The creation and integration of a nurse educator position in two hospitals in Haiti.

BACKGROUND: Continuing education is an integral part of nursing professional development and improving healthcare delivery, but literature on continuing education initiatives in low-resource settings is limited. PURPOSE: To describe the creation and integration of a nurse educator (NE) position in two Haitian hospitals and highlight barriers and facilitators experienced by the NEs in their role. METHODS: Four NEs and three support staff involved in the creation and integration of the NE positions were interviewed. Supplementary data were gathered through participant observation and document review. Data were compiled and summarized. DISCUSSION: NEs were hired to assess learning needs, evaluate skills, train and mentor nurses, and provide ongoing support to assure application of new knowledge. Barriers included lack of specialized training and limited informational resources to develop education activities, role confusion and heavy workload, poor attendance and disparate education needs of nurses, and insufficient hospital resources and support to implement practice changes. Facilitators included previous management experience, peer support, and a perception of being valued by patients and colleagues and making a difference regarding nursing care and patient outcomes. CONCLUSION: The NE is a leadership role and a promising, sustainable initiative for developing the nursing profession in Haiti.

Assessing global partnerships in graduate nursing.

North-South partnerships in graduate nursing education can prepare students to address global healthcare issues, increase cultural competence, and build research capacity. However, the current literature does not include a critical and systematic assessment of partnerships using established guidelines. This paper has two objectives: 1) Find and refine a suitable measure to assess a North-South inter-institutional research and clinical partnership in nursing; 2) Pilot test an assessment measure and describe the results of a systematic institutional self-evaluation of a developing North-South research and clinical partnership within a graduate nursing program. The first objective was addressed by searching for, examining and selecting an assessment measure. The second objective was obtained by applying the assessment measure to a developing graduate-level research and clinical partnership between a Canadian School of Nursing and a Malawian College of Nursing; qualitative data collected included information from a document review and subjective experiences of partners. Results showed that when appropriate revisions are made to an existing guideline, it is applicable to use as an assessment measure for North-South inter-institutional research and clinical partnerships. Recommendations for improvement were made, allowing the guideline to be more specific for research and clinical partnerships. Results demonstrated that the existing Canadian-Malawian partnership was strongest in the guideline category of "shaping the purpose and scope of the partnership," and weakest in "partnership implementation and context." This paper implies that: 1) evaluation can strengthen partnerships and enhance educational experience for nursing students; 2) research comparing and contrasting different genres of partnerships could help determine which type is the most appropriate for an institutions' particular outcome goals; and 3) effective establishment and maintenance of North-South partnership occurs through an on-going process of evaluation.

Enhancing research with migrant women through focus groups.

Recent systematic reviews of measurement strategies have identified a striking lack of data to support the validity of most questionnaires used with multiethnic, migrant populations. In the context of two ongoing research studies examining the reproductive health needs of migrant women in Canada, cultural validation was required for proposed study questionnaires and protocols in a total of 13 languages. Multilingual, multiethnic women with various migrant profiles were recruited from the community to review research materials in a series of focus groups. Recommendations by these women were made in relation to consent and interpretation procedures, development of trust in research, home visits after birth, approaches to sensitive topics, inclusion of discrimination as a research variable, and reimbursement of participants. Preliminary work applying focus-group methods to mixed ethno-cultural groups yielded valuable information on appropriateness of planned research.

A systematic review of questionnaires measuring the health of resettling refugee women.

Because many ethnically diverse refugee women resettle in industrialized countries, several biopsychosocial factors need to be considered in caring for them. This systematic review of studies conducted with female refugees, asylum-seekers, or "unspecified" immigrants based on six electronic databases was conducted to determine which questionnaires best measure relevant variables. Questionnaires were reviewed for measurement properties, application of translation theory, and quality of representation. Studies must have included > or = 1 measure of the following: general health; torture, abuse, sex-and-gender-based violence (SGBV); depression; stress; posttraumatic stress disorder (PTSD); anxiety; somatization; migration history; social support; socioeconomic status; discrimination; or mother-child interactions. Fifty-six studies using 47 questionnaires were identified; only five had strong evidence for use with resettling refugee women. Thus, few high-quality tools are available to measure concepts relevant to resettling refugee women's health.