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Elendu C. The evolution of ancient healing practices: From shamanism to Hippocratic medicine: A review. Medicine (Baltimore) 2024; 103:e39005. [PMID: 38996102 PMCID: PMC11245246 DOI: 10.1097/md.0000000000039005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/14/2024] Open
Abstract
In the ever-evolving healthcare landscape, ancient healing traditions cast a profound shadow, offering insights and inspirations that resonate with modern medical practice. This paper explores the enduring influence of shamanic and Hippocratic healing traditions on contemporary healthcare, examining their contributions to holistic health approaches, diagnostic techniques, and ethical standards. The Hippocratic emphasis on observation, clinical experience, and ethical principles laid the foundation for modern Western medicine, while shamanic practices highlight the importance of spiritual and psychological dimensions in healing. The comparative analysis reveals both commonalities and distinctions among various ancient practices, such as Ayurveda, Traditional Chinese Medicine, and indigenous healing systems, emphasizing their holistic understanding of health and the use of natural remedies. Cross-cultural exchanges, from the Silk Road to the Islamic Golden Age and beyond, facilitated the integration and dissemination of medical knowledge, enriching global medical traditions. The paper also discusses the impact of these ancient practices on contemporary healthcare systems, highlighting the resurgence of holistic and integrative medicine, the validation and incorporation of herbal remedies, and the challenges of cultural appropriation and scientific validation. By embracing the wisdom of ancient healing traditions and fostering collaboration between traditional and modern medicine, contemporary healthcare can enhance therapeutic options, promote patient-centered care, and address global health challenges with a more inclusive and compassionate approach. This integration holds promise for the future of healthcare, benefiting individuals and communities worldwide.
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Gudooru K, Nguyen K, Le K, Sarabu V, Hosek M, Phan A, Garza M, Flores BE, Flores A, Ramirez A, Garcini LM. Collective good and individual choice: Perceptions on COVID-19 vaccine mandate among COVID-19 vaccinated individuals. Vaccine 2024; 42:3493-3498. [PMID: 38679513 DOI: 10.1016/j.vaccine.2024.04.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Vaccine mandates are controversial, and people vary widely in their preferences to support or reject vaccine mandates. For some, vaccine mandates represent a commitment to reduce harm and support public health. For others, vaccine mandates are viewed as a threat to individual freedom and a violation of personal choice. This manuscript investigated support for a COVID-19 vaccine mandate among COVID-19-vaccinated individuals and identified differences by demographic characteristics and COVID-19 experience. METHODS Cross-sectional surveys were given to COVID-19-vaccinated individuals at a vaccination clinic in South Texas in the U.S. with the goal of identifying attitudes, beliefs, and perceptions about COVID-19 vaccination and willingness to support a COVID-19 vaccination mandate. Associations of interest were analyzed using descriptive statistics. KEY RESULTS Approximately half of the sample was of Hispanic or Latino origin (48 %); most respondents identified as White (59 %), followed by 12 % who identified as Asian. Overall, 59 % of participants supported the possibility for a COVID-19 vaccine mandate. Preliminary data showed significant racial differences in willingness to support a possible COVID-19 vaccine mandate (χ2 (1, n = 893) = 26.7, p < .001, phi = .17); 80 % of Asian people reported support for COVID-19 vaccination mandate compared to 50 % to 57 % for other racial groups. Significant differences also emerged by ethnicity (χ2 (4, n = 1033) = 7.12, p = .008, phi = .08) whereby a higher percentage of Latino participants (66 %) reported willingness to support a COVID-19 vaccine mandate. Similarly, significant differences were found by age (χ2 (4, n = 1045) = 20.92, p < .001, phi = .21), yet no significant differences were found by sex or previous COVID-19 diagnosis. CONCLUSION Support for a COVID-19 vaccination mandate is controversial even among vaccinated people. Identifying and understanding cultural and contextual factors that underlie differences in attitudes and beliefs about COVID-19 vaccination mandates is essential to advance dialogue and inform educational health campaigns to increase COVID-19 vaccination rates.
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Affiliation(s)
- Kaivalya Gudooru
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, US.
| | - Kimberly Nguyen
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, US
| | - Kathy Le
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, US
| | - Vyas Sarabu
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, US
| | - Meredith Hosek
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, US
| | - Anna Phan
- School of Nursing, University of Texas Health San Antonio, San Antonio, TX, US
| | - Michelle Garza
- Center for Research to Advance Community Health (ReACH), University of Texas Health San Antonio, San Antonio, TX, US
| | - Bertha E Flores
- School of Nursing, University of Texas Health San Antonio, San Antonio, TX, US
| | - Armida Flores
- Department of Population Health Sciences, University of Texas Health San Antonio, San Antonio, TX, US
| | - Amelie Ramirez
- Department of Population Health Sciences, University of Texas Health San Antonio, San Antonio, TX, US
| | - Luz M Garcini
- Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, US; Center for Research to Advance Community Health (ReACH), University of Texas Health San Antonio, San Antonio, TX, US; Department of Psychological Sciences, Rice University, Houston, TX, US; Kinder Institute of Urban Research, Rice University, Houston, TX, US
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Costa-Font J, Sato A. Cultural persistence and the 'herbal medicine paradox': Evidence from European data. J Health Psychol 2024:13591053241237031. [PMID: 38566399 DOI: 10.1177/13591053241237031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
The use of herbal or traditional medicines has survived the proliferation of modern medicine. The phenomenon has been labeled as the 'herbal medicines paradox' (HMP). We study whether such HMP hypothesis can be explained by the persistence of attitudes across cultural boundaries. We undertake a secondary analysis of individual-level migration data to test the persistence of the use of herbal medicines in relation to norms in the person's country of birth (or home country). We study the association between attitudes towards herbal medicine treatments of both first (N = 3630) and second-generation (N = 1618) immigrants in 30 European countries, and the average attitudes of their sending country origins. We find robust evidence of an association that is stronger for the second-generation migrants. We document a stronger effect among maternal than paternal lineages, as well as significant heterogeneity based on migrants' country of origin. Our estimates are robust to different sample analysis. Our estimates are consistent with a cultural explanation for the HMP.
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Shih YA, Lu Q. Oncology nurses' knowledge, attitudes, and practice behaviours towards advance care planning: A nationwide cross-sectional study. NURSE EDUCATION TODAY 2024; 134:106076. [PMID: 38159386 DOI: 10.1016/j.nedt.2023.106076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/07/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND With the increasing cancer prevalence in China, discussions surrounding end-of-life care have become more frequent within the purview of oncology nursing. Nonetheless, limited research has explored the current state of Advance Care Planning (ACP) among oncology nurses in China. Hence, it is essential to comprehensively assesses oncology nurses' ACP knowledge, attitudes, and practice behaviours, addressing existing literature gaps and revealing China's oncology nursing ACP status. OBJECTIVES To explore oncology nurses' knowledge, attitudes, and practice behaviours regarding ACP and identify factors impacting ACP practice behaviours. DESIGN A multi-centre, observational, cross-sectional study. SETTINGS The research is conducted in oncology hospitals across 22 provinces, 4 municipalities, and 5 autonomous regions across China. PARTICIPANTS Convenience sampling was used to recruit 1800 registered oncology nurses. METHODS Data were collected via an electronic questionnaire between December 2021 and January 2022. Univariate and hierarchical multiple regression analyses were used for data prediction (P < 0.05). RESULTS In the knowledge section, respondents achieved an average accuracy rate of 51.94 % and demonstrated moderate positive attitudes towards ACP. Their practice behaviour scores were moderately graded. Sociodemographic characteristics and attitude were included as predictors of practice behaviour in the hierarchical multiple regression analysis, explaining 12.2 % and 31.1 % of the variance, respectively. The final model accounted for 43.3 % of the variance. The results indicated that attitudes had a significant and positive impact on practice behaviours, indicating that nurses with more positive attitudes were more likely to engage in ACP practice. CONCLUSIONS Chinese oncology nurses seem to have more positive attitudes towards ACP, but they do not prepare adequately in practice. By enhancing workplace values, beliefs, and policies, it is feasible to enhance the attitudes of oncology nurses towards ACP and, consequently, promote practice behaviours. Furthermore, this study underscores the need for targeted interventions to bridge the gap between positive attitudes and actual ACP implementation among oncology nurses in China.
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Affiliation(s)
- Yi-An Shih
- School of Nursing, Peking University, Beijing, China
| | - Qian Lu
- School of Nursing, Peking University, Beijing, China.
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Lee AY, Jahansooz JR, Guittu D, Suzuki R, Pak L, Ishikawa KM, Goo C, Chen JJ, Carrazana E, Viereck J, Liow KK. Barriers to Alzheimer Disease Clinical Trial Participation in a Minority Population. Cogn Behav Neurol 2024; 37:40-47. [PMID: 37878413 PMCID: PMC10948321 DOI: 10.1097/wnn.0000000000000359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 06/12/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Alzheimer disease (AD), the most common neurodegenerative disorder in the United States, disproportionately burdens minority populations. OBJECTIVE To explore barriers to AD clinical trial participation by Asian and Native Hawaiian patients diagnosed with AD or mild cognitive impairment. METHOD We surveyed 187 patients with a Mini-Mental State Examination score ≥14 between January 2022 and June 2022. The score cutoff for clinical trial eligibility was set by the institution. Individuals also completed a 15-question telephone survey that assessed demographics, barriers to clinical trial participation, and clinical trial improvement methods. RESULTS Forty-nine patients responded, with a response rate of 26%. Asian and Native Hawaiian patients were less likely than White patients to participate in AD trials. The main barrier to participation was a lack of information about AD trials. Providing additional information regarding AD trials to patients and family members were listed as the top two reasons patients would consider participating in a clinical trial. CONCLUSION Insufficient information about AD clinical trials is the primary barrier to participation among Asian and Native Hawaiian patients, followed by difficulty coordinating transportation and, in the case of Asians, the time required for clinical trials. Increased outreach, education, and assistance with logistics in these populations should be pursued to improve rates of participation in clinical trials.
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Affiliation(s)
- Anson Y Lee
- Memory Disorders Center & Alzheimer's Research Unit, Hawaii Pacific Neuroscience, Honolulu, Hawaii
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | - Julia R Jahansooz
- Memory Disorders Center & Alzheimer's Research Unit, Hawaii Pacific Neuroscience, Honolulu, Hawaii
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | - Darrell Guittu
- Memory Disorders Center & Alzheimer's Research Unit, Hawaii Pacific Neuroscience, Honolulu, Hawaii
| | - Rexton Suzuki
- Memory Disorders Center & Alzheimer's Research Unit, Hawaii Pacific Neuroscience, Honolulu, Hawaii
| | - Lauren Pak
- Memory Disorders Center & Alzheimer's Research Unit, Hawaii Pacific Neuroscience, Honolulu, Hawaii
| | - Kyle M Ishikawa
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
- Biostatistics Core Facility, Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | - Connor Goo
- Memory Disorders Center & Alzheimer's Research Unit, Hawaii Pacific Neuroscience, Honolulu, Hawaii
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | - John J Chen
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
- Biostatistics Core Facility, Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | - Enrique Carrazana
- Memory Disorders Center & Alzheimer's Research Unit, Hawaii Pacific Neuroscience, Honolulu, Hawaii
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | - Jason Viereck
- Memory Disorders Center & Alzheimer's Research Unit, Hawaii Pacific Neuroscience, Honolulu, Hawaii
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
- Biostatistics Core Facility, Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
| | - Kore K Liow
- Memory Disorders Center & Alzheimer's Research Unit, Hawaii Pacific Neuroscience, Honolulu, Hawaii
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
- Biostatistics Core Facility, Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
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So IC. Decisional conflict in parents of children with congenital heart defect: Towards development of a model. Int J Nurs Pract 2024; 30:e13152. [PMID: 36965135 DOI: 10.1111/ijn.13152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 01/14/2023] [Accepted: 03/09/2023] [Indexed: 03/27/2023]
Abstract
AIM This study aimed to develop a model to help parents cope with decisional conflict. BACKGROUND Parents of children with congenital heart defect experience decisional conflict when they are uncertain about treatment decisions for their child, which may lead to delay in seeking care or distress over the decision made. DESIGN Correlational design with model building and data triangulation was used. METHODS Data were collected through surveys and interviews with a consecutive sample of 221 parent respondents from June to December 2018. Structural equation modelling and qualitative data analysis were used. RESULTS Lower decisional conflict was seen in parents with higher income, more nurse support and physician risk communication. Time delay for surgery was correlated with the child's age, social service coverage, and social support. Decisional conflict mediated the influence of income, nurse support and physician risk communication on satisfaction with decision. Based on model fit parameters, the emerging model is a good and parsimonious model of decisional conflict. The overall theme, 'Deciding for Surgery: What Matters Most', described the processes parents went through in making treatment decisions. CONCLUSION Nurses may help parents feel more certain, less conflicted, and more satisfied with their decision by addressing factors including knowledge gaps, personal values, available support, and resource access.
