Nursing Commons^™

Immigrant Women's Experiences Of Maternity-Care Services In Canada: A Systematic Review Using A Narrative Synthesis, Gina M A. Higginbottom, Myfanwy Morgan, Mirande Alexandre, Yvonne Chiu, Joan Forgeron, Deb Kocay, Rubina Barolia

School of Nursing & Midwifery

Background: Canada's diverse society and its statutory commitment to multiculturalism means that a synthesis of knowledge related to the healthcare experiences of immigrants is essential to realise the health potential for future Canadians. Although concerns about the maternity experiences of immigrants in Canada are relatively new, recent national guidelines explicitly call for the tailoring of services to user needs. We therefore assessed the experiences of immigrant women accessing maternity-care services in Canada. In particular, we investigated the experiences of immigrant women in Canada in accessing and navigating maternity and related healthcare services from conception to 6 months postpartum in Canada. …

“We Have Been Working Overnight Without Sleeping”: Traditional Birth Attendants’ Practices And Perceptions Of Post-Partum Care Services In Rural Tanzania, Gladys R. Mahiti, Angwara D. Kiwara, Columba Mbekenga, Anna-Karin Hurtig, Isabel Goicolea

School of Nursing & Midwifery, East Africa

Background: In many low-income countries, formal post-partum care utilization is much lower than that of skilled delivery and antenatal care. While Traditional Birth Attendants (TBAs) might play a role in post-partum care, research exploring their attitudes and practices during this period is scarce. Therefore, the aim of this study was to explore TBAs’ practices and perceptions in post-partum care in rural Tanzania.

Methods: Qualitative in-depth interview data were collected from eight untrained and three trained TBAs. Additionally, five multiparous women who were clients of untrained TBAs were also interviewed. Interviews were conducted in February 2013. Data were digitally recorded and …

Polio - An Endemic Disease In Pakistan: Literature Review, Savera Aziz Ali, Nadir Suhail, Hunaina Hadi, Mohsina Hussain, Marium Manji, Jaweria Bano, Abdul Salam, Sajida Naseer, Sumera Aziz Ali

School of Nursing & Midwifery

Poliomyelitis is a highly contagious and incurable disease, which mainly affects children under five years of age leading to irreversible paralysis and possibly death. For decades, both private and government organizations have been putting efforts through their partnership to eradicate polio completely from the different parts of the globe and as a result of those efforts there are left only three countries which are currently polio endemic. Since Pakistan is one of those three countries which still remain polio endemic along with Afghanistan and Nigeria, it is significant to address this issue and work on the preventive measures to control …

Establishing Policy Foundations And Regulatory Systems To Enhance Nursing Practice In The United Arab Emirates, Sharon Brownie, Lyndal H. Hunter, Salah Aqtash, Gary E. Day

School of Nursing & Midwifery, East Africa

In 2009, the United Arab Emirates (UAE) established a Nursing and Midwifery Council with a mandate to develop standards for the registration and regulation of nursing and midwifery and to strengthen the nursing and midwifery workforce. Priorities included workforce Emiratization and the development of regulatory standards to support advanced and speciality nursing practice and new models of care—particularly for the management of noncommunicable diseases. This article provides background, context for, and best practice inputs to the effort to provide one unified framework of nursing regulation and licensure across the whole of the UAE. This article is intended for nurse leaders, …

Uncovering The Concealed Part Of Motherhood-Postpartum Depression In Mothers, Hunaina Hadi, Shamsa Hadi

School of Nursing & Midwifery

Introduction: Motherhood is the most pleasing experience of a woman's life. Birth of a child gives birth to new hopes and ambitions. But Post-partum Depression is a condition when this blessing turns into curse. It can affect the mother, the partner and the child and can even lead to infanticide as well as maternal death, often by suicide.

