Nursing Research in Arab Countries: Current Status, Trends, Challenges, and Opportunities.

Introduction: Twenty-two Arab countries comprise the League of Arab States. While united in Arab identity, diversities among these countries exist at many levels. Conducting and publishing research in the Arabic speaking countries is an essential pillar for improving the status of the nursing profession. Purpose: The purpose of this study is to assess the current status, trends, challenges, and opportunities of nursing research in Arab countries. Methodology: An integrative review was conducted using (1) Index Medicus for the Eastern Mediterranean Regional Office Database Journals Directory (IMEMR), (2) the Iraqi Academic Scientific Journals Database (IASJD), (3) Ulrichsweb (UW), (4) The Geneva Foundation for Medical Education and Research/Middle Eastern Journals (GFMER), (5) the Nursing Journal Directory (NJD), (6) the Directory of Open Access Journals (DOAJ), and (7) Google Scholar. Journals and articles that met inclusion criteria were accessed, retrieved, reviewed, and subjected to content analysis by three authors, two of which were fluent in English, French, and Arabic languages. A third author fluent in all three languages confirmed the findings. Results: Nursing research in Arabic-speaking countries has evolved over the past decades but is still lacking compared to global nursing research. Moreover, it was found to be largely situated within academic institutions and linked to tenure and promotion requirements. Conclusion: Nursing journals in Arabic-speaking countries do not adequately represent that overall region and are limited in access.

Evaluating the Impact of an Educational Intervention on Hepatitis C Screening in a Midwest Regional Psychiatric Unit.

INTRODUCTION: Affecting more than 3.9 million Americans, the hepatitis C virus (HCV) attacks the liver by causing inflammation. Left untreated, HCV can lead to serious consequences. Targeting high-risk individuals in the inpatient psychiatric setting can lead to increased testing and referral. AIMS: This quality improvement project determined whether an intervention-consisting of a pretest, educational session, posttest, and screening implementation-increased staff knowledge about HCV screening recommendations, identified at-risk individuals, and increased the number of patients screened and referred for treatment. METHOD: An online HCV educational session was provided to 30 staff at a Midwest regional psychiatric unit. An online pre/posttest was conducted to determine staff knowledge and understanding prior to and after the educational session. An HCV screening tool checklist was incorporated into the electronic health record (EHR) system. A 3-month pre/post-intervention chart review was completed to determine the number of patients identified and screened for HCV. RESULTS: A comparison of the 30 staff members' mean pre/posttest scores were calculated using an unpaired t test, showing a prescore mean of 55.15 ± 19.09 and a postscore mean of 85.75 ± 13.44, p < .001. A chi-square analysis indicated that there was a statistically significant post-intervention increase in the percentage of high-risk patients identified (5.6%-36.4%, p < .001) and screened (5.6%-31.4%, p < .001) for HCV compared with pre-intervention. CONCLUSION: The study intervention increased staff knowledge of HCV guidelines and the number of at-risk patients identified and screened for the disease.

An Ethnohistory of the Transcultural Nursing Scholars and Their Contributions to the Field.

Introduction: The Transcultural Nursing Society (TCNS) recognizes transcultural nursing (TCN) scholars for creative leadership and advancing education, practice, research, and administration. The purpose of this study was to discover the historical context of scholars' professional growth and development and their contributions to and future vision for transcultural nursing. Method: Leininger's Ethnonursing Research Method was used to develop an ethnohistorical qualitative approach that included a semistructured, open-ended interview guide and data analysis plan. Data were analyzed using NVivo software and Leininger's Phases of Ethnonursing Data Analysis Enabler for Qualitative Data. Results: Analysis resulted in the discovery of five themes and 15 patterns related to the sources of scholars' interest in TCN; professional development strategies; contributions to TCN theory development, education, research, practice, service, and consultation; the responsibilities of being a TCN scholar; and their future vision for TCN. Discussion: These findings could inspire and guide TCN scholars as they pursue the study and practice of TCN.

Culturally Congruent Care From the Perspectives of Judaism, Christianity, and Islam.

