Health Experiences Of Individuals Research Articles

Home and nearby nature: Uncovering relational flows between domestic and natural spaces in three countries during COVID-19

This paper addresses the role of living spaces, neighborhood environments, and access to nearby nature in shaping individual experiences of health and well-being during the first wave of the COVID-19 pandemic. Key data is drawn from the GreenCOVID study across Spain, England and Ireland. The survey gathered contextual information about home environments, neighborhood spaces, and access to nature elements, and standardized measures of health and wellbeing between April and July 2020 (n = 3,127). The paper used qualitative data from the survey to document flows between home and nearby nature. These were framed as barriers/mediators with specific focus on differing interpretations of home as both trap and refuge, with additional dimensions of loss, disruption and interruption shaping the broad responses to the pandemic. By contrast nearby nature was an enabler/moderator of health and wellbeing, offering healthy flows between home and nature as well as respite and additional health-enabling factors. Differences were identified between the three countries but important commonalities emerged too, recognising the role nature plays as an asset both within and immediately beyond the home. The use of flow as metaphor also recognises the importance of embodiment and the elastic nature of connections between home and nearby nature for wellbeing. More broadly, flow provides a valuable way to trace affective relational geographers to develop a wider understanding of assemblages of health during pandemics.

Exploring a hermeneutic perspective of nursing through revisiting nursing health history.

In this article, the nursing health history is revisited with a hermeneutic lens to uncover means by which this tool can better serve nursing practice. It is argued that further distanciation from the developmental and medical model is necessary to accurately uncover health and history in the nurse-client encounter. Based on the works of prominent hermeneutic philosophers, such as Heidegger, Gadamer, Merleau-Ponty, Ricoeur, and Taylor, four orientations to health history and nursing are explored: orientation to caring, orientation to narrative, orientation to time, and orientation to the body. The nursing health history is used as a vehicle for illuminating the usefulness of a hermeneutic perspective in everyday nursing practice. This article reveals views of health, history, and health history that are already known to nurses and the nursing milieu but are concealed by more dominant outlooks. The hermeneutical perspective presented in this article can help to reveal the important dimensions of everyday nursing practice and foster a richer attunement with the complex health experiences of individuals.

Taking a closer look at gender-transformative health promotion programming as a vehicle for addressing gender-based inequities in health and care.

Gender-transformative health promotion addresses the reciprocal transactions between the socio-cultural contexts that shape gender-based values and the gender-normative behaviors and health experiences of individuals. A scoping review was conducted to (a) highlight how, when and under what circumstances gender-transformative health promotion is applied in practice, and (b) critically assess the operationalization of gender-transformative health promotion principles in practice to develop a clearer understanding of potential barriers (both conceptual and practical) that may detract from the broader employment of gender-transformative health promotion as a mainstream programming approach. Specific recommendations, based on the findings of this review, are made in an effort to further the operationalization of gender-transformative health promotion as a mainstream health promotion approach, globally.

People-powered data collaboratives: fueling data science with the health-related experiences of individuals.

The creation of people-driven data collaboratives, with governance structures that enable participants to have a meaningful voice in issues surrounding the use of their own data, is a novel strategy to harness our growing capacity to develop and maintain immense data assets from the real health experiences of individuals.

Oral health experiences of individuals with Rett syndrome: a retrospective study

BackgroundThere is relatively little literature on the oral health experiences of individuals with Rett syndrome. This study described the incidence of dental extractions and restorations in a population-based cohort, according to a range of demographic and clinical factors. The association between bruxism and age was also investigated.MethodsExisting questionnaire data in the population-based Australian Rett Syndrome Database for the years 2004, 2006, 2009 or 2011 on genetically confirmed female cases (n = 242) were analysed.ResultsThe incidence rate of restorations and extractions were 6.8 per 100 person years (py) and 9.3 per 100 py respectively. The incidence of extractions decreased with increasing levels of income. Compared to those with a C-terminal mutation, the incidence rate of extraction was higher for those with large deletions (Incidence Rate Ratio (IRR) 4.93; 95% CI 1.46–16.7, p = 0.01). There was a 5% decrease in the risk of frequent bruxism for every one-year increase in age (Risk Ratio 0.95; 95% CI 0.94–0.97).ConclusionsSocial advantage may provide some protection for dental health in individuals with Rett syndrome. Those with more severe genotypes seemed to have poorer oral health outcomes.

Patient and Practitioner Perspectives on Culturally Centered Integrated Care to Address Health Disparities in Primary Care.