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Affiliation(s)
- Iris C So
- Chinese General Hospital Colleges, Manila, Philippines
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Chung JE, Karass S, Choi Y, Castillo M, Garcia CA, Shin RD, Tanco K, Kim LS, Hong M, Pan CX. Top Ten Tips Palliative Care Clinicians Should Know About Caring for Filipino American and Korean American Patients. J Palliat Med 2024; 27:104-111. [PMID: 37200523 DOI: 10.1089/jpm.2023.0255] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
As of 2019, there are 4.2 million Filipino Americans (FAs) and 1.9 million Korean Americans (KAs) in the United States, largely concentrated in New York, California, Texas, Illinois, and Washington. In both populations, similar to the broader U.S. culture, one can find health literacy gaps around understanding and utilizing palliative care. In this article, we provide 10 cultural pearls to guide clinicians on how to sensitively approach FA and KA groups when addressing palliative and end-of-life (EOL) discussions. We fully celebrate that every person is an individual and care should be tailored to each person's goals, values, and preference. In addition, there are several cultural norms that, when appreciated and celebrated, may help clinicians to improve serious illness care and EOL discussions for members of these populations.
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Affiliation(s)
- Jenny E Chung
- Division of Geriatrics and Palliative Care Medicine, Department of Medicine, NewYork-Presbyterian Queens, Weill Cornell Medicine, Flushing, New York, USA
| | - Susan Karass
- Department of Medicine, NewYork-Presbyterian Queens, Weill Cornell Medicine, Flushing, New York, USA
| | - Yoonhee Choi
- Department of Medicine, NewYork-Presbyterian Queens, Weill Cornell Medicine, Flushing, New York, USA
| | - Matthew Castillo
- Division of Geriatrics and Palliative Care Medicine, Department of Medicine, NewYork-Presbyterian Queens, Weill Cornell Medicine, Flushing, New York, USA
| | - Christine A Garcia
- Division of Hematology and Medical Oncology, Department of Medicine, NewYork-Presbyterian, Weill Cornell Medicine, New York, New York, USA
| | - Richard D Shin
- Department of Emergency Medicine, NewYork-Presbyterian Queens, Weill Cornell Medicine, Flushing, New York, USA
| | - Kimberson Tanco
- Division of Cancer Medicine, Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Laura S Kim
- Division of Urogynecology and Reconstructive Surgery, Department of Obstetrics and Gynecology, New York-Presbyterian Queens, Weill Cornell Medicine, Flushing, New York, USA
| | - Michin Hong
- School of Social Work, Indiana University, Indianapolis, Indiana, USA
| | - Cynthia X Pan
- Division of Geriatrics and Palliative Care Medicine, Department of Medicine, NewYork-Presbyterian Queens, Weill Cornell Medicine, Flushing, New York, USA
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Quintiliani LM, Kamaka M, Henault L, Antonio MCK, Sentell T, Spencer K, Akaka G, Honda LKL, Hanakeawe D, Dillard A, Kekauoha BP, Davis AD, Seitz R, Cabral HJ, Volandes A, Leimomi Mala Mau MK, Paasche-Orlow MK. I kua na'u "Let me carry out your last wishes" Clinical trial protocol to promote advance care planning among native Hawaiian populations. Contemp Clin Trials 2023; 135:107365. [PMID: 37884121 PMCID: PMC10814879 DOI: 10.1016/j.cct.2023.107365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/06/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
Advance Care Planning (ACP) is a communication process about serious illness decision making designed to inform patients of possible medical options. Native Hawaiians consistently have low rates of ACP and low use of palliative and hospice care services. Our multidisciplinary community and research group partnered to create I kua na'u "Let Me Carry Out Your Last Wishes," an ACP intervention featuring culturally tailored videos and are now testing its efficacy. Focus groups and informant interviews were conducted with Native Hawaiian community members to ensure the curriculum honored the history, opinions, and culture of Native Hawaiians. Native Hawaiian culture has traditionally been an oral culture; the spoken word transmitted the mo'olelo, stories, traditions, histories and genealogies, which merges seamlessly with video media. The I kua na'u intervention included multiple educational sessions enhanced with videos (informational and personal). The specific aims are to compare ACP knowledge (primary outcome) and readiness for ACP engagement, ACP preferences, decisional conflict, and ACP completion rates via electronic medical record review (secondary outcomes) in 220 Native Hawaiians over age 55 in: (a) a randomized controlled trial of 110 people recruited from ambulatory clinics, and (b) a pre-post study design among 110 people living on Hawaiian Homestead communities located on lands set aside for Native Hawaiians or assisted living. Our protocol aims to evaluate the efficacy of our video-based educational intervention for Native Hawaiians to support decision making in this community and decrease disparities in serious illness care. Clinical Trial Registration Number: NCT04771208.
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Affiliation(s)
- Lisa M Quintiliani
- Department of Medicine, Tufts University School of Medicine, Tufts Medical Center, USA.
| | - Martina Kamaka
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, USA
| | | | - Mapuana C K Antonio
- Native Hawaiian and Indigenous Health, Thompson School of Social Work & Public Health, University of Hawaii, USA
| | - Tetine Sentell
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, USA
| | - Kimberley Spencer
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, USA
| | | | | | | | - Adrienne Dillard
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, USA; Kula No Na Po'e Hawaii o Papakolea, Kewalo, Kalawahine, USA
| | | | | | | | - Howard J Cabral
- Department of Biostatistics, Boston University School of Public Health, USA
| | - Angelo Volandes
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, USA
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Khanthavudh C, Grealish A, Tzouvara V, Huang J, Leamy M. Implementation and evaluation of recovery-oriented practice interventions for people with mental illness in Asia: An integrative review. Int J Nurs Stud 2023; 147:104591. [PMID: 37708624 DOI: 10.1016/j.ijnurstu.2023.104591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/18/2023] [Accepted: 08/19/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Recovery is a process involving empowering individuals to take control of their lives and develop meaningful and purposeful life, regardless of whether their mental health symptoms persist. Recovery-oriented practice has been widely implemented, particularly in Anglophone countries, during the past two decades. Mental health recovery in Asia is also moving towards recovery-oriented practice. Little is known about how recovery-oriented interventions originating in the West have been implemented and evaluated in Asian contexts. OBJECTIVE This review aimed to identify 1) types of recovery-oriented practice interventions that have been implemented in Asia, 2) how they have been culturally adapted, 3) barriers and facilitators to implementation, and 4) how the interventions have been evaluated. DESIGN This is an integrative review. METHODS This integrative review followed Whittemore and Knafl's five-stage framework. Six electronic databases (e.g., PsycINFO, MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Library) were systematically searched from their inception to January 2022 to identify eligible studies published in English language. The key search terms included "mental illness", "recovery-oriented intervention", and "Asia". Studies reporting on implementation and evaluation of recovery-focused interventions in Asian settings were eligible. Quality assessment and narrative synthesis were subsequently undertaken. RESULTS Thirty-eight studies were included. Seven main types of recovery-oriented intervention were identified: (1) peer programmes; (2) illness management and recovery; (3) individual placement and support; (4) strength model case management; (5) clubhouse model; (6) wellness recovery action plan and (7) psychiatric advance directive, alongside several novel recovery programmes. Studies reported cultural adaptations for language, content, cultural norms, religious beliefs, family, and local context. Barriers to implementation included a poor understanding of recovery concepts and inadequate organisational resources. A range of clinical and personal recovery outcome measures were reported. CONCLUSIONS Recovery-oriented interventions are increasing in Asia, with nearly half of reviewed studies featuring cultural adaptations. However, research is geographically skewed, and more rigorously conducted studies are needed across a wider range of Asian countries. REGISTRATION This review was registered with the PROSPERO International prospective register of systematic reviews (CRD42022310049). TWEETABLE ABSTRACT Recovery-oriented practice interventions for people with mental illness are on the rise in Asia @chonmananNN.
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Affiliation(s)
- Chonmanan Khanthavudh
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom; Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Annmarie Grealish
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom; Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Vasiliki Tzouvara
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
| | - Jing Huang
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
| | - Mary Leamy
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
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Alolod GP, Gardiner HM, Blunt R, Yucel RM, Siminoff LA. Organ Donation Willingness Among Asian Americans: Results from a National Study. J Racial Ethn Health Disparities 2023; 10:1478-1491. [PMID: 35595917 PMCID: PMC9675880 DOI: 10.1007/s40615-022-01333-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/05/2022] [Accepted: 05/13/2022] [Indexed: 10/18/2022]
Abstract
Asian Americans are the fastest growing racial group in the USA, but their health disparities are often overlooked. Although their needs for transplantable organs are substantial, they have the lowest rates of organ donation per million compared to other Americans by race. To better understand Asian Americans' disposition toward organ donation, a self-administered survey was developed based on formative data collection and guidance from a Community Advisory Board composed of Asian American stakeholders. The instrument was deployed online, and quota sampling based on the 2017 American Community Survey was used to achieve a sample representative (N = 899) of the Asian American population. Bivariate tests using logistic regression and the chi-square test of independence were performed. Over half (58.1%) of respondents were willing to be organ donors. A majority (81.8%) expressed a willingness to donate a family member's organs, but enthusiasm depended on the family member's donor wishes. Only 9.5% of respondents indicated that the decision to donate their organs was theirs alone to make; the remainder would involve at least one other family member. Other key sociodemographic associations were found. This study demonstrates both the diversity of Asian Americans but also the centrality of the family's role in making decisions about organ donation. Practice and research considerations for the field are also presented.
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Affiliation(s)
- Gerard P Alolod
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA.
| | - Heather M Gardiner
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Ryan Blunt
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Recai M Yucel
- Department of Biostatistics and Epidemiology, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Laura A Siminoff
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
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11
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Sun HL, Fichman P. Evolution of discussion topics on an online depression self-help group. LIBRARY HI TECH 2023. [DOI: 10.1108/lht-07-2022-0317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
PurposeThis study aims to explore the evolutionary pattern of discussion topics over time in an online depression self-help community.Design/methodology/approachUsing the Latent Dirichlet Allocation (LDA) method, the authors analyzed 17,534 posts and 138,567 comments posted over 8 years on an online depression self-help group in China and identified the major discussion topics. Based on significant changes in the frequency of posts over time, the authors identified five stages of development. Through a comparative analysis of discussion topics in the five stages, the authors identified the changes in the extent and range of topics over time. The authors discuss the influence of socio-cultural factors on depressed individuals' health information behavior.FindingsThe results illustrate an evolutionary pattern of topics in users' discussion in the online depression self-help group, including five distinct stages with a sequence of topic changes. The discussion topics of the group included self-reflection, daily record, peer diagnosis, companionship support and instrumental support. While some prominent topics were discussed frequently in each stage, some topics were short-lived.Originality/valueWhile most prior research has ignored topic changes over time, the study takes an evolutionary perspective of online discussion topics among depressed individuals. The authors provide a nuanced account of the progression of topics through five distinct stages, showing that the community experienced a sequence of changes as it developed. Identifying this evolutionary pattern extends the scope of research on depression therapy in China and offers a deeper understanding of the support that individuals with depression seek, receive and provide online.
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12
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Kwan PP, Pike JR, Co DE, Esmundo S, Vaivao DES, May VT, Pang JK, Sabado-Liwag M, Tan NS, Tanjasiri SP, Xie B, Palmer PH. Association Between Stress and Social Support Among Young Adult Pacific Islander Smokers. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:31-38. [PMID: 36779006 PMCID: PMC9910195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Recent studies have found high levels of stress among Americans, particularly amongst young adults and ethnic minority groups. The purpose of this secondary data analysis was to explore the association between stress and social support among a sample of 276 young adult smokers of Pacific Islander ancestry, specifically Samoans and Tongans with an average age of 25.3 years. Previous research had documented the protective role of social support on stress, and thus it is hypothesized that young adult Pacific Islander smokers who perceived higher levels of social support will have less perceived stress. Social support was assessed using a 12-item scale which measured participant's perceived social support from family, friends, and significant others. Perceived stress was measured using a 10-item scale with 2 subscales - self efficacy and helplessness. Standardized parameter estimates from structural equation modeling indicated a statistically significant inverse relationship between perceived social support from family and perceived stress related to helplessness. More specifically, young adult Samoans and Tongans who report higher levels of social support from family do not feel as much stress stemming from being helpless. The results highlight the importance of family social support on stress management among this population. Most importantly, these findings add to the limited research around mental health within Pacific Islander (Samoan and Tongan) communities in the US.
