Judith C. Kulig

Determinants of psychological well-being in Irish immigrants.

Immigration accounts for nearly half of the U.S. population growth in the past 20 years, and this trend is expected to continue. The purpose of this study is to examine the relationship between demographics, resilience, life satisfaction, and psychological well-being among Irish immigrants. Employing a cross-sectional design, a sample of 100 Irish immigrants completed the Demographic and Migration Questionnaire, the Resilience Scale, the Migration Quality of Life Scale, and the General Well-Being Schedule. Hierarchical regression analyses were used to test the association of psychological well-being with demographics, resilience, and life satisfaction. Findings revealed that number of annual health care appointments, higher resilience, and greater life satisfaction were the strongest predictors of psychological well-being.

Moving on? Predictors of intent to leave among rural and remote RNs in Canada

CONTEXT Examination of factors related to the retention or voluntary turnover of Registered Nurses (RNs) has mainly focused on urban, acute care settings. PURPOSE This paper explored predictors of intent to leave (ITL) a nursing position in all rural and remote practice settings in Canada. Based on the conceptual framework developed for this project, potential predictors of ITL were related to the individual RN worker, the workplace, the community context, and satisfaction related to both the workplace and the community(s) within which the RN lived and worked. METHODS A national cross-sectional mail survey of RNs in rural and remote Canada provided the data (n = 3,051) for the logistic regression analysis of predictors of ITL. FINDINGS We found that RNs were more likely to plan to leave their nursing position within the next 12 months if they: were male, reported higher perceived stress, did not have dependent children or relatives, had higher education, were employed by their primary agency for a shorter time, had lower community satisfaction, had greater dissatisfaction with job scheduling, had lower satisfaction with their autonomy in the workplace, were required to be on call, performed advanced decisions or practice, and worked in a remote setting. CONCLUSIONS The statistical evidence for predictors of ITL supported our framework with determinants related to the individual, the workplace, the community, and satisfaction levels. The importance of community makes this framework uniquely relevant to the rural health context. Our findings should guide policy makers and employers in developing retention strategies.

Culture, context and community: ethical considerations for global nursing research

High-quality research is essential for the generation of scientific nursing knowledge and the achievement of the Millennium Development Goals. However, the incorporation of Western bioethical principles in the study design may not be suitable, sufficient or relevant to participants in low-income countries and may indeed be harmful and disrespectful. Before engaging in global health studies, nurses must consider carefully the cultural and social context and values of the proposed setting in order to situate the research within the appropriate ethical framework. The purpose of this paper was to examine the ethical principles and considerations that guide health research conducted in international settings using the example of a qualitative study of Ugandan nurses and nurse-midwives by a Canadian researcher. The application of Western bioethical principles with their emphasis on autonomy fails to acknowledge the importance of relevant contextual aspects in the conduct of global research. Because ethics is concerned with how people interact and live together, it is essential that studies conducted across borders be respectful of, and congruent with, the values and needs of the community in which it occurs. The use of a communitarian ethical framework will allow nurse scientists to contribute to the elimination of inequities between those who enjoy prosperity and good health, and those who do not.

Work Setting, Community Attachment, and Satisfaction Among Rural and Remote Nurses

OBJECTIVES To describe community satisfaction and attachment among rural and remote registered nurses (RNs) in Canada. DESIGN AND SAMPLE Cross-sectional survey of rural and remote RNs in Canada as part of a multimethod study.The sample consisted of a stratified random sample of RNs living in rural areas of the western country and the total population of RNs who worked in three northern regional areas and those in outpost settings. A subset of 3,331 rural and remote RNs who mainly worked in acute care, long-term care, community health, home care, and primary care comprised the sample. MEASURES The home community satisfaction scale measured community satisfaction, whereas single-item questions measured work community satisfaction and overall job satisfaction. Community variables were compared across practice areas using analysis of variance, whereas a thematic analysis was conducted of the open-ended questions. RESULTS Home care and community health RNs were significantly more satisfied with their work community than RNs from other practice areas. RNs who grew up in rural communities were more satisfied with their current home community. Four themes emerged from the open-ended responses that describe community satisfaction and community attachment. CONCLUSIONS Recruitment and retention strategies need to include mechanisms that focus on community satisfaction, which will enhance job satisfaction.

