Prayer and Faith: Spiritual Coping among American Indian Women Cancer Survivors

Patient perceptions of nurses' cultural competence in public sector hospitals in Gauteng

Background

Healthcare institutions are increasingly receiving patients from diverse cultural backgrounds because of migration, rapid urbanisation, and easier access to healthcare. Because the satisfaction of these patients is linked to their perceptions of appropriate cultural care, understanding patient perspectives about cultural competence is imperative. Additionally, patient perceptions about nurses' cultural competence are largely unexplored in South Africa.

Aim

This study explored how the concept of cultural competence is perceived by patients.

Setting

Three public sector hospitals in Gauteng, one from each of the three different levels of public sector hospitals - district (level one), regional (level two), and academic (tertiary, level three).

Methods

This study derives from the qualitative phase of a larger sequential exploratory mixed methods study. The study population was patients in public sector hospitals. A total of 21 interviews were conducted after purposive stratified sampling was done. Data analysis followed Tesch's eight steps of data analysis.

Results

Patients in public sector hospitals in Gauteng believe consideration of culture is important in nursing. They identified the cultural needs they would like nurses to acknowledge, such as being asked about their food preferences and mentioned the need to evaluate nurses' level of cultural competence.

Conclusion

Patient perceptions about cultural competence and their cultural needs can assist nurses in gauging how culturally competent they are and improving care to patients.

Contribution

Patients' perceptions revealed that nurses must be competent to acknowledge their specific cultural needs such as food, language preferences, and religious practices.

"Prayer is Universal": How Integrative Faith Practices Enable Indigenous Peoples' Persistence and Resistance to Transcend Historical Oppression

Objective

Indigenous faith practices have enabled persistence, resistance, and transcendence despite centuries of settler colonial historical oppression. Spirituality, ceremony, and religious practices are fundamental aspects of Indigenous wellness, resilience, and liberation from a colonial mindset. The purpose of this research was understand U.S. Indigenous peoples' perspectives of spirituality and religion from the settler colonial framework of historical oppression, resilience, and transcendence (FHORT) as it relates to wellness.

Methods

Data from critical ethnographic interviews with 31 participants from rural reservation communities in the Southeast and an urban Northwest environment were analyzed using reconstructive thematic qualitative analysis.

Results

Themes include: (a) "You'd be persecuted … for your beliefs": Historical Oppression of Indigenous beliefs; (b) "I was always told that church was wherever you were": Integrative faith practices and (c) "No matter how hard times get … never forget to pray": Prayer through adversity.

Conclusions

Results clarified how settler colonial power differentials tended to relegate Indigenous spiritual and faith practices to a lower status than Western European religions, namely Christianity. Participants resisted this oppression by ingeniously integrating tribal and Western European faith practices to promote wellness. This article provides pathways to prevent clinical bias and harm by expanding awareness and familiarity with localized and heterogenous faith practices among Indigenous communities. Practitioners can honor Indigenous peoples' preferences, acknowledge Indigenous faith practices as central for wellness, and become reflexive about how an internalized settler colonial mindset may cause bias and perpetuate historical oppression by delegitimizing Indigenous worldviews and faith practices.

Cancer coping self-efficacy, symptoms and their relationship with quality of life among cancer survivors

PURPOSE

Cancer coping self-efficacy refers to an individual's confidence in dealing with challenges from cancer-related events, and a positive association with quality of life (QoL) has been demonstrated. Considering unresolved physical and psychological symptoms at the survivorship phase, which are known to worsen QoL, the association between cancer coping self-efficacy and QoL needs to be evaluated controlling for known contributing factors of QoL. This study aimed to describe cancer survivors' cancer coping self-efficacy, symptoms and their relationship with QoL.

METHODS

A descriptive correlational study was conducted. Participants were cancer survivors who completed intended treatment except for hormone therapy (N = 240). Cancer coping self-efficacy, symptoms, and QoL were measured. To evaluate the association of cancer survivors' cancer coping self-efficacy with QoL, correlation and multiple regression analysis were conducted.

RESULTS

Cancer coping self-efficacy demonstrated a significant positive association with QoL. Symptoms had a significant negative association with QoL. Fully active cancer survivors demonstrated significantly better QoL than those with functional deterioration. Self-efficacy for using spiritual coping had a significant positive association with QoL, along with symptoms and functional status, which explained 37.5% of QoL.

CONCLUSIONS

Cancer survivors' QoL was related to spiritual coping self-efficacy, symptoms and functional status. Improving spiritual coping self-efficacy and managing symptoms reflecting survivors' functional status need to be integrated into survivorship care.