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Affiliation(s)
| | | | - Danielle Erika Co
- California State University of Northridge, Northridge, CA (PPK, DEC, SE)
| | - Shenazar Esmundo
- California State University of Northridge, Northridge, CA (PPK, DEC, SE)
| | | | | | | | | | - Nasya S. Tan
- Claremont Graduate University, Claremont, CA (JRP, NST, BX, PHP)
| | | | - Bin Xie
- Claremont Graduate University, Claremont, CA (JRP, NST, BX, PHP)
| | - Paula H. Palmer
- Claremont Graduate University, Claremont, CA (JRP, NST, BX, PHP)
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Subica AM, Aitaoto N, Li Q, Morey BN, Wu LT, Iwamoto DK, Guerrero EG, Moss HB. Assessing the Impact of COVID-19 on the Health of Native Hawaiian/Pacific Islander People in the United States, 2021. Public Health Rep 2023; 138:164-173. [PMID: 36113145 PMCID: PMC9482884 DOI: 10.1177/00333549221123579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Minimal research has assessed COVID-19's unique impact on the Native Hawaiian/Pacific Islander (NH/PI) population-an Indigenous-colonized racial group with social and health disparities that increase their risk for COVID-19 morbidity and mortality. To address this gap, we explored the scope of COVID-19 outcomes, vaccination status, and health in diverse NH/PI communities. METHODS NH/PI staff at partner organizations collected survey data from April through November 2021 from 319 community-dwelling NH/PI adults in 5 states with large NH/PI populations: Arkansas, California, Oregon, Utah, and Washington. Data were analyzed with descriptive statistics, Pearson χ2 tests, independent and paired t tests, and linear and logistic regression analyses. RESULTS During the COVID-19 pandemic, 30% of survey participants had contracted COVID-19, 16% had a close family member who died of the disease, and 64% reported COVID-19 vaccine uptake. Thirty percent reported fair/poor health, 21% currently smoked cigarettes, and 58% reported obesity. Survey participants reported heightened COVID-19-related psychosocial distress (mean score = 4.9 on 10-point scale), which was more likely when health outcomes (general health, sleep, obesity) were poor or a family member had died of COVID-19. Logistic regression indicated that age, experiencing COVID-19 distress, and past-year use of influenza vaccines were associated with higher odds of COVID-19 vaccine uptake (1.06, 1.18, and 7.58 times, respectively). CONCLUSIONS Our empirical findings highlight the acute and understudied negative impact of COVID-19 on NH/PI communities in the United States and suggest new avenues for improving NH/PI community health, vaccination, and recovery from COVID-19.
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Affiliation(s)
- Andrew M. Subica
- Department of Social Medicine, Population, and Public Health, School of Medicine, University of California, Riverside, Riverside, CA, USA
| | - Nia Aitaoto
- Pacific Islander Center of Primary Care Excellence, San Leandro, CA, USA
| | - Qiuxi Li
- Special Services for Groups, Los Angeles, CA, USA
| | - Brittany N. Morey
- Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, USA
| | - Li-Tzy Wu
- School of Medicine, Duke University, Durham, NC, USA
| | - Derek K. Iwamoto
- Department of Psychology, University of Maryland, College Park, MD, USA
| | | | - Howard B. Moss
- Department of Social Medicine, Population, and Public Health, School of Medicine, University of California, Riverside, Riverside, CA, USA
- Department of Psychiatry, School of Medicine, University of California, Riverside, Riverside, CA, USA
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14
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Tan NQP, Maki KG, López-Olivo MA, Geng Y, Volk RJ. Cultural influences on shared decision-making among Asian Americans: A systematic review and meta-synthesis of qualitative studies. PATIENT EDUCATION AND COUNSELING 2023; 106:17-30. [PMID: 36344320 DOI: 10.1016/j.pec.2022.10.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/19/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To summarize how Asian Americans negotiate involvement in shared decision-making (SDM) with their providers, the cultural influences on SDM, and perceived barriers and facilitators to SDM. METHODS This is a systematic review of qualitative studies. We searched six electronic databases and sources of gray literature until March 2021. Two reviewers independently screened studies, performed quality appraisal, and data extraction. Meta-synthesis was performed to summarize themes using a three-step approach. RESULTS Twenty studies with 675 participants were included. We abstracted 275 initial codes and grouped these into 19 subthemes and 4 major themes: (1) negotiating power and differing expectations in SDM; (2) cultural influences on SDM; (3) importance of social support in SDM; and (4) supportive factors for facilitating SDM. CONCLUSIONS Asian Americans have important perspectives, needs, and preferences regarding SDM that impacts how they engage with the provider on medical decisions and their perception of the quality of their care. PRACTICE IMPLICATIONS Asian American patients valued good communication and sufficient time with their provider, and that it is important for health professionals to understand patients' desired level of involvement in the SDM process and in the final decision, and who should be involved in SDM beyond the patient. OTHER This systematic review was registered on PROSPERO (CRD42021241665).
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Affiliation(s)
- Naomi Q P Tan
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Kristin G Maki
- Department of Oncology, Wayne State University Medical School, Detroit, USA; Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, USA
| | - Maria A López-Olivo
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Yimin Geng
- Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Robert J Volk
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, USA.
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15
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Subica AM, Guerrero EG, Hong P, Aitaoto N, Moss HB, Iwamoto DK, Wu LT. Alcohol Use Disorder Risk and Protective Factors and Associated Harms Among Pacific Islander Young Adults. J Racial Ethn Health Disparities 2022; 9:1818-1827. [PMID: 34378172 PMCID: PMC9048749 DOI: 10.1007/s40615-021-01118-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 11/26/2022]
Abstract
Pacific Islander (PI) young adults (age 18 to 30 years) experience elevated rates of hazardous drinking, AUDs, and alcohol-related harms. Yet, we know little about the risk and protective factors that drive, or can prevent, PI young adult hazardous drinking behaviors and AUDs due to a lack of targeted alcohol disparities research. This large qualitative study presents data from 8 focus groups with 69 PIs (51 young adults, 18 informal providers) to explore the major risk factors, protective factors, and negative consequences associated with PI young adult hazardous drinking and AUDs. Findings revealed (1) major risk factors including the presence of significant life stressors that trigger alcohol self-medication, peer/social pressure to drink, permissive drinking norms, and frequent access to alcohol and (2) negative consequences involving physical fights, health and relationship problems, harm to personal reputation, and community harms including driving-under-the-influence and sexual violence. Protective factors against hazardous drinking and AUDs included the cultural norm of protecting the family's reputation by avoiding AUDs, church/religious faith, family responsibilities, and culturally relevant prosocial activities (e.g., sports, dance, choir). Obtaining this in-depth data revealed that an effective culturally grounded AUD prevention intervention for PI young adults-which does not currently exist-should (1) target these identified major risk factors for AUDs, while (2) integrating culturally responsive strategies that incorporate their reported protective factors.
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Affiliation(s)
- Andrew M Subica
- Department of Social Medicine, Population, and Public Health, School of Medicine, University of California, Riverside, 900 University Ave, Riverside, CA, 92521, USA.
| | - Erick G Guerrero
- Research to End Healthcare Disparities Corp, I-Lead Institute, Santa Monica, USA
| | - Phong Hong
- School of Public Policy, University of Michigan, Ann Arbor, USA
| | - Nia Aitaoto
- College of Health, University of Utah, Salt Lake City, USA
| | - Howard B Moss
- Department of Social Medicine, Population, and Public Health, School of Medicine, University of California, Riverside, 900 University Ave, Riverside, CA, 92521, USA
| | - Derek K Iwamoto
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Li-Tzy Wu
- School of Medicine, Duke University, Durham, NC, USA
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Akbar H, Gallegos D, Anderson D, Windsor C. Deconstructing type 2 diabetes self-management of Australian Pacific Islander women: Using a community participatory research and talanoa approach. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1988-1999. [PMID: 34580935 DOI: 10.1111/hsc.13580] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 07/20/2021] [Accepted: 09/03/2021] [Indexed: 06/13/2023]
Abstract
Community-based participatory research using culturally appropriate talanoa approaches provided the framework to explore diabetes self-management of Australian Pacific Islander (API) women living with type 2 diabetes in South-East Queensland. Data collection included interviews with key informants (21), in-depth interviews with API women with diabetes (10), talanoa group discussions (7) and monthly steering committee meetings. Using an interpretive-constructionist lens and the interpretations of community members, four cultural constructs in diabetes self-management emerged: self-identity, spirituality, stigma and denial, and structural factors. Self-identity connected the women to their Pacific heritage that framed their collective roles as primary caregivers in the community. This gave the women a strong sense of belonging and helped maintain cultural, family and relational connections which were important for their day-to-day management of diabetes. Although spirituality through religion supported the women to cope with their diabetes a total reliance on God resulted in disengagement with self-care. Shame associated with disclosure also prevented effective self-management. Finally, structural factors such as access to healthcare, poor health literacy and cultural barriers associated with obesogenic environments impeded women from seeking appropriate diabetes care. However, family and community were critical in ensuring women were supported with their diabetes self-management. The findings highlight the importance of engaging families in healthcare planning decisions in the development of culturally responsive models of diabetes support care for API women with type 2 diabetes.
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Affiliation(s)
- Heena Akbar
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Australia, Brisbane, Queensland, Australia
- Pasifika Women's Alliance Inc (PWA), Brisbane, Queensland, Australia
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Woolworths Centre for Childhood Nutrition Research, Queensland University of Technology, Brisbane, Queensland, 4101, Australia
| | - Debra Anderson
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Carol Windsor
- School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
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17
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Sun W, Zhang Q, Lee S, Luo Z. When Social Work Client Self-Determination Principle Meets Confucius Culture: A Living Will Decision-Making Case Study in China. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221117864. [PMID: 35941830 DOI: 10.1177/00302228221117864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. In western countries like the United States of America, living will is seen as a vehicle for achieving greater wisdom and skill in a fundamental aspect of health care and a civilized approach to mortality. However, the inception of living will in China emerged only a decade ago. Although, nowadays, Chinese medical social workers can provide living will service in health settings, their services are in a preliminary status. Objective. This exploratory case study aims to present an ethical dilemma and analyzes the reasons the social work client self-determination principle failed in living will decision-making in the oncology ward that has Confucius as a cultural context. Results. This case illustrates that the patient's family has the final say in living will decision-making. The social work principle of client self-determination exemplifies the difficulties of applying medical social work practices with living will to Chinese patients in hospital wards. Conclusions. Chinese patients and their families are still bound to Confucianism's long tradition. In China, individuals are still being defined by relationships, and the "self" exists only in a hierarchical interpersonal network known as the differential pattern. The Chinese people do not like to talk about death. Even in modern society, it will take time for the Chinese people to come to terms with the end-of-life planning with living will, mainly for cancer patients after diagnosis. Practice Implications. Future social work practices that implied living will similar to this case that has Confucius culture in the background should consider the cultural context where the social worker-client are situated and the types of social work values the profession hold.
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Affiliation(s)
- Wu Sun
- School of Philosophy and Sociology, Lanzhou University, China
| | - Qingning Zhang
- School of Philosophy and Sociology, Lanzhou University, China
| | - Serge Lee
- College of Health and Human Services, California State University, Sacramento, CA, USA
| | - Zhanlin Luo
- Radiotherapy Center, Gansu Provincial Hospital, China
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18
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Cutrer-Parraga B, Allen GEK, Conklin H, Hee C, Miller E, Chapman R, Gancinia B, Roan M, Norton A. Culture-Centered Psychotherapy Preferences for Polynesian Americans: An Interpretative Phenomenological Approach. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2022. [DOI: 10.1007/s10447-022-09472-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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Novotny R, Yamanaka AB, Butel J, Boushey CJ, Dela Cruz R, Aflague T, Coleman P, Shallcross L, Fleming T, Wilkens LR. Maintenance Outcomes of the Children's Healthy Living Program on Overweight, Obesity, and Acanthosis Nigricans Among Young Children in the US-Affiliated Pacific Region: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2214802. [PMID: 35666503 PMCID: PMC9171559 DOI: 10.1001/jamanetworkopen.2022.14802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
Importance Few obesity prevention trials among children have demonstrated sustainable outcomes in the long term. Objectives To sustain a community-wide decrease in the prevalence of overweight and obesity among young children in the US-affiliated Pacific region. Design, Setting, and Participants In the Children's Healthy Living community-randomized clinical trial, hierarchical modeling comparing the change in intervention and control communities accounted for community randomization (community clustering with jurisdictions), and adjusted for the age and sex distribution of the assessed children in a cross-sectional design. The outcome measures were repeated in communities rather than among individual children. A total of 27 communities in 5 jurisdictions (Hawai'i, Alaska, Commonwealth of the Northern Mariana Islands, American Samoa, and Guam) of the US-affiliated Pacific region were included. Participants included children aged 2 to 8 years in the 27 selected communities from October 1, 2012 (4329 in time 1 [baseline]) to August 31, 2015 (4043 in time 2 [intervention end]) and from January 1, 2019, to April 30, 2020 (1469 in time 3 [maintenance period]). Study analysis was completed March 25, 2022. Interventions Nineteen activities addressed training, policies, systems, and environments of communities and 6 target behaviors of children (consumption of fruit and vegetables, water, and sugar-sweetened beverages; sleep; physical activity; and screen time) during a 2-year intervention period. Continued partnership with community coalitions, ongoing academic training of community partners, and use of trial data during a 6-year maintenance period. Main Outcomes and Measures The primary outcome was measured anthropometry; secondary outcomes were the presence of acanthosis nigricans, dietary intake derived from 2 days of food records, and survey questions on screen time and sleep disturbance. Results Among the 9840 children included in the analysis (4866 girls [49.5%] and 4974 boys [50.5%]; 6334 [64.4%] aged 2-5 years), the intervention group showed significant improvements compared with the control group from times 1 to 3 in prevalence of overweight plus obesity (d = -12.60% [95% CI, -20.92% to -4.28%]), waist circumference (d = -1.64 [95% CI, -2.87 to -0.41] cm), and acanthosis nigricans prevalence (d = -3.55% [95% CI, -6.17% to -0.92%]). Significant improvements were also observed from times 2 to 3 in prevalence of overweight plus obesity (d = -8.73% [95% CI, -15.86% to -1.60%]) but not in waist circumference (d = -0.81 [95% CI, -1.85 to 0.23] cm). Conclusions and Relevance This randomized clinical trial found that the outcomes of the Children's Healthy Living intervention were maintained and enhanced 6 years after the intervention among young children in the US-affiliated Pacific region. The prevalence of overweight, obesity, and acanthosis nigricans was further reduced in communities, suggesting that multilevel multicomponent interventions may help reduce child overweight and obesity in this region. Trial Registration ClinicalTrials.gov Identifier: NCT01881373.
