How Health Experiences in Tanzania Foster Change in Nursing Student Perceptions of Diversity and Self.

ABSTRACT: International study abroad programs offered by American universities provide opportunities to experience global health care disparities. This qualitative phenomenological research using a hermeneutic approach was conducted to explore how clinical experience in Tanzania influenced the knowledge and attitudes of prelicensure baccalaureate nursing students toward culture, health care disparities, and health care outcomes. Two main themes emerged from the research: thinking as another and carrying it forward.

Using Simulation to Assess Nurse Practitioner Education.

ABSTRACT: Resource restraints and the movement toward competency-based education encourage exploration of innovative simulation experiences in advanced practice registered nurse education. Building upon existing best practices in simulation development, this pilot project explores opportunities and challenges translating these practices to the advanced practice registered nurse context. Innovations focused on using a competency-based framework, developing a competency-based evaluation tool, and providing feedback from faculty and standardized patients. Lessons learned from this experience inform recommendations for how to design instructional experiences and provide formative methods of feedback for nurse practitioner student assessment.

I'm Just a Person: Self-Labeling Following Sexual Assault.

OBJECTIVE: The purpose of this study was to examine college women's self-labeling as a victim or a survivor following a sexual assault and describe the relationship of self-labeling with mental health, self-blame, control over recovery, and help-seeking. METHODS: This cross-sectional study collected data in an online anonymous survey in November and December of 2018. Participants (N = 375) were recruited from two public universities, were 18- to 24-year-old undergraduate students, identified as female, and had experienced a sexual assault since entering college. RESULTS: Most respondents (46.4%, 174/375) chose labels other than victim or survivor. Statistically significant differences were found between choice of label (survivor, victim, or other) and depression, well-being, characterological self-blame, and perceived control over recovery. Short-answer responses revealed three major themes for alternative labels: choosing no label, normalizing, and seeking congruence. CONCLUSION: As when caring for a patient with any diagnosis, nurses and other healthcare providers should see a person-not a patient, a survivor, or a victim.

Improving Breastfeeding in Rural Tanzania Using Eight-Step Policy Analysis Methodology.

Appropriate breastfeeding has the potential to have the broadest impact on childhood survival in children under 5 years compared with all other preventive interventions. The World Health Organization and United Nations International Children's Emergency Fund recommend that all facilities providing maternal services and newborn care have a written policy addressing breastfeeding that is routinely disseminated to staff. A Mara region hospital in rural Tanzania does not have a breastfeeding policy. Collins adapted Bardach's eightfold path for policy analysis specifically for health policies. This eight-step process was used to evaluate three promising policies to improve breastfeeding in populations in and around this hospital. These policies include exclusive breastfeeding education, complementary food education, and community health worker home visits. Analysis identified exclusive breastfeeding with adjunct complementary food education as the most feasible policies to increase breastfeeding in and around the target hospital. With improved feeding practices, chronic malnutrition rates are expected to decline in the villages that the hospital serves. This methodology can be used by nurses to develop health polices addressing a wide range of health issues in a wide variety of settings.

Palliative care in northern Tanzania: doing a lot with a little.

The number of people in need of palliative care is growing worldwide, particularly in the developing world. The World Health Organization recognises palliative care as a basic human right, but there are many challenges for delivering palliative care in low- and middle-income countries. In the African continent, the African Palliative Care Association (APCA) provides guidance for political advocacy for developing palliative care programmes and has developed the APCA Palliative Outcome Score (POS), an evidence-based tool for measuring outcomes of palliative care. This article focuses on palliative care delivery in Shirati, Tanzania, located in the Rorya District in the Mara Region in northern Tanzania, highlighting the impressive work done with limited resources and despite many challenges. Recommendations for future research include evaluation of outcomes using the APCA POS, the application of mobile technology, and governmental advocacy for increased access to opioid medications, which have shown promise in broadening the reach of palliative care in the East African Community.

Blogging for Evaluating Objectives in an International Nursing Course.

Nursing educators need to adapt to meet students in new technological spaces and in the increasingly global environment. This article provides background on blogging as an educational tool and the use of a blogging assignment for evaluation of course objectives in an international graduate nursing course. The blog is a part of a study-abroad experience in Kenya, where graduate nursing students learn about Kenyan culture and work in the health care system.

Adolescents' experiences with uxoricide.

The purpose of this study was to describe the experiences of individuals who survived the loss of one or both parents through parental homicide or homicide/suicide as adolescents. Participants (N = 34) were aged between 12 and 19 years at the time of the death and were aged between 29 and 64 years at the time of the interview. Participants were interviewed twice and asked to tell the story of their lives. Data were analyzed in the hermeneutic phenomenological tradition using a stepwise process of developing categories and then a single complex theme. Common categories of participants' childhoods included abuse both before and after the uxoricide and vivid memories of the homicide. As adults, most participants reported difficulties with intimate relationships, legal problems, and substance use. Integrity was an overarching theme for these participants. Among those who had integrated the story of the homicide into their adult lives, some believed that they were doing well whereas others did not. Some participants had isolated the event and considered that they were doing well as a result. These findings are limited by the convenience sample but offer a rich portrait of the lives of individuals who experienced uxoricide as adolescents. Clinicians might be advised to tread carefully if individuals report that they have isolated rather than integrated the uxoricide into their adult lives. No evidence exists in support that either stance is preferable.