Seeking Divine Intervention to Manage the Advanced Stages of Breast Cancer in Southwestern Nigeria.

BACKGROUND: The World Health Organization records indicate that breast cancer is the most common cancer in women both in developed and developing regions of the world. In developed countries, breast cancer is the second cause of cancer-related deaths, whereas in developing countries, breast cancer is the leading cause of cancer-related mortality in women. The empirical literature on Nigeria indicates that women present with advanced stages of the illness. OBJECTIVES: To explore the health-seeking behaviors of Southwestern Nigerian women with advanced breast cancer from the time they noticed a breast abnormality to their eventual presentation at the hospital for the management of the illness. METHODS: Thirty women with advanced stages of breast cancer in a large tertiary, referral, teaching, and university-affiliated Southwestern Nigeria Hospital were purposively selected for study participation. Participants completed a demographic information form and an in-depth face-to-face, one-on-one, semistructured interview guided by open-ended questions. Data analysis was inductive. RESULTS: Findings revealed that women sought divine interventions for the management of breast cancer. Prayer and spirituality were associated with high levels of optimism among the study participants. CONCLUSION: Nurses should provide information and counseling to women and the general public on the etiology and appropriate management of breast abnormalities and include the importance of a spiritual dimension of care. IMPLICATIONS FOR PRACTICE: Findings indicate the need to introduce a spiritual dimension to the care of women with advanced breast cancer. Findings also indicate the need for a comprehensive population-based breast health education.

The influence of welfare spending on national immunization outcomes: A scoping review.

Background: National policies influence the environments in which people live, but the ways in which these national policies influence people's health are not well understood. Welfare spending is one national policy that may influence population health. While some research indicates higher levels of welfare investment may positively influence health, mixed findings contradict this conclusion. These mixed results examining the link between welfare policies and health may be better understood by investigating the relationship between welfare spending and preventative health interventions, such as immunization. Objective: This article's purpose is to summarize the literature studying the relationship between national welfare spending and immunization outcomes. Design: This scoping review used the Joanna Briggs scoping review method. Data sources: The scoping review utilized scholarly databases and a focused gray literature search to find research articles that explored relationships between welfare spending and immunization outcomes. Review methods: Data was extracted from articles, including themes, aims, populations, years of study, methods, and findings. The articles' themes were further analyzed with a word cloud and principal component analysis to determine which themes were more likely to coincide in the literature. Results: Seven articles were included in the review. Most of these articles did not address the relationship between welfare spending or policy and immunizations directly or with rigorous methods. Conclusions: Ultimately, the results of the scoping review suggest a lack of literature regarding the relationship between welfare spending and immunization outcomes. Further research is needed to understand the impacts of national welfare spending on immunization outcomes.

Rural Mentorships in Health Care: Factors Influencing Their Development and Sustainability.

BACKGROUND: The need to recruit and retain health care providers remains a concern in rural communities. This project aimed to better understand what health care providers and senior leaders value in mentorship and determine the best way to implement a mentorship program in rural western Canada. METHOD: Health care providers and senior leaders from a rural health region were recruited through convenience and snowball sampling. Participants were interviewed using a semistructured interview guide, and data were analyzed using thematic analysis. RESULTS: Two main themes were revealed: rural mentorship challenges and facilitators. Challenges included administrative, scope of practice, and interpersonal, whereas facilitators included mentorship as a recruitment and retention strategy, openness and commitment, structured mentorship programs, and community influence. CONCLUSION: This information will enable administrators and educators to more successfully implement mentorship programs for a variety of health care professionals working within rural environments and facilitate staff development, recruitment, and retention. J Contin Educ Nurs. 2018;49(7):322-328.

Promoting Early Detection of Breast Cancer and Care Strategies for Nigeria.

Breast cancer is the most common cancer in women particularly in developing countries like Nigeria, with high mortality, and economic costs. Worldwide, it is predicted that more than one million women are diagnosed with breast cancer, and more than 400,000 will die from the disease every year. A comparative integrative review of the literature from Nigeria and Canada showed that in Canada, there is positive association between wide spread education, early detection, the disease stage at diagnosis, and survival rates. In Nigeria, presentation with the advanced stage of the disease makes survival very low. The primary factors responsible for the late presentations are lack of awareness, misconceptions about breast cancer causes, and treatment outcomes. It is recommended that guidelines and policies about breast cancer early detection, care strategies, and ongoing management pathways be produced, disseminated, and adopted. The guidelines will assist practitioners and patients in making informed decisions and choices about the most appropriate health care for their specific clinical situations. The implementation of evidence-based guidelines will most likely help to improve care processes, the quality of clinical decisions and patient treatment outcome.

Economist intelligence unit democracy index in relation to health services accessibility: a regression analysis.

BACKGROUND: The relationship between political environment and health services accessibility (HSA) has not been the focus of any specific studies. The purpose of this study was to address this gap in the literature by examining the relationship between political environment and HSA. METHODS: This relationship that HSA indicators (physicians, nurses and hospital beds per 10 000 people) has with political environment was analyzed with multiple least-squares regression using the components of democracy (electoral processes and pluralism, functioning of government, political participation, political culture, and civil liberties). The components of democracy were represented by the 2011 Economist Intelligence Unit Democracy Index (EIUDI) sub-scores. The EIUDI sub-scores and the HSA indicators were evaluated for significant relationships with multiple least-squares regression. RESULTS: While controlling for a country's geographic location and level of democracy, we found that two components of a nation's political environment: functioning of government and political participation, and their interaction had significant relationships with the three HSA indicators. CONCLUSIONS: These study findings are of significance to health professionals because they examine the political contexts in which citizens access health services, they come from research that is the first of its kind, and they help explain the effect political environment has on health.

