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1.  Mental health training experiences among Haitian healthcare workers post-earthquake 2010 
International nursing review  2013;60(4):528-535.
After the 2010 earthquake in Haiti, the large number of persons with major limb damage, amputations, shock, trauma, anxiety and depression placed a severe strain on mental health (MH) services.
This qualitative study describes the impact and acceptability of a Mental Health Training Program (MHTP) implemented in the north of Haiti after the earthquake.
A total of 113 healthcare workers (HCWs) participated in a training program designed to build local MH care capacity. The training curriculum draws on literature related to MH and the impact of the Haiti earthquake. Two focus groups were conducted with 16 HCWs; discussions centred on the personal and professional impact and acceptability of the training program.
Results demonstrated that the MHTP changed the HCWs’ perceptions about MH issues and provided them with the knowledge and skills to respond to growing community MH needs. Acceptability of the MHTP was related to the content covered, to the delivery mode of the content and to the cultural appropriateness of the program.
Disasters of different types will continue to occur and to impact MH in communities around the world. MH training will allow nurses to quickly and effectively respond to disasters. A coordinated emergency plan that is subject to frequent review, rehearsal and evaluation is also essential.
PMCID: PMC3933925  PMID: 24251943
Disaster; Earthquake; Haiti; Healthcare; Mental Health; Prevention; Training; Trauma
2.  Immersion Research Education: Students as Catalysts in International Collaboration Research 
International nursing review  2012;59(4):502-510.
This paper describes an international nursing and health research immersion program. Minority students from the United States of America (USA) work with an international faculty mentor in teams conducting collaborative research. The Minority Health International Research Training (MHIRT) program students become catalysts in the conduct of cross-cultural research.
To narrow the health care gap for disadvantaged families in the U.S.A. and partner countries.
Faculty from the U.S.A, Germany, Italy, Colombia, England, Austria, and Thailand formed an international research and education team to explore and compare family health issues, disparities in chronic illness care, social inequities, and health care solutions. U.S.A. students in the MHIRT program complete two introductory courses followed by a three-month research practicum in a partner country guided by faculty mentors abroad. The overall program development, student study abroad preparation, research project activities, cultural learning, and student and faculty team outcomes are explored.
Cross-fertilization of research, cultural awareness, and ideas about improving family health occur through education, international exchange, and research immersion. Faculty research and international team collaboration provide opportunities for learning about research, health disparities, cultural influences, and health care systems. The students are catalysts in the research effort, the dissemination of research findings, and other educational endeavours. Five steps of the collaborative activities lead to programmatic success.
MHIRT scholars bring creativity, enthusiasm, and gain a genuine desire to conduct health research about families with chronic illness. Their cultural learning stimulates career plans that include international research and attention to vulnerable populations.
PMCID: PMC3494487  PMID: 23134134
cross cultural understanding; family health; international research collaboration; minority students; research education; student exchange; vulnerable populations
3.  Racial disparities in job strain among American and immigrant long-term care workers 
International nursing review  2011;59(2):237-244.
Nursing homes are occupational settings, with an increasing minority and immigrant workforce where several psychosocial stressors intersect.
To examine racial/ethnic differences in job strain between Black (n=127) and White (n=110) immigrant and American direct-care workers at nursing homes (total n=237).
Cross-sectional study with data collected at four nursing homes in Massachusetts, during 2006-2007. We contrasted Black and White workers within higher-skilled occupations such as Registered Nurses (RNs) or Licensed Practical Nurses (LPNs, n=82) and lower-skilled staff such as Certified Nursing Assistants (CNAs, n=155).
Almost all Black workers (96 percent) were immigrants. After adjusting for demographic and occupational characteristics, Black employees were more likely to report job strain, compared to Whites (Relative Risk [RR]: 2.9, 95% CI 1.3 to 6.6). Analyses stratified by occupation showed that Black CNAs were more likely to report job strain, compared to White CNAs (RR: 3.1, 95% CI: 1.0 to 9.4). Black workers were also more likely to report low control (RR: 2.1, 95% CI: 1.1 to 4.0). Additionally, Black workers earned $2.58 less per hour and worked 7.1 more hours per week on average, controlling for potential confounders.
Black immigrant workers were 2.9 times more likely to report job strain than Whites, with greater differences among CNAs. These differences may reflect organizational and job characteristics, individual characteristics, or potentially interpersonal or institutional racial or ethnic discrimination. Further research should consider the role of race/ethnicity in shaping patterns of occupational stress.
PMCID: PMC3622248  PMID: 22591096
Long-Term Care; Race Relations; Work Stress; Emigrants and Immigrants; Nursing Homes; Nursing Staff; United States of America
4.  Associations between work schedule characteristics and occupational injury and illness 
International nursing review  2010;57(2):188-194.
Nurses often endure working irregular day, night and evening shifts as well as mandatory overtime (i.e. employer-imposed work time in excess of one's assigned schedule). While these work characteristics are examined as potential risks for nurses' safety and health, it is not clear whether negative health impacts occur simply because of working long hours or in combination with other mechanisms.
This study investigates how these work characteristics are associated with nurses' work-related injury and illness over and above long work hours.
In this cross-sectional study, questionnaire data were collected from a sample of 655 registered nurses in the Philippines. Multiple logistic regression was used to assess associations of shift work and mandatory overtime with four work-related health outcomes.
