Facilitating and Managing Transitions: An Imperative for Quality Care

Being admitted to a hospital, preparing for discharge, receiving a chronic illness diagnosis, transferring from intensive care to regular care, moving to a nursing home, receiving a grave diagnosis, losing a family member, facing an environmental disaster, graduating and starting a new professional position­all of these scenarios may appear different, but ask yourself, what might they all have in common? They are all changes that trigger a transition process. While change is an event or a situation that is well defined and static in time, transition is a process with a range of responses. During transitions, individuals, families and communities experience unfamiliar environments, sensations and emotions, and confront different levels of uncertainty about what may come next. They may have expectations, realistic or uninformed, and experience disruptions in their daily lives and routines, all of which are influenced by and affect their health and wellbeing.

Ser admitido en un hospital, prepararse para el alta, recibir un diagnóstico de enfermedad crónica, pasar de cuidados intensivos a cuidados regulares, mudarse a un asilo de ancianos, recibir un diagnóstico grave, perder a un miembro de la familia, enfrentar un desastre ambiental, graduarse y comenzar un nuevo posición profesional: todos estos escenarios pueden parecer diferentes, pero pregúntese, ¿qué podrían tener en común? Todos son cambios que desencadenan un proceso de transición. Si bien el cambio es un evento o una situación bien definida y estática en el tiempo, la transición es un proceso con un rango de respuestas. Durante las transiciones, los individuos, las familias y las comunidades experimentan entornos, sensaciones y emociones desconocidos, y enfrentan diferentes niveles de incertidumbre sobre lo que puede ocurrir a continuación. Pueden tener expectativas, realistas o desinformadas, y experimentar interrupciones en sus vidas y rutinas diarias, todas las cuales están influenciadas por su salud y bienestar y las afectan.

The undeaning transition: Toward becoming a former dean.

Stepping up from leadership is a protracted transition that involves a complex set of interactions with many constituents. It begins with making the personal decision to step up to integrating the role of the dean in existing repertoire of roles that the person enacts. Deliberate planning, awareness of phases, challenges, goals and strategies, clear communication, transparency, and supportive interactions enhance the potential of experiencing a smooth and a healthy transition for the dean who is stepping up, the incoming dean, and the organization. The beginning and the ending of the undeaning transition are not definitive, but indicators of a healthy transition could be identified along the way through disengagement from old roles, focused new interactions, engagement in new roles, redefinition of goals, and narratives and dialogues about topics that reflect a new set of goals. The nature of the role of former dean is developed through careful onboarding strategies for the new dean and interactions with a new set of constituents who perceive the dean as a former dean. There are five phases involved in undeaning. These are the decision, the search, the naming of the new dean, the exit, and reclaiming professorial voice.

Safe womanhood is not safe motherhood: policy implications.

The world continues to be unsafe for girls and women. Although natural disasters and man-made disasters make the world unsafe for all people, the gender divide further compromises safety of women. In addition to being at higher risk for violence, rape, trafficking, and abuse, women's injury and mortality increase because of the limited definition of the nature and type of work they do, the conditions that expose them to such infections as HIV/AIDS, the pregnancy and birthing cycles, as well as unsafe abortions, and because of the inadequacy and inaccessibility of health services. To enhance safe womanhood, not just safe motherhood for women, several urgent actions are outlined in this article.

Multiple role stress and patterns of coping of Egyptian women in clerical jobs.

Egyptian women are increasingly becoming a significant work force; however, many of these women continue to occupy low-income jobs. In the study reported here, 190 women in Egypt employed in clerical jobs were asked about the satisfaction and stress they experience in their work and maternal roles. They were also asked about their coping approaches and the demands in their daily lives. The Women's Role Interview Protocol was used to collect data. The results were analyzed within the symbolism of the Arab/Egyptian language using thematic and content analysis. A prevailing theme is the interconnectedness among all women's roles when describing their stress, satisfaction, and coping. Another major theme that transcends all roles is the perception of inequality and how it affects their daily lives. Emergent stressors were grouped under employment role stress, maternal role stress, marital role stress, and relational role stress. Women coped through learning to be self-reliant and by using cognitive and emotion-focused coping approaches. Women's stress was embedded in inequality in gender roles, and the women are empowered to cope through relying on endurance and outliving conflict.

Man works from sun to sun, but woman's work is never done: insights on research and policy.

Gender equity and equality in health and human development are key national and international goals. To achieve these goals, the androcentric definition of work needs to be addressed. The current definition is driven by the globalized capitalistic model, which equates "work" with generating income or the production of goods. Indeed, employment in the formal labor force has become the de facto definition of work. Women's work, unpaid and reflecting the gendered role of caring for others, does not fit the economic mold and is, therefore, devalued. The health and social welfare sectors rely heavily on the unremunerated work of women to reduce their budgets, ignoring the unequal burden of care shouldered by women worldwide. Research on women's health has also been hampered by the dichotomous nature of work as employment. Changing the definition of work to value explicitly women's work could significantly impact social, health, and research policies.

Grandmothers and women's health: from fragmentation to coherence.

There is a paucity of models that drive integrated research agendas, and coherent approaches to development and progress of knowledge about women's health. In this article, we review four major models of women's health, present conditions supporting more integrative and coherent models of women's health based on the recommendations by two international conferences, and address major paradoxes inherent in women's health areas. For integrative and coherent models of women's health, we propose to incorporate visions and insights of previous models in developing a more coherent model that includes three major components-integration, transition, and marginalization.

Ser e tornar-se saudável: o amâgo do conhecimento de enfermagem / Being and becoming healthy: the case of nursing knowledge

A saúde tem sido descrita como um conceito central, e como a meta da enfermagem. Discute-se aqui a incongruência que existe entre essa centralidade em enfermagem e em outras disciplinas, e a visäo sustentada pelo público. Outros assuntos e pontos de vista sobre saúde säo também considerados, incluindo diversidade e unidade na conceitualizaçäo de saúde, a natureza social e as obrigaçöes societárias voltadas à saúde do indivíduo, a falta de congruência entre as visöes conceitual e empírica de saúde, e a saúde conforme é vista em enfermagem e em âmbito internacional. Säo articuladas várias condiçöes a serem incluidas nas tentativas das enfermeiras no desenvolvimento teórico de saúde. A necessidade de se focalizar numa compreensäo das necessidades de cuidado de saúde manifestas por populaçöes desfavorecidas, a vantagem potencial de se usar um marco de referência feminista, e a integraçäo entre uma concepçäo estática de ser saudável e uma concepçäo de saúde que é um processo dinâmico de tornar-se, säo algumas das estratégias que podem ser usadas para desenvolver uma concepçäo contextual de saúde.