“COVID affected us all:” the birth and postnatal health experiences of resettled Syrian refugee women during COVID-19 in Canada

Background Prior to COVID-19, postnatal resettled refugee women in Canada reported barriers to healthcare and low levels of social support, contributing to maternal health morbidities. The COVID-19 pandemic appears to be further exacerbating health inequities for marginalized populations. The experiences of resettled refugee women are not fully known. Aim To understand Syrian refugee women’s experiences accessing postnatal healthcare services and supports during the COVID-19 pandemic. Methods Semi-structured, virtual interviews were conducted with eight resettled Syrian refugee women living in Nova Scotia (Canada) who were postnatal between March and August 2020. Data analysis was informed by constructivist grounded theory. Findings Three themes emerged: “the impacts of COVID-19 on postnatal healthcare;” “loss of informal support;” and “grief and anxiety.” Women experienced difficult healthcare interactions, including socially and physically isolated deliveries, challenges accessing in-person interpreters, and cancelled or unavailable in-home services (e.g., public health nurse and doula visits). Increased childcare responsibilities and limited informal supports due to pandemic restrictions left women feeling overwhelmed and exhausted. Stay-at-home orders resulted in some women reporting feelings of isolation and loss, as they were unable to share in person postnatal moments with friends and family, ultimately impacting their mental wellness. Conclusions COVID-19 and associated public health restrictions had significant impacts on postnatal Syrian refugee women. Data presented in this study demonstrated the ways in which the pandemic environment and related restrictions amplified pre-existing barriers to care and postnatal health inequalities for resettled refugee women—particularly a lack of postnatal informal supports and systemic barriers to care.

Risky residences: An exploratory study of sexual violence in university halls of residence

<p>Sexual violence within university populations is a well-known problem, however relatively little is known about the experience of sexual violence among New Zealand university students. There is even less known about women‟s experiences of sexual violence occurring in university halls of residence. This thesis addresses this gap in knowledge and understanding. Influenced by feminist perspectives and adopting a qualitative framework, this research employed semi-structured face-to-face interviews with four victims/survivors of sexual violence in university halls, and six key informants who work with students living in student accommodation or at the wider university. This study found that sexual violence occurring in halls had devastating impacts for women, affecting their personal, emotional, social and academic worlds. Further, this study also found that women were unlikely to disclose through formal channels such as the Police, but disclosure to informal supports was common. As well as this, data suggested that responding to sexual violence in this context is complex, as the needs of both alleged victims and alleged perpetrators must be carefully balanced. This complexity has meant that current responses to sexual violence are in many ways reactive rather than proactive and need to be comprehensively developed to respond to the unique challenges provided within the university environment. The findings from this study support the development of robust sexual violence response processes and the widespread delivery of education about sexual violence among university students, as well as for those charged with managing students‟ welfare.</p>

Risky residences: An exploratory study of sexual violence in university halls of residence

<p>Sexual violence within university populations is a well-known problem, however relatively little is known about the experience of sexual violence among New Zealand university students. There is even less known about women‟s experiences of sexual violence occurring in university halls of residence. This thesis addresses this gap in knowledge and understanding. Influenced by feminist perspectives and adopting a qualitative framework, this research employed semi-structured face-to-face interviews with four victims/survivors of sexual violence in university halls, and six key informants who work with students living in student accommodation or at the wider university. This study found that sexual violence occurring in halls had devastating impacts for women, affecting their personal, emotional, social and academic worlds. Further, this study also found that women were unlikely to disclose through formal channels such as the Police, but disclosure to informal supports was common. As well as this, data suggested that responding to sexual violence in this context is complex, as the needs of both alleged victims and alleged perpetrators must be carefully balanced. This complexity has meant that current responses to sexual violence are in many ways reactive rather than proactive and need to be comprehensively developed to respond to the unique challenges provided within the university environment. The findings from this study support the development of robust sexual violence response processes and the widespread delivery of education about sexual violence among university students, as well as for those charged with managing students‟ welfare.</p>

