Search

Globalization changes the benchmarking of excellence from national to 'world class' standards. A synthesis of literature about global leadership was used to guide interviews with 17 nurse leaders from 8 countries in 5 continents. The leaders demonstrated leadership from early school years, learned from their mentors, had productive and sustained results in their work with peers and students, and realized their potential in becoming leaders in global health and nursing. The leadership development of future nurses requires formal and informal education, and training for global competencies, international experiences at home and abroad, and promoting and rewarding international work. [ABSTRACT FROM AUTHOR]

A major shortcoming to the understanding and development of HIV/AIDS programs to mitigate social stigma is the paucity of research pertaining to how young people in sub-Saharan African countries perceive those infected with HIV, and how these stigmatizing attitudes are formed, projected and reinforced. The purpose of this study was to examine stigmatizing attitudes toward people living with HIV/ AIDS among young people in Swaziland, southern Africa. A purposive convenience sampling provided urban and rural data for this crosssectional survey. Participants included 941 secondary school students attending four co-educational public schools in Swaziland. Data were collected and analyzed on individual and environmental related factors with students' stigmatizing attitudes toward people with HIV/AIDS as outcome variable. Findings from the study suggest that greater HIV/AIDS knowledge and increased peer influence were associated with lower stigmatizing attitudes. Perceived susceptibility was associated with increased stigma toward people living with HIV/AIDS. Both individual and environmental factors contributed to explaining the variance in social stigma; individual factors accounted for the largest amount. A better understanding of the factors associated with social stigma could assist healthcare and social workers to develop appropriate programs to reduce HIV/AIDS related stigma. [ABSTRACT FROM AUTHOR]

PURPOSE: To describe: (a) development and implementation of an urban outreach health program for Latino immigrants; (b) nurse-community-health advocate (CHA) partnership roles in primary health care delivery, and (c) lessons learned from these activities over 7 years in urban community settings. METHODS: Descriptive study of a community-based health project in a large Midwestern American city. Information was gathered from participants and staff, from observing staff, and from a variety of sources to describe the program and its individual, family, and community effects. FINDINGS: Major findings pertain to the project team's ability to address the health promotion needs of Latino immigrant families and to successfully incorporate CHAs in planning and implementing the program. CHAs were a 'bridge' between health programs and the community, promoting cultural sensitivity. CHAs and nurses provided a range of services including health education and promotion, outreach through home visits, assessment of family needs for referrals to appropriate resources, and follow-up support. CONCLUSIONS: The nurse-CHA team was an effective strategy for promoting Latino immigrant families' access to needed health care. This framework allowed for flexibility in assisting clients of different cultural backgrounds to obtain appropriate health care. [ABSTRACT FROM AUTHOR]

In-depth interviews with 56 urban women in Botswana revealed high levels of AIDS awareness and high reliance on mass media information. Many of the women expressed confusion about AIDS as an illness, that is, its symptoms and the latent period. Nearly all of the women were aware that the virus that leads to AIDS is sexually transmitted and believed that condoms are effective for prevention. However, one third had incorrect knowledge about transmission, lacking a full understanding of sexual transmission and believing that transmission can occur through casual contact. Two thirds believed they were at risk for getting AIDS, usually because they did not trust their partners and lacked control over their partners' behaviors. More than half of the women said they had changed their behaviors to prevent AIDS. Thirty-six said they had only one partner, but only 11 said they used condoms or would do so with a future partner. The women's responses provide important information on gaps in AIDS knowledge that need to be addressed in AIDS prevention. [ABSTRACT FROM AUTHOR]

The Graduate Nursing Concentration in Women's Health was formalized in the 1980s as a program of study that emphasizes nursing theory, research, and practice related to women's health. We describe the purposes of the program and the assumptions underlying the care of women as well as the curriculum and characteristics desired of graduates. In this program, the goal of advancing women's health is balanced by the desire to create a productive, educational environment that facilitates the personal construction of knowledge by learners. [ABSTRACT FROM AUTHOR]

Existing literature on self-care as it relates to menopause is examined to determine whether the knowledge base in this area reflects important tenets in women's health. One such tenet is that understanding the lived experience of women is critical in developing effective health care interventions. Few investigators acknowledge the lived experience of women in their studies of self-care and menopause. [ABSTRACT FROM AUTHOR]

