Effectiveness of breast cancer screening interventions in improving screening rates and preventive activities in Muslim refugee and immigrant women: A systematic review and meta-analysis.

PURPOSE: To systematically assess the effectiveness of breast cancer (BC) interventions in improving breast self-examination (BSE), clinical breast examination (CBE), mammogram screening rates, and preventive activities in Muslim refugee and immigrant women. DESIGN: Guided by the Health Belief Model, a mixed method systematic review and meta-analysis was performed using a sequential design. METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA), the Critical Appraisal Skill Program Checklists, and the Joanna Briggs Institute (JBI) methodology for systematic review and meta-analysis. A systematic search of English-language peer-reviewed articles was undertaken in multiple health and social sciences databases from January 1, 2015, to March 31, 2022. Randomized clinical trials and quasi-experimental studies focused on the uptake of BSE, CBE, and mammograms were selected. RESULTS: Fourteen articles were included in the review. Most of the studies relied on quasi-experimental designs and were carried out in the United States of America. The qualitative analysis of BC screening interventions generated three themes: (1) education, (2) access-focused, and (3) cultural and faith-based. The meta-analysis included three randomized control trials and two quasi-experimental studies. The meta-analysis demonstrates the effectiveness of community-led cultural and faith-based interventions in facilitating the completion of CBE and mammography screening. Education on BC and patient navigator interventions are more effectively used in conjunction than standalone interventions, yet community-based cultural and faith-based interventions are the most effective. CONCLUSION: This systematic and meta-analysis review provides evidence on the effectiveness of access-focused and cultural and faith-based interventions in improving BC screening in Muslim refugee and immigrant women. Future research should focus on designing and measuring the effectiveness of cultural and faith-based interventions to increase Muslim refugee and immigrant women's BC screening knowledge and practices. CLINICAL RELEVANCE: This systematic and meta-analysis review demonstrates the need to explore Muslim refugee and immigrant women's cultural contexts for developing culturally sensitive BC screening interventions. Knowledge and practice of BC and religiosity intersect with financial, geographic, and linguistic barriers to decrease participation in screening and preventive activities in Muslim refugee and immigrant women.

Diet Adherence among Adults with Type 2 Diabetes Mellitus: A Concept Analysis.

Objectives: To analyze the concept of diet adherence and its components in the management of type 2 diabetes mellitus (T2DM). Methods: The Walker and Avant (2011) method of concept analysis was used. Scientific databases were queried for research articles in the English language published during 2010-2020 using the search terms: compliance, adherence, treatment adherence, diet adherence, T2DM, and concept analysis. The tools that measure diet adherence and its attributes were identified and evaluated. Results: The concept of diet adherence implies the process of following a diet plan by means of self-monitoring, maintaining, and preventing relapses. Diet adherence is facilitated by antecedents which comprise motivation, understanding the dietary recommendations, developing appropriate health beliefs, self-efficacy, setting achievable goals, and receiving social support. Successful diet adherence brings consequences in health as reflected in improved T2DM-specific clinical parameters and enhanced health-related quality of life. Conclusions: Patients with T2DM often have poor diet adherence due to failure to understand, implement, and maintain the required antecedents, such as motivation, understanding, health beliefs, self-efficacy, practical goals, and social support. Healthcare providers need to ensure that the patients understand the concept of diet adherence and implement it in their daily lives. Further research is needed into diet adherence and its components to evolve more effective measures to be communicated to T2DM patients.

Exploring Foot Care Conditions for People Experiencing Homelessness: A Community Participatory Approach.

