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Background Evidence relating maternal history of abuse before pregnancy with pregnancy outcomes is controversial. This study aims to examine the association between maternal histories of abuse before pregnancy and the risk of preterm delivery and low birth weight. Methods We searched Subject Headings and keywords for exposure and the outcomes through MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Psycinfo, CINAHL, Scopus, PILOTS, ProQuest Dissertations & Theses Global and Web of Science Core Collection in April 2017. We selected original studies that reported associations between maternal histories of abuse of any type and either preterm delivery or low birth weight. Studies that included interventions during pregnancy to lower maternal stress but reported no control data were excluded. We utilized the Newcastle-Ottawa Quality Assessment Scales for observational studies to assess the risk of bias in the primary studies. Two independent reviewers performed the selection of pertinent studies, assessment of risk of bias, and data extraction. Unadjusted pooled odds ratios (OR) with 95% Confidence Interval (CI) were calculated for the two outcomes of preterm delivery and low birth weight in 16 included studies. Results Maternal history of abuse before pregnancy was significantly associated with preterm delivery (OR 1.28, 95% CI: 1.12–1.47) and low birth weight (OR 1.35, 95% CI: 1.14–1.59). A substantial level of heterogeneity was detected within the two groups of studies reporting preterm birth and low birth weight (I2 = 75% and 69% respectively). Subgroup analysis based on the specific time of abuse before pregnancy indicated that childhood abuse increases the risk of low birth weight by 57% (95% CI: 0.99–2.49). When the included studies were categorized based on study design, cohort studies showed the highest effect estimates on preterm delivery and low birth weight (OR: 1.69, 95%CI: 1.19–2.40, OR: 1.56, 95% CI: 1.06–2.3, respectively). Conclusions We recommend that more high quality research studies on this topic are necessary to strengthen the inference. At the practice level, we suggest more attention in detecting maternal history of abuse before pregnancy during antenatal visits and using this information to inform risk assessment for adverse pregnancy outcomes. Trial registration Registration number: PROSPERO (CRD42016033231). Electronic supplementary material The online version of this article (10.1186/s12884-018-2030-8) contains supplementary material, which is available to authorized users.

Purpose: The influence of place on health is beginning to be addressed in health research. Current understanding of rural places, however, remains in a state of disequilibrium, balancing between geographic and sociocultural positions. This article illuminates the significance of place for rural women’s experiences of health promotion in the rural church. Design: This study used a novel approach to interpretive phenomenological methodology by including the photovoice method to elicit both individual and shared experiential meanings. Method: Twenty-two participants took pictures, wrote in logbooks, and participated in individual and group interviews to share their experiences of health promotion in the rural church. Findings: The church as a place was realized through three broad discourses: (a) an intersection of physical and geographic environments, (b) a gateway to experiential attachment and personal meaning, and (c) a connection to shared culture and beliefs. It is also suggested that place may best be interpreted with an experiential lens as it exhibits lived and felt spaces. Conclusions: Data analysis suggests that place consists of both physical and experiential realities, in addition to being a resource of culture and meaning. Implications for rural women’s health promotion include fostering a deeper recognition of place-shaped experiences of health.

Purpose – The purpose of this paper is to test a model linking physical therapy (PT) and occupational therapy (OT) practitioners’ perceptions of resonant leadership, structural empowerment and psychological empowerment to their experiences of spirit at work (SAW), job satisfaction and organizational commitment within the Canadian workplace. Design/methodology/approach – The authors tested the model using LISREL 8.80 and survey data from 101 OTs and 169 PTs, randomly selected by the Alberta professional licensing associations. Content analysis of responses to the open-ended comments section provided additional depth and insight. Findings – Analysis of results culminated in minor modifications to the original theoretical model, creating separate PT and OT models. Both models revealed a good fit with the observed data. Several SAW concepts accounted for moderate to large amounts of variance in both PT and OT models, indicating that SAW is a comprehensive workplace outcome. Research limitations/implications – Theory was derived from business and nursing research literature due to limited rehabilitation research literature. Discussion of OT results must consider the small sample size. This study is initial exploratory research. Practical implications – Each discipline-specific model provides professionals, health care leaders and policy makers with a rich body of information upon which to base beneficial workplace decisions. SAW will guide leaders in the holistic development and enrichment of the work environment. Originality/value – This research contributes to the substantive knowledge of the OT and PT disciplines, particularly in the areas of leadership, workplace structural organization and indicators of healthy work environments such as SAW, empowerment, job satisfaction and organizational commitment.

The purpose of this paper is to examine the advantages and challenges of co-supervision of doctoral students, as found in the literature and from our experiences. We define co-supervision and then discuss the process in detail. Examples are based on experiences of co-supervision from faculty perspectives as well as from the point of view of a former doctoral student. We propose that the advantages of co-supervision far outweigh the challenges and should be regularly considered by seasoned academics to enhance student learning. In addition, we suggest that co-supervision is intellectually stimulating for academics.

The purpose of this article is to analyze the concept of maternal autonomy in the context of breastfeeding and propose a clearer definition of the concept.A concept analysis was undertaken using Walker and Avant's eight-stage approach.The concept analysis suggests that maternal autonomy in the context of breastfeeding refers to a mother's ability to make autonomous decisions using her control, agency, independence, and ethical reasoning. The antecedents are maternal competence, availability of support, nature of the setting, and available alternatives with respect to breastfeeding. The consequences are improvement in child health, maternal-child bonding, breastfeeding decisions, and maternal healthcare-seeking behavior.A clearer understanding of maternal autonomy in the context of breastfeeding will guide the development of a conceptual framework and expand nursing knowledge development.A clearer definition of the concept of maternal autonomy in the context of breastfeeding will guide clinicians, researchers, and policy makers in protecting, promoting, and supporting breastfeeding globally towards achieving the United Nations Sustainable Development Goals, 2015-2030.