The HIV/AIDS epidemic in Sub-Saharan Africa poses a massive diffusion and persuasion challenge for health professionals. Individuals working with adolescents to prevent the spread of HIV/AIDS must gain an understanding of adolescent's preference in obtaining information about HIV/AIDS and sexual behaviors. This study describes the primary and preferred sources of information regarding HIV/AIDS and sexual risk behavior in relation to several socio-demographic variables (n=941) in Swaziland, Southern Africa. Although print/broadcast media was the primary source for HIV/AIDS and sexual risk behavior information for the students, most participants preferred information from the healthcare workers. This study suggests a greater role for healthcare providers in providing HIV/AIDS and sexual risk information. [ABSTRACT FROM AUTHOR]

Background: School-based programs to combat childhood obesity often lack resources to incorporate strong evaluation components. This paper describes a collaborative evaluation conducted by partners implementing Active Living by Design (ALbD) programs at one Chicago elementary school., Purpose: To assess ALbD program outcomes by triangulating various forms of evidence gathered while implementing these programs., Methods: An exploratory, mixed-methods design was used to collect and analyze data from numerous physical activity initiatives implemented at the school from 2004 to 2009. The researchers triangulated quantitative (student BMI data, student standardized test and discipline data, classroom physical activity logs, and student physical activity knowledge surveys) and qualitative (classroom physical activity logs and open-ended teacher surveys questions) findings to assess outcomes., Results: Students continuously enrolled at this school from Grades 1 through 4, those most exposed to ALbD activities over time, had significantly lower BMI after 4 years, compared with peers who transferred to the school after Grade 1. Student achievement on standardized tests improved between 2004 (prior to initiating ALbD activities) and 2008. Visits to the Disciplinary Office dropped dramatically over the 4-year period. Teacher interviews and surveys and classroom Take 10! Program activity logs revealed that the program was implemented enthusiastically by all grades. The Physical Activity Knowledge Survey revealed a significant increase in physical activity knowledge after instituting these activities., Conclusions: Collaborative efforts to amass and analyze a variety of data demonstrated the effects of implementing a variety of health promotion activities in one school, documenting the growth of a "culture of health" in that school community., (Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Aims and Objectives: The purpose of this study was to assess the level of anxiety and uncertainty in Korean mothers of children with febrile convulsion and to identify factors associated with maternal anxiety., Background: In general, febrile convulsions are harmless to the child, but parents perceive the convulsion as frightening. Previous authors of a few studies suggested that providing information was helpful for parents' knowledge, attitude and fear about a febrile convulsion., Design: This was a descriptive, cross-sectional survey., Methods: The sample comprised 102 mothers whose children had been diagnosed with a febrile convulsion and admitted to paediatric wards in five general hospitals in South Korea. The researchers gave the questionnaires to nursing departments for distribution and collection by paediatric nurses. To test differences in anxiety and uncertainty by participants' characteristics, t-tests and anova were conducted. Linear regression was used to identify factors associated with maternal state anxiety. Statistical significance level was set at 0.05., Results: A multiple linear regression of maternal anxiety showed that four statistically significant predictors explained 56% of the total variations of maternal anxiety. The significant predictors were uncertainty, frequency of febrile convulsion, income and information about febrile convulsion. Among the significant variables, uncertainty was the dominant contributing factor (p < 0.001)., Conclusions: Anxiety in mothers of children with febrile convulsion was especially related to uncertainty, so health care providers can reduce anxiety through decreasing uncertainty., Relevance to Clinical Practice: For interventions to decrease maternal anxiety, provision of information and psychosocial support are needed for parents of hospitalised children with febrile convulsions., (© 2011 Blackwell Publishing Ltd.)

Physical appearance concerns lead to serious health compromising behaviors among women in Thailand. The purpose of this study was to examine differences in physical appearance identity among young women in four regions of Thailand based on 30 physical appearance characteristics generated and validated in two previous samples of young Thai women. Using Q methodology, 200 Thai young women sorted the physical appearance characteristics in terms of importance. Across-region differences exist for the most important physical appearance characteristics. Regional differences in physical appearance identity may explain the variety of behaviors used by Thai women to enhance their physical appearance. Further research should focus on regional factors that contribute to these aspects of physical appearance becoming a dominant source of self-definition so that effective prevention strategies can be developed and targeted to women at high risk.