Addressing the multifaceted health and mental health needs of ethnically and culturally diverse individuals is a challenge within the current health care system. Integrated care provides a promising approach to improve mental health treatment-seeking disparities; however, adaptation of care models to impact African Americans is lacking. Although resources to support engagement of diverse populations in depression care exist, little has been developed to tailor patient preferences in accessing and engaging mental health services that are integrated into primary care. Our research seeks to add a cultural focus to the existing literature concerning integrated health care models to help address depression and selected co-occurring chronic health conditions in primary care settings. Thirty-two adult patients of an integrated primary care clinic participated in focus groups discussing their individual health experiences. Nine health care practitioners/administrators from five different integrated practice settings in the Atlanta, GA, area participated in key informant interviews. Transcripts were analyzed for key themes related to depression care, perceived unmet cultural needs, and desired adaptations. Common themes emerged such as the importance of peer-support and community engagement as areas of patient interest. Participants had good knowledge in recognizing depressive symptoms but were less knowledgeable about treatment options and expectations of treatment. The administrative and practitioner perspective suggests that patient preferences are valued and perceived as valid. It is critical that strategies and models are developed to improve health care among underserved minorities because current models offer variable efficacy among this population.

Toward a Socio-Territorial Approach to Health: Health Equity in West Africa.

This study contributes to the literature about the effects of space and place on health by introducing a socio-territorial approach to urban health disparities in West Africa. It explores how urban spaces, specifically neighbourhoods, are shaped by social and economic relations and strategies of territorial control. We examine the potential influence of socio-territorial processes on vulnerability to disease, access to medical care, healthscapes, and illness experiences. Our research was conducted in Senegal and relied on a mixed methods design. We identified four neighbourhoods that represent the socio-spatial heterogeneity of the city of Saint-Louis and utilized the following methods: geographic and anthropological field research, household surveys, health knowledge and behaviour surveys, clinical exams, and illness interviews. Our results highlight the socio-territorial processes at work in each neighbourhood, clinical findings on three health measures (overweight, high blood pressure, and hyperglycaemia) and health experiences of individuals with hypertension or type II diabetes. We found significant differences in the prevalence of the three health measures in the study sites, while experiences managing hypertension and diabetes were similar. We conclude that a socio-territorial approach offers insight into the complex constellation of forces that produce health disparities in urban settings.

It's A Family Affair: Reflections About Aging and Health Within a Family Context.

One's health and aging cannot be uncoupled from the family system in which it occurs. Not only do families provide genetic material that determines major health risks and outcomes, families also share a culture, environment, and lifestyle that further influence health and aging trajectories. As well, family members are interconnected, so that an illness or a positive lifestyle change in one person can have reverberating effects on the health and well-being of others in the family system. This essay explores how families have the potential to both promote and threaten individual health and well-being, thereby influencing how an individual might age or experience later life. Weaving together personal biographies from three different authors, this essay provides specific examples of how the family affects the health and aging of individuals and how the health and aging of individuals affect the larger family unit. These dynamic processes have the potential to positively or negatively shape individual experiences of health and aging, even among those persons who are not yet in late life. This essay blends a developmental life course perspective with a dynamic family-systems approach to show how families engage in collaborative efforts throughout the life course, in which they both affect and are affected by the diagnosis and management of chronic diseases and the adoption of health promoting behaviors. Applying this perspective to the study of health and aging calls for interdisciplinary thinking, as well as novel methodological and quantitative solutions.

Nursing their way not our way: working with vulnerable and marginalised populations.

This paper uses the findings of two studies to explore the nature of nurses practice when working with vulnerable and marginalised populations, particularly with regard to the attributes of holism and individualised care. A secondary analysis of the findings of two separate studies was undertaken, one on the elderly with delirium and the other with indigenous Maori women. Often considered vulnerable and marginalised, elderly and indigenous experiences of health services are often fraught with their health needs not always identified or addressed. Nursing claims that holism and individualised care are pivotal attributes underpinning nursing practice. However, the secondary analysis of two research studies highlight how vulnerable and marginalised populations accessing health and nursing services experience needs that are neither acknowledged nor integrated into intervention and treatment plans. A secondary analysis of one study with the elderly with delirium used a critical gerontological methodology informed by postmodernism and Foucaults understanding of discourse. The other study with indigenous Maori women utilised Glaserian grounded theory informed by a Maori-centred methodology. The research on the elderly with delirium analysed 20 data sources, including interviews with older persons who had experienced delirium, members of their families and health professionals. The research with 38 indigenous Maori women aged between 24 and 65 years, inductively analysed interview data using constant comparative analysis, theoretical sampling and saturation of the core categories to generate a substantive grounded theory. The findings of each study showed that a problem focussed approach to health care is offered to patients that does not incorporate individual health experiences. In addition, the social context integral to peoples lives outside of the health care environment is ignored and as such the very foundations of nursing practice, that of holism, is merely a rhetorical construct. Vulnerable and marginalised patients experience care that neglects their perceived health needs and the realities of their life circumstances. Individualised care that extends beyond the presenting issue is vital, but raises challenges when working with those population groups considered vulnerable and marginalised to improve outcomes of their health experience.

