Search Results (31)

Background: Antiretroviral adherence for incarcerated individuals living with HIV/AIDS in correctional service facilities remains a challenge. This study examined the experiences of professional nurses related to this issue in Limpopo Province, South Africa. Method: A qualitative, exploratory, descriptive, and contextual approach was employed in the Correctional Services Department facilities within the Vhembe District. The professional nurses were purportedly sampled. Data were collected through semi-structured telephone interviews and analysed thematically. Results: Three themes emerged: (1) professional nurses’ experiences with incarcerated individuals from foreign countries; (2) manipulative behaviours; and (3) misuse of antiretroviral therapy (ART) medication by incarcerated individuals. Conclusion: For public policy, the findings require the development of standardised guidelines for the management of foreign national incarcerated individuals and the implementation of anti-diversion strategies to prevent misuse of medications. For nursing practice, the results emphasise the importance of specialised training programmes that equip nurses to manage manipulative behaviours, enhanced supervision systems addressing moral distress, and structured adherence monitoring, including direct observed therapy for high-risk incarcerated individuals. These evidence-based interventions are essential to improve the outcomes of ART adherence, reduce treatment failure and drug resistance, and decrease HIV-related mortality in correctional settings while protecting general public health. Full article

Approximately 10% of the US Black diaspora were born either in Latin America and the Caribbean (LAC) or Sub-Saharan Africa (SSA), projected to account for a third of the Black US diaspora by 2060. Yet, details on foreign-born Black women’s labor and delivery (L&D) characteristics, such as the type of birth attendant, remain scarce. We used the National Center for Health Statistics 2016 to 2020 Natality data (n = 2,041,880). The associations between detailed maternal nativity (DMN) and the type of attendant at birth (i.e., physician, certified nurse-midwife (CNM), certified professional midwife (CPM)) among US-born, LAC-born, and SSA-born Black women were examined using multivariate multinomial regression. The study revealed that LAC-born women were more likely to have a CNM during birth than US-born Black women, but Haitian-born and Jamaican-born women had lower odds of having a certified professional midwife (CPM) at birth. When compared to US-born Black women, Cameroonian-born women had decreased odds of having either a CNM or CPM during birth. Findings suggest that DMN could be an indicator of cultural preferences in maternity care. There is a need for further investigation beyond DMN and comprehensive data collection methods for future research to understand the specific needs and preferences of different ethnocultural groups to improve maternity care and prevent adverse maternal health outcomes. Full article

As global migration continues to expand, the diversity of migrant populations increases. This includes a growing number of highly educated individuals from lower-income countries who face significant economic and mental health challenges in attempting to integrate into new communities. Despite extensive education and experience, their expertise is often unrecognized, with many resorting to unskilled labor alternatives. While substantial research exists on the immigration experiences of physicians and nurses, little is known about other professionals, such as dentists. This case study seeks to gain an in-depth understanding of the post-migration experiences of Iranian-trained dentists in Canada, identifying barriers and facilitators to their successful integration. Using a qualitative approach, this study is based on eleven interviews with dentists trained in Iran who recently immigrated to Canada. Semi-structured interviews were conducted via Zoom in English. A thematic analysis was performed using the 2021 Dedoose software program. Barriers to successful integration were categorized into two main themes: “socio-cultural” and “institutional” impediments. The findings show that participants faced significant challenges integrating into Canadian society. Beyond the many socio-cultural obstacles, the negative economic and mental health impacts of attempting to navigate the credential recognition system were substantial, largely due to what appears to be a systematic and institutionalized bias against foreign-trained individuals built into the credentialing system. As a result, their skills often remain underutilized, benefiting neither themselves nor their new country. Findings will inform policy and practice and propose practical recommendations that include reducing institutional barriers for credential assessment, providing mental health support, and offering financial support during assessment of international education. Full article