Introduction: Judaism, Christianity, and Islam are three world religions that occupy much of the world stage in health care, journalism, and media. Nurses frequently provide care for representatives of these groups. Culturally competent nurses recognize that there are differences and similarities within and between these religions. Methodology: This article incorporates findings from a scholarly review of the literature and transcultural nursing/health care principles and is guided by Leininger's Culture Care Diversity and Universality Theory. It discusses the roots from which these religions emerged, and the similarities and differences in religious beliefs and practices as pertained to health care. Conclusion: Nurses and other health care professionals may use knowledge presented in this article to conduct individualized cultural assessments and provide culturally congruent health care to Jewish, Christian, and Muslim populations. Leininger's three culture care modes of decisions and actions offer a creative approach to providing meaningful and helpful culturally sensitive care.

Use of an educational intervention to increase screening for antenatal depression in an obstetrics and gynecology practice.

BACKGROUND: Depression affects approximately 12% of pregnant women and increases maternal and fetal risk during pregnancy and the postpartum period. The United States Preventative Services Task Force and the American College of Obstetricians and Gynecologists recommend that all prenatal care include depression screening. This study assessed the effectiveness of an educational intervention to increase screening for depression during prenatal care. LOCAL PROBLEM: The clinical site serves a socioeconomically and culturally high-risk population. Prior to the intervention, prenatal depression screening was not incorporated into prenatal care. METHODS: Health records of patients presenting for prenatal care to an obstetrics and gynecology clinic were analyzed before an educational intervention on prenatal depression was delivered to providers at the practice site. Data for prenatal depression screening rates, treatment plans, and patient demographic information were extracted and compared to determine compliance with antenatal depression screening guidelines. INTERVENTIONS: The primary intervention of this initiative is the provision of education on the importance of and techniques for prenatal depression screening, diagnosis, and treatment. RESULTS: Prenatal depression screening increased from 0% to 27% of patients following the intervention. No significant correlation was found between factors of age, gestational age, gravidity, parity, or marital status. A total of 2.8% of screened patients scored positive for severe depression, 5.7% indicated moderate depression, and 51% indicated mild depression. CONCLUSIONS: Education and training improves provision of prenatal depression screening, but further work is needed to improve the accurate and timely identification of depression, as well as its appropriate treatment, referral, and follow-up.

Leininger's Ethnonursing Research Method: Historical Retrospective and Overview.

A historical overview and evolution of Leininger's ethnonursing research method (ERM) is presented along with descriptions of the method's purpose, goal, terminology, and enablers. A succinct guide to using ERM is provided to assist novice and seasoned researchers, as well as mentors and educators, in teaching, mentoring, advising, and/or conducting ethnonursing research studies. Criteria for evaluation of qualitative research studies, such as the ERM, are highlighted.

Leininger's Theory of Culture Care Diversity and Universality: An Overview With a Historical Retrospective and a View Toward the Future.

An historical overview of Leininger's Theory of Culture Care Diversity and Universality also known as the Culture Care Theory (CCT) and evolution of the Sunrise Enabler are presented along with descriptions of the theory purpose, goal, tenets, basic assumptions, major core constructs, and orientational definitions. Recent articles, books, and book chapters provide relevant exemplars to enhance scholarly understanding and application of theory constructs. Proposed future directions encompass using the CCT to guide research of discovery and translational research projects for evidenced-based nursing practice; develop nursing courses and curricula to prepare culturally competent nurses; guide future culturally competent administrative and leadership policies and procedures; inform public policy related to cultural diversity and underserved populations; promote grant writing initiatives to enhance cultural diversity in hiring nursing staff, supervisors, and faculty; and promote admission of nursing students from underserved and/or diverse backgrounds.

Using Transcultural Nursing Education to Increase Cultural Sensitivity and Cultural Assessment Documentation by Staff in an In-Home Chronic Disease Self-Management Program.

BACKGROUND: Despite literature indicating that culturally sensitive care promotes a positive patient environment and may help improve outcomes, limited data exist on the documentation of patients' cultural concerns in electronic medical records (EMR). OBJECTIVE: The project's objective was to use an educational intervention to increase clinic staff's cultural sensitivity and cultural assessment documentation. METHODS: Researchers conducted this 3-month project at a Midwestern clinic's in-home, self-care chronic disease management program. The voluntary sample of clinical staff (n = 8) received an educational intervention on transcultural nursing practices. Researchers administered the Transcultural Self-Efficacy Tool for the Multidisciplinary Healthcare Provider (TSET-MHP) to participants before and after the intervention. A pre- and postintervention EMR audit was completed on 128 charts to evaluate cultural assessment documentation. RESULTS: TSET-MHP cognitive and practical subscales scores increased postintervention. Affective subscales scores decreased slightly. Electronic cultural assessment documentation increased by 10%. An assessment questionnaire showed an increase in participants' cultural self-awareness and comfort with cultural assessment. CONCLUSIONS: An educational intervention demonstrated an increase in providers' cultural awareness and cultural assessment documentation. IMPLICATIONS FOR NURSING: Transcultural nursing education may help increase providers' perceived cultural self-efficacy, which may improve cultural assessments and culturally competent care.

