Gender differences in beliefs about health: a comparative qualitative study with Ghanaian and Indian migrants living in the United Kingdom

Back pain beliefs among Indian migrants in Australia: a cross-sectional study

PURPOSE

One of the largest migrant communities in Australia is the Indian migrant community. Current back pain guidelines recommend assessment of patients' beliefs; however, little is known about these beliefs in Indian communities. We aimed to investigate beliefs about back pain among Indian migrants living in Sydney.

MATERIAL AND METHODS

An online questionnaire with demographic information, participant characteristics, the Back Beliefs Questionnaire (BBQ) and open-ended questions relating to beliefs about causes of back pain and treatment preferences was completed by 386 Indian migrants in Sydney.

RESULTS

The overall BBQ score was 25.1 ± 6.7. We found significant but slightly more positive beliefs among Indian females than Indian males (standardized regression coefficient, β = 0.134, p = 0.014). Presence and severity of pain did not affect back pain beliefs. There seemed to be a belief in physical and structural/anatomical causes of back pain, and a belief in the effectiveness of exercise, medications, and Indian traditional approaches for pain management.

CONCLUSIONS

Beliefs of Indian migrants aligned with a "western traditional" biomedical model for the cause of pain, but with a belief in the effectiveness of both Indian traditional and western treatment approaches. Awareness of these beliefs could enable an effective therapeutic alliance between clinicians and Indian patients.IMPLICATIONS FOR REHABILITATIONBack pain beliefs of Australian Indian migrants are similar to their western counterparts, so the current guidelines for back pain can potentially be implemented without too much adjustment for this migrant community.Awareness of these beliefs is likely to improve the therapeutic alliance between clinician and an Indian migrant patient.

A Rapid Review of Interventions to Increase Hepatitis B Testing, Treatment, and Monitoring among Migrants Living in Australia

Chronic hepatitis B (CHB) disproportionately affects migrants with low health literacy and help-seeking behaviour living in high-income countries. Evidence of effective interventions is required to increase hepatitis B (HBV) testing, treatment, and monitoring. Available evidence from Medline, Embase, Scopus, Google, and Google Scholar was identified, collated, and synthesised. Inclusion criteria included grey and peer-reviewed literature published in English between January 2012 and December 2021. Systematic reviews and meta-analyses were excluded. Seventeen peer-reviewed articles met the inclusion criteria. Most interventions were conducted at the individual level and were typically outreach testing initiatives. One study was conducted at a structural level. All studies were successful in encouraging HBV screening uptake, and 10 studies demonstrated effective linkage to care. Two studies showed evidence of monitoring participants post-intervention. Most interventions had more female than male participants. Interventions conducted across community and clinical-based settings had more participants engage in screening and/or linkage to care in community settings. Effective interventions to prevent HBV transmission and CHB-related morbidity and mortality were approaches that utilised linguistic-specific and culturally appropriate resources to successfully engage migrants. Community outreach programmes that educate participants about HBV transmission, screening, and treatment can promote community dialogue and understanding to reduce stigma and discrimination.

Understanding racial disparities in the care of patients with irritable bowel syndrome: The need for a unified approach

Irritable bowel syndrome (IBS) is a highly prevalent disorder of gut-brain interaction, which significantly erodes the quality of life of those it affects. Recent studies have confirmed that its prevalence varies quite markedly between countries, implying that it is affected by cultural and socioeconomic factors. In an important study, Silvernale at al. have recently reported racial disparities including potential referral biases, with reduced opportunities to access specialist care and differing patterns of healthcare utilization affecting ethnic minority populations with IBS. Similar disparities have also been reported for other gastrointestinal disorders. In this paper, we, therefore, discuss the potential implications of such disparities and how they can impact clinical outcomes, and discuss ways in which this problem could be addressed, and highlighting areas for future research.

'What a dog will see and kill, a cat will see and ignore it': An exploration of health-related help-seeking among older Ghanaian men residing in Ghana and the United Kingdom

BACKGROUND

Health care utilization rates are lower among men; however, little is known about how men's health care utilization is affected by migration. The aim of this study was to explore health-related help-seeking decisions among older Ghanaian men residing in the United Kingdom and in Ghana.

METHODS

Twenty-six men aged 50 years or over were recruited from community locations within two large cities in the UK and Ghana. Face-to-face semi-structured interviews were undertaken to explore the illness and help-seeking experiences of older men.

RESULTS

Help-seeking experiences differed among the Ghanaian men living in the UK and in Ghana. Three themes were identified that impacted on help-seeking decisions: (1) pluralistic approaches to managing health and illness and (2) perceptions of formal health services in Ghana and UK and (3) financial constraints and masculinity norms as barriers to help-seeking.

CONCLUSION

This is the first study to look at help-seeking decisions among older men residing in the UK and Ghana. Findings highlight how older migrant men's explanatory models of their health encompass enduring faith-based beliefs around causation of illness and approaches to management, as well as the use of pluralistic approaches to managing health. This study supports the call for culturally sensitive community-based interventions to increase engagement and facilitate improved health outcomes for migrant populations, particularly older men.

Gender and age related differences in the use of medicines for chronic diseases among undocumented migrants

Purpose

The purpose of this paper is to evaluate gender-related differences in the use of drugs for chronic diseases in undocumented migrants.