INTRODUCTION: People experiencing homelessness are faced with complex challenges and are at high risk of illness due to inequities and disparities in access to health care services. OBJECTIVE: To explore the health and foot care problems related to people experiencing homelessness in British Columbia. METHODS: A community participatory research approach was used with a sample of 65 people experiencing homelessness. Data were collected using a survey questionnaire and face-to-face semistructured interviews. RESULTS: Thematic findings shows risk of foot injuries, lack of foot care resources, and absence of family support. Barriers to equitable access to services for most participants experiencing homelessness were lack of housing (76.92%), inability to work (72.31%), and inability to afford the cost of living on their own (63.08%). CONCLUSIONS: There is a pressing need for early screening and detection by health care professionals and enhanced foot care services to reduce foot problems and improve foot care wellness of homeless people. Addressing foot-related care are necessary steps in promoting health, preventing illness, and improving access to health services among people experiencing homelessness.

Towards Equitable Health Care Access: Community Participatory Research Exploring Unmet Health Care Needs of Homeless Individuals.

Community and health services often overlook health care needs of persons experiencing homelessness, which leads to deterioration in health and increased utilization of emergency services. Since homeless people are underrepresented in health service research, little is known about their unmet health care needs, particularly in smaller cities where resources are limited. This community-based participatory research explored the experiences of small-city homeless service users (HSUs) with unmet health care needs and community service providers (CSPs) who work with them to determine barriers to health care access affecting them. Structured interviews were conducted with 65 HSUs and 15 CSPs in interior British Columbia, Canada. These interviews were audio-recorded, and the retrieved data were analyzed thematically. The three themes uncovered included: a lack of access to health care and risk of stigma, a lack of trust and fear of discrimination, and a need for community navigation and social support. The findings indicate that HSUs do not receive equitable care and face challenges in accessing appropriate and timely foot care, which contributes to increased foot-related emergency visits, loss of trust in the health care system, and disabilities due to worsening foot conditions. Various social determinants of health also impact HSUs, such as low socioeconomic status, lack of housing, decreased social support, unhealthy behaviors, and inequitable access to health services. By collaborating with HSUs, community and health services need to develop innovative outreach programs that provide better community resources as the first step toward equitable access to health care.

Kidney Disease-Specific Quality of Life among Patients on Hemodialysis.

INTRODUCTION: Quality of life (QoL) of hemodialysis patients can be examined in two aspects: kidney-specific quality of life and general quality of life. OBJECTIVE: To determine the QoL among patients undergoing hemodialysis, to assess patients' QoL on hemodialysis, and to determine the factors associated with QoL among hemodialysis patients in Oman. METHOD: A cross-sectional study was carried out with 205 patients to measure the QoL across various demographic and clinical variables in Oman. The Arabic version of the KDQOL-SFtool was used to collect data from patients undergoing hemodialysis to give QoL quantitative measures. RESULTS: The physical-QoL was 45.7 (95% CI, 44.3, 47.0), which is less than half that of a healthy human. The emotional-QoL is 53.33 (95% CI, 51.1, 55.5), slightly more than half in a healthy human-QoL. The difference between physical and emotional-QoL scores is -7.66 (95% CI, -10.3, -5.1), showing that physical QoL is significantly less than emotional-QoL. The overall general QoL score was 49.5 (95% CI, 47.8, 51.2), half the QoL score of a healthy human. Younger patients are also more likely to experience emotional problems compared with older patients. Patients with 5-8 mg/l levels of serum creatinine have lower emotional wellbeing. People on low incomes experienced social difficulties, while the maximum burden was found in physical activities and minimum social function. CONCLUSION: Both physical (45.7) and emotional (53.3) QoL scores in dialysis patients are nearly half those of an average human. Hence, there is a poor QoL among dialysis patients like other studies, and therefore, further improvement of renal rehabilitation in dialysis patients is warranted to improve patients' QoL.

Capability beliefs and the intention to adopt evidence-based practices in the future among nursing students: An international study.

