Many immigrant Hispanic women in the United States choose to bottle-feed rather than breastfeed. This article describes an intervention that was developed and tested in a two-step process. Two studies were undertaken. First, a qualitative inquiry explored the breastfeeding beliefs, attitudes, meanings, and practices of Hispanic women. Results informed the design of a culturally appropriate prenatal breastfeeding education intervention. Secondly, the researchers undertook a quantitative study of the intervention's success in increasing breastfeeding duration among Hispanic women. Methodology and findings of this study have implications for future interventions that promote breastfeeding.
The literature verifies that each of the 10 determinants of health-promoting behaviour also promotes breastfeeding for Hispanic women, particularly through the constructs of acculturation, interpersonal support, self-efficacy and immediate competing demands. Breastfeeding is not consistently defined in all studies, nor are Hispanic population groups uniformly classified according to country of origin. Specific interventions to promote breastfeeding have been implemented for women of Latin American origin, but randomized designs to measure outcomes have not been consistently employed with Hispanic women in the United States of America. Further intervention research is needed to confirm breastfeeding as a health-promoting behaviour and to inform breastfeeding education for this group.
Although the importance of providing culturally congruent care is widely recognized among nurses, many nurses lack the skill and knowledge necessary to successfully provide culturally competent care. Nursing programs need to better prepare students in transcultural nursing. This article describes an innovative collaborative learning activity that was implemented between two different nursing programs in different states aimed at improving students' transcultural knowledge. Students worked in small groups and used the Internet to collaborate on case studies that focused on transcultural health care issues. Responses collected by anonymous evaluations at the end of three semesters identified both strengths and weaknesses of the project. Results and suggestions for improvement are reported.
Nursing practice and nursing education in Kyrgyzstan are described in this article. Since the breakup of the Soviet Union and the establishment of independence in 1991, health care in Kyrgyzstan has deteriorated. In response to the Manas Health Care Reform program initiated in 1996, nursing education is being upgraded and nurses are being retrained throughout the country.Comparisons of nursing education in Kyrgyzstan with the U.S. and Soviet programs are discussed. Challenges in upgrading nursing education to meet international standards and in obtaining an advanced degree in nursing are explained.
There is a growing awareness of the need for improved end-of-life care around the globe. Kyrgyzstan, the second poorest country in Central Asia, is poised to begin palliative care initiatives, despite facing inadequate health care funding, lack of education about palliative care, and limited availability of necessary medications. With the combined efforts of clinicians and educators, along with support from governmental and nongovernmental agencies, a national program for palliative care is in development, and nursing is playing a leading role. The strategy to integrate palliative care includes 3 pillars: building clinical services, coordinating efforts to increase the availability of necessary drugs, and developing educational programs. As part of a coordinated educational program for nurses and physicians, several courses have been presented based on the End-of-Life Nursing Education Consortium curriculum. Health care professionals, educators, and representatives of government and nongovernmental organizations have participated in these courses. The Minister of Health has subsequently approved a curriculum based on End-of-Life Nursing Education Consortium for students in the college of nursing and postgraduate continuing education. The barriers faced and these educational efforts will be described as they are an essential part of a comprehensive strategy to improve the quality of life for people within this country. KEY WORDSELNEC, Kyrgyzstan, nursing, palliative care T here is a growing awareness of the need for improved end-of-life care around the globe. 1 The developed world is making progress in these efforts, but the developing world is just beginning to produce these programs. 2 Challenges in all parts of the globe include inadequate health care funding, lack of awareness and education about palliative care, limited availability of necessary medications, and other barriers. 3-5 Kyrgyzstan, a developing country in Central Asia, is poised to begin palliative care initiatives, despite facing many of these obstacles and others. 6 These efforts are desperately needed to improve the quality of life for people within this country, and nursing will have an important role in advancing care for those with life-limiting illness.Kyrgyzstan has a total population of almost 5.5 million people. 7 The median age is quite young at 25.2 years, with less than 6% of people living beyond 65 years of age. This low average life expectancy of 69.4 years (men, 65.4 years; women, 73.6 years) is in part due to a high percentage of people living below the poverty level (40%), a high prevalence of smoking (almost 50% of men smoke), and other factors. Cardiovascular disease makes up the main cause of mortality (49%), followed by cancer (9.1%), respiratory disease (8.4%), and other causes. Among men, the most common cancers are gastric, lung, colon, and liver; among women, the most common cancers are breast, cervix, stomach, and colon. In addition to cardiovascular disease and cancer, tuberculosis and HIV/AIDS make up common life-threa...
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