Health perceptions of Mexican American women

Psychosocial Determinants of Mental Healthcare Use Among Mexican-origin Women from Farmworker Families in Southern California

Little is known about the contribution of psychosocial factors related to mental healthcare use among Mexican-origin women from farmworker families. Therefore, this study assessed relationships between acculturative stress, depressive symptoms, mental healthcare service use, and preferences for seeking care. Linear and logistic regression models and chi-square tests were performed to analyze survey data from 78 Mexican-origin women from farmworker families. Women were recruited in collaboration with promotoras and completed measures of acculturative stress, depressive symptoms, and mental healthcare use and preferences. Overall, 29.5% of the sample reported clinically significant depressive symptomatology. Acculturative stress was positively associated with depressive symptoms (b = 0.43, 95%CI = 0.27,0.59) after controlling for years in the U.S., primary language, and demographic characteristics. In addition, acculturative stress was associated with lower odds of mental healthcare use (OR = 0.96) after controlling for years in the U.S. and depressive symptoms. However, this association was no longer statistically significant when controlling for health insurance status and access to transportation. Mexican-origin women with high levels of acculturative stress were significantly more likely to seek care from a psychiatrist/psychologist than their peers (54.3% vs. 45.7%); however, this preference was not indicative of their use of mental healthcare services. Results suggest that acculturative stress is a risk factor for depressive symptoms and might contribute to a delay in seeking mental healthcare services in Mexican-origin women from farmworker families. Thus, interventions for this group should address aspects of acculturative stress as a strategy to increase mental health services use.

From Physical to Spiritual: A Qualitative Study of Jakartans Health & Sickness

Understanding the perceptions of health and sickness can help the government, health providers and health promoters encourage individuals to participate in healthy behaviors and to follow a healthy lifestyle. Jakarta, the capital city of Indonesia, is a culturally, socially and financially diverse city, with complex health care needs. As yet, there is no published data available about Jakartans’ (i.e., the citizens of Jakarta city) perceptions on health and sickness. This study aimed to describe what health and sickness mean to Jakartans. To this means, we collected data using an open-ended survey about the meanings of health and sickness from 640 Jakartans. Five main themes of health and sickness emerged. The five themes of health were health as a physical condition, a psychological condition, a spiritual condition, a capability to carry out daily activities, and a healthy lifestyle. The themes regarding sickness were sickness as a physical condition, a psychological condition, an abnormal circumstance or bad situations, a spiritual condition, and an inability to carry out daily activities. We discussed how the above-mentioned perceptions might influence the daily health-related behaviors of Jakartans. In contrast to the typical biomedical approach, we found that, in Jakarta, health was not merely seen as a causal effect of the physical world. Further details are discussed.

Psychiatric nursing care experiences of immigrant patients: A Focused ethnographic study

This study aimed to describe the psychiatric nursing care experiences of immigrant patients. The incidence of mental health problems is higher and the use of mental health services is lower among immigrants, especially refugees, compared with the majority of the population. The study uses a qualitative research approach, with an emphasis on focused ethnography research methods. The participants were immigrant patients (N = 14) residing in adult psychiatric wards of certain hospitals (N = 3) selected for the study. A majority of the participants were refugees or asylum seekers. A total of 21 in-depth interviews were conducted. The experiences of these immigrant patients, both in their home countries and in their country of residence, had had an adverse effect on their mental health, with past traumatic experiences being the most central factor. Their symptoms included depression, anxiety, somatization, and psychosis. The findings show that the categories of factors that helped promote recovery among immigrant patients were nursing, medical treatment, care environment, and the patients' own methods. Based on the findings, a systematic evaluation of traumatic experiences is recommended for immigrants from countries with a history of war and/or political violence. Healthcare providers should also consider the importance of cultural desire in psychiatric nursing for the recovery of patients.

Spirituality and Resilience Among Mexican American IPV Survivors

Women with abusive partners use a variety of coping strategies. This study examined the correlation between spirituality, resilience, and intimate partner violence using a cross-sectional survey of 54 Mexican American women living along the U.S.-Mexico border. The meaning-making coping model provides the conceptual framework to explore how spirituality is used as a copying strategy. Multiple ordinary least squares (OLS) regression results indicate women who score higher on spirituality also report greater resilient characteristics. Poisson regression analyses revealed that an increase in level of spirituality is associated with lower number of types of abuse experienced. Clinical, programmatic, and research implications are discussed.

