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‘The Elephant on the Table’: Religious and Ethnic Diversity in Home Health Services

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Abstract

Healthcare services are increasingly being provided in the home. At the same time, these home contexts are changing as global migration has brought unprecedented diversity both in the recipients of care, and home health workers. In this paper, we present findings of a Canadian study that examined the negotiation of religious and ethnic plurality in home health. Qualitative analysis of the data from interviews and observations with 46 participants—clients, administrators, home healthcare workers—revealed how religion is expressed and ‘managed’ in home health services.

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Notes

  1. We use ‘home health’ in keeping with local terminology. Elsewhere, equivalent terms might be ‘homecare’, ‘domiciliary care’, or ‘district nursing’.

  2. For the sake of this paper, we use religion as shorthand for the continuum of religion and spirituality and likewise use ethnicity for the domain of race, ethnicity and culture. This pragmatic choice comes with its problems, partly because of the tendency in healthcare and nursing literatures to frame religion as a negative term in contrast to spirituality as a more inclusive term (Clarke 2009; Fowler et al. 2011; Hill et al. 2000; Sharma et al. 2011). However, given that the theoretical grounding for this project comes from the sociology of religion, we have followed that disciplinary semantic.

  3. In other publications, we have presented findings from this study in regard to religious practices in healthcare—specifically the practice of prayer (Sharma et al. 2012); spirituality and nursing leadership (Reimer-Kirkham et al. 2012a); a historical analysis of spirituality in home health (Grypma et al. 2012); and religious accommodation in healthcare organizations (Reimer-Kirkham and Cochrane 2016).

References

  • Ammerman, N. T. (2013). Spiritual but not religious? Beyond binary choices in the study of religion. Journal for the Scientific Study of Religion, 52(2), 258–278.

    Article  Google Scholar 

  • Armstrong, P., & Armstrong, H. (2016). About Canada: Health care (2nd ed.). Blackwood, NS: Fernwood.

    Google Scholar 

  • Aronson, J., & Neysmith, S. M. (2001). Manufacturing social exclusion in the home care market. Canadian Public Policy/Analyse de Politiques, 27(2), 151–165.

    Article  Google Scholar 

  • Blunt, A. (2005). Cultural geography: Cultural geographies of home. Progress in Human Geography, 29(4), 505–515.

    Article  Google Scholar 

  • Blunt, A., & Varley, A. (2004). Geographies of home. Cultural Geographies, 11(1), 3–6.

    Article  Google Scholar 

  • Bourgeault, I. L., Atanackovic, J., Rashid, A., & Parpia, R. (2010). Relations between immigrant care workers and older persons in home and long-term care. Canadian Journal on Aging/La revue canadienne du vieillissement, 29(1), 109–118.

    Article  Google Scholar 

  • Bramadat, P., Coward, H., & Stajduhar, K. (Eds.). (2013). Spirituality in hospice palliative care. Albany, NY: SUNY Press.

    Google Scholar 

  • Bramadat, P., & Seljak, D. (Eds.). (2009). Religion and ethnicity in Canada. Toronto, ON: University of Toronto Press.

    Google Scholar 

  • Bryant, T. (2016). Health policy in Canada (2nd ed.). Toronto: Canadian Scholars’ Press.

    Google Scholar 

  • Canadian Healthcare Association. (2009). Home care in Canada: From the margins to the mainstream. Accessed 14 Jan 2017 from: http://www.healthcarecan.ca/wp-content/uploads/2012/11/Home_Care_in_Canada_From_the_Margins_to_the_Mainstream_web.pdf

  • Canadian Healthcare Association. (2011). Continuing care: A Pan-Canadian approach. Accessed 14 Jan 2017 from: http://www.healthcarecan.ca/wp-content/uploads/2012/11/CHA_Continuing_Care_Synthesis_Aug_2011_EN.pdf

  • Canadian Home Care Association. (2008). Home care: Meeting the needs of an aging population. Accessed 14 Jan 2017 from: http://www.cdnhomecare.ca/media.php?mid=1914

  • Christiano, K., Swatos, W., Jr., & Kivisto, P. (2015). Sociology of religion: Contemporary developments. Lanham, UK: Rowman & Littlefield.

