The meaning of health perceived by adult immigrant women in Canada is discussed from the perspectives of immigration, culture, and lived experience to understand their encounters with health care professionals. Authors base their findings on the thematic analysis of focus group data. Immigrant women viewed health as the outcome of a web of interactions between conditions of mental, physical, social, emotional, environmental, and spiritual well-being, appealing to both biomedical and phenomenological ideologies. Our analyses of qualitative data revealed that the disagreements noted by immigrant women when interacting with health care professionals were due to the discrepancies between their cultural views of health and the dominant biomedical perspective.

In the present study, we explored family caregivers' experiences in providing end-of-life care for terminally ill South Asian immigrants. We employed qualitative methods and. in-depth interviews were conducted with seven family caregivers living in Nova Scotia, Canada. Interview data were validated, coded and organized for themes. Three major themes identified in the data illustrated (a) how South Asian caregivers experienced clashes between biomedical and ethno-cultural realms of care that led to cultural insensitivity, (b) how family members acted as mediators, and (c) how communication issues that challenged cultural sensitivity were handled. Findings provide directions for culturally sensitive end-of-life care planning.

Background: End-of-life care involves a multitude of functions delivered by a team of healthcare professionals. Family caregivers get involved in every aspect of the palliative care journey. Meeting the needs of ethnically diverse patients can be a daunting task for Western-trained healthcare professionals. Family and professional caregivers need to have a mutual understanding of perspectives and expectations to integrate family caregivers into end-of-life care. The South Asian population in Canada is fast growing, and very little is known about their understanding and expectations of end-of-life care. Methods: The purpose is to provide research-based knowledge on discordances and concordances of encounters and perceptions of end-of-life care delivery between South Asian family caregivers and palliative care health professionals. Individual interviews were conducted among seven palliative care professionals, in a tertiary care center, and seven South Asian family caregivers who have provided care, in the same inpatient center, for the same period. The constant comparison, a component of the grounded theory approach, was employed to compare the two types of caregivers’ perspectives that emerged in the qualitative data. Findings: The family caregivers were divided in their perception based on death denial and acceptance. The findings weaved the discordances and concordances of meaning assigned to palliative care to the three themes that emerged: the role of the family caregiver, communication needs and challenges, and barriers to the family caregiver participation in decision-making. The discordance between professionals and family caregivers arose in the death-denial group and concorded with the death-accepted group. The findings revealed a consequence of the survival optimistic bias, as creating dissatisfaction toward the end-of-life care delivery system when the palliative care professionals prognosticate imminent end-of-life. Conclusion: The family caregivers’ interactions and encounters were shaped by their acceptance or denial of the death of their family member in care. Gaining conceptual clarity on the meaning of palliative care and providing education on the process of end-of-life care delivery are crucial to integrating ethnically diverse family caregivers into the decision-making process.

Introduction: Children of female sex workers (CFSW) are exposed to unique bioecological vulnerabilities that negatively affect their developmental outcomes. We interviewed 1,280 female sex worker mothers (FSWM) in eight low- and middle-income countries (Angola, Brazil, South Africa, the Democratic Republic of Congo, India, Indonesia, Kenya, and Nigeria) between January 16 and October 1, 2019. This exploratory study focused on multilayered exposures from early childhood to adolescence, resulting in maldevelopment and other negative outcomes for CFSW, as reported by their mothers.Methods: We used Bronfenbrenner’s revised Bioecological System Theory of Human Development as the analytical framework. The interview data included both numerical responses and brief textual answers. Quantitative information was summarized using prevalence estimates, while textual responses were inductively coded and grouped into major categories.Results: FSWM reported that outcomes varied across countries but reflected complex interactions within and between the micro-, meso-, exo-, and macro-systems described by the theoretical framework. Findings revealed that CFSW were exposed to suboptimal child-rearing environments and faced a high prevalence of adverse outcomes. A majority (61%; country range, 45–67%) of daughters entered sex work at an early age (mean age: 14 years; range, 13.5–18 years). Both sons and daughters experienced physical harm (72%; range, 21–85%) and sexual abuse (sons, 57%; daughters, 74%). Daughters were often introduced to sex work as a survival strategy. Reported outcomes also highlighted bioecological vulnerabilities that impeded sons’ development, as well as protective environments that supported their healthy growth. These were categorized as follows: (1) vulnerabilities associated with high-risk living environments such as brothels, hotspots, and streets where they were exposed to sex work; (2) negative psychological, physical, and behavioral outcomes, including becoming criminals, victims, and perpetrators of abuse; and (3) protective environments of living away from the mother’s work and finding informal work that may mitigate the harmful effects of bioecological vulnerable exposures.Discussion: The CFSW experienced significant threats to healthy development, contributing to adverse physical and psychological developmental outcomes. These findings underscore the urgent need for evidence-based policy directives, interventions, and support.