The purpose of this focused ethnographic inquiry was to examine South Asian immigrant women's experiences and perceptions of respect within health professional-client relationships in the context of a Canadian outpatient treatment clinic. Characteristics of respect described by 11 women interviewed were the meaning of respect, health professional's way of being, their way of attending to the person, and their way of talking. Language, cultural values and beliefs, along with underlying societal, individual and institutional factors that coexist with health professionals' ability to create respect were some of the dimensions that influenced how immigrant women experienced respect. Health professionals' capacity to acknowledge South Asian immigrant women as individuals helped to formulate/construct respect for their individual identities. The need to be respected for 'my social identity' as an immigrant woman with cancer was woven throughout women's stories, illustrated by their personal experiences and perspectives.

wagner j.i.j., cummings g., smith d.l., olson j., anderson l. & warren s. (2010) Journal of Nursing Management18, 448–462 The relationship between structural empowerment and psychological empowerment for nurses: a systematic review Aim To describe the findings of a systematic review examining the relationship between structural empowerment and psychological empowerment for registered nurses (RNs). Background Workplace empowerment research reveals a link between empowerment and positive work behaviours and attitudes. Research demonstrating the essential relationship between structural empowerment and psychological empowerment will provide direction for future interventions aimed at the development of a strong and effective health care sector. Methods Published research articles examining structural empowerment and psychological empowerment for nurses were selected from computerized databases and selected websites. Data extraction and methodological quality assessment were completed for the included research articles. Results Ten papers representing six studies reveal significant associations between structural empowerment and psychological empowerment for RNs. Implications for nursing management Creation of an environment that provides structural empowerment is an important organizational strategy that contributes to RNs’ psychological empowerment and ultimately leads to positive work behaviours and attitudes. Critical structural components of an empowered workplace can contribute to a healthy, productive and innovative RN workforce with increased job satisfaction and retention.

Despite mandates to provide spiritual care, confusion persists among nurses about spirituality, spiritual needs, and related roles. To discover how practicing nurses acquire knowledge for spiritual care, the authors chose a grounded theory design. They constantly compared and analyzed verbatim transcribed interview data to find the core variable, categories, and properties. Connection, manifesting as a state, act, or process, appeared throughout the data. Categories emerged as Needing Connection, Nurturing Connection, Learning Connection, and Living Connection. Nurses used a cyclical, intertwined, and progressive learning process of opening to, struggling with, and making connections between numerous discrete personal and professional experiences. Shifting attention between these interconnected experiences fueled knowledge acquisition. Whether referring to how nurses learn, what they do, or with whom, the theory Connecting Spiritually joined categories into a cumulative experiential learning process that explained how nurses learn to care for spiritual needs.

Background Prenatal records are potentially powerful tools for the translation of best-practice evidence into routine prenatal care. Although all jurisdictions in Canada use standardized prenatal records to guide care and provide data for health surveillance, their content related to risk factors such as maternal smoking and alcohol use varies widely. Literature is lacking on how prenatal records are developed or updated to integrate research evidence. This multiphase project aimed to identify key contextual factors influencing decision-making and evidence use among Canadian prenatal record committees (PRCs), and formulate recommendations for the prenatal record review process in Canada. Methods Phase 1 comprised key informant interviews with PRC leaders across 10 Canadian jurisdictions. Phase 2, was a qualitative comparative case study of PRC factors influencing evidence-use and decision-making in five selected jurisdictions. Interview data were analysed using qualitative content analysis. Phase 3 involved a dissemination workshop with key stakeholders to review and refine recommendations derived from Phases 1 and 2. Results Prenatal record review processes differed considerably across Canadian jurisdictions. PRC decision-making was complex, revealing the competing functions of the prenatal record as a clinical guide, documentation tool and data source. Internal contextual factors influencing evidence use included PRC resources to conduct evidence reviews; group composition and dynamics; perceived function of the prenatal record; and expert opinions. External contextual factors included concerns about user buy-in; health system capacities; and pressures from public health stakeholders. Our recommendations highlight the need for: broader stakeholder involvement and explicit use of decision-support strategies to support the revision process; a national template of evidence-informed changes that can be used across jurisdictions; consideration of both clinical and surveillance functions of the prenatal record; and dissemination plans to communicate prenatal record modifications. Conclusions Decision-making related to prenatal record content involves a negotiated effort to balance research evidence with the needs and preferences of prenatal care providers, health system capacities as well as population health priorities. The development of a national template for prenatal records would reduce unnecessary duplication of PRC work and enhance the consistency of prenatal care delivery and perinatal surveillance data across Canada.