Declining availability and accessibility of perinatal health care are emergent social concerns. Based on the Listening to Mothers-II (LTM-II) surveys, we describe a total of 20 Japanese women's perinatal experiences. Data were qualitatively compared with those of U.S. women, using a theoretical framework for evaluation of primary health care. Japanese women overcame their worries by engaging in healthy behaviors, accepting hardships such as labor pain, and receiving assurance from health professionals and modern technology. We found that while U.S. and Japanese women's perinatal experiences reflected their unique cultural values and social context, a cross-cultural universality of birthing women's experiences exists.

Background: The Active Living Logan Square target audience is the community of the southwest corner of Logan Square, an urban Chicago community of 84,466 residents, mostly Latinos. Through the Active Living by Design (ALbD) initiative, the Logan Square Neighborhood Association leveraged its 48 years of existence in the neighborhood to create opportunities and build partnerships., Intervention: Activities addressed three primary goals: (1) enhance school environments and practices to support physical activity before, during, and after the school day; (2) encourage individuals and families to enjoy outdoor activities in their own communities; and (3) create safe, inviting places for activity that connect to surrounding communities. The partnership's participatory approach involved a variety of community stakeholders in developing and implementing affordable, accessible, culturally acceptable, and sustainable physical activities for children and their families., Results: The partnership successfully piloted Open Streets (temporary street closures) and advocated for development of the Bloomingdale Trail, an elevated rails-to-trails project. In schools, the partnership changed the culture at McAuliffe Elementary to support healthy behaviors through new policies, physical projects, and programs., Lessons Learned: Vital components of the project's success included a full-time coordinator with strong community ties; time to build healthy relationships within the partnership and community; the use of culturally relevant strategies; and flexibility to welcome complementary opportunities., Conclusions: The partnership intentionally did not produce a single community-recognized campaign; instead, it chose to use limited resources to promote tangible programs and projects that led to sustainable and replicable changes that promote physical activity.

We explored how Thai female adolescents describe the meaning and context of dating violence. Twenty-four students, aged 15-17, were purposively recruited from a secondary school in Bangkok for individually audio-taped interviews. The interviews lasted 45- 70 minutes. ATLAS ti 5.2 was selected for content analysis. Five themes emerged, including characteristics of adolescent romantic relationships, influences on adolescent romantic relationships, perceptions of dating violence, cycle of dating-violence experiences, and influences on adolescents' perceptions of dating violence. The findings indicate a foundation for developing culturally sensitive programs for dating-violence prevention among Thai adolescents.

Abstract The purpose of this study was to identify the essential professional values of Chinese nurses and their manifestations in the current health-care environment. Data were collected from 29 nurse experts by semi-structured individual interviews or focus groups in Beijing and Shanghai, China. Thematic analysis was used to analyze the data. Seven themes were identified: altruism, caring, trustworthiness, dignity, responsibility for the development of the profession, autonomy, and justice. On the whole, these values were in accordance with the codes of the International Council of Nurses and the Chinese Nursing Association. Additionally, culture and socioeconomic trends were found to have an influence on nurses' understanding and explanation of professional values. The findings of this study provided insight into Chinese nurses' professional values and might contribute to the future development of a culturally sensitive scale to measure nursing values in China.

A collaborative primary health care service demonstration program was conducted to improve diabetes care among limited English-proficient (LEP) Latino patients. The intervention provided a multilevel approach aimed at patients and health care providers: Community health workers (CHWs) were mobilized to offer diabetes education in Spanish to LEP Latino diabetes patients, and health professions students and providers were offered intensive Spanish language training and cultural competency workshops. Positive outcomes for patients included a significant decrease in HbA1c. Health care providers reported improved patient communication and greater appreciation for cultural influences on health. Collaborating institutions realized ongoing benefits from expansion of CHWs' role and incorporation of cultural and language classes into health professions students' and house officers' training programs. Lessons learned included the importance of working together at every stage to identify and provide for the CHWs' training and support needs and to link the program's intervention with evaluation of multilevel outcomes.

