"Let's Call a Spade a Spade. My Barrier is Being a Black Student": Challenges for Black Undergraduate Nursing Students in a Western Canadian Province.

BACKGROUND: We need more understanding of experiences that hinder or promote equity, diversity, and inclusion of Black students in undergraduate nursing programs to better inform their retention and success. PURPOSE: To explore documented experiences of Black undergraduate nursing students, review barriers affecting their retention and success, and suggest evidence-based strategies to mitigate barriers that influence their well-being. METHODS: We used a focused qualitative ethnography for recruiting Black former and current students (N = 18) in a Western Canadian province's undergraduate nursing programs via purposive and snowball sampling. Most participants were female, 34 years or younger, with over 50% currently in a nursing program. Five participants later attended a focus group to further validate the findings from the individual interviews. Descriptive statistics were used to describe participant characteristics; we applied a collaborative constant comparison and thematic analysis approach to their narratives. RESULTS: Challenges influencing Black students' retention and success fell into four main interrelated subthemes: disengaging and hostile learning environments, systemic institutional and program barriers, navigation of personal struggles in disempowering learning environments, and recommendations to improve the delivery of nursing programs. Participants also recommended ways to improve diversity and mitigate these barriers, such as nursing programs offering anti-oppression courses, platforms for safe/healthy dialogue, and more culturally sensitive learning-centered programs and responsive supports. CONCLUSIONS: The study findings underscore the need for research to better define nursing program conditions that nurture safe, learning-centred environments for Black students. A rethink of non-discriminatory, healthy learning-teaching engagements of Black students and the mitigation of anti-Black racism can best position institutions to promote equity, diversity, and inclusion of Black students.

"You have to strive very hard to prove yourself": experiences of Black nursing students in a Western Canadian province.

OBJECTIVES: This study explored the experiences of Black students in two western Canadian undergraduate nursing programs. METHODS: Using a qualitative focused ethnography design grounded in critical race theory and intersectionality, participants were recruited using purposive and snowball sampling. Data were collected through individual interviews, and a follow-up focus group. Data were analyzed using collaborative-thematic analysis team approaches. RESULTS: n=18 current and former students participated. Five themes emerged: systemic racism in nursing, precarious immigrant context, mental health/well-being concerns, coping mechanisms, and suggestions for improvement. CONCLUSIONS: An improved understanding of Black student experiences can inform their recruitment and retention. Supporting Black students' success can potentially improve equity, diversity, and inclusivity in nursing education programs and/or their representation in the Canadian nursing workforce. IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE: The presence of a diverse nursing profession is imperative to meet the needs to provide more quality and culturally competent services to diverse population.

"I die silently inside". Qualitative findings from a study of people living with HIV who migrate to and settle in Canada.

We report on qualitative findings from a mixed methods study, examining enacted and internalized stigma during mandatory HIV screening among immigration applicants living with HIV in Canada. Qualitative findings show alignment with characteristics of internalized HIV stigma. We conducted 34 semi-structured interviews, and analyzed the data through thematic analysis, using Intersectionality and the Internalized HIV Stigma Scale as our theoretical and analytical frameworks. Participants described experiences of enacted and internalized HIV stigma in ways that were consistent with the four main domains of stereotypes, disclosure concerns, social relationships, and self-acceptance, but also extended the description of HIV stigma beyond these domains. Experiences of internalized HIV stigma and enacted stigma during the Canadian Immigration Medical Examination could potentially influence individuals' long-term engagement in the HIV care cascade during the process of migration to, and settlement in, Canada. We present recommendations for the broader migrant health research agenda, health and social care providers, and public health policies.

Examination of Breast Cancer Screening Knowledge, Attitudes, and Beliefs among Syrian Refugee Women in a Western Canadian Province.

BACKGROUND: Women living in the Arab world present low breast cancer screening rates, delayed diagnosis, and higher mortality rates. PURPOSE: To further explore the Muslim Syrian refugee women's breast self-examination (BSE), utilization of clinical breast examination (CBE) and mammography. METHODS: A cross-sectional descriptive exploratory study design was used. The sample consisted of 75 refugee women. Data were collected using Champion's Health Belief Model Scale, the Cancer Stigma Scale, and the Arab Culture-Specific Barriers to Breast Cancer Questionnaire. Descriptive, Pearson correlation and logistic regression analyses were used to analyze the data. RESULTS: A minority of women had BSE (32%), CBE (12%) and mammograms (6.7%) anytime during their lifetime. Women's breast cancer screening (BCS) knowledge ranked at a medium level (M = 10.57, SD = 0.40). Low knowledge score, BSE information, policy opposition, responsibility, barriers to BSE, and seriousness were found to be statistically significant in women's BSE practice. BSE benefits and religious beliefs significantly predict CBE Age, education, knowledge, responsibility, susceptibility, social barriers, and religious beliefs were statistically significant in women's mammography use (p < .01). CONCLUSIONS: Participants' breast cancer screening practices were low. Health beliefs, Arab culture and stigma about cancer affected women's BCS practices. Faith-based interventions may improve knowledge and practices.