A qualitative exploration of the spiritual wellbeing of women with advanced cervical cancer in Ghana

BACKGROUND

Spiritual wellbeing is one of the most important aspects of human health, alongside physical, psychological and social factors. Religiosity/spirituality can play a critical role in the lives of people experiencing life-threatening illnesses, such as cervical cancer. Most women with cervical cancer in Africa, including Ghana, are diagnosed at the advanced stage. These women lean on their spiritual connections for strength during their illness. Despite the fact that numerous studies have been conducted on the relevance of religiosity/spirituality in the experience of cancer in other jurisdictions, the same cannot be said about Ghana. The study aims to fill this gap in the literature.

AIM

To explore the spiritual wellbeing of women diagnosed with advanced cervical cancer in Ghana.

METHOD

A qualitative explorative design was employed, with purposive sampling used to recruit 15 women with advanced cervical cancer from a cancer treatment centre of a teaching hospital in Ghana. Individual face-to-face interviews, lasting between 45-90 minutes, were used to gather information. Interviews were audio taped with participants' consent. Data were analysed using thematic content analysis.

FINDINGS

The following sub-themes were identified within one overarching theme of the spiritual wellbeing of women with advanced cervical cancer: the meaning of illness and acceptance; a sense of hope and religiosity; uncertainty; and the will to live.

CONCLUSION

Many participants believed they were bewitched, and the devil was responsible for their cervical cancer. Healthcare providers should adopt a multi-disciplinary approach and widen their care strategies to include spirituality, to enhance the treatment outcomes of women living with advanced cervical cancer.

Determinants of Life Satisfaction and Quality of Life Among American Indian Women Cancer Survivors: The Role of Psychosocial Resources

PURPOSE

This study assessed the relationship of spirituality, social support, and sense of mastery to life satisfaction and quality of life to identify viable psychosocial coping resources among American Indian (AI) women cancer survivors.

METHOD

We conducted a cross-sectional survey of 73 AI women cancer survivors residing in South Dakota. A series of multivariate hierarchical regression analyses was conducted.

RESULTS

Findings indicated that lower self-rated physical health was consistently associated with lower levels of life satisfaction and quality of life. Spirituality was found to be the most influential predictor for life satisfaction, while social support and sense of mastery were two significant predictors for quality of life.

DISCUSSION

Our data underscored the importance of spirituality, social support, and sense of mastery to the well-being of AI women cancer survivors and as effective coping strategies to mitigate life stressors. Implications of this evidence for the design of cancer preventions and interventions are discussed.

On a pathway to resigned acceptance: Patients' experiences of living with symptom clusters in oral cancer

PURPOSE

Patients treated for oral cancer experience multiple concurrent symptoms. A larger mixed-methods study was conducted among patients who were treated with surgery alone or in combination with other modalities. The aim of the qualitative strand was to explore the experiences of living with symptom clusters.

METHODS

A phenomenological design was used to explore the lived experiences. Participants were recruited for the larger study from two outpatient units of a tertiary teaching hospital (N = 300). After completion of a survey, a maximum variation purposive subsample of 20 participants was drawn from the larger sample and were interviewed in-depth about their experiences. Thematic analysis was conducted.

FINDINGS

All participants experienced multiple concurrent symptoms, commonly including chewing difficulties + dry mouth + speech difficulties; chewing difficulties + dry mouth + diminished taste; and chewing difficulties + dry mouth + speech difficulties + trismus. Analysis of their experiences of living with these symptom clusters revealed six themes: Acknowledged Disruptions, Inner Dialogue, Shifting Expectations, Floods of Emotions, Exercising Control over Life, and Resigned Acceptance. These themes portrayed that time and living with symptom clusters lead to what we describe as a pathway to resigned acceptance. This pathway is intermingled with disruptions, self-reflections on 'why me' and karma, negative emotions, and failed expectations regarding symptom recovery. Attempts to exercise control over their lives were also revealed through coping strategies, watchful living, future planning, and being health advocates. On realizing with time that further symptom alleviation is unlikely, and considering symptom-cluster experiences as being written in their fate, they move towards a state of resigned acceptance. However, unlike passive acceptance, their belief in fate was accompanied with resilience, evidenced by their ongoing efforts to explore pragmatic ways to live with symptom clusters.

CONCLUSIONS

Findings provide key insights into patient perspectives which most often remain unexpressed in clinical settings. Further research is required to explore watchful living, fate as a coping strategy, and intertwining of faith, fate, and karma.