Background: Although forest therapy services in South Korea have demonstrated mental and physical effects, there is no established system for forest therapy prescriptions. To this end, it is necessary to devise a systematic model for the introduction of forest therapy prescriptions by linking the existing forest therapy infrastructure and medical services. Therefore, this study aimed to derive the components and application plans needed to devise a forest therapy prescription model for the spread of medical-linked forest therapy services and to secure a forest therapy prescription infrastructure. Methods: To this end, Korean and foreign cases of prescription models and healthcare service provision systems were analyzed to derive the necessary components for prescription models. Subsequently, a Focus Group Interview (FGI) was conducted with eight experts in the fields of forest therapy and welfare, psychiatry, and health and nursing, and opinions were derived regarding the conception and empirical application of the forest therapy prescription model through content analysis. Results: As a result of the study, five components (clear role-sharing and a collaboration system, a continuous system, customized service provision, various technologies and content, and a database-based prescription system) were derived from cases of prescription models and healthcare service provision systems according to field. Furthermore, the FGI identified three primary topics: stakeholders’ scope and role, procedures and effectiveness, and additional considerations. Each was categorized into eight sub-categories relevant to the design of the forest therapy prescription model. Conclusions: These results can be used as basic data for devising a systematic Korean forest therapy prescription model in which forest therapy and medical services are linked, providing a foundation for personalized forest therapy prescriptions to be implemented. Full article

Understanding maternal behaviour is essential for good animal husbandry; yet, little scientific information currently exists regarding nursing behaviour of alpacas (Vicugna pacos). Moreover, allonursing (the nursing of non-filial offspring) has only been documented in captive non-domesticated guanacos. This study aimed to (1) describe the nursing behaviour of alpacas within traditional husbandry systems in their place of origin, and in foreign conditions, and to (2) investigate the occurrence of allonursing in alpacas. A total of 1899 nursing bouts were observed in the Andes and Central Europe. Additionally, 102 Andean farmers were asked if they observed allonursing in their herds. Nursing behaviour was similar at both locations, with most of the nursing bouts initiated by crias and terminated by dams. However, several significant differences between localities were noted, such as the less frequent sniffing of crias by Andean dams. Crias’ age and sex did not affect the percentage of nursing bouts initiated or terminated by the dams. Rare cases of allonursing were recorded in Central Europe (n = 5), and 18.6% of surveyed Andean farmers reported allonursing in their herds. This study provides insight into alpaca nursing and allonursing behaviour, which may contribute towards their management both in their place of origin and farther. Full article

Background: The number of foreign-born patients with tuberculosis (TB) has been increasing in Japan, and the number of Vietnamese patients was the highest in 2019. Tuberculosis (TB) is the second leading cause of death from infectious diseases after coronavirus disease-2019 (COVID-19). As the prevalence of TB varies widely globally, measures must be tailored to local characteristics. The Directly Observed Treatment (DOTS) short-course was introduced by the World Health Organization as a global strategy to overcome these challenges. The purpose of this study is to develop an original risk assessment for treatment interruption for Vietnamese patients with TB to be used in Directly Observed Treatment (DOTS), a tuberculosis control measure. Methods: The researchers adopted the Delphi method. Public health nurses of mid-career or above (n = 15) who had conducted DOTS for several Vietnamese patients with TB were selected and surveyed about the content and surface validities of the draft risk assessment items for treatment interruption. The survey was conducted three times. The quantification of content validity and the review and modification of responses regarding each item were analyzed by the researchers. Results: The results identified the following risk categories: “physical characteristics”, “background of life during residence”, “treatment environment”, “understanding tuberculosis and disease acceptance”, and “cultural and value trends”. Conclusions: The results suggest the need to provide support for tuberculosis recovery from various perspectives, including the living environment of Vietnamese patients with TB, their social environment in Japan, and the culture and values of their country of birth and upbringing. Full article

