Influencing Factors on Death Acceptance Among Thai Older Persons.

OBJECTIVES: This study aimed to investigate both the direct and indirect effects of various factors on the acceptance of death. METHODS: This cross-sectional study included 800 older Buddhist persons in Thailand, who were recruited through a multistage sampling method. Data were collected using six questionnaires and analyzed through path analysis using the MPlus program. RESULTS: Death anxiety was the main factor influencing death acceptance, with death anxiety exerting a negative direct effect on death acceptance. Buddhist beliefs about death demonstrated both a positive direct effect on death acceptance and a positive indirect effect on death acceptance through Buddhist practices. Furthermore, Buddhist practices exhibited a positive direct effect on death acceptance, while social support also showed a positive direct effect on death acceptance. CONCLUSIONS: This study highlights the significant direct and indirect effects on death acceptance among older Thai Buddhists. CLINICAL IMPLICATIONS: Buddhist-aligned interventions may be more effective and readily embraced by Thai older persons. For those who are receptive, nurses can foster death acceptance by developing interventions that reduce death anxiety and promote Buddhist beliefs about death, Buddhist practices, and social support.

Transforming Nurse Self-Care Through Integration of Spirituality: Lessons From an International Collaboration in Palliative Care.

INTRODUCTION: With growing evidence of compassion fatigue and burnout in health care, it is time for a deeper look at the vital practice of self-care among professionals providing palliative care. The purpose of this study was to provide insights into ways empowerment, caring for self, environment, and building relationships impact well-being among palliative care professionals. METHODS: Interpretative descriptive methods framed focus group interviews, conducted during a conference on palliative care integrative health practices held in Thailand. An interprofessional research team used inductive reasoning processes to analyze the interviews. RESULTS: Three themes emerged from the four focus groups (N = 22): Buddhist Beliefs and Practices, Community-mindedness, and Empowerment. Aspects of spirituality were consistently woven into self-care practices. DISCUSSION: Findings suggest that self-care can be reimagined to include highly personal and unique expressions of spirituality. Health care communities are called to integrate ritual in culturally congruent ways, thus supporting health care professionals to find new sources of meaning, enrichment, and empowerment.

Death Acceptance Process in Thai Buddhist Patients With Life-Limiting Cancer: A Grounded Theory.

Cancer patients with life-limiting illnesses have varied levels of death acceptance pervarious scales. Nevertheless, the process of developing death acceptance in patients with life-limiting cancer remains unclear. This study explores the death acceptance process among patients with life-limiting cancer. We used grounded theory methodology. Data were collected through in-depth interviews of 13 patients with cancer in a palliative care setting, and researchers completed field notes. Data were analyzed using constant and comparative methods. Thai Buddhist patients with cancer in palliative care process death acceptance through three dynamic phases: engaging suffering, being open-minded about death, and adhering to Buddhist practices for increasing death consciousness. The death acceptance process described in this study could serve as a guideline to support death acceptance in Thai Buddhist patients with cancer, and other patients with cancer in palliative care, to improve peaceful life and attain good death.

Describing Death Acceptance Among Thai Buddhists With Cancer.

INTRODUCTION: Death acceptance (DA) is perceived in culturally specific ways. The purposes of this study were to describe DA among Thai Buddhists with cancer and to compare DA differences in demographic data. METHODOLOGY: This research was a secondary data analysis. The participants were 363 Thai Buddhists with cancer, recruited using multistage sampling method. Data were collected using the Buddhist Death Acceptance Scale, reliability coefficient. .82. Data were analyzed using T-Tests and Two-Way ANOVA. RESULTS: The participants had high levels of DA. Age and stage of cancer had main effects on DA. DISCUSSION: This study highlighted the significant demographic differences with regard to DA levels among Thai Buddhists with cancer. Interventions include determining the patient's DA level, or offering patients and their families advance care plans. Nurses can then explore DA with patients, particularly those with life-limiting illnesses to ease their patients' lives and foster a good death.

Becoming a Transformative Nurse Educator: Finding Safety and Authenticity.

The study purpose was to evaluate and strengthen this program's nursing education curriculum to better prepare and develop future nurse faculty. As the dire nursing faculty shortage increases, the transition of expert nurse clinician to novice educator is receiving more attention. In order to prepare, recruit, and retain the nursing faculty needed to meet the growing nurse shortage, understanding what nurse educators need in order to be successful is essential. Fourteen participants from four focus groups of nurse educators shared stories about their role transition. Two administrators were interviewed to determine what they identified as crucial in hiring new nurse educators. Interpretive analysis focused on identification of themes and possible paradigm cases. Themes that emerged included: a) culture of academia surprises, b) exciting "Aha!" moments, and c) Safety with a capital "S". These findings were used to strategically revise the entire nurse educator curriculum.

Death Acceptance in Vietnamese Cancer Patients: A Phenomenological Study.

INTRODUCTION: To date, death acceptance is not well investigated in the Vietnamese population. Cultural influences may affect death acceptance. The purpose of this phenomenological study is to describe Vietnamese cancer patients' lived experience with death acceptance. METHOD: Eleven Vietnamese patients with various cancer diagnoses participated in the study. Data were analyzed using the Giorgian method of data analysis. RESULTS: Themes of death acceptance found were (1) accepting destiny, (2) knowing and sacrificing the self, (3) believing in living persons and handing over responsibilities, (4) accepting death while continuing to fight for life, and (5) looking for a "role model death." DISCUSSION: Death acceptance is a contextually bound concept, which needs further investigation. To help patients with their death acceptance, nurses should include spiritual support and the involvement of loved ones in patients' care plans.

Innovative Practice in Advancement of Academic Nurse Educator Careers: Developing Scholarship From Program Grants.

