Relations of Care: A Framework for Placing Women and Health in Rural Communities

Dolan, Holly; Thien, Deborah

doi:10.1007/bf03403803

Cited by 11 publications

(15 citation statements)

References 17 publications

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“…Reflecting this complexity, intersectional scholars (for example, see [36,47,48]) observe that no single dimension of diversity or difference should be given favour but that, instead, researchers should consider simultaneous interactions between these dimensions [47-49]. In other words, it may not be a caregiver’s experience as a woman that exposes her to the most significant inequities, even though this axis tends to receive the most attention in the caregiving literature [13-16]. Rather, it may be her collective inability to speak English or French, residence in a rural community, and lack of access to appropriate medical equipment intersecting with gender that determine support needs and in particular, whether or not programs like the CCB are effective in meeting them.…”

Section: Discussionmentioning

confidence: 99%

Critically examining diversity in end-of-life family caregiving: implications for equitable caregiver support and Canada’s Compassionate Care Benefit

Giesbrecht

Crooks

Williams

et al. 2012

Int J Equity Health

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IntroductionFamily (i.e., unpaid) caregiving has long been thought of as a ‘woman’s issue’, which ultimately results not only in gendered, but also financial and health inequities. Because of this, gender-based analyses have been prioritized in caregiving research. However, trends in current feminist scholarship demonstrate that gender intersects with other axes of difference, such as culture, socio-economic status, and geography to create diverse experiences. In this analysis we examine how formal front-line palliative care providers understand the role of such diversities in shaping Canadian family caregivers’ experiences of end-of-life care. In doing so we consider the implications of these findings for a social benefit program aimed at supporting family caregivers, namely the Compassionate Care Benefit (CCB).MethodsThis analysis contributes to a utilization-focused evaluation of Canada’s CCB, a social program that provides job security and limited income assistance to Canadian family caregivers who take a temporary leave from employment to provide care for a dying family member at end-of-life. Fifty semi-structured phone interviews with front-line palliative care providers from across Canada were conducted and thematic diversity analysis of the transcripts ensued.ResultsFindings reveal that experiences of caregiving are not homogenous and access to services and supports are not universal across Canada. Five axes of difference were commonly raised by front-line palliative care providers when discussing important differences in family caregivers’ experiences: culture, gender, geography, lifecourse stage, and material resources. Our findings reveal inequities with regard to accessing needed caregiver services and resources, including the CCB, based on these axes of difference.ConclusionsWe contend that without considering diversity, patterns in vulnerability and inequity are overlooked, and thus continually reinforced in health policy. Based on our findings, we demonstrate that re-framing categorizations of caregivers can expose specific vulnerabilities and inequities while identifying implications for the CCB program as it is currently administered. From a policy perspective, this analysis demonstrates why diversity needs to be acknowledged in policy circles, including in relation to the CCB, and seeks to counteract single dimensional approaches for understanding caregiver needs at end-of-life. Such findings illustrate how diversity analysis can dramatically enhance evaluative health policy research.

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Section: Discussionmentioning

confidence: 99%

Critically examining diversity in end-of-life family caregiving: implications for equitable caregiver support and Canada’s Compassionate Care Benefit

Giesbrecht

Crooks

Williams

et al. 2012

Int J Equity Health

View full text Add to dashboard Cite

show abstract

“…Roles are formed by and reproduced in specific places and power operates within these places to reinforce the dominant language used within these roles (Dolan and Thien 2008). This reality was reflected in our findings, where the prevailing explanatory model that informed clients’ and family caregivers’ language use was the illness narrative rather than disease‐oriented discussions.…”

Section: Discussionmentioning

confidence: 99%

Examining the language–place–healthcare intersection in the context of Canadian homecare nursing

2012

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Currently, much of the western world is experiencing a shift in the places where care is provided, namely from institutional settings like hospitals to diverse community settings such as the home. However, little is known about how language and the physical and social aspects of place interact to influence how health-care is delivered and experienced in the home environment. Drawing on ethnographic participant observations of homecare nursing visits and semi-structured interviews with Canadian family caregivers, care recipients and nurses, the intersection of language, place and health-care was explored in this secondary analysis. Our findings reveal four themes: homecare nurses view themselves as 'guests'; home environments facilitate the development of nurse-client relationships; nurses adapt healthcare language to each home environment; and storytelling and illness narratives largely prevail during medical interactions in the home. These findings demonstrate the spatiality of language and how the home environment informs decisions regarding language use. Furthermore, these findings exemplify how language and place mutually influence the experiences and delivery of home health-care. We conclude by discussing the importance of considering the language-place-healthcare intersection in order to gain a better understanding of medical exchanges in places and the associated implications for optimizing best nursing practice.

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“…Workers at PEERS were especially vulnerable in the face of these strains as many reported limited alternative employment opportunities due to a combination of limited education, cooccurring stigmas, histories of violence and trauma and ongoing health needs, such as those related to recovery from dependent substance use. It is also arguable that PEERS provides an example of how the effects of neoliberalisation and devaluation of care work in the social services sector is disproportionately borne by marginalised groups and the vulnerable workers who serve them (Benoit and Hallgrimsdottir 2011, Dolan and Thien 2008, Purkis et al 2008. However, the sensational aspects of sex work stigma are also associated with sustained public interest in public programmes and policies targeting the sex industry (Hallgrimsdottir et al 2006).…”

Section: Discussionmentioning

confidence: 99%

Courtesy stigma: a hidden health concern among front‐line service providers to sex workers

Phillips

Benoit

Hallgrímsdóttir

et al. 2011

Sociology Health & Illness

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Courtesy stigma, also referred to as 'stigma by association', involves public disapproval evoked as a consequence of associating with a stigmatised individual or group. While a small number of sociological studies have shown how courtesy stigma limits the social support and social opportunities available to family members of stigmatised individuals, there is a paucity of research examining courtesy stigma among the large network of people who provide health and social services to stigmatised groups. This article presents results from a mixed methods study of the workplace experiences of a purposive sample of workers in a nonprofit organisation providing services to sex workers in Canada. The findings demonstrate that courtesy stigma plays a role in workplace health as it shapes both the workplace environment, including the range of resources made available to staff to carry out their work activities, as well as staff perceptions of others' support. At the same time, it was evident that some workers were more vulnerable to courtesy stigma than others depending on their social location. We discuss these results in light of the existing literature on courtesy stigma and conclude that it is an under-studied determinant of workplace health among care providers serving socially denigrated groups.

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Relations of Care: A Framework for Placing Women and Health in Rural Communities

Cited by 11 publications

References 17 publications

Critically examining diversity in end-of-life family caregiving: implications for equitable caregiver support and Canada’s Compassionate Care Benefit

Critically examining diversity in end-of-life family caregiving: implications for equitable caregiver support and Canada’s Compassionate Care Benefit

Examining the language–place–healthcare intersection in the context of Canadian homecare nursing

Courtesy stigma: a hidden health concern among front‐line service providers to sex workers

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