The Complexities of Intimate Partner Violence: Mental Health, Disabilities, and Child Abuse History for White, Indigenous, and Other Visible Minority Canadian Women.

This research examines how mental health issues associated with intimate partner violence (IPV) relate to women's intersecting identities of race/ethnicity, disability status, and child abuse history. Data (N = 595) from a Canadian triprovincial study included women who were White (n = 263, 44.8%), Indigenous (n = 292, 49.7%), or visible minority (n = 32, 5.5%). Few demographic differences were found. None of the mental health measures (Symptom Checklist-Short Form [SCL-10], Centre for Epidemiological Studies-Depression [CES-D-10], Posttraumatic Stress Disorder [PTSD] Checklist) were in the clinical ranges. In a MANCOVA on the mental health scales, with IPV severity, racial group, disability status, and child abuse history as variables, only disability was significantly associated with more mental health symptoms.

A Web of Disheartenment With Hope on the Horizon: Intimate Partner Violence in Rural and Northern Communities.

Intimate partner violence (IPV) has become a worldwide epidemic, yet little is known about the experiences of women survivors living in rural and Northern Canadian communities. Existing statistics suggest that women living in rural areas of the Canadian Prairie Provinces and Northwest Territories (NWT) are at a significantly higher risk of experiencing IPV. To better understand the experiences of IPV in these regions, qualitative interviews were conducted with service providers, including the Royal Canadian Mounted Police (RCMP), Victims Services, Shelter Services, counselors, and others (e.g., physicians). In total, 122 participants were interviewed. These interviews were analyzed using a grounded theory approach where the data/results were transformed into a pictorial matrix that documents the struggles that service providers endure. The matrix/results highlight how social issues, such as isolation and poverty, contribute to social oppressions, such as lack of resources, transportation, and/or services. As service providers struggle against these forces, they begin to develop feelings of disheartenment. Yet, they continue to fight because there are opposing forces, such as Emergency Intervention Orders, police transportation, and Victim Services, that demonstrate how societal response is improving the lives and increasing safety in rural and Northern communities. Ultimately, the results suggest that to reduce the incidences of IPV, we must go beyond the violent acts and deal with the social contexts in which IPV resides.

The Mental Health and Well-Being of Canadian Indigenous and Non-Indigenous Women Abused by Intimate Partners.

Intimate partner violence (IPV), mental health, disabilities, and child abuse history were examined for 292 Indigenous compared with 295 non-Indigenous Canadian women. IPV was assessed by the Composite Abuse Scale and mental health by the Symptom Checklist-10, Center for Epidemiological Studies-Depression 10, the Posttraumatic Stress Disorder (PTSD) Checklist, and Quality of Life Questionnaire. Scores did not differ nor were they in the clinical ranges for the two groups. In a MANCOVA on the mental health/well-being scales, with IPV severity as a covariate, only disability was significantly associated with more severe mental health symptoms. Suggestions for service providers are presented.

Responding to Intimate Partner Violence: Challenges Faced Among Service Providers in Northern Communities.

The current study examined the needs of women experiencing intimate partner violence (IPV) in a profiled northern community in Saskatchewan, Canada. A focus group was conducted with eight knowledgeable and experienced service providers to gain an increased understanding of the needs of women IPV survivors in northern regions of Canada. The discussion was guided by the question of "What do you see as the needs of women coming through your services with regard to intimate partner violence?" Qualitative analyses highlighted important findings pertaining to the unique needs of women experiencing IPV and the challenges service providers face in northern regions. Suggestions for improvement among resources and services were discussed. The findings will enhance the ability of government representatives and community service providers to decipher the effectiveness of support services and resources for women living in geographically diverse areas.

Evaluation of the living with hope program for rural women caregivers of persons with advanced cancer.

