Understanding the impact of clinical and leadership development activities for pediatric cardiac nurses in India.

The major challenges for pediatric cardiac nursing in India include inadequacies in their levels of education and lack of recognition of their vital role in the health-care system. The aim of this study was to understand the impact of the leadership educational initiatives on pediatric cardiac nursing taken by Children's HeartLink and the Pediatric Cardiac Society of India. Semi-structured interviews were conducted with eight pediatric cardiac nurse leaders from different Indian hospitals. A review of interviews from a previous study and an extensive literature review provided further foundational data on two major themes. The first theme on nursing education focused on nursing curriculum update, continuing education, and leadership development. The second theme focused on improving the value of nursing in public perception, value in hospitals, and their career promotions. The study identified the potential targets for improvement and provided a nursing career development ladder applicable to India.

Completion of four or more ANC visits among women of reproductive age in Iganga district in Uganda: a quantitative study on the role of service-level factors.

BACKGROUND: Evidence indicates that antenatal care (ANC) has both indirect and direct effects on maternal and perinatal morbidity and mortality reduction. In Uganda, the ANC attendance rate stands at 97.3% for one visit, but 59.9% for four or more visits. Given the imminent shift to the eight-contact ANC model in Uganda, combined with a lack of universal coverage for completion of four ANC visits, there is need for research that provides information on the factors that differentiate completers of recommended ANC attendances from non-completers. The aim of this quantitative study was to assess service- level factors affecting completion of ANC attendance defined by completion of four or more visits among women of reproductive age in Iganga district in Uganda. METHODS: Facility assessment scores on the service-level factors of interest for health facilities were obtained using a service level index tool. The relationship between the ANC completion rates of clients sampled from records at the health facilities and facility scores on service-level factors of interest were analyzed. Regression was conducted to determine the predictive relationship between ANC service availability, ANC service content, and ANC service organization, and completion of ANC attendance. RESULTS: The model was statistically significant, χ2 (6) = 26.118, p ˂ 0.05, and accounted for approximately 17.3% of the variance of ANC attendance completion (R2 = .173). Completion of ANC attendance was primarily predicted by better timing of provision of ANC services, and to a lesser extent by higher levels of availability of medicines and medical supplies. CONCLUSIONS: This study demonstrated that service-level factors have a predictive value for completion of ANC attendance. The findings can be used to improve availability, content, and organization of ANC services with the aim of enhancing positive experiences for clients and motivating them to complete the recommended number of ANC visits.

Enactment of compassionate leadership by nursing and midwifery managers: results from an international online survey.

AIM: To explore the views of an international sample of nursing and midwifery managers concerning attributes that they associate with compassionate management. METHOD: A cross-sectional online survey. Using a snowballing sampling method, 1217 responses were collected from nursing and midwifery managers in 17 countries. A total of complete 933 responses to a question related to which actions and behaviours indicated that a manager was exercising compassionate leadership were analysed for this paper. First, content analysis of the responses was conducted, and second, a relative distribution of the identified themes for the overall sample and for each participating country was calculated. RESULTS: Six main themes were identified describing the attributes of a compassionate leader: (1) Virtuous support, (2) Communication, (3) Personal virtues of the manager, (4) Participatory communication, (5) Growth/flourishing/ nurturing and (6) Team cohesion. The first three themes mentioned above collectively accounted for 63% of the responses, and can therefore be considered to be the most important characteristics of compassionate management behaviour. CONCLUSION: The key indicators of compassionate management in nursing and midwifery which were identified emphasise approachability, active and sensitive listening, sympathetic responses to staff members' difficulties (especially concerning child and other caring responsibilities), active support of and advocacy for the staff team and active problem solving and conflict resolution. While there were differences between the countries' views on compassionate healthcare management, some themes were widely represented among different countries' responses, which suggest key indicators of compassionate management that apply across cultures.

Barriers to Cancer Care in Northern Tanzania: Patient and Health-System Predictors for Delayed Presentation.

PURPOSE: Cancer is a growing problem in Africa, and delays in receiving timely cancer care often results in poorer outcomes. The purpose of this study was to identify the patient and health-system factors associated with delayed cancer care in adults living in the Northern Zone of Tanzania. PATIENTS AND METHODS: Between July 2018 and July 2019, we surveyed adult patients presenting to an oncology clinic in Northern Tanzania. Delayed presentation was defined as 12 weeks or longer from initial symptoms to presentation for cancer care. Multivariate logistic regression and adjusted relative risk (aRR) were used to identify factors predicting delayed presentation. RESULTS: Among 244 adult patients with cancer who completed the survey, 78% (n = 191) had delayed presentation. Patient-related factors associated with delayed presentation included lower educational attainment (P = .03), increased travel time (P = .05), lack of cancer knowledge (P < .05), and fear of cancer and cancer treatments (P < .05) on multivariate analysis. On analysis of aRR, patients without private car and those with health insurance had higher risk of delayed presentation (aRR: 1.27; 95% CI, 1.02 to 1.32 and aRR: 1.15; 95% CI, 1.01 to 1.32). There was a strong association with increased number of visits before presentation at the cancer center and delayed presentation (P = .0009). CONCLUSION: Cancer awareness and prevention efforts targeting patients and community-level health care workers are key to reduce delays in cancer care in Northern Tanzania.

The Importance of Being a Compassionate Leader: The Views of Nursing and Midwifery Managers From Around the World.

INTRODUCTION: Despite the importance of compassionate leadership in health care, many of the existing publications do not account for the effect of culture. The aim of this study is to explore the views of nursing and midwifery managers from different countries in relation to the definition, advantages, and importance of compassion. METHODOLOGY: A cross-sectional, descriptive, exploratory online survey was conducted across 17 countries, containing both closed and open-ended questions. Data from N = 1,217 respondents were analyzed using a directed hybrid approach focusing only on qualitative questions related to compassion-giving. RESULTS: Four overarching themes capture the study's results: (1) definition of compassion, (2) advantages and importance of compassion for managers, (3) advantages and importance of compassion for staff and the workplace, and (4) culturally competent and compassionate leadership. DISCUSSION: Innovative research agendas should pursue further local qualitative empirical research to inform models of culturally competent and compassionate leadership helping mangers navigate multiple pressures and be able to transculturally resonate with their staff and patients.

Exploring Nurses' Meaning and Experiences of Compassion: An International Online Survey Involving 15 Countries.

PURPOSE: In recent years, there has been much focus on compassion in nursing care, and concern has been raised in a number of reports and media stories regarding decreased compassion. The aim of this study was to explore similarities and differences in the understanding and demonstration of compassion in nursing practice across 15 countries. DESIGN: A total of 1,323 nurses from 15 countries responded to questions in relation to compassion, via an international online survey. RESULTS: The data revealed the impact of sociopolitical influences on perceptions of compassion, and the conscious and intentional nature of compassion. DISCUSSION AND CONCLUSION: The study demonstrated shared understandings of the importance of compassion as well as some common perceptions of the attributes of compassionate care. The differences reported were not as significant as had been expected. IMPLICATIONS FOR PRACTICE: Further research is needed to explore the country and culture differences in the enactment of compassion.

Bricolage: making do with what is at hand.

While researching and writing her dissertation, the author discovers the concept of bricolage. She describes its application in Tanzania and in a long-term acute care hospital in the Midwestern United States.