Background. Patient- or person-centred care (PCC) has become a core competency that healthcare professionals must develop to deliver high-quality care. PCC enhances positive patient perceptions of care, promoting patient safety and overall health outcomes. Yet, little is known about PCC from nurses who become patients. Aim. To map nurse patients’ experiences and perceptions of PCC and how their illness experiences influence nursing practice after recovery. Methods. A scoping review methodology was implemented. Scopus, PubMed, Ovid Medline, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched for relevant literature using a comprehensive list of keywords, including nurse patient, nurse-as-patient, person-centred care, person-focused care, hospital, experiences, etc. Thematic analysis was conducted on extracted data, and the results were reported narratively. Results. Thirty-seven (37) studies were included in this review. Four broad themes: experiences of PCC, care practices that promote PCC, the influence of illness experience on nursing practices, and nurse patients’ unique contextual issues were developed, which revealed that nurse patients experienced heightened fear, anxiety, denial, uncertainty, and discomfort when diagnosed with life-threatening illnesses due to their knowledge of the healthcare system. While navigating treatment, most nurse patients experience care that aligns with PCC dimensions (respecting patient dignity, treating patients as persons, providing adequate information, and effective communication). Others received care that deviated from PCC principles, including waiting for long periods to access treatment services, being stereotyped, not being provided enough information, and being less engaged in their care. Furthermore, nurse patients faced unique challenges, including role ambiguity and confidentiality and privacy concerns. Nonetheless, they promoted PCC in their nursing practice after recovery by advocating for patients, serving on healthcare boards, influencing policy change, and becoming peer educators. Conclusion. Research from different nurse patients is needed to deepen our understanding of PCC and how nurse patients’ illness experiences drive quality care and patient safety.
Background: Although Africa has a large population of displaced women, there is no current review of literature on gender-based violence (GBV) among this population. This scoping review study aimed to map the literature on GBV among women of reproductive age (15-49 years) living in refugee and IDP camps in Africa in the years 2019 to 2024. Method: A literature search was conducted for full-text peer-reviewed original research articles published in English, which included women of reproductive age in refugee and internally displaced camps over five years. Results: The prevalence of GBV ranged from 4.7% to 85.8%. Perpetrators of GBV and reporting of GBV were mostly (63.3%) from the host communities in Nigeria. The associated factors of GBV include individual-level factors, community factors, and lack of social support and social protection. Discussion: Although the scope was limited by a few databases, this review provides current evidence and a summary of GBV in Africa. Conclusion: Although mostly high, there was variation in the prevalence of GBV in many African countries. There may be a need for educational intervention to mitigate GBV in Africa. More longitudinal and experimental research is recommended for causal inferences on GBV and displaced women in Africa.
Background. Integrating internationally educated nurses into the Canadian healthcare system is a multifaceted process involving numerous stakeholders who can influence their successful integration. Since the registration examination changes in Canada, in 2015 and amidst evolving registration requirements, especially during the COVID-19 pandemic, little is known about stakeholder perspectives. This study aimed to describe stakeholder views on internationally educated nurse integration processes and the strategies to streamline these processes. Methods. This study employed a qualitative description approach, using semi-structured one-on-one virtual interviews with six stakeholders. Data collection and analysis were completed concurrently, guided by the Braun and Clark framework and the Fourfold Model of Acculturation Theory. Results. Two main themes emerged from data analysis: stakeholder insights during workforce and workplace integration. Stakeholders valued the internationally educated nurses’ expertise in Canadian healthcare and were committed to improving the licensing process to accelerate integration. Conclusion. This study highlights stakeholder perspectives on the integration pathways of IENs into the Canadian healthcare system. Collaboration among stakeholders, including IENs, is essential to streamline integration processes. cesses.