BACKGROUND: Capability beliefs and the intention to adopt EBP in future nursing practice have been identified as strong antecedents of subsequent utilization of EBP. Despite this, a multicountry comparison may yield interesting findings that can be useful in designing empirically based and culturally tailored strategies to facilitate and enhance students' capability beliefs as well as their intentions to integrate evidence into nursing practice. AIMS AND OBJECTIVES: This report sought to compare capability beliefs and intentions to adopt EBP in the future among student nurses from four countries-specifically, Oman, India, Nigeria, and Saudi Arabia-and to identify specific variables that predict the intention to adopt EBP. METHODS: This study employed a descriptive, cross-sectional, comparative research design to gather data from a convenience sample of 1387 nursing students from four countries using self-report questionnaires that captured their EBP capability beliefs and their intention to adopt EBP in clinical practice upon graduation. This study adhered to STROBE guideline for cross-sectional studies. RESULTS: Overall, nursing students reported a high intent to adopt EBP in their future nursing practice; however, the exact rate varied according to the country of origin. Students' gender, student track, education, country of origin, access to the internet, and capability beliefs were seen as important in explaining the likelihood of future implementation of evidence in clinical nursing practice. Capability beliefs among students were moderate, with large differences observed between countries. CONCLUSIONS: Although the surveyed nursing students reported moderate capability beliefs, their intention to adopt and integrate EBP in their future nursing practice was relatively high. RELEVANCE TO CLINICAL PRACTICE: The findings of this study highlight the critical role of nurse educators and nurse administrators in fostering EBP capability beliefs and future intentions to adopt among students through curricular review, implementation of evidence-based strategies, and the promotion of EBP culture within the clinical learning sites.

Nursing faculty teaching characteristics as perceived by nursing students: an integrative review.

AIMS: Nursing faculty members play a pivotal role in the achievement of nursing students' learning outcomes. A broader understanding of what constitutes effective teaching is essential in order to ensure that effective learning takes place in the clinical area. This review sought to identify the most and least effective nursing faculty characteristics as perceived by nursing students. METHODS: An integrative review of the literature was undertaken. Studies were sourced from the following electronic databases: PsycINFO, PubMed Central, CINAHL, Medline and Scopus. An electronic search of relevant studies published between 2001 and 2017 was conducted using the following search terms: 'nursing', 'students', 'nurse faculty', 'nurse tutor', 'nurse educator', 'effective', 'clinical education', 'effectiveness', 'clinical instructor', 'nurse instructor', 'teaching behaviour', and 'teaching characteristics'. FINDINGS: Twenty-nine articles met the inclusion criteria. This review revealed that nursing students value nursing faculty's competence and interpersonal skills over their personality traits. Furthermore, the review highlighted that there exists a lack of studies that examine individual factors, which may influence nursing students' choice of teaching behaviours. Future studies linking teaching behaviours and nursing student learning outcomes are recommended. CONCLUSION: Nursing faculty must strive to improve their professional competence and interpersonal skills in order to better provide quality education to nursing students.

A Multicountry Study on Nursing Students' Self-Perceived Competence and Barriers to Evidence-Based Practice.

BACKGROUND: Nursing education and training are essential in the attainment of evidence-based practice (EBP) competence in nursing students. Although there is a growing literature on EBP among nursing students, most of these studies are confined to a single cultural group. Thus, cross-cultural studies may provide shared global perspectives and theoretical understandings for the advancement of knowledge in this critical area. AIMS: This study compared self-perceived EBP competence among nursing students in four selected countries (India, Saudi Arabia, Nigeria, and Oman) as well as perceived barriers to EBP adoption. METHODS: A descriptive, cross-sectional, and comparative survey of 1,383 nursing students from India, Saudi Arabia, Nigeria, and Oman participated in the study. The Evidence-Based Practice Questionnaire (EBP-COQ) and the BARRIERS scale were used to collect data during the months of January 2016 to August 2017. RESULTS: Cross-country comparisons revealed significant differences in EBP competence (F = 24.437, p < .001), knowledge (F = 3.621, p = .013), skills (F = 9.527, p < .001), and attitudes (F = 74.412, p < .001) among nursing students. Three variables including nursing students' gender (ß = .301, p < .001), type of institution, (ß = -0.339, p = .001), and type of nursing student (ß = .321, p < .001) were associated with EBP competence. Barriers to EBP adoption included having no authority to change patient care policies (M = 1.65, SD = 1.05), slow publication of evidence (M = 1.59, SD = 1.01), and paucity of time in the clinical area to implement the evidence (M = 1.59, SD = 1.05). LINKING EVIDENCE TO ACTION: Both academe and hospital administration can play a pivotal role in the successful acquisition of EBP competence in nursing students.