After weekly work hours, shift length and demographic variables were accounted for, non-day shifts were associated with work-related injury [odds ratio (OR) = 1.54; 95% confidence interval (CI): 1.07, 2.24] and work-related illness (OR = 1.48; 95% CI: 1.02, 2.16). Also, frequency of working mandatory overtime was associated with work-related injury (OR = 1.22; 95% CI: 1.06, 1.41), work-related illness (OR = 1.19; 95% CI: 1.04, 1.37) and missing more than 2 days of work because of a work-related injury or illness (OR = 1.25; 95% CI: 1.08, 1.44).
These findings suggest that non-day shifts and mandatory overtime may negatively impact nurses' health independent of working long hours. Mechanisms through which these work characteristics affect health, such as circadian rhythm disturbance, nurse-to-patient ratios and work–family conflict, should be examined in future studies.
PMCID: PMC2964142  PMID: 20579153
Health and Safety; International Issues; Occupational Health Nursing; The Philippines; Quantitative Methods; Research; Workforce Organization
5.  Correlates of physical fitness and activity in Taiwanese children 
International nursing review  2008;55(1):81-88.
This cross-sectional study examined factors related to children’s physical fitness and activity levels in Taiwan.
A total of 331 Taiwanese children, aged 7 and 8, and their mothers participated in the study. Children performed physical fitness tests, recorded their physical activities during two weekdays and completed self-esteem questionnaires. Research assistants measured the children’s body mass and stature. Mothers completed demographic, parenting style and physical activity questionnaires.
Attending urban school, lower body mass index (BMI), older age and better muscular endurance contributed to the variance in better aerobic capacity, and attending rural school and better aerobic capacity contributed to the variance in better muscular endurance in boys. Attending urban school, lower BMI and better athletic competence contributed to the variance in better aerobic capacity, and younger age, rural school and higher household income contributed to the variance in better flexibility in girls.
Despite the limitations of the study, with many countries and regions, including Taiwan, now emphasizing the importance of improving physical fitness and activity in children, an intervention that is gender-, geographically, and developmentally appropriate can improve the likelihood of successful physical fitness and activity programmes.
PMCID: PMC2883246  PMID: 18275540
Body Mass Index; Children; Chinese; Physical Activity; Physical Fitness; Taiwan
6.  Language barriers and qualitative nursing research: methodological considerations 
International nursing review  2008;55(3):265-273.
This review of the literature synthesizes methodological recommendations for the use of translators and interpreters in cross-language qualitative research.
Cross-language qualitative research involves the use of interpreters and translators to mediate a language barrier between researchers and participants. Qualitative nurse researchers successfully address language barriers between themselves and their participants when they systematically plan for how they will use interpreters and translators throughout the research process. Experienced qualitative researchers recognize that translators can generate qualitative data through translation processes and by participating in data analysis. Failure to address language barriers and the methodological challenges they present threatens the credibility, transferability, dependability and confirmability of cross-language qualitative nursing research. Through a synthesis of the cross-language qualitative methods literature, this article reviews the basics of language competence, translator and interpreter qualifications, and roles for each kind of qualitative research approach. Methodological and ethical considerations are also provided.
By systematically addressing the methodological challenges cross-language research presents, nurse researchers can produce better evidence for nursing practice and policy making when working across different language groups. Findings from qualitative studies will also accurately represent the experiences of the participants without concern that the meaning was lost in translation.
PMCID: PMC2697452  PMID: 19522941
Cross-Language Research; Ethics; International Research; Interpreters; Language Barriers; Methods; Nurses; Qualitative Research; Translators
7.  Protecting patients, protecting healthcare workers: a review of the role of influenza vaccination 
International Nursing Review  2011;59(2):161-167.
MUSIC T. (2012) A review of the role the role of influenza vaccination in protecting patients, protecting healthcare workers the role of influenza vaccination. International Nursing Review59, 161–167
Many health authorities recommend routine influenza vaccination for healthcare workers (HCWs), and during the 2009 A (H1N1) pandemic, the World Health Organization (WHO) recommended immunization of all HCWs worldwide. As this remains an important area of policy debate, this paper examines the case for vaccination, the role of local guidelines, barriers to immunization and initiatives to increase uptake.
Seasonal influenza is a major threat to public health, causing up to 1 million deaths annually. Extensive evidence supports the vaccination of priority groups, including HCWs. Immunization protects HCWs themselves, and their vulnerable patients from nosocomial influenza infections. In addition, influenza can disrupt health services and impact healthcare organizations financially. Immunization can reduce staff absences, offer cost savings and provide economic benefits.
This paper reviews official immunization recommendations and HCW vaccination studies, including a recent International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) survey of 26 countries from each region of the world.
HCW immunization is widely recommended and supported by the WHO. In the IFPMA study, 88% of countries recommended HCW vaccination, and 61% supported this financially (with no correlation to country development status). Overall, coverage can be improved, and research shows that uptake may be impacted by lack of conveniently available vaccines and misconceptions regarding vaccine safety/efficacy and influenza risk.
Many countries recommend HCW vaccination against influenza. In recent years, there has been an increased uptake rate among HCWs in some countries, but not in others. Several initiatives can increase coverage, including education, easy access to free vaccines and the use of formal declination forms. The case for HCW vaccination is clear, and in an effort to further accelerate uptake as a patient safety measure, an increasing number of healthcare organizations, particularly in the USA, are implementing mandatory immunization policies, similar to other obligatory hygiene measures. However, it would be desirable if similar high vaccination uptake rates could be achieved through voluntary procedures.
PMCID: PMC3418836  PMID: 22591085
Coverage; Education; Guideline; Influenza; Policy; Recommendation; Reimbursement; Seasonal; Vaccine

Results 1-7 (7)