Background. Integrating internationally educated nurses (IENs) into Ontario’s healthcare workforce is crucial for addressing nurse shortages, meeting increased healthcare demands, and ensuring quality patient care. However, internationally educated nurses face numerous challenges during integration. Their experiences following the 2015 registration requirement changes and the COVID-19 pandemic remain unknown. This study aimed to understand and describe internationally educated nurses’ experiences during their integration processes and the support needed to streamline them. Methods. This study employed a qualitative description approach, using semi-structured one-on-one virtual interviews with twelve internationally educated nurses. Data collection and analysis were completed concurrently and informed by the Braun and Clark framework and the Transition Theory. Results. Three main themes with twelve subthemes emerged from internationally educated nurse interview analyses: internationally educated nurse experiences pre-registration, experiences post-registration, and support and call for improvements. Conclusion. This study highlighted the multifaceted challenges internationally educated nurses face when integrating into the Canadian healthcare system. Collaboration among all stakeholders, including internationally educated nurses, is essential to overcoming these challenges and facilitating integration.
Background: Healthcare delivery models can have significant influence on patient-centred communication due to their influence on the thinking and behaviour of health workers about what constitute sickness and healthcare. While the extant knowledge shows many efforts at transforming Nigeria’s health sector towards sustainability, there are no clear facts on improvements in clinical communication, especially, the adoption of the biopsychosocial model (BPSM) for patient-centred communication (PCC) in the country. Aim: Researchers investigated the adoption of the BPSM for PCC in General Hospitals in Benue State. Methodology: Researchers adopted the pragmatic approach and convergent mixed methods design involving personal survey for 372 patients and in-depth interview for 67 clinicians from 21 of the 23 General Hospitals in the State. Results: Findings show that the BPSM has not been adequately adopted in clinical interactions, consequently, clinical communication is not patient-centred enough. Data analysis using the PCC model shows reasonable evidence of application of the BPSM in some areas, however, the contents of clinical communication largely fall short of the psychosocial and patient involvement characteristics. Inadequate adoption of the BPSM is linked to poor patient satisfaction with the usefulness of clinical interactions for patients’ psychosocial needs and home management of their conditions. Findings indicate a prevalence of systemic issues in the General Hospitals in Benue State interfering with the adoption of the BPSM for PCC. Researchers suggest a purposeful policy direction to enshrine the modern global philosophy of healthcare both in medical practice and education; a strong political will, and a commitment to proper staffing for enhancing the full integration of the BPSM, improving the PCC and clinical communication experience for both patients and clinicians.
Background: Breastfeeding has many health benefits for babies and mothers, but many families face challenges in meeting breastfeeding recommendations. Grandparents often influence new parents’ infant feeding experiences, yet little is known about their knowledge, attitudes, experiences, and needs regarding supporting breastfeeding in Canada. Purpose: This non-experimental exploratory descriptive study aimed to explore the knowledge, attitudes, and experiences of grandparents and great-grandparents in supporting breastfeeding to inform intergenerational breastfeeding promotion programs. Methods: An online survey was completed by 111 grandparents and great-grandparents living in Canada. Results: Approximately, 96% of participants had one or more children that were breastfed and 53% had a child breastfeed for over 24 months. The mean knowledge score was 78, (S.D 5.5) and the mean attitude score was 69.7 (S.D 8.71). These scores were significantly positively correlated and higher among participants who had received breastfeeding education (p=0.01). Conclusion: Grandparents and great-grandparents want information tailored to their role in supporting breastfeeding. Providing them with accessible, trustworthy, and respectful education tailored to their experiences would assist with the provision of inclusive intergenerational family-centered care.
Purpose: This concept analysis aimed to clarify family caregiver burden in schizophrenia by identifying its defining attributes, antecedents, and consequences and by situating the issue within its clinical and social relevance. Methods: Using Whittemore and Knafl’s framework, we systematically reviewed 183 studies (1950–2017) from national and international databases. Findings: Caregiver burden is a dynamic, multidimensional construct centered on two core domains. subjective burden (perceived distress, emotional strain) and objective burden (care takes, time demands) whose interaction can lead to overload. Key antecedents included illness related disability, caregiver role demands, economic strain, family conflict, and sociocultural pressures; principal consequences were reduced perceived control and adverse emotional outcomes. Brief illustrative examples (e.g., increased caregiving hours leading to social isolation) demonstrate how these elements manifest in family settings. Conclusion: Family caregiver burden is a dynamic and multidimensional supports the design targeted interventions and the development of precise measurement tools; addressing identified antecedents may reduce caregiver overload and enhance both caregiver well-being and patient care outcomes.
