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Background: In Oman, limited access to adequately prepared healthcare providers in primary healthcare threatens the provision of quality care to patients and families and access to healthcare services. Nurse practitioners (NP) are in an excellent position to address safety issues and ensure quality healthcare with their advanced nursing skills, knowledge, and acumen for acceptable cultural and religious practices. Aims: To explain Oman's national strategic plans, processes, challenges, opportunities, and both regional and global implications for the facilitation of NP role implementation and policies. Sources of evidence: The Nursing and Midwifery Human Resources framework guided the NP implementation project. Guided by the framework, the World Health Organization and the Omani Ministry of Health conducted multiple situational analyses (2004–2016). Later, the NP role was planned and implemented in Oman. During and after implementation, monitoring and evaluation of the NP role implementation were continuously conducted using multiple focus groups, individual interviews, and field visits. Discussion: The NP role implementation revealed multiple challenges and opportunities that either hinder or support NP role implementation. Additionally, the NP implementation project revealed various lessons learned. Implications for nursing and health policy: National and global nursing leaders and health policymakers should collaborate to discuss NP issues, especially NP role sustainability, legal approval and recognition, prescriptive authority, title protection, practice acts, and professional regulation. Conclusion: This paper informs nursing leaders and policymakers in the Middle East and other countries in the global community about Oman's experience regarding NP role implementation. [ABSTRACT FROM AUTHOR]

Aim: This paper is part of a larger doctoral study that investigated the impact of nationality on the job satisfaction of nurses and their intentions to leave Saudi Arabian government hospitals. The paper aims to gain an understanding of the impact of expatriate status on nurses' perceptions, by comparing the factors that influence job satisfaction among Saudi nurses to those that affect nurses recruited from other countries. Background: Job satisfaction is a known predictor of nurse retention. Although there is a broad understanding of the factors that affect job satisfaction, little is known about how these vary between home and expatriate nurses working in countries which rely on a multicultural migrant workforce. Methods: A descriptive qualitative approach was taken, in which 26 semi‐structured interviews were conducted with nurses selected from different nationalities, all of whom were working in Saudi Arabian hospitals. Eight participants were Saudi Arabian, six Filipino, four Indian, four South African, two Jordanian and two Malaysian. Findings: Five themes were identified that differentiated the perceptions of expatriates regarding their job satisfaction from those of the home nurses: separation from family, language and communication, fairness of remuneration, moving into the future and professionalism. Conclusion: Focusing on the enhancement of job satisfaction experienced by expatriate nurses can result in a healthier work environment and greater retention of these nurses. Implications for nursing and nursing policy: To enhance nurse retention, policy makers in countries with migrant nurses should address their socio‐economic needs. This includes providing both greater access to their dependent family members, and language lessons and cultural orientation to reduce linguistic and cultural challenges. [ABSTRACT FROM AUTHOR]

Purpose This paper aims to explore and describe health promotion strategies for adolescents orphaned by human immunodeficiency virus ( HIV) and acquired immunodeficiency syndrome ( AIDS), as well as the evaluation thereof. Introduction and Background Among the Sub- Saharan countries, such as Swaziland, Botswana and Lesotho, South Africa is rated as fourth in the list of countries with the highest number of people living with HIV and AIDS. Method The study employed phenomenological qualitative design. The population consisted of the purposively selected health promoters working in the Hammanskraal region, directly and indirectly involved with families with adolescents orphaned by HIV and AIDS. Following the focus group interviews, data were analysed using the seven steps of Colaizzi. Results Four categories and eight subcategories were concluded as the strategies for adolescents orphaned by HIV and AIDS as well as the evaluation thereof. The main categories identified were: the door-to-door outcome, workshop outputs, statistical data and community projects. Discussion It is evident that the health promotion strategies informed by the four themes will be implemented. The outcomes may raise an awareness in the community, support families and provide statistics on the impact of HIV and AIDS on families. Study Limitations The study was limited to one subdistrict and to health promoters in a rural area, therefore the results cannot be generalized to all other subdistricts including health promoters, especially those in urban areas. Conclusion The successful evaluation programme will pin out the strong points and challenges while assisting in improving the quality of work provided in the communities. Implication for nursing and health policy Continuing professional and practice development are required to maintain the standard of health care in South Africa. Therefore the policymakers need to include relevant information regarding health promotion strategies in reducing the statistics of people living with HIV and AIDS. [ABSTRACT FROM AUTHOR]

