Bridging the Atlantic: Optimizing the health of vulnerable community aggregates through international student exchange.

BACKGROUND: A growing diversity of cultures globally has intensified the need to educate health professionals to deliver safe, effective, and culturally appropriate care. Collaboration among global partners and development of cultural competence in nursing students in distant communities is one pedagogy to address competencies. CONTEXT: Universities in the United States (US) and Portugal established a bi-directional student exchange to foster professional relationships, enhance cultural awareness, identify health and health care roles from a global perspective, and explore collaborative research opportunities to address the health needs of vulnerable aggregates in both countries. ACTIVITIES: Students from each country are paired to work collaboratively with faculty on research or health promotion projects, visit health care facilities, participate in university classes, language instruction, visit cultural and points of interest, and disseminate new knowledge. OUTCOMES: Students expressed an understanding of cultural differences and health care systems, reconsidered the role of community nurse, integrated theory into practice, and experienced peer mutual learning. A framework to organize philosophies related to a student exchange was developed. FUTURE DIRECTIONS: Forthcoming student exchanges are being planned. Work in previous exchanges allows for sustainability and a growing body of research and health promotion activities focused on impacting vulnerability in like communities in different countries. CONCLUSIONS: A shared vision of exchange, student involvement, multi inter-institutional research, perceived relevance of work with vulnerable groups, and improved ties between local and international community agencies allows for project sustainability. Student exchanges with vulnerable groups in communities provide a catalyst to promote heightened awareness of these aggregates.

Self-perceived health and quality of life among Azorean deportees: a cross sectional descriptive study.

BACKGROUND: Immigration policies can cause significant public health consequences, posing detrimental social and health effects for migrants, their families and communities. Migrants often face obstacles to health due to access, discrimination, language and cultural barriers, legal status, economic difficulties, social isolation, and fear of deportation. The process of deportation has become more rapid and frequent in the U.S. with inadequate health information in the literature regarding this relocated population post-deportation. The PROMIS(®) Global Health Short Form was used to measure the self-reported QOL, physical and mental health of male deportees from the US to Portugal from 2009 to 2013. FINDINGS: Twenty five males aged 28-64 years who had been deported from the US to Portugal participated in the study. Overall, their EuroQol, Global Physical Health and Global Mental Health Scores were below the established tool mean, with self-reported mental health having the lowest score. Age, marital status, length of time in the US prior to deportation, and length of time since deportation may impact the well-being of deportees post deportation. CONCLUSIONS: Study results suggest the deportees in this study were less healthy than the general population. Future research and tailored initiatives regarding the overall health of deportees, with a focus on quality of life and mental health should be conducted to better understand their impact on reintegration. Overall study scores were lower than mean tool scores indicating the need for more research in this vulnerable group to support clinical practice and health policy to improve their overall QOL and health through intervention work.

[Project evidência [evidence]: research and education about accessing scientific databases in Azores]. / Projeto Evidência: investigação e formação sobre acesso a bases de dados de informação científica nos Açores.

Project Evidência [Evidence] intends to promote the use of scientific databases among nurses. This study aims to design educational interventions that facilitate nurses' access to these databases, to determine nurses' habits regarding the use of scientific databases, and to determine the impact that educational interventions on scientific databases have on Azorean nurses who volunteered for this project. An intervention project was conducted, and a quantitative descriptive survey was designed to evaluate the impact two and five months after the educational intervention. This impact was investigated considering certain aspects, namely, the nurses' knowledge, habits and reasons for using scientific databases. A total of 192 nurses participated in this study, and the primary results indicate that the educational intervention had a positive impact based not only on the increased frequency of using platforms or databases of scientific information (DSIs) s but also on the competence and self-awareness regarding its use and consideration of the reasons for accessing this information.

Projeto Evidência: investigação e formação sobre acesso a bases de dados de informação científica nos Açores / Project evidência [evidence]: research and education about accessing scientific databases in Azores / Proyecto evidencia: investigación y formación sobre acceso a bases de datos de información científica en las Azores

O projeto Evidência visa estimular os enfermeiros na utilização das bases de dados de informação científica. Este estudo teve por objetivos desenhar uma intervenção formativa facilitadora do acesso a essas bases de dados por parte dos enfermeiros, efetuar avaliação de diagnóstico relativamente aos hábitos dos enfermeiros quanto a esse tipo de ferramenta e determinar o impacto de uma intervenção formativa sobre essas matérias entre os enfermeiros residentes nos Açores. Em termos metodológicos, foi desenhado um projeto de intervenção e realizado um estudo quantitativo, do tipo descritivo, para avaliar esse impacto aos dois e cinco mêses após a formação, em dimensões como o conhecimento, hábitos e objetivos de utilização. No projeto participaram 192 enfermeiros, e os resultados apontam para um impacto positivo dessa formação, não só no aumento da frequência de utilização das bases de dados de informação científica, como na autopercepção de competência na sua utilização e motivos invocados para explorar esse tipo de informação.

