Speaking of illness: Issues of first generation Canadian women - Implications for patient education and counseling

Based upon my research with first generation Canadian women who have come from Asia, I discuss the issues in women's lives that influence how they manage a chronic illness. I argue that women's relations with health care providers, the organization of the health care system, and structural constraints, especially for those women in the lower echelons of the labour force, profoundly influence the illness experience. Taking this, as the starting point, I proceed to examine the implications for education and counseling. I propose a model for counseling that begins with a critical examination, by health professionals, of their own 'culture of health', and that acknowledges the knowledge and wisdom of women. I suggest that a pedagogical relationship between health care professionals and women can be a site for the development of transformative knowledge and the empowerment of women. (C) 1998 Elsevier Science Ireland Ltd.