    Google Scholar 

  • Clarke, J. (2009). A critical view of how nursing has defined spirituality. Journal of Clinical Nursing, 18(12), 1666–1673.

    Article  PubMed  Google Scholar 

  • Coward, H., & Stajduhar, K. (2012). Religious understandings of a good death in hospice palliative care (SUNY Series in Religious Studies). Albany, NY: State University of New York Press.

    Google Scholar 

  • Crenshaw, K. (1989). Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory, and antiracist politics. University of Chicago Legal Forum, 149, 139–176.

    Google Scholar 

  • Davie, G. (2013). The sociology of religion: A critical agenda. London, UK: Sage.

    Google Scholar 

  • Davitt, J., Bourjolly, J., & Frasso, R. (2015). Understanding inequities in home health care outcomes: Staff views on agency and system factors. Research in Gerontological Nursing. doi:10.3928/19404921-20150219-01.

    Article  PubMed  Google Scholar 

  • Debesay, J., Harsløf, I., Rechel, B., & Vike, H. (2014). Facing diversity under institutional constraints: Challenging situations for community nurses when providing care to ethnic minority patients. Journal of Advanced Nursing, 70(9), 2107–2116.

    Article  PubMed  Google Scholar 

  • Dhamoon, R., & Hankivsky, O. (2011). Why the theory and practice of intersectionality matter to health research and policy. In O. Hankivsky (Ed.), Health inequities in Canada: Intersectional frameworks and practices (pp. 16–52). Vancouver, Canada: University of British Columbia Press.

    Google Scholar 

  • Dinham, A., & Francis, M. (Eds.). (2015). Religious literacy in policy and practice. Bristol, UK: Policy Press.

    Google Scholar 

  • Durkheim, E. (1912). The elementary forms of religious experience. Glencoe, IL: Free Press.

    Google Scholar 

  • Dyer, S., McDowell, L., & Batnitzky, A. (2008). Emotional labour/body work: The caring labours of migrants in the UK’s National Health Service. Geoforum, 39(6), 2030–2038.

    Article  Google Scholar 

  • England, K., & Dyck, I. (2011). Managing the body work of home care. Sociology of Health & Illness, 33(2), 206–219.

    Article  Google Scholar 

  • Fang, M., Malcoe, L. H., Sixsmith, J., Wong, L., & Callender, M. (2015). Exploring traditional end-of-life beliefs, values, expectations, and practices among Chinese women living in England: Informing culturally safe care. Palliative and Supportive Care, 13(5), 1261–1274.

    Article  PubMed  Google Scholar 

  • Fowler, M. D. M., Johnston Taylor, E., Reimer-Kirkham, S., & Sawatzky, R. (Eds.). (2011). Religion, religious ethics and nursing. New York: Springer.

  • Gerdner, L., Tripp-Reimer, T., & Simpson, H. (2007). Hard lives, god’s help, and struggling through: Caregiving in Arkansas delta. Journal of Cross-Cultural Gerontology, 22(4), 355–374.

    Article  PubMed  Google Scholar 

  • Giesbrecht, M., Crooks, V., Williams, A., & Hankivsky, O. (2012). Critically examining diversity in end-of-life family caregiving: Implications for equitable caregiver support and Canada’s compassionate care benefit. International Journal for Equity in Health, 11(1), 1.

    Article  Google Scholar 

  • Grypma, S., Wolfs, D., & Reimer-Kirkham, S. (2012). Returning home: Historical influences in home healthcare in Canada. Home Healthcare Nurse, 30(8), 453–460.

    Article  PubMed  Google Scholar 

  • Guttmann, D. (2013). Ethics in social work: A context of caring. London: Routledge.