An Intervention to Improve Cultural Competence in Graduate Nursing Education.

Noting the small number of studies on the influence of an entire curriculum on graduate nursing students' cultural competence, the researchers examined the effect of a curricular intervention using a pretest-posttest design. The study, conducted from 2012 to 2014, focused solely on the Doctor of Nursing Practice program at a midwestern university. Results from a pre- and postintervention faculty curriculum survey indicated that the percentage of courses including a cultural competence objective increased from 65 percent to 81 percent. Results from the pre- and postintervention administration of the Transcultural Self-Efficacy Tool showed a statistically significant improvement in students' overall score and three subscale scores.

Uncovering the mask of borderline personality disorder: knowledge to empower primary care providers.

PURPOSE: This manuscript will provide a review of the literature and a report on the findings of a qualitative study that explored the lived experiences of people with borderline personality disorder (BPD). It also offers resources designed to empower healthcare professionals to provide timely and accurate referrals, diagnosis, or collaborative management of BPD in primary care. DATA SOURCES: Review of the literature examining background, epidemiology, pharmacotherapy, psychotherapy, and available resources regarding BPD. Content analysis conducted on data obtained from 1109 postings on three different public online forums/blogs specifically for BPD. CONCLUSIONS: BPD is characterized by unstable moods, behaviors, and relationships. While navigating a healthcare system fraught with health disparities, BPD sufferers may have their feelings of abandonment and hopelessness reinforced. Four core themes emerged (a) a reliance on online blogging to cope; (b) a quality of life that is impacted by debilitating effects of condition; (c) coping mechanisms that encompass healthy and destructive measures; and (d) social injustices that include stigmatization, prejudice, delayed diagnosis, misdiagnosis, limited healthcare access, and lack of cure. IMPLICATIONS FOR PRACTICE: Knowledgeable, nonjudgmental primary healthcare providers can play a key role in providing BPD sufferers and their loved ones with accurate and timely diagnosis, referral, treatment, resources, and support. Internet blogging may have important implications in care.

Silent no more! The lived experiences of women with lichen sclerosis.

PURPOSE: Lichen Sclerosis (LS) is an often unrecognized and misdiagnosed chronic inflammatory skin condition of the anogenital area that affects quality of life, bringing severe discomfort and distress to affected men, women, and children. The purpose of this qualitative study is to explore the lived experiences of women with LS. DATA SOURCES: Content analysis was conducted of data obtained from three public online forums/blogs used by women with LS. A total of 527 postings/entries were analyzed for patterns and themes by four researchers. CONCLUSIONS: Five core themes emerged as a result of this study, revealing feelings of frustration and despair stemming from healthcare providers' lack of knowledge in relation to Lichen Sclerosis, often leading to misdiagnosis, prolonged suffering, and an altered quality of life. IMPLICATIONS FOR PRACTICE: Knowledgeable healthcare providers and additional research into the cause, treatment, and cure of Lichen Sclerosis are needed. Advance-practice nurses stand to play an important role in the areas of education, research, policy making, and clinical practice to advocate for and empower women with LS.

Bridging generic and professional care practices for Muslim patients through use of Leininger's culture care modes.

The purpose of this article is to provide knowledge of traditional Muslim generic (folk) care beliefs, expressions and practices derived from research and descriptive sources, in order to assist nurses and other health care professionals to integrate generic (folk) into professional care practices. Muslim generic (folk) care beliefs and practices related to the caregiving process, health, illness, dietary needs, dress, privacy, modesty, touch, gender relations, eye contact, abortion, contraception, birth, death and bereavement were explored. A discussion involving the use of Leininger's culture care preservation and/or maintenance, culture care accommodation and/or negotiation and culture care repatterning and/or restructuring action modes to bridge the gap between generic (folk) and professional (etic) care practices and to consequently promote culturally congruent care is presented.