Jennifer Gray

Mastery over stress among women with HIV/AIDS.

To better understand how women with HIV infection deal with the stress of their disease, the authors explored the relationships between stressors, resources for managing stress, and mastery over stress in 80 HIV-positive women. Nurses and other professionals recruited participants in a variety of settings in 10 states. Participants completed a packet of research instruments that measured the stressors of perceived stress intensity, interpersonal conflict, and severity of illness; the resources of social support, support networks, and spiritual perspective; and the outcome of mastery over stress. Participants reported high levels of social support, spiritual perspective, interpersonal conflict, and perceived stress intensity. Twenty-nine women (36%) had achieved mastery over stress. Mastery over stress was significantly and positively correlated with social support, spiritual perspective, and physical functioning, a measure of severity of illness. Mastery over stress was significantly and negatively correlated with interpersonal conflict. An exploratory stepwise multiple regression analysis yielded two predictors of mastery over stress: social support and spiritual perspective. Although a comparison of these results with those reported in the literature for men suggests that men and women differ in how they respond to stressors, further research will be needed to enhance our understanding of these gender differences. Stress management training, especially related to interpersonal conflict, may be an effective intervention to facilitate mastery. Other potential interventions include assessing social support and spiritual perspective, discussing the potential benefit of these resources, and making referrals for psychosocial services as needed.

SPIRITUAL PERSPECTIVE AND NEEDS: A COMPARATIVE STUDY OF NURSING FACULTY IN A CHRISTIAN UNIVERSITY AND A STATE UNIVERSITY

To care for the whole person, nurses must provide spiritual care (Narayanasamy, 1995; Wright, 1998). The inability to consistently and effectively provide spiritual care has been linked to the lack of educational preparation in our basic nursing programs (Govier, 2000; Piles, 1990). This lack of preparation is unacceptable because patients experiencing serious illness, life transitions, loss, grief, or pain have an increased awareness of spiritual needs (Charlton, 1992; Clark, Cross, Deane, and Lowry, 1991; Narayanasamy, 1995; Taylor, Highfield, and Amenta, 1999). During these experiences, patients are likely to interact with nurses—professionals that advocate holistic care (Martsolf and Mickley, 1998; McSherry and Draper, 1998). Nurses must be prepared to provide spiritual care since spirituality is an integral part of being human. Nurses are not likely to receive this preparation unless faculty value spiritual care. Faculty who are aware of spiritual needs, value spiritual care, and have the skills to provide spiritual care are more likely to teach those skills. They are also more likely to role model or encourage the provision of spiritual care during clinical experiences. For some faculty, teaching spirituality may seem inconsistent with the dominant paradigm of scientific based practice (Govier, 2000). Nursing faculty at state universities may question whether the overt inclusion of spiritual care in the curriculum is appropriate or permissible. The study reported in this paper explored the spiritual perspectives and identified the spiritual care practices of nursing faculty in a state university and a private Christian university. Along with describing the findings, spirituality related to patients, nurses, and nursing education is discussed.

Uganda nursing research agenda: a Delphi study.

Aim Use a Delphi Methodology to identify nursing research priorities in Uganda. Background Identifying nursing research priorities, empowering researchers, and encouraging relevant studies can advance attaining global health goals. The Uganda Nurses and Midwives Union identified the need to establish a nursing research agenda. Nurse leaders have a priority of increasing the influence of nurses in practice and policy. This study was conducted as a preliminary step in a long-term strategy to build nurses’ capacity in nursing research. Methods A three-round Delphi study was conducted. The 45 study participants were nurses in practice, nurse faculty and members of the Uganda Nurses and Midwives Union. In the initial round, the participants wrote their responses during face-to-face meetings and the follow-up rounds were completed via email. Results Maternal and child morbidity and HIV/AIDS were identified as research priorities. Nurses also identified nursing practice, education and policy as key areas that nursing research could impact. Limitations Demographic characteristics such as length of time in nursing were not collected. Additionally, first round participants completed a pencil-paper survey and the follow-up rounds were done by email. Conclusions Nurse Leaders in Uganda identified areas where research efforts could have the most impact and were most relevant to nursing practice. Implications for nursing and health policy Health policy decisions have historically been made without nursing input. Nursing research can provide evidence to inform policy and, ultimately, improve population health. The focus of nursing research in priority areas can be used to guide nursing contribution in policy discussions.

Conducting international nursing research: challenges and opportunities.

