Judith Lynam | University of British Columbia (original) (raw)

Papers by Judith Lynam

The Canadian nurse, 2000

Although many health concerns of women in India differ from those of Indian women in Canada, both... more Although many health concerns of women in India differ from those of Indian women in Canada, both groups of women have a high incidence of low birthweight babies. The question of how best to improve the health status of pregnant Indo-Canadian women and consequently improve pregnancy outcomes is a complex one. It involves the availability and allocation of financial and human resources, the integration of Indian cultural beliefs and attitudes with Western biomedical knowledge, the status of women in Indian culture, and Canadian social and economic issues such as demographic changes, changes in the role of the family, government policies, economic restructuring and so on.

Nursing papers. Perspectives en nursing, 1985

Canadian journal of cardiovascular nursing = Journal canadien en soins infirmiers cardio-vasculaires, 1991

The intent of this paper is to provide nurses with a way of viewing and working with cultural dif... more The intent of this paper is to provide nurses with a way of viewing and working with cultural differences of their clients. A second goal is to make such information relevant to nurses caring for patients with cardiovascular diseases. Using nursing and social science literature the author defines culturally sensitive care and identifies concepts basic to the provision of such care. Drawing upon interviews with nurses working in a variety of cardiovascular settings a perspective on how culturally sensitive care can be provided is presented.

Social pediatrics is an approach to child and youth health in the context of their family and the... more Social pediatrics is an approach to child and youth health in the context of their family and the society in which they grow and develop. Social pediatrics takes action on social determinants such as income, housing, education, and social environment, as mediators of child and youth health. Youth in poverty and at risk for homelessness have disproportionate exposure to adverse childhood experiences (ACEs) and intergenerational trauma. Families of some ethnic minority youth are disproportionately impacted by poverty. LGBT youth are disproportionately represented among homeless youth. Youth with developmental, cognitive, and learning disabilities are at disproportionate risk for homelessness. Social pediatric models, including the Circle of the Child (and Youth) with a Medical-Legal Community Partnership, are effective and innovative practices to maintain engagement of youth with their families and community, prevent homelessness, and continue engagement when youth leave home prematur...

method: n=7 after data not before. Response: Revised accordingly.

Nursing Inquiry

The health of a nation tells much about the nature of a social contract between citizen and state... more The health of a nation tells much about the nature of a social contract between citizen and state. The way that health care is organised, and the degree to which it is equitably accessible, constitutes a manifestation of the effects of moments and events in that country's history. Research around health inequalities often focuses on demonstrating current conditions, with little attention paid to how the conditions of inequality have been achieved and sustained. This article presents a novel approach to inequalities research that focuses on examining powerful historical discourses as legitimising processes that serve to sustain unequal conditions. The use of this Foucauldian historical genealogical approach in a study of the Irish health care system is explored and proposed as a novel approach to the research of health inequities.

International Journal of Public Health

Objectives To better understand how social pediatric initiatives (SPIs) enact equitable, integrat... more Objectives To better understand how social pediatric initiatives (SPIs) enact equitable, integrated, embedded approaches with high-needs children and families while facilitating proportionate distribution of health resources. Methods The realist review method incorporated the following steps: (1) identifying the review question, (2) formulating the initial theory, (3) searching for primary studies, (4) selecting and appraising study quality, (5) synthesizing relevant data and (6) refining the theory. Results Our analysis identified four consistent patterns of care that may be effective in social pediatrics: (1) horizontal partnerships based on willingness to share status and power; (2) bridged trust initiated through previously established third party relationships; (3) knowledge support increasing providers' confidence and skills for engaging community; and (4) increasing vulnerable families' self-reliance through empowerment strategies. Conclusions This research is unique because it focused on ''how'' outcomes are achieved and offers insight into the knowledge, skills and philosophical orientation clinicians need to effectively deliver care in SPIs. Research insights offer guidance for organizational leaders with a mandate to address child and youth health inequities and may be applicable to other health initiatives. Keywords Social pediatrics Á Realist methodology Á Whole child Á Interprofessional practice Á Health equity Á Community-based practice Á Trust Á Partnership working Á Professional education Á Empowerment Abbreviations CMO Context-mechanism-outcome ECP Early childhood practitioner EMR Electronic medical record ISSOP International society of social pediatrics and child health RICHER Responsive interdisciplinary child-community health education and research SPI Social pediatrics initiative