Cardiovascular Risk among Older Hispanic Women

This study used a descriptive correlational design to describe the relationship between cardiovascular risk and anxiety, spirituality, acculturation, and the objective indices of cardiac risk among a sample of 21 adult Hispanic women. Objective indices of risk included weight, blood pressure, blood lipids, and glucose. Four survey instruments were used to assess anxiety, spirituality, acculturation, and perceived risk. Findings revealed that all study participants had 3 or more risk factors, placing them in the moderate risk category for developing heart disease or having a heart attack within 10 years. State and trait anxiety scores were lower than the normative samples for adult women. Spirituality scores were higher than average; individuals with higher anxiety scores had lower spirituality scores. More research is needed to determine the health needs of unskilled workers with limited education in employment settings.

Perceived Health Needs of Elderly Mexicans Living on the U.S.-México Border

This descriptive study explores the health beliefs of an underserved elderly group to gain insight regarding their self-perceived health needs. Focus groups were conducted with 112 elderly Mexicans living on the U.S.-México border. Participants were asked questions regarding positive aspects of aging, self-perception of health status, and health care service needs. Discussions were tape recorded, transcribed, and translated from Spanish into English. Several themes were identified: Many felt having knowledge gained from life experience and raising a family was positive; participants indicated their overall health status was poor; and they believed it was difficult to access quality health care services. Many participants self-reported that health status depended on socioeconomic status, family support, chronic diseases, and previous lifestyle. These findings can help develop culturally appropriate interventions designed to improve the overall health of the elderly living on the U.S.-México border.

Balance, balancing, and health

In this article we explore the concept of balance in the context of health. We became interested in balance during a grounded theory study of lay conceptualizations of cancer risk in which participants were concerned with having a good life, which relied heavily on balancing processes. This led us to the qualitative literature about balance in the context of health, which was large and in need of synthesis. We identified 170 relevant studies and used Thomas and Harden's technique of thematic synthesis to identify key balance-related themes and develop these into more abstract analytic categories. We found that balance and balancing were salient to people in three health-related contexts: health maintenance, disease or disability management, and lay or professional caregiving. In each of these contexts, balance or imbalance could be a state or a process. In addition, those using the word balance had either an internally or externally focused orientation to the world around them. Clinicians and public health practitioners might benefit from using these insights in their research and communication.

Migrant farmworker mothers talk about the meaning of food

PURPOSE

To describe the meaning of food in the family life of migrant farmworker mothers; specifically to describe their understanding of the relationship of dietary intake to health, the environmental contributors to their families' dietary intake, and the use of foods in the commemoration of family occasions.

METHODS

The PRECEDE-PROCEED self-management model guided the qualitative research study, which used short, guided interviews conducted at Midwest migrant camps. A sample of 43 Mexican mothers answered three interview questions, the answers to which were transcribed verbatim, read, sorted, and arranged into categories and then themes. Thematic analysis was used to analyze the data.

RESULTS

The themes identified from the interviews were a) meal cost, b) lack of preparation time, c) distance to store locations, d) the importance of traditional ethnic foods, and e) limited knowledge of healthy food choices.

CLINICAL IMPLICATIONS

Pediatric nurses should remember that before they dispense nutritional anticipatory guidance, situational and cultural assessments are needed. Because vulnerable populations such as migrant farmworkers have limited resources to follow nurses' teachings, nurses need to become knowledgeable about what is available in the community to support these families. In addition, facility appointment times may need to be expanded to accommodate their long work hours, and modes of transportation need to be evaluated. Recommendations for anticipatory guidance, prescriptions, treatments, and over-the-counter items need to consider cost and ease in purchase, and cultural acceptability.

Latino Women's Spiritual Beliefs Related to Health

PURPOSE

This study employed qualitative research to describe the relationship between spirituality and overall health among a sample of Latino women. A framework is presented for understanding this complex relationship.

DESIGN

Findings are presented from a qualitative analysis of six 1.5-hour focus group sessions.

SETTING

The research was conducted among Latino women living in Chicago, Illinois, and Northeastern New York communities. We employed a community-based participatory research approach in which community members were active participants throughout the research process.

SUBJECTS

Subjects were 47 Latino women 31 to 81 years, all of whom were Christian and the majority (43%) of whom had less than a high school education. Twenty-seven percent reported having high school diplomas, and the same percentage reported at least some college. Of the women who answered the questions, one did not have health insurance, 69% had public health insurance, and 29% had private health insurance.