Objectives: In South Korea, there has been a continuous decrease in the incidence of tuberculosis (TB) attributable to a national TB elimination program; however, TB still poses a significant socioeconomic burden. This study aimed to analyze factors associated with successful TB treatment and to identify refractory patient groups with unfavorable outcomes. Methods: We analyzed anonymized data on 89,150 patients with TB provided by the Korea Disease Control and Prevention Agency. Specifically, we collected independent variables, which were categorized as individual, regional, and medical facility factors. Individual factors included age, sex, nationality, TB type, drug-resistant status, category of TB, housing type, underlying disease status, number of referrals, and smoking status. Regional factors referred to the region where the TB case was reported. Medical facility factors included the first visit to a medical facility, categorized by hospital type and the distinction between private–public mix (PPM) and non-PPM depending on the presence or absence of dedicated TB nurses. These factors were analyzed in relation to treatment success to identify refractory patient groups with unfavorable outcomes. Results: Multivariable logistic regression analysis revealed the following significant factors associated with successful TB treatment: sex, nationality, status of drug-resistant TB, category of TB, number of referrals, region of TB registry, underlying diseases, and smoking status. Specifically, compared with their relevant counterparts, male patients had a lower rate of successful treatment (adjusted odds ratio [aOR]: 0.66, reference [Ref.]: women); Korean nationals had a higher rate of treatment success (aOR: 7.20, Ref. foreign residents in Korea); resistant TB was associated with a lower rate of treatment success (aOR: 0.35, Ref.: non-resistant TB status); newly treated patients had a higher rate of treatment success (aOR: 1.75, Ref.: retreatment patient); switching hospitals once (aOR: 1.78), never (aOR: 1.41), or twice (aOR: 1.37) was associated with increased treatment success (Ref.: three or more times); having zero (aOR: 1.45), one (aOR: 1.31), or two (aOR: 1.24) underlying diseases was associated with a higher rate of treatment success (Ref. three or more underlying diseases); and past smokers (aOR: 1.40) and non-smokers (aOR: 1.35) had a higher rate of treatment success (Ref.: current smokers). Conclusions: Our study identified several factors contributing to unfavorable treatment outcomes in tuberculosis patients, including male patients, foreign residents in Korea, drug-resistant TB, retreatment patients, frequent hospital switching, multiple underlying diseases, and current smoking status. These research findings could inform the development of efficient management strategies and policies for improving the treatment success rate among patients with TB. Full article

The economic emigration of young people from rural areas in Poland, and in particular the emigration of young medical personnel, is a relatively little-recognized phenomenon. What distinguishes this study from many works on related topics is that the subject of the study is the tendency or desire to migrate itself, and not the study of the migration motives of people who have already emigrated. The main aim of the research was to identify the migration conditions of young nurses from rural areas. An additional goal was to determine the directions and types of foreign migrations and their impact on the competitiveness and sustainable development of the studied region. The research was conducted in five voivodeships of Eastern Poland among students at state medical universities. The research tool was a survey, the essence of which was to provide data on the purpose of migration of young people, chances of finding a job abroad, and identification of push and pull migration factors. Based on the logistic regression model, a number of factors were identified explaining the tendency to migrate, such as economic factors, gaining professional experience, and prospects. The influence of factors pushing migration should be reduced through state policy tools. The intensity of migration may significantly impact the sustainable development of healthcare in Poland in the near and distant future. Full article

