Knowledge and beliefs about hypertension among Jamaican female clients.

Hypertension is a major health problem in the Caribbean Region. If health promotion programs are to be appropriate and effective, the clients' knowledge and beliefs regarding this chronic health problem need to be identified. The purpose of this study was to determine the knowledge level and beliefs about hypertension among female clients attending primary health care clinics in Jamaica, West Indies. Data were collected from 240 female clients with the use of a pretested interview schedule. Findings indicated that the respondents were of low socio-economic status, lacked knowledge regarding the predisposing factors and characteristics of the disease and had a number of misconceptions surrounding the illness. Implications for nurses and health care providers are discussed with suggestions for future research.

Predictors of success on the Canadian Nurses Association testing service (CNATS) examination.

This retrospective study examined the relationship of selected admissions variables and in-course performance to success in the Canadian Nurses Association Testing Service (CNATS) examinations of 114 students admitted directly from secondary school to a four-year integrated, problem-based learning (PBL) baccalaureate nursing program in Canada. Data were analyzed using two separate hierarchical stepwise regression equations. The first equation examined a set of secondary school grades (Ontario Academic Credits, or OACs) used to calculate university admission averages and their ability to predict CNATS performance. OAC English was found to be the best predictor, followed by OAC chemistry and the admission average obtained on other OAC subjects. The second regression equation looked at in-course grades as potential predictors of CNATS scores. The basic sciences variable proved to be the best predictor, followed by research methodology, first-year Nursing Concepts I, a problem-based nursing average, and a clinical practice average. Findings support the continued use of English and chemistry as admission criteria. The basic sciences courses and first-year nursing courses also emerged as statistically significant predictors of licensure examination success.

Rural women and power in Pakistan.

Perceptions of power in women living in rural villages in Pakistan were explored. The Lee-Hezekiah Power Perception Scale was developed by the authors to measure women's perception of their power. The instrument was administered in interviews conducted by a group of Lady Health Visitors who were participating in a project funded by the Canadian International Development Agency. Sixty-nine women ranging in age from 20 to 65 were interviewed. One-way analysis of variance revealed that the oldest group perceived themselves to have more power than the youngest group perceived themselves to have. Stepwise multiple regression indicated that the number of male children a woman had was predictive of the amount of power she perceived herself to have. The results are discussed in relation to existing literature on women and power in developing countries. Implications for further research on women's perceptions of power and health are discussed.

PIP: The study aim was to identify women's perceptions of their own power in patriarchal Pakistani society. The theoretical framework was based on French and Raven's bases of power. 69 Muslim rural women, 20-65 years old, were selected randomly from 6 rural health centers in Sindh province in December 1990. Perceptions of power were measured by the Lee-Hezekiah Power Perception Scale. The respondents had a mean age of 34 years; 41% were Sindhi, 41.5% Balouchi, and 17% other. All were married or widowed. The maximum possible score on the perception test was 95; the mean score was 47, and scores ranged from 25 to 85. Analysis of variance results showed that women 46 years and older felt significantly more powerful. The 5 literate women had a mean score of 59. Multiple regression analysis indicated that only the number of male children was a significant predictor of women's power scores. Number of male children explained 9% of the variance. Age, marital status, education, and number of female children were insignificant. The French and Raven framework suggests that legitimate power is based on cultural values and acceptance of the social structure. In Pakistan men have power in the family, but this study found that women's perception of power was more related to age, literacy, and the number of sons. The small sample size of literate women made difficult a definitive interpretation of the impact of education, but the findings suggest that education could have a powerful influence.

Creating bicultural experiences in nursing.

This article describes the process (activities) involved in helping Registered Nurse students from Pakistan in an international health project adjust to Canadian culture and readjust to their home culture. The process, involving both structured and informal activities in Pakistan and in Canada, was designed to assist the students in adapting to both the foreign and home cultures. These processes included both human and material resources. Predeparture and reentry workshops, support systems in the form of Karachi-based faculty advisers, and intensive orientation programs were identified as important factors in the project students' adjustment.

The pioneers of rural Pakistan: the Lady Health Visitors.

