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Avery J, Campbell KL, Mosher P, Al-Awamer A, Goddard K, Edwards A, Burnett L, Hannon B, Gupta A, Howard AF. Advanced Cancer in Young Adults (YAs): Living in a Liminal Space. Qual Health Res 2024; 34:72-85. [PMID: 37844970 PMCID: PMC10714712 DOI: 10.1177/10497323231204182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
Young adults (YAs), defined as individuals between the ages of 18 and 39 years, experience unique challenges when diagnosed with advanced cancer. Using the social constructivist grounded theory approach, we aimed to develop a theoretical understanding of how YAs live day to day with their diagnosis. A sample of 25 YAs (aged 22-39 years) with advanced cancer from across Canada participated in semi-structured interviews. Findings illustrate that the YAs described day-to-day life as an oscillating experience swinging between two opposing disease outcomes: (1) hoping for a cure and (2) facing the possibility of premature death. Oscillating between these potential outcomes was characterized as living in a liminal space wherein participants were unsure how to live from one day to the next. The participants oscillated at various rates, with different factors influencing the rate of oscillation, including inconsistent and poor messaging from their oncologists or treatment team, progression or regression of their cancer, and changes in their physical functioning and mental health. These findings provide a theoretical framework for designing interventions to help YAs adapt to their circumstance.
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Affiliation(s)
- Jonathan Avery
- Anew Research Collaborative: Reshaping Young Adult Cancer Care, Royal Roads University, Victoria, BC, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Kristin L. Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Pamela Mosher
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ahmed Al-Awamer
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | | | | | - Breffni Hannon
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Abha Gupta
- Division of Medical Oncology, Princess Margaret Cancer Center, Toronto, ON, Canada
| | - A. Fuchsia Howard
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
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Straus EJ, Brown H, Teachman G, Howard F. Transforming normative, ableist, and biomedical orientations to living well and quality of life in nursing: Reimagining what a ventilated body can do. Nurs Inq 2023:e12554. [PMID: 37088968 DOI: 10.1111/nin.12554] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 03/22/2023] [Accepted: 03/31/2023] [Indexed: 04/25/2023]
Abstract
A goal of living as well as possible is central to practice and research with young adults living with home mechanical ventilation (HMV). Significant effort has been put into conceptualizing and measuring the quality of life (QOL) as a proxy for living well. Yet, dominant understandings of QOL have been influenced by normative, ableist, and biomedical discourses about what constitutes a good life that, when applied in practice and systems with those living with HMV, can contribute to exclusion and constrain opportunities to live well. Inquiry into what certain understandings of living well can do is critical to opening up possibilities to reimagine living well with HMV. This paper draws on findings from a critical narrative inquiry that explored the experiences of five young adults (ages 18-40 years) living with HMV. Data were co-constructed virtually through an initial interview and photo-elicitation using participant-generated photographs. A critical narrative analysis of participants' stories made visible the ideological effects of ableist, biomedical, and individualist discourses and how the young adults reproduced and resisted these dominant discourses. Their stories further opened up possibilities for nurses and other healthcare providers to see living well and QOL differently.
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Affiliation(s)
- Elizabeth J Straus
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Helen Brown
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gail Teachman
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Fuchsia Howard
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
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Ou CHK, Hall WA, Rodney P, Stremler R. Seeing Red: A Grounded Theory Study of Women's Anger after Childbirth. Qual Health Res 2022; 32:1780-1794. [PMID: 35969648 PMCID: PMC9511239 DOI: 10.1177/10497323221120173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Persistent intense anger is indicative of postpartum distress, yet maternal anger has been little explored after childbirth. Using grounded theory, we explained how and why mothers develop intense anger after childbirth and the actions they take to manage their anger. Twenty mothers of healthy singleton infants described their experiences of anger during the first two postpartum years. Mothers indicated they became angry when they had violated expectations, compromised needs, and felt on edge (e.g., exhausted, stressed, and resentful), particularly around infants' sleep. Mothers described suppressing and/or expressing anger with outcomes such as conflict and recruiting support. Receiving support from partners, family, and others helped mothers manage their anger, with more positive outcomes. Women should be screened for intense anger, maternal-infant sleep problems, and adequacy of social supports after childbirth. Maternal anger can be reduced by changing expectations and helping mothers meet their needs through social and structural supports.
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Affiliation(s)
- Christine H. K. Ou
- School of Nursing, University of Victoria, Victoria, BC, Canada
- Canadian Institute of Substance Use Research, University of Victoria, Victoria, BC
| | - Wendy A. Hall
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Paddy Rodney
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Robyn Stremler
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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McKenzie HA, Varcoe C, Nason D, McKenna B, Lawford K, Kelm ME, Wajuntah CO, Gervais L, Hoskins J, Anaquod J, Murdock J, Murdock R, Smith K, Arkles J, Acoose S, Arisman K. Indigenous Women's Resistance of Colonial Policies, Practices, and Reproductive Coercion. Qual Health Res 2022; 32:1031-1054. [PMID: 35385333 PMCID: PMC9251744 DOI: 10.1177/10497323221087526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This analysis of urban Indigenous women's experiences on the Homeland of the Métis and Treaty One (Winnipeg, Manitoba, Canada), Treaty Four (Regina, Saskatchewan, Canada), and Treaty Six (Saskatoon, Saskatchewan, Canada) territories illustrates that Indigenous women have recently experienced coercion when interacting with healthcare and social service providers in various settings. Drawing on analysis of media, study conversations, and policies, this collaborative, action-oriented project with 32 women and Two-Spirit collaborators demonstrated a pattern of healthcare and other service providers subjecting Indigenous women to coercive practices related to tubal ligations, long-term contraceptives, and abortions. We foreground techniques Indigenous women use to assert their rights within contexts of reproductive coercion, including acts of refusal, negotiation, and sharing community knowledge. By recognizing how colonial relations shape Indigenous women's experiences, decision-makers and service providers can take action to transform institutional cultures so Indigenous women can navigate their reproductive decision-making with safety and dignity.
