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Purpose: The aim of the current study was to measure grip strength along with correlates, to inform recommendations to protect students entering the nursing workforce and increase career longevity, as well as health, among working nurses.Participants and Methods: A convenience sample of nursing staff and students (18 to 59 years) at a large teaching hospital (N = 316) participated in a cross-sectional study. A brief survey included sociodemographic questions, the Perceived Stress Scale (PSS-4), and the Nordic Musculoskeletal Questionnaire (NMQ). Anthropometric measures included height, weight, waist circumference, and hand grip strength using a Jamar digital dynamometer.Results: Only 22.5% of the participants met Indian normative grip strength parameters by age and gender, and on average had a normal body mass index (M = 22.31, SD 4.15). Grip strength was significantly associated with BMI and waist circumference, which explained 76% of the variance in grip strength.Conclusion: This study provides a baseline measurement of grip strength among Indian nursing staff and students, and documents grip strength among young adults (18– 20 years of age) who were not included in published normative grip strength data among healthy Indian participants. Data from the current study demonstrates that very few participants met normative grip strength, thus indicating the need for strengthening. Variance in grip strength was largely explained by waist circumference, pointing to the importance of nutrition. Interventions are needed to improve physical performance of nursing duties and prevent on-the-job injuries. [ABSTRACT FROM AUTHOR]

Purpose: To explore women's mental health in India's rapidly changing society. Participants and Methods: A convenience sample of low-income women (N = 286) in a medium-sized city in South-India participated in a mixed-methods, exploratory study in 2022. Institutional Review Board (IRB) approval was received from Loma Linda University in the US, and Christian Medical College-Vellore in India, in accordance with the declaration of Helsinki, prior to data collection. All study materials were forward and back translated for Tamil, the local language. Phase 1(n = 25) involved audio recorded key-informant interviews and focus groups. Verbatim transcripts were inductively coded, and emerging themes identified. Phase 2 (n = 261) entailed a quantitative survey including demographics, health history, and validated scales measuring mental health symptoms, coping strategies, social support, living situation, and life satisfaction. Data collectors were gender and language matched, research trained, community health nurses. Results: Qualitative themes included: 1) benefits of living in the city, 2) double duty for women doing household work and paid work, 3) challenges of living in the urban environment, 4) advantages of living in the village, 5) struggles associated with village life. Quantitative results: the average Hopkins Symptoms Checklist (HSCL) score of 1.82 (SD = 0.70) exceeded the 1.65 cut-off score for anxiety and depression symptomology. Among participants with elevated HSCL scores (n = 129) the average was markedly elevated (M = 2.39, SD = 0.56). These women were more likely to rely on wishful thinking, religious coping, and reported more post-migration living difficulties, less social support, and less satisfaction with life. Regression analysis further explored variables associated with participant HSCL scores. Conclusion: In this sample of low-income urban-dwelling women depression and anxiety symptomology was elevated. Given the limited mental health workforce and cultural stigmatization of mental health issues, further attention is required. [ABSTRACT FROM AUTHOR]

The Fulbright Scholar Program offers numerous awards, presenting nurse practitioners with opportunities to interact with colleagues around the world. As increasing acceptance of the nurse practitioner role is gaining acceptance and being defined in various countries across the world, with expanding role definitions, this represents a trailblazing opportunity to influence global representation. The recent completion of a Fulbright award experience in India is provided as an exemplar of the Fulbright opportunity. Nurse practitioner program development and continuing education are key to enhancing patient care and access to care among patients who need it most. To be a part of the effort to prepare nurse practitioners everywhere expands the reach beyond that of an individual nurse practitioner. We can learn from each other, share strategies for implementation across settings, and together address barriers to practice. [ABSTRACT FROM AUTHOR]

Background: India has the highest number of stillbirths and the highest neonatal death rate in the world. In the context of its pronatalist society, women who experience perinatal loss often encounter significant social repercussions on top of grief. Furthermore, even when pregnancy outcomes were favorable, adverse life circumstances put some women at risk for postnatal depression. Therefore, perinatal loss and postnatal depression take a heavy toll on women's mental health. The purpose of this study is to assess mental health among a sample of Mumbai slum-dwelling women with a history of recent childbirth, stillbirth, or infant death, who are at risk for perinatal grief, postnatal depression, or mental health sequelae.Methods: We conducted a mixed method, cross-sectional study. A focus group discussion informed the development of a comprehensive survey using mainly internationally validated scales. After rigorous forward and back-translation, surveys were administered as face-to-face structured interviews due to low literacy and research naiveté among our respondents. Interviews were conducted by culturally, linguistically, gender-matched, trained research assistants.Results: Of our reproductive age (N = 260) participants, 105 had experienced stillbirth, 69 had a history of infant death, and 25 had experienced both types of loss. Nearly half of the sample met criteria for postnatal depression, and 20% of these women also met criteria for perinatal grief. Anxiety and depression varied by subgroup, and was highest among women desiring an intervention.Conclusions: Understanding factors contributing to women's suffering related to reproductive challenges in this pronatalist context is critically important for women's wellbeing. [ABSTRACT FROM AUTHOR]