Aim To explore the experiences of women from three population groups of immediate skin-to-skin contact ( SSC) with their newborn babies. Method A mixed methods approach was adopted in a phenomenological study to elicit the experiences of English, Pakistani and Bangladeshi women. Audiotaped diaries, semi-structured interviews, photographs and video recordings were employed. Concept mapping was central to data analysis. Results This paper reports novel findings that women contextualized and accepted secretions and bodily fluids from birth. This contradicts the beliefs of midwives that Asian women find bodily secretions abhorrent and culturally unacceptable. All participants reported positive experiences of SSC despite varying degrees of soiling from birth fluids. Limitations The study was conducted in a single setting, and participants may not have been representative of others in their cultural groups. Third-party translation may have added an unsought layer of interpretation. The imposition of cultural expectations by peers in the recruitment process excluded some potential participants. Conclusion Stereotypical assumptions about cultural background often characterize professional responses. When this stereotyping was put aside, women of all three cultures, whether breastfeeding or bottle-feeding, were able to enjoy SSC with their babies. Implications for Nursing and Health Policy The findings suggest that changes will be needed in professional practice to be more open to women's expressed preferences, in local policy to ensure that choices are made clear and are available, and in national strategic direction to ensure widespread adoption of positive practices for opportunities to increase breastfeeding, promote parent-child bonding and support patient choice to be realized. [ABSTRACT FROM AUTHOR]

Background Self-harm is a widespread behaviour among people with mental health problems. Although guidance on how to manage self-harm is offered, it is still a behaviour that is misunderstood by many nurses. Such misunderstanding is generally attributed to the perceived motives for self-harm and lack of specialized education to manage the behaviour. As a consequence, the care provided is usually inadequate and inappropriate. Yet, research concerning nurses' reasons of users' self-harming behaviours is limited. Aim This paper reports on a study that explores nurses' explanations of the motives for self-harm in a secure adolescent unit in England. Methods The study utilized a phenomenological methodology with semi-structured individual interviews ( n = 25). The data were analysed thematically using interpretative phenomenological analysis. Results The findings indicate that the behaviour of self-harm has multiple motives. Examples of these include affect regulation, coping with distress, averting death, regaining control and attention seeking. Discussion Self-harm is a complex behaviour commonly experienced in secure environments. Nurses assume that users who self-harm are motivated by a desire to seek attention and manipulate others. Users may find these beliefs humiliating. Such feelings may increase users' risks for further self-harm. Most adolescents who self-harm experience unbearable emotions because of their past sexual abusive encounters. They self-harm to regulate these emotions. These affect regulatory functions may act as reinforcers of self-harming behaviours. Conclusions Improved understanding of self-harm and its motives may result in improved nurse-user relationships and thus safer and more effective care provision. [ABSTRACT FROM AUTHOR]

Aim To report on an Israeli academic nursing project, aimed at supporting the integration of Ethiopian immigrants into nursing studies. Background The representation of ethnic minorities within nursing is crucial for the provision of efficient care in diverse societies. Nevertheless, successful integration of minority students in nursing programs is not a simple task and needs developing support systems that will attract and retain students from minorities. Ethiopian Jewish immigrants and their descendants in Israel form a community of 120 000 people. Their participation in the national workforce is low, as well as their average income. Methods The paper is based on formative evaluation, using action research, of an academic nursing program in Israel. Findings Four main strategies identify this project: (1) a policy of institutional commitment, (2) personal relations with staff, (3) personal tutoring, and (4) cultural safety education. The project has reached success in terms of attraction, retention and students' satisfactions. The project's two main challenges, which need further concern, are: (1) giving support without labelling and (2) supporting without creating dependency. Conclusions and International Policy Implications Appropriate strategies can enable success of minority students. Nevertheless, the amount of support needed for such programs raises two major questions: (1) To what extent should individual nursing departments be expected to bear solutions to this widely experienced problem? (2) How does focusing on one minority affect cultural safety of the overall group? [ABSTRACT FROM AUTHOR]

