Psychological distress in ethnic minority parents of preschool children with burns

BackgroundLiterature indicates that children from ethnic minorities are at increased risk of sustaining burns. Moreover, parents may experience more psychological distress but why this is the case is poorly investigated.MethodsA prospective study including 120 mothers and 106 fathers of preschool children, of which 23 mothers and 24 fathers had an ethnic minority background, investigated levels of parental feelings of guilt, depressive and posttraumatic stress symptoms and compared Dutch parents with parents from different ethnic backgrounds on these outcomes. A qualitative study with 46 parents, 24 Dutch and 22 from different ethnic minority backgrounds, explored how they coped with the consequences of the burns.ResultsResults revealed more symptoms of posttraumatic stress and depression in ethnic minority parents. Ethnic minority fathers also had more guilt feelings. Lower social support, medical communication hampered by language barriers, lower health literacy and passive communication styles, (aspects of) religious coping and barriers to psychosocial care may partly explain the differences.ConclusionsParents with an ethnic minority background are at risk to experience increased distress after their child’s burn injury. By exploring the aforementioned factors, health care professionals may increase the family’s wellbeing. It may provide a starting point to offer tailored help.     

Health literacy and asthma management among African-American adults: an interpretative phenomenological analysis

Objective: African-Americans share a disproportionate burden of asthma and low health literacy and have higher asthma morbidity and mortality. Factors that link the relationship between health literacy and health outcomes are unclear. This study aimed to use patients’ experiences of managing asthma to better understand the relationship between health literacy and health outcomes. Methods: This study was the qualitative component of a mixed methods study. Following quantitative data collection, four participants, two with low print-related health literacy and two with adequate print-related health literacy, completed semi-structured interviews. Interview data were analyzed using interpretative phenomenological analysis. Results: Three themes emerged from the analysis: information desired versus information received, trial and error, and expectations of the patient–provider relationship. Individuals with adequate print-related health literacy had different strategies for overcoming barriers related to communicating with their providers, learning about their disease and experiences of discrimination within the healthcare system. Conclusions: Individuals with adequate print-related health literacy may be more equipped to participate in shared decision making and feel more confident to successfully manage their disease. It is also important that health literacy is discussed in the context of the cultural and racial background of the population of interest. This interdependent relationship between health literacy and culture is particularly important for African-Americans.     

Smoking prevalence and the changing risk profiles in the UK ethnic and migrant minority populations: implications for stop smoking services

Objectives

Smoking is the leading risk factor for disability-adjusted life-years, yet evidence with which to establish the smoking rates of people with different ethnic backgrounds and how they are changing in relation to recent migration is lacking. The objective is to provide current information on the changing risk profiles of the UK population.

Study design

Observational study using cross-sectional surveys.

Methods

Data from the Integrated Household Survey (pooled for the years 2009/10–2011/12), obtained under Special Licence, and the GP Patient Survey (2012) have been used to establish smoking prevalence in a wider range of ethnic groups in England and Wales, including the ‘mixed’ groups and amongst East European migrants, and how such prevalence differs across socio-economic classes.

Results

Smoking prevalence is substantially higher amongst migrants from East European countries (that for males exceeding 50% from three such countries and for females over 33% from four countries) and from Turkey and Greece, compared with most other non-UK born groups, and amongst ethnic groups is elevated in the ‘mixed’ groups. Rates are highest in the Gypsy or Irish Traveller group, 49% (of 162) and 46% (of 155) for males and females respectively. Across ethnic groups, rates are almost always higher in the UK born than non-UK born population with the notable exception of the ‘White Other’ group, with Prevalence Ratios (PRs) indicating a larger migrant-non-migrant differential amongst females (e.g. Indians 2.95 (2.33–3.73); Black Caribbeans 3.28 (2.73–3.94). Age-adjusted rates show the persistence of these differentials in females across age groups, though young males (18–29) in seven minority ethnic groups show lower rates in the UK-born groups. The ‘White’ and ‘Chinese’ groups show a strong socio-economic gradient in smoking which is absent in the South Asian groups and diminished in the ‘mixed’ and black groups.