MEASURES

Grounded theory using selective coding was employed to understand the relationship between spirituality and health and to develop the conceptual framework.

RESULTS

Spirituality was expressed as a vital component of health, and the belief in a need for balance of physical, mental, and spiritual health was described. An active and a passive relationship between spirituality and health emerged, with active being most common. Asking God for help or faith as a coping strategy were subdomains of the active relationship, and God responsible for health fell under the passive domain. These relationship types influenced beliefs about participation in one's own health.

CONCLUSION

The findings that emerged contribute to an understanding of how spirituality plays a role in health beliefs among Latino women, which has implications for health promotion research and program development for addressing health disparities.

Nurse Perceptions and Experiences of Patient Health Assets in Oncology Care: A Qualitative Study

Health assets, a term that refers to patients’ strengths and potentials, has emerged as an important aspect of health care. A conceptual analysis of health assets revealed five core dimensions: mobilization, motivational, relational, volitional, and protective strengths. How nurses experience and use patients’ health assets, however, is unknown. In this qualitative study, 26 expert nurses in cancer care participated in focus group interviews. The nurses had a large repertoire of experiences with cancer patients’ health assets. When the data were subjected to thematic analysis, three new core dimensions were revealed: cognitive, emotional, and physical strengths. Balancing processes within and among health assets—identified as an overriding theme—appeared to be affected by individual and contextual variations. The nurses realized that patients’ health assets could be better used and voiced a need for the clinical and organizational support to do so. New issues about health assets raised in this study may be caused by its novel context (e.g., expert nurses in oncology care). More research is needed on health assets in other contexts, such as patients with different health problems, and of possible strategies to support nurses’ use of health assets.

A cognitive-behavioral group therapy intervention with depressed Spanish-speaking Mexican women living in an emerging immigrant community in the United States

This article reports feasibility issues with the implementation of an intervention study for depression in Latina women from Mexico living in an emerging immigrant community in the United States. Based on the PRECEDE-PROCEED model, the study explores implementation issues such as the intervention and retention, logistical issues such as transportation and childcare, and possible measurement issues such as reliability and validity of the Center for Epidemiologic Studies-Depression Scale, Spanish version. Future studies should evaluate the Center for Epidemiologic Studies-Depression Scale, Spanish version, and test the modified cognitive-behavioral group therapy intervention in larger samples and through randomized controlled studies.

Child Health Promotion and Protection Among Mexican Mothers

For numerous reasons, children of Mexican descent experience many health disparities. One strategy for addressing these disparities is to increase health promotion and protection behaviors that mothers use with their preschool children. Limited literature is available on such practices used by mothers of Mexican descent with their healthy preschool children. This study explored child health promotion and protection practices used by mothers of Mexican descent. A naturalistic design, guided by Spradley's ethnographic interview techniques, was selected for this study. The sample included 9 Mexican-descent mothers from an urban U.S. community with healthy preschool children. Despite significant challenges, participants promoted and protected the health of their preschool children by al cuidado (taking care) and by being al pendiente (being mindful) of balancing the health of their children's bodies, minds, and souls. Understanding these mothers' approaches allows the creation of culturally sensitive health programs that can build on existing maternal strengths.

Factors contributing to depression in latinas of mexican origin residing in the United States: implications for nurses

BACKGROUND

Latinas experience more depression and are less likely to receive mental health support than White women or African American women.

OBJECTIVE

This article synthesizes the research on depression in adult Latinas of Mexican origin residing in the United States.

STUDY DESIGN

MEDLINE (PubMed), The Cumulative Index of Nursing and Allied Health Literature (CINAHL), and PsycINFO databases for the years 2000 through 2008 were searched using the keywords Latina, Latino, Hispanic, Mexican American, Mexican immigrant, women, and depression.

RESULTS

The process of acculturation and associated stressors may have a negative effect on the mental health of women of Mexican origin residing in the United States. Separation from family, harmful interpersonal relationships, unmet economic needs, conflict, and isolation may contribute to depression in this population.

CONCLUSIONS

More research is needed on the influence of family and economic strain as well as the effectiveness of assessments and interventions for depression in Mexican and Mexican American women, especially for those living in emerging Latina/o immigrant communities. J Am Psychiatr Nurses Assoc, 2008; 14(3), 193-204. DOI: 10.1177/1078390308319034.

