Structural and psychological empowerment and reflective thinking: is there a link?

Baccalaureate nursing education prepares students to become registered nurses in evolving health care systems. During their program, students' perceptions of empowerment in the nursing profession begin to form, and they are introduced to the process of reflective thinking. The purpose of this integrative literature review is unique in that three concepts are examined and linked-structural empowerment (as conceptualized by Kanter), psychological empowerment (as described by Spreitzer), and reflective thinking (as characterized by Mezirow)-and a theoretical model for testing is proposed. In examining the conceptual links, it is apparent that all three are required for learning and nursing practice. By preparing students to be empowered, reflective professionals, it is proposed that they will be more effective in their academic and future practice work. The conceptual links and proposed model described in this article provide the foundation for building a body of evidence to support or refute this contention.

The effects of infant deaths on the risk of subsequent birth: a comparative analysis of DHS data from Ghana and Kenya.

This paper examines the conditions under which there might be a strong or weak relationship between childhood mortality and fertility at the micro level. The premise is that as a society undergoes transition during which a conscious effort is made to space and limit birth, the effect associated with infant death on the risk of subsequent birth reduces. Using the 1998 DHS data from Ghana and Kenya, our multivariate hazard models show that women who have experienced infant deaths tend to have a higher risk of subsequent births than those without any infant deaths at all parities studied in both countries. In a comparative context, however, the magnitude of the effect associated with infant death was weaker in Kenya at all parities, corroborating the hypothesis that the effect indeed reduces in the course of transition. Besides infant deaths, other demographic, socioeconomic and sociocultural factors were also found to associate with the risk of births. The limitations and policy implications of the findings are discussed.