This article reports the findings from a participatory action research study concerning the experience of Ugandan nurses caring for individuals with HIV illness. Six key informants from government and non-governmental organizations were interviewed using a semistructured format. Six nurses from a large national referral hospital in Kampala, Uganda, participated in 10 focus group meetings during a period of 11 months. In-depth interviews, focus groups, and photovoice were used to collect the data. Findings indicate that nurses faced many challenges in their daily care, including poverty, insufficient resources, fear of contagion, and lack of ongoing education. Nurses experienced moral distress due to the many challenges they faced during the care of their patients. Moral distress may lead nurses to quit their jobs, which would exacerbate the acute shortage of nurses in Uganda. This study provides important knowledge for guiding clinical practice and nursing education in resource-constrained countries like Uganda.
In this article the authors present findings from a qualitative research study carried out with Ugandan nurses from September 2003 until June 2004. They highlight the process and philosophical basis of participatory action research (PAR) by reflecting on the challenges, opportunities, outcomes, and ethical issues encountered during the conduct of the research. In this study PAR fostered a climate in which nurses could engage in collective reflection on their practice, make sense of their experiences, and thereby change their understanding of their work.
Introduction:
Clients on methadone maintenance treatment (MMT) have high attrition rates that are attributed to personal and system-related factors. To develop supportive interventions for these clients, it is imperative to understand social demographic characteristics and challenges that clients in the MMT program face.
Objectives:
This article aims to describe (a) the sociodemographic characteristics and clinical profiles of clients in a MMT program, (b) factors that impact their positive clinical outcomes, and (c) the study's implications for practice.
Methods:
A retrospective review of 101 randomly selected electronic medical records representing one third of all the records were examined for sociodemographic characteristics, clinical profiles, and outcomes. Descriptive statistics were used to analyze these variables. Interviews with 18 healthcare providers focusing on their experiences of caring for clients in the MMT program were analyzed thematically.
Results:
The average age of clients on MMT is 35.5 years. Clients had early exposure to alcohol and drugs, and at the time of enrollment to the program, they presented with complex healthcare needs, borne from chronic use, and exposure to adverse traumatic events. Personal and systemic factors impact clients' recovery. These include poverty, homelessness, and inadequate healthcare services. Understanding sociodemographic characteristics, clinical profiles, and clients' challenges is central to the development of supportive interventions that enhance retention to care and recovery.
Summary
With increasing childhood obesity rates and type 2 diabetes developing in younger age groups, many schools have initiated policies to support healthy eating and active living. Policy interventions can influence not only health behaviours in students but can also impact these behaviours beyond the school walls into the community. We articulate a policy story that emerged during the data collection phase of a study focused on building knowledge and capacity to support healthy eating and active living policy options in a small hamlet located in the Canadian Arctic. The policy processes of a local school food policy to address unhealthy eating are discussed. Through 14 interviews, decision makers, policy influencers and health practitioners described a policy process, retrospectively, including facilitators and barriers to adopting and implementing policy. A number of key activities facilitated the successful policy implementation process and the building of a critical mass to support healthy eating and active living in the community. A key contextual factor in school food policies in the Arctic is the influence of traditional (country) foods. This study is the first to provide an in-depth examination of the implementation of a food policy in a Canadian Arctic school. Recommendations are offered to inform intervention research and guide a food policy implementation process in a school environment facing similar issues.
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