Nurses' perceptions about the dignity of intubated patients

BACKGROUND

The intensive and critical care units are high-dependency areas, with patients requiring complex care. The intubated status of the intensive and critical care patients makes them dependent on healthcare providers not only for acute care, but also for intimate care, imposing a threat to their dignity. Nurses, being the central care providers, become the stakeholders for dignity promotion. The incorporation of dignity in patient care improves the quality of care, and promotes the health and well-being of intubated patients.

OBJECTIVE

The purpose of the study was to explore nurses' perceptions about the dignity of intubated patients in the intensive and critical care units.

RESEARCH DESIGN

A qualitative descriptive exploratory study design was used to explore the nurses' perceptions about the dignity of intubated patients.

PARTICIPANTS AND RESEARCH CONTEXT

The intensive and critical care nurses of a tertiary care hospital were recruited using the purposive sampling technique. The data were collected through in-depth individual interviews, using a semi-structured interview guide. The findings were manually analyzed into themes and categories through content analysis.

ETHICAL CONSIDERATION

The study was conducted after the approval from the Ethical Review Committee of the Aga Khan University.

FINDINGS

Four major themes emerged from the data analysis: (1) two sides of the contemporary nursing practice; (2) benefits of dignified nursing care; (3) challenges to the dignity of intubated patients; and (4) strategies for promoting the dignity of intubated patients.

DISCUSSION

Dignity incorporates both the science and the art of nursing. The provision of dignified care is the core component of the quality nursing care and patient well-being in the high-dependency units.

CONCLUSION

This is the first exploratory and descriptive study conducted in Pakistan that explored the nurses' perceptions about the dignity of intubated patients, and also generated contextual understanding about the phenomenon.

Population Health Science: A Core Element of Health Science Education in Sub-Saharan Africa

Sub-Saharan Africa suffers an inordinate burden of disease and does not have the numbers of suitably trained health care workers to address this challenge. New concepts in health sciences education are needed to offer alternatives to current training approaches.A perspective of integrated training in population health for undergraduate medical and nursing education is advanced, rather than continuing to take separate approaches for clinical and public health education. Population health science educates students in the social and environmental origins of disease, thus complementing disease-specific training and providing opportunities for learners to take the perspective of the community as a critical part of their education.Many of the recent initiatives in health science education in sub-Saharan Africa are reviewed, and two case studies of innovative change in undergraduate medical education are presented that begin to incorporate such population health thinking. The focus is on East Africa, one of the most rapidly growing economies in sub-Saharan Africa where opportunities for change in health science education are opening. The authors conclude that a focus on population health is a timely and effective way for enhancing training of health care professionals to reduce the burden of disease in sub-Saharan Africa.

Defining the cultural milieu for implementing faculty practice in Pakistan

Faculty practice can promote a collaborative partnership mutually beneficial to both nursing education and service. However, little is known about its implementation in developing countries. The purpose of this study was to explore the potential for introducing faculty practice within the cultural milieu of Karachi, Pakistan. Focus groups of nursing faculty, staff and students were conducted in various settings: government, semigovernment and private institutions to elicit the data. Data analysis revealed that a more comprehensive definition of faculty practice is needed that will provide the foundation for a culturally acceptable model of faculty practice in Pakistan. Hierarchy dominates the current cultural milieu and must be addressed before faculty practice can be implemented.

Pakistan's community health workers

Pakistan's health characteristics are worse than those of other Asian countries at similar stages of development. Its mortality rate for children under five is 139 per 1,000, and its maternal mortality is 60 per 10,000. Malnutrition in women and children is widespread; 50 per cent of children under five are stunted. Pakistan's population growth rate of 3.1 per cent per year is among the highest in Asia. The high population growth rate and poor health status of many people call for extensive health care services, but, unfortunately, health services do not reach most of the people of Pakistan. Partly because the training of doctors and nurses is lengthy and expensive, there is an acute shortage of health care providers, especially women. Although female health professionals are preferred for caring for women, cultural constraints inhibit women from seeking education. Such is the multifaceted dilemma in the provision of primary health care in Pakistan.