PROFESSION AND SOCIETY
Course Content Related to Chronic Wounds in Nursing Degree
Programs in Spain
Angel Romero-Collado, PhD, MSc, RN1, Marta Raurell-Torreda, PhD, MSc, RN2, Edurne Zabaleta-del-Olmo,
MSc, RN3, Erica Homs-Romero, RN4, & Carme Bertran-Noguer, PhD, MSc, RN5
1 Professor of Nursing, Nursing Department, University of Girona, Spain
2 Professor of Nursing, Nursing Department, University of Girona, Spain
3 University Institute for Primary Care Research Jordi Gol (Institut Universitari d’Investigació en Atenció Primària (IDIAP) Jordi Gol), Barcelona, Spain and
Researcher associated with the Universitat Autònoma de Barcelona, Bellaterra, Spain
4 Figueres Basic Healthcare Area (Àrea Bàsica de Salut de Figueres) Catalan Health Institute (Institut Català de la Salut), Girona, Spain
5 Head of Nursing Department, University of Girona, Spain
Key words
Curriculum, nursing education research,
nursing students, pressure ulcer, professional
competence, Spain, wound healing
Correspondence
Dr. Angel Romero-Collado, Professor of
Nursing, Nursing Department, University of
Girona, C/ Emili Grahit, 77, 17071 Girona, Spain.
E-mail: [email protected]
Accepted: July 19, 2014
doi: 10.1111/jnu.12106
Abstract
Purpose: To analyze content related to chronic wounds in nursing degree
programs in Spain.
Design: Cross-sectional descriptive study.
Methods: Course descriptions available for online access during June and
July of 2012 were reviewed for the 114 centers in Spain that offer a nursing
degree, according to the official Registry of Universities, Centers, and Titles.
Findings: Of the 114 centers with degree programs, 95 (83.3%) post course
content online, which make it possible to analyze 2,258 courses. In 60 (63.1%)
of these centers, none of the courses included the concept of pressure ulcer
prevention, and the course content posted by 36 (37.9%) centers made no
mention of their treatment. None of the course descriptions contained any
reference to pain management in patients with chronic wounds. Of the 728
elective courses analyzed, only one was related to chronic wounds.
Conclusions: This review of available information about nursing degree
programs in Spain indicates that pain management in patients with chronic
wounds is not addressed in any course, and more courses consider the treat-
ment of pressure ulcers than their prevention.
Clinical Relevance: Degree programs responsible for the training of future
nurses should be reviewed and revised as needed to ensure that graduates
have acquired minimum basic competencies in the prevention and treatment
of chronic wounds that help to decrease the theory–practice gap in this field.
Chronic wounds are a major factor in morbidity, mortal-
ity, and healthcare costs (Augustin, Brocatti, Rustenbach,
Schäfer & Herberger, 2014; Sen et al., 2009). On health-
care teams, nurses typically have the responsibility of car-
ing for patients who have these wounds or are at risk for
them (Caron-Mazet, Ro ...
Using GOOGLE Scholar, you must choose a scholarly journal article .docxjessiehampson
Using GOOGLE Scholar, you must choose a scholarly journal article on the topic of psychology. You may choose any article you feel contributes to the field of psychology and will write a 5 page paper (including cover page and reference page) based on the article.
Please use the following criteria when writing your paper: Times New Roman. 12point. Double-spaced. APA Style. Reference must be included at the end of the paper.
Please use the following website: https://scholar.google.com/
This paper is worth 100 points total. This must be submitted prior to the start of class on
Monday Class, April 18, 2020, 11:59pm.
Tuesday Class, April 19, 2020, 11:00pm.
There will be 5 points deducted for every day the assignment is late up to one
week. After that point, the student will earn a score of "0".
Introduction – 10pts
Introduce the topic and your reason for choosing this topic
Main topic- 45pts
Describe and discuss the topic (15pts)
The relationship to nursing (15pts)
The impact of topic on a specific population (could be cultural, the nurse, the
health care profession, the student, education) different from the main focus. This
could be positive or negative or both- (15pts)
Summary- 10pts
Incorporate a minimum of 2 peer reviewed journal articles into your paper to provide
insight to your topic- 15pts
APA format -10pts
Grammar, spelling, punctuation- 10pts
You may have no more than ONE direct quote. Must be cited properly.
Length of paper is 2-3 pages. In addition you must have a title page and a reference page.
Times New Roman 12pt. Font
One inch margins
Double spaced
U
ndertaking clinical skills is a central part of a nurse’s
professional role and successful clinical outcomes
depend on the competent performance of technical
procedures as well as an appropriate level of
understanding and a professional attitude (McNett,
2012; Harmon et al, 2016). Therefore, clinical skills teaching is a
vital part of the curriculum for pre-registration learners.
There is debate around whether skills teaching is the domain
of universities or practice placement settings (Borneuf and Haigh,
2010). Francis (2018) suggests that, as curriculum and practice
pressures have changed over time, questions have arisen over
who is responsible for clinical skills teaching, with nurse educators
not viewing it as their role and clinical staff having insufficient
resources to deliver the teaching (Borneuf and Haigh, 2010).
Tensions exist between the demands placed on nurse educators
to demonstrate excellence in teaching, research and maintaining
clinical credibility (Råholm et al, 2016). Leonard et al (2016)
argue that nurse educators do not need to undertake regular
clinical practice to demonstrate professional credibility in the
teaching environment of a university. Although it is suggested
Teaching clinical skills in pre-registration
nurse education: value and methods
Gary Francis and Martina O ...
Using GOOGLE Scholar, you must choose a scholarly journal article .docxjessiehampson
Using GOOGLE Scholar, you must choose a scholarly journal article on the topic of psychology. You may choose any article you feel contributes to the field of psychology and will write a 5 page paper (including cover page and reference page) based on the article.
Please use the following criteria when writing your paper: Times New Roman. 12point. Double-spaced. APA Style. Reference must be included at the end of the paper.
Please use the following website: https://scholar.google.com/
This paper is worth 100 points total. This must be submitted prior to the start of class on
Monday Class, April 18, 2020, 11:59pm.
Tuesday Class, April 19, 2020, 11:00pm.
There will be 5 points deducted for every day the assignment is late up to one
week. After that point, the student will earn a score of "0".
Introduction – 10pts
Introduce the topic and your reason for choosing this topic
Main topic- 45pts
Describe and discuss the topic (15pts)
The relationship to nursing (15pts)
The impact of topic on a specific population (could be cultural, the nurse, the
health care profession, the student, education) different from the main focus. This
could be positive or negative or both- (15pts)
Summary- 10pts
Incorporate a minimum of 2 peer reviewed journal articles into your paper to provide
insight to your topic- 15pts
APA format -10pts
Grammar, spelling, punctuation- 10pts
You may have no more than ONE direct quote. Must be cited properly.
Length of paper is 2-3 pages. In addition you must have a title page and a reference page.
Times New Roman 12pt. Font
One inch margins
Double spaced
U
ndertaking clinical skills is a central part of a nurse’s
professional role and successful clinical outcomes
depend on the competent performance of technical
procedures as well as an appropriate level of
understanding and a professional attitude (McNett,
2012; Harmon et al, 2016). Therefore, clinical skills teaching is a
vital part of the curriculum for pre-registration learners.
There is debate around whether skills teaching is the domain
of universities or practice placement settings (Borneuf and Haigh,
2010). Francis (2018) suggests that, as curriculum and practice
pressures have changed over time, questions have arisen over
who is responsible for clinical skills teaching, with nurse educators
not viewing it as their role and clinical staff having insufficient
resources to deliver the teaching (Borneuf and Haigh, 2010).
Tensions exist between the demands placed on nurse educators
to demonstrate excellence in teaching, research and maintaining
clinical credibility (Råholm et al, 2016). Leonard et al (2016)
argue that nurse educators do not need to undertake regular
clinical practice to demonstrate professional credibility in the
teaching environment of a university. Although it is suggested
Teaching clinical skills in pre-registration
nurse education: value and methods
Gary Francis and Martina O ...
Using GOOGLE Scholar, you must choose a scholarly journal article .docxadkinspaige22
Using GOOGLE Scholar, you must choose a scholarly journal article on the topic of psychology. You may choose any article you feel contributes to the field of psychology and will write a 5 page paper (including cover page and reference page) based on the article.
Please use the following criteria when writing your paper: Times New Roman. 12point. Double-spaced. APA Style. Reference must be included at the end of the paper.
Please use the following website: https://scholar.google.com/
This paper is worth 100 points total. This must be submitted prior to the start of class on
Monday Class, April 18, 2020, 11:59pm.
Tuesday Class, April 19, 2020, 11:00pm.
There will be 5 points deducted for every day the assignment is late up to one
week. After that point, the student will earn a score of "0".
Introduction – 10pts
Introduce the topic and your reason for choosing this topic
Main topic- 45pts
Describe and discuss the topic (15pts)
The relationship to nursing (15pts)
The impact of topic on a specific population (could be cultural, the nurse, the
health care profession, the student, education) different from the main focus. This
could be positive or negative or both- (15pts)
Summary- 10pts
Incorporate a minimum of 2 peer reviewed journal articles into your paper to provide
insight to your topic- 15pts
APA format -10pts
Grammar, spelling, punctuation- 10pts
You may have no more than ONE direct quote. Must be cited properly.
Length of paper is 2-3 pages. In addition you must have a title page and a reference page.
Times New Roman 12pt. Font
One inch margins
Double spaced
U
ndertaking clinical skills is a central part of a nurse’s
professional role and successful clinical outcomes
depend on the competent performance of technical
procedures as well as an appropriate level of
understanding and a professional attitude (McNett,
2012; Harmon et al, 2016). Therefore, clinical skills teaching is a
vital part of the curriculum for pre-registration learners.
There is debate around whether skills teaching is the domain
of universities or practice placement settings (Borneuf and Haigh,
2010). Francis (2018) suggests that, as curriculum and practice
pressures have changed over time, questions have arisen over
who is responsible for clinical skills teaching, with nurse educators
not viewing it as their role and clinical staff having insufficient
resources to deliver the teaching (Borneuf and Haigh, 2010).
Tensions exist between the demands placed on nurse educators
to demonstrate excellence in teaching, research and maintaining
clinical credibility (Råholm et al, 2016). Leonard et al (2016)
argue that nurse educators do not need to undertake regular
clinical practice to demonstrate professional credibility in the
teaching environment of a university. Although it is suggested
Teaching clinical skills in pre-registration
nurse education: value and methods
Gary Francis and Martina O ...
HRSA Comprehensive Geriatric Education Grant Posternomadicnurse
This grant funds a Clinical Nurse Specialist position to work with current Gerontological CNS in providing education, mentoring / support, developing / measuring outcomes for knowledge, practice change and patient outcomes by:
Expanding NICHE training at Piedmont Hospital in Atlanta beyond Acute Care nurses to include Emergency Department nurses;
2) Introducing NICHE training at Piedmont Fayette, Piedmont Newnan and Piedmont Mountainside for Acute Care and Emergency Department nurses;
3) Introducing NICHE training for nursing staff at two of our Long-Term Care facility partners; and
4) Disseminating program materials and information to other healthcare entities throughout Georgia and the U.S. through local workshops and presentations at national healthcare conferences.
A Career in Nursing Essay example
Advanced Practice Nursing Essay examples
What Is Nursing? Essay
The nursing process Essay
Essay on Nursing Care Plan
Nursing Exemplar
EDUCATION TEACHING PRACTICUM 1
EDUCATION TEACHING PRACTICUM 6
Coping strategies of nurses in the ICU when faced with the death of pediatric patients.
Coping strategies of nurses in the ICU when faced with the death of pediatric patients.
Objectives for and standards of the lessons
Patient-centered Care: Show empathy with the grief of the patient's relatives.
Teamwork and Collaboration: Demonstrate assertive communication with family members and other professionals at pediatric patients' end of life.
Evidence-Based Practice: Adequate ability to understand the concept of diagnosis, grief, and death
Quality Improvement: Identify risk factors and precipitants to reduce the probability of recurrence in future cases.
Safety: Minimize the suffering of the pediatric patient through Best-practice.
Informatics: Report all events surrounding the patient's death.
Nursing theory
The theory that will be used to guide the lesson is Elisabeth Kuebler ross's nursing theory. The Elisabeth Kuebler Ross nursing theory was proposed in the 1960s where she proposed five distinctive stages that people go through after they have lost a loved one. In the theory, the first stage is the denial stage, which helps people who have lost loved ones to reduce pain. The second stage is anger which is a common emotional feeling when one starts to ask why the beloved person died. In this stage, people who lost a loved one try to adjust to a new situation that might be hard for them. The third stage is bargaining, where people tend to bargain with anything around them so that they can be able to relieve the pain they are feeling. The fourth stage of grief is depression that develops as the events of loss sink into an individual. The last stage of griefing is acceptance, where people acknowledge that they have lost a loved one and plan on how to move on with life without the person (Corr, 2018S).
Describe student audience
Novice nurses in pediatric ICU unit with basic practical functions and support to experienced nurses. These nurses lack experience with pediatric patients in the ICU unit; hence they are undertaken through general rules that will enable them to perform various procedures.
Demographics of the student nurses
The nurses are aged between thirty years and forty years. The nursing group comprises both men and women who have little or no experience in ICU pediatric.