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Affiliation(s)
- Rachel Novotny
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu
| | - Ashley B. Yamanaka
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu
| | - Jean Butel
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu
| | - Carol J. Boushey
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu
| | - Rica Dela Cruz
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu
| | - Tanisha Aflague
- Cooperative Extension and Outreach, College of Natural & Applied Sciences, University of Guam, Mangilao
| | - Patricia Coleman
- Cooperative Research, Extension, and Education Services, Northern Marianas College, Saipan
| | - Leslie Shallcross
- Health, Home and Family Development, Institute of Agriculture, Natural Resources and Extension, University of Alaska, Fairbanks
| | - Travis Fleming
- Community and Natural Resources Division (Land Grant Program), American Samoa Community College, Pago Pago
| | - Lynne R. Wilkens
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu
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20
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Fontil V, Pacca L, Bellows BK, Khoong E, McCulloch CE, Pletcher M, Bibbins-Domingo K. Association of Differences in Treatment Intensification, Missed Visits, and Scheduled Follow-up Interval With Racial or Ethnic Disparities in Blood Pressure Control. JAMA Cardiol 2022; 7:204-212. [PMID: 34878499 PMCID: PMC8655666 DOI: 10.1001/jamacardio.2021.4996] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 09/15/2021] [Indexed: 11/14/2022]
Abstract
Importance Black patients with hypertension often have the lowest rates of blood pressure (BP) control in clinical settings. It is unknown to what extent variation in health care processes explains this disparity. Objective To assess whether and to what extent treatment intensification, scheduled follow-up interval, and missed visits are associated with racial and ethnic disparities in BP control. Design, Setting, and Participants In this cohort study, nested logistic regression models were used to estimate the likelihood of BP control (defined as a systolic BP [SBP] level <140 mm Hg) by race and ethnicity, and a structural equation model was used to assess the association of treatment intensification, scheduled follow-up interval, and missed visits with racial and ethnic disparities in BP control. The study included 16 114 adults aged 20 years or older with hypertension and elevated BP (defined as an SBP level ≥140 mm Hg) during at least 1 clinic visit between January 1, 2015, and November 15, 2017. A total of 11 safety-net clinics within the San Francisco Health Network participated in the study. Data were analyzed from November 2019 to October 2020. Main Outcomes and Measures Blood pressure control was assessed using the patient's most recent BP measurement as of November 15, 2017. Treatment intensification was calculated using the standard-based method, scored on a scale from -1.0 to 1.0, with -1.0 being the least amount of intensification and 1.0 being the most. Scheduled follow-up interval was defined as the mean number of days to the next scheduled visit after an elevated BP measurement. Missed visits measured the number of patients who did not show up for visits during the 4 weeks after an elevated BP measurement. Results Among 16 114 adults with hypertension, the mean (SD) age was 58.6 (12.1) years, and 8098 patients (50.3%) were female. A total of 4658 patients (28.9%) were Asian, 3743 (23.2%) were Black, 3694 (22.9%) were Latinx, 2906 (18.0%) were White, and 1113 (6.9%) were of other races or ethnicities (including American Indian or Alaska Native [77 patients (0.4%)], Native Hawaiian or Pacific Islander [217 patients (1.3%)], and unknown [819 patients (5.1%)]). Compared with patients from all racial and ethnic groups, Black patients had lower treatment intensification scores (mean [SD], -0.33 [0.26] vs -0.29 [0.25]; β = -0.03, P < .001) and missed more visits (mean [SD], 0.8 [1.5] visits vs 0.4 [1.1] visits; β = 0.35; P < .001). In contrast, Asian patients had higher treatment intensification scores (mean [SD], -0.26 [0.23]; β = 0.02; P < .001) and fewer missed visits (mean [SD], 0.2 [0.7] visits; β = -0.20; P < .001). Black patients were less likely (odds ratio [OR], 0.82; 95% CI, 0.75-0.89; P < .001) and Asian patients were more likely (OR, 1.13; 95% CI, 1.02-1.25; P < .001) to achieve BP control than patients from all racial or ethnic groups. Treatment intensification and missed visits accounted for 21% and 14%, respectively, of the total difference in BP control among Black patients and 26% and 13% of the difference among Asian patients. Conclusions and Relevance This study's findings suggest that racial and ethnic inequities in treatment intensification may be associated with more than 20% of observed racial or ethnic disparities in BP control, and racial and ethnic differences in visit attendance may also play a role. Ensuring more equitable provision of treatment intensification could be a beneficial health care strategy to reduce racial and ethnic disparities in BP control.
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Affiliation(s)
- Valy Fontil
- Division of General Internal Medicine, University of California, San Francisco, San Francisco
- UCSF Center for Vulnerable Populations, San Francisco General Hospital, San Francisco, California
| | - Lucia Pacca
- Division of General Internal Medicine, University of California, San Francisco, San Francisco
- UCSF Center for Vulnerable Populations, San Francisco General Hospital, San Francisco, California
| | - Brandon K. Bellows
- Division of General Medicine, Columbia University Irving Medical Center, New York, New York
| | - Elaine Khoong
- Division of General Internal Medicine, University of California, San Francisco, San Francisco
- UCSF Center for Vulnerable Populations, San Francisco General Hospital, San Francisco, California
| | - Charles E. McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Mark Pletcher
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Kirsten Bibbins-Domingo
- Division of General Internal Medicine, University of California, San Francisco, San Francisco
- UCSF Center for Vulnerable Populations, San Francisco General Hospital, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
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Nakagawa T, Noguchi T, Komatsu A, Ishihara M, Saito T. Aging-in-place preferences and institutionalization among Japanese older adults: a 7-year longitudinal study. BMC Geriatr 2022; 22:66. [PMID: 35062887 PMCID: PMC8780808 DOI: 10.1186/s12877-022-02766-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background In Asia, where autonomous decision-making is not well accepted, little is known about whether and how individuals’ preferences are considered when deciding where they receive care. This study examined whether individuals preferring to age in place if confined to bed were less likely to be institutionalized, using longitudinal data of Japanese older adults. Methods We analyzed nationally representative data of 1,290 community-dwelling older adults aged 70 and above. Baseline data were collected in 1999, shortly before the long-term care insurance system was introduced. The outcome was measured as self- or proxy-reported years of institutionalization over seven years. The explanatory variable was whether individuals preferred to age in place if they were confined to bed. Participants were asked about their desired place of care (facility, home, or other) if confined to bed. Covariates were sociodemographic and health-related factors. We used Cox proportional hazards models and calculated hazard ratios (HRs) with 95% confidence intervals (CIs) to evaluate the association of aging-in-place preferences if confined to bed with institutionalization. We applied multiple imputation to deal with missing data. Results Seventy-eight respondents (6.0%) were institutionalized during the follow-up period. Compared to individuals preferring to reside in long-term care facilities if confined to bed (48.7%), those preferring to stay in their homes (39.6%) were less likely to be institutionalized, even after adjusting for relevant covariates (HR = 0.47, 95% CI 0.27–0.79 for model 1 including residential status; HR = 0.45, 95% CI 0.27–0.76 for model 2 including marital status and co-resident children). Conclusions Our findings suggest that individuals’ aging-in-place preferences tend to be considered under the long-term care insurance system. Individuals’ preferences should be shared with families and clinicians when deciding the place of care. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02766-5.
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Kwan PP, Esmundo S, Rivas EA, Co DE, Sabado-Liwag M. Experiences and impacts of COVID-19 among Pacific Islanders in Los Angeles County. Ther Adv Infect Dis 2022; 9:20499361221093102. [PMID: 35494492 PMCID: PMC9052225 DOI: 10.1177/20499361221093102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/05/2022] [Indexed: 11/24/2022] Open
Abstract
Objective: To explore and document the experiences and impacts of COVID-19 among Pacific Islander (PI) adults living in Los Angeles County. Methods: Study participants completed a brief online demographic questionnaire followed by a 45- to 60-min semi-structured one-on-one interview conducted via Zoom. Participants were asked about two main areas: (1) reasons for high rates of COVID-19 cases among the PI community and its impacts on their community and (2) the impacts of COVID-19 on them as individuals. Results: A total of 14 PI adults, a majority of whom were females (76%) with an average age of 39.2 years took part in the study. Participants cited underlying medical conditions, overrepresentation in the essential workforce, multigeneration households, and the collectivistic culture of PIs as possible reasons for high rates of COVID-19 cases in their communities. Impacts of the pandemic included loss of jobs, loss of family and friends, and poor mental health which have been exacerbated by the pandemic. Conclusion: This study documents the perspectives of PIs on why rates of COVID-19 are high in their community, their experiences with COVID-19 testing, and the impacts that the pandemic has had on themselves and their community. Findings from this study will assist public health professionals and health care providers in refining services and programs for the PI community.
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Affiliation(s)
- Patchareeya P Kwan
- Department of Health Sciences, California State University, Northridge, 18111 Nordhoff Street, Northridge, CA 91330, USA
| | - Shenazar Esmundo
- Department of Health Sciences, California State University, Northridge, Northridge, CA, USA
| | - Eugenne Andrea Rivas
- Department of Health Sciences, California State University, Northridge, Northridge, CA, USA
| | - Danielle Erika Co
- Department of Health Sciences, California State University, Northridge, Northridge, CA, USA
| | - Melanie Sabado-Liwag
- Department of Public Health, California State University, Los Angeles, Los Angeles, CA, USA
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Malik AT, Jain N, Frantz TL, Quatman CE, Phieffer LS, Ly TV, Khan SN. Discharge to inpatient care facilities following hip fracture surgery: incidence, risk factors, and 30-day post-discharge outcomes. Hip Int 2022; 32:131-139. [PMID: 32538154 DOI: 10.1177/1120700020920814] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Discharge to an inpatient care facility (skilled-care or rehabilitation) has been shown to be associated with adverse outcomes following elective total joint arthroplasties. Current evidence with regard to hip fracture surgeries remains limited. METHODS The 2015-2016 ACS-NSQIP database was used to query for patients undergoing total hip arthroplasty, hemiarthroplasty and open reduction internal fixation for hip fractures. A total of 15,655 patients undergoing hip fracture surgery were retrieved from the database. Inpatient facility discharge included discharges to skilled-care facilities and inpatient rehabilitation units. Multi-variate regression analysis was used to assess for differences in 30-day post-discharge outcomes between home-discharge versus inpatient care facility discharge, while adjusting for baseline differences between the 2 study populations. RESULTS A total of 12,568 (80.3%) patients were discharged to an inpatient care facility. Discharge to an inpatient care facility was associated with higher odds of any complication (OR 2.03 [95% CI, 1.61-2.55]; p < 0.001), wound complications (OR 1.79 [95% CI, 1.10-2.91]; p = 0.019), cardiac complications (OR 4.49 [95% CI, 1.40-14.40]; p = 0.012), respiratory complication (OR 2.29 [95% CI, 1.39-3.77]; p = 0.001), stroke (OR 7.67 [95% CI, 1.05-56.29]; p = 0.045, urinary tract infections (OR 2.30 [95% CI, 1.52-3.48]; p < 0.001), unplanned re-operations (OR 1.37 [95% CI, 1.03-1.82]; p = 0.029) and readmissions (OR 1.38 [95% CI, 1.16-1.63]; p < 0.001) following discharge. CONCLUSION Discharge to inpatient care facilities versus home following hip fracture surgery is associated with higher odds of post-discharge complications, re-operations and readmissions. These results stress the importance of careful patient selection prior to discharge to inpatient care facilities to minimise the risk of complications.