We describe an innovative practice in advancing careers of academic nurse educators: demonstrating scholarly productivity from program grants. Scholarly productivity is often narrowly defined, especially in research-intensive institutions. The expectation may be a career trajectory based on the traditional scholarship of discovery. However, nurse educators, especially at the associate and full professor ranks, are often involved in leadership activities that include writing and managing program grants. We encourage the academy to value and support the development of program grants that include significant scholarly components, and we offer exemplars of associate and full professor scholarship derived from these projects.

The future of the population-focused, public health clinical nurse specialist.

This article addresses the need for continued certification of community and public health nurses at the advanced practice registered nurse level, and explores curricular avenues and policy recommendations with regard to certification and education of these nurses. The transformation of health care and burgeoning access to information has changed what the public expects and needs from health professionals. Nursing roles have expanded and transformed, in turn requiring that the education, licensure, certification, and accreditation of the professional likewise change.

Cultural safety in New Zealand and the United States: looking at a way forward together.

Cultural safety emerged in Aotearoa, New Zealand as a nursing response to bicultural interactions between indigenous Maori and other New Zealanders. The purpose of this research is to describe the meaning and experience of cultural safety as depicted by nurses in New Zealand and to illustrate the potential for this to inform U.S. nursing education and practice. This interpretive hermeneutic study explored cultural safety as described by 12 experienced nurses who were selected through snowball and purposive sampling. Audiotaped interviews were conducted after ethics approval. Interpretive analysis uncovered five themes that are described with data and paradigm cases. Cultural safety considers the perspective of the patient as the norm in contrast to the culture of health care. Understanding historical power differences and personal biases can help challenge victim-blaming responses by health care providers. Incorporating these understandings into reflective practice enhances the possibility of culturally safe learning for students and culturally safe care for patients.

A culture of mutual support: discovering why new nurses stay in nursing.

New nurse retention and satisfaction has been a recurring topic of research and concern for nursing administrators and educators. As the nursing shortage continues to grow, the retention of new nurses becomes even more important. Most research has focused on why new nurses leave nursing. This article describes the experiences of six new nurses who chose to stay in their first nursing position for 2 years. The qualitative results suggest that even though they felt underprepared, the nurses persevered and remained resilient because of a culture of mutual support. The study participants suggested that individuals contemplating nursing as a career need to "enter with their eyes open," stay strong and "persevere," and foster a "culture of mutual support."

Retention of Native American nurses working in their communities.

PURPOSE: The purpose of this study was to describe the experiences of Native American nurses working in their tribal communities to address retention. DESIGN: An interpretive phenomenological study guided by a Native American research agenda and a Native American nursing practice model. METHODS: In-depth interviews with nine Native American nurses were conducted. Data analysis used interpretive phenomenological procedures including an iterative process with Native American consultants and researchers to develop themes. CONCLUSIONS: Native American nurses experienced a great deal of stress and illness as they attempted to fulfill their mission to help their people. The three themes were: (a) paying the price to fulfill my mission, (b) being and connecting holistically, and (c) transcending the system. Recommendations include strategies for nurse educators, tracking the ethnicity of nurses in each Indian Health Service area, documenting their reasons for leaving, and conducting further research to develop community-based interventions to improve retention.

Relevant nursing leadership: an evidence-based programmatic response.

Community and student demand for relevant nursing leadership graduate programs provided the impetus for this study. The aims were to identify components of highly competent nursing leadership, and strategies to integrate those components into education and practice. Nursing leaders gathered in five focus groups. A semi-structured interview guide was used to elicit narratives about nursing leadership. Interpretive analysis proceeded from identification of themes to uncovering of paradigm cases. Essential nursing leadership competencies comprised communication skills such as listening, conflict resolution, the ability to communicate a vision, motivate, and inspire. Additionally, leaders needed technological adroitness, fiscal dexterity, and the courage to be proactive during rapid change. Implications included a revision in the leadership focus of the nursing masters program, and the necessity that nurse retention should be enhanced by better educated nurse leaders who are grounded in practice and ready to provide a vision for the future.

Teaching teachers to teach with technology.

As the local and national shortage of nursing faculty grew, the Washington State University College of Nursing revised and expanded their nursing education courses in a technologically intense pilot program. Reflections on all phases of the planning, implementation, and evaluation of the first course in this program are described as lessons learned with implications for future nursing education and research endeavors.

Education and practice: dynamic partners for improving cultural competence in public health.

This article reports on a collaborative project linking Washington State University College of Nursing Vancouver and Southwest Washington Health District. Designed to improve the cultural competence and public health skills of registered nurses who are baccalaureate student nurses, quantitative and qualitative evaluative analyses were used to document and describe themes and strategies. The Inventory to Assess the Process of Cultural Competence Among Healthcare Professionals (IAPCC) was useful in measuring the students' progress toward cultural competence, and significant changes were documented. Themes that lead students toward population-focused nursing practice were uncovered as well as barriers to the process of cultural competency.

Ethical concerns: comparison of values from two cultures.

The present study was a secondary analysis of data from two phenomenological studies of nurses in the USA and Japan. The study incorporated hermeneutics and feminist methodologies to answer the following questions. Are there common values and ethical concerns and values within the nursing cultures of Japan and the USA? What are some commonalities and differences between Japanese nurses' ethical concerns and those of American nurses? Findings indicated that nurses from the USA and Japan share common values and ethical concerns as professional nurses, including competence, respect for the patient as a person, responsibility, relationship and connection, importance of the family, caring, good death, comfort, truth-telling, understanding the patient/situation, and anticipatory care. Although ethical concerns are similar, related background meanings and actions often look different between cultures; truth-telling is described as an example. Nurses in each country also hold unique values not found in the nursing practice of the other country. Understanding these commonalities and differences is critical for the development of global nursing ethics.