Mexican American women aging with childhood-onset paralytic polio

In this study the life histories of 11 Latinas of Mexican American descent aging with permanent impairment related to childhood-onset paralytic polio were explored. These women, age 45 to 62 years, were interviewed 3 times each. Field notes, audiotaped interviews, life course charts, and demographic data were used to collect data chronicling childhood to present day. In the results we present a thematic representation of the societal and cultural influences on the life course trajectories of these women.

Voices of Mexican American Caregivers for Family Members With Cancer

This grounded theory study report describes the experience of 34 Mexican American (MA) female caregivers who provided care to a family member with cancer. Caregivers identified a process of “Becoming Stronger” as a result of their caregiver role. The emerging theoretical model of female MA cancer caregiving offers evidence to change current cancer care approaches from patient-focused to family-focused care for this ethnic group. Findings suggest that changes most responsive to cultural values and likely to provide accessible and quality cancer care for MA families are those that involve active partnering with MA caregivers to prioritize the patient's cancer care.

Connection between the meaning of health and interaction with health professionals: caring for immigrant women

The meaning of health perceived by adult immigrant women in Canada is discussed from the perspectives of immigration, culture, and lived experience to understand their encounters with health care professionals. Authors base their findings on the thematic analysis of focus group data. Immigrant women viewed health as the outcome of a web of interactions between conditions of mental, physical, social, emotional, environmental, and spiritual well-being, appealing to both biomedical and phenomenological ideologies. Our analyses of qualitative data revealed that the disagreements noted by immigrant women when interacting with health care professionals were due to the discrepancies between their cultural views of health and the dominant biomedical perspective.

Cultural responses to health among Mexican American women and their families

Based on an in-depth analysis of current empirical research, this article presents a framework for understanding the cultural experience of the Mexican American population and presents implications for innovative health promotion practices with women and their families. The framework sheds light on the complex ways in which individuals from this population integrate their cultural values in their everyday responses to health. Three patterns emerge: (a) cultural expectations and beliefs can be shared by and work complementarily in the family and the larger social context; (b) cultural beliefs can be a source of tension and stress as a result of pressures in the environment; and (c) cultural values can become less important than other concerns, such as problems related to access when dealing with the healthcare system.

An examination of sociocultural factors associated with health and health care seeking among Latina immigrants

The purpose of this study was to examine the sociocultural factors associated with health maintenance and health care seeking among Latina immigrants. Data were collected from eight focus groups with 54 Latina immigrants between the ages of 19 and 62 (M=29.3+/-9.34). The PEN-3 model provided the framework for the study. Most of the participants came from Mexico; 46% had not completed high school; 85.2% had been in the United States for less than 7 years, and 73.6% reported not having health insurance coverage. Participants identified both positive and negative perceptions, enablers, and nurturers associated with health maintenance and health care seeking. Participants acknowledged the importance of physical, mental, and spiritual health and what they should do to be healthy. Despite such knowledge, they tended to engage in unhealthy behaviors due to a variety of nonstructural barriers such as lack of time, "tradition," and procrastination. They tended to use alternative/complementary medicine first, and then seek medical help if these practices are not effective. Many women believe that they do not have control over their own health attributing this lack of control to the "system." Participants also mentioned structural barriers to seeking health care such as lack of transportation, lack of proper documentation, lack of health insurance, language barriers, long waiting time at the clinics, and lack of knowledge on where to go for affordable care. Our study suggests that there are important structural and nonstructural barriers that hinder health maintenance and care seeking. The findings also lend support to the PEN-3 model, and suggest that positive perceptions, enablers, and nurturers associated with health maintenance and health care seeking, if properly reinforced, can counterbalance negative perceptions, enablers and nurturers in this population.

The social construction and conceptualization of sexual health among Mexican American women

Research on the social construction and contextualization of sexual health among Latina women is sparse. This ethnographic study was aimed to bridge this gap by exploring sexual health experiences and behaviors of a Latina subgroup, Mexican American women. A series of individual semistructured, in-depth interviews were conducted with 20 Mexican American women from a sexual and reproductive health clinic in a large Southwestern city with a predominantly Mexican American population. Through thematic analysis, sacrificing of self, sexual silence, and taking control of self emerged as themes. These themes reflect the context within which construction of sexual health occurs and sexual health behaviors are influenced. Study findings are discussed within a socio-cultural framework for sexual health promotion intervention for both adolescent and adult Mexican American women.

