International graduate entry nursing students: A qualitative study on engagement.

AIM: This study aims to elicit graduate entry nursing students' views on factors that enable and constrain their learning engagement. BACKGROUND: Learning engagement has been associated with student retention/attrition and the achievement of learning confidence and success. While all students are subject to challenges that affect their learning engagement, those experienced by international students who are learning in a foreign and unfamiliar context are of particular concern to academics. An understanding of international graduate entry nursing students' perspectives on factors that enable and constrain their engagement can inform development of learning and teaching strategies that are more responsive to the needs of this group of students and can support their learning achievement. DESIGN: A qualitative descriptive design conducted in one Australian multi campus university School of Nursing. Participants included first and second-year international students enrolled in a graduate entry Master of Nursing course. METHODS: Data, including demographic information, was collected via a theoretically informed online survey consisting of a Likert scale and open- ended questions. This study reports participant responses to open ended questions included in the survey. A thematic analysis was used to interpret findings. FINDINGS: Analysis identified participants' perspectives on factors that influenced their learning engagement in four theme areas: 1) Availability of study support resources, 2) Opportunities for social interaction, 3) Opportunities to build a sense of belonging, and 4) Constraints on development of a sense of engagement. Opportunities for social engagement emerged as a dominant finding across all themes. CONCLUSION: This research, which focused on international students' perspectives on learning engagement, contributed to existing knowledge on student engagement in higher education graduate entry nursing courses. Opportunities for social interaction within and beyond formal course learning experiences were valued by students and identified as key to their learning engagement. These findings have implications for academics and student support services who together, can influence the context of students learning to better meet their engagement needs.

Commercial surrogacy: Landscapes of empowerment or oppression explored through integrative review.

The surge in demand for surrogacy treatments, combined with regulatory loopholes, has spurred the widespread adoption of global commercial surrogacy. This phenomenon poses potential risks to all involved parties, including surrogates and children, encompassing ethical, legal, physical, and psychological concerns. Although commercial surrogacy is under discussion in various jurisdictions, some countries may reintroduce legislation on the matter. In addressing this intricate landscape, the researchers performed an integrative review of existing literature with the intention of providing guidance to researchers and policymakers. The researchers emphasized notable legal and ethical challenges linked to commercial surrogacy. Surrogates often experience disempowerment and oppression, exacerbated by the contractual nature of these arrangements, perpetuating structural inequalities. Children born through commercial surrogacy, especially internationally, risk losing cultural heritage and future benefits. Banning commercial surrogacy may drive it underground, harming surrogates. Reconsidering prohibitions without penalizing surrogates could mitigate downstream issues and safeguard them from exploitation.

Challenges, coping and resilience in caring for children with disability among immigrant parents: A mixed methods study.

AIMS: To examine the relationships between challenges, coping and resilience among immigrant parents caring for their children with disabilities; and to explore their coping and resilient experiences and the service centre providers' perspectives on these. DESIGN: A sequential explanatory mixed methods study. METHODS: The participants were recruited from seven centres of disability service in Australia between May 2019 and February 2020. Phase 1 consisted of a cross-sectional survey. Data were collected from 134 immigrant parents. Phase 2 consisted of semi-structured interviews. Data were collected from nine immigrant parents and nine service providers. The findings from each phase were analysed separately and then integrated to answer the research aims. RESULTS: Immigrant parents experienced challenges such as overwhelming caretaking responsibilities, lack of supportive social networks and feeling embarrassment over their children's behaviours. They used a variety of coping strategies, including reframing and mobilizing family to acquire and accept help from others to overcome their challenges. They had positive gains from the parental experience. Immigrant parents had a reasonable level of resilience. Those with a higher level of perceived challenges had a lower level of coping and resilience. Perceived barriers to parental coping included barriers to establishing social networks and utilizing available disability services. Services from competent service providers and the availability of social support networks were factors facilitating immigrant parents' coping. CONCLUSION: Sensitive communication and culturally appropriate care provided by service providers and healthcare professionals can facilitate service utilization and reduce perceived stigma over children with disability. IMPACT: Findings from the study support that special training provided to healthcare providers about the challenges of immigrant parents raising children with disabilities may enhance awareness of the experience of these parents. Information and instrumental support may help to enhance parental coping, reduce isolation and promote their mental health. PATIENT OR PUBLIC CONTRIBUTION: We thank the immigrant parents and the service providers who have been instrumental in the conception of this study.

Challenges, Coping, and Resilience Among Immigrant Parents Caring for a Child With a Disability: An Integrative Review.

PURPOSE: The aim of this integrative review is to synthesize quantitative and qualitative research evidence on challenges in caring for a child with a disability among immigrant parents and to understand their coping strategies and resiliency factors associated with their coping. METHODS: A comprehensive literature search was conducted to identify relevant studies from the following databases: MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, PsycINFO, Social work abstract, Cochrane library, and EMBASE. FINDINGS: This review included 25 studies: 1 quantitative, 23 qualitative, and 1 narrative review. The main challenges that parents faced were language barriers, financial hardships, service utilization challenges, poor adaptation to new culture, stigma related to mental illness, discrimination, and social isolation. This review found poor communication and lack of cultural awareness among some healthcare professionals. Immigrant parents used problem-focused coping, avoidance coping, spiritual coping, and social support to manage their challenges. Parents who received social, emotional, and instrumental support were more resilient. Personality traits and faith were protective factors that enhanced resilience. CONCLUSIONS: When immigration and disability are considered concurrently, the burden of care multiplies. Immigrant parents with children who have disabilities faced extra challenges related to adaptation, finance, service utilization, and stigma. Healthcare providers can play an important role in aiding these parents in service utilization and adaptation. SIGNIFICANCE: This review adds new knowledge on immigrant parents' challenges in caring for their children with disabilities. Such knowledge could help health professionals to develop supportive interventions to enhance parental coping and resilience. CLINICAL RELEVANCE: Culturally appropriate and sensitive communication and care provided by healthcare providers can facilitate service utilization and reduce perceived stigma. Special training provided to healthcare providers regarding the challenges of these families may enhance awareness. Information support and parental support groups may help to enhance parental coping and reduce isolation. An interpreting service should be provided in all aspects of care.