Interventions may be needed to account for varied learning styles.
In the learning process, the educator will need to involve different interventions to account for the different learning styles. Therefore, VARK MODEL will be used to identify the transverse learning style in the group. One of the interventions is to know and understand the students' different learning abilities. Once the appropriate learning style for the group has been identified, the educator will provide unique experiences that allow the learners to think critically to understand the concepts being taught. Al ...
Nurse Education Today 87 (2020) 104348
Contents lists available at ScienceDirect
Nurse Education Today
journal homepage: www.elsevier.com/locate/nedt
Clinical mentors' experiences of their intercultural communication T competence in mentoring culturally and linguistically diverse nursing students: A qualitative study
Pia Hagqvista,b, Ashlee Oikarainena, Anna-Maria Tuomikoskia, Jonna Juntunena, Kristina Mikkonena,⁎
a Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland b Healthcare Unit, Centria University of Applied Sciences, Finland
ARTICLE INFO
Keywords:
Clinical practice
Intercultural communication Competence
Cultural and linguistic diversity Nurse
Mentor
Student
ABSTRACT
Background: Intercultural communication has become increasingly important in nursing due to the cross-border mobility of patients, health professionals and students. Development of cultural competence continues to be a challenge, particularly among professionals such as educators or healthcare providers who work in professions requiring communication across cultural boundaries. Despite challenges in nursing education related to cultural diversity, competence in intercultural communication has been proven to empower students and to help them grow professionally.
Objectives: The aim of this study was to describe clinical mentors' experiences of their intercultural commu- nication competence in mentoring culturally and linguistically diverse nursing students during completion of their clinical practice.
Design: Qualitative study design.
Participants: The participants were 12 nurses who had previously mentored at least two culturally and lin- guistically diverse nursing students.
Methods: Data were collected during spring 2016 using semi-structured interviews of 12 mentors working in specialized nursing care at one hospital located in central Finland. Data were analyzed using deductive-inductive content analysis. The main concepts of the Integrated Model of Intercultural Communication Competence were used during the semi-structured theme interviews and during analysis. These concepts include empathy, moti- vation, global attitude, intercultural experience and interaction involvement.
Results: Mentors stated that empathy motivates them in the development of intercultural communication. Mentors experienced a lack of resources and support from their superiors, which caused psychological and ethical strain and reduced mentors' motivation. Mentors openly admitted that they had experienced fear towards unknown cultures, but that this fear was reduced through positive mentoring experiences and cultural en- counters.
Conclusions: Continuous education on intercultural communication competence could succeed to further de- velop clinical mentors' mentoring expertise, which could have the potential to greatly benefit students, patients and staff. Such education could be designed, implemented and measured for its effect in co.
COMMUNICATING WITH VENTILATED PATIENTS1COMMUNICATING WITH VE.docxrichardnorman90310
COMMUNICATING WITH VENTILATED PATIENTS1
COMMUNICATING WITH VENTILATED PATIENTS2
Communicating with Ventilated Patients
Student’s Name
Date
Communicating with Ventilated Patients
Introduction
It may be hard to communicate with patients under mechanical ventilation as a member of an inter-professional team offering care. Ventilated patients are unable to communicate because of the presence of the endotracheal tube (ETT). However, such communication is important to ensure patient safety and comfort since patients under such conditions usually experience panic, anxiety, fear, pain, and dyspnea, among other types of discomfort. Furthermore, despite their conditions, mechanically ventilated patients desire and have the right to be heard and take part in the making of decisions on their health for the attainment of patient-centered care.
This topic is important to contribute to the area of nursing to limit the gap of knowledge regarding relevant methods and strategies of communication for proper communication with ventilated patients. Research reveals that the care process for ventilated patients is undermined when there is a lack of communication between the patient and the caregivers. The presence of a communication barrier coupled with the health issue put the patients in a state of hopelessness. Identifying relevant communication methods for communicating with ventilated patients is important to eliminate feelings of fear, pain, and insecurity over the severity of their conditions.
Additionally, the identification of such communication methods will be useful towards the attainment of positive care outcomes in health care organizations that provide intensive care to critically ill patients. Organizations that consider such communication are bound to stand out as the leading in quality health care providers within their locales. Proper communication with ventilated patients will contribute to the research and study of the experiences of patients under mechanical ventilation and will enhance evidence-based care for such patients.
Literature Review (Topic)
Over the years, scholars and professionals in the healthcare industry have researched the issue of communicating with ventilated patients. One such research is documented in The Ventilated Patient’s Experience, which seeks to find out if there exists a relationship between the use of effective communication tools with ventilated patients with satisfaction with care among the patient and family (Fink, Makic, Poteet and Oman, 2015). The authors of the article indicate that anxiety, pain, and fear are some of the emotions that patients under mechanical ventilation have to deal with.
Furthermore, upon recovery, these patients deal with traumatic memories that may be realistic, delusional, or emotional. Such memories of their time in intensive care place the patients at risk of psychological problems and post-traumatic stress disorder (PTSD) that may linge.
1. The Incident Command System (ICS) is a tool forA. Co.docxstilliegeorgiana
1. The Incident Command System (ICS) is a tool for:
A. Command, control, and coordination at an incident
B. Interagency responses only
C. Multi-jurisdictional responses only
D. Responses involving first-response personnel only
2. ICS can be used to manage all types of incidents.
A. True
B. False
3. Federal law requires that ICS be used for all natural disasters.
A. True
B. False
4.The ICS General Staff includes:
A. Branch, Division, Group, and Unit managers
B. All managers of operational resources.
C. Planning, Operations, Logistics, and Finance/Administration Section Chiefs
D. Incident Commander and the Information, Safety, and Liaison Officers
5. All incidents, regardless of size, will have an Incident Commander.
A. True
B. False
6. In an ICS environment, the optimum span of control is:
A. Two (2) resources
B. Five (5) resources
C. Eight (8) resources
D. Ten (10) resources
7. Which section is responsible for providing incident facilities?
A. Planning
B. Operations
C. Logistics
D. Finance/Administration
8. Which section is responsible for documenting the status of resources, incident response, and developing the IAP?
A. Planning
B. Operations
C. Logistics
D. Finance/Administration
9. The Incident Commander is responsible for all the following EXCEPT:
A. Protecting life and property
B. Controlling resources assigned to the incident
C. Maintaining accountability
D. Coordinating the community-wide response
10. Given what you know about your agency, your job and you capabilities, where would you most likely be assigned in an ICS structure? To whom would you report? Be sure to include what your job is or would be during an event.
.
1. The Thirteenth Amendment effectively brought an end to slaver.docxstilliegeorgiana
1. The Thirteenth Amendment effectively brought an end to slavery in the United States. Lincoln had issued the Emancipation Proclamation over 3 years earlier. Why, then, was the Thirteenth Amendment issued? Was it necessary? How come?
2. The Fourteenth Amendment settled the question of who is a citizen of the United States. (anyone naturalized or born here). Why are Indians excluded?
3. Persons who are citizens may not be denied the right to vote according to the Fifteenth Amendment. The Civil Rights crises of the 1960s, and the work of Martin Luther King (and many others) sought, among other things, to assure that the right to vote was available to all. Why? The Fifteenth Amendment had been passed almost a hundred years earlier. How could persons be denied the ballot?
4. How could Andrew Johnson, Lincoln's successor, veto the Civil Rights Bill in 1866 when the 13th Amendment had already been passed in 1865? What issues did he cite to justify his veto? (Hint: look at the Johnson primary source)
5. The 14th Amendment. How does Foner explain the relationship between the Federal and the State as a result of the 14th Amendment?
https://util.wwnorton.com/jwplayer?type=video&msrc=/wwnorton.college.public/history/give/reconstruction-johnson.mp4&csrc=/wwnorton.college.public/history/give/reconstruction-johnson.vtt&cp=1
https://util.wwnorton.com/jwplayer?type=video&msrc=/wwnorton.college.public/history/give/14th-amendment.mp4&csrc=/wwnorton.college.public/history/give/14th-amendment.vtt&cp=1
https://util.wwnorton.com/jwplayer?type=video&msrc=/wwnorton.college.public/history/give/reconstruction-amendments-2.mp4&csrc=/wwnorton.college.public/history/give/reconstruction-amendments-2.vtt&cp=1
.
More Related Content
Similar to PROFESSION AND SOCIETYCourse Content Related to Chronic Wo.docx
Using GOOGLE Scholar, you must choose a scholarly journal article .docxadkinspaige22
Using GOOGLE Scholar, you must choose a scholarly journal article on the topic of psychology. You may choose any article you feel contributes to the field of psychology and will write a 5 page paper (including cover page and reference page) based on the article.
Please use the following criteria when writing your paper: Times New Roman. 12point. Double-spaced. APA Style. Reference must be included at the end of the paper.
Please use the following website: https://scholar.google.com/
This paper is worth 100 points total. This must be submitted prior to the start of class on
Monday Class, April 18, 2020, 11:59pm.
Tuesday Class, April 19, 2020, 11:00pm.
There will be 5 points deducted for every day the assignment is late up to one
week. After that point, the student will earn a score of "0".
Introduction – 10pts
Introduce the topic and your reason for choosing this topic
Main topic- 45pts
Describe and discuss the topic (15pts)
The relationship to nursing (15pts)
The impact of topic on a specific population (could be cultural, the nurse, the
health care profession, the student, education) different from the main focus. This
could be positive or negative or both- (15pts)
Summary- 10pts
Incorporate a minimum of 2 peer reviewed journal articles into your paper to provide
insight to your topic- 15pts
APA format -10pts
Grammar, spelling, punctuation- 10pts
You may have no more than ONE direct quote. Must be cited properly.
Length of paper is 2-3 pages. In addition you must have a title page and a reference page.
Times New Roman 12pt. Font
One inch margins
Double spaced
U
ndertaking clinical skills is a central part of a nurse’s
professional role and successful clinical outcomes
depend on the competent performance of technical
procedures as well as an appropriate level of
understanding and a professional attitude (McNett,
2012; Harmon et al, 2016). Therefore, clinical skills teaching is a
vital part of the curriculum for pre-registration learners.
There is debate around whether skills teaching is the domain
of universities or practice placement settings (Borneuf and Haigh,
2010). Francis (2018) suggests that, as curriculum and practice
pressures have changed over time, questions have arisen over
who is responsible for clinical skills teaching, with nurse educators
not viewing it as their role and clinical staff having insufficient
resources to deliver the teaching (Borneuf and Haigh, 2010).
Tensions exist between the demands placed on nurse educators
to demonstrate excellence in teaching, research and maintaining
clinical credibility (Råholm et al, 2016). Leonard et al (2016)
argue that nurse educators do not need to undertake regular
clinical practice to demonstrate professional credibility in the
teaching environment of a university. Although it is suggested
Teaching clinical skills in pre-registration
nurse education: value and methods
Gary Francis and Martina O ...
HRSA Comprehensive Geriatric Education Grant Posternomadicnurse
This grant funds a Clinical Nurse Specialist position to work with current Gerontological CNS in providing education, mentoring / support, developing / measuring outcomes for knowledge, practice change and patient outcomes by:
Expanding NICHE training at Piedmont Hospital in Atlanta beyond Acute Care nurses to include Emergency Department nurses;
2) Introducing NICHE training at Piedmont Fayette, Piedmont Newnan and Piedmont Mountainside for Acute Care and Emergency Department nurses;
3) Introducing NICHE training for nursing staff at two of our Long-Term Care facility partners; and
4) Disseminating program materials and information to other healthcare entities throughout Georgia and the U.S. through local workshops and presentations at national healthcare conferences.
A Career in Nursing Essay example
Advanced Practice Nursing Essay examples
What Is Nursing? Essay
The nursing process Essay
Essay on Nursing Care Plan
Nursing Exemplar
EDUCATION TEACHING PRACTICUM 1
EDUCATION TEACHING PRACTICUM 6
Coping strategies of nurses in the ICU when faced with the death of pediatric patients.
Coping strategies of nurses in the ICU when faced with the death of pediatric patients.
Objectives for and standards of the lessons
Patient-centered Care: Show empathy with the grief of the patient's relatives.
Teamwork and Collaboration: Demonstrate assertive communication with family members and other professionals at pediatric patients' end of life.
Evidence-Based Practice: Adequate ability to understand the concept of diagnosis, grief, and death
Quality Improvement: Identify risk factors and precipitants to reduce the probability of recurrence in future cases.
Safety: Minimize the suffering of the pediatric patient through Best-practice.
Informatics: Report all events surrounding the patient's death.
Nursing theory
The theory that will be used to guide the lesson is Elisabeth Kuebler ross's nursing theory. The Elisabeth Kuebler Ross nursing theory was proposed in the 1960s where she proposed five distinctive stages that people go through after they have lost a loved one. In the theory, the first stage is the denial stage, which helps people who have lost loved ones to reduce pain. The second stage is anger which is a common emotional feeling when one starts to ask why the beloved person died. In this stage, people who lost a loved one try to adjust to a new situation that might be hard for them. The third stage is bargaining, where people tend to bargain with anything around them so that they can be able to relieve the pain they are feeling. The fourth stage of grief is depression that develops as the events of loss sink into an individual. The last stage of griefing is acceptance, where people acknowledge that they have lost a loved one and plan on how to move on with life without the person (Corr, 2018S).
