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Biomedical subjects

J L Bottorff

Publications and source records attributed to J L Bottorff.

At least 19 recordsLinked to original sources
PubMed2001

The desi ways: traditional health practices of South Asian women in Canada.

Although many South Asian immigrants have made their homes in Canada, little research has examined health behaviors in this population and fewer studies have examined the use of traditional health practices. As part of a larger study on health-seeking patterns of South Asian women living in Western Canada, an analysis was done on the use of traditional health practices. Using critical ethnographic methods, data were collected through face-to-face individual interviews (n = 50), focus group discussions (n = 12), and community meetings with a cross section of women in the South Asian community. Interviews were conducted in the language of each participant's choice. Thematic analysis was done on the transcribed interviews. Women's descriptions of traditional health practices varied and consisted of home remedies, dietary regimens, prayers, rituals, and consultation with hakims, veds, babajis, pundits, homeopaths, and jyotshis. Choosing to use traditional health practices was influenced by family members, the nature and severity of problems, beliefs and prior experiences, and the feasibility of using these practices. Traditional health practices were used on a daily or episodic basis. Women rarely used traditional health practices exclusively. Traditional health practices were used for small problems or when conventional medicines did not work. For women to meet their health needs, health care providers must be culturally sensitive and respect women's choices to use traditional health practices.

Attitude↗
PubMed2001

An observational study of the development of a nurse-patient relationship.

The purpose of this exploratory descriptive case study was to identify features of nurse-patient interactions (NPI) in the development of a nurse-patient relationship (NPR). Observations of interactions in a cancer treatment unit included 60 videotaped, sequential, naturally occurring NPIs involving one dyad over a 3-day period. A microanalysis of the interactions was conducted using qualitative ethological methods. The analysis focused on identifying important recurring behavioral clusters and characteristic patterns of behavior that comprised these clusters. Important features of NPIs in the development of an NPR were identified and described in detail. The active and complementary roles of both participants in this process and the contribution of social exchange, trust, and humor are highlighted. The findings illustrate the importance of continuity of nursing care if NPRs are to be used to their fullest extent to address complex patient care needs.

Humans↗
PubMed2001

A meta-analysis of mammography screening promotion.

The purpose of this study was to identify factors that influence the effectiveness of interventions in increasing women's use of mammography screening programs. To this end, we conducted a systematic literature review of studies published between 1966 and 1997. In this review, we recorded data about the year and country in which studies were completed, the study design, the methods for measuring screening rates, various sample characteristics, the nature of the intervention, and the resulting screening rates. The PRECEDE model was used as a framework to make distinctions between the various interventions. To synthesize evidence about the baseline screening rates and the effect of interventions on the incidence of mammography screening, we fit random-effects logistic regression models. These models revealed that more recent studies (those conducted from 1990 to 1996) were associated with higher screening rates (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.2-3.9). Conversely, those designed to target older women (minimum age, 50-65 years) and those set in clinics exhibited smaller screening rates (OR, 0.6, 95% CI, 0.3-1.0, and OR, 0.5; 95% CI, 0.3-0.8, respectively). The meta-analyses also suggested methodologic issues that must be considered before the relative strength of various interventions can be assessed rigorously.

Adult↗
PubMed2001

Cervical cancer screening in ethnocultural groups: case studies in women-centered care.

INTRODUCTION: The purpose of this study was to identify and describe critical elements of women-centered care within the context of providing cervical screening to three ethnocultural groups in Canada: Asian, South Asian and First Nations. METHODS: Data for this collective case study included open-ended interviews with purposive samples of women and key informants from each target group. Following thematic analysis, cross-case analysis was completed by comparing and contrasting issues and contextual factors influencing women's and providers' experiences. RESULTS: Cervical screening services for each group were shaped by attention to ethnocultural values, women's desire for thorough explanations, and the importance of a comfortable setting. While participation rates varied across clinics, women were positive about their experiences in obtaining cervical screening. Some women's expectations that they could address a range of health concerns with female health providers at the clinics were stymied by structural barriers that prevented staff from addressing issues beyond those directly related to cervical screening. Cross-case analysis revealed three key elements of women-centered care: respectful and culturally appropriate interactions between women and health providers, the importance of providing acceptable alternatives for women, and the need for comprehensive health services. CONCLUSION: While the establishment of Pap test clinics for ethnocultural groups has the potential to enhance participation in cervical screening, changes in health policy and the structure of health services are required for existing programs to fully implement the elements of women-centered health care identified in this study. Other models of providing health care to women in ethnocultural groups, including the use of clinics staffed by nurse practitioners, should be evaluated.

