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Background: To date, little is known about the perspectives of healthcare and social service providers on the acceptability of long-term home visiting programs serving low-income, first-time mothers within a community. The present study reports on the experiences and perspectives of community professionals who participate in program referrals or deliver auxiliary services to these mothers who are enrolled in the Nurse-Family Partnership (NFP), a targeted nurse home visitation program. Methods: The present study comprised two phases. In phase one, a secondary qualitative data analysis was conducted to analyze a purposeful sample of 24 individual interviews with healthcare and social service providers, which was part of a larger qualitative case study examining adaptations required to increase the acceptability of NFP for families and service providers in Hamilton, Ontario, Canada. In phase two, identified themes from phase one were further explored and confirmed through individual, semi-structured interviews with service providers using a qualitative descriptive approach. Findings: Healthcare and social service providers recognized the added value of NFP to existing community services for low-income, first-time mothers. The public health nurses (PHNs) who delivered the NFP intervention were perceived as playing a crucial role in connecting the first-time mothers to community services, preparing them for motherhood, and for preventing or ending the involvement of child protection services. NFP services were not perceived as interfering with the logistics of existing services being delivered; they were viewed as addressing an important service gap. Discussion: This is the first qualitative study to examine the acceptability of a home visiting intervention from the perspectives of healthcare and social service providers in a community context. The study findings have relevance for policymakers by informing the general understanding of how a new early childhood prevention program is integrated among existing community-based supports servicing low-income, first-time mothers. / Thesis / Master of Health Sciences (MSc)

Masters in Public Administration - MPA / The nurse qualified in the area of administration occupies a position with immense scope and potential in the profession and in society. The task of senior nursing management is a matter of balancing and reconciling the values and aims of the organisation with the values, aims and professional aspirations of the nursing staff, and of related and interdependent groups of health professionals, while creating and gaining commitment to a wider concept of the service and of the nurses role in it. The balancing and reconciling of organisational, occupational, service and educational demands with individual aspirations and expectations are delicate but essential if all available resources are to be optimally deployed. Success in the latter marks out an effective manager though it is difficult to measure this success. I believe this many sided accomplishment is vital, for surely all philosophy, education and research within nursing is valid ultimately only in its actual application to clinical practice. Professional nurses, fulfilling various degrees of administrative functions, are to be found in all areas and levels of nursing. It is upon the role of the upper echelons of Nurse Administrators (Matrons) in large, general teaching hospitals that this thesis will be focused. Acceptance of nurse leadership and thus of nurses occupying the most senior administrative posts (in nursing) generally has been the norm in South Africa. Unfortunately, this approach is not universal. In some countries such posts are held by physicians or other non-nurses. In others, nurses hold the title but do not wield the power. According to Searle this has arisen because •••• role change to meet contemporary political, socio-economic and health care strategies has not kept pace with the changing demands and activities of the Health Care system2 ••••thus leaving nurses in such cases in historically limited rather than contemporary relevant roles. The discussion and appraisal of nurse leadership has resulted in various national and international bodies affirming the importance of the development of such leadership in ·order to ensure the continuing role of nurses in administration. The World Health Organisation has, in numerous documents, emphasised the need for nurse leadership3, and, together with the International labour Organisation (1977) and the International Council of Nurses, published a statement on conditions of work and life of nursing personnel. Recommendation 1Q states •••• There should be programmes of higher nursing education to prepare nursing personnel for the highest responsibilities in direct and supportive nursing care, in the administration of nursing services, in nursing education and in research and development of the field of nursing 4

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Excerpt: Last fall, I sat through an uncomfortable board meeting. I was charged to work with a Clinical Social Worker, Licensed Practicing Counselor, a Counseling Psychologist, and a Licensed Nurse Practitioner to develop an integrated care training program as part of a rural workforce development project.