Purpose: Given the pressures surrounding women's reproductive role in India, and persistent high rates of perinatal death, the purpose of this study is to describe and compare poor rural and urban Indian women's experiences of perinatal grief. Participants and Methods: Two cross-sectional studies were compared on shared quantitative variables. Poor rural (N = 217) and urban, slum-dwelling (N = 149) Central Indian women with a history of stillbirth, and/or infant death were recruited with the aid of local community health workers. Trained, local, gender, and linguistically matched research assistants conducted the structured interviews. Shared quantitative variables include demographics, Social Provision Scale, Shortened Ways of Coping-Revised, Perinatal Grief Scale, social norms and autonomy. Results: While similar with respect to SES, age, number of living sons and perinatal loss experiences, these samples of poor women differed significantly across many variables, most notably women's household position, joint family living, number of live daughters, religious coping, autonomy, and degrees of perinatal grief. While perinatal grief was significantly associated with many variables bi-variably, most lost their relative influence in our stepwise multivariable modeling within site (rural/urban), with only social norms and social support remaining significant for rural (31% of variance) and wishful thinking and social norms for urban participants (38.4% of variance). In the combined sample household position, social support and social norms remained significant and explained 53.6% of the adjusted variance. Conclusion: In both samples, perinatal grief was high following perinatal loss. Both groups of women with perinatal loss have increased risk of mental health sequelae. Notably, the context affected how they experienced perinatal grief, with rural women's grief being higher and more affected by their societal pressures and isolation. Such nuances are important considerations for much-needed tailored approaches to future interventions. [ABSTRACT FROM AUTHOR]

Background: Infertility is a global problem, with high prevalence in India. As a pronatalist society, infertility is particularly problematic in India, causing stigma, shame, and blame especially for women. Infertility consequences for women include discrimination, social exclusion, and abandonment, putting them at high risk for mental health distress. Furthermore, mental health is highly stigmatized and specialized care is largely unavailable. Despite the cultural importance of childbearing, research on infertility distress and resulting mental health sequelae is lacking, particularly among low-income women. The purpose of this study is to assess mental health, using validated scales, among Mumbai slum-dwelling women with a history of infertility. Methods: We conducted a mixed-method, cross-sectional study. A focus group discussion with community health workers (n = 7) informed the development of a comprehensive survey. The survey consisted of validated scales whenever possible, in addition to questions pertaining to women's sociodemographic and reproductive history. After rigorous forward and back translation, the surveys were conducted as face-to-face structured interviews due to low literacy levels and the research naiveté of our respondents. Interviews were conducted by culturally, linguistically, gender-matched, trained research assistants. Results: Mumbai slum-dwelling women of reproductive age suffering from infertility (N = 74) participated. Most (85%) women and their husbands (66%) reported previous infertility testing. Participants had elevated mental health distress (anxiety and depression symptomology) largely explained by general health, length of marriage, and coping strategy employed. Conclusion: Women facing the double stigma of mental health and infertility need innovative programs to address their challenges. [ABSTRACT FROM AUTHOR]

Background:Millennium Development Goal 4, to reduce child mortality, can only be achieved by reducing stillbirths globally. A confluence of medical and sociocultural factors contribute to the high stillbirth rates in India. The psychosocial aftermath of stillbirth is a well-documented public health problem, though less is known of the experience for men, particularly outside of the Western context. Therefore, men's perceptions and knowledge regarding reproductive health, as well as maternal-child health are important.Methods:Key informant interviews (n = 5) were analyzed and 28 structured interviews were conducted using a survey based on qualitative themes.Results:Qualitative themes included men's dual burden and right to medical and reproductive decision making power. Wives were discouraged from expressing grief and pushed to conceive again. If not successful, particularly if a son was not conceived, a second wife was considered a solution. Quantitative data revealed that men with a history of stillbirths had greater anxiety and depression, perceived less social support, but had more egalitarian views towards women than men without stillbirth experience. At the same time fathers of stillbirths were more likely to be emotionally or physically abusive. Predictors of mental health, attitudes towards women, and perceived support are discussed.Conclusions:Patriarchal societal values, son preference, deficient women's autonomy, and sex-selective abortion perpetuate the risk for future poor infant outcomes, including stillbirth, and compounds the already higher risk of stillbirth for males. Grief interventions should explore and take into account men's perceptions, attitudes, and behaviors towards reproductive decision making. [ABSTRACT FROM AUTHOR]

