Exploring Lived Experiences of Married Pakistani Women Post-Mastectomy.

OBJECTIVE: This qualitative descriptive exploratory study aimed to explore the lived experiences of married Pakistani women, 2 years post-mastectomy. METHODS: Twelve participants were recruited through purposive sampling from outpatient oncology clinic from a tertiary care hospital in Pakistan. Interviews were audio-taped and transcribed, and then themes and sub-themes were identified. RESULTS: Women verbalized a range of their experiences throughout the span from diagnosis to mastectomy. One over arching theme, quality of life and four main themes and their subthemes emerged from the data. Following are the themes; from history to diagnosis, worries, coping strategies, and recommendations. CONCLUSIONS: The study findings revealed that effective coping strategies were beneficial for these women, as these women coped well after being diagnosed with breast cancer. Strong recommendations were made by the participants for the formulation of support groups, which could help them reduce their anxiety through information exchange.

Psychobiobehavioral Model for Preterm Birth in Pregnant Women in Low- and Middle-Income Countries.

Preterm birth (PTB) is a final common outcome resulting from many interrelated etiological pathways; of particular interest is antenatal psychosocial distress (i.e., stress, anxiety, and depression). In LMI countries, both exposure to severe life stressors and rate of PTB are on average greater when compared with high-income countries. In LMI countries women are exposed to some of the most extreme psychosocial stress worldwide (e.g., absolute poverty, limited social resources). High prevalence of antenatal stress and depression have been observed in some studies from LMI countries. We propose a psychosocial, biological, and behavioral model for investigating the complex multisystem interactions in stress responses leading to PTB and explain the basis of this approach. We discuss ethical considerations for a psychosocial, biological, and behavioral screening tool to predict PTB from a LMI country perspective.

Prolonged-stay patients in the PACU: a review of the literature.

The postanesthesia care unit (PACU) provides general to intensive care to immediate postsurgical patients. Patients with extensive surgeries are often kept in PACU until their condition is stabilized before shifting them to their designated wards, creating more demands on PACU nurses. A prolonged patient stay in a PACU is a crucial issue as it creates bottlenecks that may result in the slowing down of the surgical schedule, leading to dissatisfaction for surgeons, nurses, patients, and their families. A literature search was undertaken to understand the definition and causes of prolonged PACU patient stay and the impact of these prolonged stays on PACU function and flow. Limited studies discuss the impact of prolonged PACU stays on patients, families, and PACU nurses. Future research is required to explore the experiences of PACU nurses related to prolonged-stay patients.

A review of postpartum depression, preterm birth, and culture.

Postpartum depression (PPD) varies worldwide and is considered a serious issue because of its devastating effects on mothers, families, and infants or children. Preterm birth may be a risk factor for PPD. In 2005, the global incidence of preterm birth was estimated to be 9.6%, and of these births, 85% occurred in Africa and Asia. Among Asian countries, Pakistan has a preterm birth rate of 15.7% and the highest prevalence rate of PPD (63.3%). A literature review was therefore undertaken to better understand the potential contribution of preterm birth to PPD and to identify gaps in the scientific literature. Limited studies compare prevalence rates of PPD in mothers of full-term infants and mothers of preterm infants. Furthermore, meta-analyses examining predictors of PPD have not included preterm birth as a variable. The interrelationship between preterm birth and PPD may be explained by early parental stress and mother-infant interaction among mothers of preterm infants. Culture plays an important role in shaping communication between mothers and their infants and defines social support rituals that may or may not mediate PPD. More research is needed to provide evidence for practice.

Experiences of nurses related to prolonged-stay patients in a postanesthesia care unit in Karachi, Pakistan.

The role of the postanesthesia care unit (PACU) is to provide short-term monitoring of patients after surgery until recovery from anesthesia. The transfer of patients from the PACU to their designated units, however, may be delayed for various reasons. A qualitative descriptive approach was used to explore the experiences of six nurses working in the PACU at a tertiary care hospital in Pakistan. Data were collected using semistructured interviews. The data were grouped into categories and subcategories. An overarching theme that was derived from the content analysis was that of the factors impacting quality patient care. The content analysis generated a broad category of "general effects" and subcategories that included patients, families, and PACU nurses. The findings highlight the effects of prolonged PACU stays on patients, their families, and PACU nurses.

Resilience in Afghan children and their families: a review.

Resilience enables individuals to survive the horrors of war and other such tragedies. This article draws on personal reflections of living in the post-Taliban period in Afghanistan and a review of the literature to explore resilience processes that may be present in the Afghan population. Adverse factors that Afghan children and families face include: destruction of infrastructure, danger, traumatic experiences, post traumatic stress disorder, political and ideological commitment. The protective factors that may have enabled them to survive, and subsequently rebuild in the face of multiple challenges are absolute faith in Allah (God), family support and community support. Understanding more about the kinds of adversities they face and the nature of their protective processes gives healthcare professionals a basis for working with them to improve their health and wellbeing.

Defining the cultural milieu for implementing faculty practice in Pakistan.

Faculty practice can promote a collaborative partnership mutually beneficial to both nursing education and service. However, little is known about its implementation in developing countries. The purpose of this study was to explore the potential for introducing faculty practice within the cultural milieu of Karachi, Pakistan. Focus groups of nursing faculty, staff and students were conducted in various settings: government, semigovernment and private institutions to elicit the data. Data analysis revealed that a more comprehensive definition of faculty practice is needed that will provide the foundation for a culturally acceptable model of faculty practice in Pakistan. Hierarchy dominates the current cultural milieu and must be addressed before faculty practice can be implemented.