Describe student audience
Novice nurses in pediatric ICU unit with basic practical functions and support to experienced nurses. These nurses lack experience with pediatric patients in the ICU unit; hence they are undertaken through general rules that will enable them to perform various procedures.
Demographics of the student nurses
The nurses are aged between thirty years and forty years. The nursing group comprises both men and women who have little or no experience in ICU pediatric.
Interventions may be needed to account for varied learning styles.
In the learning process, the educator will need to involve different interventions to account for the different learning styles. Therefore, VARK MODEL will be used to identify the transverse learning style in the group. One of the interventions is to know and understand the students' different learning abilities. Once the appropriate learning style for the group has been identified, the educator will provide unique experiences that allow the learners to think critically to understand the concepts being taught. Al ...
Nurse Education Today 87 (2020) 104348
Contents lists available at ScienceDirect
Nurse Education Today
journal homepage: www.elsevier.com/locate/nedt
Clinical mentors' experiences of their intercultural communication T competence in mentoring culturally and linguistically diverse nursing students: A qualitative study
Pia Hagqvista,b, Ashlee Oikarainena, Anna-Maria Tuomikoskia, Jonna Juntunena, Kristina Mikkonena,⁎
a Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland b Healthcare Unit, Centria University of Applied Sciences, Finland
ARTICLE INFO
Keywords:
Clinical practice
Intercultural communication Competence
Cultural and linguistic diversity Nurse
Mentor
Student
ABSTRACT
Background: Intercultural communication has become increasingly important in nursing due to the cross-border mobility of patients, health professionals and students. Development of cultural competence continues to be a challenge, particularly among professionals such as educators or healthcare providers who work in professions requiring communication across cultural boundaries. Despite challenges in nursing education related to cultural diversity, competence in intercultural communication has been proven to empower students and to help them grow professionally.
Objectives: The aim of this study was to describe clinical mentors' experiences of their intercultural commu- nication competence in mentoring culturally and linguistically diverse nursing students during completion of their clinical practice.
Design: Qualitative study design.
Participants: The participants were 12 nurses who had previously mentored at least two culturally and lin- guistically diverse nursing students.
Methods: Data were collected during spring 2016 using semi-structured interviews of 12 mentors working in specialized nursing care at one hospital located in central Finland. Data were analyzed using deductive-inductive content analysis. The main concepts of the Integrated Model of Intercultural Communication Competence were used during the semi-structured theme interviews and during analysis. These concepts include empathy, moti- vation, global attitude, intercultural experience and interaction involvement.
Results: Mentors stated that empathy motivates them in the development of intercultural communication. Mentors experienced a lack of resources and support from their superiors, which caused psychological and ethical strain and reduced mentors' motivation. Mentors openly admitted that they had experienced fear towards unknown cultures, but that this fear was reduced through positive mentoring experiences and cultural en- counters.
Conclusions: Continuous education on intercultural communication competence could succeed to further de- velop clinical mentors' mentoring expertise, which could have the potential to greatly benefit students, patients and staff. Such education could be designed, implemented and measured for its effect in co.
COMMUNICATING WITH VENTILATED PATIENTS1COMMUNICATING WITH VE.docxrichardnorman90310
COMMUNICATING WITH VENTILATED PATIENTS1
COMMUNICATING WITH VENTILATED PATIENTS2
Communicating with Ventilated Patients
Student’s Name
Date
Communicating with Ventilated Patients
Introduction
It may be hard to communicate with patients under mechanical ventilation as a member of an inter-professional team offering care. Ventilated patients are unable to communicate because of the presence of the endotracheal tube (ETT). However, such communication is important to ensure patient safety and comfort since patients under such conditions usually experience panic, anxiety, fear, pain, and dyspnea, among other types of discomfort. Furthermore, despite their conditions, mechanically ventilated patients desire and have the right to be heard and take part in the making of decisions on their health for the attainment of patient-centered care.
This topic is important to contribute to the area of nursing to limit the gap of knowledge regarding relevant methods and strategies of communication for proper communication with ventilated patients. Research reveals that the care process for ventilated patients is undermined when there is a lack of communication between the patient and the caregivers. The presence of a communication barrier coupled with the health issue put the patients in a state of hopelessness. Identifying relevant communication methods for communicating with ventilated patients is important to eliminate feelings of fear, pain, and insecurity over the severity of their conditions.
Additionally, the identification of such communication methods will be useful towards the attainment of positive care outcomes in health care organizations that provide intensive care to critically ill patients. Organizations that consider such communication are bound to stand out as the leading in quality health care providers within their locales. Proper communication with ventilated patients will contribute to the research and study of the experiences of patients under mechanical ventilation and will enhance evidence-based care for such patients.
Literature Review (Topic)
Over the years, scholars and professionals in the healthcare industry have researched the issue of communicating with ventilated patients. One such research is documented in The Ventilated Patient’s Experience, which seeks to find out if there exists a relationship between the use of effective communication tools with ventilated patients with satisfaction with care among the patient and family (Fink, Makic, Poteet and Oman, 2015). The authors of the article indicate that anxiety, pain, and fear are some of the emotions that patients under mechanical ventilation have to deal with.
Furthermore, upon recovery, these patients deal with traumatic memories that may be realistic, delusional, or emotional. Such memories of their time in intensive care place the patients at risk of psychological problems and post-traumatic stress disorder (PTSD) that may linge.
1. The Incident Command System (ICS) is a tool forA. Co.docxstilliegeorgiana
1. The Incident Command System (ICS) is a tool for:
A. Command, control, and coordination at an incident
B. Interagency responses only
C. Multi-jurisdictional responses only
D. Responses involving first-response personnel only
2. ICS can be used to manage all types of incidents.
A. True
B. False
3. Federal law requires that ICS be used for all natural disasters.
A. True
B. False
4.The ICS General Staff includes:
A. Branch, Division, Group, and Unit managers
B. All managers of operational resources.
C. Planning, Operations, Logistics, and Finance/Administration Section Chiefs
D. Incident Commander and the Information, Safety, and Liaison Officers
5. All incidents, regardless of size, will have an Incident Commander.
A. True
B. False
6. In an ICS environment, the optimum span of control is:
A. Two (2) resources
B. Five (5) resources
C. Eight (8) resources
D. Ten (10) resources
7. Which section is responsible for providing incident facilities?
A. Planning
B. Operations
C. Logistics
D. Finance/Administration
8. Which section is responsible for documenting the status of resources, incident response, and developing the IAP?
A. Planning
B. Operations
C. Logistics
D. Finance/Administration
9. The Incident Commander is responsible for all the following EXCEPT:
A. Protecting life and property
B. Controlling resources assigned to the incident
C. Maintaining accountability
D. Coordinating the community-wide response
10. Given what you know about your agency, your job and you capabilities, where would you most likely be assigned in an ICS structure? To whom would you report? Be sure to include what your job is or would be during an event.
.
1. The Thirteenth Amendment effectively brought an end to slaver.docxstilliegeorgiana
1. The Thirteenth Amendment effectively brought an end to slavery in the United States. Lincoln had issued the Emancipation Proclamation over 3 years earlier. Why, then, was the Thirteenth Amendment issued? Was it necessary? How come?
2. The Fourteenth Amendment settled the question of who is a citizen of the United States. (anyone naturalized or born here). Why are Indians excluded?
3. Persons who are citizens may not be denied the right to vote according to the Fifteenth Amendment. The Civil Rights crises of the 1960s, and the work of Martin Luther King (and many others) sought, among other things, to assure that the right to vote was available to all. Why? The Fifteenth Amendment had been passed almost a hundred years earlier. How could persons be denied the ballot?
4. How could Andrew Johnson, Lincoln's successor, veto the Civil Rights Bill in 1866 when the 13th Amendment had already been passed in 1865? What issues did he cite to justify his veto? (Hint: look at the Johnson primary source)
5. The 14th Amendment. How does Foner explain the relationship between the Federal and the State as a result of the 14th Amendment?
https://util.wwnorton.com/jwplayer?type=video&msrc=/wwnorton.college.public/history/give/reconstruction-johnson.mp4&csrc=/wwnorton.college.public/history/give/reconstruction-johnson.vtt&cp=1
https://util.wwnorton.com/jwplayer?type=video&msrc=/wwnorton.college.public/history/give/14th-amendment.mp4&csrc=/wwnorton.college.public/history/give/14th-amendment.vtt&cp=1
https://util.wwnorton.com/jwplayer?type=video&msrc=/wwnorton.college.public/history/give/reconstruction-amendments-2.mp4&csrc=/wwnorton.college.public/history/give/reconstruction-amendments-2.vtt&cp=1
.
1. The Thirteenth Amendment effectively brought an end to slavery in.docxstilliegeorgiana
1. The Thirteenth Amendment effectively brought an end to slavery in the United States. Lincoln had issued the Emancipation Proclamation over 3 years earlier. Why, then, was the Thirteenth Amendment issued? Was it necessary? How come?
2. The Fourteenth Amendment settled the question of who is a citizen of the United States. (anyone naturalized or born here). Why are Indians excluded?
3. Persons who are citizens may not be denied the right to vote according to the Fifteenth Amendment. The Civil Rights crises of the 1960s, and the work of Martin Luther King (and many others) sought, among other things, to assure that the right to vote was available to all. Why? The Fifteenth Amendment had been passed almost a hundred years earlier. How could persons be denied the ballot?
4. How could Andrew Johnson, Lincoln's successor, veto the Civil Rights Bill in 1866 when the 13th Amendment had already been passed in 1865? What issues did he cite to justify his veto? (Hint: look at the Johnson primary source)
5. The 14th Amendment. How does Foner explain the relationship between the Federal and the State as a result of the 14th Amendment?
https://util.wwnorton.com/jwplayer?type=video&msrc=/wwnorton.college.public/history/give/reconstruction-johnson.mp4&csrc=/wwnorton.college.public/history/give/reconstruction-johnson.vtt&cp=1
https://util.wwnorton.com/jwplayer?type=video&msrc=/wwnorton.college.public/history/give/14th-amendment.mp4&csrc=/wwnorton.college.public/history/give/14th-amendment.vtt&cp=1
https://util.wwnorton.com/jwplayer?type=video&msrc=/wwnorton.college.public/history/give/reconstruction-amendments-2.mp4&csrc=/wwnorton.college.public/history/give/reconstruction-amendments-2.vtt&cp=1
.
1. The Fight for a True Democracyhttpswww.nytimes.com201.docxstilliegeorgiana
1. The Fight for a True Democracy
https://www.nytimes.com/2019/08/23/podcasts/1619-slavery-anniversary.html
(Follow the link to the podcast)
Directions:
Students will listen to this podcast and write 3 paragraphs about it. One paragraph should summarize the podcast episode, the second paragraph should discuss its significance in U.S. History, and the last paragraph should explain what the student thought about the podcast.
.
1. The article for week 8 described hip hop as a weapon. This weeks.docxstilliegeorgiana
1. The article for week 8 described hip hop as a weapon. This week's reading makes several references to hip hop and spirituality? Can hip hop be described as a spiritual movement? Why or why not?
2. In the movie, "I Love Hip Hop in Morocco" on of the rappers repeatedly used the "N" word. Do you agree with his use of the "N" word for Moroccans? How did he justify its use?
.
1. The Hatch Act defines prohibited activities of public employees. .docxstilliegeorgiana
1. The Hatch Act defines prohibited activities of public employees. Analyze the significance of these prohibitions with regard to an individual’s political actions. Provide a rationale for your response.
2. Analyze the key ethical challenges of privatization. Take a position on whether the private sector should be responsible for program outcomes of a public program or service. Provide a rationale for your response
.
1. The Case for Reparations” by Ta-Nehisi Coates (604-19) in Rere.docxstilliegeorgiana
1. “The Case for Reparations” by Ta-Nehisi Coates (604-19) in Rereading America
2. “Choosing a School for My Daughter in a Segregated City” (152) by Nikole Hannah-Jones3. “From Social Class and the Hidden Curriculum of Work” (136) by Jean Anyon
4. John Taylor Gatto's "Against School" (114) in Rereading America
How to Do Extra Credit: 1. 5 Paged Essay-Must Be Singled Spaced.
For 100 points do extra credit where you review a film, video, music video, or lecture or book that reflects the discussions in class. Write a paper on themes presented in the class reflected in one of those mediums. Consider the ideas about culture. Observe how culture and condition were presented. Think about what values were being preserved or dismantled. Then, write in third person, what was learned. The essay is in third person; don’t write you, we, our us, or me. It is not considered academic.
Question: What are the themes in the event that link to the course, and how do those themes represent social problems or ways to resolve those problems?
1st Paragraph 100 POINTS FOR ESSAY
Introduction: Write summary of the event, lecture, music video, or song. (5 sentences)
Thesis: Answer the questions above. (1-2 sentences)
2nd Paragraph
Point: Write what is the importance of the theme. (1-2 sentences)
Illustration A. Summary (3 sentences)
Illustration B. Quotation (1-2 lines)
Explanation:
A. Explain the importance of the quote (2 sentences)
B. Explain how the importance is linked to Anzaldua (2 sentences)
3rd Paragraph
Point: Write what is the importance of the theme. (1-2 sentences)
Illustration A. Summary (3 sentences)
Illustration B. Quotation (1-2 lines)
Explanation:
A. Explain the importance of the quote (2 sentences)
B. Explain how the importance is linked Anzaldua (2 sentences)
4th Paragraph
Point: Write what is the importance of the theme. (1-2 sentences)
Illustration A. Summary (3 sentences)
Illustration B. Quotation (1-2 lines)
Explanation:
A. Explain the importance of the quote (2 sentences)
B. Explain how the importance is linked to Anzaldua (2 sentences)
5th Conclusion: Write 3 sentences on what you learned you didn't know before. Write in third person.
