were analysed using thematic analysis. The data indicated that there was no consensus among healthcare providers regarding the goals of interprofessional rounds. Discharge planning and patient care delivery were perceived as competing priorities during rounds, which limited the participation of healthcare providers. Nevertheless, study participants identified goals of rounds that were relevant to most care providers: developing shared perspectives of patients through direct communication, promoting collaborative decision making, coordinating care, and strengthening interprofessional relationships. Challenges in achieving the goals of interprofessional rounds included inconsistent attendance, exchange of irrelevant information, variable participation by healthcare providers, and inconsistent leadership. The findings of this study underscore the importance of shared goals in the context of interprofessional rounding.

Incidence of Daytime Sleepiness and Associated Factors in Two First Nations Communities in Saskatchewan, Canada

Excessive daytime sleepiness (EDS) is the tendency to sleep at inappropriate times during the day. It can interfere with day-to-day activities and lead to several health issues. The objective of this study was to investigate the association between income, housing conditions, and incidence of EDS in adults living in two Cree First Nations communities. The data for this study involved 317 individuals aged 18 years and older who participated in baseline and follow-up evaluations (after four years) of the First Nations Lung Health Project, which was conducted in Saskatchewan in 2012–2013 and 2016. Both at baseline and follow-up survey after four years, an Epworth Sleepiness Scale (ESS) score >10 was considered to be abnormal. Logistic regression models were used to assess relationships between abnormal ESS and covariates at baseline. In 2016, 7.6% (24/317) of the participants reported an ESS >10 with the mean being 12.8 ± 2.0. For the same group, the mean ESS at baseline was 6.9 ± 2.2. The incidence of subjective EDS based on the ESS >10 was estimated at 7.6% over four years. This study showed an association between incidence of subjective EDS and less money left over at end of the month, having a house in need of repairs, having water or dampness in the past 12 months, and damage caused by dampness.

“Finally when I started falling down”: Indigenous tuberculosis patient experiences of health and illness on the Canadian prairies

This paper adds evidence to a growing body of literature seeking to understand the disproportionate occurrence of tuberculosis (TB) in Indigenous populations of Canada and reveals insights that may inform effective interventions. As a disease, TB is recognized as a disorder of the body, for which there are successful treatments. Its persistence in some populations, however, requires an understanding of TB as an illness, whereby disease is shaped into behaviours and experiences. Fifty-five self-identified Indigenous participants with infectious pulmonary TB completed a questionnaire and an interview as part of the Determinants of Tuberculosis Transmission (DTT) project. Questionnaire data report on sociodemographic information and exposure to TB risk factors, while interview data describe participants’ experiences of TB within the context of their personal histories and everyday lives. Analysis showed that TB symptoms did not stand out as unusual in the everyday life and health experiences of participants. State of health and decisions about accessing healthcare were associated with socioeconomic deprivation, as well as negative experiences connected with historical and contemporary impacts of colonization. The “tipping point” concept effectively captures the shift in health that pushes participants to seek healthcare. Family, friends, and other caregivers are important influences and need to be part of the effort to avoid advanced TB illness and stop the cycle of transmission. More significantly, there is a need to address the structures and systems that produce and perpetuate life conditions that result in a usual state of compromised health.