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Hengelaar AH, Verdonk P, van Hartingsveldt M, Abma T. A sense of injustice in care networks: An intersectional exploration of the collaboration between professionals and carers with a migration background. Soc Sci Med 2024; 356:117169. [PMID: 39096534 DOI: 10.1016/j.socscimed.2024.117169] [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: 11/01/2023] [Revised: 07/24/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024]
Abstract
This study tries to understand the power of knowledge within collaborative care networks to provide insights for designing successful collaboration within care networks by combining intersectionality and epistemic (in)justice. Becoming an informal carer for someone with an acquired brain injury (ABI) causes a dramatic disruption of daily life. Collaboration between professionals and carers with a migration background may result in unjust and unfair situations within care networks. Carer experiences are shaped by aspects of diversity which are subject to power structures and processes of social (in)justice in care networks. In this study, intersectionality was used to both generate complex in-depth insights into the different active layers of carer experiences and focus on within-group differences. Intersectionality was combined with the theoretical concept of epistemic (in)justice to unravel underlying dynamics in collaborative care networks contributing to the understanding that carers with a migration background are often not seen as 'knowers of reality.' This qualitative study conducted in the Netherlands between 2019 and 2022 incorporated three informal group conversations (N = 32), semi-structured interviews (N = 21), and three dialogue sessions (N = 7) with carers caring for someone with an ABI. A critical friend and a community of practice, with carers, professionals, and care recipients (N = 8), contributed to the analysis. Three interrelated themes were identified as constituting different layers of the carer experience: (a) I need to keep going, focusing on carers' personal experiences and how experiences were related to carers social positioning; (b) the struggle of caring together, showing how expectations of family members towards carers added to carer burden; and (c) trust is a balancing act, centering on how support from professionals shaped carers' experiences, in which trusting professionals' support proved challenging for carers, and how this trust was influenced by contextual factors at organizational and policy levels. Overall, the need for diversity-responsive policies within care organizations is apparent. Carers with a migration background need to feel heard so they can meaningfully tailor care to meet recipients' needs.
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Affiliation(s)
- Aldiene Henrieke Hengelaar
- Department Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam UMC, Location VUmc and Department of Occupational Therapy, Faculty of Health, Amsterdam University of Applied Science, Tafelbergweg 51, 1000CN Amsterdam, the Netherlands.
| | - Petra Verdonk
- Department Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam UMC, Location VUmc, de Boelelaan 1105, 1081 HV Amsterdam, the Netherlands.
| | - Margo van Hartingsveldt
- Department of Occupational Therapy, Faculty of Health, Amsterdam University of Applied Science, Tafelbergweg 51, 1000CN Amsterdam, the Netherlands.
| | - Tineke Abma
- Department Public Health and Primary Care, Leiden University Medical Centre, Leiden University and Leyden Academy on Vitality and Ageing, Rijnsburgerweg 10, 2333 AA Leiden, the Netherlands.
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Lillekroken D, Bye A, Halvorsrud L, Terragni L, Debesay J. Food for Soul-Older Immigrants' Food Habits and Meal Preferences After Immigration: A Systematic Literature Review. J Immigr Minor Health 2024; 26:775-805. [PMID: 38165601 PMCID: PMC11289087 DOI: 10.1007/s10903-023-01571-5] [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] [Accepted: 11/21/2023] [Indexed: 01/04/2024]
Abstract
There are few primary studies that focused on the older immigrants' food habits and meal preferences after immigration and settlement in a new country. A comprehensive database search for literature was conducted in May 2021 and upgraded in September 2021. Ten databases (Medline (Ovid), EMBASE (Ovid), PsycInfo (Ovid), Cinahl (EBSCOhost), Food Science Source (EBSCOhost), SocIndex (EBSCOhost), Social Care Online, Applied Social Sciences Index & Abstracts (ASSIA), Web of Science and Google Scholar), were scanned for original, peer-reviewed papers published in English. The review was conducted and reported in accordance with the PRISMA 2020 guidelines and SWiM items. Out of 3069 records, 10 papers were included for thematic synthesis. A data synthesis across all studies resulted in three main findings: (i) the significance of food in maintaining cultural identity, (ii) the continuity of traditional food culture and (iii) adapting to the host country's food culture. Although different forms of dietary acculturation occur throughout life, older immigrants often want to maintain their traditional food habits and meal preferences. For them, traditional eating habits offer comfort and security by serving as a means of identifying who they are and reminding them where they have come from. Public health and social services play an important role in providing cultural nutritional care to older immigrants; therefore, this issue should be carefully addressed by professionals and future research.Registration: The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on 27 September 2022 with registration number CRD42022358235.