BACKGROUND: Hope has been identified as a key psychosocial resource among family caregivers to manage and deal with the caregiver experience. The Living with Hope Program is a self-administered intervention that consists of watching an international award winning Living with Hope film and participating in a two week hope activity ("Stories of the Present"). The purpose of this study was to examine the effects of the Living with Hope Program on self-efficacy [General Self-Efficacy Scale], loss and grief [Non-Death Revised Grief Experience Inventory], hope [Herth Hope Index] and quality of life [Short-Form 12 version 2 (SF-12v2)] in rural women caring for persons with advanced cancer and to model potential mechanisms through which changes occurred. METHODS: A time-series embedded mixed method design was used, with quantitative baseline outcome measures repeated at day 7, day 14, and 3, 6 and 12 months. Qualitative data from the hope activity informed the quantitative data. Thirty-six participants agreed to participate with 22 completing all data collection. General estimating equations were used to analyze the data. RESULTS: Herth Hope Index scores (p=0.05) had increased significantly from baseline at day 7. General Self Efficacy Scale scores were significantly higher than baseline at all data time points. To determine the mechanisms of the Living with Hope Program through which changes occurred, results of the data analysis suggested that as General Self Efficacy Scale scores increased (p<0.001) and Non-death Revised Grief Experience Inventory scores decreased (p=0.01) Herth Hope Index scores increased. In addition as Herth Hope Index scores increased (p<0.001) and Non-death Revised Grief Experience Inventory scores decreased (p=0.01), SF-12v2 mental health summary scores increased. Qualitative data suggested that through the hope activity (Stories of the Present) the participants were able to find positives and hope in their experience. CONCLUSIONS: The Living with Hope Program has potential to increase hope and improve quality of life for rural women caregivers of persons with advanced cancer. The possible mechanisms by which changes in hope and quality of life occur are by decreasing loss and grief and increasing self-efficacy. TRIAL REGISTRATIONS: Registration ClinicalTrials.gov, NCT01081301.

Completing the circle: elders speak about end-of-life care with aboriginal families in Canada.

In this article, we share words spoken by Aboriginal elders from Saskatchewan, Canada, in response to the research question, "What would you like non-Aboriginal health care providers to know when providing end-of-life care for Aboriginal families?" Our purpose in publishing these results in a written format is to place information shared by oral tradition in an academic context and to make the information accessible to other researchers. Recent theoretical work in the areas of death and dying suggests that cultural beliefs and practices are particularly influential at the end of life; however, little work describing the traditional beliefs and practices of Aboriginal peoples in Canada exists to guide culturally appropriate end-of-life care delivery. Purposive sampling procedures were used to recruit five elders from culturally diverse First Nations in southern Saskatchewan. Key informant Aboriginal elder participants were videotaped by two Aboriginal research assistants, who approached the elders at powwows. Narrative analysis of the key informant interview transcripts was conducted to identify key concepts and emerging narrative themes describing culturally appropriate end-of-life health care for Aboriginal families. Six themes were identified to organize the data into a coherent narrative: realization; gathering of community; care and comfort/transition; moments after death; grief, wake, funeral; and messages to health care providers. These themes told the story of the dying person's journey and highlighted important messages from elders to non-Aboriginal health care providers.

Child and adolescent mental health policy and plans in Canada: an analytical review.

OBJECTIVE: Child and adolescent mental disorders are common, with a substantial disease burden, yet services for young people are nationally inadequate. As services should be based on policies and (or) plans, we analyzed the availability and content of child and adolescent mental health policies and plans in all provinces and territories. METHOD: The World Health Organization (WHO) framework for Child and Adolescent Mental Health Policy and Plans was applied. RESULTS: Four provinces in Canada have a child and adolescent mental health policy and (or) plan. The other provinces do not have a policy or plan in place, or else try to integrate these components into existing mental health strategies. Among the policies and plans that exist, there is substantial variability regarding content as well as degree of adherence to the WHO template. Five essential content areas: legislation and human rights, information systems, quality improvement, improving access to and use of psychotropics, and human resource development and training are poorly or very poorly addressed in existing policies and (or) plans. CONCLUSION: This lack of specific policy and (or) plans for child and adolescent mental health care and the variability of content in plans that exist may help explain why child and adolescent mental health services are poorly developed across Canada. We suggest that a national child and adolescent mental health policy framework be developed for Canada so that the provinces and territories may be encouraged to create or amend their current child and adolescent mental health frameworks in a manner that may enhance national cohesion and commonly addresses service needs in this population.

A process model of Depo-Provera use in Canadian women.

This study investigated women's experiences with the long-acting, injectable contraceptive Depo-Provera. Fourteen women were interviewed and 57 charts of clients at a Canadian Sexual Health Centre were reviewed to generate a theory of use. A three-stage process model describes women's choice of this contraceptive and decision to continue or discontinue use. This model suggests that women's use of Depo-Provera is determined by a complex interaction of individual cognition, relational processes, and sociocultural contexts.