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Affiliation(s)
| | | | - Dory Nason
- First Nations University of Canada, Regina, SK, Canada
| | | | | | | | | | | | | | | | | | | | | | - Jillian Arkles
- First Nations University of Canada, Saskatoon, SK, Canada
| | - Sharon Acoose
- First Nations University of Canada, Saskatoon, SK, Canada
| | - Kayla Arisman
- University of British Columbia, Vancouver, BC,
Canada
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Okoye HU, Saewyc E. Fifteen-year trends in self-reported racism and link with health and well-being of African Canadian adolescents: a secondary data analysis. Int J Equity Health 2021; 20:108. [PMID: 33902594 PMCID: PMC8077748 DOI: 10.1186/s12939-021-01446-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 04/12/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND We assessed the prevalence and trends in racial discrimination among African Canadian adolescents in British Columbia. The association between racial discrimination and self-rated health, access to mental health services, substance use, suicidal thoughts and attempts, experience of extreme stress, among others were examined within the 2018 dataset. METHODS Secondary analysis used the data collected from African Canadian adolescents (n = 2448) as part of the British Columbia Adolescent Health Surveys (2003-2018). We examined whether racial discrimination increased, decreased, or remained stable over time. We evaluated experiences of racial discrimination for all adolescents, and then disaggregated analyses for boys, girls, immigrant, and Canadian-born African adolescents. We used Rao-Scott's adjusted chi-square to test differences in racial discrimination and adjusted logistic regressions to test trends across survey years, widening or narrowing gaps in racial discrimination, as well as the link to health outcomes. RESULTS Racial discrimination was significantly different across the survey years (Adjusted F = 4.60, p < .01), with the highest percentage of adolescents reporting past year racial discrimination in 2018 (29.9%) and the lowest percentage in 2013 (21.3%). Girls and immigrant African Canadian adolescents were more likely to have experienced racial discrimination. However, girls and Canadian-born adolescents had the highest odds of reporting racial discrimination in 2018 compared to 2003, AOR = 1.85, and 1.58, respectively. The findings reveal significant differences in the experiences of racial discrimination for boys and girls, as well as for immigrant and Canadian-born African adolescents. Significant differences were noted in the link between racial discrimination and self-rated health and engaging in behaviours that might expose them to health risks. The worst negative health outcomes were found for boys and immigrant African Canadian adolescents. CONCLUSION The study suggests that more than 1 in 4 African Canadian adolescents in British Columbia report racial discrimination, which is an increasing trend in recent years. Those who reported racial discrimination also had the worst adverse health outcomes. There is a need for more public health action to reduce racism, create awareness about the negative health impacts, and provide better support for African Canadian adolescents.
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Affiliation(s)
- Helen U Okoye
- University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada.
| | - Elizabeth Saewyc
- University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada
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Ferlatte O, Salway T, Oliffe JL, Saewyc EM, Holmes C, Schick L, Purdie A, Damstrom-Albach DD, Mantler ERG, Ho D, Knight R. It is time to mobilize suicide prevention for sexual and gender minorities in Canada. Can J Public Health 2020; 111:737-742. [PMID: 32328989 PMCID: PMC7501336 DOI: 10.17269/s41997-020-00316-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 03/15/2020] [Indexed: 01/21/2023]
Abstract
Suicide is a significant health issue among sexual and gender minority adults (SGMA); yet, there are no tailored suicide prevention programs for these marginalized populations in Canada. We hosted two world cafés with community leaders, health professionals, policymakers, and researchers to identify recommendations for mobilizing SGMA-focused suicide prevention programs. We identified five priorities: (1) make society safer for sexual and gender minorities; (2) decrease barriers to mental health services; (3) support community-driven and community-based interventions; (4) increase suicide knowledge and reduce stigma; (5) expand the knowledge base on SGMA suicide. In the absence of a national Canadian SGMA suicide prevention policy, these priorities provide a starting point in addressing SGMA suicide inequities by advancing SGMA-tailored interventions.
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Affiliation(s)
- Olivier Ferlatte
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada.
- Centre de Recherche en Santé Publique, Montreal, Canada.
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- British Columbia Centre for Disease Control, Vancouver, Canada
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
| | - John L Oliffe
- School of Nursing, University of British Columbia, Vancouver, Canada
- Department of Nursing, University of Melbourne, Melbourne, Victoria, Australia
| | - Elizabeth M Saewyc
- School of Nursing, University of British Columbia, Vancouver, Canada
- Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC), Vancouver, Canada
- McCreary Centre Society, Vancouver, Canada
| | - Cindy Holmes
- School of Social Work, University of Victoria, Victoria, Canada
| | | | | | | | | | - Darren Ho
- Community-Based Research Centre, Vancouver, Canada
| | - Rod Knight
- British Columbia Centre on Substance Use, Vancouver, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
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