Nursing in transition in Kyrgyzstan.

Nursing practice and nursing education in Kyrgyzstan are described in this article. Since the breakup of the Soviet Union and the establishment of independence in 1991, health care in Kyrgyzstan has deteriorated. In response to the Manas Health Care Reform program initiated in 1996, nursing education is being upgraded and nurses are being retrained throughout the country.Comparisons of nursing education in Kyrgyzstan with the U.S. and Soviet programs are discussed. Challenges in upgrading nursing education to meet international standards and in obtaining an advanced degree in nursing are explained.

Breastfeeding as health-promoting behaviour for Hispanic women: literature review.

AIM: This paper reports a literature review to synthesize the evidence that breastfeeding is a health-promoting behaviour for Hispanic women and to demonstrate the usefulness of the Health Promotion Model in understanding and increasing breastfeeding behaviours in Hispanic women. BACKGROUND: While breastfeeding has been shown to promote the health of both mother and infant, it has not been widely viewed from the perspective of the Health Promotion Model. METHODS: The CINAHL and MEDLINE databases were searched using the terms 'Hispanic' or 'Latina', 'breastfeeding' and concepts specific to the Health Promotion Model (interpersonal relationships, social support, acculturation, self-efficacy, barriers, benefits, and commitment). Only papers in the English language from 1990 to 2003 (except for classic papers) that used research techniques were reviewed. Only those addressing breastfeeding intention, initiation or duration were included. The reference lists of each paper were examined for additional empirical papers that linked any of the determinants of the Health Promotion Model to breastfeeding among Hispanic women. Papers were organized using the ten determinants as headings: prior related behaviour, personal factors, perceived benefits, perceived barriers, perceived self-efficacy, activity-related affect, interpersonal influences, situational influences, immediate competing demands, and commitment to a plan of action. The review was conducted in 2003. FINDINGS: The literature verifies that each of the 10 determinants of health-promoting behaviour also promotes breastfeeding for Hispanic women, particularly through the constructs of acculturation, interpersonal support, self-efficacy and immediate competing demands. Breastfeeding is not consistently defined in all studies, nor are Hispanic population groups uniformly classified according to country of origin. Specific interventions to promote breastfeeding have been implemented for women of Latin American origin, but randomized designs to measure outcomes have not been consistently employed with Hispanic women in the United States of America. Further intervention research is needed to confirm breastfeeding as a health-promoting behaviour and to inform breastfeeding education for this group.

Development and testing of a prenatal breastfeeding education intervention for Hispanic women.

Many immigrant Hispanic women in the United States choose to bottle-feed rather than breastfeed. This article describes an intervention that was developed and tested in a two-step process. Two studies were undertaken. First, a qualitative inquiry explored the breastfeeding beliefs, attitudes, meanings, and practices of Hispanic women. Results informed the design of a culturally appropriate prenatal breastfeeding education intervention. Secondly, the researchers undertook a quantitative study of the intervention's success in increasing breastfeeding duration among Hispanic women. Methodology and findings of this study have implications for future interventions that promote breastfeeding.

Building transcultural knowledge through intercollegiate collaboration.

Although the importance of providing culturally congruent care is widely recognized among nurses, many nurses lack the skill and knowledge necessary to successfully provide culturally competent care. Nursing programs need to better prepare students in transcultural nursing. This article describes an innovative collaborative learning activity that was implemented between two different nursing programs in different states aimed at improving students' transcultural knowledge. Students worked in small groups and used the Internet to collaborate on case studies that focused on transcultural health care issues. Responses collected by anonymous evaluations at the end of three semesters identified both strengths and weaknesses of the project. Results and suggestions for improvement are reported.