.
1. Some people say that chatbots are inferior for chatting.Others di.docxstilliegeorgiana
1. Some people say that chatbots are inferior for chatting.Others disagree. Discuss.
2. Discuss the financial benefits of chatbots.
3. Discuss how IBM Watson will reach 1 billion people by 2018 and what the implications of that are.
4. Compare the chatbots of Facebook and WeChat. Which has more functionalities?
5. Research the role of chatbots in helping patients with dementia
6. Microsoft partners with the government of Singapore to develop chatbots for e-services. Find out how this is done.
APA format with 2 references.
2 pages
.
1. Some people say that chatbots are inferior for chatting.Other.docxstilliegeorgiana
1. Some people say that chatbots are inferior for chatting.Others disagree. Discuss.
2. Discuss the financial benefits of chatbots.
3. Discuss how IBM Watson will reach 1 billion people by 2018 and what the implications of that are.
4. Compare the chatbots of Facebook and WeChat. Which has more functionalities?
5. Research the role of chatbots in helping patients with dementia
6. Microsoft partners with the government of Singapore to develop chatbots for e-services. Find out how this is done.
APA format with 2 references.
2 pages
.
1. Some people say that chatbots are inferior for chatting. Others d.docxstilliegeorgiana
1. Some people say that chatbots are inferior for chatting. Others disagree. Discuss.
2. Discuss the financial benefits of chatbots.
3. Discuss how IBM Watson will reach 1 billion people by 2018 and what the implications of that are.
4. Compare the chatbots of Facebook and WeChat. Which has more functionalities?
5. Research the role of chatbots in helping patients with dementia.
6.Microsoft partners with the government of Singapore to develop chatbots for e-services. Find out how this is done.
Note: Each question must be answered in 6-7 ines and refernces must be APA cited
.
1. Tell us about yourself and your personal journey that has to .docxstilliegeorgiana
1. Tell us about yourself and your personal journey that has to lead you to the University of the ABC. (Currently, I’m pursuing my masters in IT and next applying for Ph.D. In IT) in same ABC university
2. What are your research interests in the area of information technology? How did you become interested in this area of research?
3. What unique qualities do you think you have that will help you in being successful in this program? (Ph.D. IT Program)
4. How can obtaining a doctorate impact your contribution to the practices of information technology? Where do you see yourself after obtaining a doctorate from ABC?
.
1. Tell us what characteristics of Loma Linda University are particu.docxstilliegeorgiana
1. Tell us what characteristics of Loma Linda University are particularly attractive and meaningful to you and why you have chosen to apply for advanced education.
(500 words)
2.
LLU believes deeply in integrating spiritual values into the educational experience. As a result, religion courses and chapel attendance are part of the curriculum. Tell us why you believe such a faith-based education would be of special benefit to you. (500 words)
3.
Tell us the desirable qualities that you see in yourself that you believe would aid us in considering your application. (1000 words)
4. Discuss how your spiritual origins, development, and experience have influenced and been integrated into your daily life. (1000 words)
.
1. Tell us about yourself and your personal journey that has lea.docxstilliegeorgiana
1. Tell us about yourself and your personal journey that has lead you to University of the Cumberlands.
2. What are your research interests in the area of information technology? How did you become interested in this area of research?
3. What is your current job/career and how will this program impact your career growth?
4. What unique qualities do you think you have that will help you in being successful in this program?
5. How can obtaining a doctorate impact your contribution to the practices of information technology? Where do you see yourself after obtaining a doctorate from UC?
.
1. The Research paper will come in five parts. The instructions are.docxstilliegeorgiana
1. The Research paper will come in five parts. The instructions are:
RESEARCH PAPER TOPIC
Impact of Women in Missions History
o
Part 2:
Refined topic, edited abstract, outline, and ten sources - Students will incorporate any changes to topic, outline the paper, write questions to be answered by the research, and submit ten sources. Submit Part 2 by 11:59 p.m. (ET) on Sunday of Module/Week 3.
Note:
Some will need to limit their topic. Others will need to expand their topic. This process should begin this week and continue until the final project is submitted.
DUE SUNDAY, MAY 31ST
o
Part 3:
Introduction and first five pages - Students will submit the introduction and first five pages of the research paper. Submit Part 3 by 11:59 p.m. (ET) on Sunday of Module/Week 4.
DUE FRIDAY, JUNE 5TH
o
Part 4:
Introduction and first ten pages - Students will submit introduction and first ten pages, incorporating changes made to initial submission. Submit Part 4 by 11:59 p.m. (ET) on Sunday of Module/Week 5.
DUE FRIDAY, JUNE 12TH
o
Part 5:
Complete research paper - Students will submit the complete research paper. The paper will be 5000-6000 words in the body of the paper, with a minimum of ten academic resources cited. Submit Part 5 by 11:59 p.m. (ET) on Sunday of Module/Week 7
DUE FRIDAY, JUNE 19TH
.
1. The minutiae points located on a fingerprint will help determine .docxstilliegeorgiana
1. The minutiae points located on a fingerprint will help determine the _________________ of a fingerprint since it has been empirically demonstrated that no two fingerprints are alike.
2. A fingerprint will remain ______________ during an individual's lifetime.
3. The epidermis is the outer layer of the skin, while the ___________ is the inner layer of the skin.
4. The ____________ is formed by ridges entering from one side of the print, rising and falling, and exiting on the opposite side (like a wave).
5. Level 2 includes locating and comparing _________________
.
1. The initial post is to be posted first and have 300-500 words.docxstilliegeorgiana
1. The initial post is to be posted first and have 300-500 words
· The original post is substantive, showing depth of knowledge on the topic and requires 2 references. References are from LDRS 300 course text or readings.
· Substantive replies occur under two or more different threads, other than that belonging to you.
· Response posts to peers' original postings are respectful, show clear synthesis and evaluation of the content read, and provides depth, breath, or new insight to the topic.
· Be clearly written and contain no APA/spelling/grammatical errors
Use
APA Citations for all your sources and include an APA References list. (No Title Page, or other APA formatting is required)
Spelling and Grammar is important.
Discussion Question: Servant Leadership in a movie, book, or drama film you have enjoyed.
Based on our readings from
Lead Like Jesus
(Blanchard, Hodges, & Hendry, 2016),
Jesus on Leadership (Wilkes, 1998)
and thus far in the lectures of LDRS 300;
A Servant Leader models Jesus by having the following leadership traits
:
1. Followership.
2. Greatness in Service.
3. Takes Risks.
4. Shares Responsibility and Authority.
5. Practices
one of
the Being Habits or Doing Habits.
6. Embodies the Vision, Mission, and Values of the group.
7. Is a Performance Coach.
8. Displays Lessons Learned from The Work of a Carpenter.
Choose a character from a movie and discuss the following two questions.
1.
How did the character display TWO (2) traits of a Servant Leader like Jesus from the list above?
1.
Give
2 examples from the movie to support your position.
2. H
ow would you describe the EGO of this character in terms of the two ways EGO is discussed in this class? (
Edging God Out
Verses
Exalting God Only
)
1.
Give at least 2 examples from the movie to support your position.
.
1. The key elements of supplier measurement are quality, delivery, a.docxstilliegeorgiana
1. The key elements of supplier measurement are quality, delivery, and price. On the surface this appears to be a simple matter, but what are the complicating factors?
2. David Atkinson, the founder and Managing Director of Four Pillars, a management consulting and training company, states that “supplier relationship management is . . . process-focused. It’s a lot more about how the organization systematically plans, than it is about an ’interpersonal’ skill set of the procurement person or relationship manager.” Do you agree or disagree with this statement?
3. Supplier performance measurement is an essential lever for successful supplier management that encompasses both pre- and post-contract management. From this vantage point, how would you distinguish the focuses of supplier performance measurement undertaken pre-contract stage versus post-contract stage?
.
1. Search the Internet and locate an article that relates to the top.docxstilliegeorgiana
1. Search the Internet and locate an article that relates to the topic of HACKING and summarize the reading in your own words. Your summary should be 2-3 paragraphs in length and uploaded as a TEXT DOCUMENT.
2. Do you feel the benefits of cloud computing are worth the threats and vulnerabilities? Have we arrived at a point where we can trust external agencies to secure our most precious data? Please explain your answer.
3. In a few short paragraphs, explain which cloud services you use (Google, Amazon, iCloud, Verizon, Microsoft One, Dropbox, etc) and what type of information you store (docs, photos, music, other files?). How much space do you have and what does this cost per month?
.
1. Text mining – Text mining or text data mining is a process to e.docxstilliegeorgiana
1. Text mining – Text mining or text data mining is a process to extract high-quality information from the text. It is done through patterns and trends devised using statistical pattern learning. Firstly, the input data is structured. After structuring, patterns are derived from this structured data and finally, the output is evaluated and interpreted. The main applications of text mining include competitive intelligence, E-Discovery, National Security, and social media monitoring. It is a trending topic for the thesis in data mining.
Some research needs
Problem definition – In the first phase problem definition is listed i.e. business aims and objectives are determined taking into consideration certain factors like the current background and future prospective.
Data exploration – Required data is collected and explored using various statistical methods along with identification of underlying problems.
Data preparation – The data is prepared for modeling by cleansing and formatting the raw data in the desired way. The meaning of data is not changed while preparing.
Modeling – In this phase the data model is created by applying certain mathematical functions and modeling techniques. After the model is created it goes through validation and verification.
Evaluation – After the model is created, it is evaluated by a team of experts to check whether it satisfies business objectives or not.
Deployment – After evaluation, the model is deployed and further plans are made for its maintenance. A properly organized report is prepared with the summary of the work done.
Research paper Policy
· APA format
. https://apastyle.apa.org/
. https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/general_format.html
· Min number of pages are 15 pages
· Must have
. Contents with page numbers
. Abstract
. Introduction
. The problem
4. Are there any sub-problems?
4. Is there any issue need to be present concerning the problem?
. The solutions
5. Steps of the solutions
. Compare the solution to other solution
. Any suggestion to improve the solution
. Conclusion
. References
· Missing one of the above will result -5/30 of the research paper
· Paper does not stick to the APA will result in 0 in the research paper
Spring 2020 Name: ______________________________
MATH 175 – Test 2 (Show Your Work )
7. Given
5
cos2
18
q
=-
and
180270
q
<<
oo
, find values of
sin
q
and
cos
q
.
8. Verify that each of the following is a trigonometric identity.
22
1sin
sec2sectantan
1sin
q
qqqq
q
-
=-+
+
9. Give the exact value of
4
cos2arctan
3
æö
ç÷
èø
without using a calculator.
10. Solve
2cos2cos2
qq
=
for all exact solutions in degrees.
PAGE
1
_1234567891.unknown
_1234567893.unknown
_1234567895.unknown
_1234567896.unknown
_1234567894.unknown
_1234567892.unknown
_1234567890.unknown
Information Systems for Business and Beyond (2019)
Information System.
1. Students need to review 3 different social media platforms that a.docxstilliegeorgiana
1. Students need to review 3 different social media platforms that are not mainstream.
a. TikTok
b. Lasso
c. Vero
d. Steemit
e. Caffeine
f. Houseparty
g. Amazon Spark
h. Anchor
i. Facebook for Creators
j. Foursquare Swarm
k. Facecast
l. Google My Business
m. Reddit
2. Provide background of how the platform started, who owns them and how big of a following they have?
3. What are the platforms demographics?
4. Strategies and Tools/Platforms – Strengths, Opportunities for Improvement, and recommendation for each platform.
5. Monitoring and Measuring what to measure? What analytics? What tools to use?
6. What companies are currently posting on this platform?
7. Develop 2 case examples of how companies are using this platform to engage with their customers? Include images of posts.
.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
How libraries can support authors with open access requirements for UKRI fund...
PROFESSION AND SOCIETYCourse Content Related to Chronic Wo.docx
1. PROFESSION AND SOCIETY
Course Content Related to Chronic Wounds in Nursing Degree
Programs in Spain
Angel Romero-Collado, PhD, MSc, RN1, Marta Raurell-
Torreda, PhD, MSc, RN2, Edurne Zabaleta-del-Olmo,
MSc, RN3, Erica Homs-Romero, RN4, & Carme Bertran-
Noguer, PhD, MSc, RN5
1 Professor of Nursing, Nursing Department, University of
Girona, Spain
2 Professor of Nursing, Nursing Department, University of
Girona, Spain
3 University Institute for Primary Care Research Jordi Gol
(Institut Universitari d’Investigació en Atenció Primària
(IDIAP) Jordi Gol), Barcelona, Spain and
Researcher associated with the Universitat Autònoma de
Barcelona, Bellaterra, Spain
4 Figueres Basic Healthcare Area (Àrea Bàsica de Salut de
Figueres) Catalan Health Institute (Institut Català de la Salut),
Girona, Spain
5 Head of Nursing Department, University of Girona, Spain
Key words
Curriculum, nursing education research,
nursing students, pressure ulcer, professional
competence, Spain, wound healing
Correspondence
Dr. Angel Romero-Collado, Professor of
2. Nursing, Nursing Department, University of
Girona, C/ Emili Grahit, 77, 17071 Girona, Spain.