Richter M.S., Mill J., Muller C.E., Kahwa E., Etowa J., Dawkins P. & Hepburn C. (2013) Nurses' engagement in AIDS policy development. International Nursing Review 60, 52-58 Background: A multidisciplinary team of 20 researchers and research users from six countries - Canada, Jamaica, Barbados, Kenya, Uganda and South Africa - are collaborating on a 5-year (2007-12) program of research and capacity building project. This program of research situates nurses as leaders in building capacity and promotes collaborative action with other health professionals and decision-makers to improve health systems for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) nursing care . One of the projects within this program of research focused on the influence of workplace policies on nursing care for individuals and families living with HIV. Nurses are at the forefront of HIV prevention and AIDS care in these countries but have limited involvement in related policy decisions and development. In this paper, we present findings related to the barriers and facilitators for nurses' engagement in policymaking. Methods: A participatory action research design guided the program of research. Purposive sampling was used to recruit 51 nurses (unit managers, clinic and healthcare managers, and senior nurse officers) for interviews. Findings: Participants expressed the urgent need to develop policies related to AIDS care. The need to raise awareness and to 'protect' not only the workers but also the patients were critical reason to develop policies. Nurses in all of the participating countries commented on their lack of involvement in policy development. Lack of communication from the top down and lack of information sharing were mentioned as barriers to participation in policy development. Resources were often not available to implement the policy requirement. Strong support from the management team is necessary to facilitate nurses involvement in policy development. Conclusions: The findings of this study clearly express the need for nurses and all other stakeholders to mobilize nurses' involvement in policy development. Long-term and sustained actions are needed to address gaps on the education, research and practice level. [ABSTRACT FROM AUTHOR]

THUPAYAGALE-TSHWENEAGAE G. & MOKOMANE Z. (2013) Needs of South African adolescents orphaned by AIDS: evidence from photography and photo-elicitation. International Nursing Review 60, 88-95 Background: Available evidence shows that over half of all orphans under the age of 18 years are adolescents aged between 12 and 17 years. Despite this, the needs of adolescents orphaned by AIDS are seldom recognized or adequately addressed in policy and programmes. Instead, the focus tends to be on the needs of orphans and vulnerable children. However, there are several factors that render adolescent-specific programmes important. Purpose: Using data from an urban area in South Africa, this paper illuminates the needs of adolescents orphaned by AIDS. Method: A phenomenological study using photography and photo-elicitation was used with 15 adolescents aged between 14 and 18 years orphaned by AIDS. Results: The study participants captured different objects that were grouped under six broad themes: symbols of death, nature, people, past life, children and hope. The photographic component of the study was followed by photo-elicitation. From the meanings the adolescents made of their images, the needs of adolescents orphaned by AIDS were discerned as love, care and acceptance, safety, and security and support. Conclusion: Overall, the results showed that adolescents orphaned by AIDS want to feel secure, safe, wanted by caregivers and to feel that caregivers support them in their grieving journey. [ABSTRACT FROM AUTHOR]

