Eulalia K Kahwa - Academia.edu (original) (raw)

Papers by Eulalia K Kahwa

Research paper thumbnail of while Building Capacity in Nurses

reproduction in any medium, provided the original work is properly attributed, not used for comme... more reproduction in any medium, provided the original work is properly attributed, not used for commercial purposes, and if transformed, the resulting work is redistributed under the same or similar license to this one. Nurses are knowledgeable about issues that affect quality and equity of care and are well qualified to inform policy, yet their expertise is seldom acknowledged and their input infrequently invited. In 2007, a large multidisciplinary team of researchers and decision-makers from Canada and five low- and middle-income countries (Barbados, Jamaica, Uganda, Kenya, and South Africa) received funding to implement a participatory action

Research paper thumbnail of Scale-up to address HIV/AIDS and other health priorities

13th World Congress on Public Health (April 23-27, 2012), Apr 22, 2012

ABSTRACT Scaling up the model for engaging nurses will involve multi-disciplinary stakeholders fr... more ABSTRACT Scaling up the model for engaging nurses will involve multi-disciplinary stakeholders from different levels of authority and responsibility working across the health system. Both horizontal and vertical linkages will be required. Approaches to leverage dynamic collaboration of stakeholders in other settings and for other priority health issues will be considered.

Research paper thumbnail of Anticardiolipin antibodies in Jamaican women: the relationship to thromboembolic disorders and pregnancy

Research paper thumbnail of Qualitative Research in an International Research Program: Maintaining Momentum while Building Capacity in Nurses

International journal of qualitative methods, Feb 1, 2014

Research paper thumbnail of The impact of leadership hubs on the uptake of evidence-informed nursing practices and workplace policies for HIV care: a quasi-experimental study in Jamaica, Kenya, Uganda and South Africa

Implementation Science, Dec 1, 2015

Background: The enormous impact of HIV on communities and health services in Sub-Saharan Africa a... more Background: The enormous impact of HIV on communities and health services in Sub-Saharan Africa and the Caribbean has especially affected nurses, who comprise the largest proportion of the health workforce in low-and middle-income countries (LMICs). Strengthening action-based leadership for and by nurses is a means to improve the uptake of evidence-informed practices for HIV care. Methods: A prospective quasi-experimental study in Jamaica, Kenya, Uganda and South Africa examined the impact of establishing multi-stakeholder leadership hubs on evidence-informed HIV care practices. Hub members were engaged through a participatory action research (PAR) approach. Three intervention districts were purposefully selected in each country, and three control districts were chosen in Jamaica, Kenya and Uganda. WHO level 3, 4 and 5 health care institutions and their employed nurses were randomly sampled. Self-administered, validated instruments measured clinical practices (reports of self and peers), quality assurance, work place policies and stigma at baseline and follow-up. Standardised average scores ranging from 0 to 1 were computed for clinical practices, quality assurance and work place policies. Stigma scores were summarised as 0 (no reports) versus 1 (one or more reports). Pre-post differences in outcomes between intervention and control groups were compared using the Mantel Haenszel chi-square for dichotomised stigma scores, and independent t tests for other measures. For South Africa, which had no control group, pre-post differences were compared using a Pearson chi-square and independent t test. Multivariate analysis was completed for Jamaica and Kenya. Hub members in all countries self-assessed changes in their capacity at follow-up; these were examined using a paired t test.