Socio-cultural factors and HIV-related misinformation contribute to the increasing number of Chilean women living with HIV. In spite of this, and to date, few culturally specific prevention activities have been developed for this population. The goal of the present study was to elicit the perspectives of low-income Chilean women regarding HIV and relevant socio-cultural factors, as a forerunner to the development of a culturally appropriate intervention. As part of a mixed-methods study, fifty low-income Chilean women participated in a survey and twenty were selected to participate in prevention, in-depth interviews. Results show evidence of widespread misinformation and misconceptions related to HIV/AIDS. Machismo and marianismo offer major barriers to prevention programme development. Future HIV prevention should stress partner communication, empowerment and improving the education of women vulnerable to HIV.

A comprehensive literature review was conducted to determine if there was a research gap between women's vulnerability to HIV and research addressing that vulnerability in China. Türmen's article Gender and HIV/AIDS served as a framework for examining the eight determinants placing women and adolescent girls at greater risk of HIV infection than men. Eighty-eight research reports were retrieved and categorized by general characteristics and the eight determinants. Women were found to be more vulnerable than men to HIV infection in China and worldwide. While researchers reported a considerable amount of research regarding women's HIV/AIDS-related issues in China, there is insufficient attention to some risk determinants. Investigators are encouraged to take advantage of political commitment and policy changes in China to conduct more research focusing on female vulnerability and to address the effects of violence, laws, stigma, and discrimination in female HIV prevention.

Primary health care (PHC) is a systems perspective for examining the provision of essential health care for all. A multidisciplinary collaborative approach to health care delivery is associated with effective delivery and care providers' enrichment. Yet data regarding multidisciplinary practice within PHC are limited. The purpose of this exploratory qualitative descriptive study was to better understand team-based PHC practice in the US. Aims included (a) describing nursing faculty involvement in PHC, (b) analyzing ways that multidisciplinary work was enacted, and (c) recommending strategies for multidisciplinary PHC practice. After institutional review board (IRB) protocol approval, data collection occurred by: (a) surveying faculty/staff in a Midwestern nursing college (N=94) about their PHC practice, and (b) interviewing a purposive sample of nursing faculty/staff identified with PHC (n=10) and their health professional collaborators (n=10). Survey results (28% return rate) were summarized, interview notes were transcribed, and a systematic process of content analysis applied. Study findings show team practice is valued because health issues are complex, requiring different types of expertise; and because teams foster comprehensive care and improved resource use. Mission, membership attributes, and leadership influence teamwork. Though PHC is not a common term, nurses and their collaborators readily associated their practice with a PHC ethos. PHC practice requires understanding community complexity and engaging with community, family, and individual viewpoints. Though supports exist for PHC in the US, participants identified discord between their view of population needs and the health care system. The following interpretations arise from this study: PHC does not explicitly frame health care activity in the US, though some practitioners are committed to its ethics; and, teamwork within PHC is associated with better health care and rewarding professional experience. Nurses integrate PHC in multiple roles and are experts at aspects of PHC teamwork.

International nurse migration is natural and to be expected. Recently, however, those who have fostered nurse migration believe that it will solve nursing shortages in developed countries and offer nurse migrants better working conditions and an improved quality of life. Whether natural or manipulated, migration flow patterns largely occur from developing to developed countries. In this article, nurse migration is examined using primary health care (PHC) as an ethical framework. The unmanaged flow of nurse migrants from developing to developed countries is inconsistent with "health for all" principles. Removing key health personnel from countries experiencing resource shortages is contrary to PHC equity. Often, nurse migrants are placed in vulnerable, inequitable work roles, and employing nurse migrants fails to address basic causes of nurse shortages in developed countries, such as dissatisfaction with work conditions and decreased funding for academic settings. Nurse migration policies and procedures can be developed to satisfy PHC ethics criteria if they (1) leave developing countries enhanced rather than depleted, (2) contribute to country health outcomes consistent with essential care for all people, (3) are based on community participation, (4) address common nursing labor issues, and (5) involve equitable and clear financial arrangements.

