PurposeThe purpose of this paper is to describe Karen refugee women’s experience of resettlement and the factors which structured community capacity to support their mental health and well-being.Design/methodology/approachA postcolonial and feminist standpoint was used to bring Karen women’s voice to the knowledge production process. Data were collected through ethnographic field observation, in-depth semi-structured individual and focus group interviews with Karen women as well as healthcare and social service providers.FindingsThree interrelated themes emerged from the data: Karen women’s construction of mental health as “stress and worry”; gender, language and health literacy intersected, shaping Karen women’s access to health care and social resources; flexible partnerships between settlement agencies, primary care and public health promoted community capacity but were challenged by neoliberalism.Research limitations/implicationsKaren women and families are a diverse group with a unique historical context. Not all the findings are applicable across refugee women.Practical implicationsThis paper highlights the social determinants of mental health for Karen women and community responses for mitigating psychological distress during resettlement.Social implicationsPublic health policy requires a contextualized understanding of refugee women’s mental health. Health promotion in resettlement must include culturally safe provision of health care to mitigate sources of psychological distress during resettlement.Originality/valueThis research brings a postcolonial and feminist analysis to community capacity as a public health strategy.

The findings suggest improvement in the competency scores for residents and overall usefulness of this course; however, limited conclusions can be made due to a small sample size and lack of adequate comparison groups. Establishing educational significance will require gathering larger usable control data as well as validation of the Course Impact Questionnaire tool to distinguish between different skill levels.

The purpose of this qualitative study is to investigate how South and East Asian immigrant women who have diagnoses of serious mental illness make treatment choices in relation to spirituality and to explore how gender, cultural beliefs, and spirituality intersect with the process of choice. The findings reveal that the process of spiritual choice includes three interrelated phases: (1) identifying contributing factors, (2) exploring spiritual resources and strategies, and (3) living with the choices. Variations among health beliefs and health care decisions are explained and services that women see as being helpful are identified.

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One goal of qualitative health research is to fully capture and understand stories of people who experience inequities shaped by complex interlocking structural and social determinants. With this social justice–oriented goal in mind, it is critical to use a methodological approach that appreciates prevailing inequities and oppression. In this article, we propose an innovative approach that joins qualitative health research methodology with critical inquiry. Specifically, we propose advancing constructive grounded theory (CGT) through applying intersectionality as an emergent critical social theory and an analytical tool. With our proposed approach being novel, minimal attempts to conceptualize and operationalize CGT with intersectionality exist. This article focuses on initiating theoretical conceptualization through focusing on demonstrating congruency. We are guided by this focus to seek connectedness and fit through analyzing historical and philosophical assumptions of CGT and intersectionality. In our article, we demonstrate congruency within four units of analysis: reflexivity, complexity, variability, and social justice. Through these units, we offer implications to applying intersectionality within CGT methodology. These include a foundation that guides researchers toward further conceptualizing and operationalizing this novel research approach. Implications also include innovatively exploring complex population groups who face structural inequities that shape their lived vulnerabilities. Our proposed research approach supports critical reflection on the research process to consider what shapes the researcher–participant relationship. This includes reflecting on analysis of power dynamics, underlying ideologies, and intermingling social locations. Thus, our conceptual paper addresses the call for evolving social justice methodologies toward inquiring into complex populations and generating knowledge that challenges and resists inequity.

Bipolar disorder (BD) affects approximately half a million Canadians. Religion and spirituality (R/S) may play an important role for individuals with BD by providing a means of coping with, and an explanatory model for, their disorder. We conducted a systematic review of empirical studies that have explored R/S in individuals with BD or samples that explicitly delineate individuals with BD. Only six studies met our inclusion criteria. Findings from these studies suggest that R/S strategies may be important for some people in the management of BD. Religion and spirituality thus become relevant concerns for a therapeutic regime that seeks to develop wellness within a bio-psychosocial model. However, the limited body of research and methodological shortcomings of existing research make it difficult to draw relevant conclusions about how this might be accomplished. The authors propose a need for longitudinal, prospective, mixed methods research in order to inform evidence-based practice.

Migrants, that is people who experience forced displacement or move based on being lesbian, gay, bisexual, trans, two-spirit, queer, and intersex (LGBTQI+), experience increased trauma and stigma when compared to heterosexual and cisgender people. The aim of this paper is to highlight LGBTQI+ migrants’ experiences of health and social care encounters in Canada. Gadamerian hermeneutics and an intersectionality lens was used to understand LGBTQI+ migrants’ experiences. A total of 16 semi-structured individual interviews were conducted with LGBTQI+ migrants. Themes of stigma and discrimination were identified as (1) “I never went back”: Stigma as an exclusionary experience, (2) “Is [your country of birth] really that bad”: Fear, safety, and cultural stigma, and (3) “The circle … is not going to fix my life”: LGBTQI+ migrants’ call for affirming care. Results suggest that health and social care practices are stigmatizing and discriminatory which negatively impacts LGBTQI+ migrant mental health. Salient practices for promoting mental health included affirming LGBTQI+ identities and orientations through health and social care practices that are culturally safe as well as trauma and violence informed.

ObjectiveTo identify the key themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making across the organisation and system domains of healthcare systems.MethodsWe conducted a scoping review. Seven databases of journal articles were searched from their inception to June 2019. Eligible articles were literature reviews published in English and provided useful information for determining aspects of engaging patients and family caregivers in decision-making to evaluate. We extracted text under three predetermined categories: structure, process and outcomes that were adapted from the Donabedian conceptual framework. These excerpts were then independently open-coded among four researchers. The subsequent themes and their corresponding excerpts were summarised to provide a rich description of each theme.ResultsOf 7747 unique articles identified, 366 were potentially relevant, from which we selected the 42 literature reviews. 18 unique themes were identified across the three predetermined categories. There were six structure themes: engagement plan, level of engagement, time and timing of engagement, format and composition, commitment to support and environment. There were four process themes: objectives, engagement approach, communication and engagement activities. There were eight outcome themes: decision-making process, stakeholder relationship, capacity development, stakeholder experience, shape policy/service/programme, health status, healthcare quality, and cost-effectiveness.ConclusionsThe 18 themes and their descriptions provide a foundation for identifying constructs and selecting measures to evaluate the quality of initiatives for engaging patients and family caregivers in healthcare system decision-making within the organisation and system domains. The themes can be used to investigate the mechanisms through which relevant initiatives are effective and investigate their effectiveness.