Research paper thumbnail of Participación de enfermeras en la formulación de políticas del sida

International nursing review en español: revista oficial del Consejo Internacional de Enfermeras, 2013

Research paper thumbnail of Workshop: Scaling-up a Model for Nurses’ Engagement in Health Policy in Lower- and Middle-Income Countries

13th World Congress on Public Health (April 23-27, 2012), Apr 22, 2012

Research paper thumbnail of Anticardiolipin antibodies in Jamaican primiparae

Journal of Obstetrics and Gynaecology, 2006

A prevalence survey of anticardiolipin antibodies (aCL) was done among 924 primiparae. aCL were m... more A prevalence survey of anticardiolipin antibodies (aCL) was done among 924 primiparae. aCL were measured in serum by the standardised anticardiolipin enzyme linked immunosorbent assays (ELISA) and beta(2)-glycoprotein 1 assays to determine the seroprevalence of both beta(2) glycoprotein 1 dependent aCL and beta(2)-glycoprotein 1 independent aCL in Jamaican primiparae, to determine whether aCL are associated with abnormal pregnancy outcomes and if treatment with aspirin had any effect on pregnancy outcome in aCL positive primiparae. The prevalence of aCL was (32/671) 4.8% (95%CI 3.2-6.4) in women who were tested twice. A total of 49 of 924 primiparae or 5.3% (95%CI 3.9-6.7) were positive for aCL on at least one occasion. Only three of the 32 primiparae 3/32 (9.4%) who were positive for aCL on two occasions were positive for beta(2)-glycoprotein 1 dependent aCL. Pregnancy outcome did not differ significantly with respect to aCL status. Aspirin therapy did not influence pregnancy outcome in the 49 aCL positive primiparae studied.

Research paper thumbnail of Re: Anticardiolipin Antibodies Are Not an Independent Risk Factor for Stroke

Stroke, May 1, 2001

Proinflammatory Cytokines and Glutamate in Acute Stroke To the Editor: I have with great interest... more Proinflammatory Cytokines and Glutamate in Acute Stroke To the Editor: I have with great interest read the article, "Proinflammatory Cytokines and Early Neurological Worsening in Ischemic Stroke," by Vila et al. 1 Bearing in mind the complexities of interleukin (IL)-6 effects, I would like to ask the authors the following questions: Are the patients included in this study the same patients as in the earlier published studies 2 from the same research group concerning glutamate? If so, is there a relationship between IL-6 and glutamate that can be identified in the material?

Research paper thumbnail of A review of equity issues in quantitative studies on health inequalities: the case of asthma in adults

BMC Medical Research Methodology, Jul 12, 2011

Background: The term 'inequities' refers to avoidable differences rooted in injustice. This revie... more Background: The term 'inequities' refers to avoidable differences rooted in injustice. This review examined whether or not, and how, quantitative studies identifying inequalities in risk factors and health service utilization for asthma explicitly addressed underlying inequities. Asthma was chosen because recent decades have seen strong increases in asthma prevalence in many international settings, and inequalities in risk factors and related outcomes. Methods: A review was conducted of studies that identified social inequalities in asthma-related outcomes or health service use in adult populations. Data were extracted on use of equity terms (objective evidence), and discussion of equity issues without using the exact terms (subjective evidence). Results: Of the 219 unique articles retrieved, 21 were eligible for inclusion. None used the terms equity/inequity. While all but one article traced at least partial pathways to inequity, only 52% proposed any intervention and 55% of these interventions focused exclusively on the more proximal, clinical level. Conclusions: Without more in-depth and systematic examination of inequities underlying asthma prevalence, quantitative studies may fail to provide the evidence required to inform equity-oriented interventions to address underlying circumstances restricting opportunities for health.

Research paper thumbnail of Anticardiolipin Antibodies and Risk of Thromboembolic Disease in Young Jamaican Women

