Lucie M Ramjan

Translation of interviews from a source language to a target language: examining issues in cross‐cultural health care research

AIMS AND OBJECTIVES To illuminate translation practice in cross-language interview in health care research and its impact on the construction of the data. BACKGROUND Globalisation and changing patterns of migration have created changes to the worlds demography; this has presented challenges for overarching social domains, specifically, in the health sector. Providing ethno-cultural health services is a timely and central facet in an ever-increasingly diverse world. Nursing and other health sectors employ cross-language research to provide knowledge and understanding of the needs of minority groups, which underpins cultural-sensitive care services. However, when cultural and linguistic differences exist, they pose unique complexities for cross-cultural health care research; particularly in qualitative research where narrative data are central for communication as most participants prefer to tell their story in their native language. Consequently, translation is often unavoidable in order to make a respondents narrative vivid and comprehensible, yet, there is no consensus about how researchers should address this vital issue. DESIGN An integrative literature review. METHODS PubMed and CINAHL databases were searched for relevant studies published before January 2014, and hand searched reference lists of studies were selected. RESULTS This review of cross-language health care studies highlighted three major themes, which identify factors often reported to affect the translation and production of data in cross-language research: (1) translation style; (2) translators; and (3) trustworthiness of the data. CONCLUSION A plan detailing the translation process and analysis of health care data must be determined from the study outset to ensure credibility is maintained. A transparent and systematic approach in reporting the translation process not only enhances the integrity of the findings but also provides overall rigour and auditability. RELEVANCE TO CLINICAL PRACTICE It is important that minority groups have a voice in health care research which, if accurately translated, will enable nurses to improve culturally relevant care.

Original research: an inpatient program for adolescents with anorexia experienced as a metaphoric prison.

ObjectiveThe purpose of this study was to explore the experiences of adolescents within an inpatient behavioral program for the treatment of anorexia nervosa, as well as those of the nurses who cared for them. In particular, the study focused on the effects of the programs behavior modification principles on the relationship between patient and nurse. MethodsUsing a qualitative, naturalistic design, the investigator (LMR) conducted in-depth, face-to-face, semistructured interviews with adolescent patients being treated for anorexia in an acute care setting and the pediatric nurses working there. She invited all patients and nurses involved in the program to participate in the study, and then conducted interviews up until the point of saturation (when responses ceased to reveal any new information or themes). She interviewed 10 adolescent patients and 10 pediatric nurses in total. ResultsStudy findings illuminated the challenges nurses and patients face in forming therapeutic relationships within an environment the patient often experiences as a de facto prison, with nurses taking on the role of prison warden. In interviews, both patients and nurses frequently used language suggestive of incarceration, and from their accounts of life within the program, three major themes emerged: “entering the system,” “‘doing time’ within the system,” and “on parole or release.” ConclusionThematic analysis revealed that an oppressive prison metaphor colored the experiences of both patients and nurses within this program and negatively affected the development of therapeutic relationships between them. Findings suggest that policy changes regarding length of stay, nurse training, visitation, initiation of psychological therapy, and mealtime may improve therapeutic relationships within such programs.

Comparison of four teaching methods on Evidence-based Practice skills of postgraduate nursing students.

The aim of this study was to compare four teaching methods on the evidence-based practice knowledge and skills of postgraduate nursing students. Students enrolled in the Evidence-based Nursing (EBN) unit in Australia and Hong Kong in 2010 and 2011 received education via either the standard distance teaching method, computer laboratory teaching method, Evidence-based Practice-Digital Video Disc (EBP-DVD) teaching method or the didactic classroom teaching method. Evidence-based Practice (EBP) knowledge and skills were evaluated using student assignments that comprised validated instruments. One-way analysis of covariance was implemented to assess group differences on outcomes after controlling for the effects of age and grade point average (GPA). Data were obtained from 187 students. The crude mean score among students receiving the standard+DVD method of instruction was higher for developing a precise clinical question (8.1±0.8) and identifying the level of evidence (4.6±0.7) compared to those receiving other teaching methods. These differences were statistically significant after controlling for age and grade point average. Significant improvement in cognitive and technical EBP skills can be achieved for postgraduate nursing students by integrating a DVD as part of the EBP teaching resources. The EBP-DVD is an easy teaching method to improve student learning outcomes and ensure that external students receive equivalent and quality learning experiences.

