Evolving Palliative Care Practices among Marshall Islanders in Hawai'i: Generational Comparisons.

Little is known about Marshallese palliative care practices. We explored traditional and contemporary Marshallese palliative care practices and examined generational differences. We performed three focus groups in 2011-2012 among Marshall Islanders in Hawai'i. A native speaking interpreter assisted group facilitators. Data were analyzed using classical thematic triangulation methods to identify specific Marshallese palliative care practices, the effect of economic and social challenges in Hawai'i, and generational differences comparing young and old. Nineteen persons (10 men and 9 women, youth aged 17-27 years, and elders as defined in Marshallese culture, aged 46-79) participated. A "good death" was defined as "peaceful and pain free," occurring from natural causes. Factors associated with a "good death" included gathering of family to absolve conflicts, and proper and timely cultural practices. Factors associated with "bad deaths" included young age, active suffering, accidents, suicides, "black magic/curses," or lack of timely or proper burial. Comparing generational differences, older Marshallese had differing opinions regarding preferred place of death, burial site, cultural practice preservation, artificial prolongation of life, and cremation. Barriers included mortuary fees, cost of transporting bodies, United States (US) government policies, and wait times for death certificates. Many cultural factors contribute to "good" or "bad" deaths. Attitudes toward palliative care practices differ by generation. Having previously documented different approaches by Yapese, a generalized "one size fits all" approach to Micronesians is inappropriate. Overcoming identified barriers may facilitate practices necessary for a good death in Micronesian populations in their home nations and as they migrate to communities throughout the US.

Intergenerational differences in the personal and professional values of nurses.

OBJECTIVES:: This study was conducted descriptively for the purpose of determining the differences in the personal and professional values of nurses according to their generation. METHODS:: The study was planned according to the descriptive research method. The population of the research consisted of nurses carrying out their duties in Istanbul, and the sample consisted of 718 nurses. The number of nurses to be included in the sample was determined by stratified sampling, and the nurses to be included in the sample were determined through random sampling. The data were collected using an information form, the Value Preferences Scale, Professional Value Order of Priority Scale, and the Nurses' Professional Values Scale. ETHICAL CONSIDERATIONS:: Ethics committee approval for the study was received from the Ethics Committee Presidency of the I.U. Cerrahpasa Medical Faculty of Clinical Studies. The study began after the participants were informed that they could decide to withdraw from the study at any time during the data collection process. In order to use the Nurses Professional Values Scale, written permission was received from Nuray Sahin Orak. FINDINGS:: The primary value preference is social value for nurses from the Baby Boomers generation, Y and Z generations, and political value for nurses from X generation. It is the nurses from every generation who prioritized human dignity among professional values, which is follow by activation and responsibility. It is determined that a great majority of nurses from the Baby Boomers generation, X, Y, and Z generations prioritized human dignity among professional values, which was followed by the values of equality, justice, and freedom. CONCLUSION:: These results indicate that nurses from all generations agree on the professional values required by their profession and thus carry out their duties in accordance with the ethical principles and the values of their profession.

A 22 year comparison survey of dental knowledge in Al-Jubail antenatal clinic population.

OBJECTIVE: To analyze and compare dental knowledge between two generations of pregnant women attending the same antenatal clinic in Al-Jubail, Saudi Arabia. METHODS: A cross sectional self administered questionnaire was conducted among 252 pregnant women in three different antenatal clinics. Data were analyzed using SPSS (v. 21), p value <0.05 was considered statistically significant. RESULTS: Most surveyed women were knowledgeable about dental health issues, although a large percentage did not visit dental clinics regularly during pregnancy. Results showed a decline in dental knowledge, compared with data collected 22 years ago. Pregnant women participating in the current survey had more dental problems and underwent more dental procedures than did those participating in the previous survey. CONCLUSIONS: Results of this study show a decline in dental knowledge and oral health in pregnant women of the current generation, compared with those of the previous generation. Antenatal clinics should educate pregnant women more about the relationship between good oral and fetal health.