Method: A qualitative systematic review was conducted through electronic medium to explore the relevant literature. Various databases i.e. Pubmed, Google search engines, Science Direct, JPMA, the Cumulative Index to Nursing and Allied Health Literature CINHAL and SAGA were used. Manual search was …

Case Report: Bicornuate Uterus – A Precipitator Of Maternal Morbidity, Merlin Mary James

Journal of Asian Midwives (JAM)

This case report concerns a woman diagnosed with a bicornuate uterus with ovarian torsion. She had been married for seven years and had conceived three times, giving birth to two live babies and had onespontaneous abortion. She was presently admitted to the hospital with complaints of pain in the left iliac fossa,which she had had for two hours before admission along with vomiting, severe bleeding, and burning micturition.During the abdominal examination, left iliac tenderness was present. During the speculum examination, cervical erosions were seen and discharge was present. A vaginal examination revealed a normal sized uterus and the left fornix …

National Skills Training Centre In India, Manju Chhugani, Ashin Merlin

Journal of Asian Midwives (JAM)

A key determinant which can ensure the quality of healthcare in public health institutions is the skill set of the individuals providing service delivery. Health professionals possess the skills and the expertise in this respect; however, they fail to utilize these optimally. This is because there is a disconnect between their knowledge and practice, it is now imperative tobridge the gap between basic education and clinical practice. The creation of skill labs is one way in which this gap can be addressed. Though India has seen a decline inboth the Maternal and Infant Mortality Rates, significant changes are yet to …

Factors Affecting The Midwifery-Led Service Provider Model In Pakistan, Surriya Shahnaz, Rafat Jan, Arusa Lakhani, Rozina Sikandar

Journal of Asian Midwives (JAM)

Background: Pakistan has a high rate of maternal and infant mortality, and a shortage of skilled birth attendants (SBAs). Many efforts have been made through the health sector and the international agencies to resolve the problem of both a high Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR), but the desired outcomes have not been achieved so far. Literature shows that midwifery plays a significant role in the reduction of MMR and IMR in other parts of the world, and the implementation of a Midwifery-led Service Provider Model could help reduce these rates in Pakistan. This study aims to …

To Achieve Safe And Respectful Maternity Care In Tertiary Level Hospitals In Nepal, Relatives Are A Valued Addition To The Provision Of Maternity Care, Sabitri Sapkota, Jamuna T. Sayami, Maiya Manadhar, Kerstin Erlandsson

Journal of Asian Midwives (JAM)

Introduction: The White Ribbon Alliance for safe motherhood believes respectful maternity care is the universal right of every childbearing woman.
Methods: NHRC in 2012 approved an inquiry of respectful care at facility-based childbirth. Individual-, focus group interviews and content analysis was used for gathering and analysis of data.
Findings: The participating women and the SBAs shared similar views, and this was that together the SBAs and relatives ensured the women remained within the comfort and safety zone when giving birth in a tertiary level maternity unit.
Conclusion: The SBAs strategy of having relatives provides basic care alongside the provision of …

Community Based Skilled Birth Attendants Programme In Bangladesh; Intervention Towards Improving Maternal Health, Sabera Turkmani, Fatima Gohar

Journal of Asian Midwives (JAM)

Aim: To review the strength and weakness of a community based skilled birth attendant (CSBA) program in Bangladesh.
Specific Objective: To explore perceptions of the providers, decision makers and community regarding newly trained community based skilled birth attendants.
To understand challenges, gaps and obstacles and recommend potential solutions for programme improvement.
Design: A descriptive study, using a qualitative approach was chosen to elicit the views and experiences of different stakeholders and the beneficiaries of the program was undertaken. The study intended to enhance understanding on gaps and challenges during program implementation by getting insight into different views. The data were …

Is “Empowerment” A Trickle-Down Effect Of The Afghanistan Midwifery Education Program?, Fatima Gohar, Pashtoon A. Zyaee, Sabera Turkmani

Journal of Asian Midwives (JAM)

Introduction: The patriarchal Afghan society has thousands of years of history. For most parts it has been governed by its tribal systems. The society has systematically evolved with its thousands of years old tradition, which has resulted in the subjugation of women. Although it is widely assumed that the midwifery education program (MEP) has contributed to female empowerment, no formal investigation has been carried out that explores the actual impact of MEP on the status of women midwifery graduates. Therefore, this study systematically explores the trickle down effects of MEP on women’s empowerment.
Methodology:
Design: Exploratory qualitative study
Study sites: …

News & Events

Journal of Asian Midwives (JAM)

No abstract provided.