E-mail: [email protected]
Accepted: July 19, 2014
doi: 10.1111/jnu.12106
Abstract
Purpose: To analyze content related to chronic wounds in
nursing degree
programs in Spain.
Design: Cross-sectional descriptive study.
Methods: Course descriptions available for online access during
June and
July of 2012 were reviewed for the 114 centers in Spain that
offer a nursing
degree, according to the official Registry of Universities,
Centers, and Titles.
Findings: Of the 114 centers with degree programs, 95 (83.3%)
post course
content online, which make it possible to analyze 2,258 courses.
In 60 (63.1%)
of these centers, none of the courses included the concept of
pressure ulcer
prevention, and the course content posted by 36 (37.9%) centers
made no
mention of their treatment. None of the course descriptions
contained any
reference to pain management in patients with chronic wounds.
Of the 728
elective courses analyzed, only one was related to chronic
wounds.
3. Conclusions: This review of available information about nursing
degree
programs in Spain indicates that pain management in patients
with chronic
wounds is not addressed in any course, and more courses
consider the treat-
ment of pressure ulcers than their prevention.
Clinical Relevance: Degree programs responsible for the
training of future
nurses should be reviewed and revised as needed to ensure that
graduates
have acquired minimum basic competencies in the prevention
and treatment
of chronic wounds that help to decrease the theory–practice gap
in this field.
Chronic wounds are a major factor in morbidity, mortal-
ity, and healthcare costs (Augustin, Brocatti, Rustenbach,
Schäfer & Herberger, 2014; Sen et al., 2009). On health-
care teams, nurses typically have the responsibility of car-
ing for patients who have these wounds or are at risk for
them (Caron-Mazet, Roth, & Guillaume, 2007; Romero-
Collado, Homs-Romero, & Zabaleta-del-Olmo, 2013).
Despite increased knowledge about chronic wound
prevention and treatment, scientific evidence is not
always translated into clinical practice to the extent that
would be desirable. The knowledge possessed by health-
care professionals is one of the key factors most fre-
quently identified in efforts to explain the existence of
this theory–practice gap, although organizational and
environmental factors also have an impact (Moore,
2010). Cowman et al. (2012) conducted an international,
multidisciplinary eDelphi study to identify the research
and education priorities in wound management and tis-
5. give the nursing profession equivalency with other de-
grees with respect to future options and opportunities.
This includes access to higher academic degrees (mas-
ter’s and doctoral degrees) by way of their own disci-
pline rather than by way of disciplines such as biology
or psychology.
Another substantial impact of the Bologna process is a
change in the concept of learning. The previous model
was that learning was based on the knowledge consid-
ered necessary to obtain the diploma. This could concur—
or not—with what the future professional would need to
know for success in the workforce, but there sometimes
appeared to be a large gap between the academic and
working worlds. Under the Bologna process, learning is
oriented toward skills and competencies and is student
centered (Zabalegui & Cabrera, 2009). To address the
theory–practice gap, courses must be designed to achieve
essential competencies, along with knowledge of theory.
This aligns with the white paper on the degree in nurs-
ing published by Spain’s national accreditation agency,
which indicated that the cross-cutting competency most
valued by practicing nurses, university professors of nurs-
ing, and nursing administrators is “the ability to apply
knowledge to practice” (Agencia Nacional de Evaluación
de la Calidad y Acreditación, 2004).
The theory–practice gap, defined as the lack of match-
ing textbook descriptions of clinical situations with
the reality of practice, is a vitally important topic for
nursing education (Scully, 2011). For example, the lack
of education about the prevention of pressure ulcers
(PUs) is cited as a cause of their high prevalence and
incidence (Moore, 2010) and of the persistence of care
interventions that are not recommended, such as the
6. use of “doughnut”-type devices or massaging areas of
redness (Iranmanesh, Rafiei, & Foroogh Ameri, 2011;
Panagiotopoulou & Kerr, 2002; Pancorbo-Hidalgo,
Garcı́a-Fernández, López-Medina, & López-Ortega, 2007;
Saleh, Al-Hussami, & Anthony, 2013). In other studies,
the majority of nurses in an intensive care unit had the
perception that their unit could improve its attention
to patients who had or were at risk for developing PUs
(Quesada Ramos & Garcı́a Dı́ez, 2008), and slightly more
than half of the nurses in 14 long-term care units consid-
ered their knowledge of chronic wound management to
be “average” (Caron-Mazet et al., 2007).
The prevalence of PUs in Spain ranges from 5.9% to
13.5%, depending on whether the population is being
treated as part of a primary care home-health program
or in a hospital or long-term care center (Leyva-Moral &
Caixal-Mata, 2009; Soldevilla Agreda, Torra Bou, Verdú
Soriano, & López Casanova, 2011). These values are
similar to those of other European countries, such as
Sweden’s 14.5% prevalence in nursing homes and 16.6%
in hospitals (Gunningberg, Hommel, Bååth, & Idvall,
2014), the 6.4% reported in a long-term care study in
France (Caron-Mazet et al., 2007), and the 9% observed
in a long-term care setting in the Republic of Ireland
(Moore & Cowman, 2012).
Training nurses in the prevention and treatment of PUs
is of fundamental importance. Nonetheless, there are ma-
jor deficiencies in undergraduate course content related
to this type of wounds (Ayello, Zulkowski, Capezuti, &
Sibbald, 2010). In a study of emergency care profession-
als in Spain (Hinojosa-Caballero, 2012), just 23% consid-
ered their university education about PU prevention to be
“good,” and the rate decreased to 19% when asked about
aspects of PU treatment. Other studies have reported that
8. taining skin integrity (Ousey, Stephenson, Cook, Kinsey,
& Batt, 2013).
Given the impact of chronic wounds in the gen-
eral population, a multidisciplinary, international eDel-
phi study (Cowman et al., 2012) was conducted to
identify research and education priorities to improve
wound management and tissue repair. The purpose of the
present study was to analyze the content specified in de-
scriptions of the basic courses taught in the 114 degree
in nursing programs in Spain to identify instruction re-
lated to the four priorities identified by Cowman et al.
(2012): pain management, PU prevention, wound bed as-
sessment, and selection of dressings.
Methods
Design
A cross-sectional design was used to analyze the con-
tent on chronic wounds in nursing degree programs
in Spain.
Centers
We analyzed the degree programs offered by the 114
teaching centers that award the degree in nursing in
Spain, as indicated by Spain’s official database of uni-
versities, centers, and diplomas offered, the Registro de
Universidades, Centros y Tı́tulos (RUCT; Gobierno de
España, 2008). Search terms included degree titles con-
taining “Nursing,” academic level of “Degree program,”
and discipline of “Health Sciences.” For each center, we
obtained the names of courses and number of credits for
each course in the nursing degree program.
9. Data Collection
From June 11 to July 6, 2012, we analyzed the degree
in nursing program information included in the RUCT,
accessed the web page for each center, and assessed the
program and course content that was available online. No
centers were excluded from the study. We would note,
however, that Spain has gradually implemented the un-
dergraduate nursing degree and not all universities have
proceeded at the same pace. Therefore, not all programs
have published course descriptions for the full 4-year de-
gree in nursing program.
Two researchers independently analyzed the content of
each course description or syllabus and reached a consen-
sus agreement. A third researcher was available to review
the course information in the event of any discrepancy.
A data collection form was designed ad hoc to record the
data obtained about each degree program and course. The
following variables were recorded for each program:
� Access: The number of years of the 4-year undergradu-
ate degree in nursing for which online access to courses
was available.
� Number of Required Courses: Total numbers of re-
quired courses, basic courses, guided practice, and fi-
nal project (recorded to determine the nursing degree
requirements, excepting elective courses).
� Courses Entirely Related to Chronic Wounds: Number
of required courses with a title explicitly containing the
words “chronic wound.”
� Courses With Content Related to Wounds: Number of
11. Course Content Related to Chronic Wounds Romero-Collado et
al.
identified in the same course, each one was counted as “a
course” containing that information.
Electives. All elective course options were recorded
and placed into the following categories: “chronic
wounds,” “language courses,” “palliative care,” “oc-
cupational health,” “health promotion,” “Catholicism,”
“dependency and chronic illness,” “urgent, emergency
and/or catastrophic patient care,” “research,” “com-
plementary/alternative therapies,” “cooperation,” and
“school health.”
Ethical Considerations
All of the information recorded (degree programs,
course content) was found online, in the RUCT database,
and on the official web site of each university; therefore,
all data were publicly available. No personal data were
accessed (e.g., related to any individual who designed a
degree program or course) for this study.
Data Analysis
Univariate descriptive methods (i.e., frequencies, per-
centages, means, and standard deviations [SD]) were
used to analyze the data. IBM SPSS Statistics 19
(IBM Corporation, Armonk, NY, USA) was used for
the analysis.
Results
The assessments completed by the two designated eval-
12. uators were in consensus, eliminating the need for the
intervention of a third evaluator and for inter-rater reli-
ability analysis. The study included the 114 degree pro-
grams available online, although detailed course analysis
was limited to the 95 (83.3%) centers that provided on-
line access to course content, of which 37 (32.5%) centers
had implemented 2 full years of the new degree require-
ments, 34 (29.8%) provided 3 years, and 24 (21.1%)
provided detailed information for the full content of the
4-year degree in nursing program.
Of the 3,436 required, basic, guided practice, and fi-
nal project course descriptions reviewed, representing
all of the nursing degree programs in Spain, 2,258
(65.7%) courses were analyzed in detail. The mean num-
ber of courses required for degree completion was 30.1
(SD 3.56) required and 6.7 (SD 4.56) elective courses. Ta-
ble 1 contains a descriptive analysis of the number and
type of courses.
The highest number of nursing degree programs are lo-
cated in 3 of Spain’s 17 autonomous communities, with
18 (15.8%) in Andalucia, and 15 (13.2%) in Catalunya
and in Madrid. Only 1 (0.9%) program is offered in 4
communities: Cantabria, Ceuta, La Rioja, and Melilla. The
remaining 62 (54.2%) programs are distributed across 10
autonomous communities.
Our analysis identified no course offered at any center
that was dedicated to chronic wounds or included con-
tent on pain management specific to chronic wounds;
however, 94 (98.9%) centers offered at least one course
related to general pain control. Only 40 (46.9%) cen-
ters offered a course with specific content on prevention
of PUs in adults, although some type of content specif-
13. ically related to PUs was offered at 62 (65.3%) centers
(Table 2). Only 10 (10.5%) centers indicated both of
these content areas in their courses and 37 (38.9%) cen-
ters offered neither of them. “Wound bed assessment”
was identified in one course in 1 (1.1%) center, and
“How to select dressings” was found in 23 courses in 21
(22.1%) centers. “Treatment of pressure ulcers or other
chronic wounds” was contained in 98 courses distributed
across 59 (62.1%) centers (see Table 2).
Half of the centers offered no courses related to ve-
nous or arterial disorders in the lower extremities, and
91 (95.8%) centers offered no course description with the
term “diabetic foot.” We included 131 courses offered by
75 (78.9%) centers in a “wounds, acute processes” cate-
gory (Table 3).
The analysis of elective courses showed 50 courses re-
lated to the Bologna requirement for instruction in other
European Union languages in 42 (40.4%) centers, 44
courses related to instruction in research methods in 34
(32.7%) centers, and 36 courses related to complemen-
tary or alternative therapies in 31 (29.8%) centers. In
all of Spain, only one center (1.0%) offered one elec-
tive course that included the term “chronic wounds”
(Table 4).
Discussion
Analysis of course content in degree in nursing courses
at Spanish universities revealed that the education of-
fered future nurses about chronic wounds is insufficient
and largely fails to meet the four educational priorities
identified by Cowman et al. (2012). We considered our
results in the context of each of these priorities.
15. (n = 107)
0 23 728 6.68 4.56
Number of elective credits, ECTS
(n = 114)
0 30 1157.5 10.15 7.05
Note. ECTS = European Credit Transfer System.
Defloor, & Worboys, 2006), deficiencies exist in the im-
portance assigned to them in clinical practice (Caron-
Mazet et al., 2007) despite recommendations that wound
care should be incorporated into all patient care plans
(Günes, 2008). We must be aware that all PUs cause pain
and that wound care treatments (e.g., dressing changes)
also can cause pain. Inadequate knowledge of pain man-
agement is a barrier to proper treatment. This deficiency
must be addressed by including content about pain as-
sessment and management in training related to chronic
wounds (Pieper, Langemo & Cuddigan, 2009). In Spain,
for example, the needed change could readily be accom-
modated by incorporating a unit on “pain management
and chronic wounds” into the appropriate courses as, in
response to the mandates of the Bologna Plan, the 3-year
diploma program is converted to a 4-year university de-
gree and credit hours in pharmacology are increased.