Codesigning a supportive online resource for Australian cancer carers: a thematic analysis of informal carers’ and healthcare professionals’ perspectives about carers’ responsibilities and content needs

ObjectiveTo gather preliminary qualitative data that will assist in the codesign and development of a new informational and supportive website to assist informal cancer carers in Australia.Design and settingUtilising a previously tested codesign process, informal carers’ experiences and perspectives, including those of healthcare professionals’, were examined via focus groups and/or interviews. Data were analysed via thematic analysis.ParticipantsRural (n=9) and urban (n=11) carers’, and healthcare professionals’ (n=8) perspectives were collected. Carers participated in a focus group (n=9) or telephone interview (n=11). Healthcare professionals completed an interview (n=6) or online survey (n=2).ResultsRural and urban carers typically felt ill prepared for their multitudinal caregiving responsibilities. Supporting patient-to-healthcare professional liaisons could especially challenge. Carers’ biopsychosocial and fiscal strains were affected by patients’ hardships and available informal supports. Rural carers described greater social support than urban carers. Both rural and urban carers also described discontentment related to a carer neglecting healthcare system. Both carers and healthcare professionals endorsed the need for a user-friendly, carer-specific website encompassing practical information and resources, peer-driven advice and evidence-based illness information, tailored to the Australian context.ConclusionsCarers and healthcare professionals recognise the pressing need for an Australian, cancer carer-specific online resource. Findings will inform the next phase, where a resource will be designed, developed and tested.

“COVID Affected Us All:” The Birth and Postnatal Health Experiences of Resettled Syrian Refugee Women During COVID-19 in Canada

Background: Prior to COVID-19, postnatal resettled refugee women in Canada reported barriers to healthcare and low levels of social support, contributing to maternal health morbidities. The COVID-19 pandemic appears to be further exacerbating health inequities for marginalized populations—yet the experiences of resettled refugee women are not fully known. Aim: To understand Syrian refugee women’s experiences accessing postnatal healthcare services and supports during the COVID-19 pandemic. Methods: In-depth interviews were conducted with eight resettled Syrian refugee women living in Nova Scotia (Canada) who were postnatal between March and August 2020. Data analysis was informed by constructivist grounded theory. Findings: Three themes emerged: “the impacts of COVID-19 on postnatal healthcare;” “loss of informal support;” and “grief and anxiety.” Women experienced difficult healthcare interactions, including socially and physically isolated deliveries, challenges accessing in-person interpreters, and cancelled or unavailable in-home services (e.g., public health nurse and doula visits). Increased childcare responsibilities and limited informal supports due to pandemic restrictions left women feeling overwhelmed and exhausted. Stay-at-home orders resulted in some women reporting feelings of isolation and loss, as they were unable to share in person postnatal moments with friends and family, ultimately impacting their mental wellness. Conclusions: COVID-19 and associated public health restrictions had significant impacts on postnatal Syrian refugee women. Data presented in this study demonstrated the ways in which the pandemic environment and related restrictions amplified pre-existing barriers to care and postnatal health inequalities for resettled refugee women—particularly a lack of postnatal informal supports and systemic barriers to care.

Harm Reduction Interventions to Prevent Overdose Deaths

Overdose deaths have been occurring at high rates in many parts of Canada. From January 2016 (when national surveillance began) to March 2019, an estimated 12,800 Canadians died of an opioid overdose.1 In addition to opioid-related harms, stimulants such as methamphetamine have re-emerged in some regions and are also contributing to the current rise in overdose deaths. COVID-19 has resulted in a more compromised illicit drug supply, and those who use drugs have had limited access to formal and informal supports because of public health measures regarding physical distancing. As a result, overdose deaths have increased during the pandemic. Harm reduction approaches provide a mechanism to prevent overdose deaths and have additional health and public safety benefits. The current crisis has been exacerbated by COVID-19; therefore, it is an appropriate time to consider the entire continuum of harm reduction approaches available to reduce preventable overdose deaths. People with lived experience of drug use should be meaningfully included in policy discussions about harm reduction and overdose prevention interventions. This would enhance the person-centredness of programs and ensure they are reflective of the lived realities of those who use drugs. Although societal attitudes about drug use are changing, harm reduction interventions remain politically contentious. Countering stigma, being prepared to engage with community concerns, and clearly articulating that harm reduction services are intended to complement and not replace drug treatment are all important in enhancing public understanding of harm reduction.

