How Nurses Come to Race: Racialization in Public Health Breastfeeding Promotion.

This research study shows how race becomes ascribed through nursing theory and day-to-day workplace socialization processes. We show how public health nurses supporting and promoting breastfeeding for new mothers learn about and reproduce racialized stereotypes, which shape the care they provide. Even when nurses attempt to actively resist racialized stereotypes, most participate in essentialized nursing practice by using racialized institutional practices. Nursing theory needs to expand to help the nurse navigate and understand both the nurses' and client's local histories as well as individual-to-systems level constraints and supports that may impede, or promote, a mother's ability to breastfeed.

Sociodemographic and health situation of teenage students according to sex.

OBJECTIVE: To verify the association between sex (male and female) and sociodemographic, reproductive and sexual variables in teenagers and identify the highest rates of social and health issues among them. METHOD: This was a cross-sectional study conducted with 239 adolescents enrolled in a public school of Salvador, Bahia, Brazil, whose data were produced by applying a structured form processed in Stata. RESULTS: The research indicated an association between females and higher education level (p = 0.02), living with both parents (p = 0.02) and a higher rate of mental, social and behavioral issues. Being a man was associated with sexual initiation (p = 0.00), which occurred before they turned 14 years old (p = 0.05). CONCLUSION: The study variables behave, depending on sex, with smaller or greater chances of experiencing harmful situations, this understanding being essential for subsidizing educational activities that promote the quality of life of teenagers.

PART I: The role of public health nursing in addressing health care needs of children in foster care.

AIMS AND OBJECTIVES: The purpose of this study was to describe the role of Public Health Nurses (PHN) addressing the needs of children and adolescents in foster care. BACKGROUND: Children in foster care have more physical, mental, dental, developmental health problems than the general pediatric population. National data indicate that between 30%-80% of children come into foster care with at least one physical health problem. DESIGN: An online survey was developed to describe PHN day-to day activities, PHN funding, case load and case management responsibilities. METHOD: Thirty-nine PHNs completed the survey (72% response rate). RESULTS: Nurses described the most important needs as being mental and emotional health services, self-esteem/self-worth and dental care. Care coordination, case management and monitoring/oversight of psychotropic medications were the top responsibilities. CONCLUSION: The study demonstrated that public health nursing expertise is an essential part of the child welfare team in addressing medical, dental, mental and developmental needs of children in foster care. RELEVANCE TO CLINICAL PRACTICE: There is an expanding role of Public Health Nurses in non-health care settings to intervene at the system level of the Intervention Wheel that includes policy development and enforcement, community organizing, and coalition building.

Sociodemographic and health situation of teenage students according to sex / Situación sociodemográfica y de salud de adolescentes escolares según el sexo / Situação sociodemográfica e de saúde em adolescentes escolares segundo o sexo

ABSTRACT Objective: To verify the association between sex (male and female) and sociodemographic, reproductive and sexual variables in teenagers and identify the highest rates of social and health issues among them. Method: This was a cross-sectional study conducted with 239 adolescents enrolled in a public school of Salvador, Bahia, Brazil, whose data were produced by applying a structured form processed in Stata. Results: The research indicated an association between females and higher education level (p = 0.02), living with both parents (p = 0.02) and a higher rate of mental, social and behavioral issues. Being a man was associated with sexual initiation (p = 0.00), which occurred before they turned 14 years old (p = 0.05). Conclusion: The study variables behave, depending on sex, with smaller or greater chances of experiencing harmful situations, this understanding being essential for subsidizing educational activities that promote the quality of life of teenagers.

RESUMEN Objetivo: Verificar la asociación entre el sexo (hombre y mujer) y las variables sociodemográficas, sexuales y reproductivas de adolescentes e identificar los mayores promedios de problemas sociales y de salud de ellos. Método: Estudio transversal en el cual participaron 239 adolescentes matriculados en una escuela pública de Salvador, Bahía, Brasil; siendo recolectados los datos mediante la aplicación de formulario estructurado y procesados en el programa Stata. Resultados: La investigación presentó una asociación entre el sexo femenino y mayor nivel de escolaridad (p-valor = 0,02), convivir con ambos padres (p-valor = 0,02) y con un mayor promedio de problemas psíquicos, sociales y comportamentales. Se asoció ser hombre con la iniciación sexual (p-valor = 0,00), que ocurre hasta los 14 años de edad (p-valor = 0,05). Conclusión: Las variables en cuestión se comportaron, dependiendo del sexo, con menor o mayor posibilidad para una experiencia de agravios, siendo fundamental entenderlas para subsidiar acciones que promuevan la calidad de vida de los adolescentes.

