Other Mental and Social Health Commons^™

Patient-Centered Communication And Prognosis Discussions With Cancer Patients, Cleveland G. Shields, Casey J. Coker, Shruti S. Poulsen, Jennifer M. Doyle, Kevin Fiscella, Ronald M. Epstein, Jennifer J. Griggs

Shruti Poulsen

To examine physician communication associated with prognosis discussion with cancer patients.

A Survey Of Resilience, Burnout, And Tolerance Of Uncertainty In Australian General Practice Registrars, Georga Cooke, Jenny Doust, Michael Steele

Jenny Doust

Burnout and intolerance of uncertainty have been linked to low job satisfaction and lower quality patient care. While resilience is related to these concepts, no study has examined these three concepts in a cohort of doctors. The objective of this study was to measure resilience, burnout, compassion satisfaction, personal meaning in patient care and intolerance of uncertainty in Australian general practice (GP) registrars. Methods: We conducted a paper-based cross-sectional survey of GP registrars in Australia from June to July 2010, recruited from a newsletter item or registrar education events. Survey measures included the Resilience Scale-14, a single-item scale for burnout, …

Identifying Self-Perceived Hiv-Related Stigma In A Population Accessing Antiretroviral Therapy, D. Tzemis, J. Forrest, C. Puskas, W. Zhang, Treena Orchard, A. Palmer, C. Mcinnes, K. Fernandes, J. Montaner, R. Hogg

Dr. Treena Orchard

No abstract provided.

How Do We ‘See’ Occupations? An Examination Of Visual Research Methodologies In The Study Of Human Occupation, L. Hartman, A. Mandich, L. Magalhaes, Treena Orchard

Dr. Treena Orchard

This article argues that visual research methodologies have potential to contribute to the study of occupation. The use of visual research methodologies is quickly growing in a number of disciplines and can help researchers to access information and reasoning not accessible through interview, log or survey. The reflexive, reflective, engaged process of creating and analysing visual materials allows for rich representations on behalf of participants, and immersion in the data on the part of researchers. This paper explores photovoice, body mapping and textual analysis of visual materials to understand how they can contribute to occupational science research. These methods were …

A Dimensional Analysis Of Caregiver Burden Among Spouses And Adult-Children, Marie Savundranayagam, R. Montgomery, K. Kosloski

Marie Y Savundranayagam

Purpose of the study: Caregiver burden is a multidimensional construct, addressing tension and anxiety (stress burden), changes in dyadic relationships (relationship burden), and time infringements (objective burden) resulting from caregiving. The study aims were to assess (a) whether the dimensions of burden were the same for caregiving spouses and adult children, (b) the role of assisting with problem behaviors (PBs) and activities of daily living (ADLs) on each dimension of burden, and (c) the role of each dimension of burden on self-rated health and intention to institutionalize the care receiver. Design and Methods: This study included 280 spouse/partner and 243 …

Impact Of A Psychoeducational Program On Three Types Of Caregiver Burden Among Spouses, Marie Savundranayagam, R. Montgomery, K. Kosloski, T. Little

Marie Y Savundranayagam

Abstract Purpose The purpose of this study was to investigate the extent to which a psychoeducational intervention called “Powerful Tools for Caregivers” (PTC) influences burden of spouse caregivers. Specifically, this study examined whether spouse caregivers who attended PTC exhibited reductions in stress burden, relationship burden, and objective burden compared to a comparison group.

Design and Methods The 6 week intervention used a self-efficacy framework to train caregivers to focus on self-care, communicate effectively, and manage emotions. This quasi-experimental study included 115 participants from the PTC group and 95 participants from a comparison group. Assessments were completed before and after the …

Storycorps Memory Loss Initiative: Enhancing Personhood For Storytellers With Memory Loss, Marie Savundranayagam, L. Dilley, A. Basting

Marie Y Savundranayagam

StoryCorps’ Memory Loss Initiative was designed to gather oral histories of people with memory loss. This study investigated the StoryCorps interview experience for storytellers who self identify with early stage memory loss and the persons who interviewed them. StoryCorps interviews took place in Milwaukee, Chicago, and New York. Follow-up interviews were conducted with 42 persons with memory loss, along with 27 family members who participated in the StoryCorps interviews. Results revealed that the StoryCorps experience was a meaningful activity that allowed participants to acknowledge the beauty of the present moment, to reflect and engage in meaningful conversations, to re-affirm both …