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Affiliation(s)
- Daniela Lillekroken
- Department of Nursing and Health Promotion, Oslo Metropolitan University, PB 4, St. Olavs Plass, N-0130, Oslo, Norway.
| | - Asta Bye
- Department of Nursing and Health Promotion, Oslo Metropolitan University, PB 4, St. Olavs Plass, N-0130, Oslo, Norway
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Liv Halvorsrud
- Department of Nursing and Health Promotion, Oslo Metropolitan University, PB 4, St. Olavs Plass, N-0130, Oslo, Norway
| | - Laura Terragni
- Department of Nursing and Health Promotion, Oslo Metropolitan University, PB 4, St. Olavs Plass, N-0130, Oslo, Norway
| | - Jonas Debesay
- Department of Nursing and Health Promotion, Oslo Metropolitan University, PB 4, St. Olavs Plass, N-0130, Oslo, Norway
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Kabir ZN, Tyrrell M, Konradsen H, Craftman Å, Joshi N, Gupta MK, Sharma S, Bhardwaj P. mHealth based intervention by social care professionals to support family caregivers to persons with dementia living at home in Sweden (Caregiver Connect): a randomized controlled trial. BMC Geriatr 2024; 24:519. [PMID: 38877412 PMCID: PMC11177475 DOI: 10.1186/s12877-024-05106-x] [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: 09/21/2023] [Accepted: 05/24/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND The majority of persons with dementia in Sweden reside in their own homes with support from family members. Approximately, 12% of persons with dementia have immigrant background. Within the next 20 years, the number of persons with dementia who are non-ethnic Swedes is said to double. Family caregivers with immigrant backgrounds are noted to receive less support in the community than ethnic Swedes and rate their health status lower than ethnic Swedish peers. The Swedish National Board of Health and Welfare have highlighted the importance of follow-up support for family caregivers with immigrant backgrounds as there is a recognized gap in research and available information tailored to meet the needs of this group. PURPOSE OF THE STUDY The purpose of the study is to test effectiveness of an mHealth based intervention through which community social workers can improve caregiving competence of non-European immigrant family caregivers of people with dementia living at home in Sweden. The overarching aim is to reduce caregiver burden and depressive symptoms, and improve quality of life. METHODS A randomized controlled trial (RCT) including wait list control group will be performed consisting of an intervention group (A, n = 44) and a wait list control group (B, n = 44), totaling a sample size of 88. On completion of the 10-weeks long intervention in the intervention group, the intervention will be delivered to group B. Effect of the intervention will be analyzed between and within groups over time. The content of the educational component of the intervention is inspired by the iSupport manual developed by the World Health Organization. The contents, in the form of a booklet, aims to equip the family caregivers with structured information on understanding dementia as a condition and its management at home, including self-care guidance designed specifically for family caregivers themselves. DISCUSSION Similar telephone-delivered intervention studies targeted for family caregivers to persons with dementia are ongoing in Malaysia and will start in India using the same booklet adapted to the local context. These studies will provide evidence on the effectiveness of using digital technologies to deliver support to those who may not be reached or adequately served by the traditional healthcare system. TRIAL REGISTRATION ISRCTN registry, Registration number ISRCTN64235563.
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Affiliation(s)
- Zarina Nahar Kabir
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, 141 52, Sweden.
| | - Marie Tyrrell
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, 141 52, Sweden
- Department of Nursing, Sophiahemmet University, Valhallavägen 91, Stockholm, 11428, Sweden
| | - Hanne Konradsen
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, 141 52, Sweden
| | - Åsa Craftman
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, 141 52, Sweden
| | - Nitin Joshi
- School of Public Health, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Manoj Kumar Gupta
- School of Public Health, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Suresh Sharma
- College of Nursing, All India Institute of Medical Sciences (AIIMS), Jodhpur, 342005, India
| | - Pankaj Bhardwaj
- School of Public Health, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, 342005, India
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Yilmaz-Aslan Y, Annac K, Aksakal T, Yilmaz H, Merz S, Wahidie D, Razum O, Brzoska P, Tezcan-Güntekin H. What Self-Management Skills Do Turkish Caregivers Have in Caring for People with Dementia? Results of a Qualitative Survey. Healthcare (Basel) 2024; 12:1187. [PMID: 38921301 PMCID: PMC11202945 DOI: 10.3390/healthcare12121187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/27/2024] Open
Abstract
Family caregivers can be overwhelmed by the care they provide within the family without external support. The development of self-management skills and the associated ability to actively and responsibly manage one's own health or illness situation therefore plays a vital role in the home care of people living with dementia. As part of an individualized intervention for family caregivers of people of Turkish origin with dementia, existing self-management skills were examined through qualitative interviews to gain insight into health literacy and empowerment in caregiving and in interviewees' own practices to maintain their health. Ten caregivers of Turkish origin who were responsible for family members living with dementia were interviewed using problem-centered interviews. We found that the target group has very heterogeneous self-management competencies, which are based, on the one hand, on existing supportive resources and, on the other hand, on diverse care-specific, psychosocial and life-world challenges in intrafamily care that have not been overcome. Self-management skills in family caregivers are influenced by a complex interplay of both available resources that support these skills and challenging caregiving situations. This dynamic combination of resources and challenges results in varying levels of self-management ability among family caregivers. Strengthening resources can help caregivers to meet the challenges resulting from caregiving and to expand their self-management competencies. There is great need for action in promoting self-management skills among Turkish caregivers of people living with dementia in home care. Interventions to promote self-management skills must take into account the individual resources of those affected as well as their social and cultural diversity.