Predictors of evidence-based practice knowledge, skills, and attitudes among nursing students.

PROBLEM: Evidence-based practice (EBP) competence is one of the most desirable outcomes in nursing education. Assessment of knowledge, skills, and attitudes of nursing students regarding EBP is vital in examining the extent to which current approaches to EBP teaching is effective. PURPOSE: This study examined the predictors of knowledge, skills, and attitudes regarding EBP among Omani nursing students. METHODS: This study utilized a descriptive, cross-sectional approach. Two hundred and forty-eight nursing students enrolled in one of the universities in Oman participated in the study during the months of May 2016 to August 2017. The evidence-based practice questionnaire (EBP-COQ) was used for data collection. Descriptive and inferential statistical tools were used to analyze the data. FINDINGS: The mean values for the three EBP domains (knowledge, skills, and attitudes) were 3.41 (SD = 0.66), 3.62 (SD = 0.51), and 3.41 (SD = 0.68), respectively. Nursing students' sex (being female), classification (being a registered nurse to Bachelors of Science degree in Nursing nursing student), and access to the internet and to nursing journals strongly predicted the knowledge, skills, and attitudes regarding EBP. Overall, 79.0% of Omani nursing students intended to adopt EBP in the future. CONCLUSIONS: Omani nursing students possessed moderate knowledge, skills, and attitudes on EBP; however, more efforts are needed to ensure that future Omani nurses are competent and confident to apply EBP in the actual clinical area. Both academe and the hospital administration play a pivotal role in the acquisition and achievement of EBP competence in student nurses.

Perceptions of risk of coronary heart disease among people living with type 2 diabetes mellitus.

AIMS: Our aim is to assess perception of risk of developing coronary heart disease and to examine its associations with individuals' characteristics and health behaviours among Omani people with type 2 diabetes mellitus (T2DM). BACKGROUND: Evaluating perceptions of being at risk of developing a disease may give insight into health promotion behaviours. People with diabetes are at high risk of coronary heart disease. The management of diabetes mellitus should include prevention and control of coronary heart disease. DESIGN: A cross-sectional correlational study was conducted. METHODS: A convenience sample of 160 adults with T2DM was invited to participate in this study between November 2014 and March 2015. Descriptive and regression analyses were performed to examine associations between study variables. RESULTS: Perception of risk of developing coronary heart disease was significantly associated with low educational level (ß = 0.191, P < .05), low income (ß = 0.201, P < .05), and high level of knowledge about diabetes mellitus (ß = 0.200, P < .05). People with T2DM who perceived coronary heart disease as having few moderate known outcomes and consequences reported consuming healthy diet more frequently. CONCLUSION: Teaching people with T2DM about the risk of developing coronary heart disease is essential as it could motivate them to perform health promotion behaviours, which may assist in controlling and reducing coronary heart disease.

Self-efficacy and self-care behaviours among adults with type 2 diabetes.

BACKGROUND: Type 2 Diabetes Mellitus (T2DM) has an impact on an individuals' health and is influenced by glycemic control. AIM: To examine the relationship between glycemic control, demographic and clinical factors on self-efficacy and self-care behaviours among adults with T2DM. DESIGN: A correlational, descriptive study was used. One hundred and forty Omani adults with T2DM were recruited from a public hospital. METHODS: Data on self-efficacy, self-care behaviours and glycemic control were collected between April and July 2016. The study was approved by the College Ethics Committee and Hospital Board. Bivariate and multivariate analyses were conducted. RESULTS: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating 'uncontrolled' or poor HbA1c of >8% (65%). Variance of self-care behaviour (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. CONCLUSIONS: Adults with T2DM with poor glycemic control were more probable to have poor self-efficacy and self-care behaviours. Glycemic control has an effect on improving diet, exercise, medication, foot care efficacy and behaviours. CLINICAL RELEVANCE: The study recommends using these findings to plan self-efficacy and self-care behaviour to improve glycemic control among adults with T2DM.