Adult↗
PubMed2000

Narratives of smoking relapse: the stories of postpartum women.

Many women who stop smoking during pregnancy relapse soon after the birth of their infants. Using narrative research, experiences of smoking relapse were explored using interviews with 27 postpartum women. The stories of relapse were analyzed to identify important components, paying attention to commonalities, differences, and areas of emphasis. Five general story lines were identified: (1) controlling one's smoking (starting with a "puff" and consciously restricting the amount smoked); (2) being vulnerable to smoking(relapsing because of an inability to resist cigarettes); (3) nostalgia for one's former self(relapsing to recapture feelings of freedom and happier times); (4) smoking for relief(relapsing to manage emotions and stress); and (5) never really having quit (relapsing because they did not quit for themselves). The findings of this study provide support for the claim that the experiences of smoking cessation and relapse among postpartum women may be unique and, consequently, may require specialized intervention.

Adaptation, Psychological↗
PubMed2000

Facilitating day-to-day decision making in palliative care.

As part of a larger grounded theory study investigating the process by which palliative care patients make everyday choices, a secondary analysis of data was conducted to investigate the ways nurses support or restrict patients' participation in their care. Constant comparative methods were used to generate a detailed, contextually grounded description of nurses' strategies that influenced patients' participation in making everyday choices about their personal and nursing care. Data consisted of field notes derived from observations of patients and their caregivers in two hospital-based palliative care units and from 23 transcripts of interviews with participating nurses and patients. Nurses' efforts to support patients' participation in decision making were described as a four-phase process: getting to know the patient, enhancing opportunities for choice, being open to patient choice, and respecting choice. Factors influencing nurses' use of supportive behaviors and behaviors that restricted patients' participation in everyday choices were identified. Given the importance patients attributed to making choices, these findings provide a foundation for the design of nursing interventions that hold great potential for directly influencing quality of life.

Adult↗
PubMed2000

Falling through the cracks. Women's experiences of ineligibility for genetic testing for risk of breast cancer.

OBJECTIVE: To describe experiences of women seeking information about their risk of hereditary breast cancer who fail to meet strict eligibility criteria for genetic counseling and testing. DESIGN: Qualitative descriptive study. SETTING: Hereditary cancer program in western Canada. PARTICIPANTS: Women who had received notification of their ineligibility for referral for hereditary breast cancer risk assessment (n = 20) and some of their referring physicians (n = 10). Of 28 attempted contacts, five women had moved, one declined the invitation to participate, and two could not be interviewed because of scheduling conflicts. Ten of 20 physicians declined the invitation to participate. METHOD: In-depth, open-ended telephone interviews were conducted. Transcribed interviews were systematically analyzed to identify salient themes. MAIN FINDINGS: Three themes emerged. The first theme, "It's always on your mind," points to the profound concern about breast cancer that underlies women's experiences in seeking genetic testing. The second theme, "A test is a test," reflects women's beliefs that the test was relatively simple and similar to other medical tests in that it would provide a definitive answer. The third theme, "Falling through the cracks," captures the experience of ineligibility. Women reacted with a range of emotional responses and were left frustrated in their search for more specific information about their personal risk for breast cancer. Although women were encouraged to contact their physicians, few did. CONCLUSION: These findings point to the psychological consequences in women who seek genetic testing for risk of breast cancer when they are told they are ineligible and they are not given adequate information and support.

Adult↗
PubMed1999

South Asian womens' views on the causes of breast cancer: images and explanations.