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Affiliation(s)
- Azeem Tariq Malik
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Nikhil Jain
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Travis L Frantz
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Carmen E Quatman
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Laura S Phieffer
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Thuan V Ly
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Safdar N Khan
- Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Wang ML, McElfish PA, Long CR, Lee MS, Bursac Z, Kozak AT, Ko LK, Kulik N, Yeary KHCK. BMI and related risk factors among U.S. Marshallese with diabetes and their families. ETHNICITY & HEALTH 2021; 26:1196-1208. [PMID: 31288554 PMCID: PMC6952582 DOI: 10.1080/13557858.2019.1640351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/28/2019] [Indexed: 06/09/2023]
Abstract
Objective: Examine cross-sectional associations between body mass index (BMI) and related health behaviors, barriers and facilitators to health care, and perceived health status among a sample of U.S. Marshallese adults with Type 2 diabetes and evaluate associations of interest between participants and their family members.Design: Cross-sectional baseline data were analyzed from participants in a diabetes self-management education intervention trial.Setting: Data collection took place in home or community settings through a community-academic partnership in Arkansas.Participants: Study participants consisted of U.S. Marshallese adults with Type 2 diabetes (N = 221) and their family members (N = 211) recruited through community settings.Intervention(s): N/A.Main Outcome Measure(s): Participants' height and weight were measured using standard protocols to calculate BMI (kg/m2). Diet, physical activity, health care access, financial strain related to health care, perceived health status, and health care satisfaction were measured using self-report surveys.Results: Participants' mean BMI was 31.0 (95% CI: 30.2-31.7), with over half of study participants and their family members' BMI falling in the obese category. Participants' BMI was positively associated with spreading health care bill payments over time (β = 1.75 (SE = 0.87); p = 0.045). Positive associations between participants and their family members were observed for self-reported health status conditions, health care coverage, health care utilization, and health care satisfaction.Conclusion: Study findings highlight the high prevalence of obesity and related risk factors among U.S. Marshallese adults with Type 2 diabetes and emphasize the need for intervention strategies that build upon cultural strengths and target community, policy, systems, and environmental changes to address obesity and chronic disease in this marginalized community.
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Affiliation(s)
- Monica L. Wang
- Department of Community Health Sciences, Boston University School of Public Health
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest
| | | | - Morgan S Lee
- Health Sciences, Helen and Arthur E. Johnson Beth-El College of Nursing and Health Sciences, University of Colorado-Colorado Springs
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University
| | | | - Linda K. Ko
- Department of Health Services, University of Washington School of Public Health
| | - Noel Kulik
- College of Education, Wayne State University
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25
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Teh WL, Roystonn K, Vaingankar JA, Goh CMJ, Zhang Y, Chong SA, Verma S, Tay B, Subramaniam M. Caregivers' hopes, expectations and concerns surrounding the employment and future of young people with mental health conditions. Int J Soc Psychiatry 2021; 67:432-440. [PMID: 33012238 PMCID: PMC8290979 DOI: 10.1177/0020764020960763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Informal caregivers are often placed in a better position to understand and advocate for the vocational needs of young persons with mental health conditions. However, their opinions are largely ignored in the planning of vocational outcomes. This qualitative study had two broad aims: to explore (1) the perceptions of caregivers of young adults with mental health conditions on issues of paid employment and (2) their views and expectations of employment support services. METHODS A total of 30 semi-structured interviews were conducted. Caregivers were 45 years old on average, the majority were women (73%) and were of Chinese ethnicity (53%). Most participants (60%) were parents of the young persons with psychotic disorders (57%), or affective and mood disorders, such as depression or anxiety disorders (43%). RESULTS Thematic analyses of data revealed three superordinate themes: (1) caregiving roles, (2) caregivers' expectations and hopes, and (3) barriers to employmentof young persons with mental health conditions. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Caregivers strongly believed that employment support services should prioritise and advocate for recovery while securing employment. Local mental health employment support services should incorporate the views and expectations of caregivers of young persons with mental health conditions to foster better coordination between stakeholders, and enhance support for successful employment, reintegration into the community, and ultimately recovery for these individuals.
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Affiliation(s)
- Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore
| | | | | | | | - YunJue Zhang
- Research Division, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore
| | - Benjamin Tay
- National Council of Social Service, Ulu Pandan Community Building, Singapore
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Patient autonomy and participation in end-of-life decision-making: An interpretive-systemic focus group study on perspectives of Asian healthcare professionals. Palliat Support Care 2021; 18:425-430. [PMID: 31699170 DOI: 10.1017/s1478951519000865] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Asia's first national advance care planning (ACP) program was established in Singapore in 2011 to enhance patient autonomy and self-determination in end-of-life (EoL) care decision-making. However, no known study has examined the extent to which ACP in Singapore successfully met its aims. The purpose of the current study was to examine the attitudes of local healthcare professionals on patients' autonomy in decision-making at the EoL since they strongly influence the extent to which patient and family wishes are fulfilled. METHODS Guided by the Interpretive-Systemic Framework and Proctor's conceptual taxonomy of implementation research outcomes, an interview guide was developed. Inquiries focused on healthcare professionals' attitudes towards ACP, their clinical experiences working with patients and families, and their views on program effectiveness. Sixty-three physicians, nurses, medical social workers, and designated ACP coordinators who were actively engaged in ACP facilitation were recruited from seven major hospitals and specialist centers in Singapore through purposive sampling. Twelve interpretive-systemic focus groups were conducted, recorded, transcribed, and analyzed using a thematic analysis. RESULTS The extent to which patients in Singapore can exert autonomy in EoL care decision-making is influenced by five themes: (i) collusion over truth-telling to patient, (ii) deferment of autonomy by patients, (iii) negotiating patient self-determination, (iv) relational autonomy as the gold standard and (v) barriers to realization of patient choices. SIGNIFICANCE OF RESULTS Healthcare practitioners in Asian communities must align themselves with the values and needs of patients and their family and jointly make decisions that are consistent and congruent with the values of patients and their families. Sensitivity towards such cross-cultural practices is key to enhancing ACP awareness, discourse, and acceptability in Asian communities.
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27
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Goodwin J, Shand B, Wiseman R, Brough N, McGeoch G, Hamilton G, Grundy K. Achievements and challenges during the development of an advance care planning program. Australas J Ageing 2021; 40:301-308. [PMID: 33847458 DOI: 10.1111/ajag.12945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 11/26/2022]
Abstract
A nationwide program to promote preparation of advance care plans (AC Plans) was introduced in Canterbury, New Zealand, in 2013. The program was developed by local facilitators who provided support and organised education seminars and an accredited training program for health-care professionals. Information and templates for an AC Plan were available to these professionals and the community on local health-care websites and secure online systems designed to allow plans to be viewed across all health-care sectors. The number of AC Plans prepared has increased steadily, although people in minority ethnic populations or in the most deprived socioeconomic quintile are less likely to have a plan. While nurses have become the predominant group guiding people through the process of preparing an AC Plan, the involvement of staff in residential care homes has remained low. Local audit showed that 82% of people with an AC Plan died in a community setting, frequently their preferred place of death.
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Affiliation(s)
- Jane Goodwin
- The Canterbury Initiative, Canterbury District Health Board, Christchurch, New Zealand
| | - Brett Shand
- The Canterbury Initiative, Canterbury District Health Board, Christchurch, New Zealand
| | - Rachel Wiseman
- Respiratory Medicine, Canterbury District Health Board, Christchurch, New Zealand
| | - Natalie Brough
- The Canterbury Initiative, Canterbury District Health Board, Christchurch, New Zealand
| | - Graham McGeoch
- The Canterbury Initiative, Canterbury District Health Board, Christchurch, New Zealand
| | - Greg Hamilton
- Planning and Funding and Decision Support, Canterbury District Health Board, Christchurch, New Zealand
| | - Kate Grundy
- Oncology Services, Canterbury District Health Board, Christchurch, New Zealand
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Goli F, Roohafza H, Feizi A, Gholamrezaei A, Farzanegan M, Hashemi M, Kube T, Rief W. The Illness Belief Network Questionnaire: Development and Evaluation of a Psychosomatic Assessment Tool. IRANIAN JOURNAL OF PSYCHIATRY 2021; 16:177-186. [PMID: 34221044 PMCID: PMC8233563 DOI: 10.18502/ijps.v16i2.5819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: Patients’ beliefs and emotions toward an illness can influence their coping responses, illness behaviors, adherence to treatment, quality of life, and even the psychoneuroimmune responses. The aim of present study was to develop and validate a novel questionnaire assessing both rational and irrational beliefs of patients regarding their illness. Method: In a cross sectional methodological study, the items of the Illness Belief Network (IBN) were developed regarding patients and clients’ opinions about and attribution of their disease extracted from 400 clinical interviews and were coded based on Leventhal’s self-regulation model. An expert panel coded the items. A total of 400 patients with different medical conditions completed the questionnaire. Participants additionally rated the Illness Perceptions Questionnaire in its revised form (IPQ-R) to assess convergent validity. Construct validity was examined by conducting exploratory and confirmatory factor analysis. The Cronbach alpha and Intracluster Correlation Coefficient (ICC) were used for examining Internal consistency and test-retest reliability of the IBN. Results: The IBN questionnaire was finalized with 84 items, and the results of factor analysis revealed 5 factors: psychosocial causes, environmental causes, control, meaning, and consequence/timeline; extracted factors were confirmed by confirmatory factor analysis. Cronbach’s α coefficient for scale was 0.92 and it ranged from 0.79 to 0.89 for the subscales. IBN indicated excellent test-retest reliability results based on ICC 0.842(95%CI: 0.798-0.846). The correlation coefficients of all items exceeded the prespecified acceptable value of 0.40, indicating satisfactory item discriminant validity, and correlation between IBN and IPQ-R subscales were statistically significant (all p values < 0.01), indicating acceptable convergent validity. Conclusion: The IBN questionnaire is a valid and reliable phenomenological, non-judging, and clinical tool to assess patient’s rational and irrational or faith-based beliefs about the illness. This tool can be used to improve doctor-patient communication by exploring the complex nature of human thinking.
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Affiliation(s)
- Farzad Goli
- Danesh-e Tandorosti Institute, Isfahan, Iran.,Energy Medicine University, California, United States of America
| | - Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Gholamrezaei
- Department of Chronic Diseases, Metabolism and Ageing, Translational Research Center for Gastrointestinal Disorders, Leuven, Belgium
| | - Mahboubeh Farzanegan
- Danesh-e Tandorosti Institute, Isfahan, Iran.,Energy Medicine University, California, United States of America
| | | | - Tobias Kube
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University of Marburg, Marburg, Germany
| | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University of Marburg, Marburg, Germany
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29
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Negash M, Chanyalew M, T Gebresilase T, Sintayehu B, Anteye T, Aseffa A, Newport MJ. Rapid ethical appraisal of stakeholder views on research prior to undertaking immunopathogenesis studies on podoconiosis in northeast Ethiopia during a period of social instability. Trans R Soc Trop Med Hyg 2021; 115:1026-1038. [PMID: 33570141 PMCID: PMC8417087 DOI: 10.1093/trstmh/trab003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/24/2020] [Accepted: 01/12/2021] [Indexed: 11/26/2022] Open
Abstract
Background Undertaking research and attaining informed consent can be challenging when there is political unrest and community mistrust. Rapid ethical appraisal (REA) is a tool that uses qualitative methods to explore sociocultural issues that may affect the ethical conduct of research. Methods We used REA in northeast Ethiopia shortly following a period of unrest, during which violence against researchers occurred, to assess stakeholder perceptions of research, researchers and the informed consent process. We held 32 in-depth interviews and 2 focus group discussions. Results Most community members had little awareness about podoconiosis or healthcare research. Convincing the community to donate blood for research is challenging due to association with HIV testing. The attack on researchers was mainly motivated by the community's mistrust of their intentions against the background of a volatile political situation. Social media contributed to the spread of misinformation. Lack of community engagement was also a key contributing factor. Conclusions Using REA, we identified potential barriers to the informed consent process, participant recruitment for data and specimen collection and the smooth conduct of research. Researchers should assess existing conditions in the study area and engage with the community to increase awareness prior to commencing their research activities.