Barriers to Colorectal Cancer Screening in Primary Care Settings: Attitudes and Knowledge of Nurses and Physicians.

OBJECTIVE: Healthcare providers (HCPs) play a critical role in reducing colorectal cancer (CRC) related morbidity and mortality. This study aimed at exploring the attitudes and knowledge of nurses and physicians working in primary care settings regarding CRC screening. METHODS: A total of 142 HCPs (57.7% nurses and 42.3% physicians) participated in a cross-sectional survey. Data were collected using a Self-administered Questionnaire. The participants were clinically experienced (mean = 9.39 years; standard deviation [SD] = 6.13), regularly taking care of adults eligible for CRC screening (62%) and had positive attitudes toward CRC screening (83.1%). Most participants (57%) had low levels of knowledge about CRC screening (mean = 3.23; SD = 1.50). The participants were most knowledgeable about the recommended age for initiating screening (62.7%) and the procedures not recommended for screening (90.8%). RESULTS: More than 55% did not know the frequency of performing specific screening procedures, the upper age limit at which screening is not recommended, and the patients at high-risk for CRC. There were no significant differences between nurses' and physicians' attitudes and knowledge. The participants' perceptions about professional training (odds ratio [OR] = 2.17, P = 0.003), colonoscopy (OR = 2.60, P = 0.014), and double-contrast barium enema (OR = 0.53, P = 0.041), were significantly associated with knowledge about CRC screening. CONCLUSIONS: The inadequate knowledge levels among nurses and physicians may be one of the barriers affecting CRC screening. Enhancing HCPs knowledge about CRC screening should be considered a primary intervention in the efforts to promote CRC screening and prevention.

Foot care behaviors among adults with type 2 diabetes.

AIM: The aim of the study was to determine factors influencing foot care behaviors among adults with type 2 diabetes. METHODS: A correlational descriptive study was conducted with a random sample of 160 adults with type 2 diabetes from the public hospital between April and July 2014. RESULTS: Just over 15% of the sample had a history of foot ulcers and almost 42% had numbness/tingling and pain in their feet. Positive foot care behaviors were correlated with higher income, higher educational attainment, lower body weight, positive attitude and higher awareness of diabetes and its management. CONCLUSION: Targeting type 2 diabetes people with low level of education, low income and overweight may help to enhance their foot care and reduce foot complications in similar populations, Implications. Those most at risk of foot problems should be targeted for education to increase their awareness of ways to prevent and to manage foot problems.

Effectiveness of patient navigator interventions on uptake of colorectal cancer screening in primary care settings.

AIM: Colorectal cancer is the fourth most common type of cancer in the world and every year it is responsible for 610,000 deaths worldwide. The aim of this review was to examine the effectiveness of patient navigator interventions towards enhancing uptake of colorectal cancer screening in primary care settings. METHODS: Electronic databases such as PubMed, CINHAL, Google Scholar and SCOPUS were searched to retrieve articles reporting on primary studies applying any patient navigator intervention to promote uptake of colorectal cancer screening in eligible patients. The search yielded 292 articles and 15 met the inclusion criteria. RESULTS: All 15 studies were conducted in urban settings located in the USA. The findings of the review show that patient navigator interventions can increase colorectal cancer screening rates in diverse primary care settings. Patient navigator interventions were most effective in patients who belong to minority groups and enhanced uptake of colorectal cancer screening with rates ranging 11-91%. CONCLUSION: There is a need for further studies to examine the effectiveness of patient navigator interventions in rural populations and other countries. Such studies will help us to clearly characterize the effectiveness of patient navigator interventions.

