Nutritional Beliefs and Practices of Arabic-Speaking Middle Eastern Mothers Living in the United States.

INTRODUCTION: Culture and acculturation influence nutritional beliefs. Little is known about the Arabic population in the United States. In this study, Arabic-speaking Middle Eastern mothers' perceptions of motherhood and childhood nutritional beliefs and practices are explored. METHOD: Semi-structured interviews with 12 mothers from Arabic-speaking Middle Eastern countries. RESULTS: Food and family are central to everyday life. Mothers worked hard to maintain traditional nutritional practices with their school-age children. DISCUSSION: Findings can enhance school nurses' ability to collaborate with mothers in nutritional education and address any issues in the classroom.

Perceptions of health and illness among older Hispanic adults.

BACKGROUND: Understanding perceptions of health and illness among older Hispanic adults is vital for nurses when designing effective health promotion programs. PURPOSE: The purpose of this study was to explore the perceptions of health and illness and how health was maintained during times of illness. METHOD: This inductive qualitative descriptive study used a single focus group with interviews over three sessions. All eight members of the focus group were Spanish-speaking, older adults living in the community. Immersion/crystallization and editing analytic styles were used to analyze the data. RESULTS: Participants were parishioners at a local church and knew each other from participating in community events. Perceptions of health mainly focused on both the absence of illness and physical limitations. Maintaining health included a healthy lifestyle and being physically active; however, food was central to maintaining health. Perceptions of illness were described as "feelings of sickness" such as sadness and worry. Dealing with illness was equated with physical limitations, with strategies suggested, including going to the doctor, preparing natural and folk remedies, spirituality, and support from family and friends. CONCLUSION: Nurses have an important role in assessing the health management strategies of older Hispanic adults and need to incorporate the older adults' understanding of health and illness into their plan of care.

A group respite pilot project for children with special needs.

Providing ongoing care for a family member or loved one with special needs is challenging. It is estimated that about 21% of the adult population in the United States are providing unpaid care for loved ones at home. Of that group, 5.7% are caring for children with special needs. Special needs can range from developmental delay to the provision of complex medical treatments. Family caregivers take on numerous roles to coordinate activities of daily living, therapies, in-home services, school, and appointments. This is often a great source of stress on family caregivers. Providing the proper support for care to remain at home reduces the disruption to children and families' lives (Carter et al., 2012). A pilot project was developed for children with physical, cognitive, and/or developmental impairment. This project was coordinated by nursing and physical therapy faculty and their students. Parents as well as nursing and physical therapy students benefited mutually. Our preliminary responses from families indicated stress relief from caregiving and benefiting from the ability to talk to other parents in similar circumstances.

Coping with mental health issues among older Hispanic adults.

Access to mental health services for older Hispanic adults is limited and often older Hispanic adults must rely on their own resources in dealing with mental health issues. The aim of this study was to understand how older Hispanic immigrants cope mental health issues (e.g. stress, anxiety, and/or depression). A qualitative, descriptive approach was used to interview 17 older Hispanic immigrants from Guatemala, Dominican Republic and Colombia. Interviews were audio recorded, transcribed and translated verbatim by bilingual research assistants. Data were analyzed using content analysis with a combination of immersion/crystallization, editing and template organizing styles. Ways of coping included spiritual beliefs and religious practices, social support, distraction, medications and professional help. Primary care providers may be more effective if they build upon the cultural constructs that undergird older Hispanic immigrants' ways of coping in addressing emotional distress and mental health issues in this population.

Perceptions of Mental Health Among Hispanic Older Adults: Findings Among Immigrants from the Dominican Republic, Colombia, and Guatemala.

Disparities exist in the recognition and treatment of mental health issues among Hispanic community-dwelling older adults. Previous researchers have focused on accessing mental health services, with limited attention to older Hispanic immigrants' perceptions of mental health issues. A qualitative descriptive research design was used to understand older Hispanic immigrants' perceptions of mental health issues, especially those related to stress, anxiety, and depression. Seventeen older adults from the Dominican Republic, Colombia, and Guatemala were interviewed. Despite having experienced significant personal tragedies, participants did not initially describe emotional distress or any mental health issues. When specifically questioned, depression was the most recognized illness. Depression was commonly described as sadness, whereas stress and anxiety had multiple definitions among participants. Understanding older Hispanic immigrants' perceptions of mental health issues and establishing a therapeutic relationship between the health care provider and patient may be helpful in recognizing and treating individuals who may be at high risk for emotional distress, anxiety, and depression. [Journal of Gerontological Nursing, 44(11), 44-50.].