Aims. The aims of this paper are to add clarity to the discussion about paradigms for nursing research and to consider integrative strategies for the development of nursing knowledge. Background. Paradigms are sets of beliefs and practices, shared by communities of researchers, which regulate inquiry within disciplines. The various paradigms are characterized by ontological, epistemological and methodological differences in their approaches to conceptualizing and conducting research, and in their contribution towards disciplinary knowledge construction. Researchers may consider these differences so vast that one paradigm is incommensurable with another. Alternatively, researchers may ignore these differences and either unknowingly combine paradigms inappropriately or neglect to conduct needed research. To accomplish the task of developing nursing knowledge for use in practice, there is a need for a critical, integrated understanding of the paradigms used for nursing inquiry. Methods. We describe the evolution and influence of positivist, postpositivist, interpretive and critical theory research paradigms. Using integrative review, we compare and contrast the paradigms in terms of their philosophical underpinnings and scientific contribution. Findings. A pragmatic approach to theory development through synthesis of cumulative knowledge relevant to nursing practice is suggested. This requires that inquiry start with assessment of existing knowledge from disparate studies to identify key substantive content and gaps. Knowledge development in under-researched areas could be accomplished through integrative strategies that preserve theoretical integrity and strengthen research approaches associated with various philosophical perspectives. These strategies may include parallel studies within the same substantive domain using different paradigms; theoretical triangulation to combine findings from paradigmatically diverse studies; integrative reviews; and mixed method studies. Conclusion. Nurse scholars are urged to consider the benefits and limitations of inquiry within each paradigm, and the theoretical needs of the discipline.

Se utilizó etnografía enfocada para identificar creencias, valores y prácticas de Promoción de la Salud y Calidad de Vida entre madres de preadolescentes en Argentina. Se describió la influencia materna en las elecciones que hacen los preadolescentes y la protección de los jóvenes ante comportamientos de riesgo. Los datos se obtuvieron de una muestra intencional de 10 madres con observación participante, entrevistas grabadas, notas de campo y diario personal suplementadas con genogramas y fotografías como opción. El análisis temático de los datos condujo al significado del rol materno en la protección de los hijos ante comportamientos de riesgo para la salud. También se identificaron 2 patrones de cuidado y los componentes del "buen vivir". Focused ethnography was used to identify beliefs, values and practices of Health Promotion and Quality of Life among mothers of preadolescents in Argentina. This study described how they influence their preadolescents' choices and protect them from risk behaviors. Data were collected from a purposive sample of 10 mothers, including participant observation, tape recorded interviews, field notes and personal diary, supplemented by genograms and used photographs as an option. Through content and theme analysis, we gained greater understanding of the role of mothers in protecting their children from health risk behaviors. We also identified the meaning of two care patterns and how the term "good life" made sense to them. A etnografia enfocada foi usada para aprender a respeito de crenças, valores e práticas de promoção da saúde e qualidade de vida entre mães de pré-adolescentes na Argentina. Este estudo descreve como as mães influenciam nas escolhas dos pré-adolescentes e protegem os jovens com respeito aos comportamentos de risco. Os dados foram coletados em uma amostra intencional de 10 mães, através da observação participante, entrevistas gravadas e notas de campo, suplementadas por genogramas e por fotografia como opção. O tratamento os dados foi feito mediante análise temática, e permitiu a compreensão do papel de proteção da mãe frente ao comportamento de risco, bem como de 2 padrões de cuidado e dos componentes do bom viver.

The First International Research Capacity-Building Program for Nurses to Study the Drug Phenomenon in the Americas is a result of a partnership between the Inter-American Drug Abuse Control Commission (CICAD) of the Organization of American States (OAS) and the Faculty of Nursing in the University of Alberta, with financial support from the Government of Canada. The program was divided into two parts. The first part of the program was held at the University of Alberta in Edmonton, Alberta, Canada. It involved capacity-building in research methodologies at the Faculty of Nursing, which lead to the preparation of four multi-centric research proposals for drug demand reduction in the home countries of the eleven participants in the program. The second part of the program was related to the implementation of multi-centric research proposals in seven countries in Latin America and in Canada. This program presented expertise in research methodology to members of Latin American Schools of Nursing and introduced Latin American expertise to members of a Canadian Faculty of Nursing. The International Research Capacity-Building Program for Nurses to Study the Drug Phenomenon in the Americas has fostered the kind of inter-cultural respect and mutual appreciation necessary to confront the global health problem of the abuse of both licit and illicit drugs. El Primer Programa Internacional de Capacitación en Investigación para Enfermeros en el Estudio del Fenómeno de las Drogas en las Américas resultó de una colaboración entre la Comisión Interamericana para el Control del Abuso de Drogas (CICAD) de la Organización de los Estados Americanos (OEA) y la Facultad de Enfermería en la Universidad de Alberta, con apoyo financiero del Gobierno de Canadá. El programa fue dividido en dos partes. La primera parte del programa se organizó en la Universidad de Alberta en Edmonton, Alberta, Canadá. Abarcó la capacitación en metodologías de investigación en la Facultad de Enfermería, que llevó a la preparación de cuatro propuestas de investigación multicéntrica con vistas a la reducción de la demanda de drogas en los países de origen de los once participantes en el programa. La segunda parte del programa estaba relacionada a la implementación de propuestas de investigación multicéntrica en siete países de América Latina y en Canadá. Este programa presentó conocimientos especializados en metodologías de investigación a miembros de Escuelas de Enfermería latinoamericanas e introdujo los conocimientos especializados latinoamericanos a miembros de una Facultad de Enfermería canadiense. El Programa Internacional de Capacitación en Investigación para Enfermeros en el Estudio del Fenómeno de las Drogas en las Américas estimuló el tipo de respecto intercultural y apreciación mutua necesario para confrontar el problema de salud global del abuso de drogas lícitas e ilícitas. O Primeiro Programa Internacional de Capacitação para Enfermeiros no Estudo do Fenômeno das Drogas nas Américas é resultado de uma parceria entre a Comissão Interamericana para o Controle do Abuso das Drogas (CICAD) da Organização dos Estados Americanos (OEA) e a Faculdade de Enfermagem da Universidade de Alberta, com apoio financeiro do Governo do Canadá. O programa foi dividido em duas partes. A primeira parte do programa foi realizada na Universidade de Alberta em Edmonton, Alberta, Canadá. Compreendeu a capacitação em metodologias de pesquisa na Faculdade de Enfermagem, que levou à preparação de quatro propostas de pesquisas multicêntricas para a redução da demanda de drogas nos países de origem dos onze participantes no programa. A segunda parte do programa estava relacionada à implementação de propostas de pesquisa multicêntricas em sete países da América Latina e no Canadá. Este programa apresentou expertise em metodologias de pesquisa a membros de Escolas de Enfermagem latino-americanas e introduziu expertise latino-americana a membros de uma Faculdade de Enfermagem canadense. O Primeiro Programa Internacional de Capacitação para Enfermeiros no Estudo do Fenômeno das Drogas nas Américas estimulou o tipo de respeito intercultural e apreço mútuo necessário para confrontar o problema de saúde global do abuso das drogas lícitas e ilícitas.