Health Related Quality of Life among Omani Men and Women with Type 2 Diabetes.

The aim of this study was to explore predictors of health related quality of life (HRQoL) among men and women with type 2 diabetes. This cross-sectional descriptive study consisted of a random sample of 300 adults with type 2 diabetes in a selected public hospital. Euro-QoL and Revised Summary of Diabetes Self-Care Activities scales were used to collect data between January and June 2010. Schooling and ability to manage positively were highly significant predictors of quality of life (QoL) among women as compared to men. Age, prevention of activities of daily living and knowledge/management of diabetes were significant predictors of Health state among women as compared to men. Findings demonstrate that 30.6% (versus 35.7%) of the variance in the total QoL and 14% (versus 23%) of the variance in health state could be explained by personal and clinical characteristics among women and men, respectively. The study underlines the importance for nurse educators to assess HRQoL among men and women and to develop effective self-care management strategies based on personal and clinical characteristics.

Contrasts in Practices and Perceived Barriers to Colorectal Cancer Screening by Nurses and Physicians Working in Primary Care Settings in Oman.

Colorectal cancer (CRC) is the fourth most common type of cancer worldwide and it is responsible for 610,000 deaths annually, despite availability of screening tests that ensure early detection. Predictions specific to the Middle East show that this region will experience a significant increase in cancer mortality over the next 15 years. This study explored the practices and perceived barriers to CRC screening from the perspective of health care providers (HCPs) working in primary care settings in Muscat, Oman. A cross-sectional design and self-administered questionnaires were used to collect data from 142 HCPs. The HCPs were nurses (57.7 %) and physicians (42.3 %) with average age and clinical experience of 32.5 and 9.5 years, respectively. The majority of the HCPs (64.8 %) rarely ordered, referred, health educated, or recommended CRC screening to eligible patients. The only major patient-related barrier to CRC screening reported by HCPs was lack of awareness about CRC tests (63.7 %). There were significant differences between nurses' and physicians' rating of patient-related barriers such as fear of cancer diagnosis (p = 0.037), belief that screening is not effective (p = 0.036), embarrassment or anxiety about screening tests (p = 0.022), and culture (p = 0.001). The major system barriers to CRC screening were lack of hospital policy or protocols, lack of trained HCPs, lack of CRC screening services, and timely appointments to get CRC screening. The findings indicate a need for interventions to enhance patient awareness, HCPs CRC screening practices, and strategies to ameliorate patient and system barriers to CRC screening.

Do Perceptions of Empowerment Affect Glycemic Control and Self-Care Among Adults with Type 2 Diabetes?

BACKGROUND: The Arab adult with T2DM is understudied with less known facts about the perception of empowerment and its relationship with self-care and glycemic control. PURPOSE: The purpose of this study was to determine the extent to which perception of empowerment by Arab adults living with Type 2 Diabetes Mellitus (T2DM) was associated with better glycemic control and self-care management. METHODS: A cross-sectional descriptive study was led among 300 Arab adults living in Oman with T2DM in an outpatient diabetes clinic. The Diabetes Empowerment Scale (DES), glycosylated haemaglobin (HbA1c) and Body mass index was assessed. The DES was found to be valid and reliable for the population. ANOVA, Regression analysis, and Structural equation modeling was used for analysis. RESULTS: The composite score and three subscales of DES were a significant and strong predictor of good glycemic control among Omani adults with T2DM (p<0.001). Age, education, duration of DM, prior DM education program and medications were significantly associated with DES. CONCLUSION: Diabetes nurse educators engaged in the care of adults with T2DM should assess self-empowerment and tailor interventions to increase empowerment for better glycemic control. Patient empowerment plays an essential role in maintaining self-care behaviours and HbA1c.

Perception of and satisfaction with the clinical learning environment among nursing students.