Jam Carries On To Serve Midwives And The Midwifery Profession, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

The Patterns Of Health Seeking Behavior Among Patients With Hepatitis C In Karachi, Pakistan, Shahina Sabz Ali Pirani, Tazeen S. Ali, Saleema Allana, Faisal Wasim Ismail

School of Nursing & Midwifery

Background: The study aimed to assess the patterns of health seeking behavior and the level satisfaction with the health care providers among hepatitis C patients in Karachi, Pakistan.
Methodology: A descriptive, cross-sectional study was conducted among 250 hepatitis C patients, who were recruited from the Aga Khan University Hospital and the Civil Hospital Karachi, Pakistan, between March and May 2013.
Results: The patterns of health seeking behavior showed that a majority of the study participants approached a medical doctor (n=359), followed by spiritual healers (n=103), and a few participants approached traditional healers (n=38) and homeopaths (n=11). The pattern …

Interaction And Cognitive Engagement In Online Discussions In Professional Development Leadership And Management Course At A Private Nursing Institution, Nimira Asif, Samina Vertejee, Sharifa Bashir Lalani

School of Nursing & Midwifery

In the Post RN BScN curriculum, one of the courses “Professional Development and Leadership (PDLM)” was offered as blended mode for the first time. In order to explore the students’ interactions and Cognitive Engagement (CE) in Online Discussion Forums (ODFs), the research team conducted a retrospective study for the first time at a private nursing institution of Karachi-Pakistan. The study was conducted by utilizing the retrospective qualitative paradigm of discourse analysis to understand student’s CE in ODFs. The study has addressed the following one main and three subsidiary research questions: How do threaded discussions (in the part of online forums) …

Difficult And Frustrating? Caring For Those With Chronic And Complex Conditions, Rachel Rossiter, Sharon Brownie

School of Nursing & Midwifery, East Africa

Caring for people with chronic and complex health needs has become an ever-larger part of everyday nursing. The World Health Organization has identified common and preventable risk factors that are the primary cause of chronic illness worldwide—hypertension, tobacco use, hyperglycaemia, physical inactivity, and overweight or obesity. Nurses now need an expanded range of skills and expertise that will enable them to work effectively with people whose chronic and frequently complex health issues may be seen as difficult and challenging.

This article invites you to think about your experiences of caring for people with chronic and complex conditions. Before you read …

Safe Motherhood Training For Rural Health Care Workers In Odukpani Local Government Area Of Cross River State, Nigeria, Josephine Etowa, Ekaete Asuquo, Ani Etokidem

School of Nursing & Midwifery, East Africa

Maternal mortality remains a challenge in developing countries which bear 99% of global maternal deaths (WHO, 2014). Nigeria, India, Pakistan, Afghanistan and Ethiopia carry more than 50% of the global burden of maternal mortality. According to the UNDP Human Development Report (2014), Nigeria’s maternal mortality ratio of 630 per 100,000 live births ranks among the highest in Africa. Two countries accounted for one third of all global maternal deaths: India at 17% (50 000) and Nigeria at 14% (40 000) (WHO, 2014).. Archibong and Aghan (2010) found that hospital based maternal mortality ratio in Cross River state was 1,513.4per 100,000 …

Practices Of Tracheal Suctioning Technique Among Health Care Professionals: Literature Review, Rozina Khimani, Fauziya Ali Dr., Salma Rattani, Mohammad Sohail Awan

Department of Surgery Docs

The current study aims to assess tracheal suctioning practices among health care practitioners; nurses, critical care technicians and physiotherapist. Employing literature review as the methodology, multiple databases were searched focusing on three phases of tracheal suctioning (a) the pre suctioning phase, (b) the suctioning phase, (c) the post suctioning phase and complications related to tracheal suctioning. It was concluded that to provide quality care it is important that the evidence based practice guidelines should be followed.

Engagement Of Undergraduate Nursing Students In Virtual Learning Environment In Karachi Pakistan, Zohra Kurji, James Mwenda, Amina Aijaz

School of Nursing & Midwifery, East Africa

Aga Khan University (AKU) is implementing blended learning (BL) in their existing programs. This study reports the use of BL mode in one of the courses entitled Advanced Concepts of Community Health nursing (ACCHN), offered for undergraduate nursing students, for the first time in Karachi Pakistan. A qualitative exploratory design was adopted.The year II students of Post-RN BScN programme who were studying the course were invited to participate in the study. Data was collected by using focus group discussions (FGDs.). Students found ACCHN course flexible because of the use of blended modalities. They felt that their learning was enhanced by …

A Delphi Survey Of Leadership Attributes Necessary For National Nurse Leaders’ Participation In Health Policy Development: An East African Perspective, Nilufa Jivraj Shariff

School of Nursing & Midwifery, East Africa

Background: Nurses’ involvement in health policy development ensures that health services are: safe, effective, available and inexpensive. Nursing history reveals several legendary nurse leaders who have influenced policy and the course of nursing and health care. In the recent times there have been concerns regarding the availability of effective leaders physically, symbolically and functionally at clinical, organizational and national levels, who can effectively influence health policy. Exerting influence in the policy arena requires that nurse leaders acquire attributes that enable them to be effective in policy development activity.