Gender difference in academic performance of nursing students in a Malaysian university college

PURPOSE To examine differences in academic performance between male and female nursing students, and to identify whether professional identity and language usage were explanatory factors of academic performance. BACKGROUND Although the numbers of men entering the nursing profession are increasing, societal stereotypes and the lack of male role models in nursing may have a negative impact on motivation, and hence, academic performance. METHODS A total of 147 students who were enrolled in an undergraduate nursing programme in Peninsula Malaysia were surveyed in January 2011. In addition to demographic and academic data, three instruments were administered to measure language acculturation and professional identity. FINDINGS The mean age of participants was 20.0 (SD: 1.5) years with 81% being female. Almost all students spoke the Malay language at home. Although there were no differences between male and female nursing students in relation to professional identity (P=0.496), male nursing students reported a lower mean English language usage score (9.9 vs. 10.9, P=0.011) and a higher mean Malay language usage score (20.4 vs. 18.8, P=0.017). Males were also found to have lower academic performance than female students, as measured by grade point average (GPA) (2.7 vs. 3.2, P<0.001). Regression analysis revealed gender was the only significant predictor of academic performance (β=-0.44, P<0.001). CONCLUSIONS Males represent less than 10% of the nursing workforce in developed countries, with some developing countries experiencing even lower participation rates. Promoting academic support of male nursing students may assist in increasing the number of male registered nurses in the nursing workforce.

A systematic review and meta-synthesis of the effects and experience of mentoring in eating disorders and disordered eating.

In this review, we aimed to explore the benefits, effects and experiences of mentoring on those with an eating disorder or disordered eating. After a systematic search of the literature, four papers were included in the review. A qualitative analysis of the papers identified three key themes. The themes were (1) diverse benefits (mentees), (2) finding comfort in belonging (mentees), and (3) affirmation of the transformation they have made (mentors). The experience of mentoring was shown to have value for both mentors and mentees. Mentorship should be further utilized in the areas of eating disorders and disordered eating, as it shows promising reciprocal benefits for both mentor and mentee.

Diagnosis of Type 2 Diabetes: The Experience of Jordanian Patients with Co-existing Depression

In Jordan, Type 2 diabetes mellitus (T2DM) is becoming a significant health problem, and a high concomitant rate of depression among this population complicates the situation. This qualitative study explored and described the emotional reactions of Jordanian patients with co-existing depression, on diagnosis of T2DM. Data were collected using semi-structured qualitative interviews from 15 patients with T2DM and depression in 2013. Interviews were audiotaped, translated and then analysed using thematic analysis. A major theme–‘Initial reactions to the diagnosis’–emerged with four accompanying sub-themes (Devastation, Mixed Emotions, Denial and Acceptance). Although the majority of participants expressed negative emotional reactions on first diagnosis, a strong religious conviction allowed for acceptance of the diagnosis. Overall, the study findings support that in Arabic countries, spirituality and faith played a key role in promoting acceptance of concomitant comorbidities, and will often be useful in enhancing positive coping strategies among patients with T2DM and depression.

Barriers to breast and cervical cancer screening for women with physical disability: A review

ABSTRACT This review critically examined the barriers to breast and cervical cancer screening services for women with physical disability and discussed ways forward to change practice. When compared to the rest of the community, women with disability were less likely to use preventive health screening services for multiple reasons. Moreover, women with disability live longer than in previous years, and as age is linked to an increased risk of developing cancer, it is imperative that the barriers to screening for these women become a focus of discussion. We designed an integrative literature review to investigate this. Multiple databases were systematically searched for literature published between 2001 and 2013. Search terms used were a combination (AND/OR) of key terms. After excluding duplicates and articles not meeting the eligibility criteria, twenty-five articles were systematically and critically reviewed. Sociodemographic factors were associated with less access to preventive health screening for women with disability. The literature reviewed indicated that this was complicated further by three prominent barriers: health insurance, health care workers, and physical barriers. Sociodemographic, health insurance, health workers, and physical barriers impair access for disabled women to breast and cervical cancer screening, which are vital measures in the timely detection of breast and cervical cancers and preventable morbidity and mortality. Measures are needed to address these limiting factors for women with disability so that they can be active participants in health care, rather than being marginalized because of their disability.