Purpose: To describe culturally embedded values that implicitly guide Filipino Canadian patients' interactions with Canadian nurses and are integral to nurse-patient relationships. DesignandMethods: A focused ethnography was conducted, with a purposive sample of 23 Filipino Canadians who received care in Canadian hospitals. Data consisted of interviews, field notes, and diary. Findings: When receiving care, patients delineated hindi ibang tao (one of us) and ibang tao (not one of us) and this determined their preference for who performed personal and private tasks or received information. The urgency of the patients' conditions, the intimacy required for most nursing procedures, and short hospitalizations meant that patients often interacted without progressing through the cultural levels of pakikitungo (formality), pakikibagay (adjustability), and pakikisama (acceptance). Rather, the crisis of being hospitalized forced patients to immediately move toward the cultural levels of pakikipagpalagayang-loob (mutual comfort) or pakikiisa (oneness). Patients' willingness to trust and to share their kapwa-oriented worldview in relating with fellow human beings, and their use of their languages of words, gaze, touch, and food, allowed nurses to become hindi ibang tao (one of us). Caregiving roles and establishing relationships also distinguished that hindi ibang tao (one of us) was to bantay (watch over) the patient, whereas ibang tao (not one of us) was expected to alaga (care for) them (i.e., provide professional care). Conclusions: Communicating and caring effectively requires understanding of Filipino Canadians' languages of words, gaze, touch, and food and their levels of interaction. Culturally safe nurse-patient relationships can then develop.

Nurse educators must confront the issue of nursing students' personal safety in community health practice, provide the necessary knowledge and skills, and document their actions. Learning opportunities are required to assist students to recognize and evaluate risks, and prevent their consequences. Thematic analysis of interviews with 56 public health nurses in Alberta, Canada uncovered knowledge, skill, and attitudinal components of risk assessment. Categories under the theme framing personal risk in work environments and the sub-themes framing for action and framing for no action provided a conceptual framework for planning educational strategies. Based on how these nurses framed their personal risk, 4 educational strategies are presented: a checklist, small group learning activities, a template for Web-based courseware, and a problem-based learning scenario.

We describe our experience of developing two university nursing courses and Clinical Pastoral Education (CPE) programs for parish nurses. We note the differences between nursing prepared and theologically prepared professionals. A vignette demonstrates our joint work and adaptation of the McGill Model of Nursing.

Many rural health resources are linked to community churches, which are often well attended, especially by rural women. We used interpretive phenomenology and the photovoice method to understand how the church influenced health promotion for rural women, whose health is often significantly compromised compared with the health of urban women. Our analysis of the data from individual interviews, group sessions, photographs, and logbooks suggested that the rural church significantly facilitated rural women’s health promotion. The church supported the physical, intellectual, emotional, and spiritual health of rural women, facilitated social connectedness, and provided healthful opportunities to give and to receive. Implications included reframing religious places as health-promoting and socially inclusive places for rural women.

Canadian researchers have developed the Spirit At Work (SAW) tool for identifying the experiences of individuals who are passionate about and energized by their work. This article describes (a) what registered nurses perceive as contributing to their personal SAW; and (b) the relationships among resonant leadership, structural empowerment concepts, psychological empowerment concepts, SAW concepts, job satisfaction, organizational commitment, and the demographic variables of experience, education, and rank in the RN workplace. The theoretical model was tested using LISREL 8.80 and survey data from 147 randomly selected RNs. Engaging work was found to account for 63% of the explained variance in the model's endogenous variables. Spiritual connection had a causal effect on organizational commitment, while resonant leadership and individual empowerment had significant causal influence on SAW, job satisfaction, and organizational commitment. These results strengthen those of previous studies reporting workplace structures/processes/contributions leading to superior care environments. Future studies will clarify the role of SAW in the workplace.

Para as pessoas que lidam com mudancas no estado de saude, os cuidados de enfermagem frequentemente envolvem atencao aos aspectos fisicos da condicao dos pacientes. Alem disso, ha muito tempo as pessoas discutem com os profissionais da saude como as suas vidas mudaram como resultado das circunstâncias. Tais discussoes baseiam-se no pressuposto de que todos precisam de esperanca, significado e um proposito na vida, e a conexao com sua dimensao espiritual (a essencia do eu) pode ser uma parte poderosa [...]

