Irena Papadopoulos

Women's perceptions of their right to choose the place of childbirth: an integrative review

OBJECTIVE to provide a critical synthesis of published research concerning womens experiences in choosing where to give birth. METHOD an integrative literature review was conducted using three databases (MEDLINE, CINAHL and Ovid) for 1997-2009. Inclusion criteria were: (1) publication in the English language; (2) research article; (3) focus on womens perceptions for their birthplace choices; and (4) data collected during pregnancy, at birth and post partum. FINDINGS twenty-one research-based papers met the inclusion criteria, and these used a range of approaches and methods. Four themes were derived from the data: choice of birthplace and medicalisation of childbirth; the midwifery model of care and the rhetoric of birthplace choices; perceptions of safety shaped womens preferences; and choice is related to womens autonomy. CONCLUSION there is considerable evidence that women worldwide wish to be able to exercise their rights and make informed choices about where to give birth. The medical model remains a strong and powerful influence on womens decisions in many countries. The midwifery model offers birthplace choices to women, while policies and culture in some countries affect midwifery practise. Perceptions of safety shaped womens preferences, and womens autonomy facilitated birthplace choices. IMPLICATIONS FOR PRACTISE these findings can be seen as a challenge for health professionals and policy makers to improve perinatal care based on womens needs. Local research is advisable due to cultural and health system differences.

Establishing hospice care for prison populations: an integrative review assessing the UK and USA perspective

Background: models of care based on the hospice model have delivered effective support to dying people since their inception. Over the last 20 years this form of care has also been introduced into the prison system (mainly in the United States) to afford terminally ill inmates the right to die with dignity. Aim: the aim of this review is to examine the evidence from the United States and the United Kingdom on the promotion of palliative care in the prison sector, summarizing examples of good practice and identifying barriers for the provision of end-of-life care within the prison environment both in the USA and UK. Design: an integrative review design was adopted using the Green et al. model incorporating theoretical and scientific lines of enquiry. Data sources: literature was sourced from six electronic databases between the years 2000 and 2011; the search rendered both qualitative and quantitative papers, discussion papers, ‘grey literature’ and other review articles. Results: the results highlight a number of issues surrounding the implementation of palliative care services within the prison setting and emphasize the disparity between the USA model of care (which emphasizes the in-prison hospice) and the UK model of care (which emphasizes palliative care in-reach) for dying prisoners. Conclusion: the provision of palliative care for the increasing prison population remains under-researched globally, with a notable lack of evidence from the United Kingdom.

Measuring compassion in nurses and other healthcare professionals: An integrative review.

BACKGROUND Compassion is an essential part of nursing practice. However recent high profile public inquiries have uncovered failings in the NHS and revealed a need for nursing education to assure that both undergraduate and postgraduate healthcare professionals receive training in compassion. OBJECTIVES The aim of this study was to review how compassion is being measured in nurses and other healthcare professionals. REVIEW METHODS An integrative review methodology was used. The literature was searched systematically, using electronic databases, internet searches, recommendations by experts in the field, and manual searches. RESULTS Six papers on measuring compassion in healthcare were included in the final analysis. Several overarching themes were identified as the main elements of compassion being measured. These included: being empathetic, recognising and ending suffering, being caring, communicating with patients, connecting to and relating with patients, being competent, attending to patients needs/going the extra mile, and involving the patient. CONCLUSIONS Further research is needed to develop and test tools that nurse and healthcare educators can use to assess the levels of compassion in their undergraduate and postgraduate students, as well as making this available to qualified nurses in practice.

Cultural competence in action for CAMHS: development of a cultural competence assessment tool and training programme

This article details the development of a tool to measure the cultural competence of individuals working within the Children and Adolescent Mental Health Services (CAMHS). The CAMHS Cultural Competence in Action Tool – known as the CAMHS ‘CCATool’ – was one of the components of a national project which aimed at promoting cultural competence within CAMHS. The other component was a two day training programme. Both components were based on the Papadopoulos, Tilki and Taylor model of cultural competence development. The article also outlines the educational principles and learning strategies used in the training.

Intercultural education of nurses and health professionals in Europe (IENE).

AIMS The study aimed to explore the perceived learning and teaching needs of students and practitioners of health-care professions in relation to preparation for working in another European country and/or in a multicultural environment. The participating countries were: Belgium, Bulgaria, Germany, Romania and the UK. METHODS Questionnaires, consisting of open questions, were completed by a total of 118 participants. Data analysis adopted both a priori and inductive approaches. The predetermined constructs of cultural awareness, cultural knowledge, cultural sensitivity and cultural competence were used to structure suggestions for theoretical input and practical activities and experiences. Inductive analysis revealed other emergent themes that underpin all four of these constructs. RESULTS Practical experiences form a fundamental part of preparation for labour mobility and/or for practice within a multicultural environment. However, health-care practitioners need to be adequately prepared for such experiences and value the opportunity to learn about culture, to explore values and beliefs, and to practise intercultural skills within the safe environment of an educational establishment, facilitated by skilled teachers.