Ageing out of place: The meaning of home among hispanic older persons living in the United States.

AIM: To explore the meaning of home among older Hispanic immigrants who are "aging out of place." BACKGROUND: Emerging evidence supports the concept of older persons ageing in place. Nurse researchers have demonstrated that older person who age in place have better physical, psychological and cognitive outcomes. Less, however, is known about older persons who are "aging out of place," meaning out of their country of origin. With the growth of home health care, there is a need to understand the older immigrants' meaning of home when ageing out of their country of origin. DESIGN AND METHOD: An inductive, qualitative descriptive research design was used. Seventeen Hispanic participants, ranging in age from 65 to 83 years were interviewed using a semi-structured interview protocol. FINDINGS: Two major finding of the study focused on participants' descriptions of home in their country of origin and in the USA. The majority of participants described their home in their native country as the community, countryside or town (pueblo) and in the U.S.A. as family. The level of social isolation and loneliness among participants was evident. CONCLUSIONS: Older Hispanic immigrants who are "aging out of place" integrate their past experiences of sense of place in their native country with their present experiences of home in the USA. The need to understand the role of the community and the family in the provision of nursing care in the home may be more important than the physical structure or setting in which it is delivered. Further intra- and cross-national studies are needed to provide a framework for understanding the issues of ageing and immigration globally. IMPLICATIONS FOR PRACTICE: Gerontological nurses need to recognise the complexity of family relationships for older Hispanic persons who are ageing out of place of origin and their risk of depression, social isolation, and loneliness.

Exploring the Use of Critical Reflective Inquiry With Nursing Students Participating in an International Service-Learning Experience.

BACKGROUND: Increasing interest in providing international educational experiences for nursing students has led to a variety of short-term international service-learning experiences. However, the impact of these experiences has not been clearly articulated. METHOD: In this qualitative descriptive research study, Kim's critical reflective inquiry model was used to help guide students in reflecting on and identifying the impact of an international service-learning program in the Dominican Republic. RESULTS: The model was helpful in promoting in-depth description and reflection on the students' underlying assumptions and values, as well as identifying beginning strategies for emancipation in specific patient care situations. CONCLUSION: Providing a group process for critical reflection may optimize the perspective transformations in meeting the goals and objectives of the experience.

Assessment of Food Intake, Obesity, and Health Risk among the Homeless in Rhode Island.

OBJECTIVE: The objective of this study was to examine the relationship between the nutritional status, incidence of food insecurity, and health risk among the homeless population in Rhode Island. DESIGN AND SAMPLE: This correlational study utilized a convenience sample of 319 homeless adults from Rhode Island's largest service agency for the homeless. Information on use of services such as access to emergency foods, shelters, and the Supplemental Nutrition Assistance Program (SNAP) was requested. MEASURES: Food security was measured by the six-item subset of the USDA Food Security Core Module. Anthropometric measures included height, weight, and waist circumference. A 24-hr dietary recall was collected to determine the food intake for a subset of participants who agreed to supply this information (n = 197). CONCLUSION: Average dietary recall data indicated insufficient intake of vegetables, fruit, dairy, and meats/beans. It also indicated excessive intake of fats. Of the 313 participants, 29.4% were overweight and 39% were obese. Over 94% of the participants were food insecure, with 64% of this subset experiencing hunger. Fifty-five percent of the participants were currently receiving SNAP benefits. The majority of the sample was found to be food insecure with hunger.

A mixed methods evaluation of an international service learning program in the Dominican Republic.

OBJECTIVE: To examine the impact of an international service learning experience (ISL) using a quantitative and qualitative approach. DESIGN AND SAMPLE: A descriptive study was used to explore the impact of an ISL experience on global awareness, professional and personal growth with 11 baccalaureate nursing students in the Dominican Republic. INTERVENTION: Students participated in a three credit ISL program in the Dominican Republic which included pre- and postexperience seminars and a 2-week, on-site immersion experience. MEASURES: The International Education Survey (IES) was used as the quantitative measure. Content analysis of Critical Reflective Inquiry (CRI) narratives was used as the qualitative method. RESULTS: Students reported a high overall impact (M = 5.9) using the IES with high means for the Professional Student Nurse Role (M = 6.10, SD: 0.74), Personal Development (M = 6.08, SD: 0.76), International Perspectives (M = 6.03, SD: 0.71), and a lower mean for Intellectual Development (M = 5.40, SD: 0.69). CRI narratives revealed specific areas of impact, for example, increased empathy and ability to communicate effectively with patients from life situations very different from their own. CONCLUSIONS: Further exploration of the usefulness of various evaluation tools and methodological designs is warranted to understand this type of pedagogy and its' impact on student learning outcomes short- and long-term.