This paper reports part of a larger study whose purpose included: “build …

Infectious Disease Outbreaks And Increased Complexity Of Care, Joan Musau, A. Baumann, C. Kolotylo, T. O’Shea, A. Bialachowski

School of Nursing & Midwifery, East Africa

Aim: This study examined the effects of healthcare-associated infectious disease outbreaks on nurses’ work in a large acute care hospital in Ontario, Canada.

Background: The incidence of healthcare-associated infections has increased. Previous research focuses on epidemiology, healthcare systems, and the economic burden of outbreaks. Few published studies focus on the impact of outbreaks on nurses’ work in acute care facilities.

Introduction: Since the severe acute respiratory syndrome epidemic in 2003, combating infectious diseases has become a key issue. Hospitals have implemented measures related to healthcare-associated infections. However, nurses experience challenges in preventing, controlling, and contending with outbreaks.

Methods: A retrospective …

Knowledge And Attitudes Of Select Ugandan Nurses Towards Documentation Of Patient Care, Grace Nakate, Diane Dahl, Karen B. Drake, Pammla Petrucka

School of Nursing & Midwifery, East Africa

Ideally through documentation, nurses track changes in a patient’s condition, make decisions about needs, and ensure continuity of care. However, nursing documentation has often not met these objectives. In Uganda, the systematic nursing specific approach is not reflected in documentation of nursing care. A mixed methods intervention study was conducted to determine knowledge and attitudes of nurses towards documentation, including an evaluation of nurses’ response to a designed nursing documentation form. Forty participants were selected through convenience sampling from six wards of a Ugandan health institution. The study intervention involved teaching nurses the importance of documentation and using of the …

Psychobiobehavioral Model For Preterm Birth In Pregnant Women In Low- And Middle-Income Countries, Shahirose S. Premji, Ilona S. Yim, Aliyah Dosani (Mawji), Zeenatkhanu Kanji, Salima Sulaiman, Wangira Musana, Pauline Samia, Kiran Shaikh, Nicole Letourneau

School of Nursing & Midwifery, East Africa

Preterm birth (PTB) is a final common outcome resulting from many interrelated etiological pathways; of particular interest is antenatal psychosocial distress (i.e., stress, anxiety, and depression). In LMI countries, both exposure to severe life stressors and rate of PTB are on average greater when compared with high-income countries. In LMI countries women are exposed to some of the most extreme psychosocial stress worldwide (e.g., absolute poverty, limited social resources). High prevalence of antenatal stress and depression have been observed in some studies from LMI countries. We propose a psychosocial, biological, and behavioral model for investigating the complex multisystem interactions in …

Perceptions Of Patients Regarding Quality Nursing Care (Qnc) At A Tertiary Hospital In Karachi, Pakistan, Ayyub Rehan, Zeenatkhanu Kanji, Dias J., Roshan R.

School of Nursing & Midwifery, East Africa

Background: Patients’ experiences regarding the quality of care continue to be a hot topic of discussion in the healthcare industry. Exploring the quality of nursing care from the patients’ perspectives is a vital element of quality evaluation. The purpose of this study was to explore the patients’ perspectives regarding quality nursing care.

Methodology: A qualitative descriptive exploratory design was used. A total of twelve participants were recruited from one medical and one surgical unit at a tertiary care hospital in Karachi, Pakistan. Purposive sampling was used to select the participants. Data was collected through semi-structured interviews. A thematic analysis approach …

Pedagogy And Culture: An Educational Initiative In Supporting Uae Nursing Graduates Prepare For A High-Stakes Nurse Licensing Examination, Sharon Brownie, Ged Williams, Kate Barnewall, Suzanne Bishaw, Jennifer L. Cooper, Walter Robb, Neima Younis, Dawn Kuzemski