Design/methodology/approach

The authors analyzed the databases of two charitable organizations providing medical help and medicines to undocumented migrants. Data were available for 9,822 patients in the period 2014–2016. The authors grouped medicines according to the Anatomical Therapeutic Chemical (ATC) classification. We considered the ATC group as an indicator of a group of diseases.

Findings

Both males and females needed medicines for chronic diseases in a comparable manner. When we analyzed the age distribution, The authors noticed that males showed a tendency to begin to be affected at an earlier age; however, this cumulative difference was not statistically significant. But when we looked at six groups of drugs separately (cardiovascular, respiratory, anti-thrombotic, neurologic, psychiatric, anti-diabetic), the authors found that females always needed drugs for chronic diseases at a later age, always with a significant difference (p<0.0001 for cardiovascular, antithrombotic, antidiabetic and psychoactive drugs; p<0.002 for neurologic products; p<0.04 for drugs used in chronic respiratory conditions).

Research limitations/implications

This is a retrospective study based on the analysis of existing databases, but the peculiar features of this population (undocumented migrants) do not allow at the moment controlled studies.

Practical implications

Our observations could be important when planning public health strategies, especially in the field of prevention.

Originality/value

This is the first report of gender differences in the use of medicines for chronic diseases within a large sample of undocumented migrants.

Dietary intake and lifestyle behaviors of children in Mauritius

The purpose of the study was to explore the dietary intake, fruit, vegetable and energy intake and lifestyle behaviors among Mauritian children. A validated questionnaire was used, assessing dietary intake, mean energy intake, mean body mass index (BMI), lifestyle behaviors as well as nutritional knowledge (NK) among males and females. 336 children aged 6–12 years (165 males and 171 females) from 8 public primary schools were recruited. Statistical analyses revealed that children consumed less nutritious foods such as fruits, vegetables and whole grains and more of refined and calorie-laden foods, with no significant differences across genders. Mean energy intake of children was 1522 ± 282.4 kcal per day while mean BMI was 17.5 ± 4.03 kg/m². Majority of children had a low-to-moderate physical activity level (PAL), with males being more active than females on average (P = 0.021). 88.7% of children watched TV for more than an hour daily, with 84.8% of them reporting to be eating during the process. Females were more likely to be breakfast skippers (P = 0.003). Maximum frequency of snacking was twice daily (72.7%) while consumption of fast food was once or twice weekly (44.0%). Results indicate the need for intervention with aim of improving the dietary and life quality of children in Mauritius.

Patient's Decision to Disclose the Use of Traditional and Complementary Medicine to Medical Doctor: A Descriptive Phenomenology Study

Nondisclosure of traditional and complementary medicine (T&CM) use may cause individual to be at risk of undue harm. This study aimed to explore patient's experience and views on their decision to disclose the use of T&CM to the doctor. An exploratory qualitative study using in-depth interview involving 10 primary care clinics attendees in Kuching was conducted. The results indicated that disclosure of T&CM use will motivate them to get information, increase doctor's awareness, and get support from family and friends for disclosure. Fear of negative relationship and negative response from doctors was a barrier for disclosure. Doctor's interpersonal and communication skills of being involved, treating patients respectfully, listening attentively, respecting privacy, and taking time for the patient were a critical component for disclosure. Intrapersonal trust regarding doctor influences their satisfaction on healthcare. Women are more open and receptive to a health concern and expressing negative emotions and tend to share problems, whereas men always described themselves as healthy, tended to keep their own personal feeling to themselves, and tended to not share. The doctor should consider gender differences in disclosure, their attitude towards T&CM use, and gained patient's trust in the delivery of healthcare services. Good interpersonal and communication skills must be maintained between doctor and patients.

Beliefs about hypertension among Nigerian immigrants to the United Kingdom: A qualitative study

Objective

The aim of the study was to elicit beliefs about hypertension among Nigerian immigrants in the United Kingdom.

Background

The distributions of cardiovascular risk factors and diseases are not shared equally across ethnic and economic groups in the United Kingdom. Its burden is more clustered among minority ethnic populations and migrant groups including black African Nigerian migrants. Similar patterns have been reported across Europe, Australia, Canada, Nordic countries and the United States of America. There are about 300 distinct ethnic groups in Nigeria and reliable information about their beliefs about hypertension is not available. Given that the United Kingdom has a large community of Nigerian immigrants from these different ethno-cultural backgrounds, understanding their unique beliefs about hypertension may help promote appropriate care for this population in the United Kingdom and Nigeria.

Setting

A single Pentecostal church community in West London

Participants

Twenty-seven Nigerian migrant members of the church entered and completed the study

Methods and outcome measure

A qualitative interview study was conducted. The interviews were analysed using thematic framework analysis. The outcome measures were emerging themes from the thematic framework analysis.

Results

Participants expressed beliefs in four major areas related to hypertension: (1) The Meaning of the term hypertension, (2) Perceptions of causation, (3) Effects of hypertension, and (4) Perceptions of treatment. The study revealed a diversity of beliefs about hypertension which incorporated both orthodox and culturally framed ideas.

Conclusions

This study identified important beliefs among Nigerian migrants about hypertension that can contribute to our understanding of the management of hypertension in this group and suggests the need for further research to determine whether these beliefs may be representative of this group.