Low-income Korean community women were assessed for factors relating to decreased bone mineral density (BMD) and fractures in order to determine appropriate health promotion programs. Factors associated with decreased BMD were menopause (OR=3.30, p<0.01), menarchal age (OR=2.01, p<0.05), thyroxin (T(4); OR=11.32, p<0.05), age (OR=2.19, p<0.1), marital status (OR=0.56, p<.01), oral contraceptive use (OR=2.18, p<.01), and tubal ligation (OR=3.30, p<0.1). The risk factors for fractures were earlier menarchal age (OR=13.15, p<0.05), urban residency (OR=0.75, p<0.05), and T(4) abnormality (OR=64.29, p<0.1). The beneficial factor for decreased incidence of fractures was physical activity (OR=40.94, p<0.05). The strategy recommended for fracture risk reduction programs is focused on the prevention of both decreased BMD and fractures. Continuous physical activity should be encouraged as well as reduction of risk factors including associated risk behaviors.

Thai adolescents are hesitant to openly talk to adults; however, they are avid users of the Internet. In 2002, faculty of the Boromarajonani College of Nursing, Nopparat Vajira, Thailand, established a webboard to reach out to high school students for questions and answers on adolescent health. Adolescents pose health questions, which are answered by nursing faculty and students. A total of 106 questions were selected for content analysis. Thai adolescent studies for the years 1992 to 2004 were identified from searches of CINAHL, ERIC, MEDLINE, and PsycINFO databases. The selection criteria required that chosen articles have a Thai adolescent health focus, be written in English, and be retrievable. Of the 68 citations identified, 23 studies met inclusion criteria. Content of the Thai adolescent webboard was compared with a content analysis of the retrieved Thai adolescent research. Physiological development, sexuality, and risky behaviors were common literature themes, whereas Thai adolescents expressed concerns about love and dating relationships. Parenting and parent-child relationships were discussed on the webboard but not in the literature. Analysis of the mental health revealed differences between the literature that covered psychosocial change, and the webboard questions concerned with body image, the need for emotional support, and satisfaction and conflicts of friendship. It is recommended that investigators consider incorporating adolescents as research team participants, particularly as they examine mental health promotion, adolescent and family relationships, and concerns of Thai adolescents.

A peer group HIV prevention intervention based on social-cognitive learning theory, gender inequality, and the primary health care model for community-based health promotion was developed for more than 300 urban employed women in Botswana. All women volunteered to participate in the intervention. To control for self-selection, matched workplaces were assigned to the intervention group or to the delayed control group. Compared with women in the delayed control group, women in the intervention group had significantly higher postintervention levels of knowledge of HIV transmission, sexually transmitted diseases (STDs), and HIV prevention behaviors; positive condom attitudes and confidence in condom use; personal safer sex behaviors; and positive attitudes toward persons living with HIV/AIDS and community HIV/AIDS-related activities. The peer group leaders have sustained the program for more than 5 years after the end of research funding. Peer groups are a low-cost and sustainable intervention that can change HIV prevention knowledge, attitudes, and behaviors for ordinary urban employed women in sub-Saharan Africa.

Most nurse researchers are embedded in research ethics guidelines based predominantly on the ethical principles of autonomy, beneficence, and justice. They are oriented toward protecting the rights of individual research participants. However, in cross-cultural, community-based, and international projects, further examination is required of community rights, as an entity in and of itself, to acknowledge and protect the community's rights. We suggest that communitarian philosophy is a perspective for the researcher to use in examining cross-cultural and international ethical questions. To show this assertion, dilemmas in community research are examined by using case studies and existing research ethics guidelines. Specific recommendations are offered for nursing scientists in practice, educational, and research settings seeking to balance the rights of the individual with those of the community.