Development and evaluation of an international service learning program for nursing students.

OBJECTIVES: (1) Using Riner's framework, the development of an international service learning program in the Dominican Republic (DR) for Baccalaureate nursing students will be described, and (2) an initial impact of the students' experiences will be examined. DESIGN AND SAMPLE: A qualitative descriptive research design was used to examine its impact. The international service learning program included (1) didactic (five, 2 hr and one full day educational sessions) prior to (2) immersion (2 weeks in country), and (3) posttrip debriefing session. Ten females, senior nursing students participated in the program. Students' daily journals were examined using thematic analysis. RESULTS: Five major themes that emerged were as follows adapting physically, encountering frustration in their inability to fully meet patients' needs, increasing confidence in speaking Spanish and assessing health problems, and increasing cultural awareness. Students were descriptive regarding their daily activities, and did some, but limited, critical reflection. CONCLUSIONS: Models of reflection need to be explored to select the most appropriate technique to facilitate students' critical reflection in meeting the goals and objectives of the experience. Curriculum integration of global learning, social consciousness, and global cultural competence development is needed.

Teaching undergraduate nursing research: a comparison of traditional and innovative approaches for success with millennial learners.

Historically, nursing students have questioned the value of a nursing research course and have not appreciated the research-practice link. These are important concerns in light of the increasing emphasis on evidence-based nursing practice. The purpose of this study was to develop innovative strategies for teaching undergraduate nursing research that engage millennial learners and emphasize the relationship between evidence-based practice and clinical outcomes. Innovative assignments were developed that included interactive learning, group work, and practical applications preferred by these learners. Using a Likert scale, students' perceived effectiveness of innovative assignments and more traditional assignments were compared. Results indicated a preference for active learning assignments, reading quizzes, clinical nurse researcher presentations, and collaboration with clinical course assignments. By combining traditional assignments with innovative strategies and nursing practice applications, millennial learners were engaged and able to clearly articulate the value of the research-practice link vital to evidence-based nursing practice.

Symbolic interactionism and critical perspective: divergent or synergistic?

Throughout their history, symbolic interactionism and critical perspective have been viewed as divergent theoretical perspectives with different philosophical underpinnings. A review of their historical and philosophical origins reveals both points of divergence and areas of convergence. Their underlying philosophies of science and views of human freedom are different as is their level of focus with symbolic interactionism having a micro perspective and critical perspective using a macro perspective. This micro/macro difference is reflected in the divergence of their major concepts, goals and basic tenets. While their underlying philosophies are different, however, they are not necessarily contradictory and areas of convergence may include the concepts of reference groups and looking glass self within symbolic interactionism and ideological hegemony within critical perspective. By using a pragmatic approach and combining symbolic interactionism and critical perspectives, both micro and macro levels come into focus and strategies for change across individual and societal levels can be developed and applied. Application of both symbolic interactionism and critical perspective to nursing research and scholarship offers exciting new opportunities for theory development and research methodologies. In nursing education, these two perspectives can give students added insight into patients' and families' problems at the micro level while, at the same time, giving them a lens to see and tools to apply to problems at the macro level in health care. In nursing practice, a combined symbolic interactionism/critical perspective approach assists nurses to give high-quality care at the individual level while also working at the macro level to address the manufacturers of illness. New research questions emerge from this combination of perspectives with new possibilities for theory development, a transformation in nursing education, and the potential for new practice strategies that can address individual client and larger system problems through empowerment of clients and nurses.

Development of a theoretical construct for risk and vulnerability from six empirical studies.

The concepts of risk and vulnerability are frequently the subject of nursing scholarship but lack semantic and conceptual clarity in the nursing literature. Using empirical evidence from 6 research studies, the authors define the concepts of risk and vulnerability, apply shared definitions to each of the study populations, and discuss 3 types of responses to risk observed in the research setting. This collaborative effort by nursing scholars advances conceptual clarity of risk and vulnerability for the development of nursing knowledge. Further, the examination of risk responses has the potential to link the various perspectives of risk and vulnerability common in nursing and generate nursing practice implications explored in this review.