Novas vidas, novos desafios: acesso a serviços de violência por parceiro íntimo para mulheres imigrantes de língua portuguesa / New lives, new challenges: access to intimate partner violence services for portuguese-speaking immigrant women

A violência por parceiro íntimo é um problema global e mais comum sofrida pelas mulheres. Este estudo explorou barreiras aos serviços de saúde relacionadas à violência por parceiro íntimo entre mulheres imigrantes de língua portuguesa em Toronto, Canadá. Estudo exploratório de discussões em grupo com 12 mulheres imigrantes de língua portuguesa. Os resultados esclarecem lutas enfrentadas pelas mulheres imigrantes e seus caminhos para cuidar e buscar ajuda. O medo de serem deportadas, a obtenção de evidências de abuso e a falta de serviços no idioma específico foram as barreiras relatadas. Fé e religião foram apontadas como fatores-chave no apoio a resiliência das mulheres, quando disponíveis os serviços comunitários no idioma específico. Enfermeiros que prestam assistência às mulheres que lidam com a violência por parceiro íntimo devem repensar o escopo de suas ações de defesa para abordar essas barreiras estruturais, construindo alianças com organizações para melhor servir e proteger as mulheres em situações vulneráveis.

Intimate partner violence is a global health issue and the most common form of violence experienced by women. This study explored barriers to accessing help to Intimate partner violence related health services among Portuguese-speaking immigrant women in Toronto, Canada. Exploratory study conducted by a survey and focus group discussions with 12 Portuguese-speaking immigrant women. Results clarify the struggles faced by Portuguese-speaking immigrant women and their pathways to care and help-seeking. Participants reported that the fear of being deported, obtaining evidence of abuse, and lack of language-specific services were the key barriers to seeking help. When available, language-specific community-based services, along with faith and religion, were noted as key factors that supported women's resilience. Nurses who provide care and services to women who are dealing with Intimate partner violence should rethink the scope of their advocacy actions toward addressing these structural barriers by building alliances with organizations to better serve and protect women in such vulnerable situations.

Insights for public education provided by French media on ideas about prostate cancer - A media analysis study.

Background: This study explored the French media's presentation of ideas and medical information about prostate cancer (PC) that may influence men's understanding, attitudes and behavior. Methods: A qualitative media content analysis centered on PC information delivered by French professional media. The selected data were produced in the aftermath of the High Health Authority's decision in 2008 not to recommend systematic screening by prostate specific antigen(PSA) for men over 50. Source was the Media Archives of the French National Library. Content was analyzed from 15 television programs, 14 radio programs, and 55 articles from 35 popular French newspapers (online and printed, weekly and monthly) and 20 magazines. Audio content was narrated into textual form and submitted to manual coding along with the print content. Results: Television and radio content focused on the nature of PC, screening and treatment,and conveyed a gender-centric position linked to male sexuality and virility. Newspapers and magazines targeted the testing controversy, the lack of consensus among professionals, and scientific advances in screening and treatment. Conclusion: Media participation in the European testing debate is valuable for allowing patients to hear all opinions on PC risk factors. Debate on testing policy contributes to confusion and uncertainty regarding appropriate action.

Immigrant grandmothers' and mothers-in-law's cancer literacy within their family context.

Data from focus groups held in Montréal (Canada) with 13 women born in Cameroon, Colombia, and Democratic Republic of Congo were used to explore cancer knowledge among immigrant grandmothers and mothers-in-law and their influence over family cancer-preventative practices. Thematic analysis identified the following leading themes: cancer literacy and influence over family cancer preventative and early detection practices, cancer literacy in relation to family health behaviors, and barriers to accessing health services. Perceived external causes of cancer and its prevention are countered by healthy eating and exercises. Cancer literacy was contextualized by the development of women's ways of being and doing.

Canadian Men's Self-Management of Chronic Diseases: A Literature Analysis of Strategies for Dealing With Risks and Promoting Wellness.

This article reviews the qualitative research on men's self-management of mental and physical chronic diseases, with emphasis on strategies for dealing with risks and promoting wellness. Using Bardin's method of document analysis, it was focused on the findings of Canadian qualitative studies published in French or English from 2005 to 2011. Boltanski's theory on social uses of the body inspired the analysis. Living with a chronic disease threatens men's sense of masculinity and self-image, as well as their perceived ability to fulfill expected social roles. Social images of men's bodies influence how men express their emotions, attributes, and attitudes, or acknowledge the need for and seek social affirmation. Self-management has been documented in Canadian qualitative literature as a complex phenomenon influenced by the social environment, personal capacities, feelings, perceptions, and potentials. The extent of how all these features interact within the scope of men's mental and physical health and illness experiences was partially revealed in this study. The findings underscore the social invisibility of men's bodies, especially those of men facing social inequities. Attending to principles of social justice can ensure that future research on men's health will amplify the range of men's voices and allow them to be heard. Recommendations address also the international scientific community interested in advancing men's health research, especially in those countries that lack a national men's health policy.

Partnership, Trust and Leadership among Nursing Researchers.