RESUMO Objetivo: Verificar a associação entre sexo (homem e mulher) e as variáveis sociodemográficas, sexuais e reprodutivas para adolescentes e identificar maiores médias de problemas sociais e de saúde para estes. Método: Estudo transversal realizado com 239 adolescentes matriculados numa escola pública de Salvador, Bahia, Brasil, cujos dados foram produzidos mediante aplicação de formulário estruturado e processado no programa Stata. Resultados: A pesquisa apontou associação entre o sexo feminino e maior escolaridade (p-valor = 0,02), conviver com ambos os pais (p-valor = 0,02) e com maior média de problemas psíquicos, sociais e comportamentais. Ser homem foi associado com iniciação sexual (p-valor = 0,00) e desta ocorrer até os 14 anos (p-valor = 0,05). Conclusão: As variáveis em estudo se comportam, a depender do sexo, com menor ou maior chance para vivência de agravos, sendo essencial tal compreensão no sentido de subsidiar ações que promovam a qualidade de vida dos adolescentes.

Feasibility of describing community strengths relative to Omaha system concepts.

OBJECTIVES: The purpose was to determine the feasibility of using a standardized language, the Omaha System, to describe community-level strengths. The objectives were: (a) to evaluate the feasibility of using the Omaha System at the community level to reflect community strengths and (b) to describe preliminary results of community strengths observations across international settings. DESIGN AND SAMPLE: A descriptive qualitative design was used. The sample was a data set of 284 windshield surveys by nursing students in 5 countries: Mexico, New Zealand, Norway, Turkey, and the United States. MEASURES: An online survey included a checklist and open-ended questions on community strengths for 11 concepts of the Omaha System Problem Classification Scheme: Income, Sanitation, Residence, Neighborhood/workplace safety, Communication with community resources, Social contact, Interpersonal relationship, Spirituality, Nutrition, Substance use, and Health care supervision. Themes were derived through content analysis of responses to the open-ended questions. RESULTS: Feasibility was demonstrated: Students were able to use the Omaha System terms and collect data on strengths. Common themes were described among the five countries. CONCLUSIONS: The Omaha System appears to be useful in documenting community-level strengths. Themes and exemplar quotes provide a first step in developing operational definitions of strengths at a more granular level.

Description of public health nursing nutrition assessment and interventions for home-visited women.

OBJECTIVE(S): The purpose of this manuscript was to describe: Public Health Nurse (PHN) home-visited, female client Nutrition Knowledge (K), Behavior (B), and Status (S); the number and types of nutrition interventions PHNs used with these clients; and the types of clients receiving nutrition interventions. DESIGN AND SAMPLE: This descriptive study used PHN-generated Omaha System, electronic health record data from January 2012 to July 2015. The analytic sample contains 558 women who received home visits in a rural Midwestern U.S. county that employed universal nutrition assessment for clients. MEASUREMENTS: Omaha System data included nutrition KBS scores (from 1 = low to 5 = high) and nutrition interventions delivered. Analyses included descriptive, bivariate, and multivariate analyses (means, frequencies, chi-squares, general linear models). RESULTS: PHNs assessed nutrition KBS scores for 84.1% of clients; average Nutrition Knowledge was 3.4 (SD = 0.7), Behavior 3.7 (SD = 0.8), and Status 4.3 (SD = 1.0). PHNs provided 0-36 nutrition interventions per client. Nutrition intervention patterns were detected by the type of visit clients received. CONCLUSIONS: Results suggest home-visited women have room to improve Nutrition KBS and PHNs utilize myriad nutrition interventions. Results also point to opportunities to improve home-visited client care by providing more nutrition interventions, especially to those not receiving interventions, and revising standard care plans to reflect important Case Management nutrition interventions.

Expressions of cultural safety in public health nursing practice.

