Understanding the role of culture in shaping the attitudes and beliefs regarding UI of older Sikh women
Bibliographic record
Abstract
ABSTRACT Background: Urinary incontinence (UI) is highly stigmatized, and many individuals are reluctant to seek support. UI has a range of health consequences if left untreated. Cultural factors may be influential in healthcare seeking but are currently poorly understood. The goal of this thesis was to investigate the role of culture in shaping the attitudes and beliefs of individuals living with UI, through a scoping review and a community-based participatory research (CBPR) qualitative study. First, the aim was to investigate the role of race, ethnicity, culture, religion, and folklore on the knowledge, attitudes, beliefs, and management practices associated with UI through a scoping review. Second, to conduct a CBPR qualitative study with Sikh women to understand the role culture plays in shaping their attitudes and beliefs regarding UI. Sikh women are underrepresented in the health literature, and their perspectives on UI are missing. The long-term goal of this qualitative study is to utilize the findings to co-design a culturally appropriate UI self-management program for older Sikh women. Methods: The scoping review utilized the Joanna Briggs Institute method. MEDLINE, PsychINFO, Embase, Cumulated Index in Nursing and Allied Health Research, Scopus databases, the WHO Index Medicus, EBSCOhost, and grey literature were searched for studies of any type which addressed the review question, used qualitative or mixed methods, and included adults. Source screening and analysis were managed using Covidence. Researchers discussed and synthesized themes in an iterative manner. The qualitative study was conducted in Edmonton, Alberta. A total of 11 older Sikh women (aged 55+) were recruited through snowball sampling and took part in qualitative interviews. Over a year was spent forging robust relationships with community organizations to form a multigenerational advisory group with whom the study was co-designed. Individual semi-structured qualitative interviews were conducted until thematic saturation was reached. The interviews were transcribed verbatim, coded, and analyzed using conventional content analysis. Results: In the scoping review: after exclusions, from 1604 studies, 19 met inclusion criteria, these mainly focused on women. Apart from information on knowledge, attitudes and beliefs, four themes were identified: ‘preservation of self’, informed by face saving behaviors, ‘hygiene and cleanliness’ which focused on women’s navigation of expectations of cleanliness for religious activities, ‘locus of control’ entailed perceptions of the causes of UI, and ‘patriarchal aspects of women’s lives’ included complex gendered roles/expectations and caste systems. For the qualitative study: overarching findings were that : 1. Although older Sikh women have agency over their health and feel responsible for their well-being, they may not have access to reliable sources of health information, 2. Women have diverse perceptions of UI based on their source of knowledge (e.g., friends, technology, doctors), and 3. There is a lack of conversation regarding UI within the Sikh community, due to fear of malodour, shame, shyness, and complex family dynamics in multigenerational households. Conclusion: The role of culture in shaping attitudes and beliefs regarding UI is complex and nuanced. Experience of UI is likewise multifaceted and varies depending on cultural context. From the results of our qualitative study we can conclude that Sikh women have agency and feel responsible for their well-being. Through this study, women provided crucial information which needs to be considered when co-designing a culturally sensitive management program to address UI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.022 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".