School of Nursing & Midwifery, East Africa

Graduates of an Abu Dhabi transnational nursing degree struggled with the mandatory national licensing examination. Poor pass rates undermine graduate career futures and impact on the workforce capacity building contributions of the partnering transnational educational providers. This paper describes how the design and delivery of an intensive examination preparation program dramatically reversed this trend. The objectives of this educational initiative involved the design, delivery and evaluation of a program that would align with cultural learning preferences and which improve the success rates of graduates attempting the national nurse licensing examination. To achieve these objectives, the program combined a range of …

The Changing Role Of Nursing: Opportunities For Nurse-Led Services For The Management Of Chronic Disease And Diabetes In The Uae, Sharon Brownie

School of Nursing & Midwifery, East Africa

There is little debate that current and future healthcare is, and will continue to be, dominated by the prevention and management of increasingly complex chronic health disease; the UAE is no exception. Preventive and disease management services directed at groups and individuals at risk of unfavourable health outcomes are core to the make-up of an effective health system. The burden of noncommunicable, chronic and diabetes-related diseases places a heavy strain on health service cost and service delivery requirements. The UAE is faced with the challenge of identifying and developing effective strategies for the prevention and management of the burgeoning prevalence …

Birth Preparedness And Complication Readiness – A Qualitative Study Among Community Members In Rural Tanzania, Furaha August, Andrea B. Pembe, Edmund Kayombo, Columba Mbekenga, Pia Axemo, Elisabeth Darj

School of Nursing & Midwifery, East Africa

Background: Birth preparedness and complication readiness (BP/CR) strategies are aimed at reducing delays in seeking, reaching, and receiving care. Counselling on birth preparedness is provided during antenatal care visits. However, it is not clear why birth preparedness messages do not translate to utilisation of facility delivery. This study explores the perceptions, experiences, and challenges the community faces on BP/CR.

Design: A qualitative study design using Focused Group Discussions was conducted. Twelve focus group discussions were held with four separate groups: young men and women and older men and women in a rural community in Tanzania. Qualitative content analysis was used …

Exploring Unprotected Anal Intercourse Among Newly Diagnosed Hiv Positive Men Who Have Sex With Men In China: An Ethnographic Study, Haochu Li, Eleanor Holroyd, Joseph Lau

School of Nursing & Midwifery, East Africa

Background: Unprotected anal intercourse (UAI) is a major pathway towards secondary HIV transmission among men who have sex with men (MSM). We explored the socio-cultural environment and individual beliefs and experiences conducive to UAI in the context of Southern China.

Methods: We employed an ethnographic approach utilizing a socio-ecological framework to conduct repeated in-depth interviews with thirty one newly diagnosed HIV positive MSM as well as participant observations in Shenzhen based healthcare settings, MSM venues and NGO offices.

Results: Some men (6/31) reported continuing to practice UAI after an initial diagnosis of being HIV positive. For MSM who had existing …

Stigma, Subsistence, Intimacy, Face, Filial Piety, And Mental Health Problems Among Newly Hiv-Diagnosed Men Who Have Sex With Men In China, Haochu (Howard) Li, Eleanor Holroyd, Joseph Lau, Xiaoming Li

School of Nursing & Midwifery, East Africa

High rates of mental health problems among people living with HIV (PLWH) have been widely reported in the literature; however, an understanding of the socioecological contexts of these presentations remains limited, particularly in China. In order to explore potential socioecological factors associated with mental health problems among newly diagnosed HIV-infected migrant men who have sex with men (MSM), we employed a life profile approach conducting semistructured in-depth interviews with 31 newly diagnosed HIV-infected MSM residing in a city in Southern China. Participants’ life profile accounts outlined their concerns, including internalized stigma, subsistence living, difficulties finding a lover or a stable …

Food Choices And Practices During Pregnancy Of Immigrant Women With High-Risk Pregnancies In Canada: A Pilot Study, Gina M A. Higginbottom, Helen Vallianatos, Joan Forgeron, Donna Gibbons, Fabiana Mamede, Rubina Barolia

School of Nursing & Midwifery

Background: Immigrant women may be regarded as a vulnerable population with respect to access and navigation of maternity care services. They may encounter difficulties when accessing culturally safe and appropriate maternity care, which may be further exacerbated by language difficulties and discriminatory practices or attitudes. The project aimed to understand ethnocultural food and health practices and how these intersect in a particular social context of cultural adaptation and adjustment in order to improve the care-giving capacities of health practitioners working in multicultural perinatal clinics.
Methods: This four-phase study employed a case study design allowing for multiple means of data collection …