Cross-border migration has implications for immigrant experiences of the host country’s health care system and health care provisions. Female genital mutilation/cutting (FGM/C) is a traditional practice performed on young girls between infancy and age 15. While illegal in Canada, proxy estimates of females aged 0 to 49 years at risk of FGM/C in the country range from 95,000 to 161,000, based on internationally accepted estimation methodologies. Two of the top source continents for immigrants in Canada – Asia and Africa – demonstrate high prevalence of FGM/C, raising concerns about implications for the health outcomes of female immigrants who are at risk of having undergone the practice and the need for awareness among health care professionals and other stakeholders. To date, little is known about the health outcomes for females at risk of having undergone FGM/C and who are living in Canada. Using Canadian linked administrative data, the Longitudinal Immigration Database (1980-2013) and Discharge Abstract Database (2004-2005 to 2013-2014), regression analyses were conducted to compare causes of hospitalizations for female immigrants born in countries identified at risk for FGM/C and female immigrants from non-FGM/C practicing countries. The results suggest female immigrants from FGM/C-practicing countries appear to be at higher-risk for obstetric-related conditions requiring acute-care hospitalization.
Introduction: Traditional mentorship in higher education often assumes hierarchical relationships in professional development. While this model has its place, as scholars, we sought to co-create a more relational, reciprocal space where the whole person: mind-body-spirit, could belong and flourish. In response to these holistic learning principles, our Scholarly Gathering Circle (the Circle) was created as a mutually encouraging community that fosters the continuity of knowledge and experience across generations in a safe space. Methods: The Circle consists of a mentor, a retired professor, and four of her former graduate students. Every season, we co-create a space rooted in mutual trust, respect and care. We meet on Saturday afternoons for three hours to, using holistic learning principles, share stories of our academic, professional and personal achievements and challenges. In this article, we share and analyze, using the Narrative Inquiry framework, reflections of our experiences within the Circle. Results: Five narrative patterns emerge within our reflections of shared experiences: holistic wellbeing, organic co-construction of knowledge, relationality and belonging in academic spaces, intergenerational learning and knowledge continuity, and reimagining of higher education. Much like Dewey argued, learning is deeply rooted in human connections that foster the continuity of education in a particular setting. Conclusion: Our experience suggests that relational, community-based mentorship, like our Scholarly Gathering Circle, can serve as a powerful contrast to the often-isolating structures of traditional higher education. By centering humanity, care, and reciprocity, without diminishing academic rigour, we can sustain and empower scholars in ways that established models may not. This reflective account outlines how others may create their own scholarly gathering circles within higher education, unrestricted by physical, academic, or geographical space.
Introduction: Brazil has acknowledged the importance of health literacy at all levels of healthcare. There is a growing demand for nutritionists’ expertise in many areas of practice, particularly in the public health system, to respond to the population’s needs. Methods: Consultations were held from September to December 2023 in Fortaleza, Brazil. Eleven nutritionists and four nutrition students participated in face-to-face and online consultations. The sessions were audio recorded, transcribed, and analyzed using thematic analysis. The coding was guided by the ideas of organizational structural response to health literacy. Findings: Consultees criticized their traditional biomedical training, which contained little emphasis on communication and health literacy, and pointed to structural barriers hindering patient-centered care. When discussing tertiary health services, consultees identified better flows of information and greater access to technological equipment and materials that foster health literacy. Low-cost strategies—such as use of WhatsApp groups, bedside visuals, and mobile apps—have the potential to enhance patients’ health literacy. Implications for international health, policy, and practice: Measuring health literacy can inform other professional contexts, particularly those in middle- and low-income countries. Strategies to make health literacy a key tool in promoting professional practice include investing in continuing education, reviewing curricula, and expanding resources. Conclusion: Healthcare professionals are ready to integrate health literacy into public healthcare systems, but there are gaps in the infrastructure and in conceptions of nutritionists’ role.