Cultural safety is an essential concept within New Zealand nursing that is formally linked to registration and competency-based practice certification. Despite its centrality to New Zealand nursing philosophies and the stated expectation of cultural safety as a practice element, there is limited evidence of its application in the literature. This research presents insight into public health nurse's (PHN) experiences, demonstrating the integration of cultural safety principles into practice. These findings emerged following secondary analysis of data from a collaborative, educative research project where PHNs explored the use of family assessment tools. In particular, the 15-minute interview tool was introduced and used by the PHNs when working with families. Critical analysis of transcribed data from PHN interviews, utilising a cultural safety lens, illuminated practical ways in which cultural safety concepts infused PHN practice with families. The themes that emerged reflected the interweaving of the principles of cultural safety with the application of the five components of the 15-minute interview. This highlights elements of PHN work with individuals and families not previously acknowledged. Examples of culturally safe nursing practice resonated throughout the PHN conversations as they grappled with the increasing complexity of working with a diverse range of families.

Health prevention in the era of biosocieties: a critical analysis of the 'Seek-and-Treat' paradigm in HIV/AIDS prevention.

On 18 November 2014, the United Nations launched an urgent new campaign to end AIDS as a global health threat by 2030. With its proposed strategy, the UN follows leading scientists who had declared the failure of former prevention strategies and now were promoting a 'Seek and Treat for Optimal Prevention' (STOP) approach as the most cost-effective response to the pandemic to meet the goal of 'an AIDS-free generation'. STOP combines antiretroviral therapy and routine HIV screening to find persons unaware that they are HIV-positive, because research has shown that people consistently change their behaviour (i.e. increase condom use, have fewer partners) after an HIV diagnosis. AIDS activists have broadly criticized this strategy on different levels. In this article, we go beyond these criticisms and try to analyse the political rationalities behind this 'new' strategy. We believe that it is necessary to put the rationale underpinning the STOP programme into the context of broader societal transformations that can best be captured as the development of advanced liberal societies and the new emphasis on self-controlling or self-responsibility rather than on disciplining behaviour.

Projetos terapêuticos: uma construção coletiva para a prática do enfermeiro na estratégia saúde da família / Therapeutic projects: a collective construction for the nursing practice in the family health strategy

Neste estudo, fundamentado na aproximação de um referencial teórico-metodológico híbrido entre pesquisa-ação e a Teoria da Intervenção Práxica da Enfermagem em Saúde Coletiva (TIPESC), buscou-se defender que o Projeto Terapêutico Singular (PTS), como atenção à saúde e organização das práticas de cuidado, favorece o desenvolvimento de projetos de intervenções terapêuticas pelo enfermeiro no campo da saúde coletiva e pode, assim, subsidiar a reflexão sobre um projeto de Enfermagem nesse campo de atenção. A apreensão dos dados empíricos realizou-se por meio da triangulação de coleta de dados a partir da entrevista semiestruturada com 12 enfermeiros da Estratégia de Saúde da Família (ESF) do município de Maricá (RJ), análise documental do Plano Municipal de Saúde ‒ 2014/2017 e diário de campo do acompanhamento de seis reuniões de equipe da ESF na construção do PTS. A partir deste estudo, confirmou-se a tese de que o PTS favorece o desenvolvimento de projetos de intervenções terapêuticas pelo enfermeiro no campo da saúde coletiva ao desenvolver, como organizador do PTS, visão crítica e reflexiva sobre os determinantes do processo saúde-doença na atenção à saúde e na organização das práticas de cuidado. Quanto às intervenções necessárias para subsidiar a reflexão sobre um projeto de Enfermagem no município de Maricá (RJ), os enfermeiros indicaram intervenções relacionadas às dimensões particular, singular e estrutural. A partir destes resultados, apresentou-se, como síntese, a compreensão de como o PTS pode subsidiar a reflexão de um projeto de Enfermagem no campo da saúde coletiva na atenção à saúde e na organização das práticas de cuidado. Neste sentido, acredita-se que alguns impactos podem ser esperados a partir do desenvolvimento do PTS na prática de cuidado do enfermeiro: aumento da qualidade do cuidado prestado ao sujeito, à família e grupos populacionais; organização dos serviços de saúde, a partir de uma nova lógica de cuidado; legitimação do trabalho em equipe e reconhecimento profissional do enfermeiro na saúde coletiva.

