This study explored spirituality as a lived experience through in-depth, face-to-face interviews of 15 Taiwanese women with breast cancer. A Phenomenological research method was employed to guide the study. Four main themes and 12 subthemes, conceptualized under a meta-theme of hsin, emerged as characteristic of the current “lifeworlds” of the study participants. Interpretation of the findings revealed that spirituality is a journey and a unidirectional evolving process that the participants experienced at different levels of wholeness and integration. Spirituality in Taiwan not only must be seen as metaphysics but also should be approached in the cultural context of patients. Nurses should attend to each patient as a unique person, focus on “here-and-now” encounters, and help their patients transform and evolve to a higher plane of wholeness and integration. Nurses should, as well, nurture and support their own spirituality to be available healing resources for others.

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The sharing of experiences in advanced practice nursing clinical courses allows for application of core principals to different facets of practice, with the potential to promote discussions beyond the course objectives, create opportunities for mentoring, foster critical thinking, and facilitate change and socialization into advanced practice. A pilot test of online, directed journaling, an innovative sharing and reflection strategy, was incorporated in a two-quarter community health advanced practice nursing clinical course in an attempt to enhance clinical learning. Six female graduate nursing students completed the journaling. A 10-item evaluation measure demonstrated that the online journaling strategy was highly effective and valuable for the students. An assessment of the journaling entries found multiple examples of discussion, mentoring, critical thinking, and socialization. Innovative online strategies should become the standard for sharing in advanced practice nursing education.

Cardiovascular disease (CVD) is the number 1 killer of American women, with African American women disproportionately represented. Dietary fat consumption is a major risk factor for the development of CVD. This study examined the average daily diet of urban midlife African American women, specifically the relation between dietary fat, readiness to change, ethnocultural association, and selected sociodemographic variables. Three hundred days of dietary data were collected. Sixty five percent of the participants reported currently avoiding high fat food with another 25% planning to avoid high fat food. Although 90% of the participants were avoiding or planning to avoid high fat foods, 77% were consuming diets with over 30% of their calories from fat. Of 11 variables considered, ethnocultural association was the only variable found to be consistently positively related to dietary fat intake. Community dietary education for midlife African American women needs to target all, especially those with stronger cultural bonds.

Background: Volunteer physicians are crucial for the operation of safety-net clinics, which provide medical care for uninsured and underinsured populations. Thus, identifying ways to maximize the number of physicians volunteering at such clinics is an important goal.Objective: To investigate the perceptions, motivations, functions, and barriers associated with physician volunteering in four safety-net clinics in San Bernardino County, Southern California, a location of great medical need with many barriers to care.Methods: The study participants are physicians belonging to the Southern California Permanente Medical Group who use a combination of discretionary time (during regular work hours) and personal time in evening and weekend hours to volunteer their services. The experimental design incorporates a mixed methodology: an online survey of 31 physicians and follow-up interviews with 8 of them.Results: Physicians conveyed uniformly positive perceptions of their volunteer service, and most were motivated by humanitarian or prosocial desires. Volunteering also provided a protective "escape hatch" from the pressures of the physicians' regular jobs. Physicians cited few challenges to volunteering. The most common personal barrier was a lack of time. The most common professional barriers were organizational and supply issues at the clinic, along with the patients' social, transportation, and financial challenges. Conclusion:The results suggest that appealing to physicians' values and faith, and highlighting the burnout-prevention qualities of volunteering, may be key to recruitment and retention of volunteer physicians who serve underserved and underinsured populations in community clinics.