Lori A. Spies

An Exploratory Descriptive Study on Task Shifting in East Africa.

The purpose of this study was to explore the perceptions of nurse leaders in Ethiopia, Kenya, Tanzania, and Uganda who have taken on expanded roles through task shifting. Understanding how nurses perceive task shifting directs education and training to more effectively meet population health needs in their communities. Participants were nurse leaders in countries with complex health care systems and few resources. Participants identified conflicting roles and expectations that were not consistent with their role preparation or scope of practice.

traditional beliefs and practices among Mexican American immigrants with type Ii diabetes: A case study

Purpose:To describe selected common health beliefs and practices among Mexican American immigrants with type II diabetes. Data sources:Selected clinical trials, qualitative studies, and systematic reviews. Conclusions:The Hispanic folk illness belief susto refers to an episode of severe fright, and Mexican American immigrants hold varying views on its relation to diabetes. Culturally and in the research, susto has also been linked with depression. Sabila (aloe vera) and nopal (prickly pear cactus) are herbal remedies that have had widespread, longstanding use in Mexican culture and while this is not the gold standard of research, it does provide ample evidence and a strong cultural belief that these therapies work. There is some evidence in the literature to support their efficacy as glucose‐lowering agents, but lack of Food and Drug Administration (FDA) regulation, potential side effects, and a dearth of rigorous clinical trials preclude aloe vera and nopal from being recommended therapy. Implications for practice:Awareness about susto beliefs, commonly used herbal remedies, and development of culturally sensitive communication skills are essential for nurse practitioners to effectively assist patients in this population achieve their glycemic goals. Research on the effects of nopal and aloe vera on diabetes is needed to guide clinical decisions.Purpose To describe selected common health beliefs and practices among Mexican American immigrants with type II diabetes. Data sources Selected clinical trials, qualitative studies, and systematic reviews. Conclusions The Hispanic folk illness belief susto refers to an episode of severe fright, and Mexican American immigrants hold varying views on its relation to diabetes. Culturally and in the research, susto has also been linked with depression. Sabila (aloe vera) and nopal (prickly pear cactus) are herbal remedies that have had widespread, longstanding use in Mexican culture and while this is not the gold standard of research, it does provide ample evidence and a strong cultural belief that these therapies work. There is some evidence in the literature to support their efficacy as glucose-lowering agents, but lack of Food and Drug Administration (FDA) regulation, potential side effects, and a dearth of rigorous clinical trials preclude aloe vera and nopal from being recommended therapy. Implications for practice Awareness about susto beliefs, commonly used herbal remedies, and development of culturally sensitive communication skills are essential for nurse practitioners to effectively assist patients in this population achieve their glycemic goals. Research on the effects of nopal and aloe vera on diabetes is needed to guide clinical decisions.

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.

A model for upscaling global partnerships and building nurse and midwifery capacity

AIM To provide a unique model for use in guiding global collaboration and policy to upscale nursing and midwifery partnerships. BACKGROUND AND INTRODUCTION Nurses and midwives across nations need skills reaching beyond the bedside and unit level in todays complex, global, multifaceted healthcare milieu. Thoughtful consideration, research and concomitant development of models to guide appropriate upscaling of nurse and midwifery capacity within and between nations are needed. DISCUSSION This article explores an integrated global approach to upscaling nurse and midwifery capacity using examples of partnerships between nursing and midwifery programmes across multiple continents. CONCLUSION AND IMPLICATIONS FOR NURSING Global nurse and midwifery capacity is effectively being developed using a myriad of approaches. A new model is presented to illustrate supports, strategies and activities to achieve intermediate and long-term goals for capacity building through strong and sustainable global partnerships. IMPLICATION FOR NURSING POLICY Development of global skills can focus the nurse and midwife to influence policy-level decisions. Human resource planning that can impact countrywide provision of health care begins in the preservice setting for both nurses and midwives. A global experience can be a value-added component to the well-rounded education of future nurses. Education during preparation for entry into practice is a strategic way to develop a worldview. Incorporating reflective practice can build skills and shape attitudes to prepare the new nurse to be comfortable as a global healthcare provider. An expanded world view is the springboard to more robust and informed involvement and inclusion in policy-level discussions.

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.

Diarrhea A to Z: America to Zimbabwe

Purpose: To review international statistics on the morbidity and mortality of diarrhea, pathophysiology, global incidence, and implications for the clinical practice of nurse practitioners (NPs). Data sources: Selective review of literature. Conclusions: Because of ever‐increasing international travel, immigration, and rising awareness of global health issues, NPs must be current on the prevention, diagnosis, and treatment of diarrhea. Implications for Practice: Increased awareness of diarrhea as a significant international health issue mandates that NPs counsel clients who travel to high‐risk areas about preventive measures to avoid exposure or manage symptoms while traveling. Guidelines for evidence‐based treatments of diarrheal illness are widely available and should be followed.

The Pad Project: A Global Initiative Uniting Women

The Pad Project is a womens health program used to educate women on their monthly menstrual cycles. Through this ministry, women who do not have access to menstrual hygiene products are given sustainable hygienic kits to promote menstrual health. This unique health education program also integrates stories from the gospel to illustrate Christs love and caring commitment toward women and womens health.

Travel as a Transformational Spiritual Event

There is a philosophical connection between elements of travel and elements of spirituality. Nurses can develop spiritual intelligence, hone transcultural skills, and develop cultural humility through travel. Concepts of spiritual intelligence are incorporated to distinguish spirituality from religion. This discussion is to describe the spiritual attributes of travel through exploration of unique cultural sameness and differences, stepping out of one’s routine, experiences of solitude, and the application to nursing. Venues such as study abroad, mission trips, cultural exchange opportunities, and service learning projects all can provide meaningful times of transformation, spiritual growth, learning new ways of doing things, and of being in the world. Nurses who integrate these practices into the care they provide daily will be enriched personally and rewarded with improved outcomes.

Developing Global Nurse Influencers.

ABSTRACT: How can universities create engaged citizens and global leaders? Each year, a select group of advanced practice nursing students at Baylor University Louise Herrington School of Nursing travel to Africa for a month-long clinical mission experience. Students work alongside local and missionary healthcare providers in a comprehensive Christian outreach to the community at a high-volume clinic. Creating rich learning experiences in a global setting in significant and sustainable ways is difficult, but intentionally focusing on what we are called to do and who we serve provides ballast for faculty and students. The success of the trip in preparing students to be global influencers is evident by the work graduates elect to do around the world, following graduation.