Transcultural Nursing Society Position Statement on Human Rights

In 2006, the Transcultural Nursing Society created a business plan with a firm commitment to social change and the support of human rights. One of the primary goals of the plan was to seek recognition from the United Nations as a Human Rights Organization. As a first step in articulating this goal, the board of trustees of TCNS tasked a small group of Transcultural Nursing Scholars to develop a position statement. This article is the culmination of the collaborative task forces efforts to define how TCNS seeks the fulfillment of human rights for people of all cultures worldwide.

Chapter 3: Theoretical Basis for Transcultural Care

Margaret Andrews, PhD, RN, CTN, FAAN1 Jeffrey R. Backstrand, PhD2 Joyceen S. Boyle, PhD, RN, CTN, FAAN3 Josepha Campinha-Bacote, PhD, MAR, PMHCNS-BC, CTN-A, FAAN4 Ruth E. Davidhizar, DNSc, RN, APRN, BC, FAAN (deceased)5 Dawn Doutrich, PhD, RN, CNS6 Mercedes Echevarria, DNP, APN7 Joyce Newman Giger, EdD, APRN, BC, FAAN8 Jody Glittenberg, PhD, RN, FAAN, TNS9 Carol Holtz, PhD, RN10 Marianne R. Jeffreys, EdD, RN11 Janet R. Katz, PhD, RN12 Marilyn R. McFarland, PhD, RN, FNP-BC, CTN-A13 Gloria J. McNeal, PhD, MSN, ACNS-BC, FAAN14 Dula F. Pacquiao, EdD, RN, CTN15 Irena Papadopoulos, PhD, MA, RN, RM, FHEA16 Larry Purnell, PhD, RN, FAAN17 Marilyn A. Ray, PhD, MA, RN, CTN-A18 Mary C. Sobralske, PhD, RN, CTN19 Rachel Spector, PhD, RN, CTN-A, FAAN20 Marian K. Yoder, EdD, RN21 Rick Zoucha, PhD, PMHCNS-BC, CTN22

Developing organisational systems and culture to support evidence-based practice: the experience of the Evidence-Based Ward Project

The advancement of research based practice has been a goal in nursing for many years. Evidence-based practice (EBP) provides a framework and process for the systematic incorporation of research evidence and patient preference into clinical decision making at the level of the individual practitioner and the healthcare organisation. Few well designed studies have tested the effectiveness of organisational strategies for encouraging the systematic use of research in nursing practice,1 and more research is needed into the reality and consequences of adopting EBP.2 In 1996, an acute National Health Service (NHS) hospital trust and a university department in London, UK began a joint project to increase the systematic use of research by nurses in clinical practice. EBP was selected as the approach, and the hospital-wide project began in late 1996. The project was facilitated by a senior lecturer appointed jointly by the 2 organisations, with half of his time allocated for this role. A diagnostic assessment done early in the project identified the need for the development of organisational and individual capacity to support and use EBP.3 The Evidence-Based Ward Project used action research to explore ways in which the organisation and culture of practice in a busy acute ward could be developed to make EBP part of the “normal” approach to practice. The project ran for 10 months and was coordinated by the new ward manager and the senior lecturer. When the project began, the hospital was a fairly typical UK NHS district general hospital, with approximately 520 beds. During the project, the hospital merged with a neighbouring NHS trust of similar size. The hospital had a history of providing nurse training but had only recently become a clinical placement site for medical students. The ward was selected as typical of other wards in the hospital, with …

Reporting and Validating Research Findings Through Reconstructed Stories

This paper describes the use of and reasons why reconstructed stories were used as a method of presenting and validating the findings from the interview data with visually impaired people obtained from Enfield Vision Research Project, into the needs of visually impaired people resident in the London Borough of Enfield. In order to present and validate the findings of the first 20 interviews the researchers organised a group respondent validation event. The researchers orally presented the findings in the form of reconstructed stories. These stories encompassed a number of themes and sub-themes that had emerged from the analysis. The attendees were separated into two groups to discuss the stories. Thirty-seven of the 90 visually impaired research participants attended the event. The research participants felt that the stories were an effective method in presenting and communicating the research findings. They also confirmed the credibility of the findings, and thereby dependability and confirmability were also achieved. The use of reconstructed stories is a novel, user friendly and effective method of presenting and validating qualitative research data, and is particularly suitable method when the respondents have visual difficulties.

The Need for Nursing and Midwifery Programmes of Education to Address the Health Care Needs of Minority Ethnic Groups.

The article reviews some of the more influential literature of the past decade on the health needs of ethnic groups, in an effort to identify what is being done by nursing and midwifery education to address the health care needs of these groups and to prepare practitioners who are able to respond to these needs. The article suggests that despite the relative lack of progress in this field of health care and education, there still exists much confusion, disagreement and lack of clarity around many issues, such as the identification of relevant content, the integration of this content into the curriculum and more importantly the delivery of this content. The literature seems to point to a lack of cultural knowledge, particularly for certain ethnic groups, which needs to be rectified. But even when knowledge is available, the evidence clearly indicates that both educators and practitioners are failing to translate this into effective and culturally sensitive care. The article suggests that nursing and midwifery education could and should play an important role in the development and dissemination of culturally sensitive care.