Mano a Mano-Mujer: an effective HIV prevention intervention for Chilean women.

The impact of a professionally facilitated peer group intervention for HIV prevention among 400 low-income Chilean women was examined using a quasiexperimental design. At 3 months postintervention, the intervention group had higher HIV-related knowledge, more positive attitudes toward people living with HIV, fewer perceived condom use barriers, greater self- efficacy, higher HIV reduction behavioral intentions, more communication with partners about safer sex, and decreased depression symptoms. They did not, however, have increased condom use or self-esteem. More attention to gender barriers is needed. This intervention offers a model for reducing HIV for women in Chile and other Latin American countries.

Anxiety and uncertainty in Korean mothers of children with febrile convulsion: cross-sectional survey.

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.

Japanese women's experiences from pregnancy through early postpartum period.

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.

Capturing nursing care workflow disruptions: comparison between nursing and physician workflows.

Clinical information systems implementation in healthcare delivery has changed clinical work patterns. Nursing practice is under pressure of the changes, which often lead to dysfunctional workflow. The purposes for this literature review were (1) to identify what has been examined about disruptions of nursing care workflow in using Clinical information systems and (2) to obtain a lesson for future research to investigate disruptions of nursing care workflow in using Clinical information systems. In reviewed studies, nursing workflow disruptions have limitedly been reported. Nursing care workflow has not been investigated sufficiently; thus, what happened to nursing care workflow by using a Clinical information system has not been fully known. Nurses have a need for the use of a Clinical information system in aspects of nursing perspective in patient care. Unless the use of Clinical information systems provides effective workflow of nursing care, it will result in confusion in nursing practice as well as poor quality of patient care. It is essential to capture disruptions and/or effectiveness in nursing care workflow from the perspectives of nurses. The required research approach to clinical settings is to identify all facets of adverse consequences triggered from the use of a Clinical information system by following the context of nursing care workflow.

Implementation, outcomes, and lessons learned from a collaborative primary health care program to improve diabetes care among urban Latino populations.

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.

Bridges to the Doctorate: mentored transition to successful completion of doctoral study for underrepresented minorities in nursing science.

Nursing has a shortage of doctorally-prepared underrepresented minority (URM) scientists/faculty. We describe a five-year University of Illinois at Chicago (UIC) Bridges program for URM master's students' transition to doctoral study and factors in retention/graduation from the PhD program. Four master' students from two partner schools were recruited/appointed per year and assigned UIC faculty advisors. They completed 10 UIC credits during master's study and were mentored by Bridges faculty. Administrative and financial support was provided during transition and doctoral study. Partner schools' faculty formed research dyads with UIC faculty. Seventeen Bridges students were appointed to the Bridges program: 12 were admitted to the UIC PhD program since 2004 and one graduated in 2007. Eight Bridges faculty research dyads published 5 articles and submitted 1 NIH R03 application. Mentored transition from master's through doctoral program completion and administrative/financial support for students were key factors in program success. Faculty research dyads enhanced the research climate in partner schools.

Thai female adolescents' perceptions of dating violence.

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.

Nursing values in China: the expectations of registered nurses.

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.

Multidisciplinary teamwork in US primary health care.

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.

Global nurse leaders: lessons from the sages.

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.

Comparisons between Thai adolescent voices and Thai adolescent health literature.

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.

Ethical concerns in nurse migration.

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.

Primary and preferred sources for HIV/AIDS and sexual risk behavior information among adolescents in Swaziland, Southern Africa.

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.

Approaching ethical reasoning in nursing research through a communitarian perspective.

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.

Minority international research training program: global collaboration in nursing research.

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.

Adolescent performance enhancing substance use: regional differences across the US.

Performance enhancing substances (PES) constitute a multi-billion dollar industry, fueling public health concerns regarding use in adolescents hoping to enhance athletic performance and body appearance, or fight obesity. Adverse effects may include violent behavior, suicide attempts, and premature deaths. Prevalence of use is difficult to ascertain due to secrecy issues and misinterpretation of survey questions. Healthcare providers are less familiar with PES than other types of substance use. A correlational secondary analysis of 2007 National Youth Risk Behavior Survey (YRBS) data was conducted (n =14,041) to better understand predictors of PES use (methamphetamines, steroid pills/injections, and diet pill/powder/liquids). Bandura's Social Cognitive Theory served as the organizing framework guiding the analysis. SPSS version 17.0 Complex Samples was used to examine relationships among variables; bi-variate and logistic regression analyses were performed. Feeling sad/ hopeless, considering suicide, perceiving being overweight, being offered drugs at school, geographic location, being sexually active, cigarette smoking, and alcohol use were significantly associated (p <.05) with PES use. Rates of being offered/sold/given illegal drugs at school ranged from 17-39%; PES use ranged from 5-17% across the US. Multiple factors predicted PES use; those contributing to morbidity and mortality may be preventable. Though policies are designed to ensure safe school settings, high rates of obtaining drugs at school were reported. The South US region reported the highest rates of PES use. Regional differences have implications for health professionals and policy makers who must address physical, psychological, and social issues related to adolescent PES use.

A mixed-methods evaluation of school-based active living programs.

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.

Japanese Translation and Cultural Adaptation of the Listening to Mothers II Questionnaire.

The questionnaire used for the U.S. Listening to Mothers II survey was translated and culturally adapted to measure Japanese women's experience during the period of pregnancy planning through early postpartum. Methods included expert panels and two phases of cognitive interviews with 20 postpartum Japanese adult women. The number of problems with the translated questionnaire effectively decreased in the iterative process. Most problems were found in the question-interpretation stage of cognitive processing, such as wording/tone. Culture-specific concepts and unclear items were adapted to prevent erroneous interpretations in future studies. The future use of this questionnaire to generate data sets will be useful for professionals interested in developing evidence-based practices. The knowledge from this study can be helpful in improving health-care services and education for women with diverse languages and cultural backgrounds.

Regional differences in physical appearance identity among young adult women in Thailand.

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.

Active Living Logan Square: joining together to create opportunities for physical activity.

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.