Purpose: To demonstrate how a middle-range theory was developed and tested through research that examined relationships between nurse-expressed empathy and two patient outcomes: patient-perceived empathy and patient distress. Significance: Nurse-patient relationships are the basis for all nursing care and empathy is an important aspect of these relationships. Research is needed, however, to determine the patient outcomes that are related to the empathy of nurses. Organizing Framework: Orlando's (I 96 1, 1972) nursing model. Scope: 140 subjects, 70 staff RNs and 70 patients from hospital medical-surgical acute care units. Each nurse-subject completed two measures of nurse-expressed empathy and each patient-subject completed a measure of perceived empathy and two measures of distress. Findings: Negative relationships were found between nurse-expressed empathy and patient distress (r = -.71, p < .001), and between patient-perceived empathy and patient distress (r = -.71, p < .007). A moderate positive relationship was found between nurse-expressed empathy and patient-perceived empathy (r = .35 to .47, p < .05). Conclusions: A model can be tested when propositions theoretically linked to the model are empirically tested. This study's findings demonstrated support for relationships proposed in Orlando's model.

It is increasingly important that nursing care be associated with measurable patient outcomes. A correlational study examined relationships between nurse-expressed empathy and two patient outcomes: patient perceived empathy and patient distress. Subjects (N = 140) were randomly selected from RNs and patients on medical and surgical units in two urban, acute care hospitals. Nurse-subjects (N = 70) completed two measures of nurse-expressed empathy: the Behavioral Test of Interpersonal Skills and the Staff-Patient Interaction Response Scale. Patient-subjects (N = 70) completed the Profile of Mood States, the Multiple Affect Adjective Checklist, and the Barrett-Lennard Relationship Inventory. Findings indicated a negative relationship (r = .71, p < .001) between a set of empathy variables and a set of patient distress variables and a positive relationship between nurse-expressed and patient perceived empathy (r = .37-.47, p < .05). This study is one of the first to link behavioral measures of nurse empathy to patient outcomes.

The purpose of this exploratory study was to gain insight into students' perceptions of learning to nurse families using a team approach. A sample of 112 thirdyear baccalaureate nursing students provided data from clinical journals and responses to a teacher-developed questionnaire regarding number of home visits made with a partner, the extent to which partners shared responsibility for the nursing care of two families, perceived benefits and disadvantages of teamwork, roles assumed by team members, perceived outcomes of the team approach, and suggestions for revision of the approach. The degree to which students shared responsibility was moderate and positive perceptions of teamwork were significantly correlated with the degree of sharing of nursing activities. Using Spradle/s qualitative method of domain analysis, interpretation of data from students' clinical journals revealed subjective aspects of the experience that appeared to influence teamwork practices and attitudes. Results suggest that the shared assignment approach offers students a unique opportunity to learn about the realities of collaborative nursing practice.

Spirituality, as a basic characteristic of humans and a contributor to human health, is regarded as part of nursing practice. The purpose of this study was to examine how Tanzanian nurses understand spirituality and spiritual care. Using the qualitative method of interpretive description, fifteen registered nurses engaged in clinical practice in a Tanzanian hospital were recruited to participate in this study. In-depth interviews using open-ended questions were carried out, tape-recorded, and transcribed verbatim. Data collection and inductive analysis occurred concurrently. In this paper, key findings are grouped under the following headings: meaning of spiritual care, recognition of spiritual needs, and interventions to respond to spiritual needs. Although there were some differences, overall participants’ understanding of spirituality and spiritual care was similar to what is found in the literature about nurses in other countries. The provision of spiritual care also included some unique elements that may reflect the African context.

To describe the findings of a systematic review examining the relationship between structural empowerment and psychological empowerment for registered nurses (RNs).Workplace empowerment research reveals a link between empowerment and positive work behaviours and attitudes. Research demonstrating the essential relationship between structural empowerment and psychological empowerment will provide direction for future interventions aimed at the development of a strong and effective health care sector.Published research articles examining structural empowerment and psychological empowerment for nurses were selected from computerized databases and selected websites. Data extraction and methodological quality assessment were completed for the included research articles.Ten papers representing six studies reveal significant associations between structural empowerment and psychological empowerment for RNs.Creation of an environment that provides structural empowerment is an important organizational strategy that contributes to RNs' psychological empowerment and ultimately leads to positive work behaviours and attitudes. Critical structural components of an empowered workplace can contribute to a healthy, productive and innovative RN workforce with increased job satisfaction and retention.

Background There is a significant gap in the knowledge translation literature related to how research evidence actually contributes to health care decision-making. Decisions around what care to provide at the population (rather than individual) level are particularly complex, involving considerations such as feasibility, cost, and population needs in addition to scientific evidence. One example of decision-making at this "population-policy" level involves what screening questions and intervention guides to include on standardized provincial prenatal records. As mandatory medical reporting forms, prenatal records are potentially powerful vehicles for promoting population-wide evidence-based care. However, the extent to which Canadian prenatal records reflect best-practice recommendations for the assessment of well-known risk factors such as maternal smoking and alcohol consumption varies markedly across Canadian provinces and territories. The goal of this study is to better understand the interaction of contextual factors and research evidence on decision-making at the population-policy level, by examining the processes by which provincial prenatal records are reviewed and revised. Methods Guided by Dobrow et al.'s (2004) conceptual model for context-based evidence-based decision-making, this study will use a multiple case study design with embedded units of analysis to examine contextual factors influencing the prenatal record revision process in different Canadian provinces and territories. Data will be collected using multiple methods to construct detailed case descriptions for each province/territory. Using qualitative data analysis techniques, decision-making processes involving prenatal record content specifically related to maternal smoking and alcohol use will be compared both within and across each case, to identify key contextual factors influencing the uptake and application of research evidence by prenatal record review committees. All study participants will be required to give written informed consent prior to participating in data collection. Conclusion This study will advance knowledge in the field of evidence-based decision-making by illustrating the complex interaction of contextual factors and evidence on health policy decision-making by provincial-level committees. By increasing the transparency of decision-making within provincial prenatal record committees, this study will help inform more effective strategies for enhancing the integration of best-practice evidence into prenatal records.