How to Prevent Pressure Ulcers
In the courses we reviewed, this second priority was
absent from the content of the degree courses offered at
nearly two thirds of the centers that award the degree
of nursing in Spain. We consider this lack of training in
PU prevention alarming because this is a cross-cutting
problem that can affect patients of any age—children,
16. adults, the elderly—in any healthcare setting (primary
care, hospitals, long-term care). This limited presence of
the topic in nursing studies could be related to the finding
by Zamora Sánchez (2006) that 25% of Spanish nurses
reported receiving no specific PU training during their of-
ficial program of study, or to the 23% of health profes-
sionals on the other end of the spectrum who indicated
that they had received “good” training in PU prevention
(Hinojosa-Caballero, 2012). We must add that, despite
clinical guidelines that recommend against particular care
interventions (such as massaging reddened skin or using
doughnut cushions), many nurses in different countries
and of different professional generations continue to use
them (Iranmanesh et al., 2011; Panagiotopoulou & Kerr,
2002; Pancorbo-Hidalgo et al., 2007).
Basic theory taught in nursing programs should explain
what is and is not recommended by clinical guidelines for
the prevention of PUs. This should be complemented by
guided practice and the involvement of clinical instruc-
tors in practical training to ensure that traditional inter-
ventions give way to current, evidence-based standards
of practice (Saleh et al., 2013; Zamora Sánchez, 2006).
Other researchers have reported a lack of course offer-
ings on certain related topics in other university degree
programs (e.g., medicine, physical therapy). For exam-
ple, required courses related to aging are needed in Spain
(Jiménez Dı́az, Pulido Jiménez, Villanueva Lupión, Villar
Dávila, & Calero Garcı́a, 2011), and gerontological care is
not adequately addressed in nursing education programs
in Flanders, Belgium (Deschodt, de Casterlé, & Milisen,
2010). Although PU prevention tends to be considered
a nursing task, some researchers have advocated that it
should be the responsibility of the entire medical team
and therefore should also be incorporated into physician
66. best practice and ensure that it is demonstrated by ex-
ample at the clinical site.
Acute Wounds
We included the term “wounds, acute processes” as a
control indicator to assess whether this type of wound
is given importance similar to the category of “treatment
of pressure ulcers and other chronic wounds.” This term
was more prevalent than “chronic wounds” in 30% of
the courses (5.8% vs. 4.34%) and was at least present in
some course at 16 more centers (75 vs. 59). These results
concur with Ayello et al. (2005), who reported that 70%
of nurses responded that they had not received sufficient
education on chronic wounds in their basic nursing ed-
ucation program. Although more courses and more cen-
ters indicate content related to “wounds, acute processes”
than to “treatment of pressure ulcers and other chronic
wounds,” acute wound care remains an area of concern
because all centers should be providing this instructional
content, independently of the present study’s focus on
chronic wounds.
Lower Extremity Wounds
We also considered it important to identify content
related to assessing nursing care of patients with dia-
betic foot or venous and arterial disorders in the lower
limb, which are the other large groups of chronic wounds
and have great impact on patients’ quality of life (Fe-
inglass et al., 2012). We found content on “venous and
arterial disorders of the lower extremities” to be slightly
more prevalent than “prevention of pressure ulcers” (55
vs. 50), and more centers offered at least one related
course (47 vs. 35). We consider this a deficiency be-
67. cause future nurses must know the characteristics, diag-
nosis, progression, and treatment of ulcers with venous
or arterial etiology. These deficiencies have also been re-
ported in specialized training of internal medicine resi-
dents (Schwarcz, Quijano, Olin, & Ostfeld, 2012; Wyatt
et al., 2010). Researchers have recommended a greater
emphasis on lower extremity wounds in medical school
and residency programs (Georgakarakos et al., 2013;
Wyatt et al., 2010).
Content on “diabetic foot” is almost anecdotal in the
courses analyzed, and was found only in four courses in
four different centers. Between 15% and 25% of diabetic
patients present with a foot ulcer at some point, and 14%
to 20% of them are amputated (Conferencia Nacional de
Consenso sobre Úlceras de la Extremidad Inferior, 2009).
The training of nursing professionals in foot care is one
of the implementation objectives that support patient ed-
ucation and the prevention of possible disorders (van
Houtum, 2012); therefore, it is critical to include this con-
tent in the curriculum.
Elective Courses
When we analyzed the presence of elective courses,
we were surprised to find only one elective course in
all of Spain that offered the possibility of consolidating
and deepening students’ knowledge of chronic wounds,
far below other fields such as complementary or alterna-
tive therapies (1 vs. 36). It could be argued that there
is no need to offer elective courses related to chronic
wounds because sufficient content is provided in the de-
gree courses. However, the same case could be made for
elective courses about research methods (the second most
frequent elective offering); urgent, emergency, or disaster
care (the third most frequent elective); or dependency,
98. through the second year, and had access to 65.72% of all
listed courses. Therefore, our results are drawn from an
extensive panorama of the undergraduate nursing degree
programs in Spain.
Another limitation of this study is the lack of elec-
tronic access to the course content taught at 16.7% of
the centers that award the degree in nursing. However,
we gained access to more than 80% of the relevant infor-
mation through the second year of the degree program,
at which point students have completed the bulk of their
required and introductory courses.
The analysis was confined to nursing degree pro-
grams in Spain. Although we found no studies with sim-
ilar methodology, we located several reports of these
same deficiencies in other countries: in Germany, us-
ing content analysis of nursing textbooks (Wilborn
et al., 2009); in England, where students in the fi-
nal year of their nursing degree reported a perception
that they did not know how to manage patients’ skin
integrity effectively (Ousey et al., 2013); and a U.S.
study of faculty perceptions and documentation of PU
content in all 50 states and the District of Columbia
(Ayello et al., 2010).
Conclusions
In this study, we observed differences in the presence
of the four top educational priorities in wound manage-
ment and tissue repair (Cowman et al., 2012) in courses
that comprise the degree in nursing in Spain. Content on
pain management in patients with chronic wounds (top
priority) is nonexistent and about PU prevention (second
priority) is deficient, compared to content about PU treat-
ment (third and fourth priorities).
99. The course content related to chronic wounds that is
offered to future nurses in Spain appears to be deficient.
This situation must improve in order to phase out the
use of nursing interventions not recommended for PU
prevention. In the 21st century, we simply cannot allow
more than half of the teaching centers that offer a degree
in nursing to ignore the prevention of PUs in their course
content. This change must be implemented in required
courses, because there are almost no elective courses re-
lated to the prevention and treatment of chronic wounds.
Degree programs responsible for preparing future
nurses must guarantee the acquisition of minimum basic
skills in the prevention and treatment of chronic wounds.
University programs in all countries should review their
curricular offerings and take steps to reduce the theory–
practice gap in this field.
Acknowledgments
We appreciate the translation and manuscript editing
provided by Elaine Lilly, PhD. Preliminary results of this
study were presented at a GNEAUPP Symposium (IX
Simposio Nacional GNEAUPP. Ciencia, Arte y Compro-
miso) held in Sevilla November 14–16, 2012.
Clinical Resources
� European Pressure Ulcer Advisory Panel: http://
www.epuap.org
� European Wound Management Association: http://
ewma.org/english.html
� Spain’s official database of universities, centers,
101. Care, 18(5, Pt. 1), 268–275.
Ayello, E. A., & Meaney, G. (2003). Replicating a survey of
pressure ulcer content in nursing textbooks. Journal of
Wound, Ostomy, and Continence Nursing, 30(5), 266–
271.
Ayello, E. A., Zulkowski, K. M., Capezuti, E., & Sibbald, G.
(2010). Pressure ulcer in undergraduate programs. Nursing
Outlook, 58(2), e4. doi:10.1016/j.outlook.2010.02.083
Caron-Mazet, J., Roth, B., & Guillaume, J. C. (2007).
Prevalence and management of chronic wounds in 14
geriatric institutions of the Haut-Rhin. Annales de
Dermatologie et de Venereologie, 134(8–9), 645–651.
Conferencia Nacional de Consenso sobre Úlceras de la
Extremidad Inferior. (2009). Documento de consenso. Madrid:
Edikamed. Retrieved from http://www.gneaupp.es/
app/adm/documentos-guias/archivos/8 pdf.pdf
Cowman, S., Gethin, G., Clarke, E., Moore, Z., Craig, G.,
Jordan-O’Brien, J., . . . Strapp, H. (2012). An international
102. eDelphi study identifying the research and education
priorities in wound management and tissue repair. Journal
of Clinical Nursing, 21(3–4), 344–353.
Davies, R. (2008). The Bologna process: The quiet revolution
in nursing higher education. Nurse Education Today, 28(8),
935–942.
Deschodt, M., de Casterlé, B. D., & Milisen, K. (2010).
Gerontological care in nursing education programmes.
Journal of Advanced Nursing, 66(1), 139–148.
European Ministers of Education. (1999). The Bologna
Declaration of June 1999. Retrieved from http://
www.bologna-bergen2005.no/Docs/00-Main doc/
990719BOLOGNA DECLARATION.PDF
Feinglass, J., Shively, V. P., Martin, G. J., Huang, M. E.,
Soriano, R. H., Rodriguez, H. E., . . . Gordon, E. J. (2012).
How “preventable” are lower extremity amputations? A
qualitative study of patient perceptions of precipitating
factors. Disability and Rehabilitation, 34(25), 2158–2165.
103. Georgakarakos, E., Papadaki, E., Vamvakerou, V., Lytras, D.,
Tsiokani, A., Tsolakaki, O., . . . Papanas, N. (2013).
Training to measure ankle-brachial index at the
undergraduate level: Can it be successful? International
Journal of Low Extremity Wounds, 12(2), 167–171.
Gobierno de España. Ministerio de Educación, Cultura y
Deporte. (2008). Registro de Universidades, Centros y Tı́tulos
(RUCT). Retrieved from https://
www.educacion.gob.es/ruct/home#
Günes, U. Y. (2008). A descriptive study of pressure ulcer
pain. Ostomy Wound Management, 54(2), 56–61.
Gunningberg, L., Hommel, A., Bååth, C., & Idvall, E. (2014).
The first national pressure ulcer prevalence survey in
county council and municipality settings in Sweden.
Journal of Evaluation in Clinical Practice, 20(1), 58–65.
Hinojosa-Caballero, D. (2012). Professional’s knowledge of
the department of urgencies on the prevention and
treatment of pressure ulcers. Gerokomos, 23(4), 178–184.
104. Hopkins, A., Dealey, C., Bale, S., Defloor, T., & Worboys, F.
(2006). Patient stories of living with a pressure ulcer.
Journal of Advanced Nursing, 56(4), 345–353.
Huff, J. M. (2011). Adequacy of wound education in
undergraduate nursing curriculum. Journal of Wound,
Ostomy, and Continence Nursing, 38(2), 160–164.
Iranmanesh, S., Rafiei, H., & Foroogh Ameri, G. (2011).
Critical care nurses’ knowledge about pressure ulcer in
southeast of Iran. International Wound Journal, 8(5),
459–464.
Jiménez Dı́az, M. C., Pulido Jiménez, M. C., Villanueva
Lupión, C., Villar Dávila, R., & Calero Garcı́a, M. J. (2011).
Ageing, the forgotten course in Spanish university: The
iceberg type of negligence? Gerokomos, 22(1), 8–12.
Larcher Caliri, M. H., Miyazaki, M. Y., & Pieper, B. (2003).
Knowledge of pressure ulcers by undergraduate nursing
students in Brazil. Ostomy Wound Management, 49(3), 54–63.
Levine, J. M., Ayello, E. A., Zulkowski, K. M., & Fogel, J.
105. (2012). Pressure ulcer knowledge in medical residents: An
opportunity for improvement. Advances in Skin and Wound
Care, 25(3), 115–117.
Leyva-Moral, J. M., & Caixal-Mata, C. (2009). Prevalence of
bed sores in geriatrics nursing home residences. Revista de
Enfermeria, 32(1), 52–56.
Moore, Z. (2010). Bridging the theory-practice gap in pressure
ulcer prevention. British Journal of Nursing, 19(15, Suppl.),
S15–S18.
Moore, Z., & Cowman, S. (2012). Pressure ulcer prevalence
and prevention practices in care of the older person in the
Republic of Ireland. Journal of Clinical Nursing, 21(3–4),
362–371.
Ousey, K., Stephenson, J., Cook, L., Kinsey, L., & Batt, S.
(2013). Final year student nurses’ experiences of wound
care: An evaluation. British Journal of Community Nursing,
18(Supp. 1), S7–S16.
Panagiotopoulou, K., & Kerr, S. M. (2002). Pressure area care:
107. Råholm, M. B., Hedegaard, B. L., Löfmark, A., & Slettebø, A.
(2010). Nursing education in Denmark, Finland, Norway
and Sweden—From bachelor’s degree to PhD. Journal of
Advanced Nursing, 66(9), 2126–2137.
Romero-Collado, A., Homs-Romero, E., & Zabaleta-del-Olmo,
E. (2013). Knowledge about medications and products to
prevent and treat pressure ulcers: A cross-sectional survey
of nurses and physicians in a primary health care setting.
Journal of Clinical Nursing, 22(17–18), 2562–2571.
Saleh, M. Y., Al-Hussami, M., & Anthony, D. (2013). Pressure
ulcer prevention and treatment knowledge of Jordanian
nurses. Journal of Tissue Viability, 22(1), 1–11.