Developing Culturally Tailored Mobile Web App Education to Promote Breast Cancer Screening: Knowledge, Barriers, and Needs Among American Indian Women

American Indian (AI) women face disproportionate rates of breast cancer mortality and cancer disparities. This study conducted qualitative research to assess perspectives of AI women towards breast cancer screening, knowledge, barriers, and needs about mobile web app-based education to promote breast cancer screening. This study, in collaboration with the Yankton Sioux Tribe (YST), followed a community-based participatory research approach and conducted two focus groups with a total of 22 YST women aged 40-70 years living on reservation in rural South Dakota. Each group consisted of 11 local professionals working in healthcare and social services and community members. A grounded theory was used for the qualitative analysis. A large portion of participants reported having prior knowledge about breast cancer and screening methods, yet lacked awareness of the detailed procedure and recommended guidelines. Competing priorities and cost of mammograms were noted as major barriers to screening. Participants wanted to learn-in a convenient and easy-to-understand manner-more about breast cancer and prevention from a credible source. Both groups were favorable toward novel educational tools, such as the mobile web app education, and cited potential health benefits, particularly for women aged 40s to 60s. Our findings highlighted the importance of creating effective, culturally tailored educational interventions built into programs specific to AIs to increase understanding about breast cancer screening and promote screening behaviors among AI women. Particular attention to how AIs' culture, beliefs, and barriers are implicated in screening behaviors could help with developing culturally tailored health education tools for this population.

Why Are So Many Indigenous Peoples Dying and No One Is Paying Attention? Depressive Symptoms and "Loss of Loved Ones" as a Result and Driver of Health Disparities

Indigenous peoples have not only experienced a devastating rate of historical loss of lives, they are more likely to experience mortality disparities. The purpose of this article is to examine Indigenous women's lived experiences of grief and loss in two Southeastern tribes and the relationship between depressive symptoms and recent loss of a loved one. Our exploratory sequential mixed-methods research was informed by the Indigenous based Framework of Historical Oppression, Resilience, and Transcendence (FHORT). We summarized key qualitative themes from ethnographic data from 287 female participants across the two tribes, collected through focus groups, family interviews, and individual interviews. We then quantitatively examined how these themes predicted depressive outcomes among 127 respondents. Specifically, we examined associations between depressive symptoms and components of historical oppression-historical loss, loss of lives, and the presence of PTSD symptoms-along with resilience and transcendence.

Protective personality factors for stress in the elderly during COVID-19 pandemic: A cross-sectional study

Background/Aim. One of the anti-epidemic measures in the COVID-19 pandemic in 2020 in Serbia was the mandatory complete ban on movement for people over 65 years of age. Two main stress factors affecting their health have been identified: intensive media coverage of the new disease and total physical and even social isolation of the elderly. The aim of this study was to assess the immediate impact of these anti-epidemic measures to combat the COVID-19 epidemic in Serbia on the health of people over 65 years old and to recognize protective factors for their health in the conditions of their obligatory isolation. Methods. The cross-sectional study was conducted on a 20‰ sample of inhabitants over 65 (184 in total) in the urban part of the city of Kruševac, in the central part of Serbia, during April and May 2020. Results. Anti-epidemic measures to combat the COVID-19 epidemic have been associated with deteriorating health in a significantly large proportion of the elderly in the sample (approximately 84%), such as unreasonable fatigue, tension, difficulties performing routine activities due to immobility, concerns, sleeping disorders, and hypertensive episodes. Gender, higher education, and material status were not related to protection and emotional well-being, but some personality factors are related to stress resilience. Conclusion. The protective personality factors for health are the respondents' inclination toward hope, having a purpose in life, faith, optimism, interest, as well a high appreciation of positive emotions in the respondent's life (love, joy, enthusiasm, closeness, and belonging) and having a fulfilled emotional life.

Una aproximación desde la etnografía focalizada al papel de la religiosidad durante la vivencia del cáncer de mama

Resumen En este trabajo se exploró el papel de la religiosidad durante la vivencia del cáncer de mama de un grupo de mujeres del sur de Colombia. Se realizó una etnografía focalizada donde participaron 17 mujeres que padecen cáncer de mama en cualquier estadio de la enfermedad y que habían concluido el primer año de tratamiento. La información se recolectó a través de un grupo de discusión y diez entrevistas semiestructuradas. El análisis temático se utilizó para el tratamiento de los datos. Para las mujeres, la religiosidad fue esencial para la aceptación del padecimiento, al asumirlo como una oportunidad de crecimiento personal y, además, la consideraron una fuente de afrontamiento durante el padecimiento. Se concluye que acercarse al papel de la religiosidad, desde las voces de las mujeres, devela el esencial papel que juega durante la trayectoria del cáncer de mama y la imperiosidad de la inclusión de la atención religiosa como un componente esencial para las mujeres durante el padecimiento del cáncer de mama. Asimismo, es un llamado a la importancia que la investigación sobre este padecimiento no se centre solo desde una perspectiva biomédica.