Using ethnoscience methods, interviews with 50 South Asian women living in Western Canada were conducted and analyzed to explore explanations and images of breast cancer. Embedded in the women's stories of breast cancer were distinctive, often vivid and fear-provoking images of abnormal growth. Explanations about the causes of breast cancer involved five domains of belief. The first domain was of a physical nature and centred on damage to the breast. A second domain of explanations, 'can catch it,' focused on the way this disease could be spread to others. Other women attributed breast cancer to the ways women could 'bring it upon yourself,' often linking a negative lifestyle with the development of cancer. Many women attributed cancer to being 'in the hands of others,' explaining the cancer was caused by careless words, curses or divine power. Finally, breast cancer was seen as something that could be passed down in the family. The taxonomy developed in this study provides a useful framework for understanding the explanations that might underlie women's health-seeking behaviours and for developing culturally suitable counseling strategies.

Adult↗
PubMed1999

Decision making related to complementary therapies: a process of regaining control.

The process by which women with breast cancer make decisions related to using complementary therapies was investigated using grounded theory. Open-ended interviews were conducted with 16 women receiving orthodox treatment from across the breast cancer trajectory and who used a wide range of complementary therapies. Constant comparative analysis revealed that decision making regarding complementary therapies involved three interconnected sequential phases: (1) Getting something in place: covering all the bases, (2) hand-picking complementary therapies that fit: getting a personalized regimen in place and (3) living with the security of complementary therapies: fine-tuning a regimen to live with. Factors that influenced the decision-making process, both positively and negatively, were identified. Decision making related to the use of complementary therapies was perceived as a means of regaining control during experiences of uncertainty associated with breast cancer; the outcome of which was the maintenance of hope. Implications for supporting women's decision-making efforts regarding complementary therapies are presented.

Adaptation, Psychological↗
PubMed1999

Smoking relapse and early weaning among postpartum women: is there an association?

BACKGROUND: Smoking in the postpartum period may contribute to early weaning, although the nature and temporal aspect of the relationship are poorly understood. The objective of this study was to examine the association between early weaning and smoking relapse among women who stopped smoking during pregnancy. METHODS: A secondary analysis of data from a randomized controlled trial was conducted. The participants were 228 women who had stopped smoking for pregnancy, who participated in a smoking relapse prevention trial, and who breastfed. Women who relapsed to daily smoking postpartum were compared with those who remained abstinent or smoked occasionally. The dependent variable was breastfeeding for less than 26 weeks (early weaning). Potential covariates included intended duration of breastfeeding, parity, partner's smoking, nicotine dependence, emotional health, return to paid employment, and various sociodemographic variables. RESULTS: Approximately two-thirds (65.1%) of the women who relapsed to daily smoking weaned before 26 weeks compared with 33.8 percent of the women who remained abstinent or smoked occasionally. Controlling for intended duration of breastfeeding, education, and return to paid employment, women who resumed daily smoking were almost four times more likely to wean early than those who abstained or smoked occasionally. CONCLUSIONS: Early weaning may result from psychological or physiological changes associated with tobacco use. Smoking relapse prevention in the postpartum period may be one of the most effective interventions in ensuring that women who stop smoking for pregnancy remain stopped and breastfeed their babies for the recommended duration.

Adolescent↗
PubMed1999

Breast health practices and South Asian women.

Breast cancer is an important women's health issue in all communities. To detect breast cancer early, all women should practise monthly breast self-examination, have regular clinical breast examinations and attend mammography screening at suggested intervals. Participation in these breast health practices is influenced by a wide variety of factors, including how women define health and health practices, priorities in women's lives and their explanations of the causes of diseases such as cancer.

Adult↗
PubMed1998

Beliefs related to breast health practices: the perceptions of South Asian women living in Canada.