Schwarcz, A. I., Quijano, A., Olin, J. W., & Ostfeld, R. J.
(2012). Incoming internal medicine interns have a poor
knowledge of peripheral artery disease. Angiology, 63(8),
597–602.
Scully, N. J. (2011). The theory-practice gap and skill
acquisition: An issue for nursing education. Collegian, 18(2),
108. 93–98.
Sen, C. K., Gordillo, G. M., Roy, S., Kirsner, R., Lambert, L.,
Hunt, T. K., . . . Longaker, M. T. (2009). Human skin
wounds: A major and snowballing threat to public health
and the economy. Wound Repair and Regeneration, 17(6),
763–771.
Soldevilla Agreda, J. J., Torra Bou, J. E., Verdú Soriano, J., &
López Casanova, P. (2011). 3rd National Survey of the
prevalence of pressure ulcers in Spain, 2009. Epidemiology
and defining variables in lesions and patients. Gerokomos,
22(2), 77–90.
van Houtum, W. H. (2012). Barriers to implementing foot
care. Diabetes Metabolism Research and Reviews, 28(Suppl. 1),
112–115.
Wilborn, D., Halfens, R. J., & Dassen, T. (2009).
Evidence-based education and nursing pressure ulcer
prevention textbooks: Does it match? Worldviews on
Evidence-Based Nursing, 6(3), 167–172.
110. Transnational Marriages in Taiwan
Yung-Mei Yang, PhD, RN1, Hsiu-Hung Wang, PhD, RN,
FAAN2, Fang-Hsin Lee, PhD, RN3, Miao-Ling Lin, MN,
RN4, & Pei-Chao Lin, MSN, RN5
1 Assistant Professor, College of Nursing, Kaohsiung Medical
University, Kaohsiung, Taiwan
2 Professor, College of Nursing, Kaohsiung Medical University,
Kaohsiung, Taiwan
3 Assistant Professor, Department of Nursing, Chung Hwa
University of Medical Technology, Tainan, Taiwan
4 Section Head, Department of Health, Kaohsiung City
Government, Kaohsiung, Taiwan
5 Doctoral Candidate, College of Nursing, Kaohsiung Medical
University, Kaohsiung, Taiwan
Key words
Marriage migrant women, health
empowerment, participatory action research
Correspondence
Dr. Hsiu-Hung Wang, Professor, No. 100,
Shih-Chuan 1st Rd., Kaohsiung 80708, Taiwan.
E-mail: [email protected]
Accepted: August 31, 2014
doi: 10.1111/jnu.12110
Abstract
Purpose: The aim of this study was to develop, implement, and
evaluate
a theory-based intervention designed to promote increased
111. health empower-
ment for marriage migrant women in Taiwan. The rapid increase
of interna-
tional marriage immigration through matchmaking agencies has
received great
attention recently because of its impact on social and public
health issues in the
receiving countries.
Design and Methods: A participatory action research (PAR) and
in-depth
interviews were adopted. Sixty-eight women participated in this
study. Eight
workshops of the health empowerment project were completed.
Findings: Through a PAR-based project, participants received
positive out-
comes. Four outcome themes were identified: (a) increasing
health literacy,
(b) facilitating capacity to build social networks, (c) enhancing
sense of self-
worth, and (d) building psychological resilience.
Conclusions: PAR was a helpful strategy that enabled
disadvantaged migrant
women to increase their health literacy, psychological and
social health, and
well-being.
Clinical Relevance: The findings can be referenced by the
government in
making health-promoting policies for Southeast Asian
immigrant women to
increase their well-being. Community health nurses can apply
PAR strategies
to plan and design health promotion intervention for
disadvantaged migrant
women.
The rapid increase of international marriage immigration
113. social and public health issue.
For many women in developing countries, interna-
tional marriage immigration has emerged as a way to
escape poverty and achieve a better life by marrying
men from more financially developed countries. For
men in East Asia who experience difficulties finding a
wife, matchmaking agencies can arrange a trip to al-
low men to locate a partner in a few days and return
to their homeland with a new bride. The bridal candi-
dates, however, are called by many derogatory terms,
such as “mail-order brides” or “foreign brides,” and are
often treated with disrespect and derision in the receiving
country (Choe, 2005).
Health Care Among Immigrant Women
in Transnational Marriages
The growing number of immigrant women has be-
come a significant global concern in the social and public
health sectors. According to the United Nations’ Commit-
tee on the Elimination of Discrimination Against Women
(2009), immigrant women may not only be subject to
sex discrimination in their receiving country but also face
specific health challenges. Indeed, one of the primary
goals outlined in Healthy People 2020 is to eliminate
health disparities among different segments of vulnera-
ble populations, such as immigrants (U.S. Department of
Health and Human Services, 2013). Studies showed that
immigrant women in Taiwan not only tended to be more
vulnerable to illness but also experienced more barriers
to their health care than nonimmigrants. A cross-cultural
comparison indicated that Vietnamese immigrant women
in Taiwan had a generally lower health-related quality
of life than native Taiwanese women (Yang & Wang,
2011a). Lin and Wang (2008) investigated Southeast
114. Asian pregnant immigrant women and found they had
irregular prenatal examination behavior.
Immigration is a stressful, unexpected life event in
which immigrants experience a complicated process of
re-adaptation in the host society (Meleis & Lipson, 2004).
To cope with the challenges of living in a new coun-
try, marriage migrant women in Taiwan are also vulnera-
ble to psychological distress, which can negatively impact
their health and well-being (Yang, Wang, & Anderson,
2010). Moreover, greater acculturative stress increases
the risk for developing psychological problems, partic-
ularly in the initial months of immigrating to the new
host society (Berry, 1997). The lack of true friendships,
personal relationships, and social support in their host
country intensifies their loneliness and social isolation
(Yang & Wang, 2011b).
Marriage migrant women’s marginalized status and dif-
ficulties in accessing adequate health care indicate a lack
of empowerment to effectively seek the resources they
need to improve their health and well-being. Shearer
(2007) asserted that health empowerment may increase
one’s awareness in health and one’s own healthcare
decisions. Ensuring health empowerment among mar-
riage migrant women may improve their ability to access
health care, achieve better health, and overcome their
marginalized status in their receiving country. The aim
of this study was to develop, implement, and evaluate a
theory-based intervention designed to promote increased
health empowerment for marriage migrant women in
Taiwan.
Methods
116. Yang et al. Health Empowerment Among Immigrant Women
Intervention
Planning cycles. During the planning phases of
our PAR-based HEP, the specific health concerns of the
participants had been identified based on the previous
literature (Lee, Wang, Yang, & Tsai, 2013; Tsai, Cheng,
Chang, Yang, & Wang, 2014; Yang & Wang, 2011b), in-
cluding social isolation, acculturative stress, lack of health
information, and lack of health literacy. Investigators
established a collaborative relationship with community
partners, and integrated community resources. The re-
search team met with community partners several times
to discuss the appropriateness and effectiveness of the
health promotion strategies presented in the workshops.
Investigators established a preliminary curriculum.
To recruit participants, the research team established
community partnerships such as the local neighborhood
managers (the heads of the subdivisions of the districts),
the local Christian church, the primary healthcare center,
and the Management of Assistance Center for Foreign
Spouses. The community of interest was considered and
the appropriate consent procedures were implemented
for participants who were involved in the design of
the curriculum. We formalized an arrangement with
community leaders to establish contacts with community
partners, to build a trusting relationship between par-
ticipants and our research team, and to agree on a time
frame for the HEP.
Acting cycles. The goal of the various acting cycles
117. of our PAR project was to develop an HEP, implemented
as a series of eight workshops, in order to generate pos-
itive psychological and social changes among the partici-
pants. A major component of the HEP’s curriculum was a
holistic health concept, which included physical, psycho-
logical, and social well-being. The curriculum addressed
the following six topics: reproductive health (maternal
health and family planning); disease prevention (human
immunodeficiency virus, sexually transmitted illnesses,
cancer screening); healthcare system utilization (health
information and health insurance); cultural competence
(social support and acculturation); mental health (inter-
personal relationships and stress management); and the
special issue (domestic violence prevention and manage-
ment). The study’s principal investigator designed and
developed the preliminary curriculum based on previ-
ous studies (Lee et al., 2013; Wang & Yang, 2002) and
discussion with community leaders, and two instructors
presented the health information by means of various
activities conducted in the workshops, such as lectures,
demonstrations, drama, role-play exercises, group discus-
sions, and group presentations.
Reviewing cycles. During the multiple reviewing
cycles of the PAR project, the research team worked
with community partners to evaluate and reassess the
HEP during intermittent periods and at the final stage
of the program. Participatory observations and group dis-
cussions during the workshops, as well as in-depth indi-
vidual interviews with each participant at the conclusion
of the program, provided the participants’ points of view
and reflections during the PAR process. Feedback from
the participants was ongoing. For example, many partic-
ipants complained their husbands beat them after quar-
rels, so the special session on domestic violence in the
curriculum was in response to participants’ feedback in
118. the reviewing cycles.
Data generation and analysis occurred concurrently
and began in the early stages of the HEP, which enabled
the use of emerging themes and issues to guide group dis-
cussions in the workshops. The researchers’ role through-
out the reviewing cycles was to explore and stimulate
the participants’ reflections on their experience during
the HEP.
Participants and Setting
Among the 87 women who were invited to participate
in this study, 68 completed the eight workshops of the
HEP. The reasons of those who did not complete the
study included transportation problems, being forbid-
den to go outside by their mother-in-law, taking care of
young children, or moving out of the community. Eligible
participants were women who fit the following criteria:
(a) were marriage migrants from Vietnam, Indonesia, the
Philippines, Thailand, or Cambodia; (b) were married to
a Taiwanese man; (c) had a basic conversation ability in
Taiwanese or Mandarin; and (d) were willing to partic-
ipate in the study. Although immigrants from Mainland
China comprise the majority of the marriage migrants,
they were not included as part of the inclusion criteria.
This is because Mainland China migrants share the
same culture and speak the same language (Mandarin)
with Taiwanese. They can access more information by
themselves with no language barrier and have better
acculturation in Taiwan. The women from Vietnam,
Indonesia, the Philippines, Thailand, or Cambodia who
were included have all learned a new language since
immigrating. They need to learn Mandarin or Taiwanese
dialect to communicate with their husband and in-laws.
From June 2009 to February 2010, eight workshops with
120. Ethical Considerations
The institutional review board of Kaohsiung Medical
University, Taiwan, approved the research and proce-
dures before the study began. The participants in the
study did not experience any physical harm, discomfort,
or psychological distress. They were fully aware of par-
ticipating in a study, and they understood the purpose of
the research by giving their informed consent. The study
procedures were fully described in advance to each par-
ticipant, the participants had an opportunity to decline
to participate, and appropriate consent procedures were
implemented.
Data Analysis
Following guidelines recommended by Miles and
Huberman (2013) for qualitative data analysis, three
members of the research team used the transcribed data
for a thematic analysis to examine the qualitative data,
which were categorized based on prominent theme pat-
terns expressed in the text of the individual interviews
with participants. First, the researchers applied categories
to each transcript code. They read and analyzed all the
transcripts in a three-stage process of data analysis and
synthesis, as recommended by Rice and Ezzy (2001). The
verbatim transcripts of the 68 interviews in our study
generated a codebook of 36 units. In the next stage, the
same three researchers used the focused coding method
for the second coding cycle. They met together and,
through peer discussion and agreement, recategorized
the 36 coding units. Finally, on the basis of the coding,
the principal investigator of our research team identi-
fied themes that integrated substantial sets of the coding
units. Data were collected by two trained, bilingual re-
121. search assistants who were proficient in Taiwanese dialect
and Mandarin and had each obtained a bachelor’s degree
in nursing.
Rigor
Rigor was guided by the process of trustworthiness
(Lincoln & Guba, 1985). Prolonged engagement and
peer debriefing were used to assess the credibility of the
themes. To ensure dependability, the principal investiga-
tor conducted an 8-hr training session for the research
assistants, advising them on the inclusion and exclusion
criteria of the study and instructing them in the use of
interviewing techniques, participatory observation skills,
and field-study knowledge to ensure reliability. In addi-
tion, thick description of text and field notes enhanced
research transferability.
Results
Sixty-eight marriage migrant women in Taiwan partic-
ipated in and completed this study. Participants ranged
in age from 20 to 42 years, with a mean age of 32.4
years (SD = 4.6). Their spouses’ ages ranged from 27 to
72 years, with a mean age of 42.5 years (SD = 4.34).
The participants’ original nationalities were Vietnamese
(n = 42, 61.8%), Thai (n = 12, 17.6%), Indonesian
(n = 8, 11.8%), Filipino (n = 5, 7.3%), or Cambodian
(n = 1, 1.5%). The women’s length of residency in Tai-
wan ranged from 2 to 12 years, with a mean length of
stay of 8.3 years (SD = 2.6). The levels of education for
most of the participants before immigrating to Taiwan
were elementary school and junior high school (n = 62,
91.2%). The highest level of education for most of the
women’s spouses was junior high school or high school
(n = 60, 88.2%). Among the participants, 53 (77.9%)
123. shops for our HEP, the participants reported that they
felt more informed about healthcare information and re-
sources. For example, one of the participants said:
When I arrived here [in Taiwan], I very quickly became
pregnant. Because I am not a citizen, I thought I
am not covered by the National Health Insurance.