Since 1978, when the World Health Organization and the United Nations International Children's Emergency Fund called for urgent action by all governments to provide appropriate health care for the underprivileged, the world community has attempted to implement primary health care strategies. Pakistan, with a population of 118 million people, is one of those countries where the rural population and the underprivileged groups in the katchi-abadis (squatter settlements) of the urban areas lack appropriate and accessible health services. This article highlights the community experiences of a remarkable group of young Muslim women, the Lady Health Visitors (LHVs) of the Aga Khan Health Services, who deliver primary health care services to disadvantaged women and children in the northern mountainous areas and rural villages of Pakistan. The LHVs are the first contact with the health care system that these underprivileged women experience. The LHVs cure, care, teach, and train traditional birth attendants. In addition, they perform health promotion and document their findings. To provide their maternal and child health services, the LHVs travel by foot through miles of rough terrain to settlements and villages. Prenatal and postnatal care, anemia, diarrhea, and malnutrition are among the major health care problems of these rural women and their children under 5 years of age.

Feminist pedagogy: a framework for nursing education?

This article describes the feminist pedagogical strategies used in a nursing course in the post-RN Bachelor of Science in Nursing (BScN) program, Aga Khan University, Karachi, Pakistan. A variety of concepts that have direct relevance for nurses were discussed within small groups. These settings provided the venue for an examination of the issues that nurses, as primarily female, face in a patriarchal Muslim society and an androcentric health care system. Emphasis is on the process used in terms of feminist pedagogical practices and its relationship to feminist theory and critical pedagogy. The five process goals suggested by Schniedewind (1983) formed the basis for an exploration of this relationship through an analysis of the content and practices used in the course. It is demonstrated that the teaching practices advocated by feminist pedagogy hold much promise for nursing education to empower nurses and to make an impact on the health care system.

Postcolonial nursing education in Trinidad and Tobago.

In this article the impact of the developed nations on basic nursing education in Trinidad and Tobago in the postcolonial period is discussed and analyzed. Subsequent to self-government in 1956, the national government, in its efforts to become independent of its reliance on Great Britain, turned to the United States and Canada for technical and financial aid. Consequently, sources such as the World Bank, Inter-American Development Bank, Pan American Health Organization/World Health Organization, and the Canadian International Development Agency were major avenues for the provision of ideas, concepts, and values in health planning and policy making with primary health care endorsed by the government. Nursing education was thus influenced by these industrialized concepts and values. The impact of socioeconomic and nursing events in the Caribbean region coupled with local initiatives taken by the indigenous leadership to improve nursing education resulted in a program that was an amalgamation of British, North American, and indigenous features.

The development of health care policies in Trinidad and Tobago: autonomy or domination?

This article is part of a study that described and analyzed the development of nursing education in Trinidad and Tobago from self-government in 1956 to 1986, with special emphasis on the forces that helped to shape the society from colonial times, and consequently, nursing education. Adaptation and application of major concepts from theories of underdevelopment and development and colonialism formed the basis of the study's theoretical framework. The article focuses on the impact of the metropolitan countries on the development of health care policies. Because of the nation's historical legacy of colonialism and its current linkages with the United States and Canada, a major area fundamental to the analysis was to determine whether those two countries had superseded traditional British influences in determining health care policies. This raised the issue of whether or not health care policies could be autonomously developed to meet the needs of the people.

PIP: This article is part of a study that described and analyzed the development of nursing education in Trinidad and Tobago from self-government in 1956 to 1986, with special emphasis on the forces that helped to shape the society from colonial times, and consequently, nursing education. Adaptation and application of major concepts from theories of underdevelopment and development and colonialism formed the basis of the study's theoretical framework. The article focuses on the impact of the metropolitan countries on the development of health care policies. Because of the nation's historical legacy of colonialism and its current-linkages with the US and Canada, a major area fundamental to the analysis was to determine whether those 2 countries had superseded traditional British influences in determining health care policies. During the colonial era, the health care services and related policies reflected the economic and social structures and relationships that characterized the society. The focus of health care was primarily curative with limited attention paid to public health. In the postcolonial era, psychological and administrative factors inherited from an earlier period hindered the effective functioning of the health care services. Despite this handicap, the national government in power, with input from metropolitan sources, had effected structural changes. While there was still an emphasis on curative services, public health initiatives received high priority with the development of rural and suburban health care centers, and subsequent improved health status of the masses. The health care of North American medicine was imitated but unsustainable. Expansion of education has created increased expectations and demand for improved and accessible health services but health care policies did not develop autonomously for meeting the needs of the masses. During a period of economic recession, this remains a critical problem facing the nation.

Major health problems of women in a Kenyan village.

Major health problems encountered by women in one village situated in the northwestern area outside of Nairobi, Kenya, are addressed in this paper. A retrospective, descriptive account of the nature and cost of health services provided to clients is provided, with a particular focus on the three most critical health problems facing women in that village (which is a prototype of surrounding villages). Female circumcision, childbearing, and malaria are examined, and implications for change are suggested.