Relationships Between Appraisals Of Caregiver Communication Strategies And Burden Among Spouses And Adult-Children, Marie Savundranayagam, J. Orange

Marie Y Savundranayagam

Background: The purpose of this study was to investigate the impact of caregivers’ appraisals of the effectiveness of their own communication strategies on caregiver burden when caring for family members with Alzheimer's disease (AD).

Methods: Family caregivers (N = 84) of participants with AD completed questionnaires appraising communication strategies, problem behaviors, and levels of three types of burden.

Results: Hierarchical linear regression models revealed that effective strategies and kinship status were significantly linked with stress burden, whereas effective strategies and problem behaviors were significantly related to relationship burden. Cognitive status of participants with AD significantly predicted objective burden. Caregivers who …

Testing Self-Efficacy As A Pathway That Supports Self Care Among Family Caregivers In A Psychoeducational Intervention, Marie Savundranayagam, M. Brintnall-Peterson

Marie Y Savundranayagam

This study investigated the extent to which a psychoeducational intervention supports family-centered care by influencing health risk and self-care behaviors of caregivers of individuals with Alzheimer's disease (N = 325). Moreover, this study investigated the extent to which changes in self-efficacy explained changes in health risk and self-care behaviors. Data were analyzed using repeated measures and multivariate analysis of variance and multiple regression. Qualitative written accounts of the impact of the intervention augmented the quantitative findings. The study's findings revealed that family caregivers experienced reductions in health risk behaviors and improvements in exercise, stress management, and relaxation activities as a …

Impact Of Role Discrepancies On Caregiver Burden Among Spouses, Marie Savundranayagam, R. Montgomery

Marie Y Savundranayagam

Using caregiver identity theory, the authors investigated whether role discrepancies mediated the relationships between illness-related stressors (activities of daily living [ADLs] limitations and problem behaviors) and burden (stress, relationship, and objective burden) for spouse caregivers. Participants completed measures of identity standards for spouse and caregiver roles and behaviors, burden, assistance with ADLs, and problem behaviors. Structural equation modeling analyses revealed that role discrepancies completely mediated the relationships between ADLs and stress and relationship burden. Although role discrepancies mediated the relationships between problem behaviors and all forms of burden, there were direct relationships between problem behaviors and burden. Finally, participants who …

Factors Behind Hiv Testing Practices Among Canadian Aboriginal Peoples Living Off-Reserve, Treena Orchard, C. Mcinnes, K. Fernandes, M. Clement, M. Gilbert, V. Lima, J. Montaner, R. Hogg

Dr. Treena Orchard

The objective of this study was to examine factors associated with HIV testing among Aboriginal peoples in Canada who live off-reserve. Data were drawn for individuals aged 15–44 from the Aboriginal Peoples Survey (2001), which represents a weighed sample of 520,493 Aboriginal men and women living off-reserve. Bivariable analysis and logistic regression were used to identify factors associated with individuals who had received an HIV test within the past year. In adjusted multivariable analysis, female gender, younger age, unemployment, contact with a family doctor or traditional healer within the past year, and “good” or “fair/poor” self-rated health increased the odds …

Insert Discourse: Rectal Douching Among Young Hiv-Positive And Hiv-Negative Gay Men In Vancouver, Canada, A. Schilder, Treena Orchard, C. Buchner, S. Strathdee, R. Hogg

Dr. Treena Orchard

Douching is a common practice among certain groups of women and MSM, and it is conducted for the purpose of cleanliness as part of bodily hygiene maintenance. Although there has been considerable research about female vaginal douching, understandings of rectal douching (RD) for MSM are limited. In the epidemiological and medical literature, RD is presented as a behaviour that removes beneficial bacteria and the surface epithelium layer of the colon, which can, potentially, increase the risk of HIV transmission in MSM. The paucity of research on male douching practices is curious given the primacy of anal sex in HIV prevention …