Conclusions

Given the evidence that smoking behaviour is significantly different in some of the new groups, notably East European migrants, stop smoking services are failing to optimize the acceptability and, consequently, favourable outcomes for these programmes. These services need to be adapted to the particular patterns of smoking behaviour and language skills within different communities of descent.     

Culturally (In)competent? Dismantling Health Care Barriers for Sexual Minority Women

Lesbian and bisexual (LB) women exhibit elevated rates of a variety of behaviors (i.e., smoking, excessive caloric intake, physical inactivity, heavy alcohol consumption) that put them at risk for adverse health consequences. Furthermore, LB women experience numerous barriers to obtaining culturally competent health care. In this article we review risk behaviors and health care barriers and we discuss the role of stress as an important contributing factor in LB women’s health outcomes. We suggest future research, health care delivery changes, and training improvements that will prepare social workers to effectively address the needs of their LB clients.     

Understanding feeding practices of Latinx mothers of infants and toddlers at risk for childhood obesity: A qualitative study

Infancy and toddlerhood are critical stages for the development of habits that can lead to future obesity, and caregivers have an important influence on these habits. We conducted this qualitative semistructured interview study to explore the feeding practices of Latinx mothers of young children who are at risk for childhood obesity in order to identify targets for obesity prevention. We interviewed Latinx mothers (N = 14) of a child ages 6–18 months with a weight‐for‐length ratio > 85th percentile at the time of recruitment. Two researchers independently read through the interviews, identified sections of the interviews pertaining to feeding, and used constant comparative methods to identify the following common themes: mothers overwhelmingly reported permissive feeding styles, driving overfeeding and frequent night‐time feeding. Mothers expressed some difficulty with transitioning to solid foods and reported desiring to feed their child healthy foods by minimizing juice and giving vegetables. Paediatricians and WIC staff were viewed by mothers as trustworthy sources of nutrition information. Most identified a connection between their child's weight and diet, but many lacked the insight or capacity to change their current practices. The mothers in our study provide insight into factors that may predispose young children to obesity and thus potential avenues to support these families. Healthcare providers can better serve them by giving clear, actionable advice on healthy feeding practices for their child, while understanding constraints that may make healthy habits difficult to implement. Paediatricians should be honest about their child's weight status early on to allow time for intervention.     

边疆少数民族地区寄宿制小学生同伴关系、亲子沟通与孤独感之间的关系

目的:分析边疆少数民族地区的农村寄宿制小学生同伴关系、亲子沟通和孤独感之间的关系,探讨影响孤独感的内在机制。方法:采用同伴关系量表、亲子沟通问卷和孤独感量表对463名边疆少数民族地区寄宿制小学生进行调查,用结构方程对三者之间的因果关系构建模型,并用收集来的数据进行模型拟合。结果:1同伴关系、亲子沟通和孤独感有密切的相关关系;2亲子沟通对孤独感产生直接影响,路径系数分别为-0.45和-0.30;3同伴关系是亲子沟通对孤独感产生影响的中介因素,亲子沟通通过同伴接受和同伴恐惧自卑影响孤独感的路径系数分别为-0.47和0.57。结论:亲子关系、同伴关系和孤独感之间的关系表现为亲子关系不仅对孤独感产生直接影响,还通过同伴关系这一中介对孤独感产生影响。     

西双版纳少数民族0～7岁儿童β-地中海贫血筛查分析

目的了解云南省西双版纳州少数民族0～7岁儿童β-地中海贫血的发病情况,为本地区该病的预防和控制服务。方法用血液学筛查方法对该地区少数民族0～7岁儿童进行β-地中海贫血筛查,测定受检者的红细胞脆性及平均红细胞容积,对筛查阳性者进行血红蛋白电泳。结果在2642名受检者中,总的发病率为12.6%,勐腊为16.5%,勐海为8.1%,景洪为16.1%,在本地区少数民族中汉族(母亲为少数民族)为19.8%,基诺族为15.8%,傣族为13.4%。结论本地区的β-地中海发病率较高,通过对地中海贫血的调查获取其流行病学资料,对今后在该地人群中进行疾病防治、优生优育、遗传咨询、提高人口素质具有重要的指导意义。