No abstract

Objective To identify the effects of health literacy levels on health outcomes in patients with diabetes in a type V health center in Western Jamaica. Method A correlational survey design with a random sampling technique was used. An 18-item questionnaire and the Newest Vital Sign tool were administered to 88 consenting adults with diabetes to assess their health literacy levels. Their health outcomes were evaluated with docket review. Data were analyzed using SPSS version 18. Results The participants were predominantly female (77.3%), aged 51–70 years, married (44%), employed (46%), and diagnosed with diabetes > 10 years (42%). Only 13.6% of the study population was adequately health literate. The health literacy scores for gender were not significant ( P = 0.84). The health literacy scores of the patients with different ages and educational levels were significant ( P < 0.001). Pearson's correlations revealed no linear relationship between health literacy scores and health outcome ( r = 0.185, P = 0.084). Conclusion Limited health literacy and high likelihood of limited health literacy are predominant in the study population. Age and educational level are significantly associated with health literacy levels. However, these findings suggest no association between health literacy level and diabetic health outcomes.

Purpose The purpose of this study was to identify the ways in which urban Jamaican mothers influence their adolescent daughters’ sexual beliefs and behaviors in order to incorporate them into the design of a family-based human immunodeficiency virus (HIV) risk reduction intervention program. Design Focus groups were conducted with 46 14- to 18-year-old adolescent girls and 30 mothers or female guardians of adolescent girls recruited from community-based organizations in and around Kingston and St. Andrew, Jamaica. Separate focus groups were held with mothers and daughters; each included 6 to 10 participants. Focus group sessions were scripted, led by teams that included trained Jamaican and American facilitators and note-takers, and audio-taped to ensure data accuracy. Data were analyzed using qualitative content analysis. Findings Four major maternal influences were identified: mother-daughter relationship quality, mother-daughter sexual communication, monitoring or supervision, and maternal sexual role modeling. Mothers’ and daughters’ reports were consistent; both groups identified positive and negative influences within each category. Conclusions Some maternal influences were positive and health promoting; others were negative and promoted unsafe sexual activity and risk for HIV and other sexually transmitted infections. These influences were incorporated into the design of a culture-specific family-based HIV risk reduction intervention tailored to the needs of urban Jamaican adolescent girls and their mothers. Clinical Relevance In order to be effective, family-based HIV risk reduction interventions should be theory based and tailored to the target audience. The four maternal influences identified in this formative study were incorporated into the subsequent intervention design.

As part of a multinational program of research, we undertook a community-based participatory research project in Jamaica to strengthen nurses' engagement in HIV and AIDS policy. Three leadership hubs were purposefully convened and included small groups of people (6-10) from diverse HIV and AIDS stakeholder groups in Jamaica: frontline nurses and nurse managers in primary and secondary care settings; researchers; health care decision makers; and other community members. People living with HIV or AIDS were among the hub members. Using a relational public health ethics framework, we outline some of the ethical challenges and opportunities experienced by the research team and the leadership hubs. Data included research assistant field notes and hub progress reports. Emerging ethical concerns were associated with relational personhood, social justice, relational autonomy, relational solidarity, and sustainability of the hub activities.

Purpose: In many first-world settings, lateral violence among nurses is pervasive and has been associated with deleterious psychological effects, high staff turnover and negative patient outcomes. This study explored lateral violence among nurses at a Jamaican hospital. Methods: A fixed concurrent QUAN= QUAL mixed method study design was employed. Data were gathered from 114 registered nurses using the 38-item Briles' Sabotage Savvy self-administered questionnaire and two focus group discussions. Results: Exposure to lateral violence was reported by 96% of participants, and 3/4 rated the exposure as moderate to severe. Nurse Managers were the main perpetrators of lateral violence (63%). Lateral violence created a hostile environment, and half of the nurses surveyed indicated an intent to resign. These survey findings were supported by the focus group discussions which yielded themes inclusive of professional disengagement and erosion of team work. Conclusion:The high levels of lateral violence reported in this study indicates an urgent need for the implementation of appropriate workplace violence policies. Reported threats to the healthcare system included poor staff retention and professional disengagement. Highlights:• Lateral violence among nurses is one of the most damaging issues affecting the progress of the nursing profession and is well studied in the developed world.• The attributes of the phenomenon of lateral violence in a low and middle-income country are described in this paper.• Exposure to lateral violence was reported by 96% of participants, forms of lateral violence appeared to be mainly verbal or emotional and nurse managers were the major perpetrators.• Assimilated behavior in response to lateral violence among the nurses included professional disengagement, retaliation, avoidance and intent to resign.• The pervasiveness of lateral violence among the nurses studied indicates the need to implement appropriate workplace violence policies.