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Affiliation(s)
- Mikias Negash
- Brighton and Sussex Centre for Global Health Research , Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK.,Armauer Hansen Research Institute, Addis Ababa, Ethiopia.,Addis Ababa University, College of Health Sciences, Department of Medical Laboratory Science, Addis Ababa, Ethiopia
| | | | - Tewodros T Gebresilase
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.,Unit of Health Biotechnology, Institute of Biotechnology, College of Natural and Computational Sciences, Addis Ababa University, Ethiopia
| | | | | | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Melanie J Newport
- Brighton and Sussex Centre for Global Health Research , Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK
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Abdul Wahab NA, Makmor Bakry M, Ahmad M, Mohamad Noor Z, Mhd Ali A. Exploring Culture, Religiosity and Spirituality Influence on Antihypertensive Medication Adherence Among Specialised Population: A Qualitative Ethnographic Approach. Patient Prefer Adherence 2021; 15:2249-2265. [PMID: 34675490 PMCID: PMC8502050 DOI: 10.2147/ppa.s319469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/21/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Hypertension is one of the major risk factors of stroke and leading risk factors for global death. Inadequate control of blood pressure due to medication non-adherence remains a challenge and identifying the underlying causes will provide useful information to formulate suitable interventions. PURPOSE This study aimed to explore the roles of culture, religiosity, and spirituality on adherence to anti-hypertensive medications. METHODOLOGY A semi-structured qualitative interview was used to explore promoters and barriers to medication adherence among hypertensive individuals residing in urban and rural areas of Perak State, West Malaysia. Study participants were individuals who are able to comprehend either in Malay or English, above 18 years old and on antihypertensive medications. Interview transcriptions from 23 participants were coded inductively and analyzed thematically. Codes generated were verified by three co-investigators who were not involved in transcribing process. The codes were matched with quotations and categorized using three levels of themes named as organizing, classifying and general themes. RESULTS Cultural aspects categorized as societal and communication norms were related to non-adherence. The societal norms related to ignorance, belief in testimony and anything "natural is safe" affected medication adherence negatively. Communication norms manifested as superficiality, indirectness and non-confrontational were also linked to medication non-adherence. Internal and organizational religiosity was linked to increased motivation to take medication. In contrast, religious misconception about healing and treatment contributed towards medication non-adherence. The role of spirituality remains unclear and seemed to be understood as related to religiosity. CONCLUSION Culture and religiosity (C/R) are highly regarded in many societies and shaped people's health belief and behaviour. Identifying the elements and mechanism through which C/R impacted adherence would be useful to provide essential information for linking adherence assessment to the interventions that specifically address causes of medication non-adherence.
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Affiliation(s)
- Noor Azizah Abdul Wahab
- Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, 50300, Malaysia
- Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Perak, 30450, Malaysia
| | - Mohd Makmor Bakry
- Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, 50300, Malaysia
| | - Mahadir Ahmad
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 50300, Malaysia
| | - Zaswiza Mohamad Noor
- Faculty of Pharmacy and Health Sciences, Universiti Kuala Lumpur Royal College of Medicine Perak, Perak, 30450, Malaysia
| | - Adliah Mhd Ali
- Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, 50300, Malaysia
- Correspondence: Adliah Mhd Ali Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, MalaysiaTel +603-9289 7964Fax +603-2698 3271 Email
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Sherriff R, Preisz A, Adams S, Smyth J, Coudanaris E, Jacobs M, Tan K, Oei JL. Complex survival in extreme prematurity parents, their options and the need for a unified team approach. J Paediatr Child Health 2020; 56:1959-1962. [PMID: 32043681 DOI: 10.1111/jpc.14804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 01/15/2020] [Accepted: 01/20/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Renee Sherriff
- Department of Newborn Care, the Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Anne Preisz
- Department of Newborn Care, the Royal Hospital for Women, Randwick, New South Wales, Australia.,Clinical Ethics, Clinical Governance Unit, Sydney Children's Hospital Network, Westmead, New South Wales, Australia
| | - Susan Adams
- Department of Paediatric Surgery, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - John Smyth
- Department of Newborn Care, the Royal Hospital for Women, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Eric Coudanaris
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.,Department of General Paediatrics, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Mark Jacobs
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.,Department of Ophthalmology, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Kimberley Tan
- School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.,Department of Ophthalmology, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Ju L Oei
- Department of Newborn Care, the Royal Hospital for Women, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
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33
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Vlaev I, Uttamlal T, Kudrna L. Social Care Insurance: A Review of Psychological Influences on Uptake. Front Public Health 2020; 8:564471. [PMID: 33224914 PMCID: PMC7674604 DOI: 10.3389/fpubh.2020.564471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/05/2020] [Indexed: 11/13/2022] Open
Abstract
There is not currently a developed market for long-term social care insurance in England. Policymakers are interested in what behavioral influences should be considered in the design of insurance products for long-term social care to increase uptake. This review describes the behavioral factors that might be barriers or facilitators of uptake and could be considered in future policy solutions. Behavioral factors include psychological capabilities (knowledge and understanding), which are important given that public knowledge on this topic is poor. Psychological motivations (reflective or automatic biases) may also influence consumers' decision-making. Cultural factors such as language barriers and family norms for caring are considered. Overall, the authors demonstrate processes by which the uptake of long-term social care insurance can be encouraged, pertinent to policymakers.
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Affiliation(s)
- Ivo Vlaev
- Warwick Business School, University of Warwick, Coventry, United Kingdom
| | - Trishna Uttamlal
- Warwick Business School, University of Warwick, Coventry, United Kingdom
| | - Laura Kudrna
- College of Medical and Dental Sciences, Institute of Applied Health, University of Birmingham, Birmingham, United Kingdom
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Family Members' Experience of Discussions on End-of-Life Care in Nursing Homes in Japan: A Qualitative Descriptive Study of Family Members' Narratives. J Hosp Palliat Nurs 2020; 22:401-406. [PMID: 32769693 PMCID: PMC7469871 DOI: 10.1097/njh.0000000000000677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In nursing homes, discussions between family members and staff regarding the end of life for residents with cognitive impairment are crucial to the choice of treatment and care consistent with residents' wishes. However, family members experience burden in such discussions, and communication with staff remains inadequate. The purpose of this qualitative descriptive study was to elucidate the meaning of continuous end-of-life discussion for family members. Data were collected using semistructured individual interviews. Thirteen family members of residents from 3 nursing homes in Kyoto, Japan, participated in the study. Data were analyzed using thematic analysis, which focused on both explicit and implicit meanings. Four themes emerged regarding the experience of end-of-life discussion: “the end of life soaking in,” “hardship of making the decision to end my family member's life,” “wavering thoughts about decisions made and actions taken,” and “feeling a sense of participation about the care.” Family members had come to accept the deaths of residents through continuous discussion and experienced strong conflict in facing the death of their family members. Moreover, staff members should understand family members' beliefs and the burden they experience in facing residents' death.
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Felicilda-Reynaldo RFD, Choi SY, Driscoll SD, Albright CL. A National Survey of Complementary and Alternative Medicine Use for Treatment Among Asian-Americans. J Immigr Minor Health 2020; 22:762-770. [PMID: 31583560 PMCID: PMC7117985 DOI: 10.1007/s10903-019-00936-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Asian Americans (AAs) are more likely to use complementary and alternative medicine (CAM) compared to other race/ethnicities, yet previous studies have conflicting results. The 2012 National Health Interview Survey data was analyzed to investigate AA's (n = 2214) CAM use for treatment. AAs were divided into four subgroups: Chinese, Asian Indian, Filipino, and Other Asian. Only 9% of AAs reported using CAM for treatment, with 6% indicating CAM use specifically for chronic conditions. This could be a form of medical pluralism, a mixture of Eastern and Western health approaches. The "Other Asian" subgroup reported highest use of CAM for treatment. Significant predictors included age (≥ 65 years) and high educational attainment (≥ college degree). Sociodemographic factors were also significant predictors within Asian subgroups. Further investigation of this and other forms of medical pluralism among AAs are needed to explore potential cofounders and risks like underreporting, CAM schedules/dosages, cultural influences, and CAM's impact on one's health.
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Affiliation(s)
- Rhea Faye D Felicilda-Reynaldo
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster 402, Honolulu, HI, 96822, USA.
| | - So Yung Choi
- Biostatistics Core, Department of Complementary and Integrative Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Susan D Driscoll
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster 402, Honolulu, HI, 96822, USA
| | - Cheryl L Albright
- Office of Public Health Studies, Myron B. Thompson School of Social Work, School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI, USA
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La IS, Lee MC, Hinderer KA, Chi I, Liu R, Liu M, Fu Y. Palliative Care for the Asian American Adult Population: A Scoping Review. Am J Hosp Palliat Care 2020; 38:658-670. [PMID: 32489147 DOI: 10.1177/1049909120928063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The Asian American (AA) population is rapidly becoming one of the largest racial/ethnic groups in the United States. Despite this growth and advances in palliative care (PC) programs in the United States, the scope and nature of the literature regarding PC for AAs remains unclear. This review provides an overview of existing research on PC for AAs, identifies gaps in the research with recommendations for future research and delineates practice implications. METHODS A scoping review of studies published in English was conducted. Electronic Databases (PubMed, Embase, CINAHL, and PsycINFO databases) were searched up to December 2019. No starting date limit was set. Arksey and O'Malley's methodological framework was followed for scoping reviews. RESULTS Of 2390 publications initially identified, 42 studies met our inclusion criteria for this review. Southeast AA subgroups remain understudied compared to East and South AAs. Most studies were descriptive; a few (n = 3) evaluated effectiveness of PC interventions for AAs. Research synthesized in this review addresses the following topics and includes considerations in PC related to care recipients and their relatives: treatment choice discussions (73%), coordination of care with health care providers (26%), symptom management (14%), and emotional support (10%). This review identified various factors around PC for AAs, specifically the influence of cultural aspects, including levels of acculturation, traditional norms and values, and religious beliefs. CONCLUSION A culturally inclusive approach is vital to providing appropriate and accessible PC for AAs. Further research is needed concerning core PC components and effective interventions across diverse AA subgroups.
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Affiliation(s)
- In Seo La
- 16112University of Maryland School of Nursing, Baltimore, MD, USA
| | - Mei Ching Lee
- 16112University of Maryland School of Nursing, Baltimore, MD, USA
| | | | - Iris Chi
- 115162Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Ruotong Liu
- 115162Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Mandong Liu
- 115162Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Yunting Fu
- Health Sciences and Human Services Library, 12265University of Maryland, Baltimore, MD, USA
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Park JY, Pardosi JF, Seale H. Examining the inclusion of patients and their family members in infection prevention and control policies and guidelines across Bangladesh, Indonesia, and South Korea. Am J Infect Control 2020; 48:599-608. [PMID: 31919010 PMCID: PMC7132722 DOI: 10.1016/j.ajic.2019.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Although familial involvement during inpatient care is not uncommon in western countries, the types of caring activities that family members in Asian countries provide are significantly different. These activities may place the family member at risk from a health care-associated infection. This study aimed to examine whether the role of patients' families has been accounted for in the infection prevention and control (IPC) guidelines and policy, using examples from Bangladesh (low-income country), Indonesia (middle-income country), and South Korea (high-income country). METHODS The World Health Organization website and Institutional Repository for Information Sharing, Centers for Disease Control and Prevention website, Australian Government Web Archive, Open Grey, Grey Matters, World Bank, and advanced Google search, as well as the Health Department/Ministry of Health websites for each target country and 4 western countries (Australia, Canada, England, and the United States) were searched. Other databases, such as Embase, Medline, CINAHL, Global Health, ProQuest databases, Google scholar, Web of Science, and Scopus were also searched. This was to review the reflection of the cultural influence in IPC policies/guidelines by reviewing those from the global organizations, which are often used as a blueprint for policy development, as well as those from western countries, which hold different cultures in care arrangement. Search was conducted with attention to the key areas: definition and role of carer in the acute health care facility, involvement of patients/family members in IPC activities, patient and family member hand hygiene, and IPC education. RESULTS Ninety-two articles were identified based on the criteria for the study. Only 6 acknowledged that care is provided to hospitalized patients by their family members, and only 1 recommended that family members receive the same level of training as health care workers on IPC precautions. Other guides recommended the provision of information on IPC measures as means of patient involvement in the IPC program. Recognition of family caregivers or inclusion of them in the IPC strategies was not included in the target countries' guidelines. CONCLUSIONS Although health care workers are the primary actors when it comes to providing care in acute health care settings, it is important to expand the IPC guides by considering the role of other caregivers. Policies and guidelines should reflect the cultural influence over healthcare. This is especially true when cultural values strongly influence over healthcare arrangements and the healthcare accommodates these cultural influences in the practice. Further work needs to be undertaken on the level of training/education provided to family members in Bangladesh, Indonesia, and South Korea.
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Affiliation(s)
- Ji Yeon Park
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
| | | | - Holly Seale
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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Care of the Asian American Child With Cleft Lip or Palate. Plast Surg Nurs 2020; 39:142-147. [PMID: 31790043 DOI: 10.1097/psn.0000000000000286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Orofacial clefts are one of the most common global birth defects. Orofacial clefts may be part of a syndrome or an isolated birth defect, and affect approximately 1-1.5 per 1,000 live births worldwide with noted inequalities across geographical areas and cultures. In the United States, Asian American populations have a substantially higher incidence of cleft lip with or without cleft palate (2/1,000 live births). Orofacial clefts are a key health issue with substantial health care costs, and associated medical, psychological, and social ramifications. It has been estimated that the health care costs within the United States are approximately $697 million over a child's lifetime. In disorders like orofacial clefts, because of the complexity of the condition and subsequent medical interventions, as well as the cultural intricacies of the Asian culture, it requires significant knowledge and understanding by the health care providers. In order to provide optimal and safe cleft care, reduce health care costs, and improve the outcomes for the Asian American population, a culturally sensitive, multidisciplinary, and coordinated approach is needed. Increased culturally specific education, early access to prenatal care, and ongoing infant and pediatric health care are essential.