Integrating cortisol and isotopic analyses of archeological hair: reconstructing individual experiences of health and stress.

Archeological hair from 14 adults from the Nasca Region, Peru (c. AD1-1000) was analyzed for carbon and nitrogen isotopic compositions and cortisol levels. We investigated the relationship between isotopic compositions, which reflect diet, and cortisol, which reflects biogenic cortisol production and chronic stress. Using a case study approach, we determined that there are consistent changes in cortisol production associated with the rapid dietary change characteristic of local mobility. Moreover, changes in nitrogen- and carbon-isotope compositions, when integrated with cortisol levels, enabled inferences to be made about nitrogen metabolism and carbon routing, and elucidated the nature of potential stressors in the months before death. The isotopic and cortisol data suggested a relatively high rate of exposure to stress that is consistent with what is known about the Nasca Region social and physical environments. Of the 14 adults included in this study, six likely suffered from illness/trauma before death, and a further three experienced stress without an observable associated change in isotopic composition. Five individuals also experienced increased stress related to local mobility, inferred from co-occurring changes in cortisol production and dietary shifting. The integration of cortisol and isotopic data revealed individual characteristics of hidden frailty and risk that would not be apparent using more traditional methods of evaluating health status. This approach will provide a powerful enhancement to the understanding of stress, morbidity, and well-being developed through skeletal analysis.

Rethinking the Experience of HIV-Positive Refugee Women in the Context of Pregnancy: Using an Intersectional Approach in Nursing

When providing care to HIV-positive refugee women in the context of pregnancy, nurses must be able to move beyond the individual experiences of health and illness and acquire a more meaningful understanding of the historical, social, cultural, political, and structural influences that shape women's health and women's lives. Intersectionality is a framework that focuses on various dimensions of a refugee woman's social identity such as race, class, gender, as well as education, citizenships, and geographic location and how these dimensions intersect to influence the experiences of health and illness. In this article, we present a brief overview of the origins and evolution of intersectionality. From there we describe three distinct levels of analysis: (a) micro-level analysis to examine the influences that impact the social identity and social location of women; (b) meso-level analysis to explore informal and formal support systems; and (c) macro-level analysis to interrogate historical, social, cultural, political, and structural influences that shape health outcomes. Finally, we will examine how this framework may be useful for nursing practice, research, and knowledge development. We hope to illustrate how intersectionality is a useful framework to understand the experiences of HIV-positive refugee women in the context of pregnancy.

Gender (in)equality among employees in elder care: implications for health.

IntroductionGendered practices of working life create gender inequalities through horizontal and vertical gender segregation in work, which may lead to inequalities in health between women and men. Gender equality could therefore be a key element of health equity in working life. Our aim was to analyze what gender (in)equality means for the employees at a woman-dominated workplace and discuss possible implications for health experiences.MethodsAll caregiving staff at two workplaces in elder care within a municipality in the north of Sweden were invited to participate in the study. Forty-five employees participated, 38 women and 7 men. Seven focus group discussions were performed and led by a moderator. Qualitative content analysis was used to analyze the focus groups.ResultsWe identified two themes. "Advocating gender equality in principle" showed how gender (in)equality was seen as a structural issue not connected to the individual health experiences. "Justifying inequality with individualism" showed how the caregivers focused on personalities and interests as a justification of gender inequalities in work division. The justification of gender inequality resulted in a gendered work division which may be related to health inequalities between women and men. Gender inequalities in work division were primarily understood in terms of personality and interests and not in terms of gender.ConclusionThe health experience of the participants was affected by gender (in)equality in terms of a gendered work division. However, the participants did not see the gendered work division as a gender equality issue. Gender perspectives are needed to improve the health of the employees at the workplaces through shifting from individual to structural solutions. A healthy-setting approach considering gender relations is needed to achieve gender equality and fairness in health status between women and men.