Japan has accepted nurses from Indonesia, the Philippines, and Vietnam under the Economic Partnership Agreement, but nearly half of them have already left the workforce. This study aimed to clarify the factors related to the job continuance of nurses who migrated to Japan under the Economic Partnership Agreement. Our goal was to explore factors specific to migrant nurses and to contribute to the development of support measures for them. This research was a cross-sectional study in which a web-based questionnaire and interview were conducted at a single point in time. Migrant nurses (n = 40) participated in the web-based questionnaire survey. Of those, nine nurses were also interviewed. Spearman’s rank correlation coefficient was used to establish correlations, and qualitative descriptive analysis was used to analyse interviews. The questionnaire survey results revealed the content of work, human relationships in the workplace, the number of night shifts, and satisfaction with the balance between work and private life were significantly and negatively correlated with the Intention to Quit scale total score. All correlation coefficients were less than 0.5, indicating weak correlations. Three categories emerged from the interviews as positive factors related to job continuance: “generous support from the workplace”, “beneficial nursing experience in Japan”, and “determination to live in Japan”. A good working environment, generous support from the supervisor and colleagues, high values of nursing in Japan, and desire to migrate to Japan were the factors that had a positive effect on migrant nurses’ job continuance in Japan. Understanding the characteristics of migrant nurses and providing generous support will enable them to continue working in Japan. This study was not registered. Full article

Demand for foreign nurses and medical staff is rapidly increasing due to the severe labor shortage in U.S. hospitals triggered by the COVID-19 pandemic. However, empirical studies on the effect of the racial diversity of medical staff on hospital operations are still lacking. This research gap is thus investigated based on the foreign medical staff working in 3870 U.S. hospitals. Results show that workforce racial diversity has a significantly positive relationship with hospital operational efficiency regarding occupancy rate, manpower productivity, capacity productivity, and case mix index. Notably, this study empirically supports that increasing the ratio of foreign nurses positively affects the overall operational efficiency of hospitals. In addition, the study results also indicate that the hospital location, size, ownership, and teaching status act as significant control variables for the relationship between racial diversity and hospital efficiency. These results imply that hospitals with these specific operating conditions need to pay more attention to racial diversity in the workplace, as they are structurally more sensitive to the relationship between racial diversity and operational efficiency. In short, the findings of this study suggest that hospital efficiency can be operationally improved by implementing workforce ethnic diversity. For this reason, hospital stakeholders and healthcare policymakers are expected to benefit from this study’s findings. Above all, the results of this study imply that if an organization adapts to extreme external environmental changes (e.g., the COVID-19 pandemic) through appropriate organizational restructuring (i.e., expanding the workforce racial diversity by hiring foreign medical staff), the organization can gain a competitive advantage, a claim that is supported by contingency theory. Further, investors are increasingly interested in ESG, especially companies that embody ethical and socially conscious workplaces, including a diverse and inclusive workforce. Thereby, seeking racial diversity in the workforce is now seen as a fundamental benchmark for organizational behavior that predicts successful ESG business practices, a claim that is supported by stakeholder theory. Therefore, in conclusion, the findings of this study suggest that workforce racial diversity is no longer an optional consideration but should be considered as one of the essential determinants of competitive advantage in organizations, particularly in the healthcare sector. Full article

This report provides an overview of the skilled migrant health workforce and their contribution to health systems in European countries, particularly in relation to the COVID-19 pandemic. Migrant workers at all skill levels have worked in key areas during the pandemic. Skilled migrant health workers, particularly medical practitioners and nurses, make up a significant portion of the frontline health workforce and are essential to keeping health systems in developed countries running. While skilled migrants often face fewer hard barriers (entry control policies: visa policy, work permit schemes, labour migration quotas), this workforce faces soft barriers (e.g., lack of recognition of foreign educational credentials and other restrictive or discriminatory measures) in accessing the host nation’s labour market, as evidenced during the COVID-19 pandemic. This article explores this phenomenon, focusing on Italy’s health sector and foreign health professionals’ dynamics. The report concludes by proffering some practical policy recommendations to promote the inclusion of migrant health professionals in the health and social care systems in the context of the COVID-19 pandemic. Full article