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Affiliation(s)
- Yüce Yilmaz-Aslan
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, 33615 Bielefeld, Germany; (Y.Y.-A.); (K.A.); (T.A.); (H.T.-G.)
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany; (D.W.); (P.B.)
| | - Kübra Annac
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, 33615 Bielefeld, Germany; (Y.Y.-A.); (K.A.); (T.A.); (H.T.-G.)
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany; (D.W.); (P.B.)
| | - Tugba Aksakal
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, 33615 Bielefeld, Germany; (Y.Y.-A.); (K.A.); (T.A.); (H.T.-G.)
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany; (D.W.); (P.B.)
| | - Hüriyet Yilmaz
- Intercultural Specialized Services of the Arbeiterwohlfahrt UB Gelsenkirchen/Bottrop, 45881 Gelsenkirchen, Germany;
| | - Sibille Merz
- Department of Health and Education, Alice Salomon University of Applied Sciences, 12627 Berlin, Germany;
| | - Diana Wahidie
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany; (D.W.); (P.B.)
| | - Oliver Razum
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, 33615 Bielefeld, Germany; (Y.Y.-A.); (K.A.); (T.A.); (H.T.-G.)
| | - Patrick Brzoska
- Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, 58455 Witten, Germany; (D.W.); (P.B.)
| | - Hürrem Tezcan-Güntekin
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, 33615 Bielefeld, Germany; (Y.Y.-A.); (K.A.); (T.A.); (H.T.-G.)
- Department of Health and Education, Alice Salomon University of Applied Sciences, 12627 Berlin, Germany;
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Moser A, Korstjens I. Series: Practical guidance to qualitative research. Part 7: Qualitative evidence synthesis for emerging themes in primary care research: Scoping review, meta-ethnography and rapid realist review. Eur J Gen Pract 2023; 29:2274467. [PMID: 37902265 PMCID: PMC10990260 DOI: 10.1080/13814788.2023.2274467] [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: 03/15/2023] [Accepted: 10/09/2023] [Indexed: 10/31/2023] Open
Abstract
This article, the seventh in a series aiming to provide practical guidance for qualitative research in primary care, introduces qualitative synthesis research for addressing health themes in primary care research. Qualitative synthesis combines rigorous processes and authorial judgement to present the collective meaning of research outputs; the findings of qualitative studies - and sometimes mixed-methods and quantitative research - are pooled. We describe three exemplary designs: the scoping review, the meta-ethnography and the rapid realist review. Scoping reviews aim to provide an overview of the evidence/knowledge or to answer questions regarding the nature and diversity of the evidence/knowledge available. Meta-ethnographies intend to systematically compare data from primary qualitative studies to identify and develop new overarching concepts, theories, and models. Rapid realist reviews aim to provide a knowledge synthesis by looking at complex questions while responding to time-sensitive and emerging issues. It addresses the question, 'what works, for whom, in what circumstances, and how?'We discuss these three designs' context, what, why, when and how. We provide examples of published studies and sources for further reading, including manuals and guidelines for conducting and reporting these studies. Finally, we discuss attention points for the research team concerning the involvement of necessary experts and stakeholders and choices to be made during the research process.
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Affiliation(s)
- Albine Moser
- Faculty of Health Care, Research Centre Autonomy and Participation of Chronically Ill People, Zuyd University of Applied Sciences, Heerlen, The Netherlands
- Faculty of Health, Medicine and Life Sciences, Department of Family Medicine and Department of Health Service Research, Maastricht University, Maastricht, The Netherlands
| | - Irene Korstjens
- Faculty of Health Care, Research Centre for Midwifery Science, Zuyd University of Applied Sciences, Maastricht, The Netherlands
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