European journal of cardiovascular prevention & rehabilitation, Dec 1, 2001

Research paper thumbnail of Building capacity for nurse-led research

International Nursing Review, Mar 1, 2009

Aim: To discuss factors that have influenced the development of research capacity among nurses in... more Aim: To discuss factors that have influenced the development of research capacity among nurses in lower and middle-income countries (LMICs). Background: Concerned health scientists have addressed the importance of building research capacity among health professionals. Strengthening capacity specifically among LMIC nurses has been infrequently discussed. Without the requisite educational preparation or an enabling environment for research, nurses are unlikely to either demand research capacity-building opportunities or initiate research examining nursing practice and health system challenges. Methods: A scan was conducted of nine internationally funded research capacity-building initiatives to identify programme targeting and the proportion of nurse trainees. A literature review examined graduate and postgraduate training opportunities for LMIC nurses, and barriers and enablers to nurses' involvement in research. Informal consultations were held with nurse leaders in 15 LMICs and leaders of eight LMIC nursing organizations. Findings: The scan found a generic targeting of health professionals with a very low percentage of nurse trainees. Programmes specifically targeting nurses did attract and prepare a significant number of nurses. Factors limiting nurses' involvement in research include hierarchies of power among disciplines, scarce resources, a lack of graduate and postgraduate education opportunities, few senior mentors, and prolonged underfunding of nursing research. Conclusions: Fully engaging LMIC nurses in health services research may yield pragmatic and evidence-informed service delivery and policy recommendations. Investments in supports for nursing research capacity may enrich global health policy effectiveness and improve quality of care.

Research paper thumbnail of Building and evaluating research capacity in healthcare systems : case studies and innovative models

is a nurse epidemiologist with nearly 40 years' experience in the field of public health. Her pro... more is a nurse epidemiologist with nearly 40 years' experience in the field of public health. Her programme of research examines multi-strategy and multi-level interventions in community health. She has taught and/or led research projects in various international settings, including

Research paper thumbnail of Ethical Challenges and Opportunities for Nurses in HIV and AIDS Community-Based Participatory Research in Jamaica

Journal of Empirical Research on Human Research Ethics, Feb 1, 2013

Research paper thumbnail of Strategies for Successful Implementation of Best Practices Guidelines in a Nursing Curriculum

45th Biennial Convention (16-20 November 2019), Oct 31, 2019

Research paper thumbnail of Validation of the Jamaican Maternal Sexual Role Modelling Questionnaire

West Indian Medical Journal, Dec 1, 2012

Objective: Urban Jamaican adolescent girls face significant risk for sexually transmitted infecti... more Objective: Urban Jamaican adolescent girls face significant risk for sexually transmitted infections including HIV. Studies from the United States of America have found that parents influence adolescents' sexual risk attitudes and behaviours through parent-child sexual communication and monitoring/ supervision. Data from an ongoing mother-daughter HIV risk reduction intervention study in Kingston, Jamaica identified an additional influence of adolescent girls' sexual risk-maternal sexual role modelling (MSRM). As no reliable and valid questionnaires existed to measure MSRM, one was developed. The objective of the current study was to evaluate the psychometric properties of the Jamaican Maternal Sexual Role Modelling questionnaire. Method: Data were collected from 209 Jamaican female adolescents recruited from Kingston, St Andrew and St Catherine parishes. Results: The final 19-item Jamaican MSRM questionnaire was found to have excellent internal reliability (Cronbach's alpha = 0.89). Content validity expert ratings and modified kappa statistics were all 1.0. Principal component analysis identified a three-factor structure that accounted for 53.7% of the variance. Greater MSRM scale scores, indicating more positive and protective maternal sexual role modelling, were associated with less sexual experience, lower intentions to have sex, greater intentions to use condoms if having sex and greater condom use self-efficacy among adolescent girls. Conclusion: The MSRM scale was found to be a reliable and valid measure of Jamaican adolescent females' perceptions of their mothers' sexual role modelling. Further research is needed to assess the reliability and validity of the instrument with other populations.