With the increasing complexities of health care and the associated strong advocacy for baccalaureate of science in nursing (BScN) program as entry to practice in the developing countries, gradually, nurse leaders are moving in that direction. Although extensive information is available in the literature about the outcomes of prelicensure BScN programs in developed countries, little is known about the outcomes of such programs in developing countries. In this article, we report strengths and challenges of the first prelicensure BScN program in Pakistan. Using a focused ethnographic approach, data for this study were collected mainly through semistructured interviews of the graduates from the first five cohorts of the BScN program and their supervisors at Aga Khan University, Pakistan. Interviews were tape-recorded, transcribed verbatim, and content analyzed for explicit and implicit patterns of themes, meanings, and understanding about the program. Findings of this study affirmed the worth of BScN program for preparing competent nurses that can contribute to the development of nursing in Pakistan. However, various contextual issues and challenges in the nurses work environment have affected the utilization and retention of these graduates and hence the perceived outcome of the program.

The aim of this ethnographic trial was to identify cultural patterns present in mothers' actions when protecting their children from environmental risks like drugs and violence. Data collection consisted in a tape-recorded structured interview with 10 mothers of 9 to 13-year-old preadolescents, complemented with pictures, field notes and participant observation. Mothers conceptualize their child as a "Big Boy" who wants to make his own decisions and be independent, generating conflicts in the family as a whole. As a conclusion, mothers perceive their pre teenagers as more vulnerable, so a close guiding and control is necessary for their developing activities. They believe it will help their children to recognize hazardous situations and stay away from them.

This is a focused ethnography study of 10 preadolescents' mothers who participate in OASE (Help Group of Evangelic Women) in Timbó, Santa Catarina, Brazil. The purpose of the study was to describe variances in patterns of health promotion, quality of life and preadolescents' risk behavior from the mothers' perspective, exploring how they influence their children and protect them in terms of risk behavior such as alcohol, tobacco, other drugs and violence. Semistructured interviews, participant observation, field notes, genograms and photography were used for data collection. Data were analyzed according to Bardin and the results were grouped in 4 categories: mothers see their function as a challenge; being healthy as a condition for quality of life; obstacles to achieve quality of life; health promotion practices to protect preadolescents from risks. The study showed mothers see themselves as participants in health promotion, which can guide health policy makers and encourage behavioral changes.

In this article, the authors discuss the value of international health in advancing the nursing profession through the development of strong leadership in the area of drug demand reduction. Paradigms for nursing leadership are briefly reviewed and linked to the development of the "International Nursing Leadership Institutes" organized by the Inter-American Commission for the Control of Drug Abuse (CICAD). The "International Nursing Leadership Institutes" have facilitated the implementation of Phase III of the CICAD Schools of Nursing Project: a) planning and implementing the first "International Research Capacity-Building Program for Nurses to Study the Drug Phenomenon in Latin America", b) development of Regional and National Strategic Plans for Nursing Professionals in the Area of Demand Reduction in Latin America, and c) preparation of a document that provides guidelines on how to include drug content into undergraduate and graduate nursing curricula. The article also brings reflections directly from several of the participants in the first International Research Capacity-Building Program for Nurses to Study the Drug Phenomenon in the Americas, offered in collaboration with the Faculty of Nursing at the University of Alberta in Edmonton, Canada. These reflections demonstrate the multiplicity of ways in which this capacity-building program has made it easier for these members of Latin American Schools of Nursing to show leadership in the area of drug demand reduction. En este artículo, los autores debaten el valor de la salud internacional para el avance de la profesión de enfermería a través del desarrollo de un sólido liderazgo en el área de reducción de la demanda de drogas. Los paradigmas de liderazgo de enfermería son brevemente revisados y tiene apoyado el desarrollo de la serie de "Institutos Internacionales de Liderazgo de Enfermería", organizados por la Comisión Interamericana para el Control del Abuso de Drogas (CICAD). Los "Institutos Internacionales de Liderazgo de Enfermería" han servido como facilitadores de la implementación de la Fase III del Proyecto de la CICAD de las Escuelas de Enfermería: a) planeamiento e implementación del primer "Programa Internacional de Capacitación de Enfermeras(os) para Estudiar el Fenómeno de las Drogas en América Latina", b) desarrollo de los Planes Estratégicos Regionales y Nacionales para la Profesión de Enfermería en el Área de la Reducción de la Demanda de Drogas y c) preparación de un documento directriz de como incluir el contenido de drogas en los currículos de pregrado y postgrado de enfermería. El articulo presenta también las consideraciones de los diversos participantes del primer Programa Internacional de Capacitación para Enfermeras(os), realizado en colaboración con la Facultad de Enfermería de la Universidad de Alberta, Edmonton, Canadá. Estas consideraciones demuestran la multiplicidad de maneras que el programa de capacitación ha presentado a los miembros de las Escuelas de Enfermería de América Latina para avanzar el liderazgo en el área de Reducción de la demanda de drogas. Neste artigo, os autores discutem o valor da saúde internacional para o avanço da profissão de enfermagem através do desenvolvimento de uma sólida Liderança na área de redução da demanda de drogas. Os paradigmas de Liderança em enfermagem são brevemente revisados e têm apoiado o desenvolvimento de uma série de "Institutos Internacionais de Liderança em Enfermagem", organizados pela Comissão Interamericana para o Controle do Abuso de Drogas (CICAD). Os "Institutos Internacionais de Liderança em Enfermagem" têm servido como facilitadores da implementação da Fase III do Projeto da CICAD das Escolas de Enfermagem: a) planejamento e implementação do primeiro "Programa Internacional de Capacitação de Enfermeiros no Estudo do Fenômeno das Drogas na América Latina", b) desenvolvimento de Planos Estratégicos Regionais e Nacionais para a Profissão de Enfermagem na Área da Redução da Demanda de Drogas e c) preparação de um documento de diretrizes de como incluir o conteúdo de drogas nos currículos de graduação e pós-graduação em enfermagem. O artigo apresenta também as considerações dos diversos participantes do primeiro Programa Internacional de Capacitação para Enfermeiras(os), realizado com a colaboração da Faculdade de Enfermagem da Universidade de Alberta, Edmonton, Canadá. Estas considerações demonstram a multiplicidade de maneiras que o programa de capacitação trouxe para os membros das Escolas de Enfermagem da América Latina para avançar a Liderança na área de redução da demanda de drogas.

