Physical Activity and Breast Cancer Prevention Among Chinese American Women: A Qualitative Descriptive Study

Physical inactivity is a modifiable behavioral risk factor for breast cancer. Chinese American women have an increased breast cancer incidence and a low prevalence of meeting physical activity (PA) recommendations, yet little is known about their knowledge and experience regarding PA and breast cancer prevention. Given the significant cultural differences between Eastern and Western societies, effective interventions to promote PA among Chinese American women require understanding their knowledge levels regarding PA in breast cancer prevention and their PA experiences through a cultural lens. This qualitative descriptive study used virtual semi-structured individual interviews to explore Chinese American women's knowledge and perception of PA, their understanding of the role of PA in breast cancer prevention, and influence of culture and acculturation on PA experience. Twenty-one Chinese American women residing in eight states were interviewed. Using thematic analysis, four themes emerged: A limited appreciation of the preventability of breast cancer, variability in PA perception, Chinese culture norms and lifestyles influencing PA behavior, and the influence of the process of acculturation on PA behavior. Chinese American women had a limited understanding of PA in breast cancer prevention. Chinese culture, lifestyles, and traditional Chinese medicine positively and negatively influence Chinese American women's PA behaviors. When exposed to American culture, Chinese American women tended to adopt new PA behaviors, including increasing leisure-time PA while decreasing occupation- and transportation-related PA. Interventions to increase PA and reduce breast cancer risk among Chinese American women should address cultural factors and acculturation along with education and behavioral change strategies.

Supporting occupational therapists to initiate conversations about sexuality with people with intellectual disability: Co-design by deliberative dialogue

INTRODUCTION

Occupational therapists routinely report low levels of confidence in addressing needs related to sexuality and intimacy. These issues are compounded when supporting clients with intellectual disability, due to prevailing assumptions about capacity and few practical support resources. At a disciplinary level, there is ongoing discourse around how to best conceptualise and support sexual and gender identities generally, within models of human occupation. Leveraging interdisciplinarity, where sexuality overlaps as a sphere of interest, can aid the development of practical support resources. Engagement with sociology (focussed on relationality) and disability studies (focussed on embodiment) offers a generative path forward.

METHODS

The deliberative dialogues framework was used to develop a co-designed resource by occupational therapists for occupational therapists. Six Australian occupational therapists with experience working with clients with intellectual disability and/or sexuality were purposively recruited to participate in co-design groups. Using the eight features of deliberative dialogue, data was collected and analysed by an interdisciplinary research team to collaboratively produce a practical support resource.

RESULTS

Participants agreed the greatest need was to develop a resource for clinicians, to support conversations with clients about sexuality. Five key themes emerged: (1) Theoretical explanations addressing why sexuality is important must be paired with practical advice; (2) make a conversational call to action from 'OTs' for 'OTs' by locating sexuality within the domain of occupational therapy; (3) make explicit that people with intellectual disability are sexual beings; (4) need for self-reflection; and (5) demonstrate how existing understandings of occupation apply to sexuality.

CONCLUSION

A resource in the form of a brochure was developed, intended to be used as a conversation primer. The process used to develop the resource demonstrated the value of interdisciplinary collaboration and the utility of deliberative dialogue as a co-design method.

"Tailoring homely meals": Family members' motivations underlying nursing home visits during residents' meals

AIM

Elderly nursing home residents are often malnourished or at risk of malnutrition. Family members often visit residents during mealtimes, which might be an ideal opportunity for interventions targeted at improving the nutritional status of older residents. Therefore, this study aimed to explore motivations behind family member visits with nursing home residents during mealtime in Taiwan.

METHODS

This phenomenological study was conducted with family members of residents from four nursing homes in Taiwan. Participants were purposively sampled. Data were collected with individual face-to-face interviews from 18 family members. Data from transcribed audio-recorded interviews were analyzed using the approach of van Manen.

RESULTS

Analysis of the interview data identified the essence of motivations underlying family members' visits to nursing home residents during mealtimes, which we termed "tailoring homely meals." This referred to providing food tailored to residents' needs, providing a comforting family atmosphere, assisting residents during mealtime, and monitoring food consumption.

CONCLUSIONS

The motivations of family members to visit during mealtime could guide healthcare professionals working with East Asian populations in developing interventions to reduce the possibility of malnutrition, while also improving their quality of life. We recommend providing the following for nursing home residents: a nutritious and balanced diet, supporting their independence and ability to feed themselves, and encouraging involvement of family members during mealtimes.

The Uses of Self and Space: Health Providers' Approaches to Engaging Patients into the HIV Care Continuum

In the context of HIV prevention, the provider-patient relationship has been found to profoundly impact HIV screening, patient initiation into HIV care, and adherence to medication following an HIV diagnosis. Given the importance of the provider-patient relationship, insight into provider approaches to cultivate such relationships is essential. Such insight could highlight considerations for provider engagement with patients that can address the current challenges in HIV prevention and treatment. This qualitative descriptive study sought to describe current health providers' approaches to engage patients into the HIV care continuum (HCC). Findings from the content and thematic analysis indicated that health providers (N = 22) used various approaches to engage patients/clients into HIV screening, and subsequent HIV care. Approaches were represented by an interpersonal process and a thematic analysis revealed the nuances in the approaches that manifested in the following themes: uses of self, normalizing disease, and engaging couples. This study demonstrated the importance for health providers to be aware of the specific context of patient's vulnerability to HIV infection and barriers to care. Self-awareness and the capability to self-reflect on one's personal practice also helped to ensure engagement of those vulnerable to infection or infected with HIV into the HCC.

Exploring Nurses' Knowledge and Experiences Related to Trauma-Informed Care

Trauma-informed care is an emerging concept that acknowledges the lasting effects of trauma. Nurses are uniquely positioned to play an integral role in the advancement of trauma-informed care. However, knowledge related to trauma-informed care in nursing practice remains limited. The purpose of this article is to present the results of a qualitative study which explored nurses’ understandings and experiences related to trauma-informed care. Seven semistructured interviews were conducted with nurses and four categories emerged from the analysis: (a) Conceptualizing Trauma and Trauma-Informed Care, (b) Nursing Care and Trauma, (c) Context of Trauma-Informed Care, and (d) Dynamics of the Nurse–Patient Relationship in the Face of Trauma. These findings highlight important considerations for trauma-informed care including the complex dynamics of trauma that affect care, the need to push knowledge about trauma beyond mental health care, and noteworthy parallels between nursing care and trauma-informed care.

Managing occupations in everyday life for people with advanced cancer living at home

BACKGROUND

People with advanced cancer are able to live for extended periods of time. Advanced cancer can cause functional limitations influencing the ability to manage occupations. Although studies have shown that people with advanced cancer experience occupational difficulties, there is only limited research that specifically explores how these occupational difficulties are managed.

OBJECTIVE

To describe and explore how people with advanced cancer manage occupations when living at home.

MATERIAL AND METHODS

A sub-sample of 73 participants from a larger occupational therapy project took part in the study. The participants were consecutively recruited from a Danish university hospital. Qualitative interviews were performed at the homes of the participants. Content analysis was applied to the data.

RESULTS

Managing occupations were manifested in two main categories; (1) Conditions influencing occupations in everyday life and (2) Self-developed strategies to manage occupations.

SIGNIFICANCE

The findings suggest that people with advanced cancer should be supported to a greater extent in finding ways to manage familiar as well as new and more personally meaningful occupations to enhance quality of life.