Journal of Research in Nursing

This exploratory qualitative study draws attention to an area of nursing practice that has receiv... more This exploratory qualitative study draws attention to an area of nursing practice that has received little attention in research. The study aims to gain insight into the unique needs and perspectives of lesbian and bisexual (LB) women facing diagnoses of reproductive cancer. The analysis of interview data, collected from six LB women facing cancer and one healthcare professional, highlighted the women’s needs for support and identified ways in which being identified as LB, in some situations, limited access to support for themselves and their partners. In addition to these relational impacts, which the authors clearly describe, it is of interest to me that the story goes beyond individual healthcare providers’ knowledge and actions. The data also suggest that the lack of a clear organisational philosophy of care that is inclusive creates ambiguities for patients and healthcare professionals alike. In this case, the women are left to look for signals from healthcare providers that they would be ‘safe’ and that their identities and personal relationships would be recognized and respected in how care was being provided. Rather, it appeared to be more typical that healthcare professionals’ actions were interpreted as being unsupportive because the professionals lacked awareness of, or were indifferent to, the women’s identities and personal relationships. The analysis, however, also begins to unpack the complexities associated with healthcare relationships and the assumptions inherent in them. For example, while some participants clearly presented themselves to the care providers as Lesbian or Bisexual women, other study participants spoke about the dilemmas they faced in trying to decide whether they should represent themselves as Lesbian or Bisexual to nurses and other care providers. The participants indicated that they could not always anticipate how the information might impact the care they received. In addition, a number of participants noted that typically

Health:: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine

In this paper, we draw upon research with women in middle and later life who have a chronic illne... more In this paper, we draw upon research with women in middle and later life who have a chronic illness to explore the issues in their everyday lives that organize the management of their illness. Our analysis aims to show the complex interweaving of relations that constrain the women's management of illness, even when they use creative and innovative approaches to managing their illness. The constraints women experience cannot be adequately explained solely by their interactions with health professionals, by their culture or through a single focus on gender relations. We discuss the implications of our interpretation for the practice of health professionals.

Ubc Medical Journal, Oct 9, 2012

Polycystic Ovarian Syndrome (PCOS) is a common, complex endocrine disorder that has serious impli... more Polycystic Ovarian Syndrome (PCOS) is a common, complex endocrine disorder that has serious implications for women from adolescence to beyond menopause. This paper provides an overview of the diagnostic criteria for PCOS and outlines the goals of care to help physicians and other healthcare providers to move beyond the debates about diagnosis and to embrace an approach to management that is responsive to patients. Women with hyperandrogenism as a presenting feature of PCOS are known to have metabolic and cardiovascular risks, including type 2 diabetes mellitus and dyslipidemia. Despite the serious consequences of PCOS, women are not being identified early in the course of the disease or managed effectively across the lifespan in order to reduce their long-term health risks. Optimizing detection and management of patients with PCOS may reduce the prevalence of type 2 diabetes mellitus and unmanaged dyslipidemia. With effective management, women may be able to conceive earlier and experience fewer adverse obstetrical outcomes. PCOS affects women physically, psychologically, and socially, and challenges their healthcare providers to take a proactive and comprehensive approach to treat symptoms and manage long-term risks.

Handbooks in Health, Work, and Disability, 2016

This chapter illustrates ways qualitative research has shaped our understandings of cultural infl... more This chapter illustrates ways qualitative research has shaped our understandings of cultural influences on health and considers some of the problems, particularly the problems associated with categorization and representation, that have arisen as the culture concept has been taken up in research and practice. In addition, it illustrates ways qualitative research can offer alternatives to categorical representation. To achieve these aims, I draw upon my own program of research that seeks to generate insights that may help us to understand and address inequities in health. In this chapter I offer a brief overview of the theoretical stance that informs my program of research and explicate the ways this stance is reflected in how the research is conceptualized and undertaken. I then introduce and illustrate the methodological techniques and analytic tools and resources that can be employed to achieve the research goals while also countering the problems associated with categorical representation. Examples of ways these approaches can be enacted over the course of the research process, from framing the question to presenting the analyses and engaging in knowledge translation, are provided.