Sociodemographic Profiles and Clinical Outcomes for Clients on Methadone Maintenance Treatment in a Western Canadian Clinic: Implications for Practice.

INTRODUCTION: Clients on methadone maintenance treatment (MMT) have high attrition rates that are attributed to personal and system-related factors. To develop supportive interventions for these clients, it is imperative to understand social demographic characteristics and challenges that clients in the MMT program face. OBJECTIVES: This article aims to describe (a) the sociodemographic characteristics and clinical profiles of clients in a MMT program, (b) factors that impact their positive clinical outcomes, and (c) the study's implications for practice. METHODS: A retrospective review of 101 randomly selected electronic medical records representing one third of all the records were examined for sociodemographic characteristics, clinical profiles, and outcomes. Descriptive statistics were used to analyze these variables. Interviews with 18 healthcare providers focusing on their experiences of caring for clients in the MMT program were analyzed thematically. RESULTS: The average age of clients on MMT is 35.5 years. Clients had early exposure to alcohol and drugs, and at the time of enrollment to the program, they presented with complex healthcare needs, borne from chronic use, and exposure to adverse traumatic events. Personal and systemic factors impact clients' recovery. These include poverty, homelessness, and inadequate healthcare services. Understanding sociodemographic characteristics, clinical profiles, and clients' challenges is central to the development of supportive interventions that enhance retention to care and recovery.

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.

Cardiovascular risk factors among prisoners: an integrative review.

BACKGROUND AND AIM: Incarceration is characterized by inequalities in disease burden and an increased risk for cardiovascular disease (CVD). The aim of this review was to critique published empirical research studies on cardiovascular risk factors among prisoners and to summarize and synthesize current knowledge and findings across these studies. DESIGN AND REVIEW METHOD: An integrative review of the studies was conducted. Cooper's five stage method was used as a framework to guide data collection, analysis, and synthesis. Quality appraisal of retrieved studies was done using a combined evaluation tool for quantitative research studies and a checklist. The following databases were searched: CINAHL, MEDLINE, PubMed, Cochrane, Indigenous Studies Portal (iPortal), Native Health Database, Criminal Justice Abstracts, and PsychInfo using keywords. Inclusion criteria were used to select published papers. RESULTS AND CONCLUSION: A total of 12 studies that met the inclusion criteria were identified and analyzed. Hypertension, among other CVD risk factors such as smoking, physical inactivity and obesity, was one of the three most common CVD risk factors found in prisoners. Women and young offenders had a higher prevalence of hypercholesterolemia. Identifying prevalent risks factors among prisoners might influence the development of CVD prevention strategies that are specifically directed to at risk prisoners.

Preliminary reliability and validity of the grandparent version of the Grandparent Support Scale for Teenage Mothers (GSSTM-G).

This study demonstrates the preliminary reliability and validity of the grandparent version of the Grandparent Support Scale for Teenage Mothers (GSSTM-G), a measure designed to assess grandparents' perceptions of triadic relationships that support or imperil the teen mother's care of her baby. Grandparents (N = 61) who participated in this study were parents and parent surrogates of teen mothers who completed a teen version of the scale (GSSTM-T). Principal axis factoring with oblique rotation resulted in a reduction of the GSSTM-G scale from 19 to 14 items. A two-factor solution was supported by item factor loadings and conceptual clarity. The GSSTM-G factors revealed two different patterns of family relationships, Responsive Family Relationships (alpha = .82) and Adversarial Family Relationships (alpha = .81), that correlated with other measures. Construct validity and internal consistency support further exploration of the GSSTM-G as a measure of family relationships, as related to the care of the infant, from grandparents' perspectives.

A profile of accelerated BSN graduates, 2004.

In 1971, Saint Louis University initiated a new type of baccalaureate nursing curriculum, the accelerated option. Since then, there has been an explosion of accelerated baccalaureate nursing (BSN) programs. Despite the popularity of these programs, there is little reported research on the type of students entering accelerated BSN programs and their degree of satisfaction with the programs. This descriptive study aimed to provide a profile of one graduating class of accelerated BSN students. Students in this study had a mean age of 28 and were most likely to have previous baccalaureate degrees in the physical or social sciences. Results indicated that students were, on the whole, satisfied with the accelerated BSN experience, but that the program does pose academic, financial, and personal challenges. Implications for recruitment and retention of accelerated BSN students are discussed.