Prolonged Grief and Bereavement Supports Within a Caregiver Population Who Transition Through a Palliative Care Program in British Columbia, Canada

Objective: To determine the prevalence of prolonged grief disorder (PGD), and self-reported resilience among bereaved caregivers within a palliative care program that serves a large region of the Lower Mainland in British Columbia, Canada. Additionally, to discern effective bereavement supports utilized by caregivers following the loss of a loved one. Methods: A descriptive study using both quantitative and qualitative methods. Sociodemographic information (n = 427) was collected from bereaved caregivers 3 months after their loss. PGD and resilience were prospectively assessed 12 months post-loss using the prolonged grief scale (PG-13, n = 212) and brief resilience scale (BRS, n = 215), respectively. A qualitative thematic analysis was conducted on responses to the open-ended question on what bereavement services or activities caregivers found helpful in coping with the loss of a loved one. Results: Of the 212 individuals that completed the PG-13, 4.7% met diagnostic criteria for PGD, 27.4% were moderate risk, and 67.9% were low risk for PGD. Of the 215 caregivers that completed the BRS, 48.4% had low resilience, 51.6% had normal resilience, and 0% had high resilience. The major themes of formal supports, informal supports, and self-care activities emerged from caregiver comments regarding effective bereavement supports. Conclusion: The incidence of PGD in caregivers is low within the Fraser Health Palliative Care program. Bereaved caregivers mainly utilize existing social networks and activities to cope with their loss. Focusing on a community-based approach to supports may improve bereavement experiences and lower rates of prolonged grief.

A Clinician's Guide to Disclosures of Sexual Assault

Sexual assault is a worldwide public health concern, as it occurs to people of all genders at alarming rates and results in serious physical and mental health sequelae. The reactions survivors receive from formal and informal supports can significantly influence their recovery. Given the prevalence of sexual assault, all providers need to be prepared to handle disclosures of sexual assault from clients. The aim of this book is to provide guidance on how to interact with survivors of sexual assault, which the authors define as sexual contact or penetration without the explicit consent of the victim. While the book is primarily geared toward mental health professionals, the content is also relevant for professionals who work in medical settings, educational settings, law enforcement, and victim services. The authors also highlight that there are particular populations (e.g., racial and sexual minorities) and settings (e.g., military, higher education) that require particular considerations when discussing sexual violence. Overall, professionals have an instrumental role in facilitating survivor recovery, and this book provides best practices for providing services in an affirming manner. The book begins with a review of literature focused on sexual assault and survivor disclosure. Then, recommendations are provided for conducting assessments and psychotherapy with survivors of sexual assault. Case examples are presented to help illustrate specific recommendations for working with survivors of sexual assault. Finally, particular recommendations for various specific populations are provided.

Empowering Practices With Domestic Violence Survivors in India

There is a growing concern about women’s safety in India. This study examined a grassroots agency’s response to domestic violence in the community by examining their empowerment-focused work with survivors through crisis intervention centers. Multi-informant perspectives examined (a) the organizational process of facilitating or strengthening empowerment of survivors and (b) the mechanisms central to this process. Results highlight various salient mechanisms, namely, the adoption of a survivor-centered approach, collaborative relationships with staff, meeting women where they are, systems advocacy, fostering independence, and building long-term networks with formal and informal supports. Implications for intervention and prevention work are discussed.