    Book  Google Scholar 

  • Haque, E. (2010). Homegrown, muslim and other: Tolerance, secularism and the limits of multiculturalism. Social Identities, 16(1), 79–101.

    Article  Google Scholar 

  • Hill, P. C., Pargament, K. I., Hood, R. W., McCullough, M. E., Jr., Swyers, J. P., Larson, D. B., et al. (2000). Conceptualizing religion and spirituality: Points of commonality, points of departure. Journal for the Theory of Social Behaviour, 30(1), 51–77.

    Article  Google Scholar 

  • Lefebvre, S., & Beaman, L. (Eds.). (2014). Religion in the public sphere: Canadian case studies. Toronto, ON: University of Toronto Press.

    Google Scholar 

  • McGuire, M. (2008). Religion: The social context. Long Grove, CA: Waveland Press.

    Google Scholar 

  • Narayan, M. C., & Scafide, K. N. (2017). Systematic review of racial/ethnic outcome disparities in home health care. Journal of Transcultural Nursing. doi:10.1177/1043659617700710.

    Article  PubMed  Google Scholar 

  • Parreñas, R. (2015). Servants of globalization: Migration and domestic Work. Stanford, CA: Stanford University Press.

    Google Scholar 

  • Peckover, S., & Chidlaw, R. (2007). The (un)-certainties of district nurses in the context of cultural diversity. Journal of Advanced Nursing, 58(4), 377–385.

    Article  PubMed  Google Scholar 

  • Reimer-Kirkham, S., & Cochrane, M. (2016). Resistant, reluctant or responsible? The negotiation of religious and cultural plurality in Canadian healthcare. In D. Llewellyn & S. Sharma (Eds.), Religion, equalities and inequalities (pp. 65–77). Abingdon, UK: Routledge.

    Google Scholar 

  • Reimer-Kirkham, S., Pesut, B., Sawatzky, R., Cochrane, M., & Redmond, A. (2012a). Discourses of spirituality and leadership in nursing: A mixed methods analysis. Journal of Nursing Management, 20, 1029–1038.

    PubMed  Google Scholar 

  • Reimer-Kirkham, S., & Sharma, S. (2011). Adding religion to gender, race, and class: Seeking new insights on intersectionality in health care contexts. In O. Hankivsky (Ed.), Health inequities in Canada: Intersectional frameworks and practices (pp. 112–131). Vancouver, Canada: University of British Columbia Press.

    Google Scholar 

  • Reimer-Kirkham, S., Sharma, S., Pesut, B., Sawatzky, R., Meyerhoff, H., & Cochrane, M. (2012b). Sacred spaces in public places: Religious and spiritual plurality in health care. Nursing Inquiry, 19(3), 202–212.

    Article  PubMed  Google Scholar 

  • Saroglou, V., & Cohen, A. (2011). Psychology of culture and religion introduction to the JCCP special issue. Journal of Cross-Cultural Psychology, 42(8), 1309–1319.

    Article  Google Scholar 

  • Sharma, S., & Llewellyn, D. (2016a). Introduction: Religion, equalities and inequalities. In D. Llewellyn & S. Sharma (Eds.), Religion, equalities and inequalities (pp. xvii–xxvii). Abingdon, UK: Routledge.

    Google Scholar 

  • Sharma, S., & Llewellyn, D. (2016b). Introduction: Religion, equalities and inequalities. In D. Llewellyn & S. Sharma (Eds.), Religion, equalities and inequalities (p. xviii). Abingdon, UK: Routledge.

    Google Scholar 

  • Sharma, S., & Reimer-Kirkham, S. (2015). Faith as social capital: Diasporic women negotiation religion in secularized healthcare services. Women’s Studies International Forum, 49, 34–42.

    Article  Google Scholar 

  • Sharma, S., Reimer-Kirkham, S., & Cochrane, M. (2012). Prayer as transgression: Stories from healthcare. In G. Giordan & L. Woodhead (Eds.), Annual review of the sociology of religion volume 4: Prayer in religion and spirituality (pp. 189–204). Leiden, The Netherlands: Brill.