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Pitcho-Prelorentzos S, Mahat-Shamir M. "Empty Chairs at Empty Tables": Disenfranchisement by Association. OMEGA-JOURNAL OF DEATH AND DYING 2020; 84:998-1010. [PMID: 32380897 DOI: 10.1177/0030222820925365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The rise in research publications over the last few decades about disenfranchised grief has deepened our understanding of this field. Importantly, it raises awareness and validates human experiences of bereavement, which are often socially ignored, muted, and stigmatized. However, while researchers in the field actively engage in the task of "enfranchisement," as they present their work at scientific conferences, they might experience what we term disenfranchisement by association in the academic sphere. Based on our own experience, this article will demonstrate the parallel pathways between disenfranchisement of bereaved individuals and disenfranchisement of disenfranchised grief researchers, as it emerges in three main expressions of disenfranchisement: reluctance to listen, shame and guilt inflicting, and demand for euphemism. A conclusive note on how to address this kind of disenfranchisement is suggested.
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Hall T, Kakuma R, Palmer L, Martins J, Minas H, Kermode M. Are people-centred mental health services acceptable and feasible in Timor-Leste? A qualitative study. Health Policy Plan 2020; 34:ii93-ii103. [PMID: 31723965 DOI: 10.1093/heapol/czz108] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2019] [Indexed: 12/14/2022] Open
Abstract
People-centred mental healthcare is an influential concept for health system strengthening and sustainable development that has been developed and promoted primarily in Western contexts. It characterizes service users, families and communities as active participants in health system development. However, we have limited understanding of how well people-centred mental healthcare aligns with the multiplicity of peoples, cultures, languages and contexts in low- and middle-income countries (LMICs). Timor-Leste, a lower-middle income country in South-East Asia, is in the process of strengthening its National Mental Health Strategy 2018-22 to align with people-centred mental healthcare. To support the implementation of this Strategy, this study investigated the acceptability and feasibility of people-centred mental health services in Timor-Leste. In-depth semi-structured individual (n = 57) and group interviews (n = 15 groups) were conducted with 85 adults (≥18 years). Participants were service users, families, decision-makers, service providers and members of civil society and multilateral organizations across national and sub-national sites. Government and non-government mental health and social care was also observed. Framework analysis was used to analyse interview transcripts and observation notes. The study found that the ecology of mental healthcare in Timor-Leste is family-centred and that government mental health services are largely biomedically oriented. It identified the following major challenges for people-centred mental health services in Timor-Leste: different sociocultural perceptions of (in)dividual personhood, including a diminished status of people with mental illness; challenges in negotiating individual and family needs; a reliance on and demand for biomedical interventions; and barriers to health service access and availability. Opportunities for people-centred mental healthcare are better available within the social and disability sectors, which focus on social inclusion, human rights and peer support. Accounting for local cultural knowledge and understandings will strengthen design and implementation of people-centred mental healthcare in LMIC settings.
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Affiliation(s)
- Teresa Hall
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, 333 Exhibition Street, Melbourne, VIC, Australia
| | - Ritsuko Kakuma
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.,Global and Cultural Mental Health Unit, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Carlton, Victoria, Melbourne, Australia
| | - Lisa Palmer
- School of Geography, University of Melbourne, Level 1 221 Bouverie St, Carlton, Victoria, Melbourne, Australia
| | - João Martins
- Faculty of Medicine and Health Sciences, Universidade Nacional Timor Lorosa'e, Av. Cidade de Lisboa, Dili, Timor-Leste
| | - Harry Minas
- Global and Cultural Mental Health Unit, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Carlton, Victoria, Melbourne, Australia
| | - Michelle Kermode
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, 333 Exhibition Street, Melbourne, VIC, Australia
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Kørup AK, Søndergaard J, Christensen RD, Nielsen CT, Lucchetti G, Ramakrishnan P, Baumann K, Lee E, Frick E, Büssing A, Alyousefi NA, Karimah A, Schouten E, Schulze A, Wermuth I, Hvidt NC. Religious Values in Clinical Practice are Here to Stay. JOURNAL OF RELIGION AND HEALTH 2020; 59:188-194. [PMID: 30328542 PMCID: PMC6976554 DOI: 10.1007/s10943-018-0715-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Research to date has shown that health professionals often practice according to personal values, including values based on faith, and that these values impact medicine in multiple ways. While some influence of personal values are inevitable, awareness of values is important so as to sustain beneficial practice without conflicting with the values of the patient. Detecting when own personal values, whether based on a theistic or atheistic worldview, are at work, is a daily challenge in clinical practice. Simultaneously ethical guidelines of tone-setting medical associations like American Medical Association, the British General Medical Council and Australian Medical Association have been updated to encompass physicians' right to practice medicine in accord with deeply held beliefs. Framed by this context, we discuss the concept of value-neutrality and value-based medical practice of physicians from both a cultural and ethical perspective, and reach the conclusion that the concept of a completely value-neutral physician, free from influence of personal values and filtering out value-laden information when talking to patients, is simply an unrealistic ideal in light of existing evidence. Still we have no reason to suspect that personal values, whether religious, spiritual, atheistic or agnostic, should hinder physicians from delivering professional and patient-centered care.
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Affiliation(s)
- Alex Kappel Kørup
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, 5000 Denmark
- Department of Mental Health Service, University of Southern Denmark, Vejle, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, 5000 Denmark
| | - René dePont Christensen
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, 5000 Denmark
| | | | - Giancarlo Lucchetti
- Department of Medicine, Federal University of Juiz de Fora, Avenida Eugênio de Nascimento s/n-Aeroporto, Juiz de Fora, 36038330 MG Brazil
| | - Parameshwaran Ramakrishnan
- Graduate Theological, Union-University of California, 2400 Ridge Rd, Berkeley, CA 94709 USA
- AdiBhat Foundation, New Delhi, 110048 India
| | - Klaus Baumann
- Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwig-University, 79085 Freiburg, Germany
| | - Eunmi Lee
- Caritas Science and Christian Social Work, Faculty of Theology, Albert-Ludwig-University, 79085 Freiburg, Germany
| | - Eckhard Frick
- Research Centre Spiritual Care, Department of Psychosomatic Medicine and Psychotherapy, The University Hospital Klinikum rechts der Isar, Langerstr. 3, Munich, 81675 Germany
- Munich School of Philosophy, Kaulbachstr. 31, Munich, 80539 Germany
| | - Arndt Büssing
- Institute of Integrative Medicine, Faculty of Medicine, Witten/Herdecke University, Gerhard-Kienle-Weg 4, Herdecke, 58313 Germany
| | - Nada A. Alyousefi
- College of Medicine, King Saud University (KSU), Riyadh, 11461 Saudi Arabia
| | - Azimatul Karimah
- Department of Psychiatry, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, East Java, Indonesia
| | - Esther Schouten
- Department of Neonatology, University Hospital Munich, Marchioninistrasse 15, 80366 Munich, Germany
| | - Andreas Schulze
- Department of Neonatology, University Hospital Munich, Marchioninistrasse 15, 80366 Munich, Germany
| | - Inga Wermuth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Munich, Munich, Germany
| | - Niels Christian Hvidt
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, 5000 Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, 5000 Odense, Denmark
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Priyanti RP, Kholis AH, Asri A, Rifa'i R, Praningsih S. Family Experience in Dealing with Emergency Cardiovascular Disease. JURNAL NERS 2020. [DOI: 10.20473/jn.v14i3.17020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Discusiion: The risk of cardiovascular disease has shifted. Cardiovascular disease initially only affected certain age groups but not with the current incidence of cardiovascular disease. This makes the community more susceptible to cardiovascular disease attacks. An attack of cardiovascular disease, in general, is only considered to be a cursory attack. The patients with high-risk factors must be supported by the ability of families to recognize and perform first aid in cardiovascular disease attacks. The purpose of this study was to understand the family's experience in dealing with emergency heart disease at home.Method: This study used qualitative research with a case study approach; 2 participants with family members who face emergency heart disease were selected. The data collection used semi-structured interview techniques using observation and field notes. The data analysis used Creswell's qualitative data analysis method.Result: The results of the study found 4 themes related to the family experience in dealing with emergency heart disease at home. The themes were knowledge, past experience, values and beliefs.Conclusion: The conclusion of the study is that the family experience when dealing with emergency heart disease is strongly influenced by the knowledge that forms a value and belief which then influences the attitudes involved in decision making.
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Widayanti AW, Norris P, Heydon S, Green JA. Medicine taking behaviours of people with type 2 diabetes in Indonesia: a qualitative study. Int J Clin Pharm 2019; 42:31-39. [PMID: 31701339 DOI: 10.1007/s11096-019-00933-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 11/01/2019] [Indexed: 11/24/2022]
Abstract
Background Medicine-taking behaviour of people in Indonesia is particularly complex because of Indonesia's pluralistic health system, in which public and private medical services co-exist with traditional and alternative treatments. Objective This study aimed to explore medicine-taking behaviours of people with type 2 diabetes in Indonesia. Setting Rural and urban communities in East Nusa Tenggara and West Sumatera Provinces. Method Qualitative study with focus group discussions. Six focus groups, involving 45 diabetes patients, were conducted. The discussions were recorded and transcribed verbatim in the original language. The transcripts were translated into English and analysed for common themes. Main outcome measure People's medicine-taking behaviours after being diagnosed with diabetes. Results Medicine-taking behaviours of diabetes participants aligned with the concept of resistance to medicine taking and a therapeutic decision model. It varied based on individual lay evaluation processes. After being diagnosed, participants commonly took the prescribed medicines for some period. They then self-evaluated the effectiveness of the prescribed medicines. Based on the self-evaluation, patients either continued to take the prescribed medicines or made a variety of changes: they discontinued taking the prescribed medicines, combined or alternated prescribed medicines with traditional medicines, or occasionally took medicines they bought without prescription. Reasons mentioned by participants for choosing traditional medicines including perceived ineffectiveness or side effect of the prescribed-medicines. Long-term medicine taking burdened the participants as the notion of being fed up with taking medicines was frequently mentioned. Problems of inaccessibility of the prescribed-medicines also emerged. Conclusion Diabetes patients' medicine-taking behaviours and their reasons for decision-making need to be acknowledged to improve adherence to medicine. Health professionals should assist patients on how to evaluate effectiveness, manage side effects, and reduce the medicine-related burden.
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Affiliation(s)
- Anna Wahyuni Widayanti
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. .,Faculty of Pharmacy, Universitas Gadjah Mada, Sekip Utara, Yogyakarta, Indonesia.
| | - Pauline Norris
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - Susan Heydon
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - James A Green
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.,School of Allied Health and Physical Activity for Health Cluster, University of Limerick, Limerick, V94 T9PX, Ireland.,Health Research Institute (HRI), University of Limerick, Limerick, Ireland
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Kim JW, Choi JY, Jang WJ, Choi YJ, Choi YS, Shin SW, Kim YH, Park KH. Completion rate of physician orders for life-sustaining treatment for patients with metastatic or recurrent cancer: a preliminary, cross-sectional study. BMC Palliat Care 2019; 18:84. [PMID: 31640677 PMCID: PMC6806497 DOI: 10.1186/s12904-019-0475-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/02/2019] [Indexed: 11/24/2022] Open
Abstract
Background “End of life” is a difficult topic of conversation in East Asian cultures, even among patients and doctors who share a good rapport. In 2016, the Hospice, Palliative Care, and Life-Sustaining Treatment Decision-Making Act, which took the form of “Physician Orders for Life-Sustaining Treatment,” was introduced in South Korea. This study was conducted to investigate the completion rate of Physician Orders for Life-Sustaining Treatment in patients with advanced cancer on the active recommendation of physicians, as well as patients’ general attitudes toward end-of-life care. Methods We conducted a preliminary, cross-sectional descriptive survey on patients with advanced cancer. A total of 101 patients with advanced solid cancer agreed to participate in the study. The primary endpoint was the rate of completion of Physician Orders for Life-Sustaining Treatment based on a doctor’s suggestion. Written interviews were conducted to understand the perceptions and factors influencing patients’ decisions. Results Of the 101 patients, 72 (71.3%) agreed to prepare Physician Orders for Life-Sustaining Treatment. Patients who had an educational level of high school or higher were more likely to agree to complete Physician Orders for Life-Sustaining Treatment documentation as compared to the lower educational status group. More than half of the respondents who completed Physician Orders for Life-Sustaining Treatment documentation reported that they had more than a fair understanding of “life-sustaining care” or “Physician Orders for Life-Sustaining Treatment.” Participants’ reasons for Physician Orders for Life-Sustaining Treatment completion were diverse. Conclusions We found that highly educated patients, who understood the concept behind the policy well, tended to accept Physician Orders for Life-Sustaining Treatment without hesitation. Better education, information shared through the media, and conversations with health care providers might improve understanding of Physician Orders for Life-Sustaining Treatment in patients with cancer.
