Engaging black sub-Saharan African communities and their gatekeepers in HIV prevention programs: challenges and strategies from England

Objective: HIV infection is a sensitive issue in black communities [Serrant-Green L. Black Caribbean men, sexual health decisions and silences. Doctoral thesis. Nottingham School of Nursing, University of Nottingham; 2004]. Statistics show black sub-Saharan African (BSSA) communities disproportionately constitute two-thirds of people with HIV [Heath Protection Agency. Health protection report: latest infection reports-GOV.UK; 2013]. African communities constitute 30% of people accessing HIV treatment in the United Kingdom yet represent less than 1% of the population [Health Protection Agency. HIV in the United Kingdom: 2012 report; 2012], [Department of Health. DVD about FGM. 2012. Available from [email protected].]. This article explores the sociocultural challenges in engaging BSSA communities in HIV prevention programs in England and possible strategies to improve their involvement. Methods: Twelve focus group discussions and 24 semistructured interviews were conducted in a 2-year period with participants from the BSSA communities and sexual health services in the West Midlands, England. The research was supported by the Ubuntu scheme, a sexual health initiative working with African communities in Birmingham, England. Results: Ineffective engagement with African communities can hinder the effectiveness of HIV prevention programs. Skills and strategies sensitive to BSSA culture are important for successful implementation of prevention programs. HIV prevention programs face challenges including stigma, denial, and marginalized views within BSSA communities. Conclusion: Networking, coordination, and cultural sensitivity training for health professionals are key strategies for engaging BSSA communities in HIV prevention programs

Research Readiness: A Core aspect of fitness for practice?

Florence Nightingale is one of the most famous nurses in history, credited for establishing the origins of nurse education and training. What is not so commonly known however, is her work in promoting evidence based practice and Foundations of nursing researchacceptedVersio

Compassion in Practice – evaluating the awareness, involvement and perceived impact of a national nursing and midwifery strategy amongst health care professionals in NHS Trusts in England

Aim: To report the findings from an evaluation of the impact of the Compassion in Practice Vision & Strategy (CiPVS) (National Health Service England (NHSE), 2012) on nursing, midwifery and care staff. Background: The CiPVS was a programme of work to highlight the importance of compassionate care following the Francis Report in 2013 into the deficits in care in an NHS hospital trust. It was launched by NHS England in 2012 at a time when fiscal cuts were introduced by the Department of Health in England. Design and setting: Mixed methods. Results: Inferential statistics were used to test whether there were significant differences between staff at different levels of seniority with regard to awareness and involvement in CiPVS and their attitudes to it. Awareness and involvement of staff in CiPVS was high amongst middle and senior management but limited at ward level. Staff were not involved in CiPVS due to a lack of awareness. Ward level staff who were aware and involved perceived a lack of support and communication from senior leadership to deliver CiPVS. Discussion: Results reveal professional anger, distress and resistance to CiPVS and a view of the programme as a top down initiative which did not sufficiently recognise structural constraints on nurses’ ability to deliver compassionate care. We discuss the implications of our findings for global nursing. Conclusion: Participants emphasised that compassion for patients is only sustainable where there is compassion for staff and many participants felt that they were not being treated with compassion. Relevance for practice: NHSE should strongly affirm that nurses and midwives in general provide compassionate care. Trust leadership should provide support for ward level staff who deliver compassionate care in difficult circumstances

The impact of HIV stigma in accessing sexual health services among black sub-Sahara African woman and gay men: a systematic literature review

For many years HIV related stigma and denial has characterized the pandemic and presented a major challenge to the uptake of HIV testing, prevention and normalization among black sub-Sahara African (BSSA) women and gay men. The challenges have had a ripple effect on the access to sexual health services and resources within the communities in question. This article reviews literature on the types of HIV stigma and its impact in accessing sexual health services and resources by the aforesaid communities. Furthermore the article will review literature on attempts made to de-mystify HIV stigma in order to increase its uptake among the groups in question. The findings from the literature suggest that HIV stigma remains a big challenge to the uptake of HIV testing and access to sexual health services including resources among different social groups under consideration in this article. Despite the efforts to normalize HIV testing, including access to sexual health services and resources, HIV stigma has tended to take a new complex dimension and has proved hard to disappear. In addition to the current efforts to end HIV stigma there is need to understand more about the forms, contexts and social construction of HIV stigma and sexual health seeking behavior in different communities, if we are to succeed in our endeavor to control the epidemic

Research Readiness: A Core aspect for Fitness for Practice?

Research and clinical practice education are often conceptualised as related but opposing areas of professional development. While nurse education and training highlights the importance of evidence based practice, often in reality the career trajectories and leadership development of nurses working as researchers or practitioners exist as parallel entities. In many countries this is further complicated by the fact that becoming a nurse researcher, educationalist or clinical practitioner requires an individual to select disparate career pathways. However the professional regulatory bodies for nursing stipulate that utilising evidence to inform education, policy and practice of healthcare is an essential part of nurses’ fitness to practice (Nursing Midwifery Council 2014). In addition, in the UK as elsewhere, national strategic priorities for nurses highlight nurses’ responsibility to evidence the work they do and the impact it has on patient care (NHS England 2016; Nursing Council New Zealand 2016). The authors here therefore assert, that far from being disparate requirements nurse educators have a responsibility to ensure that research and practice are unified and that nurses at the point of qualification and beyond are research ready and research able respectively. This paper explores the critical relationship between research readiness and fitness to practice in a nursing context and argues that failure to ensure that education programmes equip nurses with the skills to use, understand, create and apply research evidence fail to adequately prepare them for practice in the 21st century. NHS England, 2016. Leading Change; adding value a framework for nursing midwives and care staff. London: NHS. Nursing Council for New Zealand. 2016. Competencies for registered nurses. Nursing Council for New Zealand: Wellington. Nursing Midwifery Council, 2014. Standards for competence for registered nurses. London: Nursing Midwifery Council