Research paper thumbnail of Nutrition in critical illness: Critical care nurses' knowledge and skills in the nutritional management of adults requiring intensive care - A review of the literature

Background: Critical illness is physiologically debilitating and is affected by the nutritional s... more Background: Critical illness is physiologically debilitating and is affected by the nutritional status of patients. There is a strong relationship between adequate nutritional status and recovery from critical illness. The health care team, nurses in particular, play a major role in the management and maintenance of an optimal nutritional status in patients who are critically ill. Aims of the review: 1) To examine current evidence regarding the relationship between nutrition and critical illness 2) to examine the relationship between nutritional intake and clinical outcomes of critically ill patients; 3) To determine the role of critical care nurses and the health care team in meeting the nutritional needs of critically ill patients. Methods: A Computerized search of Google Scholar, CINAHL, ProQuest, Medline, and HINARI was done using key terms. The search was delimited to peer reviewed, full text descriptive and intervention research articles with abstracts, which were reviewed. Results: Current evidence suggests that there is a strong positive relationship between nutritional status and critical illness. Improved nutritional status is associated with positive clinical outcomes. However, the evidence is inconsistent in supporting this relationship. The healthcare team particularly nurses' play a major role in the nutritional status of critically ill patients. Conclusion: Maintaining optimal nutritional status is key to improving clinical outcomes of critically ill patients. Knowledge and skills of the healthcare team in nutritional management and the availability of management protocols are important in maintaining optimal nutrition of critically ill patients.

Research paper thumbnail of Jamaican Adolescent Girls With Older Male Sexual Partners

Journal of Nursing Scholarship, Oct 17, 2011

Purpose: The purpose of this study was to describe the relationships between adolescent girls and... more Purpose: The purpose of this study was to describe the relationships between adolescent girls and older male sexual partners in urban Kingston, Jamaica, and identify the human immunodeficiency virus (HIV)-related sexual risks that occur within these relationships. Design: The study employed a descriptive qualitative design. Methods: Data were collected through focus groups and individual interviews conducted with 43 late adolescent girls (18-21 years old). An age-discordant relationship was defined as a sexual relationship between a Jamaican adolescent female and a man who was 2 or more years older. Data were analyzed using qualitative content analysis. Findings: Age-discordant relationships were common and often began when girls were early adolescents. Both adolescent girls and older men tended to have multiple partners, and transactions of gifts, money, or resources from an older partner were expected and common. Older partners were highly influential in HIV-related risk behaviors. Conclusions: Age-discordant relationships need to be explicitly addressed in HIV prevention programs for adolescent girls in Jamaica. Further, the implications of gift-giving, informal sexual transactions, and intradyadic power must be incorporated into strategies for reducing HIV-related sexual risk with older partners. Future studies should examine the perspectives of Jamaican men. Clinical Relevance: This study found that many Jamaican adolescent girls engage in sexual relationships with older men and that the unique characteristics of these relationships may increase girls' risks for HIV and other sexually transmitted diseases. HIV risk reduction interventions for adolescent girls should address sexual risks associated with older male partners.

Research paper thumbnail of Jamaican Mothers’ Influences of Adolescent Girls’ Sexual Beliefs and Behaviors

Journal of Nursing Scholarship, Feb 16, 2012

Purpose-The purpose of this study was to identify the ways in which urban Jamaican mothers influe... more 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.

Research paper thumbnail of Factors Influencing Nurses' Self Care Practices

Journal of Holistic Nursing

Background: The COVID-19 pandemic has exposed nurses to more stress and inability to practice sel... more Background: The COVID-19 pandemic has exposed nurses to more stress and inability to practice self-care activities. These have resulted in conditions that threaten their health, well-being, and ability to work. Nurses’ lack of self-care can predispose them to chronic health conditions and staff burnout which may adversely affect patient care. The panacea for this concern is a deliberate effort to promote holistic health and wellbeing through self-care activities targeted towards physical, mental, social and spiritual aspects of nurses. The purpose of this study was to explore factors influencing self-care practices among registered nurses during COVID-19 pandemic. Methods: Convenience sampling was used to select 294 nurses from four urban hospitals in Kingston Jamaica. A questionnaire was utilized for data collection. Logistical regression analysis was conducted using Statistical Package for Social Sciences (SPSS) software version 22.0. Ethical approval was obtained. Results: The re...