Project Evidência [Evidence] intends to promote the use of scientific databases among nurses. This study aims to design educational interventions that facilitate nurses' access to these databases, to determine nurses' habits regarding the use of scientific databases, and to determine the impact that educational interventions on scientific databases have on Azorean nurses who volunteered for this project. An intervention project was conducted, and a quantitative descriptive survey was designed to evaluate the impact two and five months after the educational intervention. This impact was investigated considering certain aspects, namely, the nurses' knowledge, habits and reasons for using scientific databases. A total of 192 nurses participated in this study, and the primary results indicate that the educational intervention had a positive impact based not only on the increased frequency of using platforms or databases of scientific information (DSIs) s but also on the competence and self-awareness regarding its use and consideration of the reasons for accessing this information.

El proyecto Evidencia procura estimular al enfermero a utilizar bases de datos de información científica. Se objetivó ejecutar una intervención formativa para facilitar el acceso a tales bases por parte de enfermeros, efectuar evaluaciones de diagnóstico relativas a hábitos del enfermero respecto de dichas herramientas y determinar el impacto de una intervención educativa sobre el tema entre enfermeros residentes en las Azores. En términos metodológicos, fue diseñado un proyecto de intervención y realizado un estudio cuantitativo y descriptivo, para evaluar ese impacto a los dos y cinco meses luego de la formación, en dimensiones como conocimiento, habitualidad y objetivos de utilización. Participaron 192 enfermeros. Los resultados expresan un impacto positivo de la formación, no sólo en el aumento de frecuencia de utilización de bases de datos, sino también en la autopercepción de competencia en el uso y motivos expresados para abordar este tipo de información.

Rigour in phenomenological research: reflections of a novice nurse researcher.

AIM: This paper is intended to explore conflicts and doubts that novice researchers face when using phenomenological research methods, especially with regard to methodological rigour. BACKGROUND: There is an increasing interest in different qualitative approaches. The best way to evaluate the quality of qualitative studies has been debated intensively. The great theoretical and methodological diversity of qualitative approaches suggests that a single set of criteria may not be appropriate for all types of research. REVIEW METHODS: This is a methodological paper that discusses a personal experience of addressing rigour in a phenomenological study, supported by literature on the topic. DISCUSSION: Generic qualitative criteria may not be the most adequate to ensure rigour in phenomenological research. The different poles of discussion about the best way to ensure validity of phenomenological research puzzle novice nurse researchers. CONCLUSION: Focusing on integrative validity that addresses experiential and methodological concerns ensures that researchers will respect the philosophical assumptions underlying a method and allows them to recognise study soundness in the findings and the research process. IMPLICATIONS FOR RESEARCH/PRACTICE: Phenomenological research must demonstrate methodological congruence and provide meaningful results about lived experiences in a balanced way. Novice researchers need support to understand the articulation between philosophical and methodological foundations that guide the methods they use.

Sudden informal caregivers: the lived experience of informal caregivers after an unexpected event.

AIM: The purpose of this qualitative study was to understand the lived experience of individuals taking on the role of informal adult caregivers after an unexpected event involving a relative. BACKGROUND: The literature on the development of the role of informal caregivers widely recognises that protecting and promoting the quality of life of caregivers should be a priority for health professionals. However, knowledge about how individuals develop as sudden caregivers is scarce, with existing knowledge centring mainly on the physical aspects of caregiving. What it means to become a caregiver or to experience role redefinition remains largely unclear. DESIGN: Hermeneutic phenomenology provided the framework that guided this study. METHODS: Unstructured interviews were used for collecting data. We used Van Manen's approach to analyse data and to reveal themes. Reflexivity and collaborative analysis were used to address rigour. RESULTS: From caregivers' interviews (n = 14), four main themes were identified: losing control over time, feeling alone, failing expectations and taking over someone else's life. CONCLUSIONS: The caregiving experience is characterised as a transition process or a period of ongoing focussing and de-focussing. The extent to which caregivers feel connected with others, redefine their personal use of time and feel comfortable with their new responsibilities indicates how they are managing this transition and how well they are achieving balance in their new role, i.e. from feeling 'exclusively' a caregiver to being 'also' a caregiver. RELEVANCE TO CLINICAL PRACTICE: Facilitating successful transitions is within the scope of the role of professional nurses. Information about the meaning that caregivers attribute to their experience - relationships, options and strategies - is crucial, as it will help nurses to plan, assess and design adequate nursing interventions to support informal caregivers, especially in unexpected situations.