The present study was based on a hybrid theoretical and methodological framework between action research and the theory of praxis intervention in collective health nursing (TIPESC). Its aim was to advocate that, as a form of health care and organizing health practices, the singular therapeutic project (STP) favors the development of therapeutic intervention programs by nurses in the field of collective health and can thus substantiate reflections about a nursing program in this field of care. Empirical data were gathered via data triangulation, based on a semi-structured interview with 12 family health strategies (FHS) in the municipality of Maricá (RJ), document analysis of the Municipal Health Plan 2014/2017, and a field journal of six FHS team meetings to construct STP. Based on this study, we confirmed the thesis that STP favors the development of nursing therapeutic programs in the field of collective health by developing a critical and reflexive viewpoint about the determinants of the health-illness process in health care and the organization of health practices. Regarding the interventions needed to underpin the reflection about a nursing program in the municipality of Maricá (Rio de Janeiro), the nurses indicated interventions related to particular, singular and structural dimensions. Based on these results, we present a synthesis on how STP can substantiate reflections about a nursing program in the field of collective health in terms of health care provision and in the organization of health practices. In this sense, we believe that some possible impacts of STP on the practice of nursing care are: increased quality of care provision to individuals, families and population groups; organization of health services, based on a new logic of care; legitimization teamwork and professional recognition of nurses in collective health.

Design of a Medical Triage Evidence-Based Clinical Management Protocol and Implementation of Medical Triage On-Line Training for Use by Mission of Mercy Volunteers.

Evidence-based protocols in safety net settings can help standardize care practices, increase organizational workflow, and enhance quality outcomes for those receiving services. The purpose of this quality improvement project is two-fold: to design an evidence-based medical triage clinical management protocol, and, to influence adherence to that protocol by safety net medical triage volunteers through an on-line volunteer orientation. Leadership skills were required to help translate evidence-based practice recommendations into useful tools to assist in directing practice. Project outcomes included successful multidisciplinary practice change, significantly improved volunteer knowledge surrounding medical triage protocol parameters, increased organizational workflow, and enhanced quality client outcomes.

[Creating a "Health Promotion Checklist for Residents" Attempt to promote healthy activities].

OBJECTIVE: To create a "Health Promotion Checklist for Residents" to help promote healthy habits among local residents. METHODS: First, we investigated items for a health promotion checklist in the Health Japan 21 (2(nd) edition) and other references. Next, we conducted a questionnaire survey including these checklist items in August 2012. The study subjects were randomly selected Hatsukaichi city residents aged ≥20 years. Anonymous survey forms explaining this study were mailed to the investigated subjects and recovered in return envelopes. Data were compared by sex and age group. RESULTS: We created a checklist comprising a 23-item health promotion evaluation index with established scoring. There were 33 questions regarding health checkups; cancer screenings; dental checkups, blood pressure; glycated hemoglobin or blood glucose; dyslipidemia; body mass index; number of remaining teeth; breakfast, vegetable, fruit, and salt intake; nutrient balance; exercise; smoking; drinking; sleep; stress; and mental state. There were also questions on outings, community involvement, activities to improve health, and community connections. The questions were classified into six categories: health management, physical health, dietary and exercise habits, indulgences, mental health, and social activities. Of the 4,002 distributed survey forms, 1,719 valid responses were returned (recovery rate, 43.0%). The mean score by category was 1.69 (N=1,343) for health management, 6.52 (N=1,444) for physical health, 12.97 (N=1,511) for dietary and exercise habits, and 2.29 (N=1,518) for indulgences, all of which were higher for women, and 5.81 (N=1,469) for mental health, which was higher for men. The health management scores were higher among subjects in their 40s and 50s. The physical health score increased gradually with age from the 70 s and older to the 20 s, whereas the dietary and exercise habits increased gradually from the 20 s to the 70 s and older. The 20 s had high scores for indulgences, while mental health was low for the 20 s and 30 s and gradually increased from the 40 s to the 70 s and older. The social activities score (1.93; N=1,539) tended to be higher in the 40 s and older. CONCLUSION: Here we created and attempted to validate a checklist that promotes healthy habits nd found that subjects were able to use it to examine their living habits.

Important interactional strategies for everyday public health nursing practice.

This Clinical Concepts article concerns the relational tools required by public health nurses to establish relationships with single mothers living on public assistance, mothers who are vulnerable and often stigmatized. The implications of stigmatization for relationship building are highlighted based on previous research investigating how public health nurses working in Canadian jurisdictions establish professional caring relationships with this cohort of mothers. Public health nurses employed interactional strategies including engaging in a positive manner and offering verbal commendations which served as effective relational tools to break through mothers' walls of defensiveness and to resume the dynamic process of relationship building. Building Relationship is a key practice standard for public health nurses and is instrumental to their work at both individual and community levels to improve social determinants of health. The author concludes with recommendations to facilitate building relationships during everyday public health nursing practice.

