Experiencing transformation: the case of Jordanian nurse immigrating to the UK

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/112229/1/jocn12810.pd

What facilitates the delivery of dignified care to older people? A survey of health care professionals Geriatrics

Background: Whilst the past decade has seen a growing emphasis placed upon ensuring dignity in the care of older people this policy objective is not being consistently achieved and there appears a gap between policy and practice. We need to understand how dignified care for older people is understood and delivered by the health and social care workforce and how organisational structures and policies can promote and facilitate, or hinder, the delivery of such care. Methods: To achieve our objective of understanding the facilitators and to the delivery of dignified care we undertook a survey with health and social care professionals across four NHS Trusts in England. Participants were asked provide free text answers identifying any facilitators/barriers to the provision of dignified care. Survey data was entered into SPSSv15 and analysed using descriptive statistics. These data provided the overall context describing staff attitudes and beliefs about dignity and the provision of dignified care. Qualitative data from the survey were transcribed verbatim and categorised into themes using thematic analysis. Results: 192 respondents were included in the analysis. 79 % of respondents identified factors within their working environment that helped them provide dignified care and 68 % identified barriers to achieving this policy objective. Facilitators and barriers to delivering dignified care were categorised into three domains: 'organisational level'; 'ward level' and 'individual level'. Within the these levels, respondents reported factors that both supported and hindered dignity in care including 'time', 'staffing levels', training',' 'ward environment', 'staff attitudes', 'support', 'involving family/carers', and 'reflection'. Conclusion: Facilitators and barriers to the delivery of dignity as perceived by health and social care professionals are multi-faceted and range from practical issues to interpersonal and training needs. Thus interventions to support health and social care professionals in delivering dignified care, need to take a range of issues into account to ensure that older people receive a high standard of care in NHS Trusts.Professor David Oliver, Professor Andree le May, Dr. Sally Richards, Dr Wendy Marti

Farming practices, varietal preferences, and land suitability analyses for yam production in Eastern D.R. Congo: implications for breeding initiatives and food sovereignty

Yam (Dioscorea spp.) is a key tuber crop in sub-Saharan Africa (SSA) with huge potential for poverty alleviation, food sovereignty, and nutrition security. Exploiting its full potential requires that factors holding it down are understood and mitigated. This study, conducted between May and July 2022 and 2023, assessed yam farming practices, varietal preferences, and land suitability in the Eastern Democratic Republic of Congo (DRC). We interviewed 765 smallholder farmers within four agro-ecological zones (AEZ) to assess the sociocultural, agronomic, varietal, and biophysical factors affecting yam production. Land suitability analyses were conducted using the Analytic Hierarchy Process (AHP) to identify areas suitable to extensive yam production and to cluster environments that could optimize yam varietal selection and testing. Results showed that yam is mainly cultivated by women in eastern DRC (70%). The seed delivery system is informal, relying primarily on farmer-saved seeds and farmer-seed exchanges (74.9%). Soil depletion (68.3%), limited access to high-quality seeds (54.5%), youth disengagement in yam value chain (50.3%), insect pests (17.9%), and short tuber shelf-life (65.8%) were, respectively, the main ecological, agronomic, sociocultural, biological, and tuber quality factors hindering yam production in eastern DRC. However, the perceived importance of most factors significantly varied with farmer gender and age categories. A multitude of varietal traits was used to assess yam varieties in eastern DRC, of which the tuber taste (59%) was the most valued trait regardless of gender and age categories, though it had highest scores among middle-aged adult women. Land suitability analyses discriminated five clusters; the most significant part of the region falling under suitable (27%), highly suitable (24%), and very highly suitable classes (37%). We further discussed how breeding initiatives for delivering yam varieties, suiting local producers’ and end-users’ needs, could unlock the crop’s potential for enhancing food security and wealth creation in eastern DRC. The land suitability map from this study is a valuable decision-making tool in defining priority areas for extensive yam production and varietal selection and testing. This study provided valuable insights on factors affecting yam production and suggested yam breeding as a backbone of a holistic approach seeking to address challenges faced in unlocking the potential for yam production in eastern DRC

Interrogating the language of integration: the case of internationally recruited nurses

AIMS: This paper suggested the need to interrogate the notion of 'integration' to facilitate the retention of migrant nurses. BACKGROUND: The growth in internationally recruited nurses in the UK's health system has led to a raft of policies that aim to ensure that such nurses are well 'integrated' into their 'new environment'. It is assumed that integration will improve the quality of internationally recruited nurses' experience in the UK, improve their retention rates and thus improve the quality of health delivery within the UK. However, most of the steps through which integration is sought tend to move between some version of assimilation and 'respect for difference'. CONTRIBUTIONS: This paper aimed to add to existing literature on the integration of internationally recruited nurses in the UK by suggesting three steps towards rethinking 'integration policies'. It suggests the need to recognize migration as only one of the differentiating factors within the nursing sector, to ensure that integration does actually become a two-way process and to be cognizant of the multiple shapes that racism can take. The first two steps will prevent a slip between integration and assimilation while the last will help rethink any anti-racist training that may form part of integration policies. CONCLUSIONS: There are many factors influencing the experiences of internationally recruited nurses and not all of them can be addressed within current integration policies. RELEVANCE TO CLINICAL PRACTICE: Rethinking integration can help improve the experience of internationally recruited nurses

Dignity, equality and diversity: an exploration of how discriminatory behaviour of healthcare workers affects patient dignity

This paper explores dignity within the context of equality and diversity, and examines some of the ways in which discriminatory behaviour of healthcare workers contributes to loss of dignity in healthcare. We argue that dignity is a human right for every individual, but one that has different interpretations and may thus be easily compromised. Healthcare professionals have an ethical and professional duty to promote dignity and to adopt anti-discriminatory behaviour. We argue therefore that a recognition and understanding of diversity and equality, and how these concepts can be applied in healthcare, is essential for the provision of dignity in care. A person-centred approach can support dignity in care, acknowledging and valuing each person's diversity. We also argue that organisations have a duty to support dignity and equality in care delivery and to recognise and respond to the diversity of their patient populations and workforce. © 2013 Radcliffe Publishing

Patients' expectations of the maintenance of their dignity

Aims and objectives. To explore patients' views regarding the factors that contribute to the maintenance of their dignity while in hospital, together with their perceptions of whether or not these were realised. Background. It has long been recognised that a consideration of patients' dignity in the hospital setting is of paramount importance and its maintenance can contribute to the 'emotional comfort' that may assist recovery. There have been several attempts to define dignity as a theoretical concept, but few studies of the factors that contribute to its maintenance from the patients' perspective. Design. A phenomenological hermeneutic approach was used. Method. Interviews were conducted with 102 patients in three hospitals in the UK over 18 months. The intention was to interpret what was being said and also the underlying meaning of how patients considered that their dignity was compromised. Results. The findings revealed that although many patients were satisfied with the maintenance of their dignity while in hospital, a significant number were not. Six key themes that contribute to the preservation of their dignity were identified - privacy; confidentiality; communication and the need for information; choice, control and involvement in care; respect and decency and forms of address. Patients provided details of their expectations with respect to these factors. Conclusions. Patients, irrespective of their situation and degree of health have their own expectations in relation to their dignity. These need to be assessed and matched by relevant nursing activities to assist recovery. Relevance to clinical practice. Nurses have an important role in meeting patients' expectations of how they would like their dignity to be maintained. The identification of the most important factors that contribute to this from patients' perspective will help develop dignified nursing practice. © 2008 Blackwell Publishing Ltd