Debriefing as a form of reflection and catharsis for researchers

Background The collection of sensitive data can arouse emotional reactions and researchers may have difficulty distancing themselves from personal stories. Debriefing can address the emotional effect of an experience on researchers. Aim To explore the debrief responses of three research assistants who were involved in the review of retrospective charts and medical notes in a study that examined the risk factors for readmission in young people with anorexia nervosa. Discussion Based on a review of the responses, the principal research team reflected on the value and effectiveness of a debrief tool for research assistants entering sensitive quantitative data. The paper highlights these reflections. Conclusion The use of an electronic debrief tool, while not without its challenges, provides an opportunity for individual reflection and a platform for emotional release for researchers engaged in sustained and intensive collection of sensitive data. This type of tool may serve as a guide for research teams and assist them in monitoring the well-being of those collecting sensitive data. We also advocate that a debriefing tool may contribute to closure for research assistants who become emotionally invested and affected by meticulous quantitative data entry. Implications for practice This paper provides recommendations for future use of an electronic debrief tool for researchers collecting sensitive data.

Participatory action research for women with anorexia nervosa.

AIM To discuss the application of the principles of participatory action research (PAR) in a project that developed and evaluated a mentor-mentee support programme for women with anorexia nervosa. BACKGROUND A programme was developed and implemented in which mentors and mentees participated in workshops, social activities and focus groups that sought to support and develop resilience for those experiencing anorexia nervosa. DISCUSSION PAR principles were mirrored in the programme, paying respect to the views and needs of each participant, an open trajectory to possible conclusions and a continuous feedback cycle. Mentees had a sense of empowerment, ownership of the programme and hope that recovery was possible. It allowed their voices to be heard and provided them with belief they could begin new relationships and friendships. CONCLUSION The principles of PAR suited a project aimed at developing self-determination and resilience in women with anorexia nervosa. IMPLICATIONS FOR RESEARCH/PRACTICE PAR would be readily transferable to a number of mental health settings where empowerment is of paramount concern.

Self-Efficacy, Depression, and Self-Care Activities in Adult Jordanians with Type 2 Diabetes: The Role of Illness Perception

Diabetes mellitus is reaching epidemic levels worldwide. In a developing country like Jordan, type 2 diabetes mellitus (T2DM) has reached a prevalence rate of 17.1%. This cross-sectional study examined the relationship between self-care activities and: illness perception, depression, social support, religiosity and spiritual coping, and self-efficacy among patients with T2DM. A random sample of 220 patients with T2DM, who attended Jordan University Hospital in Jordan were enrolled. The data were collected through a structured interview and the medical files. The instruments consisted of a sociodemographic and clinical standardised questionnaires: Brief Illness Perception Questionnaire, Patients’ Health Questionnaire-9; ENRICH Social Support Instrument; Religious and Spiritual Coping Subscale; Diabetes Management Self-Efficacy Scale; and Summary of Diabetes Self-Care Activities. Bivariate analysis investigated the relationship between variables. Structure Equation Modelling (SEM) was performed to test the proposed conceptual model. The study found that approximately 70% of the respondents suffered some form of depressive symptoms. The SEM showed a direct relationship between self-efficacy and self-care activities (β = 0.40; p < 0.001). Depression was indirectly related to self-care activities through self-efficacy (β = –0.20; p = 0.003); nevertheless, it was directly related to perception of: treatment control, consequences, and emotional representations. Overall, the sequence between illness perception and self-efficacy was mediated by depression. Strategies to promote self-efficacy and illness perception are vital in customising a diabetes health plan to meet Arabic cultural expectations.