Qualities of exemplary nurse leaders: perspectives of frontline nurses.

AIM:  This paper reports on a study that looked at the characteristics of exemplary nurse leaders in times of change from the perspective of frontline nurses. BACKGROUND:  Large-scale changes in the health care system and their associated challenges have highlighted the need for strong leadership at the front line. METHODS:  In-depth personal interviews with open-ended questions were the primary means of data collection. The study identified and explored six frontline nurses' perceptions of the qualities of nursing leaders through qualitative content analysis. This study was validated by results from the current literature. RESULTS:  The frontline nurses described several common characteristics of exemplary nurse leaders, including: a passion for nursing; a sense of optimism; the ability to form personal connections with their staff; excellent role modelling and mentorship; and the ability to manage crisis while guided by a set of moral principles. All of these characteristics pervade the current literature regarding frontline nurses' perspectives on nurse leaders. CONCLUSION:  This study identified characteristics of nurse leaders that allowed them to effectively assist and support frontline nurses in the clinical setting. IMPLICATIONS FOR NURSING MANAGEMENT:  The findings are of significance to leaders in the health care system and in the nursing profession who are in a position to foster development of leaders to mentor and encourage frontline nurses.

Taking the right action in the right way: a comparison of frameworks for assessing the health and quality of life of a postsecondary student campus community.

The focus of campus health research, historically, has been on population health at the individual or aggregate level with little effort to examine the health of the students at a community level with a focus on the broader determinants of health and community-level intervention. The purpose of this article is to critique three models or frameworks of campus health, articulate the World Health Organization (WHO) vision of a health-promoting university, and demonstrate the efficacy of adapting the Community Health Action model for use in university and college settings. Foundational within this proposed model is taking the right action using the right process, an inclusive participatory process. Adaptation of the model requires careful attention to student engagement in community, a healthy campus infrastructure and processes, and relationships beyond the campus. Effective student community assessment and improvement of student community health, ultimately, will serve to generate knowledge and build skills at various levels to benefit the health and quality of life of the students, their student community, the educational institution, and the broader community.

Knowledge of the professional role of others: a key interprofessional competency.

In this paper, the authors present the results of a study which delineated six key competencies of interprofessional collaborative practice for patient-centred care: communication; strength in one's professional role; knowledge of professional role of others; leadership; team function; and negotiation for conflict resolution. While all of these competencies are important and require special attention, this paper examines and discusses the competency knowledge of professional role of others and its associated behavioural indicators, especially as these relate to the interprofessional education of nursing students. The identification of these competencies and their behavioural indicators serve two purposes. It forms the basis for the preparation of students, preceptors, and faculty for interprofessional practice, and it develops a tool for assessing student performance in such practice. Consequently, we believe that the utilization of this key competency and its behavioural indicators will contribute to the development of programs that include specific knowledge and skills related to interprofessional nursing education. This will enable educators to support and evaluate students in interprofessional educational experiences more efficiently and effectively. Ultimately, as nursing students practice and become fully functioning practitioners, client care will be optimized.

Strategies to support recruitment and retention of First Nations youth in baccalaureate nursing programs in Saskatchewan, Canada.

Aboriginal youth is one of the fastest growing of all populations in Saskatchewan today. This is a prime group to target for training in the health care professions. The need for strategies to support recruitment and retention in these programs is critical for maintaining our present standard and increasing demands of quality health care. Program initiatives and supports need to be implemented to encourage this population to enroll in and complete health care programs. Although only 5 years old, the University of Saskatchewan, First Nations University of Canada, and Saskatchewan Institute of Applied Science and Technology (SIAST) have created a viable northern nursing program with a retention rate of Aboriginal postsecondary students 13% greater than the provincial norm. They graduated their first class of nursing students from and for the North, May 2006.

Personal digital assistants in the classroom--and beyond: a collaborative initiative of the College of New Caledonia, British Columbia and the University of Saskatchewan.

In an attempt to address the shortage of northern and, particularly, Aboriginal healthcare providers, northern Canada educational institutions have been researching solutions for self-paced study with up-to-date information for remote students. Current statistics show that nearly 12 million Canadians live in northern provinces and territories. A pilot PDA program initiated and implemented in northern British Columbia and Saskatchewan is expected to enhance northern nursing education, attract and recruit regional nursing students and provide better patient outcome.

Planting the seeds of leadership.

The college of New Caledonia (CNC) in Prince George, British Columbia, believes in creating an environment where students can learn leadership skills from the beginning of their professional education. To that end, students, faculty members and administrators of CNC's health sciences and social services division worked together to engage in a campaign called "Expect a Leader." The intention of this campaign was to strengthen interdisciplinary awareness between programs and to introduce leadership qualities to future healthcare professionals. This article demonstrates how this initiative created change within six health science programs and across an entire division. The authors represent a cross-disciplinary team of health professionals: former CNC students, faculty members and the administrator. This team came together to discuss leadership strategies and activities that occurred within the educational setting and in the community during the Expect a Leader campaign. The authors anticipate that the campaign will foster students' involvement in interdisciplinary leadership activities within practice settings. Readers of this article will learn about the positive effects of promoting interdisciplinary leadership campaigns across healthcare disciplines, and will gain an understanding of reasons for nurturing leadership from the beginning of the students' education.