CLEREHAN R., MCCALL L., MCKENNA L. & ALSHAHRANI K. (2012) Saudi Arabian nurses' experiences of studying Masters degrees in Australia. International Nursing Review 59, 215-221 Aim: This paper presents findings from a study which explored a group of Saudi Arabian nurses' experiences of studying for a Masters degree in Australia. Background: Arab states in the Middle East, Saudi Arabia in particular, have high expatriate nursing populations, and governments in the region have allocated considerable funding to up-skilling their health workforce, often at Western universities. However, there has been little research into the learning experiences of nursing students from Middle East nations. Methods: A descriptive qualitative study design was used. Middle Eastern students undertaking Masters courses in a School of Nursing and Midwifery at one Australian university were invited to participate in a semi-structured interview. Ten Saudi students participated and data were analysed using content analysis. Findings: Students experienced challenges related to the transition to very different forms of study; to managing relationships and family. They were resourceful, employing strategies to manage multiple demands, including differences in culture, and stressed the significance of strong personal relationships with staff. Students acknowledged being changed, even transformed, by their experience, and saw themselves as future change agents. Conclusion: Highly skilled local nursing professionals are being sought in many Middle Eastern countries and may undertake post-graduate studies in Western contexts quite different from their own. Students reported that, in spite of difficulties, their experience prompted transformational change: intellectually, psychologically and developmentally. It is necessary for staff to understand expectations and learning preferences of these students to ensure fruitful learning outcomes and benefits to nursing in their home countries. [ABSTRACT FROM AUTHOR]

UJUJU C., ANYANTI J., ADEBAYO S.B., MUHAMMAD F., OLUIGBO O. & GOFWAN A. (2011) Religion, culture and male involvement in the use of the Standard Days Method: evidence from Enugu and Katsina states of Nigeria. International Nursing Review 58, 484-490 Aim: This paper presents findings from an exploratory study on the use of the Standard Days Method® (SDM) of family planning (FP) in Katsina and Enugu states of Nigeria. Background: Potential users of FP often do not use modern methods if its practice is in dissonance with cultural and religious values. Increasing FP options through the introduction of effective natural methods is important, as it will ensure that FP providers, particularly nurses, can provide appropriate non-hormonal methods to women who are interested in their use. This will bring about an increased contraceptive prevalence in countries with strong religious barriers to modern FP methods. Methods: A qualitative study using focus group discussions and in-depth interviews was conducted with nurses, community FP providers and users of the SDM following the introduction of the method in two Nigerian states. Discussion: Both users and providers perceive the SDM to be religiously and culturally acceptable. They found it useful particularly among women who could not use hormonal methods for medical reasons. Conclusion: There was no religious/cultural opposition to the use of SDM. Spousal involvement in use within localities where hormonal methods are not accepted was perceived as an important factor in making the method acceptable. It is imperative to scale up the intervention to other areas both in Nigeria and in other countries that have similar religious and cultural resistance to modern FP methods. [ABSTRACT FROM AUTHOR]

DOMAJNKO B. & PAHOR M. Mistrust of academic knowledge among nurses in Slovenia. International Nursing Review 57, 305–311 Aim: The paper discusses the negative attitudes of some nursing assistants in Slovenia towards higher nursing education and academic (theoretical and research based) knowledge. Background: The topic is discussed in the context of traditional hierarchical and patriarchal relations in the health-care sector, professionalization of nursing and the evidence-based debate in nursing. Methods: A secondary analysis of data gathered in 2005 was carried out. The topic of the original research was the interprofessional collaboration between medical and nursing care professionals in Slovenia. The secondary study looked closely into the relations within nursing care. Specifically it focused on the nursing assistants' perspective. Five hundred ninety-two answer to two open-end questions (307 from nurses and 285 from nursing assistants) and five semi-structured interviews (with three nurses and two nursing assistants) were re-analyzed (with the new focus), applying inductive qualitative content analysis and the pragmatic approach to interpretation. Findings: In nursing assistants' view, the difference between themselves and graduate nurses was described in terms of the distinction ‘work – non-work’. Higher education was associated primarily with striving for higher social status. Academic knowledge was not perceived to include the right competencies for either practising or improving the quality of nursing care. Conclusions: The mistrust of the academic nurse on the part of some nursing assistants is interpreted as a barrier to full professionalization of nursing care and also interprofessional collaboration in the health-care sector. [ABSTRACT FROM AUTHOR]