BACKGROUND: Clinical nursing education provides baccalaureate nursing students an opportunity to combine cognitive, psychomotor, and affective skills in the Middle East. OBJECTIVE: The aim of the paper is to assess the satisfaction with and effectiveness of the clinical learning environment among nursing students in Oman. DESIGN: A cross-sectional descriptive design was used. SETTING AND PARTICIPANTS: A convenience sample consisting of 310 undergraduate nursing students was selected in a public school of nursing in Oman. METHODS: Ethical approval was obtained from the Research and Ethics Committee, College of Nursing in 2011. A standardized, structured, validated and reliable Clinical Learning Environment Supervision Teacher Evaluation instrument was used. Informed consent was obtained from all the students. Data was analyzed with ANOVA and structural equation modeling. RESULTS: Satisfaction with the clinical learning environment (CLE) sub-dimensions was highly significant and had a positive relationship with the total clinical learning environment. In the path model 35% of its total variance of satisfaction with CLE is accounted by leadership style, clinical nurse commitment (variance=28%), and patient relationships (R(2)=27%). Higher age, GPA and completion of a number of clinical courses were significant in the satisfaction with the CLE among these students. CONCLUSIONS: Nurse educators can improvise clinical learning placements focusing on leadership style, premises of learning and nursing care, nurse teacher, and supervision while integrating student, teacher and environmental factors. Hence the clinical learning environment is integral to students' learning and valuable in providing educational experiences. RELEVANCE TO PRACTICE: The CLE model provides information to nurse educators regarding best clinical practices for improving the CLE for BSN students.

Women's well-being and reproductive health in Indian mining community: need for empowerment.

This paper is a qualitative study of women's well-being and reproductive health status among married women in mining communities in India. An exploratory qualitative research design was conducted using purposive sampling among 40 selected married women in a rural Indian mining community. Ethical permission was obtained from Goa University. A semi-structured indepth interview guide was used to gather women's experiences and perceptions regarding well-being and reproductive health in 2010. These interviews were audiotaped, transcribed, verified, coded and then analyzed using qualitative content analysis. Early marriage, increased fertility, less birth intervals, son preference and lack of decision-making regarding reproductive health choices were found to affect women's reproductive health. Domestic violence, gender preference, husbands drinking behaviors, and low spousal communication were common experiences considered by women as factors leading to poor quality of marital relationship. Four main themes in confronting women's well-being are poor literacy and mobility, low employment and income generating opportunities, poor reproductive health choices and preferences and poor quality of martial relationships and communication. These determinants of physical, psychological and cultural well-being should be an essential part of nursing assessment in the primary care settings for informed actions. Nursing interventions should be directed towards participatory approach, informed decision making and empowering women towards better health and well-being in the mining community.

Factors associated with health-related quality of life among Indian women in mining and agriculture.

BACKGROUND: Women facing social and economic disadvantage in stressed communities of developing countries are at greater risk due to health problems. This paper investigates the relationships between structural, health and psychosocial predictors among women in mining and agricultural communities. This paper is a report of a study of the predictors of the health-related quality of life among Indian women in mining and agricultural communities. METHODS: A descriptive cross-sectional research design was used. The instruments used are SF-36 Health Survey and Coping Strategy Checklist. ANOVA, MANOVA and GLM were used in the analysis. The study was conducted between January-September 2008 with randomly selected women in a mining (145) and an agricultural community (133) in India. RESULTS: Women in the agricultural community had significantly increased Physical Health, Mental Health and SF36 scores compared with those in the mining community. Years of stay, education and employment were significant predictors among women in the agricultural community. 39% (33%) and 40% (26%) of the variance in Physical and Mental health respectively among women in agricultural and mining communities are predicted by the structural, health and psychosocial variables. CONCLUSION: Perceived health status should be recognised as an important assessment of Physical and Mental Health among women in rural stressed communities. Cognitive, emotional and behavioural coping strategies are significant predictors of health related quality of life. Implications. Nurses should use the SF-36 as a diagnostic tool for assessing health related quality of life among women and discuss coping strategies, so that these can target women's adaptive behaviour. This should be an essential part of the nursing process for facilitating adaptive process for improved health related quality of life.