Research paper thumbnail of while Building Capacity in Nurses

reproduction in any medium, provided the original work is properly attributed, not used for comme... more reproduction in any medium, provided the original work is properly attributed, not used for commercial purposes, and if transformed, the resulting work is redistributed under the same or similar license to this one. Nurses are knowledgeable about issues that affect quality and equity of care and are well qualified to inform policy, yet their expertise is seldom acknowledged and their input infrequently invited. In 2007, a large multidisciplinary team of researchers and decision-makers from Canada and five low- and middle-income countries (Barbados, Jamaica, Uganda, Kenya, and South Africa) received funding to implement a participatory action

Research paper thumbnail of Scale-up to address HIV/AIDS and other health priorities

13th World Congress on Public Health (April 23-27, 2012), Apr 22, 2012

ABSTRACT Scaling up the model for engaging nurses will involve multi-disciplinary stakeholders fr... more ABSTRACT Scaling up the model for engaging nurses will involve multi-disciplinary stakeholders from different levels of authority and responsibility working across the health system. Both horizontal and vertical linkages will be required. Approaches to leverage dynamic collaboration of stakeholders in other settings and for other priority health issues will be considered.

Research paper thumbnail of Anticardiolipin antibodies in Jamaican women: the relationship to thromboembolic disorders and pregnancy

Research paper thumbnail of Qualitative Research in an International Research Program: Maintaining Momentum while Building Capacity in Nurses

International journal of qualitative methods, Feb 1, 2014

Research paper thumbnail of The impact of leadership hubs on the uptake of evidence-informed nursing practices and workplace policies for HIV care: a quasi-experimental study in Jamaica, Kenya, Uganda and South Africa

Implementation Science, Dec 1, 2015

Background: The enormous impact of HIV on communities and health services in Sub-Saharan Africa a... more Background: The enormous impact of HIV on communities and health services in Sub-Saharan Africa and the Caribbean has especially affected nurses, who comprise the largest proportion of the health workforce in low-and middle-income countries (LMICs). Strengthening action-based leadership for and by nurses is a means to improve the uptake of evidence-informed practices for HIV care. Methods: A prospective quasi-experimental study in Jamaica, Kenya, Uganda and South Africa examined the impact of establishing multi-stakeholder leadership hubs on evidence-informed HIV care practices. Hub members were engaged through a participatory action research (PAR) approach. Three intervention districts were purposefully selected in each country, and three control districts were chosen in Jamaica, Kenya and Uganda. WHO level 3, 4 and 5 health care institutions and their employed nurses were randomly sampled. Self-administered, validated instruments measured clinical practices (reports of self and peers), quality assurance, work place policies and stigma at baseline and follow-up. Standardised average scores ranging from 0 to 1 were computed for clinical practices, quality assurance and work place policies. Stigma scores were summarised as 0 (no reports) versus 1 (one or more reports). Pre-post differences in outcomes between intervention and control groups were compared using the Mantel Haenszel chi-square for dichotomised stigma scores, and independent t tests for other measures. For South Africa, which had no control group, pre-post differences were compared using a Pearson chi-square and independent t test. Multivariate analysis was completed for Jamaica and Kenya. Hub members in all countries self-assessed changes in their capacity at follow-up; these were examined using a paired t test.