Patient perception in medical practice is crucial, as it reveals how patients interpret and understand their healthcare experiences, including interactions with healthcare providers, treatments, and the overall healthcare system. The primary objective of the study was to investigate two key ethical principles in the medical field: patient autonomy and informed consent, at Dormaa Ahenkro Presbyterian Hospital. The study employed a mixed-methods approach and utilised a cross-sectional design. Through simple random sampling, 53 patients from various units in the hospital were selected. Through a well-structured questionnaire, the data were analysed with GNU PSPP version 1.4.1. The findings revealed that patients held negative perceptions regarding informed consent (30.2%) and autonomy (18.9%). The study also revealed that doctors, in their quest to respect the patients' rights, are limited by inadequate decision-supporting tools to aid patients and the lack of continuing education in this area of patient autonomy and informed consent. The study recommends that both healthcare professionals and patients receive periodic training in bioethical principles to strengthen understanding and ensure compliance.
Introduction: Immigrant older adults in Canada face unique post-migration challenges and barriers that place them at significant risk of social isolation. Evidence-based interventions exist that address the determinants of social isolation, but it is unclear whether these are acceptable to immigrant older adults in Canada. Acceptability is known to influence the uptake and engagement of and adherence to interventions. This paper presents a protocol for a proposed study that will examine the acceptability of selected evidence-based interventions and explore modifications that may be required to enhance their cultural appropriateness. Methods: A mixed-method – concurrent quantitative and qualitative – design will be used. Immigrant older adults from nine Canadian cities will be recruited if they are 60 years of age or older, self-identify as belonging to the Arabic, Mandarin, and Punjabi-speaking immigrant communities, live in the community, and be able to provide informed consent. The total sample size will be 600 to 800. Participants will be informed of each intervention; asked to rate its acceptability using 5 items adapted from the Treatment Acceptability and Preference instrument; and invited to participate in a semi-structured interview to explore their perspectives on cultural appropriateness and possible modifications needed to enhance the acceptability of each intervention. Descriptive statistics will be used to analyze acceptability ratings. Interviews will be audio-recorded with consent, translated into English when needed and transcribed, and content analyzed. Interventions with rating scores > 2 and qualitative comments indicating their fit with participants’ beliefs and values will be considered acceptable. Results: The project is in its initial stage of data collection. Conclusions: Results will help clarify which of the selected interventions are acceptable and what modifications they may require before evaluating them for their effectiveness in reducing social isolation, and fostering social connectedness among Arabic, Mandarin, and Punjabi-speaking immigrant older adults in Canada.
Background: One of the paramount hurdles to Nigeria's development in maternity-care service is the emigration of midwives to developed countries. However, midwives’ perspectives on the effects of the emigration of their colleagues’ to developed countries have yet to be investigated. This study examined the impact of midwives’ emigration on maternity care services and associated challenges in Nigeria. Methods: This study adopted a cross-sectional survey of 121 midwives and nurses at Adeoyo Maternity Teaching Hospital (AMTH), Ibadan Nigeria. Data were collected using a self-structured questionnaire. Results: 98.3% reported negative maternal health outcomes, 98.3% indicated midwives’ burnout, 93.4% reveal midwives’ low morale. Logistic regression analysis identified that the strongest challenge faced by care providers was lack of staff support (OR = 4.05, p = 0.001). Conclusion: The nursing implications of midwife emigration are far-reaching, affecting both maternity care service and remaining midwives. The increased workload reduces the quality of care and poses a high risk to maternal and neonatal outcomes. Addressing these challenges requires a multi-faceted approach, including workforce development, policy reforms, retention strategies. Despite ongoing challenges, maternity-care services can be strengthened through implementation of these strategies.
