Sustaining hope: A narrative inquiry study exploring midwives' hope-focused practices in HIV care in Ghana.

HIV remains a statistically significant issue for women of childbearing age in Ghana. Nurses and midwives form the backbone of care providers for the prevention of mother-to-child transmission programmes. However, nurses and midwives receive little support to provide the emotional aspects of HIV/AIDS care. AIM: Our aim was to build an understanding of how midwives currently embrace their experience of hope and hoping to support mothers living with HIV. DESIGN: This is narrative inquiry study. METHODS: We engaged in two to three conversations with five midwives in rural settings in Ghana to understand their experiences of hope and hoping in their interactions with mothers living with HIV. Using the narrative inquiry common places of temporality, the social and personal, and space/place, we wrote narrative accounts for each participant and then searched for resonances across the narrative accounts. RESULTS: We highlight three emerging narrative threads that resonated across narrative accounts. The three emerging narrative threads were (1) sustaining hope by drawing on life experiences across time and place; (2) hope is sustained through a focus on relational engagement with mothers; (3) midwives embrace the possibility to learn more about hope-focused practices. CONCLUSION: The midwives began, although tentatively, to shine light on the things and events that diminished their abilities to maintain a hopeful perspective. At the same time, they became more comfortable and familiar with the notion of making hope visible and accessible in their experiences. IMPACT: Since the midwives welcomed additional support to cope with the challenges they were experiencing, we imagine one day being able to make sense of how nurses and midwives engage with a narrative pedagogy of hope. Including hope-focused practices in nursing and midwifery preservice and in-service opportunities is important. PATIENT OR PUBLIC CONTRIBUTION: There was no direct patient or public involvement in this study.

Sustaining hope: A narrative inquiry into the experiences of hope for nurses who work alongside people living with HIV in Ghana.

Aim: In this research, we explored how nurses working in HIV care in Ghana live and work with hope. Background: Nurses who work with people living with HIV have concerns about their well-being and quality of life. They also complain of stress-related workload due to high nurse-patient ratio. The study sought to examine the experiences of nurses in Ghana and the ways that hope is intertwined with their experiences in working with people living with HIV. Design: This study was a narrative inquiry study. Narrative inquiry is a collaborative way to inquire into participants' experiences in the three-dimensional spaces of temporality, sociality and place. Methods: We engaged with five nurses who work in an acute care setting where their primary focus is to provide care to people living with HIV. We engaged in six to eight conversations with each participant over several months. We asked participants to describe memories of significant experiences in their past and present lives, and share experiences that they would describe hopeful in their HIV nursing practice. Results: In this narrative inquiry study, four resonant threads emerged and included: (a) becoming a nurse for people living with HIV took time; (b) experiences of practising with hope were important; (c) faith in God, allowed them to gain strength, which was connected to hope; and (d) learning to live with hope was shaped by childhood experiences.

A scoping review of bereavement service outcomes.

OBJECTIVE: This scoping literature review, through finding and assessing researched bereavement service outcomes, sought to determine the state of bereavement services evaluation, to catalogue service types, and to identify which service or services, if any, demonstrate clear evidence of effectiveness. METHOD: Our methods included: (1) a literature search for published English-language research articles from 2005-2015; (2) critical appraisal of articles to identify findings; (3) compilation of findings; and (4) determination of the relevance of our findings. RESULTS: Some 38 papers were found, and all were retained to identify the outcomes researched and research findings. Many different outcomes were studied in the 18 quantitative, 11 qualitative, and 9 mixed-methods investigations undertaken worldwide. Ten studies focused on level of grief, six on stress/distress level, six on grief knowledge, six on level of depression, and five on somatization or physical symptoms. Most commonly, a group of bereavement services was evaluated as a whole, followed by group therapy, individual counseling, written information, and other less common services. No group of services or individual service was determined to yield clear and convincing evidence of effectiveness. Regardless, all but one service were shown to have value-most often related to gaining grief information and/or emotional support. Until high-quality research studies have repeatedly revealed evidence of effectiveness, it is possible that the positive outcomes of bereavement services will be largely based on bereaved people receiving helpful educational information and emotional support from organizations and people prepared to help them. SIGNIFICANCE OF RESULTS: This project outlines existing bereavement service types and the state of science in relation to determination of outcomes. It offers suggestions to advance the state of science to validate or refine bereavement services. It brings to light the issue that bereavement service outcomes need to be carefully researched so that evidence can drive service refinement and expansion. It also highlights the importance of effective bereavement services.

Attracting and retaining nurses in HIV care.

Attracting and retaining nurses in HIV care is essential to treatment success, preventing the spread of HIV, slowing its progression, and improving the quality of life of people living with HIV. Despite the wealth of studies examining HIV care, few have focused on the factors that influenced nurses' choices to specialize in HIV care. We examined the factors that attracted and retained eight nurses currently working in HIV care in two large Canadian cities. Participants were primarily women between the ages of 20 and 60 years. Interviews were conducted between November 2010 and September 2011 using interpretive description, a qualitative design. Factors that influenced participants to focus their careers in HIV care included both attracting factors and retaining factors. Although more research is needed, this exploration of attracting and retaining factors may motivate others to specialize in HIV nursing, and thus help to promote adequate support for individuals suffering from the disease.