El objetivo de este estudio etnográfico fue identificar patrones culturales presentes en las acciones de las madres al proteger a sus hijos de riesgos ambientales como drogas y violencia. Para la recopilación de las informaciones se realizó una entrevista estructurada y grabada con 10 madres de niños entre 9 y 13 años, complementadas con fotografías, notas de campo y observación participante. Las madres conceptualizan a su hijo como "un niño grande" que quiere tomar sus propias decisiones e independizarse, lo que genera conflictos al interior de la familia. Como conclusión, las madres perciben al preadolescente como más vulnerable, por lo que es necesario guiar y controlar muy de cerca el desarrollo de sus actividades, y creen que, de esta forma, ayudaran a su hijo a reconocer el peligro y a no involucrarse. The aim of this ethnographic trial was to identify cultural patterns present in mothers' actions when protecting their children from environmental risks like drugs and violence. Data collection consisted in a tape-recorded structured interview with 10 mothers of 9 to 13-year-old preadolescents, complemented with pictures, field notes and participant observation. Mothers conceptualize their child as a "Big Boy" who wants to make his own decisions and be independent, generating conflicts in the family as a whole. As a conclusion, mothers perceive their pre teenagers as more vulnerable, so a close guiding and control is necessary for their developing activities. They believe it will help their children to recognize hazardous situations and stay away from them. O objetivo deste estudo etnográfico foi identificar padrões culturais presentes nas ações das mães ao proteger seus filhos de riscos ambientais como drogas e violência. Para a coleta de informações, realizou-se uma entrevista estruturada gravada com 10 mães de crianças entre 9 e 13 anos, complementada com fotografias, notas de campo e observação participante. As mães conceitualizam seus filhos como "uma criança grande" que quer tomar suas próprias decisões e tornar-se independente, o que gera conflitos dentro da família. Como conclusão, as mães percebem seus filhos como mais vulneráveis, sendo necessário guiar e controlar mais de perto o desenvolvimento de suas atividades. Desta forma, elas acreditam que ajudarão seus filhos a reconhecer o perigo e a não envolver-se nele.

Purpose: To describe nursing education research literature in terms of quality, content areas under investigation, geographic location of the research, research designs utilized, sample sizes, instruments used to collect data, and funding sources.Design and Methods: Quantitative and qualitative research literature published between January 1991 and December 2000 were identified and classified using an author-generated Relevance Tool.Findings: 1286 articles were accepted and entered into the inventory, and an additional 22 were retained as references as they were either literature reviews or meta-analyses. Not surprisingly, 90% of nursing education research was generated in North America and Europe, the industrialised parts of the world. Of the total number of articles accepted into the inventory, 61% were quantitative research based. The bulk of the research was conducted within the confines of a course or within a program, with more than half based in educational settings. Sample sizes of the research conducted were diverse, with a bare majority using a sample between 50 and 99 participants. More than half of the studies used questionnaires to obtain data. Surprising, 80% of the research represented in these articles was not funded. The number of publications of nursing education research generated yearly stabilised at approximately 120 per year.Conclusion: Research programs on teaching and learning environments and practice in nursing education need to be developed. Lobbying is needed to increase funding for this type of research at national and international levels.

Neste artigo, os autores discutem o valor da saúde internacional para o avanço da profissão de enfermagem através do desenvolvimento de uma sólida Liderança na área de redução da demanda de drogas. Os paradigmas de Liderança em enfermagem são brevemente revisados e têm apoiado o desenvolvimento de uma série de Institutos Internacionais de Liderança em Enfermagem , organizados pela Comissão Interamericana para o Controle do Abuso de Drogas (CICAD). Os Institutos Internacionais de Liderança em Enfermagem têm servido como facilitadores da implementação da Fase III do Projeto da CICAD das Escolas de Enfermagem: a) planejamento e implementação do primeiro Programa Internacional de Capacitação de Enfermeiros no Estudo do Fenômeno das Drogas na América Latina , b) desenvolvimento de Planos Estratégicos Regionais e Nacionais para a Profissão de Enfermagem na Área da Redução da Demanda de Drogas e c) preparação de um documento de diretrizes de como incluir o conteúdo de drogas nos currículos de graduação e pós-graduação em enfermagem. O artigo apresenta também as considerações dos diversos participantes do primeiro Programa Internacional de Capacitação para Enfermeiras(os), realizado com a colaboração da Faculdade de Enfermagem da Universidade de Alberta, Edmonton, Canadá. Estas considerações demonstram a multiplicidade de maneiras que o programa de capacitação trouxe para os membros das Escolas de Enfermagem da América Latina para avançar a Liderança na área de redução da demanda de drogas.