Research paper thumbnail of Participación de enfermeras en la formulación de políticas del sida

International nursing review en español: revista oficial del Consejo Internacional de Enfermeras, 2013

Research paper thumbnail of Workshop: Scaling-up a Model for Nurses’ Engagement in Health Policy in Lower- and Middle-Income Countries

13th World Congress on Public Health (April 23-27, 2012), Apr 22, 2012

Research paper thumbnail of Anticardiolipin antibodies in Jamaican primiparae

Journal of Obstetrics and Gynaecology, 2006

A prevalence survey of anticardiolipin antibodies (aCL) was done among 924 primiparae. aCL were m... more A prevalence survey of anticardiolipin antibodies (aCL) was done among 924 primiparae. aCL were measured in serum by the standardised anticardiolipin enzyme linked immunosorbent assays (ELISA) and beta(2)-glycoprotein 1 assays to determine the seroprevalence of both beta(2) glycoprotein 1 dependent aCL and beta(2)-glycoprotein 1 independent aCL in Jamaican primiparae, to determine whether aCL are associated with abnormal pregnancy outcomes and if treatment with aspirin had any effect on pregnancy outcome in aCL positive primiparae. The prevalence of aCL was (32/671) 4.8% (95%CI 3.2-6.4) in women who were tested twice. A total of 49 of 924 primiparae or 5.3% (95%CI 3.9-6.7) were positive for aCL on at least one occasion. Only three of the 32 primiparae 3/32 (9.4%) who were positive for aCL on two occasions were positive for beta(2)-glycoprotein 1 dependent aCL. Pregnancy outcome did not differ significantly with respect to aCL status. Aspirin therapy did not influence pregnancy outcome in the 49 aCL positive primiparae studied.

Research paper thumbnail of Re: Anticardiolipin Antibodies Are Not an Independent Risk Factor for Stroke

Stroke, May 1, 2001

Proinflammatory Cytokines and Glutamate in Acute Stroke To the Editor: I have with great interest... more Proinflammatory Cytokines and Glutamate in Acute Stroke To the Editor: I have with great interest read the article, "Proinflammatory Cytokines and Early Neurological Worsening in Ischemic Stroke," by Vila et al. 1 Bearing in mind the complexities of interleukin (IL)-6 effects, I would like to ask the authors the following questions: Are the patients included in this study the same patients as in the earlier published studies 2 from the same research group concerning glutamate? If so, is there a relationship between IL-6 and glutamate that can be identified in the material?

Research paper thumbnail of A review of equity issues in quantitative studies on health inequalities: the case of asthma in adults

BMC Medical Research Methodology, Jul 12, 2011

Background: The term 'inequities' refers to avoidable differences rooted in injustice. This revie... more Background: The term 'inequities' refers to avoidable differences rooted in injustice. This review examined whether or not, and how, quantitative studies identifying inequalities in risk factors and health service utilization for asthma explicitly addressed underlying inequities. Asthma was chosen because recent decades have seen strong increases in asthma prevalence in many international settings, and inequalities in risk factors and related outcomes. Methods: A review was conducted of studies that identified social inequalities in asthma-related outcomes or health service use in adult populations. Data were extracted on use of equity terms (objective evidence), and discussion of equity issues without using the exact terms (subjective evidence). Results: Of the 219 unique articles retrieved, 21 were eligible for inclusion. None used the terms equity/inequity. While all but one article traced at least partial pathways to inequity, only 52% proposed any intervention and 55% of these interventions focused exclusively on the more proximal, clinical level. Conclusions: Without more in-depth and systematic examination of inequities underlying asthma prevalence, quantitative studies may fail to provide the evidence required to inform equity-oriented interventions to address underlying circumstances restricting opportunities for health.

Research paper thumbnail of Anticardiolipin Antibodies and Risk of Thromboembolic Disease in Young Jamaican Women