Objective: Existing research points to how increasing male engagement in public health interventions without addressing gender inequities can perpetuate power imbalances in a relationship which may lead to increased stress and anxiety for women. The aim of this study was to identify profiles of couples who attended a violence prevention intervention based on their attitudes toward gender norms and power sharing within a couple, determine if these profiles have different women’s mental health outcome and examine whether male engagement moderates this relationship. Methods: Using data from a cluster randomized controlled trial conducted in North Kivu, Democratic Republic of Congo, we conducted a latent profile analysis to categorize different profiles amongst couples in the intervention (n=202) and conduct logistic regression to examine the study aims. Results: The latent profile analysis identified three profiles of couples: (1) discordant dyads, (2) concordant high gender equity dyads, and (3) concordant average dyads. There were no differences in women’s depression symptoms at the end of the intervention amongst the three profiles. Male engagement, measured through attendance data, did not moderate the relationship between the couple’s relationship profile and women’s mental health. Conclusion: Small sample size, measurement sensitivity, and potential response bias to the scales assessing gender norms, power dynamics and mental well-being might have led to the null results we see. Yet, future studies should further explore the potential for differences in mental health outcomes and the impact of interventions on these outcomes based on intercouple dynamics in understanding and expression of power and gender norms.
Background: Zambia has embarked on the devolution of various health functions to the subnational levels at provincial and district level. Objectives: (i) To examine the decentralisation process in Zambia using the lens of the Constitution, enabling pieces of legislation, the relevant policy frameworks and (ii) To examine the decentralisation implementation process using the change management process. Methodology: This was an observational study involving both qualitative and quantitative methods using purposive selection of participants from the District Health Offices, Health facilities and the Local authorities. Interviews and focus group discussions were used to collect the data over a period covering January and February 2024 in three sites namely Mazabuka, Lusaka and Chongwe Districts of Zambia. Key Findings: Inadequate legal and policy framework, operationalization of the decentralisation policy, the acceleration of the implementation before the legal framework, as well as other change management processes and procedures were identified as key challenges. Conclusion: While there are adequate constitutional provisions, inadequacies in policy and legal frameworks, implementation capacity in councils, community participation, change management process as well as the collaborative framework to facilitate smooth and effective implementation of decentralizing some health functions to the Local Authorities.
The management of health crises entails a comprehensive spectrum of actions, spanning from prevention and preparedness planning, through resource allocation, communication strategies, stakeholder coordination, community involvement, intervention implementation, and culminating in recovery and rehabilitation phases, with additional complexities in developing countries. This article aims to explore the concept of success in health crisis management by conducting a literature review and analyzing qualitative data collected in Guinea in 2022. The study seeks to identify key dimensions that contribute to the comprehensive evaluation of success in health crisis response and recovery. The research design employed for this study is a qualitative approach, specifically utilizing semi-structured interviews with international, national, and local stakeholders involved in health crisis management in Guinea. Effective crisis management is crucial for public health but lacks comprehensive research identifying key success factors. This gap limits evidence-based guidelines for crisis preparedness, response, and recovery. While some literature covers aspects like timely actions and resource mobilization, detailed studies on success conditions are rare. More empirical research is needed to guide policymakers and healthcare professionals in developing robust health crisis management frameworks. The study underscores the multifaceted nature of successful health crisis management, emphasizing elements like timeliness, resource mobilization, transparent communication, socio-economic impacts mitigation, experiential learning, governance integration, community engagement, and interdisciplinary coordination. Ultimately, robust and resilient health systems are essential for effectively managing health crises, as they enable rapid disease surveillance, efficient resource allocation, and timely delivery of medical interventions to mitigate the spread and impact of outbreaks.