Breast cancer is becoming a major concern for many South Asian women. Clinical observations of women from a South Asian community living in Canada revealed an under use of early detection strategies. The purpose of this qualitative ethnoscience study was to examine breast health practices from the perspective of South Asian women to provide a foundation for the development of culturally suitable breast health services for this group. Open-ended interviews were conducted with a convenience sample of 50 South Asian women over the age of 30 who had not been diagnosed with breast cancer. Adequate representation of the main religious groups (i.e. Sikh, Hindu, Muslim and Christian) was ensured through sampling techniques. Analysis of translated interviews involved identification of themes and the development of a taxonomy to represent relationships among emerging cultural themes and domains. Four central domains of beliefs related to breast health practices were identified: beliefs about a woman's calling, beliefs about cancer, beliefs about taking care of your breasts and beliefs about accessing services. These beliefs hold important implications for how health promotion strategies should be structured and offered, In particular, attention must be paid to the language that is used to talk about breast cancer, the importance of the role of the family in women's health decisions and traditions related to using narratives to share information and advice.

Adult↗
PubMed1998

Communicating cancer risk information: the challenges of uncertainty.

Developments in predictive testing for inherited cancers have focused attention on the accurate and sensitive communication of risk information. Although sharing risk information is often equated with genetic testing, it is important to acknowledge that the need for risk information related to familial cancer is also relevant to those not eligible for, or interested in, testing. Communicating cancer risk information is germane to a number of health professions including physicians, geneticists, genetic counsellors, psychologists, nurses, health educators and social workers. Based on a literature review of 75 research reports, expert opinion papers and clinical protocols, we provide a synthesis of what is known about the communication of cancer risk information and make recommendations for the enhancement of knowledge and practice in the field.

Communication↗
PubMed1998

Striving for balance: palliative care patients' experiences of making everyday choices.

A fundamental principle of palliative care is the provision of patient-centred care, an approach explicitly based on the patient's perspective. Although much attention has been given to determining patients' preferences for involvement in medical decisions, choices related to personal and nursing care routines have been largely ignored in the literature. Data from participant observations of nurse-patient interactions involving 16 palliative care patients and their nurses as well as 10 in-depth open-ended interviews with patients were analyzed using grounded theory methods. Although the choices made by patients appeared uncomplicated on the surface, the context of unfamiliarity, uncertainty, and unpredictability in palliative care increased the underlying complexity of decision making. Through a process of deliberation and trade-offs, patients attempted to regain or maintain some balance in their lives. This process of striving for balance consisted of three overlapping phases: weighing things up, communicating choice, and living with one's choices.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Using multiple indicators to test the dimensionality of concepts in the health promotion model.

Data from 197 randomly selected male adults were analyzed in order to examine the dimensionality of two of the concepts in the Health Promotion Model-perceived control of health and definition of health. The model, tested with LISREL, examines the impact of age on exercise with the key concepts modeled as intervening variables. The addition of multiple indicators resulted in a model that failed to meet the data constraints, thereby calling into question the putative dimensionality of perceived control of health and definition of health. The proportionality constraints within multiple-indicator structural equation models seem to provide a more stringent test of whether several indicators measure the same concept than the test provided by the internal consistency constraints implicit in factor analysis.

Adult↗
PubMed1995

Smokers who fail to identify smoking cessation as a health priority.

BACKGROUND: Smokers who identified smoking cessation as the primary activity they could undertake to improve their health were compared with smokers who did not identify smoking cessation. Examined factors included personal characteristics, health status, smoking attitudes and behaviors, and social factors. METHODS: Subjects were 225 smokers who participated in a telephone survey of 853 randomly selected adults. RESULTS: Fifty-six percent of smokers did not identify smoking cessation as a priority. Nonidentifiers were more likely than identifiers to have minimal personal income, no paid employment, poor or fair health, dissatisfaction with their overall physical condition, less energy than others, little perceived control over their health, smoked fewer cigarettes per day, and reported no previous quit attempts. They were less likely to agree that they lacked the willpower to quit or that smoking helped them deal with stress. CONCLUSIONS: Smokers who fail to identify smoking cessation as a priority strategy for health improvement are unlikely to be exposed to workplace and social censures and should be targeted by health professionals.

Adult↗