Experiences of Parish Nurses in Providing Diabetes Education and Preconception Counseling to Women With Diabetes

Challenges of Faith Community Nursing in a Midwestern Healthcare System

ABSTRACT

Faith community nurses are positioned to play a vital role in addressing whole person health in multiple settings. A steady decline of nurses completing faith community nurse (FCN) training in a midwestern healthcare system sparked the system's hospital leadership to re-evaluate the FCN training and outreach program. To inform future education programs, an online needs assessment survey was deployed to FCNs. Focus groups were used to understand the FCNs' experiences in their role. The findings highlight a need for comprehensive educational programs, support networks, and funding mechanisms to support faith community nursing practice.

Are physicians creating a barrier to pre-conception care access? A qualitative study exploring patients' experiences and perspectives around pre-conception care

BACKGROUND

The pre-conception period is an unmissable opportunity to introduce preventive measures before pregnancy to improve maternal and fetal outcomes. Despite the global pre-conception initiatives and the 2030 Saudi national vision to promote maternal, fetal health and safety, various barriers still exist. This study focuses on exploring pre-conception care extensively from the patients' perspectives and their experience in accessing this type of care in the primary care setting.

METHODS

A qualitative study using interpretive thematic analysis was used to explore patients' perspectives, and experiences in accessing pre-conception care in the city of Riyadh from January 2019 to January 2020. A semi-structured interview guide and field notes were used to collect data. A step wise interpretive and iterative process was used for data analysis and thematic extraction. Theme saturation was achieved by the eleventh interview.

RESULTS

The participants' perspectives were influenced by their cultural beliefs, understanding of pre-conception, and their prevised barriers to approaching physicians. Three main themes emerged: A) Acceptance of pre-conception care; was heavily influenced by how they understood and defined per-conception care. B) Pre-conception health seeking behavior; demonstrated a clear disconnect between the patient and the physician. C) Expectation from health services; to raise awareness about pre-conception care and push physicians to initiate the conversation with their patients.

CONCLUSIONS

An appreciable gap in the patient-physician relationship was revealed as a source of inconsistency in accessing pre-conception care. Physicians are encouraged to take the first step in demonstrating to their patients both the importance of pre-conception care and their intent to offer respectful, empathetic, and culturally appropriate care.

"A patient should not have to ask": Women's experiences of patient education about preconception care for type 2 diabetes

OBJECTIVES

To characterize perspectives and experiences regarding preconception care (PCC) patient education among women with type 2 diabetes.

METHOD

Descriptive, qualitative research design. Thirty-two English-speaking women with type 2 diabetes identifying as Black and/or Latina, ages 18-40 years old, participated. We conducted semi-structured interviews about PCC perspectives and experiences which we analyzed with conventional content analysis. To enhance rigor, we collected freelisting data from which we calculated salience scores. We triangulated our qualitative findings with salience scores.

RESULTS

We identified three themes. Our first theme concerned mismatch between women's desires for PCC counseling to be frequent in contrast with their experiences of its infrequency. Our second theme captured how women felt responsible for initiating care in the clinical encounter but uncertain about what they "should" be asking for. Our third theme characterized women's perspectives on receiving information about PCC and pregnancy planning.

CONCLUSIONS

Young adult women with type 2 diabetes who are Black and/or Latina welcome more education about how PCC can prevent obstetrical complications associated with diabetes, which disproportionately affect their communities.

PRACTICE IMPLICATIONS

Our findings provide actionable suggestions for improving acceptability and accessibility of PCC patient education in the United States where PCC awareness and uptake are low.

What Are the Characteristics of the Parish Nursing Research Literature and How Can it Inform Parish Nurse Practice and Research in Canada? A Scoping Review

BACKGROUND

Parish nursing is a specialized branch of professional nursing that promotes health and healing by integrating body, mind and spirit as a practice model. Parish nurses contribute to the Canadian nursing workforce by promoting individual and community health and acting as system navigators. Research related to parish nursing practice has not been systematically collated and evaluated.

PURPOSE

This review seeks to explore, critically appraise and synthesize the parish nurse (PN) research literature for its breadth and gaps, and to provide recommendations for PN practice and research.

METHODS

A scoping review was conducted using Levac and colleagues' procedures and Arksey and O'Malley's enhanced framework. The CINAHL, ProQuest and PubMed databases were comprehensively searched for original research published between 2008 and 2020. The final sample includes 43 articles. The Mixed Methods Appraisal Tool was used to critically assess literature quality.

RESULTS

There is a significant gap in PN research from Canada and non-U.S. countries. Methodological quality is varied with weak overall reporting. The literature is categorized under three thematic areas: (1) practice roles of the PN, (2) role implementation, and (3) program evaluation research. Research that evaluates health promotion program interventions is prominent.

CONCLUSIONS

More rigorous research methods and the use of reporting checklists are needed to support evidence-informed parish nursing practice. Building relationships among parish nurses, nursing researchers and universities could advance parish nursing research and improve evidence-based parish nursing practice. Research into the cost effectiveness, healthcare outcomes, and the economic value of PN practice is needed.

Wise Women's Provision of Maternal-Child Health Information and Support for Urban, African American Women

Introduction: The United States is experiencing a maternal-child health (MCH) crisis including racial inequalities in mortality. This study explored the roles of lay experts who provide information and support to women of childbearing age (i.e., Wise Women) and cultural norms for sharing MCH information and support in an urban, predominantly African American community. Methodology: This qualitative community-engaged study (N = 49) of social networks utilized a semistructured guide and brainstorming activities with eight focus groups (three community leader, three community women, and two Wise Women). Results: Although several sources of MCH information and support were noted, Wise Women were the most frequently reported culturally normative sources. Emergent themes included positive affirmations for informal exchange of MCH information among women and roadblocks to MCH information exchange and support. Discussion: Results suggest a need for culturally relevant interventions that would strengthen lines of communication and social connectedness among African American women.

Delivering family planning and preconception care to women with diabetes: Implementation challenges and promising strategies

Diabetes is increasingly prevalent among women of reproductive age and during pregnancy. The American Diabetes Association, which has called for improvements in the patient-centeredness of care, recommends preconception counseling and care for women of reproductive age with diabetes. However, data suggests this care is not sufficiently delivered. In this article, we describe demographic shifts in the need for preconception care and outline several changes at the clinical encounter as well as the health system- and community-levels that can help improve the delivery of diabetes-specific preconception care.

Exploring the Experiences, Challenges, and Approaches of Parish Nurses in Their Community Practice

PURPOSE

To explore the personal experiences, challenges, and practices of parish nurses in their communities.

METHOD/DESIGN

The overall study used a mixed methods concurrent embedded design to describe parish nurses' experiences with diabetes education and preconception counseling in their practice. Also included were descriptions of generalized practices. Therefore, this current report will focus on these broader experiences. Focus group data were collected using face-to-face, teleconference, and video conferencing formats with 48 nurses who consider themselves to be parish nurses and analyzed with content analysis.

FINDINGS

Four qualitative themes were identified in the data: (1) Gaining Entry Through Trust, (2) Enhanced Focus on Spiritual Caring, (3) Accomplishing Much Despite Challenges, and (4) Practice Making a Difference. Parish nurses are uniquely situated to provide holistic care for the mind, body, and spirit of their patients. Despite the many positive aspects, parish nurses experience unique challenges, such as funding their practice and working independently.

CONCLUSIONS

The parish nurses can play a vital role in providing holistic care to patients in a faith-based community. Future work is needed to address the challenges of parish nurses such as access to continuing education programs related to health topics of concern to their community members.