A nurturing and caring environment to facilitate nursing students' professional development in Rwanda: a focused ethnographic study.

OBJECTIVES: To explore the values, practices, and behaviours that support nursing students' professional development in practice-based learning environments in Rwanda. METHODS: A focused ethnographic approach was used. Nursing students (n=12), nurses (n=11), clinical instructors (n=7) and nurse leaders (n=8) from three teaching hospitals and an educational program participated in the study. Data was collected trough individual interviews and participant observation. RESULTS: Participants embraced a culture of preparing nursing students for their professional roles as a professional responsibility, and a means of securing the nursing profession. Modeling the appropriate behaviours to students and respecting them as learners and humans constituted the caring attributes that sustain a positive learning environment for their professional growth. CONCLUSIONS: Nurturing and caring environments offer students opportunities to integrate caring attitudes into their interactions with patients and to develop professionally. IMPLICATIONS FOR INTERNATIONAL AUDIENCE: Findings underscore the need to enhance caring values within nursing curricula.

[The mental health nurse as a cornerstone of mental health care in Rwanda]. / L'infirmier en santé mentale, pierre angulaire des soins de santé mentale au Rwanda.

In the aftermath of the genocide against the Tutsis in Rwanda in 1994, the country was left with a collapsed health system and a huge burden of mental health problems to deal with. With only one psychiatrist at the time, a health ecosystem had to be reinvented to deal with these fragilities. The training of mental health nurses since 1998 has forged the professionals who have contributed significantly to the rebuilding of the mental health system in Rwanda.

A "Co-CREATES" framework to foster a positive learning environment for nursing students' professional development in Rwanda.

AIM: The future of the nursing profession in Rwanda in large part depends on the students who join the workforce and the education they have received. Preparing students with the necessary knowledge, values and judgement requires practice settings to be learner-centered. This study aimed at exploring strategies that might improve the current practice-based learning environment. DESIGN: A focused ethnographic approach was used. METHODS: Nursing students, staff nurses, clinical instructors and nurse leaders from three hospitals and an educational program participated in individual interviews. RESULTS: Five key areas of improvement emanated from study data: 1) strengthening institutional support; 2) improving school-hospital collaboration; 3) building the capacity of nurses and clinical instructors; 4) restructuring clinical placement; and 5) reviewing the current supervision model. Based on these findings a "Co-CREATES" framework grounded in the actions of collaboration, care, recognizing, empowering, actively engaging, transforming, enhancement and support was developed. The framework offers a collaborative approach that engages every stakeholder in "cocreating" conditions that build positive practice environments which are conducive to preparing students as professional nurses. CONCLUSION: The positive outcomes stemming from such a collaborative approach can further enhance a positive culture of collaboration in nursing education and practice.

An International Pilot Study of Self-Reported Quality of Life in Outpatient and Inpatient Mental Health Settings.

Introduction: Measuring quality of life (QoL) is essential to understand how clients perceive their care. In practice, many instruments are in place to identify mental health diagnoses and measure treatment outcomes, but there are fewer standardized instruments to routinely collect information about self-reported QoL, especially across different mental health settings. Moreover, existing tools have been criticized for being built from the perspective of care professionals rather than the users' perspective. The 23-item Self-Reported interRAI-QoL Survey for Mental Health and Addictions (interRAI SQoL-MHA) tackles these issues, as it is based on self-reported measures and has proven validity across settings and countries. Objective: The aim of this study is to assess and compare QoL across settings and explore associations between dimensions of self-reported QoL and some items from the interRAI SQoL-MHA in a multinational sample. Settings: Inpatient and community mental health services. Methods: Data were collected from organizations in Belgium, Finland, Russia, Brazil, Rwanda, Canada and Hong Kong. Logistic regression models were constructed using each domain scale of the interRAI SQoL-MHA (relationship, support, hope, activities and relationship with staff) as dependent variables. Results: A total of 2,474 people (51.2% female, 56.7% of age 45 or older) were included in the study. A benchmark analysis showed the samples that performed above the benchmark line or below. The models yielded significant odds ratios among the domain scales, as well as for the items of the interRAI SQoL-MHA, with positive associations for the items "work and education opportunities" and "satisfied with services", and inverse associations for the items "financial difficulties" and for the inpatient setting. Conclusion: The analysis of associations between the determinants offers relevant information to improve mental health care and clients' perceived quality of life. Information about the determinants can help policymakers to design interventions to improve care outcomes, as well as provide more possibilities for integration into the community. The interRAI SQoL-MHA is innovative, as it can be linked to the third generation interRAI MH and Community MH-instruments, to be used in different mental health care settings, combining the objective and subjective QoL domains.