My husband and I didn’t know that we can have
free prenatal examinations and obstetrical services
provided by primary healthcare centers. We spent a
lot of money to visit a private clinic. Now, through
this workshop, I know where I can get medical care to
help me.
The participants’ increased health literacy and knowl-
edge about illness prevention and health promotion
prompted them to change their behavior in favor of
more healthy choices. For example, one of the par-
ticipants decided to change her use of an oral pill to
the use of condoms for contraception and safer sex.
The increased exchange of health-related information
and resources provided in the workshops improved the
immigrant women’s decision-making skills and their
ability to apply these skills in health-related situations.
For example, one of the participants who experienced
domestic violence stated:
From the special issue workshop on domestic violence
prevention and management, I learned that nobody
has the right to hurt another’s body. My husband beat
me and the kids. Now, I will call 113 for help and will
have free-of-charge medical treatment.
Facilitating Capacity to Build Social Networks
Many of the participants experienced extreme lone-
124. liness and isolation in their community. They missed
their friends and family and the familiar culture of their
homeland. Moreover, their husbands and in-laws often
forbid them to leave the house, preventing them from
developing new friendships with others. The women
reported that attending these workshops helped alleviate
their sense of loneliness and facilitate their capacity to
build social networks in the community. By the end
of program, participants had developed small, informal
groups that would arrive early to the workshops in order
to chat with each other and enjoy the company of other
participants. These advantages of attending the program’s
workshops are described in the following statements
from participants:
To get in touch with other immigrant friends is the
happiest thing I have. I look forward to the workshops
because this is a chance I can go out and meet friends
from the same country. My family is afraid that the
“bad friends” might influence me.
The women’s shared ethnicities and personal interac-
tions with other participants at the workshops provided
them the opportunity to develop friendships that offered
strong emotional support, which reduced their feelings
of loneliness and social isolation. Attending the work-
shops helped them facilitate their capacity to build social
networks and communicate with their husbands and in-
laws to decrease social isolation. One participant stated
that “After the teaching, I have learned to use better way
to talk with my husband and mother-in-law, not just al-
ways keep silent. They have more patience to communi-
cate with me.”
Enhancing Sense of Self-Worth
126. Some of the participants experienced physical abuse by
their husbands and, in some cases, their in-laws. In the
special section workshop on domestic violence preven-
tion and management, participants learned about rescue
resources, their legal rights, and the hidden health prob-
lems related to abuse. After attending the workshop, the
women described feeling more self-empowered and more
confident in dealing with and overcoming domestic vio-
lence. For example, one participant mentioned:
Now I know my human rights, that nobody can beat
me. I can call the 113 protection hotline for help. They
[mother-in-law and husband] have no right to beat
me. Before attending the workshops, I thought I was
stupid. If I do something wrong, my mother-in-law
will slap me, and my husband will kick me when he
is drunk.
Building Psychological Resilience
The participants felt burdened with the stress of accul-
turation and its psychological effects, such as emotional
distress. This form of distress was reflected in the follow-
ing statement from one of the women:
I can’t sleep very well, and I often cry in the middle of
the night. I miss my home town. Immigration marriage
in Taiwan is a challenge and a bet. Our lives are filled
with hardships, such as no money in my pocket most
of the time. If I fight with my husband, I have nowhere
to go.
Attending the HEP, however, helped the participants
transform their life distress into a more positive outlook.
They resolved to make a greater effort to successfully
adapt to their new home in Taiwan. During the work-
127. shops, they discussed the need to increase their ability
to endure the difficulties in life by accepting the chal-
lenges as their destiny and focusing on their children’s
future. Successfully caring for and raising their children
became the women’s main purpose in life. For example,
one participant stated:
I have learned this for my children. I can bear the
hardships in life. Sisters, we must stay in Taiwan,
because this is our home, now we are mothers and
daughters-in-law. In the future, we will be other
women’s mother-in-law. So we keep going and take
care of our kids; they are our roots in Taiwan.
Discussion
The findings from our study not only confirm the
disadvantaged status of marriage immigrant women
in Taiwan and their vulnerability to health risks, but
also demonstrate the effectiveness of PAR as a useful
strategy to empower these women to make sustainable
and beneficial changes in their health and well-being.
The study participants had poor health literacy and
limited knowledge about medical care resources. This
finding is consistent with previous studies that found
immigrant women tend to have low levels of health
literacy, which acts as a barrier to seek out and access
appropriate health care (Kreps & Sparks, 2008; Lee
et al., 2013; Tsai et al., 2014). The women in our study
were unaware of such helpful resources as Taiwan’s
NHI, migrant welfare program, free services and medical
checkups provided by the local health centers, and
the telephone hotline number for domestic violence
protection. Findings from previous studies showed
129. Yang et al. Health Empowerment Among Immigrant Women
empowerment that promotes positive health behaviors,
improves access to community health services, and en-
hances healthcare policies that support the rights of indi-
viduals (Meyer, Torres, Cermeño, MacLean, & Monzón,
2003; Minkler & Wallerstein, 2010).
We also found that healthcare professionals can
play an important role in advocating for disadvantaged
women by participating in community advocacy orga-
nizations and serving as spokespersons for the needs
of immigrant women within the community and the
healthcare system. During the research process, we
collaborated with the local media to call attention to
the challenges that marriage migrant women face and
to arouse community concern. The local newspaper
published an article on the workshop activities, and
a reporter from a television program interviewed the
research team members who described the problems and
needs of migrant women in Taiwan.
Study Limitations
The study has some limitations. First, in our study,
convenience and snowball sampling was used to re-
cruit participants. The methods could have led to a ho-
mogeneous sample, resulting in findings that are not
representative of the entire population. Second, the in-
clusion criteria of the participants were limited to those
who had basic conversation ability in Taiwanese and
Mandarin. This would exclude those who could not speak
Taiwanese and Mandarin. A third limitation is that the
average length of residency in Taiwan was 8.3 years.
However, our participants live in a very remote area.
130. The social isolation is very severe, and health resources
and culturally appropriate education are limited. Even
though they have stayed in Taiwan for several years,
these women are still facing immigrant distress. And be-
cause recruiting was done in a remote area, transferability
of our findings may be limited to women who immigrate
into a remote area, and our findings may not reflect the
experiences of immigrant women in urban areas.
Conclusions
The study provides an example of a successful health
empowerment model for disadvantaged immigrant
women and offers a framework for using the PAR
approach to advance the efforts of community agencies
and healthcare professionals. The present study can
inform government agencies in making appropriate
healthcare policies and in shaping a comprehensive,
health-promoting program that improves marriage mi-
grant women’s well-being. It is also recommended that
primary care centers offer counseling and support groups
for migrant women. Increasing the women’s social par-
ticipation through women-to-women discussion groups,
conducted in an atmosphere of confidence and trust, can
reduce their isolation. Also, providing immigrant women
with the opportunity to meet and share experiences with
other migrant women, especially those from the same
native country, can improve their social support. The
findings of this study can be used not only to understand
the current situation of health empowerment among
marriage migrant women in Taiwan but also to advocate
for the health rights of all disadvantaged immigrant
women and their families. Health professionals are
encouraged to continuously emphasize the importance
of identifying and addressing immigrant women’s health
131. needs in practice, theory, research, and health policy.
Acknowledgments
The authors extend appreciation to all the research par-
ticipants and community partners for sharing their ex-
perience. This study was funded by the National Science
Council, Taiwan (NSC 96–2628-B-037–041-MY3).
Clinical Resources
� Bureau of Consular Affairs, Ministry of For-
eign Affairs, Republic of China (Taiwan): http://
www.boca.gov.tw/mp?mp=2
� Committee on the Elimination of Discrimi-
nation Against Women: http://www.un.org/
womenwatch/daw/cedaw/
� National Health Insurance Administration Ministry
of Health and Welfare: http://www.nhi.gov.tw
� National Immigration Agency: http://www.
immigrat-ion.gov.tw
� Lite-on Cultural foundation: http://liteoncf.org.
tw/wealth/a2.htm
References
Berry, J. W. (1997). Immigration, acculturation, and
adaptation. Applied Psychology: An International Review,
46(1),
5–38.
133. research on equity and access for marriage migrants. Retrieved
from http://www.apmigrants.org/jsmallfib top/
Research/0Better%20or%20For%20Worse.pdf
Hung, C. H., Wang, H. H., Chang, S. H., Jian, S. Y., & Yang,
Y.
M. (2012). The health status of postpartum immigrant
women in Taiwan. Journal of Clinical Nursing, 21(9),
1544–1553.
Koshy, V. (2005). Action research for improving practice: A
practical guide. London, UK: Paul Chapman Publishing.
Kreps, G. L., & Sparks, L. (2008). Meeting the health literacy
needs of immigrant populations. Patient Education and
Counseling, 71(3), 328–332.
Lee, F. H., Wang, H. H., Yang, Y. M., & Tsai, H. M. (2013).
Barriers faced by Vietnamese immigrant women in Taiwan
who do not regularly undergo cervical screenings: A
qualitative study. Journal of Advanced Nursing, 70(1),
87–96.
Lin, M. L., & Wang, H. H. (2008). Prenatal examination
134. behavior of Southeast Asian pregnant women in Taiwan: A
questionnaire survey. International Journal of Nursing
Studies, 45(5), 697–705.
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry.
Thousand Oaks, CA: Sage.
McNiff, J. (2013). Action research: Principles and practice.
New
York: Routledge.
Meleis, A. I., & Lipson, J. G. (2004). Cross-cultural health and
strategies to lead development of nursing practice. In J.
Dalay, S. Speedy, & D. Jackson (Eds.), Nursing leadership
(pp. 69–88). Chatswood, Australia: Elsevier.
Meyer, M. C., Torres, S., Cermeño, N., MacLean, L., &
Monzón, R. (2003). Immigrant women implementing
participatory research in health promotion. Western Journal
of Nursing Research, 25(7), 815–834.
Miles, M. B., & Huberman, A. M. (2013). Qualitative data
analysis: A methods sourcebook (2nd ed.). Thousand Oaks,
135. CA: Sage.
Ministry of the Interior. (2012). National immigration agency:
Statistics on foreign spouses. Retrieved from
http://www.immigration.gov.tw/public/
Minkler, M., & Wallerstein, N. (2010). Community-based
participatory research for health: From process to outcomes.
San
Francisco, CA: John Wiley & Sons.
Reason, P., & Bradbury, H. (Eds.). (2008). The handbook of
action research: Participative inquiry and practice. Thousand
Oaks, CA: Sage.
Rice, P. L., & Ezzy, D. (2001). Qualitative research methods: A
health focus. South Melbourne, Australia: Oxford University
Press.
Shearer, N. B. (2007). Toward a nursing theory of health
empowerment in homebound older women. Journal of
Gerontological Nursing, 33(12), 38–45.
Speros, C. (2005). Health literacy: Concept analysis. Journal of
Advanced Nursing, 50(6), 633–640.
136. Tapp, H., & Dulin, M. (2010). The science of primary
health-care improvement: Potential and use of
community-based participatory research by practice-based
research networks for translation of research into practice.
Experimental Biology and Medicine, 235(3), 290–299.
Tsai, H. M., Cheng, C. Y., Chang, S. C., Yang, Y. M., & Wang,
H. H. (2014). Health literacy and health-promoting
behaviors among multiethnic groups of women in Taiwan.
Journal of Obstetric, Gynecologic, and Neonatal Nursing, 43(1),
117–129.
U.S. Citizenship and Immigration Services. (2013). The
“mail-order bride” industry and its impact on U.S. immigration.
Retrieved from http://www.uscis.gov/portal/site/uscis
U.S. Department of Health and Human Services. (2013).
Healthy people 2020. Retrieved from
http://www.healthypeople.gov/2020/default.aspx
Von, W. C., Knight, K., Steptoe, A., & Wardle, J. (2007).
Functional health literacy and health-promoting behavior
137. in a national sample of British adults. Journal of
Epidemiology and Community Health, 61(12),
1086–1090.
Wang, H. H., & Yang, Y. M. (2002). The health of Southeast
Asian women in transnational marriages in Taiwan.
Journal of Nursing, 49(2), 35–41.
Yang, Y., Wang, H. H., & Anderson, D. (2010). Immigration
distress and associated factors among Vietnamese women
in transnational marriages in Taiwan. Kaohsiung Journal of
Medical Sciences, 26(12), 647–665.
Yang, Y. M., & Wang, H. H. (2003). Life and health concerns
of Indonesian women in transnational marriages in
Taiwan. Journal of Nursing Research, 11(3), 167–176.
Yang, Y. M., & Wang, H. H. (2011a). Cross-cultural
comparisons of health-related quality of life between
Taiwanese women and transnational marriage Vietnamese
women in Taiwan. Journal of Nursing Research, 19(1),
44–52.
139. Brief Description of Method Employed:
Study 2: Health empowerment among immigrant women in
transnational marriages in Taiwan.
Brief Description of Method Employed:
Data Collection Steps (add more steps if needed)
Study – describe the process of how data were collected
Comments about the data collection
Step 1
Step 2
Step 3