European journal of cardiovascular prevention & rehabilitation, Dec 1, 2001

Research paper thumbnail of Building capacity for nurse-led research

International Nursing Review, Mar 1, 2009

Aim: To discuss factors that have influenced the development of research capacity among nurses in... more Aim: To discuss factors that have influenced the development of research capacity among nurses in lower and middle-income countries (LMICs). Background: Concerned health scientists have addressed the importance of building research capacity among health professionals. Strengthening capacity specifically among LMIC nurses has been infrequently discussed. Without the requisite educational preparation or an enabling environment for research, nurses are unlikely to either demand research capacity-building opportunities or initiate research examining nursing practice and health system challenges. Methods: A scan was conducted of nine internationally funded research capacity-building initiatives to identify programme targeting and the proportion of nurse trainees. A literature review examined graduate and postgraduate training opportunities for LMIC nurses, and barriers and enablers to nurses' involvement in research. Informal consultations were held with nurse leaders in 15 LMICs and leaders of eight LMIC nursing organizations. Findings: The scan found a generic targeting of health professionals with a very low percentage of nurse trainees. Programmes specifically targeting nurses did attract and prepare a significant number of nurses. Factors limiting nurses' involvement in research include hierarchies of power among disciplines, scarce resources, a lack of graduate and postgraduate education opportunities, few senior mentors, and prolonged underfunding of nursing research. Conclusions: Fully engaging LMIC nurses in health services research may yield pragmatic and evidence-informed service delivery and policy recommendations. Investments in supports for nursing research capacity may enrich global health policy effectiveness and improve quality of care.

Research paper thumbnail of Building and evaluating research capacity in healthcare systems : case studies and innovative models

is a nurse epidemiologist with nearly 40 years' experience in the field of public health. Her pro... more is a nurse epidemiologist with nearly 40 years' experience in the field of public health. Her programme of research examines multi-strategy and multi-level interventions in community health. She has taught and/or led research projects in various international settings, including

Research paper thumbnail of Ethical Challenges and Opportunities for Nurses in HIV and AIDS Community-Based Participatory Research in Jamaica

Journal of Empirical Research on Human Research Ethics, Feb 1, 2013

Research paper thumbnail of Strategies for Successful Implementation of Best Practices Guidelines in a Nursing Curriculum

45th Biennial Convention (16-20 November 2019), Oct 31, 2019

Research paper thumbnail of Validation of the Jamaican Maternal Sexual Role Modelling Questionnaire

West Indian Medical Journal, Dec 1, 2012

Objective: Urban Jamaican adolescent girls face significant risk for sexually transmitted infecti... more Objective: Urban Jamaican adolescent girls face significant risk for sexually transmitted infections including HIV. Studies from the United States of America have found that parents influence adolescents' sexual risk attitudes and behaviours through parent-child sexual communication and monitoring/ supervision. Data from an ongoing mother-daughter HIV risk reduction intervention study in Kingston, Jamaica identified an additional influence of adolescent girls' sexual risk-maternal sexual role modelling (MSRM). As no reliable and valid questionnaires existed to measure MSRM, one was developed. The objective of the current study was to evaluate the psychometric properties of the Jamaican Maternal Sexual Role Modelling questionnaire. Method: Data were collected from 209 Jamaican female adolescents recruited from Kingston, St Andrew and St Catherine parishes. Results: The final 19-item Jamaican MSRM questionnaire was found to have excellent internal reliability (Cronbach's alpha = 0.89). Content validity expert ratings and modified kappa statistics were all 1.0. Principal component analysis identified a three-factor structure that accounted for 53.7% of the variance. Greater MSRM scale scores, indicating more positive and protective maternal sexual role modelling, were associated with less sexual experience, lower intentions to have sex, greater intentions to use condoms if having sex and greater condom use self-efficacy among adolescent girls. Conclusion: The MSRM scale was found to be a reliable and valid measure of Jamaican adolescent females' perceptions of their mothers' sexual role modelling. Further research is needed to assess the reliability and validity of the instrument with other populations.