Commonalities are presented from the experiences of U.S. nurse researchers who conducted studies in India, Jordan, Aotearoa/New Zealand, and Trinidad and Tobago. While planning research, it is important to engage collaborators who are members of the culture to be studied to understand what are culturally appropriate aims and methods. It is also vital to observe cultural etiquette, especially while gaining entrée and collecting data. Issues related to data collection include timing it around local holidays and events, and adapting individualist methods for obtaining consent and data to be more respectful for those in a collectivist culture. Care must be taken to give back, to sharing findings, and insure sustainability for future research in the host culture. Based on these and other reflections, recommendations are offered to support investigators planning research in a culture that is not their own. [ABSTRACT FROM AUTHOR]

We explored the concept of using a Mindfulness-based intervention to reduce perinatal grief among Indian women. Data were collected using mixed methods to explore concept acceptability, receptivity, modality, and feasibility of the intervention. The intervention was piloted and evaluated with measures of perinatal grief, psychosocial wellbeing, religious coping, perceived social provision of support, and mindfulness. The intervention was well received and effective in teaching skills to help women deal with high levels of grief and subsequent mental health challenges. To overcome attendance barriers modification is necessary. Partnership with a local nursing school is critical to enhance sustainability of the intervention. [ABSTRACT FROM AUTHOR]

Stillbirth is a globally significant public health problem with many medical causes. There are also indirect causal pathways including social and cultural factors which are particularly salient in India's traditional society. The purpose of this study was to explore women's perceptions of stillbirth and to determine how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India. Structured interviews were done face-to-face in 21 randomly selected villages among women of reproductive age ( N = 355) who had experienced stillbirth ( n = 178) and compared to those who had not ( n = 177), in the Christian Hospital, Mungeli catchment area. Perinatal grief was significantly higher among women with a history of stillbirth. Greater perinatal grief was associated with lack of support, maternal agreement with social norms, and younger maternal age. These predictors must be understood in light of an additional finding-distorted sex ratios, which reflect gender discrimination in the context of Indian society. The findings of this study will allow the development of a culturally appropriate health education program which should be designed to increase social support and address social norms, thereby reducing psychological distress to prevent complicated perinatal grief. Perinatal grief is a significant social burden which impacts the health women. [ABSTRACT FROM AUTHOR]

Asian-Indians, one of the fastest growing US immigrant groups, experience depression and anxiety, particularly among women. In this mixed-methods study, quantitative (n = 217) and qualitative (n = 36) data explored egalitarian vs. traditional views regarding women's roles and rights. Bicultural integration, family planning decision-making ability, and anxiety were associated with more egalitarian views, while Punjabi language preference, depression, and more births were associated with traditional views. Health care professionals serving this population need to be aware of the potential cultural values conflicts and gender role expectations that influence decisions around reproductive health and mental health care for Asian-Indian immigrant women.

Cultural influences are deeply rooted, and continue to affect the lives of Asian-Indian (AI) immigrants living in Western culture. Emerging literature suggests the powerful nature of traditions and culture on the lives, mental and physical health of AI immigrants, particularly women. The purpose of this study was to explore depression among AI women in Central California (CC). This mixed-methods research was conducted in collaboration with the CC Punjabi community and the support of local religious leaders. All interviews were conducted in Punjabi and English. Whenever possible we utilized validated scales aligned with emerging themes from the qualitative data, which also provided contextualization to survey responses. In all we conducted 11 key informant interviews, four focus groups (n = 47) and a rigorously developed anonymous survey (n = 350). Social dynamics and traditional expectations including gendered roles significantly affected mental health among women participants. Subgroups along the lines of language choice (Punjabi vs. English) experience and report depression differently in part due to the highly stigmatized nature of mental health issues in this model minority community. The findings of this study highlight the importance of utilizing mixed methods to access hard to reach populations regarding sensitive topics such as mental health.

Perinatal grief following stillbirth is a significant social and mental health burden. We examined associations among the following latent variables: autonomy, social norms, self-despair, strained coping, and acute grief-among poor, rural women in India who experienced stillbirth. A structural equation model was built and tested using quantitative data from 347 women of reproductive age in Chhattisgarh. Maternal acceptance of traditional social norms worsens self-despair and strained coping, and increases the autonomy granted to women. Greater autonomy increases acute grief. Greater despair and acute grief increase strained coping. Social and cultural factors were found to predict perinatal grief in India.