Enfermería en la cobertura universal en salud: nuevos términos, viejas acciones / Nursing in the universal health coverage: new terms and old actions

La cobertura universal en salud significa tener acceso equitativo a servicios integrales de salud suficientes y de calidad. Supone además, que lo anterior esté acompañado de las mínimas afectaciones económicas a las personas atendidas. El presente artículo tiene como objetivo analizar las principales áreas en la que esta profesión desarrolla proyecciones de trabajo que tributan a la cobertura universal en salud. Se revisaron los informes emitidos por el Consejo Internacional de Enfermería en los últimos 12 años, así como las declaraciones más recientes de esta organización en relación con la temática objeto de análisis. Los profesionales de enfermería forman parte de los recursos humanos llamados a concretar su aporte en el alcance de la cobertura universal en salud pero resulta de vital importancia comprender que aportar a ello no supone detenerse en el establecimiento de nuevas acciones cuando ya se han definido varias que pueden contribuir a lo esperado. Se describen también algunas áreas en las que no se han concretado acciones. Se concluye que si bien el término Cobertura Universal en Salud no ha formado, de manera explícita, parte de la agenda de los organismos internacionales que lideran la profesión enfermera, las proyecciones que han desarrollado incluyen acciones que tributan a su alcance. La contribución con los aspectos vinculados al financiamiento constituyen aún un reto para la profesión de enfermería en tanto no ha formado parte de las agendas analizadas en la última década(AU)

Universal health coverage means having equitable access to sufficient comprehensive and quality health services. It also presupposes that this process is accompanied by minimum economic effects for the cared persons. The objective of this article was to analyze the main areas in which nursing develops work projects that contribute to the universal health coverage. The reports of the International Council of Nursing in the last 12 years as well as the most recent statements of this organization about this topic were all reviewed. The nursing staff is part of the human resources that should materialize their contribution to the universal health coverage scope; however, it is vital to understand that this contribution does not mean just establishing new actions when several ones have been already defined and may support reaching the expected results. Likewise, some areas in which no actions have been set were described. It was concluded that although the term universal health coverage has not been explicitly included in the agenda of the leading international bodies of nursing, the work projections that they have designed do cover actions that encourage the scope of universal coverage. Financing contribution is still a challenge for the nursing profession since it has not been part of the analyzed agendas in the last decade(AU)

"Civil unrest does not stop ovulation": women's prenatal and family planning services in a 1960s Detroit neighborhood clinic.

In 1965, Nancy Milio established a prenatal and family planning clinic in Detroit, Michigan, to address health disparities and limited access to care among low-income, African American, urban women. Women's health disparities persist today nationally and internationally. Using historical methods, this research analyzes how Milio provided women's health services in the context of the social and political environment. Milio empowered neighborhood women to direct, plan, and participate in the care they received. Successful methods to address disparities in access to family and planning and prenatal care should include empowered participation from the women these programs are intending to serve.

The 'active ingredients' for successful community engagement with disadvantaged expectant and new mothers: a qualitative comparative analysis.

AIMS: To explore which conditions of community engagement are implicated in effective interventions targeting disadvantaged pregnant women and new mothers. BACKGROUND: Adaptive experiences during pregnancy and the early years are key to reducing health inequalities in women and children worldwide. Public health nurses, health visitors and community midwives are well placed to address such disadvantage, often using community engagement strategies. Such interventions are complex; however, and we need to better understand which aspects of community engagement are aligned with effectiveness. DESIGN: Qualitative comparative analysis conducted in 2013, of trials data included in a recently published systematic review. METHODS: Two reviewers agreed on relevant conditions from 24 maternity or early years intervention studies examining four models of community engagement. Effect size estimates were converted into 'fuzzy' effectiveness categories and truth tables were constructed. Using fsQCA software, Boolean minimization identified solution sets. Random effects multiple regression and fsQCA were conducted to rule out risk of methodological bias. RESULTS/FINDINGS: Studies focused on antenatal, immunization, breastfeeding and early professional intervention outcomes. Peer delivery (consistency 0·83; unique coverage 0·63); and mother-professional collaboration (consistency 0·833; unique coverage 0·21) were moderately aligned with effective interventions. Community-identified health need plus consultation/collaboration in intervention design and leading on delivery were weakly aligned with 'not effective' interventions (consistency 0·78; unique coverage 0·29). CONCLUSIONS: For disadvantaged new and expectant mothers, peer or collaborative delivery models could be used in interventions. A need exists to design and test community engagement interventions in other areas of maternity and early years care and to further evaluate models of empowerment.