The purpose of this qualitative study was to conduct a thematic analysis of unanalyzed semistructured interview segments from data that emerged during an earlier exploratory descriptive study on organizational factors and work hazards. The sample consisted of 56 transcribed interviews with staff and managerial public health nurses (PHNs) in five health units of the Province of Alberta before health care restructuring. The framework that resulted from this secondary analysis describes the ideologies (values, beliefs, concepts, and attitudes) of female PHNs related to their workplace environmental risks. Four categories of the overarching theme, framing personal risk in work environments, emerged: becoming aware, recognizing influences, comparing with others, and knowing rights and freedoms. Two subthemes also emerged: framing for no action and framing for action. When framing for no action, PHNs were either unconcerned or wanted to avoid trouble. When framing for action, PHNs found humor, took responsibility, used voice, collected support, and struggled for action.

Clarification of conceptualizations of empathy Background. If understanding our clients needs, emotions, and circumstances is fundamental to nursing practice, and empathy is the foundation of that understanding, then a conceptualization of empathy that can be used by nurses is of utmost importance to the profession. In 1992, Morse, Anderson, Bottorff, Yonge, O’Brien, Solberg and McIlveen analysed the concept of empathy in the psychological and nursing literature, and suggested the conceptualization of empathy was incomplete. Since that time, nurse authors have continued to publish conceptualizations and research on empathy. Purpose. The purpose of our analysis was to describe empathy as presented in the nursing literature between 1992 and 2000. Method. A concept clarification methodology of concept analysis was used because of the many definitions, the rich descriptions, and the application of empathy as a research variable in the reviewed literature. Findings. Five conceptualizations of empathy were revealed: empathy as human trait, empathy as a professional state, empathy as a communication process, empathy as caring, and empathy as a special relationship. Conclusions. The literature reviewed contained evidence that the concept is developing more depth and breadth. Nurse authors are approaching empathy from a variety of perspectives, time frames, measurements, and outcomes. While all are important to the development of the concept, further enrichment of the conceptual work on empathy is needed before a fully mature concept emerges that is fully useful in nursing practice, research, and education.

This study investigated the effects of a training module on the active listening skills of non-degree registered nurses. Active listening skills were defined as understanding what another person is saying and feeling and then communicating this understanding of his thoughts and feelings back to him. The sample consisted of 26 postdiploma RNs registered in the first year of a baccalaureate degree nursing program. Pretraining and posttraining data were collected when subjects verbally responded to two portions of the Behavioral Test of Interpersonal Skills for Health Professionals (BTIS). Subjects were audiotaped while responding and tapes were scored using BTIS guidelines. Paired t-tests were used to determine differences between pretraining and posttraining scores. Active listening scores increased significantly (p_< .0005) while attempts to suppress or discount speakers' feelings decreased significantly (2

Foreword, Richard Coll.- PART I: Conceptual Issues in the Nature of Science Research.- Chapter 1Changing the Focus: From Nature of Science to Features of Science, Michael Matthews.- Chapter 2 Perceptual, Attentional, and Cognitive Heuristics that Interact with the Nature of Science to Complicate Public Understanding of Science, Tina A. Grotzer, Rebecca B. Miller, Rebecca A. Lincoln.- Chapter 3 The Natures of Scientific Thinking: Creativity as the Handmaiden to Logic in the Development of Public and Personal Knowledge, Keith S Taber.- Chapter 4 The Bounded Nature of Science: An effective Tool in a Equitable Approach to the Teaching of Science, Sherry Southerland, Barry Golden, Patrick Enderle.- Chapter 5 Why the Study of Pseudoscience Should Be Included in Nature of Science Studies, Ronald Good.- Chapter 6 The Status of the Nature of Science in Science Education, Saouma BouJaoude, Garine Santourian.- PART II: Methodological Advances in the Nature of Science Research.- Chapter 7 Teaching and Learning of Nature of Science and Scientific Inquiry: Building Capacity through Systematic Research-Based Professional Development, Judith S. Lederman, Norman G. Lederman, Byoung Sug Kim, Eun Kyung Ko.- Chapter 8 The Nature of Scientists' Nature of Science Views, Renee' Schwartz.- Chapter 9 The Nature of Science or the Nature of Teachers: Beginning Science Teachers' Understanding of NOS, Jonah B. Firestone, Sissy S. Wong, Julie A. Luft, Derek Fay.- Chapter 10 Learning about Nature of Science in Undergraduate Biology Laboratories, Elisabeth Schussler, Nazan Bautista.- Chapter 11 Context Matters: Linking Nature of Science Instruction to Science Process Skills, Randy L. Bell, Bridget K. Mulvey, Jennifer L. Maeng.- Chapter 12 Impact of a Nature of Science and Science Education Course on Teachers' Nature of Science Classroom Practices, Michael Clough, Joanne Olson.- Index.