Daily Life and Challenges Faced By Households With Permanent Childhood Developmental Disability in Rural Tanzania - A Qualitative Study.

Severe developmental disability in children affects the life of the child and entire household. We conducted a qualitative study to understand how caregivers manage severe developmental disabilities in children in rural Africa. Families and six children (out of 15 children) who had serious permanent sequelae from a cerebral infection in Handeni, Tanzania, were contacted and invited to a workshop to recount their experience living with severe developmental disabilities. After consent, individual interviews were conducted first through recording of individual digital stories and then through individual semi-structured interviews. Pre-determined key categories were used to analyse the data. Our results showed that developmental disabilities required constant care and reduced the autonomy of the children. Schooling had not been attempted or was halted because of learning problems or inability to meet specialized school costs. Parents were under constant physical, emotional and financial stress. Their occupational earnings decreased. Some families sold their assets to survive. Others began to rely on relatives. Understanding the consequences of developmental disability helps to identify where social support should be focused and improved.

Challenging the shock of reality through digital storytelling.

The transition from student to qualified nurse is widely acknowledged to entail a difficult period of adjustment, involving significant personal and professional challenges. Kramer [1974. Reality Shock--Why Nurses Leave Nursing. Mosby, St. Louis] originally described this as a "reality shock" due to the dissonance experienced between the expectations of the newly qualified nurse and the actuality of clinical practice. This experience continues to be echoed throughout the literature exploring factors influencing the quality of compassionate care, post-qualification support strategies, and attrition rates. Despite this, the phenomenon of a reality shock appears to have been accepted as an inevitable aspect of professional socialisation. This paper aims to report on an educational development which attempted to challenge these negative experiences and outcomes. The Division of Nursing at the University of Nottingham worked alongside the Patient Voices Programme (www.patientvoices.org.uk) to create reflective digital stories of newly qualified nurses. In their own words and using personal photos, the newly qualified nurses relate stories about an event that they have found particularly challenging during the transition from student to nurse. The stories were intended to provide opportunities for future students to learn and educationalists to reconsider the curriculum to facilitate preparation for the world of clinical practice. A learning environment was developed and piloted that utilises the digital stories to encourage student nurses to reflect upon the challenges of this transition by engaging with the storytellers, empathising with their experience and considering ways they might respond in similar situations. Evaluation of this educational forum suggests that the digital stories offer the audience a unique opportunity to walk in the shoes of the storyteller. As a consequence, an altered story might be told through encouraging newly qualified nurses to develop their core strengths and, in doing so, maintain their capacity to care.

Tell me a story--a conceptual exploration of storytelling in healthcare education.

The importance of storytelling as the foundation of human experiences cannot be overestimated. The oral traditions focus upon educating and transmitting knowledge and skills and also evolved into one of the earliest methods of communicating scientific discoveries and developments. A wide ranging search of the storytelling, education and health-related literature encompassing the years 1975-2007 was performed. Evidence from disparate elements of education and healthcare were used to inform an exploration of storytelling. This conceptual paper explores the principles of storytelling, evaluates the use of storytelling techniques in education in general, acknowledges the role of storytelling in healthcare delivery, identifies some of the skills learned and benefits derived from storytelling, and speculates upon the use of storytelling strategies in nurse education. Such stories have, until recently been harvested from the experiences of students and of educators, however, there is a growing realization that patients and service users are a rich source of healthcare-related stories that can affect, change and benefit clinical practice. The use of technology such as the Internet discussion boards or digitally-facilitated storytelling has an evolving role in ensuring that patient-generated and experiential stories have a future within nurse education.