3rd Annual Worldwide Nursing Conference (WNC 2015), 2015

Purpose: The purpose of this study is to explore the issues related to primary care access by old... more Purpose: The purpose of this study is to explore the issues related to primary care access by older (aged 60 years and older) Korean immigrants to Canada. As many elderly are managing ongoing chronic health conditions as part of their everyday lives, issues of access to health services are particularly important. The aim of the study is to generate insights to assist health care professionals to understand the nature of the challenges and issues older Korean immigrants face when seeking health care and how they resolve them. Methods: The study employed the methodology of interpretive description. Interview data were gathered from 10 older Korean immigrants (mean of age =71.5 years). Five of the participants were male and five were female. Open-ended interviews and field notes were used to collect data. Findings: The findings revealed that older Korean immigrants have had difficulty gaining access to appropriate primary health care services because of language and social barriers. Such barriers resulted in an inappropriate use of primary care services and contributed to delay in health care services and lack of continuity in service delivery. Also, primary health care was often unresponsive to the health care needs of older Korean immigrants. Conclusions: This study offers insights to assist health care professionals to understand the nature of the challenges and issues older Korean immigrants face when seeking health care and how they resolve them. Describing this phenomenon has provided some insights to propose interventions that respect the older Korean immigrants’ values and improve their access to primary health care. The insights from this exploratory study give some preliminary direction to health care professionals as they provide care that respect and support the older Korean immigrants.

Nursing papers. Perspectives en nursing, 1986

The manner in which people communicate influences the nature of the interpersonal relationships t... more The manner in which people communicate influences the nature of the interpersonal relationships that they are able to establish. Although the processes involved in establishing interpersonal relationships and in developing communication skills are lifelong, these processes are particularly important in adolescence. During adolescence, teenagers are not only expected to expand the number and variety of their social contacts, but to negotiate a change in the nature of the contacts as well. Relationships with parents and peers, for example, must alter if the adolescent is to succeed in accomplishing the developmental tasks of this age group (Duvall, 1971).

The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières, 2012

The authors briefly introduce a clinical outreach initiative that is innovative because of the ty... more The authors briefly introduce a clinical outreach initiative that is innovative because of the types of partnerships that have been formed within an inner-city community context. The initiative was designed to foster access to primary health care and specialized services for children and families who are vulnerable because of their social and material circumstances.Through ongoing engagement and dialogue, the clinicians and the community have developed a number of points of engagement with the children and families.The authors use the case of Learning Circles to describe ways in which Indigenous knowledge and ways of being influenced the approaches taken to working with children and families. They reflect upon the ways in which this approach influenced community engagement and consider its potential for achieving health equity.

International journal of nursing studies, 2006

Health care restructuring, in an effort to control costs, has resulted in marked organizational c... more Health care restructuring, in an effort to control costs, has resulted in marked organizational change with concomitant influences on nursing practice in the hospital and community contexts. Such changes have resulted in increased levels of acuity among patients and shorter hospital stays. As a consequence, families are being asked to assume greater roles in illness care of family members. At the same time societies and therefore patient populations are becoming increasingly culturally and linguistically diverse. Yet, little is known about hospitalization and help-seeking practices of family caregivers in an ethnoculturally diverse context and the nature of support they require from the health care system. This paper addresses this gap in knowledge. Here we draw upon data gathered in two ethnographic studies of illness care and help-seeking practices in an enthoculturally diverse community. Analysis of family data identified 'resisting vulnerability' as a process central to ...

The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières, 2010

This article is based on a knowledge translation (KT) study of the transition of patients from ho... more This article is based on a knowledge translation (KT) study of the transition of patients from hospital to home. It focuses on the lessons learned about the challenges of translating research-derived critical knowledge in practice settings. The authors situate the article in current discourses about KT; discuss their understanding of the nature of critical knowledge; and present themes from their body of research, which comprises the knowledge that was translated. The findings have the potential to guide future KT research that focuses on the uptake of critical knowledge in nursing practice.