Members of a nursing research cluster realized that they needed to determine whether, given their diverse philosophies, they could formulate a collective research agenda responding to an administrative recommendation. The cluster's leaders conducted an appraisal of the role and importance of trust as an element for promoting collaboration in a nursing research cluster and for building a collective social identity. The Social Exchange Theory framed the appraisal. A survey and a facilitation session about trust in research partnerships were conducted with eight female nursing researchers/faculty. Facilitation day's discussion was fully audio recorded, transcribed verbatim and the content coded using ATLAS.ti 6. Thematic analysis was employed to analyze the qualitative aspects of the recorded discussion and the survey questionnaire explanatory responses. Responses to survey closed-questions were compiled as descriptive statistics. Participants revealed that mutual support, valuing each other and working collaboratively facilitated trust in intellectual partnership. Hindering factors were an environment suppressing expression of ideas and views, lack of open dialogue and decision-making among team members and lack of a sense of belonging. This paper has the potential to contribute to the knowledge of nursing leaders who are intending to develop and sustain nursing research teams in both academic and non-academic organizations. The paper will be especially useful as they deal with issues of trust in intellectual partnership in diverse settings.

Brazilian community health agents and qualitative primary healthcare information.

AIM: The aim of this study was to explore female community health agents' views about the value of recording qualitative information on contextual health issues they observe during home visits, data that are not officially required to be documented for the Brazilian System of Primary Healthcare Information. BACKGROUND: The study was conducted in community primary healthcare centres located in the cities of Araçatuba and Coroados (state of São Paulo) and Rio de Janeiro (state of Rio de Janeiro), Brazil. METHODS: The design was a qualitative, exploratory study. The purposeful sampling criteria were being female, with a minimum of three years of continuous service in the same location. Data collection with 62 participants was conducted via 11 focus groups (in 2007 and 2008). Audio files were transcribed and submitted to the method of thematic analysis. Four themes guided the analysis: working with qualitative information and undocumented observation; reflecting on qualitative information; integrating/analysing quantitative and qualitative information; and information-sharing with agents and family health teams. In 2010, 25 community health agents verified the final interpretation of the findings. FINDINGS: Participants valued the recording of qualitative, contextual information to expand understanding of primary healthcare issues and as an indicator of clients' improved health behaviour and health literacy. While participants initiated the recording of additional health information, they generally did not inform the family health team about these findings. They perceived that team members devalued this type of information by considering it a reflection of the clientele's social conditions or problems beyond the scope of medical concerns. Documentation of qualitative evidence can account for the effectiveness of health education in two ways: by improving preventative care, and by amplifying the voices of underprivileged clients who live in poverty to ensure the most appropriate and best quality primary healthcare for them.

Self-determination and information seeking in end-stage cancer.

When patients learn that their cancer has recurred after primary treatments or is no longer responding to therapy and no alternative treatment options exist, their motivation to carry on living may be impacted greatly. Using the Self-Determination Theory, this article's reflective analysis explores the unique situation of a woman with end-stage cancer and her continuous motivation to seek information about her illness. Information was gathered during clinical observations and informal conversations. The analysis showed how the patient sought information about her illness, how she manifested motivation, and how the hospital's social environment influenced her behavior. To understand the experience of being confronted with a terminal illness, the following issues are identified: expansion of awareness, life-facing knowledge contradictions, being open-minded and an active explorer of information sources, medical truth, and professional attitudes toward patients' informational needs. Nurses must understand patients' reasons for self-determination when facing illness uncertainty. Reflecting on such situations will strengthen nursing practice.

Health literacy within the reality of immigrants' culture and language.

The Second Canadian Conference on Literacy and Health addressed issues of health literacy, culture, and linguistic diversity. This article aims to introduce the presenters' ideas, reports of the learners' discussion, and attendees' recommendations. There is also a literature review of the links between health literacy and use of health services among newcomers in Canada. Newcomers to Canada tend to be unfamiliar with the Canadian health care system in terms of navigating needed services and/or seeking health-related information. Health professionals report difficulties in communicating effectively with these populations about risk-taking behaviours. Educational resources and approaches only partially reach people from cultural minorities. E-health information does little for those with language and literacy limitations. Barriers to accessing information, specifically written material, are widely reported. Consequently, many ethnocultural groups do not participate in health promotion initiatives. Among newcomers to Canada, the problems of adapting to a new health culture are linked to both a lack of information about the new health care available and subsequently their experience with that health care system. There is also a structural barrier. It includes lack of access to preventive health care services and the lack of a formal and informal support network. This results in less effective use of these preventive services. Linguistic, religious, and cultural factors contribute to the newcomers' social isolation. Multidisciplinary work to enhance health literacy and awareness about health and healthy lifestyles will permit ethnocultural populations to develop their potential and more fully enjoy their lives in Canada. Simultaneously, health educators should have the opportunity to realize their limitations and challenges in dealing with the complexity of providing health education to this population. There remain gaps in our knowledge about the access and use of health services by subpopulations from different cultural groups in terms of their gender, learning practices, ways of navigating services, and help-seeking behaviours.