AIM To describe practical experiences before, during and after gaining entry into research fields in Kenya and Uganda. BACKGROUND Planning, conducting and implementing international research can be an arduous task. Novice researchers need practical guides to accessing international fields and mitigating challenges met in the field. DATA SOURCES The researchers conducted three different studies in two developing nations. REVIEW METHODS This paper reviews challenges encountered when conducting international research. Solutions used to overcome these challenges are discussed. DISCUSSION Establishing and maintaining effective partnerships is critical to the success of international research efforts. Researchers must be tactful, flexible and creative when handling methodological, ethical and logistical challenges encountered in settings poor in resources. CONCLUSION International research provides opportunities for increasing dedication, building cross-cultural competence and advancing health professional practice globally. IMPLICATIONS FOR RESEARCH/PRACTICE This paper contributes to nursing scholarship by highlighting the practical challenges of conducting international research. Illustrations aimed at lending insight and encouraging others to expand their dedication to conducting international research are offered.

Meeting Tomorrow's health care needs through local and global involvement

Strengthened efforts to achieve the United Nations Millennium Development Goals by 2015 are urgently needed. A fundamental step toward achieving these goals is strengthening global partnerships for development. This article describes critical challenges and opportunities in global health and the social responsibility of the nursing profession in this area. Examples and suggestions for nursing action are provided for consideration by those interested in influencing global health. Engaging in global health activities such as study abroad programs, interprofessional exchanges, continuing education workshops, and seminars with a global health focus can have significant implications for nursing education, research, policy, and practice. Equipping nurses with the leadership skills, knowledge, and attitudes needed to advance global health is integral in the delivery of effective, culturally relevant health care.

HIV and Nurses: A Focus Group on Task Shifting in Uganda

&NA; The HIV prevalence rate is 7.4% in Uganda, where the HIV‐related Presidents Emergency Plan for AIDS Relief and United Nations millennial development goals have not been met. This is partially due to a critical shortage of nurses and other health care providers. Task shifting is a World Health Organization strategy to address the shortage of human resources for health by shifting work from one cadre of health care worker to another, often less‐trained, cadre. We conducted three focus groups with nurses in Uganda to better understand perceptions of their preparation for and implementation of task shifting. The focus group included nurses from diverse work settings. Data analysis revealed that nurses were proud of the work they were doing but were challenged by the lack of consistent and appropriate support. We found a need for additional policies, regulations, and consistent preparation for nurses who work in environments with task shifting.

Stigma in HIV-infected Health Care Workers in Kenya: A Mixed-method Approach

&NA; HIV‐related stigma decreases access to HIV testing, prevention, and treatment services. Our mixed methods study explored stigma as perceived, experienced, and managed in a sample of 76 HIV‐infected health care workers in Kisumu, Kenya. Stigma was quantitatively measured using the HIV/AIDS Stigma Instrument for People Living with AIDS (HASI‐P). Overall, subjects experienced low stigma levels (mean = 7.88, SD = 12.90; range = 0–61), and none of the sociodemographic variables were predictive of stigma. Transcript analysis of 20 qualitative interviews revealed two negative themes (blame, lack of knowledge) and five positive themes (living positively, optimism, empathy, support, changes over time). Three themes emerged on reducing stigma (normalizing, empowerment, leading by example). Disclosure, access to treatment, stigma reduction training, workplace support groups, and awareness of an HIV workplace policy may have contributed to low stigma scores. Qualitative findings corroborated quantitative findings and corresponded to the six domains of the HASI‐P.

Intentions and Motivations of Nurses to Migrate: A Review of Empirical Studies

Six empirical studies of nurse migration motivations and intentions were identified for review. The review revealed that motivations and intentions varied by country of origin and by individual nurses. Nurses from more developed countries migrated for personal reasons, while nurses from less developed countries migrated for economic, professional and family reasons. Country‐level studies are needed in resource‐poor countries to inform health system policies and workforce development. These policies must simultaneously protect the right of the individual nurse to migrate and create conditions conducive to retention of nurses. Additional research is needed to understand the decision‐making processes related to migration and the experiences of individual nurses who migrate to more developed countries.

The adapted model of institutional support for Hispanic student degree completion: revisions and recommendations.

This article describes the historical development of the adapted model of institutional support (AMIS) for Hispanic student degree completion. The model was developed using 6 major categories of support: financial support, emotional and moral support, mentoring, professional socialization, academic advising, and technical support. Studies used to validate the inclusion of each of the components are presented. Two self-assessment instruments based on the model, the Institutional Self-Assessment for Factors Supporting Hispanic Student Recruitment and Persistence and the Healthcare Professions Education Program Self-Assessment (PSA), used to evaluate institutional supports for Hispanic student degree completion are described. This article describes the results of 2 studies using the PSA. The findings from these studies provide support for the AMIS. Limitations of the model and recommendations for further research are presented.