The Irrational Woman: Informed Consent And Abortion Decision-Making, Maya Manian

Maya Manian

In Gonzales v. Carhart, the Supreme Court upheld a federal ban on a type of second-trimester abortion that many physicians believe is safer for their patients. Carhart presented a watershed moment in abortion law, because it marks the Supreme Court’s first use of the anti-abortion movement’s “woman-protective” rationale to uphold a ban on abortion and the first time since Roe v. Wade that the Court denied women a health exception to an abortion restriction. The woman-protective rationale asserts that banning abortion promotes women’s mental health. According to Carhart, the State should make the final decisions about pregnant women’s healthcare, because …

Social Psychological Aspects Of Communication And Aging, Marie Savundranayagam, E. Ryan

Marie Y Savundranayagam

Language plays an important role in defining identities in older adulthood. Both self-perception and others' perceptions of older adults are reflected through language used by older and younger adults (see recent texts: de Bot & Makoni, 2005; Harwood, 2007; Hummert & Nussbaum, 2001; Nussbaum & Coupland, 2004). In this review, we outline key theoretical perspectives on the study of communication with older adults and provide evidence supporting these perspectives within the context of age stereotypes, intergenerational communication, cross-cultural communication, and health care encounters. Given that communication is an interactive process, we discuss how older adults use language and communication to …

Best Practices In Intercultural Health; Five Case Studies In Latin America, J. Mignone, J. Bartlett, J. O'Nwil, Treena Orchard

Dr. Treena Orchard

The practice of integrating western and traditional indigenous medicine is fast becoming an accepted and more widely used approach in health care systems throughout the world. However, debates about intercultural health approaches have raised significant concerns. This paper reports findings of five case studies on intercultural health in Chile, Colombia, Ecuador, Guatemala, and Suriname. It presents summary information on each case study, comparatively analyzes the initiatives following four main analytical themes, and examines the case studies against a series of the best practice criteria.

In This Life: The Impact Of Gender And Tradition On Sexuality And Relationships For Devadasi Sex Workers In Rural India, Treena Orchard

Dr. Treena Orchard

In the popular imagination and certain academic fields, sex workers' experiences of sexuality and intimate relationships are often "naturalized," to the point where they are assumed to be deviant or completely different than those of women in mainstream society. Researchers and sex worker organizations are challenging these reified constructions by examining more diverse and representative models of sexuality and relationships. However, the experiences of women selling sex in the "third world" are consistently portrayed as violent, non-pleasurable, and oppressive, characteristics often applied universally to "third world women". Using data from ethnographic fieldwork with girls and women who belong to the …

Girl, Woman, Lover, Mother: Towards A New Understanding Of Child Prostitution Among Young Devadasi Sex Workers In Rural Karnataka, India, Treena Orchard

Dr. Treena Orchard

The emotive issue of child prostitution is at the heart of international debates over ‘trafficking’ in women and girls, the “new slave trade”, and how these phenomena are linked with globalization, sex tourism, and expanding transnational economies. However, young sex workers, particularly those in the ‘third world’, are often represented through tropes of victimization, poverty, and “backwards” cultural traditions, constructions that rarely capture the complexity of the girls’ experiences and the role that prostitution plays in their lives. Based on ethnographic fieldwork with girls and young women who are part of the Devadasi (servant/slave of the God) system of sex …

Dhandha, Dharma And Disease: Traditional Sex Work And Hiv/Aids In Rural India, J. O'Neil, Treena Orchard, J. Swarankar, J. Blanchard, K. Gurav, B. Barlaya, R. Patil, C. Hussain Khan, S. Moses

Dr. Treena Orchard

This paper discusses the results of two ethnographic studies with female sex workers in rural areas of Karnataka and Rajasthan, India. In particular, we focus on women whose socio-economic status, and religious and occupational practices, are part of sex work systems that have historical precedents such that they can be termed “traditional” sex workers. The approach taken in the ethnographic work was informed by current critical approaches in medical anthropology and public health. The paper argues that in the context of an expanding HIV/AIDS epidemic in rural areas of India, understanding the historical and structural factors that operate to perpetuate …