Educação, crescimento e fortalecimento profissional do Agente Comunitário de Saúde - estudo etnográfico / Education and professional strengthening of the community health agent - an ethnography study

Este estudo-piloto explorou as ações educativas do agente comunitário de saúde (ACS) junto a populações socialmente não afiliadas1 em área metropolitana do Rio de Janeiro. Através de entrevistas individuais e grupais, observação participante em visitas às comunidades e fotografias, apreendeu-se a dimensão filosófica e empírica do trabalho educativo conduzido pelo ACS. O material coletado foi codificado utilizando-se o software ATLAS ti. 4.2 e analisado segundo o método "Abdução em Comunicação" revelando identidade sócio-profissional, consciência política quanto à organização trabalhista e críticas quanto ao descaso à proteção ocupacional e à falta de apoio governamental. O presente artigo enfatiza a "voz" do ACS como liderança social, principal facilitador do fortalecimento da população assistida e importante otimizador da rede de prestação de serviços de saúde, propondo elementos de reflexão dos pontos de conflitos, contradições e paradoxos na prática profissional e no suporte aos seus desejos de mudar de condição e de liberdade para atuar.

This inquiry explored the educative actions of Community health agents (CHAs) with socially disaffiliated populations in a Rio de Janeiro metropolitan area. Individual and group interviews, participant observation during visits to the shantytowns, and picture gathering apprehended the philosophical and empirical dimensions of such actions. The software ATLAS ti. 4.2 supported the coding procedures of the raw material. Abduction in communication framed findings' analysis and interpretation. Analysis revealed their social professional identity, political awareness regarding their own organization as a professional group, plus criticisms regarding the negligence of occupational safety and the lack of governmental help. CHAs "voice" is a tool of social leadership and a main facilitator to empower the population, and to promote optimization of the health care system. Since their professional practice revealed conflicts, contradictions and paradoxes, it seems necessary a collective reflection on the needed support to sustain CHAs wishes for change and freedom to act.

Este estudio piloto exploro las acciones educativas del agente comunitario de salud (ACS) con poblaciones socialmente no afiliadas del área metropolitana de Río de Janeiro. A partir de entrevistas individuales y de grupo, observaciones participativas realizadas durante las visitas en las comunidades y fotografías, se trato de comprender las dimensiones filosóficas y empíricas del trabajo educativo del ACS. El material recogido fue codificado utilizando ATLAS ti. 4.2 y analizado según el método "Extracción en la comunicación". El análisis mostró elementos sobre la identidad profesional, la conciencia política en relación a su propia organización como grupo profesional y críticas en cuanto a la inseguridad ocupacional y la carencia de ayuda gubernamental. "La voz" del ACS es un instrumento de liderazgo social y un mecanismo importante para fortalecer la población, y promover la optimización del sistema de salud. Ya que su práctica profesional revela conflictos, contradicciones y paradojas, parece necesaria una reflexión colectiva sobre el apoyo necesario para sostener el ACS para el cambio y la libertad de actuar.

A incerteza e o comportamento de busca de informação em saúde / Uncertainty and health information-seeking behaviour

Esta análise conceitual explorou a influência da incerteza sobre o comportamento de busca de informação em saúde. Relevantes para a promoção da saúde, a incerteza na doença e, a orientação pela incerteza foram analisadas ao interior de duas teorias aplicando-se o método de Wilson1. Os resultados destacaram o significado cognitivo e o comportamento guiado por desejos, motivação e desempenho. Concluiu-se que autoproteção, transição, transformação ou transcendência justificam tal comportamento. Os resultados contribuem para a prática reflexiva e a incorporação de teorias. Pesquisas utilizando outras teorias motivacionais contribuirão para redimensionar intervenções educativas ou de sustentação de tal comportamento de saúde.

This conceptual analysis explored the influence of "uncertainty" on the health information-seeking behaviour. The concepts of uncertainty in illness and uncertainty orientation were analyzed within two theoretical frameworks applying Wilson's 1method. The results proved relevant to the field of health promotion indicating that cognitive meaning, behavioural tendency, wishes, motivation and performance were at play in information-seeking. In conclusion, self-protection, transition, transformation and transcendence justified such behaviour. The results contribute to the reflective practice and incorporation of theories into practice. New studies with other motivational theories will further contribute to redesign educative interventions and to sustain interventions related to health behaviour.

Understanding functional health literacy in experiences with prostate cancer: older men as consumers of health information

This paper presents part of the findings of a doctoral study aiming to understand the construction of informational strategies for living and dealing with Prostate Cancer related information according to self-reported levels of functional health literacy. A qualitative modeling design framed the inquiry through the constructivist perspective. Older men recreate modes of living and attitudes toward information according to their social and cultural capital, as well as the intensity of their contact with an informational network. Self-reported levels of functional health literacy seem to be harmonious with distinct informational profiles/patterns despite differences in general literacy or formal education. This study implies a new understanding of functional health literacy and its role, the dynamics of social/informational networks, as well as the needs of redesigning communication strategies.