Research paper thumbnail of Nutrition in critical illness: Critical care nurses' knowledge and skills in the nutritional management of adults requiring intensive care - A review of the literature

Background: Critical illness is physiologically debilitating and is affected by the nutritional s... more Background: Critical illness is physiologically debilitating and is affected by the nutritional status of patients. There is a strong relationship between adequate nutritional status and recovery from critical illness. The health care team, nurses in particular, play a major role in the management and maintenance of an optimal nutritional status in patients who are critically ill. Aims of the review: 1) To examine current evidence regarding the relationship between nutrition and critical illness 2) to examine the relationship between nutritional intake and clinical outcomes of critically ill patients; 3) To determine the role of critical care nurses and the health care team in meeting the nutritional needs of critically ill patients. Methods: A Computerized search of Google Scholar, CINAHL, ProQuest, Medline, and HINARI was done using key terms. The search was delimited to peer reviewed, full text descriptive and intervention research articles with abstracts, which were reviewed. Results: Current evidence suggests that there is a strong positive relationship between nutritional status and critical illness. Improved nutritional status is associated with positive clinical outcomes. However, the evidence is inconsistent in supporting this relationship. The healthcare team particularly nurses' play a major role in the nutritional status of critically ill patients. Conclusion: Maintaining optimal nutritional status is key to improving clinical outcomes of critically ill patients. Knowledge and skills of the healthcare team in nutritional management and the availability of management protocols are important in maintaining optimal nutrition of critically ill patients.

Research paper thumbnail of Jamaican Adolescent Girls With Older Male Sexual Partners

Journal of Nursing Scholarship, Oct 17, 2011

Purpose: The purpose of this study was to describe the relationships between adolescent girls and... more Purpose: The purpose of this study was to describe the relationships between adolescent girls and older male sexual partners in urban Kingston, Jamaica, and identify the human immunodeficiency virus (HIV)-related sexual risks that occur within these relationships. Design: The study employed a descriptive qualitative design. Methods: Data were collected through focus groups and individual interviews conducted with 43 late adolescent girls (18-21 years old). An age-discordant relationship was defined as a sexual relationship between a Jamaican adolescent female and a man who was 2 or more years older. Data were analyzed using qualitative content analysis. Findings: Age-discordant relationships were common and often began when girls were early adolescents. Both adolescent girls and older men tended to have multiple partners, and transactions of gifts, money, or resources from an older partner were expected and common. Older partners were highly influential in HIV-related risk behaviors. Conclusions: Age-discordant relationships need to be explicitly addressed in HIV prevention programs for adolescent girls in Jamaica. Further, the implications of gift-giving, informal sexual transactions, and intradyadic power must be incorporated into strategies for reducing HIV-related sexual risk with older partners. Future studies should examine the perspectives of Jamaican men. Clinical Relevance: This study found that many Jamaican adolescent girls engage in sexual relationships with older men and that the unique characteristics of these relationships may increase girls' risks for HIV and other sexually transmitted diseases. HIV risk reduction interventions for adolescent girls should address sexual risks associated with older male partners.

Research paper thumbnail of Jamaican Mothers’ Influences of Adolescent Girls’ Sexual Beliefs and Behaviors

Journal of Nursing Scholarship, Feb 16, 2012

Purpose-The purpose of this study was to identify the ways in which urban Jamaican mothers influe... more 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.

Research paper thumbnail of Factors Influencing Nurses' Self Care Practices

Journal of Holistic Nursing

Background: The COVID-19 pandemic has exposed nurses to more stress and inability to practice sel... more Background: The COVID-19 pandemic has exposed nurses to more stress and inability to practice self-care activities. These have resulted in conditions that threaten their health, well-being, and ability to work. Nurses’ lack of self-care can predispose them to chronic health conditions and staff burnout which may adversely affect patient care. The panacea for this concern is a deliberate effort to promote holistic health and wellbeing through self-care activities targeted towards physical, mental, social and spiritual aspects of nurses. The purpose of this study was to explore factors influencing self-care practices among registered nurses during COVID-19 pandemic. Methods: Convenience sampling was used to select 294 nurses from four urban hospitals in Kingston Jamaica. A questionnaire was utilized for data collection. Logistical regression analysis was conducted using Statistical Package for Social Sciences (SPSS) software version 22.0. Ethical approval was obtained. Results: The re...