Suicide is the third leading cause of death among youth and young adults ages 10--24. In 2001 the U.S. Surgeon General laid out a national strategic plan to more effectively address suicide prevention (United States Public Health Service, 2001). In 2008, Gene Cash, then president of The National Association of School Psychologists, made a "call to action" to prevent suicide. Although suicide prevention has been repeatedly identified as a priority in mental health care, the vast majority of interventions with suicidal youth are not evidence based due to a lack of research utilizing controlled studies (Daniel & Goldston, 2009). Unfortunately this leaves mental health professionals (MHPs) to routinely implement interventions that are not research based and not proven effective in deterring suicidal thoughts and actions. No-suicide contracts (NSCs), commonly used in clinical and medical settings, solicit a commitment from a suicidal individual, a promise not to complete suicide. The prevalence of school-based MHPs' use of NSCs with suicidal youth (SY) is unknown. Additionally, minimal feedback is available regarding MHPs' perceptions of and current practice regarding implementation of NSCs. Likewise, school policy directing MHPs' intervention when working with SY is neither well described nor understood. A brief survey was created to access these perceptions and practices. Of 326 MHPs attending a Utah Youth Suicide Prevention Conference, 243 completed a survey (74.5% participation rate). Half of participants intervening with SY reported using NSCs. Only 27 of the 243 participants indicated that their school's policy encouraged or required a NSC. Only 8 participants reported knowledge of a formal written school policy that specifically guided their intervention with SY. Reasoning underlying decisions to use or not to use NSCs were explored. Common explanations included attending to individual student needs, following perceived guidelines, building trust with SY and adapting contracts to fit student needs, and opening discussion about suicide. Several participants expressed a need for additional training with no-suicide contracting. A few participants called for either renaming NSCs or implementing a similar, but more positive, "commitment to treatment" strategy. Participants did not mention a need for additional research to explore the efficacy of NSCs. In fact, research was not mentioned. This reflects the gap between research and practice and the dependency on personal experience and going along with the status quo versus depending on research findings to dictate improvement and change in practice.

This photovoice study explored the lived experiences of nine Puerto Rican mental health professionals who provided postdisaster counseling services to children. Due to the complex and multilayered experiences of Puerto Rican mental health professionals, this study used intersectionality as the theoretical lens to facilitate thematic analysis of the data. Results from coresearchers' narratives and photographs generated seven major themes: (a) la politiquería of disasters; (b) the impact of compounding disasters; (c) Puerto Rico se levanta: strategies for collective healing; (d) impact of disasters on children; (e) experiences with clients; (f) awareness, action, change; and (g) supporting, connecting, and transforming. The results and discussion provide awareness into the experiences of Puerto Rican clinicians who formed part of disaster response efforts in their own community. Clinical, educational, and research implications are drawn from coresearchers' narratives and insight.

Bakgrund: Tio procent av kvinnor och flickor i fertil ålder drabbas av endometrios. Vid endometrios har vävnad eller endometrioshärdar växt till sig utanför livmodern, vilket resulterar i inflammation och tillväxt av nervändar. Laparoskopi och laparotomi används för att säkerställa eller utesluta en endometriosdiagnos. Analgetika används som om den basala smärtbehandlingen mot dysmenorré, det främsta symtomet. Syfte: Syftet var att beskriva kvinnor med endometrios upplevelser av hälso- och sjukvårdens bemötande. Metod: En kvalitativ litteraturöversikt genomfördes med en tematisk analys varav 13 artiklar analyserades. Resultat: Ett tema och fyra subteman identifierades. Tema: Bemötande påverkar kvinnors självbild. Subteman: Invalidering av känslor och upplevelser, Normalisering av symtom, Hopplöshet relaterat till inadekvat vård orsakad av inkompetens, samt Bristande informationsgivning och vikten av lyhördhet. Slutsats: Kunskapsbristen bidrog till invalidering av kvinnors känslor och upplevelser, normalisering av symtom, samt bristande lyhördhet och informationsgivning. Detta tillsammans med okunskap bidrog till både fel- och sen diagnostisering. Detta bidrog till negativa upplevelser av hälso- och sjukvården. Resultatet visade att ett fortsatt behov av vidare forskning inom syftet behövs. / Background: Ten percent of women and girls of childbearing age are affected by endometriosis. In endometriosis, tissue or endometrial lesions have grown outside the uterus, resulting in inflammation and growth of nerve endings. Laparoscopy and laparotomy are used to confirm or exclude a diagnosis of endometriosis. Analgesics are used as basic pain management for dysmenorrhea, the main symptom. Purpose: The aim was to describe the perception of health care treatment among women with endometriosis. Method: A qualitative literature review was conducted with a thematic analysis of which 13 articles were analyzed. Results: One theme and four sub-themes were identified. Theme: Treatment affects women's self-image. Sub-themes: Invalidation of feelings and experiences, Normalization of symptoms, Hopelessness related to inadequate care caused by incompetence, and Lack of information and the importance of attentiveness.  Conclusion: The lack of knowledge contributed to the invalidation of women's feelings and experiences, normalization of symptoms, and lack of sensitivity and information provision. This, together with the lack of knowledge, contributed to both misdiagnosis and late diagnosis. This contributed to negative experiences of healthcare. The results show that there is a continued need for further research within the research question.

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