Gender Flexibility as a Social factor in Men's Recovery from Schizophrenia in Northern Nigeria

BackgroundSchizophrenia is a severe mental health condition that impacts more heavily on men. In Nigeria, studies on men and health have mainly focused on sexual health, in contrast, men’s experience of schizophrenia and the role of gender in influencing beliefs about their recovery has rarely been studied. This study explored men’s perceptions of developing schizophrenia in northern Nigeria and what emerged as facilitating factors in their recovery.&#x0D; MethodThis qualitative study utilized semi-structured interviews with 30 male outpatients with a previous diag-nosis of schizophrenia and 10 mental health professionals. All were recruited through Nigerian psychiatric hospital clinics. A thematic approach informed analysis of the data collected.&#x0D; ResultsA commitment to flexibility in gender-relations emerged as a key finding. Within household members, the meeting of financial needs was talked about interchangeably. This flexible gender-relations was then associ-ated with household poverty reduction, which was previously seen as influencing the men’s recovery from the mental illness. In particular, providing for family needs became a shared responsibility, with departure from traditional gender expectations imposing fewer family hardships. This was also reported as having a bearing on the men’s willingness to access services, which aided recovery.&#x0D; ConclusionThe influence of flexible gender-relations demonstrated in this study has practice implications for under-standing men’s management of recovery from schizophrenia. Community-focused gender transformative programs for the men and those involved in their care in Nigeria could help engage participants in discus-sions relevant to facilitate changes in gender expectations.</jats:p

‘Hearing silences’: Exploring culturally safe transitional care: A qualitative study among Turkish-speaking migrant frail older adults

Aims: This study aimed to investigate the experiences and transitional care needs of Turkish frail older adults living in the UK and determine how this information can be utilized to improve the provision of culturally sensitive care during the transitional period. Design: Qualitative descriptive research with semi-structured individual interviews. Methods: “The ‘Silences’ Framework guided the research design, from conceptualizing the research question to structuring the report of final outputs. For this study, semi-structured, in-depth interviews were conducted with sixteen older adults living with frailty and five family caregivers between January and May of 2023 in the United Kingdom. Results: Major themes that were identified included: (i) information and communication, (ii) care and support, (iii) the role of culture and (iv) trust and satisfaction. Further analysis, through discussion and immersion in the data, revealed that care transition periods were presented alongside three phases of transitional care: pre-transition (during hospitalization), early-transition (the period between discharge and the 7th day after discharge) and late transition (the period between the 8th day and 12th month after discharge). Conclusions: Our study revealed that the communication and informational needs of frail older individuals change during the transition period. While Turkish older adults and family caregivers expressed satisfaction with healthcare services in the UK, many struggled due to a lack of knowledge on how to access them. Impact: The support of family caregivers is a crucial component in facilitating transitional care for frail older patients, as they help in accessing healthcare services and using technological devices or platforms. It should be noted that family caregivers often hold the same level of authority as their elderly Turkish counterparts. Patient or Public Contribution: No patient or public contribution

A pilot study exploring the experiences of mental health among internal migrants in Nigeria

Purpose: This article identified and explored factors that impact on the mental health of internal migrants in Nigeria. Design: A pilot qualitative phenomenological study with four participants from the Federal Capital Territory and Lagos states in Nigeria. Semi-structured interviews were undertaken using the application known as Zoom© from August to September 2019. Interviews were analysed using the six steps of thematic analyse described by Braun and Clarke (2006). Findings: Five themes emerged from this study; ‘purpose of migration’, ‘experience of migration’, ‘coping strategies’, ‘knowledge of mental health’, and ‘impact of internal migration on mental health’. In summary, the participants described the reasons or migrating as work, marriage, and wanting a better life. They described having accommodation issues, difficulties finding a job after migration and also experienced challenges of building new friendships. Participants also explained that religion and perseverance helped them cope after relocating. Practical implications: The pilot study concludes that the stress of internal migration combined with socio-economic challenges and lack of social support can result in a lack of ability to settle in a new culture (ethnic group) which may likely result in poor mental health. Originality: This article contributes to existing knowledge of mental health in Nigeria, a sensitive topic that is rarely discussed in the country, by studying an under-researched group (internal migrants)

Tuberculosis/HIV/AIDS coinfection in Porto Alegre, RS/Brazil - invisibility and silencing of the most affected groups

OBJECTIVE: To analyze how belonging to certain social groups contributes to constituting the vulnerabilities associated with illnesses due to tuberculosis/HIV/AIDS coinfection. METHODOLOGYThis is a qualitative study carried out in the city of Porto Alegre, state of Rio Grande do Sul, in regions of high social vulnerability. Twenty coinfected people were interviewed in specialized health services between August and December 2016. The analysis was based on the frameworks The Sound of Silence and Vulnerability and Human Rights. RESULTS: Socioeconomic conditions were decisive for the constitution of the vulnerability conditions. Processes of people invisibilization, and the silencing of their voices, in a scenario marked by economic, racial and gender inequalities, contributed for their health needs not to be understood and effectively taken into account in the services actions. FINAL CONSIDERATIONS: The more effective strategies are to legitimize voices and to understand the needs of those affected by coinfection, the greater the chances that programmatic responses to the problem will be successful