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Affiliation(s)
- Ju Won Kim
- Division of Oncology/Hematology, Department of Internal medicine, Korea University Anam Hospital, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, South Korea
| | - Jung Yoon Choi
- Division of Oncology/Hematology, Department of Internal medicine, Korea University Anam Hospital, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, South Korea
| | - Won Jin Jang
- Division of Oncology/Hematology, Department of Internal medicine, Korea University Anam Hospital, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, South Korea
| | - Yoon Ji Choi
- Division of Oncology/Hematology, Department of Internal medicine, Korea University Anam Hospital, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, South Korea
| | - Youn Seon Choi
- Department of Family Medicine, Korea University Guro Hospital, 97 Guro-dong Gil, Guro-gu, Seoul, 08308, South Korea
| | - Sang Won Shin
- Division of Oncology/Hematology, Department of Internal medicine, Korea University Anam Hospital, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, South Korea
| | - Yeul Hong Kim
- Division of Oncology/Hematology, Department of Internal medicine, Korea University Anam Hospital, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, South Korea
| | - Kyong Hwa Park
- Division of Oncology/Hematology, Department of Internal medicine, Korea University Anam Hospital, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, South Korea.
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Pokharel M, Elrick A, Canary HE, Clayton MF, Sukovic M, Champine M, Hong SJ, Kaphingst KA. Health communication roles in Latino, Pacific Islander, and Caucasian Families: A qualitative investigation. J Genet Couns 2019; 29:399-409. [PMID: 31605434 DOI: 10.1002/jgc4.1177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/28/2019] [Accepted: 09/16/2019] [Indexed: 11/06/2022]
Abstract
Family communication about health is critical for the dissemination of information that may improve health management of all family members. Communication about health issues, attitudes, and behaviors in families is associated with life expectancy as well as quality of life for family members. This study addresses family communication about health by examining individual roles for family health communication and factors related to these roles, among families of three different racial/ethnic groups: Caucasians, Latinos, and Pacific Islanders. Data were collected from 60 participants recruited as 30 family dyads, 10 from each group, through qualitative semistructured interviews. Interviews were conducted with each participant separately and then together in a dyadic interview. Two coders independently coded interview transcripts using NVivo 11. Results identified the family health communication roles of collector, disseminator, health educator, and researcher. We also identified several factors related to these roles using the lens of family systems theory-the presence of chronic conditions in the family, previous experience, medical education, and family hierarchy. Findings demonstrate many similarities and relatively few differences in the family health communication roles and the related factors among the families of different race/ethnicity. Conclusions highlight implications for future research and intervention development.
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Affiliation(s)
- Manusheela Pokharel
- Department of Communication Studies, Texas State University, San Marcos, Texas
| | - Ashley Elrick
- Department of Communication, University of Utah, Salt Lake City, Utah.,Huntsman Cancer Institute, Salt Lake City, Utah
| | - Heather E Canary
- School of Communication, San Diego State University, San Diego, California
| | - Margaret F Clayton
- Huntsman Cancer Institute, Salt Lake City, Utah.,College of Nursing, University of Utah, Salt Lake City, Utah
| | - Masha Sukovic
- Department of Communication, University of Utah, Salt Lake City, Utah
| | | | - Soo Jung Hong
- Department of Communications and New Media, National University of Singapore, Singapore
| | - Kimberly A Kaphingst
- Department of Communication, University of Utah, Salt Lake City, Utah.,Huntsman Cancer Institute, Salt Lake City, Utah
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Zhu L, Zhai S, Siu PT, Xia HY, Lai S, Zambrano CN, Ma GX. Factors Related to Chinese Parents' HPV Vaccination Intention for Children. Am J Health Behav 2019; 43:994-1005. [PMID: 31439104 DOI: 10.5993/ajhb.43.5.10] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: Successful human papilloma virus (HPV) vaccine delivery depends heavily on parents' attitudes, perceptions, and willingness to have their children vaccinated. In this study, we assessed parental knowledge, attitudes, and beliefs about the HPV vaccine, and examine factors associated with willingness to have eligible children receive HPV vaccination. Methods: From a community health center serving Chinese members in the Greater Philadelphia area, 110 Chinese-American parents with at least one child aged 11 to 18 who had not received HPV vaccine were recruited. Data were collected in face-to-face interviews. Results: Chinese-American parents generally lacked knowledge on HPV and the HPV vaccine, yet had a moderately high level of intention to vaccinate their children against HPV. Ordinal logistic regression results indicated that knowledge, whether or not to involve children, doctor influence, and time lived in the United States were significantly and independently related to parental intention to have their children vaccinated against HPV. Conclusion: Interventions should make efforts to raise awareness of HPV and promote vaccination in doctors' offices. The lower level of parental intention among relatively recent immigrants indicated the necessity to target this population in public health campaigns and intervention efforts.
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Affiliation(s)
- Lin Zhu
- Postdoctoral Associate, Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Shumenghui Zhai
- Graduate Research Associate, Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Philip T. Siu
- Associate Medical Director, Greater Philadelphia Health Action, Inc, Philadelphia, PA
| | - Helen Y. Xia
- Medical Student, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ
| | - Sarah Lai
- Chief Health Center Administrator, Greater Philadelphia Health Action, Inc, Philadelphia, PA
| | - Cristina N. Zambrano
- Research Education Coordinator, Department of Biological Sciences, Hunter College, City University of New York, New York, NY
| | - Grace X. Ma
- Director, and Associate Dean for Health Disparities, Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA;,
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Fung LC, Nguyen KH, Stewart SL, Chen MS, Tong EK. Impact of a cancer education seminar on knowledge and screening intent among Chinese Americans: Results from a randomized, controlled, community-based trial. Cancer 2019; 124 Suppl 7:1622-1630. [PMID: 29578592 DOI: 10.1002/cncr.31111] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 10/10/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND Cancer is the leading cause of death for Asian Americans. The authors evaluated the status of cancer prevention for Chinese Americans in San Francisco, which has had years of cancer prevention efforts. METHODS Through a community-based clinic serving Chinese Americans, a randomized, controlled trial (n = 395) was conducted among participants who attended either a cancer prevention seminar or biospecimen education seminar. Changes in knowledge, attitudes, and screening completion/intent were measured across and between seminar groups. RESULTS Participants were mostly women who had low acculturation and education levels. Over two-thirds to almost all participants knew about modifiable risk factors for cancer and that screening tests were available, including for lung cancer. The majority of women had already completed mammography and Papanicolaou (Pap) tests. Approximately one-half reported having completed colorectal cancer screening, prostate screening, or hepatitis B screening. Most were nonsmokers, but about one-half "strongly agreed" that they would want a test for tobacco smoke exposure. After the cancer prevention seminar, significant increases within group were noted for knowledge (eating healthy foods, from 93.1% to 97.7% [P = .0002]; secondhand smoke causes cancer, from 66.3% to 74.8% [P = .04]) and for screening completion/intent (colorectal cancer, from 58.1% to 64.5% [P = .002] cervical cancer, from 72.9% to 75.5% [P = .04]) and there was a trend toward an increase for prostate cancer (from 50.0% to 61.1%; P = .10). There was a significant change between groups for eating healthy foods (P = .004). CONCLUSIONS The current reports documents the gains in cancer prevention among Cantonese-speaking Chinese Americans, fostered by academic, community, and public health efforts. A community-based seminar demonstrated improvement in some cancer knowledge or screening intent and opportunities for continued efforts. Cancer 2018;124:1622-30. © 2018 American Cancer Society.
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Affiliation(s)
- Lei-Chun Fung
- Chinatown Public Health Center, San Francisco Department of Public Health, San Francisco, California
| | - Kim H Nguyen
- Institute for Health Policy Studies, University of California-San Francisco, San Francisco, California
| | - Susan L Stewart
- Department of Public Health Sciences, University of California-Davis, Sacramento, California
| | - Moon S Chen
- Department of Internal Medicine, University of California-Davis, Sacramento, California
| | - Elisa K Tong
- Department of Internal Medicine, University of California-Davis, Sacramento, California
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Tong EK, Saw A, Fung LC, Li CS, Liu Y, Tsoh JY. Impact of a smoke-free-living educational intervention for smokers and household nonsmokers: A randomized trial of Chinese American pairs. Cancer 2019; 124 Suppl 7:1590-1598. [PMID: 29578595 DOI: 10.1002/cncr.31115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 10/10/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Chinese American men smoke at a high rate, which puts household nonsmokers at risk. The objective of this study was to evaluate the effectiveness of a brief-intensity versus moderate-intensity smoke-free-living educational intervention for household pairs. METHODS The authors conducted a randomized controlled trial of Cantonese-speaking Chinese American smoker and household nonsmoker pairs in San Francisco, California. Pairs were randomized to moderate-intensity or brief-intensity group sessions with their household partner. The moderate-intensity group received 2 group sessions, a laboratory report of their baseline smoke exposure, as measured by 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and 3 follow-up calls over 6 months. The brief-intensity group received 1 group session on tobacco-cessation resources. Primary outcomes were biochemically validated, past-month smoking abstinence and elimination of nonsmoker household exposure at 12 months. RESULTS Participant pairs (n = 203) were male smokers, one-half of whom did not intend to quit within 6 months, with mostly female spouses as household nonsmokers. Approximately three-quarters of nonsmokers in both groups already had smoke-free home rules. At 12 months, smokers in both groups had similar biochemically validated 30-day abstinence rates (moderate-intensity group, 0%-20.7%; brief-intensity group, 0%-20.0%; P = .002 over time). More smokers in the moderate-intensity group used subsequent cessation group classes (moderate-intensity group, 50%; brief-intensity group, 24%; P = .004). Household nonsmokers in both groups had similar biochemically validated rates of no home exposure (moderate-intensity group, 24.5%-42.2%; brief-intensity group, 24.8%-33.3%; P = .0001 over time). CONCLUSIONS A moderate-intensity smoke-free-living educational intervention for Chinese-speaking household pairs was not more effective than a brief-intensity intervention for smoking abstinence and elimination of household nonsmoker exposure. Abstinence rates were similar to those achieved with standard group counseling. Cancer 2018;124:1590-8. © 2018 American Cancer Society.
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Affiliation(s)
- Elisa K Tong
- Department of Internal Medicine, University of California-Davis, Sacramento, California
| | - Anne Saw
- Department of Psychology, DePaul University, Chicago, Illinois
| | - Lei-Chun Fung
- Chinatown Public Health Center, San Francisco, California
| | - Chin-Shang Li
- Department of Public Health Sciences, University of California-Davis, Sacramento, California
| | - Yu Liu
- Department of Statistics, University of California-Davis, Sacramento, California
| | - Janice Y Tsoh
- Department of Psychiatry, University of California-San Francisco, San Francisco, California
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Abstract
Orofacial clefts are one of the most common global birth defects. Orofacial clefts may be part of a syndrome or an isolated birth defect, and affect approximately 1-1.5 per 1,000 live births worldwide with noted inequalities across geographical areas and cultures. In the United States, Asian American populations have a substantially higher incidence of cleft lip with or without cleft palate (2/1,000 live births). Orofacial clefts are a key health issue with substantial health care costs, and associated medical, psychological, and social ramifications. It has been estimated that the health care costs within the United States are approximately $697 million over a child's lifetime. In disorders like orofacial clefts, because of the complexity of the condition and subsequent medical interventions, as well as the cultural intricacies of the Asian culture, it requires significant knowledge and understanding by the health care providers. In order to provide optimal and safe cleft care, reduce health care costs, and improve the outcomes for the Asian American population, a culturally sensitive, multidisciplinary, and coordinated approach is needed. Increased culturally specific education, early access to prenatal care, and ongoing infant and pediatric health care are essential.
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Freitas E, Zhang G. Exploration of Patients' Spiritual/Religious Beliefs and Resuscitation Decisions. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2019; 78:216-222. [PMID: 31475249 PMCID: PMC6697654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Artificial resuscitation has potential to reverse a premature death or to prolong the dying process. The resuscitation decision is one of life and death making it imperative that healthcare providers understand patients' beliefs. Making the decision to resuscitate has been associated with patients' spiritual/religious beliefs. Clinicians' assumptions based upon a patients' religion or spiritual beliefs may bias the resuscitation decision. The purpose of this study was to determine associations between hospitalized patients' spiritual/religious beliefs and their resuscitation decisions. A single-site, correlational study was conducted with a convenience sample of hospitalized patients in Honolulu, HI. Patients were enrolled November 2015 to January 2016. Spiritual/religious beliefs were assessed using two validated metrics. Two questions were used to determine the resuscitation decision (chest compressions and intubation). The sample of 84 patients represented no ethnic majority among Caucasian, Asian, and Native Hawaiian/Pacific Islander. Seventy-nine percent of the participants identified theistic spiritual beliefs. No associations were found between resuscitation decisions with either spiritual/religious beliefs or demographic characteristics of this study sample. Interestingly, 20% of the participants answered yes to only one of the resuscitation decision questions. Thus, providers' assumptions should not be made about an association between spiritual/religious beliefs and resuscitation decisions. It is imperative that patients are aware of the necessity for both medical interventions of chest compressions and intubation. Further research should address the complexity of the resuscitation decision, including patients understanding of medical interventions and anticipated prognosis, and other influencing factors.
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