Integrating health and prevention services in syringe access programs: a strategy to address unmet needs in a high-risk population.

Injection drug users are at a high risk for a number of preventable diseases and complications of drug use. This article describes the implementation of a nurse-led health promotion and disease prevention program in New Jersey's syringe access programs. Initially designed to target women as part of a strategy to decrease missed opportunities for perinatal HIV prevention, the program expanded by integrating existing programs and funding streams available through the state health department. The program now offers health and prevention services to both men and women, with 3,488 client visits in 2011. These services extend the reach of state health department programs, such as adult vaccination and hepatitis and tuberculosis screening, which clients would have had to seek out at multiple venues. The integration of prevention, treatment, and health promotion services in syringe access programs reaches a vulnerable and underserved population who otherwise may receive only urgent and episodic care.

Evaluation of a statewide public health nursing training in Utah.

Public health nurses continue to struggle to provide culturally relevant services that focus on the multiple needs of an ethnically diverse population while at the same time providing services to the population at large. This article describes the formative research, implementation, and results of a statewide effort to broaden UtahAEs public health nurses perception about their role and responsibility in addressing and serving the emerging needs of underserved and atrisk populations in Utah. A total of 51% of Utah state and local health department public health nurses participated in the training. There was a statistically significant increase in the mean level of perceived understanding of topic material from pretest to posttest, and 80% of participants reported applying what they learned in the training to their practice. Our experience demonstrates that even with limited resources, it is possible to deliver high quality training to a large proportion of public health nurses practicing in urban, rural, and frontier populations; observe significant results in their comprehension of training material and, most importantly; see application of what they learned in the training to their health care practice.

Establishing therapeutic relationships with vulnerable and potentially stigmatized clients.

Grounded theory was employed to elucidate how public health nurses (PHNs) develop therapeutic relationships with vulnerable and potentially stigmatized clients, specifically, single mothers living in low-income situations. We named the emerging theoretical model Targeting Essence: Pragmatic Variation of the Therapeutic Relationship, after discovering that although PHNs strove to achieve relational goals, their attention was primarily focused on the goal of ascertaining concerns foremost on the hearts and minds of mothers, and that PHNs had to accomplish these goals within short practice timeframes. The study's focused context elicited a nuanced explanation of the dynamic relationship-building process derived from subjective relationship experiences of PHNs and single mothers living in low-income situations. We believe Targeting Essence will serve as an effectual relationship-building model, enabling PHNs to know essentially what mothers want and need, and enabling mothers to know essentially that their PHN can be trusted not to render judgment.

An international collaborative study comparing Swedish and Japanese nurses' reactions to elder abuse.

AIM: This paper reports an analysis of aggregated data from two national studies on Swedish community-based nurses' and Japanese Public Health Nurses' responses to hypothetical elder abuse cases. BACKGROUND: Elder abuse is an under-researched area despite being globally recognized as a serious and escalating problem. Yet research, adding needed socio-cultural perspectives to current knowledge has been limited. METHODS: Eighty-one community-based nurses in Sweden and 124 Public Health Nurses in Japan responded to a questionnaire based on three hypothetical elder abuse cases. Swedish and Japanese results (data collection 2006-2007) were combined and the aggregated data were analysed using manifest and qualitative content analyses. RESULTS: Nurses' response patterns in the aggregated data were similar across all three hypothetical cases and within themes Awareness, Assessment and Intervention. However, there were also noteworthy differences between Swedish and Japanese responses, e.g. Swedish responses were generally practical, action oriented and involved increased levels of suspicion and personal intervention to achieve increased control; whereas Japanese responses concerned better understanding that involved the family members and their situation, focusing on interventions grounded in collaboration. CONCLUSION: Despite cultural differences, responses of Swedish and Japanese nurses were very similar which points to a global 'humanness' of the problem of, and nurses' responses to, elder abuse. Results endorse the value of international collaborations that give information and inspiration to nursing colleagues across cultural boundaries. Results also give hope that global tools for elder abuse assessment and intervention can be developed.