Social cohesion and resilience across communities that have experienced a disaster

Disasters are unpredictable events that have catastrophic impacts. There is now a focus on disaster resilience and capacity building in the recovery of the community. Resilience literature also suggests a staged model of disaster impacts and likelihood of staged manifestations of resilience. It also points to a potentially important link between place-based social cohesion and resilience. This article reports on comparative findings of cohesion and resilience indices in four Canadian rural communities that experienced disasters and evacuation in potentially different phases of coping and resilience. Buckner’s Index of Cohesion and the Index of Perceived Community Resilience are examined in each community for relationships (correlation) between cohesion and resilience and for differences in the intensity of these variables. Our findings show a consistent significant positive correlation between cohesion and resilience, although the strength of the relationship varies. Findings also show place-specific differentiation in the mean intensity of both cohesion and resilience scores; temporal phases of disaster recovery for each community are also noted. This information can help in disaster recovery planning by ensuring supports are available at key points in time for communities that experience disasters. Other research is needed that compares communities that have experienced different types of disasters and over time periods to document any changes to resilience or cohesion thereby assisting with disaster policy development and programme planning.

Sexuality beliefs among Cambodians: Implications for health care professionals

An ethnographic study was conducted among 53 Cambodian women and men to generate information about the sexuality beliefs of this group. Major themes included the relationship between womens sexuality and family honor, the acceptance of pregnancy as inevitable, and the limited discussion of sexuality among intimate friends and family members. During the war, sexuality was controlled by the Khmer Rouge when family life was restructured. Personnel in the refugee camps introduced the concept of family planning to Cambodians, exposing them not only to new information, but also to discussion of an intimate topic with strangers. The resettlement experience continues this trend while rumors about family planning methods continue and premarital pregnancies occur. Health care professionals who work with Cambodians need to do so in collaboration and conjunction with the community.

Kanadier Mennonites: A Case Study Examining Research Challenges Among Religious Groups

In this article, the authors address the research issues experienced in carrying out a study with the Kanadier Mennonites, members of the Anabaptist religious group who support a lifestyle that demonstrates separation from mainstream society. The authors provide a brief description of the Kanadiers along with the purpose of the research and a synopsis of the sample. They focus primarily on discussing the methodological challenges in approaching this group. In addition, they place emphasis on addressing the research questions in ways that are respectful and nonintrusive. They discuss the lessons learned from the study within the context of qualitative cross-cultural research.

A review of the health status of Southeast Asian refugee women.

Six substantive areas that contribute to knowledge of the health status of Southeast Asian (SEA) refugee women were identified in the current literature. The six areas are general information, childbearing issues, health beliefs and practices, health-illness focus, stress and adaptation, and miscellaneous issues. The majority of the articles focused on the womens childbearing role, emphasizing their unique cultural beliefs and the implications of those for health care delivery. The remaining substantive areas provided more limited information about this groups health status, including incidence and prevalence of disease, the womens role in resettlement, and the presence of mental health problems. Future research with this group could be conducted from a feminist perspective by studying the multitude of roles of SEA refugee women and their effects on health status.

Maternal role of women in clerical jobs in southern Brazil: Stress and satisfaction

The number of women in the work force in Brazil is increasing, and a pattern of early work participation and a later decline continues to be manifested. The maternal role is a central role for these women. We investigated the quality of the maternal role as perceived by women who hold clerical jobs in a southern Brazilian city. Qualitative and quantitative data were collected from a random sample of 60 women. Thirty-three of these women were mothers with one or more children. Maternal role likes, dislikes, and stresses were obtained through questionnaires. Coping strategies and resources to cope with the maternal role needs were also obtained. Analytical categories were developed for each of these variables and the analysis was completed through the use of a qualitative computer program.

Critical Ethnography, Cultural Safety, and International Nursing Research

Critical qualitative methodology provides a strategy to examine the human experience and its relationship to power and truth. Cultural safety is a concept that has been applied to nursing education and practice and refers to interactions that acknowledge and respect the unique cultural background of patients. It recognizes power inequities between caregivers who belong to dominant cultures and patients who may belong to oppressed groups. Culture is interpreted from a critical constructivist perspective as a fluid relational process that is enacted contextually. The purpose of this paper is to examine the congruence between and