Background: Sexual Minority People (LGBTQ) are a population experiencing significant health disparities, including higher rates of diseases, injury, and violence. Their marginalized status also limits their opportunities to achieve optimal health outcomes. While LGBTQ individuals face significant stigma and discrimination in accessing healthcare, the experiences of healthcare providers – key stakeholders in addressing these challenges – remains underexplored, which is the objective of this study, exploring the experiences of the care providers. Purpose: To describe the experiences of providers and contribute to improving the competence of Ghanaian nurses in their care for sexual minority patients. Methods: An integrative literature review, following the standards of Whittemore and Knafl’s framework. Literature was search on CINAHL, Medline, Web of Science, Global Public Health, and Google Scholar, using sexual minority (LGBTQ), healthcare providers and West Africa as broad concepts to generate keywords. Results: A total of 156 articles were retrieved from database searches, and were filtered using predefined inclusion criteria, focusing on relevance and methodological rigor, using the PRISMA review process and 4 final articles were included in the review. These studies highlighted stigma from healthcare providers, poor knowledge of sexual identity, sexual orientation and the unique needs of sexual minority people. Institutional homophobia and unsafe healthcare facilities for LGBTQ people were also unearthed. Implications: Healthcare related stigma must be addressed through; continued professional development training for healthcare workers to understand the impact of stigma and promote their knowledge of sexual minority health needs, implementing culturally safe curriculum on minority healthcare, and making healthcare facilities minority friendly.
Background: Persons with intellectual and developmental disabilities (IDD) face interlocking inequities in access to healthcare services. Nurses require education and training in specific competencies to address their needs. This cross-sectional study explored the experiences and perspectives of youth with IDD on nursing care in the times of COVID-19 restrictions across 4 provinces in Canada. Methods: Nine youth (16-29 years) completed a virtual survey: without assistance of caregiver parent (n=3), supported by a parent (n=3), and represented by parent proxy (n=3). Close-ended Likert-type questions assessed health, mental health, and Quality of Care and Support (QOCS). Open-ended questions addressed Person-and-Family-centred Care (PFCC), communication and behaviour management. At the analytical stage the qualitative and quantitative data were integrated applying concurrent mixed-methods principles. Results: Emerging themes include: 1) Limited access to quality of care (e.g., dismissive attitude, safety concerns, insufficient respite funding, unaffordable care, shortage of nurses prepared in developmental disability, complicated program enrolment process, insufficient knowledge on IDD rights and services, competency and professionalism); 2) Person-and-Family-Centered Care (e.g., experiences of PFCC, not a Person-Centered care; 3) Communication is key to quality nursing care; and 4) Inadequate emotional support (e.g., respect and value youths’ wishes, nurses need emotional support too). Conclusion: Barriers to quality nursing care for youth with IDD include lack of communication skills, emotional support, and Person-and-Family-Centered Care. Nursing care tailored to the needs of persons with IDD is crucial for their health and wellbeing and requires structural changes at the macro (enhanced funding for program/services), meso (education, curricula, training), and individual levels (awareness).
Introduction: Research has shown that the mental health of Canadians has been negatively impacted during the pandemic, particularly within racialized populations. This impact may be especially true among Chinese (due to xenophobia) and South Asian people (due to high COVID-19 infection) in Canada. This study examines the change in self-reported mental health among Chinese, South Asian, and Other Southeast and East Asian populations compared to the White population by immigration status before and during the pandemic. Methods: This retrospective, cross-sectional study used four cycles (2019 to 2022) of the Canadian Community Health Survey. Differences in high levels of mental health were compared using logistic regression, taking into consideration immigrant status and duration since landing, and controlled for demographic, socio-economic factors, and sense of belonging. Results: The overall Asian and White populations reported similar prevalence of high mental health. This was followed by a widening of the Asian-White differential, advantaging the Asian population. The Chinese sub-group had the lowest prevalence of high mental health pre-pandemic compared to their White counterparts, but the differential disappeared by 2022. Conclusion: Study results support an overall deterioration in mental health during the pandemic, especially among White and non-immigrant Asian populations, while highlighting a healthy immigrant effect among recent Asian immigrants. The low mental health level of the Other Southeast and East Asian non-immigrant group in 2022 warrants further exploration.