    Google Scholar 

  • Sharma, S., Reimer-Kirkham, S., & Fowler, M. D. M. (2011). Emergent nonreligious spiritualities. In M. D. M. Fowler, E. Johnston Taylor, S. Reimer-Kirkham, & R. Sawatzky (Eds.), Religion, religious ethics and nursing (pp. 295–313). New York: Springer.

    Google Scholar 

  • Smith, L., Anderson, W., Kenyon, A., Kinyara, E., Teichman, L., Dean-Whittaker, D., et al. (2015). Racial and ethnic disparities in patients’ experience with skilled home health care services. Medical Care Research and Review. doi:10.1177/1077558715597398.

    Article  PubMed  Google Scholar 

  • Taylor, E. J. (2008). Promoting spiritual health in home healthcare. Home Healthcare Now, 26(6), 367–374.

    Article  Google Scholar 

  • Thaler, M. (2009). From public reason to reasonable accommodation: Negotiating the place of religion in the public sphere. Diacritica, 23(2), 249.

    Google Scholar 

  • Thorne, S. (2016). Interpretive description: Qualitative research for applied practice (2nd ed.). London: Routledge.

    Book  Google Scholar 

  • Vallurupalli, M., Lauderdale, K., Balboni, M., Phelps, A., Block, S., Ng, A., et al. (2012). The role of spirituality and religious coping in the quality of life of patients with advanced cancer receiving palliative radiation therapy. The Journal of Supportive Oncology, 10(2), 81.

    Article  PubMed  Google Scholar 

  • Vermandere, M., De Lepeleire, J., Van Mechelen, W., Warmenhoven, F., Thoonsen, B., & Aertgeerts, B. (2013). Spirituality in palliative home care: A framework for the clinician. Supportive Care in Cancer, 21(4), 1061–1069.

    Article  PubMed  Google Scholar 

  • Walsh, H.A. (2014). Cultural considerations in the delivery of homecare services: “Beyond 2 kitchens and a disability/più di due cucine e disabilità”. Unpublished doctoral dissertation. University of Toronto.

  • Williams, C., & Davis, C. (2005). Therapeutic interaction in nursing. Sudbury, MA: Jones and Bartlett Publishers.

    Google Scholar 

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Acknowledgements

We are grateful to the home health staff, administrators, patients and families who generously participated in this study. We also extend thanks to the reviewer for their insightful comments.

Funding

This study was funded by Social Sciences and Humanities Research Council Canada (2009–2012; 410-2009-0494).

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Authors and Affiliations

  1. School of Nursing, Trinity Western University, 7600 Glover Road, Langley, BC, V2Y 1Y1, Canada

    Sheryl Reimer-Kirkham, Sonya Grypma, Richard Sawatzky & Dorolen Wolfs

  2. Faculty of Arts and Social Sciences, Kingston University London, Penrhyn Road, Surrey, KT1 2EE, UK

    Sonya Sharma

  3. School of Nursing, University of British Columbia-Okanagan, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada

    Barbara Pesut

  4. Centre for Health Evaluation and Outcome Sciences, Providence Health Care, Vancouver, Canada

    Richard Sawatzky

Authors
  1. Sheryl Reimer-Kirkham
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  2. Sonya Sharma
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  3. Sonya Grypma
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  4. Barbara Pesut
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  5. Richard Sawatzky
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  6. Dorolen Wolfs
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Corresponding author

Correspondence to Sheryl Reimer-Kirkham.

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The authors have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Reimer-Kirkham, S., Sharma, S., Grypma, S. et al. ‘The Elephant on the Table’: Religious and Ethnic Diversity in Home Health Services. J Relig Health 58, 908–925 (2019). https://doi.org/10.1007/s10943-017-0489-7

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  • DOI: https://doi.org/10.1007/s10943-017-0489-7

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