The onset of COVID-19 across the world has elevated interest in geographic information systems (GIS) for pandemic management. In Germany, however, most spatial analyses remain at the relatively coarse level of counties. In this study, we explored the spatial distribution of COVID-19 hospitalizations in health insurance data of the AOK Nordost health insurance. Additionally, we explored sociodemographic and pre-existing medical conditions associated with hospitalizations for COVID-19. Our results clearly show strong spatial dynamics of COVID-19 hospitalizations. The main risk factors for hospitalization were male sex, being unemployed, foreign citizenship, and living in a nursing home. The main pre-existing diseases associated with hospitalization were certain infectious and parasitic diseases, diseases of the blood and blood-forming organs, endocrine, nutritional and metabolic diseases, diseases of the nervous system, diseases of the circulatory system, diseases of the respiratory system, diseases of the genitourinary and symptoms, and signs and findings not classified elsewhere. Full article

Nurses have faced during the COVID-19 pandemic a tough professional situation in which they have had to work in a resource-limited context and with a high probability of COVID-19 transmission. In today’s multicultural societies, care for immigrant patients is also included. In our study, we have delved into the perception of hospital nurses towards migrant people in the context of the COVID-19 pandemic. We used a qualitative methodology with a phenomenological approach. Semi-structured interviews were conducted with 16 nurses. Seven categories emerged and were distributed in the three blocks of the interviews: (a) perception before the pandemic: prejudices make a mark and communication problems; (b) perception after the pandemic: prejudices weaken and communication worsens; and (c) how to improve care: improve communication, more nurses, and no need for training. The approach in the interpersonal relationship between nurses and patients during the pandemic has improved health care. Proposals arise to overcome the language barrier such as the incorporation of intercultural translators-mediators and professionals of foreign origin. There is a lack of awareness of the need for training in cultural competence on the part of the nurses in the study. Full article

This study utilizes a recently developed framework for the well-being economy to evaluate the impacts of COVID-19 in the sparsely populated Westfjords region of northwestern Iceland. A total of 42 semi-structured interviews were conducted with a broad spectrum of local community members, nearly all undertaken in October 2021. Local impacts to human and social capital were very evident, whilst economic consequences to individuals and business were largely mitigated through national economic packages. The remoteness of the Westfjords and pre-existing challenges, such as exposure to nature disasters, a harsh climate, and limited infrastructure, provided a bedrock of resilience with which to tackle the pandemic. This underpinned the sustainability of the communities, and flexible approaches to work and education constrained some of the worst potential effects of social distancing and isolation. Nevertheless, some socio-demographic groups remained harder hit than others, including the elderly in nursing homes and non-Icelandic speaking foreigners, who were marginalized via isolation and lack of information provision in the early, most severe outbreaks of COVID-19. The study demonstrated the coping mechanisms and solutions that were adopted to sustain subjective and community well-being, whilst reinforcing the importance of utilizing local community strengths in tackling the many challenges induced by a pandemic crisis. Full article

Globally, foreign citizens, particularly ethnic and racial minorities, experienced discrimination and received imbalanced medical services and insufficient economic resources during the COVID-19 pandemic. This study aimed to examine the factors that affect the cultural competence of nursing students. This is descriptive cross-sectional study adheres to Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. A convenience sample of 235 nursing students from two nursing colleges in D city completed an online Google Forms questionnaire from 9 August to 12 August 2022. The self-report questionnaire included a sociodemographic data form, a cultural intelligence scale, an ethnocentrism scale, a global competence scale, and a cultural competence scale. The mean score of cultural competence was 95.39 ± 15.64 (out of 135 points); cultural competence was significantly positively correlated with cultural intelligence and global competence (p < 0.001), and significantly negatively correlated with ethnocentrism (p < 0.001). The factors that significantly affected cultural competence were cultural intelligence (β = 0.31, p < 0.001) and global competence (β = 0.37, p < 0.001). The explanatory power of these effects was 47.3%. To improve the cultural competence of nursing students, it is necessary to develop, apply, and evaluate the results of curriculum and programs that can enhance the cultural intelligence and global competence of nursing students. Full article