In the current century, nurses, along with other health professionals, require preparation for their roles in international health. For faculty and students to practice and learn in this global community, they also will want to have added knowledge of economics, business, and public policy. To gain an immersion experience in global health, nursing faculty and students will need to spend time abroad collaborating with nursing colleagues in other countries. This report describes an academic-research training program (Minority International Research Program [MIRT]) established 7 years ago to enhance the international health experience of minority nursing students. Qualified undergraduate and graduate nursing students are recruited and paired with faculty mentors to conduct short-term research abroad for a period of 10 to 14 weeks. The purpose of international research experiences for minority nursing students is to develop leaders in nursing science and to increase collaboration in the resolution of global health issues. To date, 26 undergraduate students, 22 graduate students, 6 postdoctoral trainees, and 11 faculty mentors have participated and completed the program through research immersion experiences in 9 countries. The program is described in terms of its strengths, challenges, and lessons learned, as well as opportunities for future activities., (Copyright 2003 Elsevier, Inc. All rights reserved.)

Ethnic and racial diversity in the United States has led to increasing interest in research on biculturalism, yet the meaning and underlying processes of biculturalism in the context of development in young adults are not well understood. Fifteen interviews were conducted with second-generation Chinese American women to explore how being bicultural fit into their lives. Data analysis yielded a developmental map that reflected their experiences throughout life as minority women. Findings suggest that biculturalism is more than being functionally competent in two cultures, it is both a behavioral and psychological orientation in life. From the findings of this study, we have increased our knowledge of Asian American women's development and provided a foundation for nursing research with minority women.

HIV/AIDS is a serious public health problem in Swaziland, a small land-locked Southern African country. The epidemic affects all subpopulations, but women are increasingly at risk for contracting the disease. Focus groups were conducted in a rural area to obtain qualitative information on the rural dimensions of HIV/AIDS, vulnerability to HIV/AIDS, and sociocultural factors influencing the spread of AIDS. Five themes were identified from analyses of the focus groups that are relevant in developing an AIDS prevention program for this population in Swaziland. Implications for future research and health care practice focus on gender-sensitive cultural research (e.g., women and men's roles and responsibilities in rural Swaziland society) and how social, economic, and cultural factors impact the spread of AIDS. Recommendations include reorienting and allocating resources for health, education, and social services to address the relative neglect of rural areas and strengthening policies and programs to achieve the equal participation of all women in all aspects of society's decisions. Specifically, policies related to economic and food security should result in programs to improve local access by women to all resources.

Globalization is an inevitable trend in the modern world, as our communities become both closer and more diverse. Globalization is examined in this report as a key factor in recognizing the intersection of health and development. Nurse leaders face the crucial need to understand and take initiatives in responding to this radically changing world. The transformation of nursing requires active participation and leadership in practice, education, research, and policy arenas. To participate in shaping the public understanding of health and development, nurse leaders must be included in the multinational and multidisciplinary decision processes that shape health care at home and abroad.

The Chicago Health Corps is an AmeriCorps*USA program, established in 1994 by the Corporation for National Service in partnership with the Health Resources and Services Administration (HRSA) of the U.S. Public Health Service. The Chicago Health Corps deploys 20 full-time equivalent corps members in selected community sites that offer primary health care services to Chicago's underserved families. Chicago Health Corps members provide a combination of outreach, home visit, and case management services to address unmet health needs identified by community members, including both laypersons and professionals. Providing meaningful opportunities for participants to assist their communities with health care helps corps members develop an awareness of their fellow community members and an ethic of service.

Assuring that the quality of life is continually improved for community residents is an important outcome of primary health care (PHC) programmes. Yet, how can it be measured. Below, the authors describe a tool developed to elicit client perceptions of PHC conditions in two communities in two different cultures: one in Thailand, the other in the USA. Such a tool can help communities prioritize their concerns and monitor the effect of PHC interventions.

In summary, our health advocacy program uses PHC teams in urban, underserved communities to deal with the interaction of social and health factors in solving problems related to access to appropriate (as perceived by residents) and affordable health care. This approach encourages grass-roots participation in problem identification and solution, a fundamental ingredient of community empowerment. Further, this program facilitates community identification of nurses as resource persons who encourage collaboration to improve the community's health status and as health providers who enhance the authority and autonomy of community participation in the resolution of health issues.

The emerging profile of a healthy older woman in the community is that of an active, independent, and positive person. Data from in-depth interviews are presented to illustrate the value of research in assessing health status. Nurses are encouraged to use research to accurately portray older women and their nursing care requirements.