An Exploration of Spirituality in Rural Women With Chronic Illness

The purpose of this study was to explore expressions of spirituality in rural women with chronic illness. Six categories that emerged were prayer, faith, verse, finding meaning, transcendence, and family. Results of this study were consistent with findings in previous literature that spirituality can be an extremely helpful and powerful coping mechanism that can be used in managing the stressors of a chronic illness. Spirituality is an important illness management tool that needs to be acknowledged by healthcare professionals.

Struggle as the Context of Household Health Work for Mexican American Women

A focused ethnographic study was conducted among 13 moderately to highly acculturated American mothers of Mexican ancestry to determine how they influence the health of their family members. Using the World Health Organization (WHO) definition of health (a state of physical, mental, and social well-being and not merely the absence of disease) as a guide for interview questions, we conducted 32 in-depth interviews with study participants. The thread of struggle ran through each woman's narrative. Women's process of struggle is presented as one way to conceptualize the gendered nature of household health work.

Sources of emotional help sought by low income women of Mexican descent

From a larger convenience sample of 315 women of Mexican descent, the focus of this secondary analysis of cross sectional data was a subset of 68 women who reported that they sought help for feelings of sadness, hopelessness, or depression within the last year Women who sought help from professional sources had significantly higher depressive (CES-D) and PTSD (IES-R) symptoms than women who sought help from "other or multiple" sources that included friends. Women who sought help exclusively from family or from professionals scored over the CES-D and IES-R cutpoints. Results are useful for designing future research on help-seeking preferences of Latina women.

Positive pregnancy outcomes in Mexican immigrants: what can we learn?

OBJECTIVE

To provide an integrated review of the literature of potential explanations for better than expected pregnancy outcomes in Mexican immigrants, focusing on socioeconomics, social support, desirability of pregnancy, nutrition, substance use, religion, acculturation, and prenatal care.

DATA SOURCES

Computerized searches of MEDLINE and CINAHL databases, as well as reference lists from published articles on low birth weight and prematurity in immigrants and acculturation in immigrants from January 1989 to December 2002. Search terms were Mexican immigrant women, childbearing, and pregnancy outcome, and only English-language articles were reviewed.

STUDY SELECTION

Literature was selected from refereed publications in the areas of nursing, medicine, public health, family, and sociology.

DATA EXTRACTION

Data were extracted using keywords pertinent to pregnancy outcome in Mexican immigrants.

DATA SYNTHESIS

Despite having many of the risk factors for poor pregnancy outcomes, Mexican immigrants have superior birth outcomes when compared to U.S.-born women. Social support, familism, healthy diet, limited use of cigarettes and alcohol, and religion may play a role in improved outcomes. The superior outcomes diminish with the process of acculturation as the individual adapts to her new culture.

CONCLUSIONS

Low birth weight and prematurity are public health concerns in the United States. Through further study of the factors that lead to superior birth outcomes among Mexican immigrant women, rates of low birth weight and prematurity in the United States may be reduced.

Creating healthy environments: household-based health behaviors of contemporary Mexican American women

This article describes the household-based health behaviors of a sample of contemporary Mexican American women.1 Using the Household Production of Health (HHPH) as a conceptual framework and ethnographic methods of inquiry, 13 moderately to highly acculturated women of Mexican ancestry participated in multiple interviews about their health beliefs and household health behaviors. This article examines the findings related to the following research question: What are the health-producing and help-seeking behaviors (proximate determinants of health) used by Mexican American women to produce health? Themes focusing on creating healthy environments and treating illness are discussed. Awareness of the activities that women use to create and support household health can enhance the practice of nurses interested in supporting women's health work and improving health outcomes in the Mexican American community.

Health-promoting lifestyle behaviors of Spanish-speaking Hispanic adults

The study purpose was to determine (a) health-promoting lifestyle behaviors of Spanish-speaking Hispanics, (b) differences in these behaviors by demographics and acculturation, and (c) the extent to which perceived health status, demographics, and acculturation explain health-promoting lifestyles. The Spanish-language Health-Promoting Lifestyle Profile II (HPLPII) and other instruments were completed by a convenience sample of 545 Hispanic adults recruited in several midwestern communities. Of the six behavioral dimension scores of the HPLPII, scores were lowest for physical activity and highest for spiritual growth. They differed by age, gender, employment status, marital status, and acculturation. Perceived health status, demographics, and acculturation explained 12% of the variance in overall health-promoting lifestyle. These findings can help guide culturally appropriate interventions designed to improve this population's overall health.