A Postcolonial Feminist Perspective Inquiry into Immigrant Women's Mental Health Care Experiences

The number of immigrants coming to Canada has increased in the last three decades. As a result, there is greater emphasis on health care providers and the health care system to provide culturally appropriate and equitable care. It is well documented that many immigrant women suffer from serious mental health problems and experience difficulties in accessing and using mental health services. In this paper we advocate for new ways of research inquiry in exploring immigrant women's mental health care experiences, ones that move beyond the individual experiences of health and illness toward recognition that the health of immigrant women must be addressed within the social, cultural, economic, historical, and political context of their lives. Drawing on past research we demonstrate how the postcolonial feminist perspective can be used to illuminate the ways in which race, gender, and class relations influence social, cultural, political, and economic factors, which, in turn, shape the lives of immigrant women. We suggest that postcolonial feminism provides an analytic lens to (a) generate transformative knowledge about immigrant women's mental health care experiences; (b) improve equitable health care; and (c) increase understanding of what would be helpful in meeting the immigrant women's health care needs.

Nursing their way not our way: Working with vulnerable and marginalised populations

Aims and objectives: This paper uses the findings of two studies to explore the nature of nurses’ practice when working with vulnerable and marginalised populations, particularly with regard to the attributes of holism and individualised care. A secondary analysis of the findings of two separate studies was undertaken, one on the elderly with delirium and the other with indigenous Māori women.Background: Often considered vulnerable and marginalised, elderly and indigenous experiences of health services are often fraught with their health needs not always identified or addressed. Nursing claims that holism and individualised care are pivotal attributes underpinning nursing practice. However, the secondary analysis of two research studies highlight how vulnerable and marginalised populations accessing health and nursing services experience needs that are neither acknowledged nor integrated into intervention and treatment plans.Design: A secondary analysis of one study with the elderly with delirium used a critical gerontological methodology informed by postmodernism and Foucault’s understanding of discourse. The other study with indigenous Māori women utilised Glaserian grounded theory informed by a Māori-centred methodology.Methods: The research on the elderly with delirium analysed 20 data sources, including interviews with older persons who had experienced delirium, members of their families and health professionals. The research with 38 indigenous Māori women aged between 24 and 65 years, inductively analysed interview data using constant comparative analysis, theoretical sampling and saturation of the core categories to generate a substantive grounded theory.Results: The findings of each study showed that a problem focussed approach to health care is offered to patients that does not incorporate individual health experiences. In addition, the social context integral to people’s lives outside of the health care environment is ignored and as such the very foundations of nursing practice, that of holism, is merely a rhetorical construct.Conclusions: Vulnerable and marginalised patients experience care that neglects their perceived health needs and the realities of their life circumstances.Relevance to clinical practice: Individualised care that extends beyond the presenting issue is vital, but raises challenges when working with those population groups considered vulnerable and marginalised to improve outcomes of their health experience.

“What do you expect? You're just getting older”: A comparison of perceived osteoarthritis‐related and aging‐related health experiences in middle‐ and older‐age adults

To compare the health experiences of middle- and older-age adults with moderate osteoarthritis (OA) symptoms with experiences of individuals with no chronic health conditions. Similarities and differences in health changes, the meaning of these changes, and their impact were examined. Sixteen focus groups (10 OA, 6 control) were conducted with 53 women and 37 men (age 39-88 years). OA participants were recruited from practitioners' offices and The Arthritis Society, Ontario Division. Additional OA participants and controls were recruited from community centers and newspaper advertisements. All participants were asked about changes in health, the impact of these changes, and self-management strategies. Participants also completed standardized measures including demographic information; the Short Form 36; Western Ontario and McMaster Universities Osteoarthritis Index; and Disabilities of the Arm, Shoulder and Hand questionnaire. Differences in the depth, breadth, and meaning of symptoms such as pain, stiffness, and fatigue were reported with little overlap between OA and control groups. OA was often seen as part of a normal aging process requiring acceptance, not treatment. However, younger OA participants reported more distress and frustration managing the disease. OA participants reported an impact of their health on work, leisure, social activities, and relationships that was described as upsetting compared with controls. This study illuminates personal and social factors associated with OA by comparing health experiences of individuals with OA and controls. It highlights directions for future research that can improve our understanding of the needs of individuals with OA and can help link individuals' health status to the broader framework of their lives.