First generation immigrant and native nurses enacting good care in a nursing home

2020 ◽  
pp. 096973302092148
Author(s):  
Anita Ham
Keyword(s):  
Nursing Home ◽  
First Generation ◽  
Common Ground ◽  
Medical Center ◽  
Standards Of Care ◽  
Ethical Review ◽  
Good Care ◽  
Generation Immigrant ◽  
Dutch Study ◽  
Immigrant Nurses

Background: Several studies have investigated the experiences of first-generation immigrant nurses in new workplaces. Yet, little is known about how native nurses and newcomers collaborate in their care for aging residents in European nursing homes. Objective: To gain a deeper understanding of interactions between first-generation immigrant nurses and native nurses in their care for aging residents in a Dutch nursing home. Methods: Ethnography, including 105 h of shadowing immigrant and native nurses, 8 semi-structured interviews with 4 immigrant and 4 established nurses, and 2 focus group discussions with 8 immigrant and 6 established nurses in a Dutch nursing home. Data were analyzed by a post-positivist grounded theory coding approach. Ethical consideration: The Medical Ethical Review Committee of the Leiden University Medical Center approved this study. Results: The interactions between established staff and newcomers were influenced by norms, rules and regulations, policies and protocols. In daily practice and institutional structure, we observed both opportunities and challenges. The strict time schedules and the requisite standards of care were opportunities related to nurses’ expectations. Residents’ needs were sometimes challenging and inhibited newcomers’ active participation. However, sometimes new practices were developed where nurses created common ground, tinkered, and formed an inclusive playing field to enact good care. Conclusion/ discussion: This study shows that despite obstacles, there was room to make small changes in the rules of the game of nursing. These moments of tinkering may be sufficient to establish a stable, inclusive workforce for first-generation immigrants and give room to the evolvement of hybrid professional identities. Implications: The findings of this Dutch study are relevant for nursing ethics related to “good care” and nurses in other cultural contexts on how the integration of immigrant nurses in European countries in general could be facilitated.

scholarly journals Social Processes Affecting the Workforce Integration of First-Generation Immigrant Health Care Professionals in Aging Citizens in the Netherlands

2019 ◽  
Vol 31 (5) ◽  
pp. 460-467
Author(s):  
Anita Ham
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
The Netherlands ◽  
Health Care Professionals ◽  
Immigrant Health ◽  
First Generation ◽  
Social Processes ◽  
Generation Immigrant ◽  
Dutch Health ◽  
Workforce Integration

Introduction: Within a Dutch nursing home, the prevailing workforce culture was challenged by new personnel, which caused institutional change, which in turn, affected workforce integration. The purpose of this study was to examine social processes affecting workforce integration of first-generation immigrant health care professionals in aging citizens in a Dutch health institution in the Netherlands. Method: A purposive sample of 10 immigrants and 10 established nurses was recruited. Ethnography was used to guide this study. 105 hours of participant observation, 8 semistructured interviews with 4 immigrants and 4 established nurses, and 2 focus-group discussions with 8 immigrants and 6 established nurses. Results: The study identified various processes that affect culturally congruent care in the nursing home, like the imposing professional norms, the use of “weapons of the weak,” mutual suspicions of indifference, and collective images of “us” versus “them.” Both groups conceived the “others” as the source of their discomfort, however, both had pain of not mattering. Discussion: When recruiting international educated nurses “all nursing staff” face difficulties when going through the precarious process of mutual integration in daily care practices. We recommend that nurse leaders facilitate positive intergroup interactions that promotes reciprocity for all groups of nurses for better health care outcomes for all.

scholarly journals Caregivers' perspectives on good care for nursing home residents with Korsakoff syndrome

2020 ◽  
pp. 096973302092150
Author(s):  
Ineke J Gerridzen ◽  
Cees MPM Hertogh ◽  
Karlijn J Joling ◽  
Ruth B Veenhuizen ◽  
Els ML Verschuur ◽  
...  
Keyword(s):  
Nursing Home ◽  
Cognitive Deficits ◽  
Medical Center ◽  
Human Subjects ◽  
Nursing Home Residents ◽  
Good Care ◽  
Ethical Challenges ◽  
Structured Interviews ◽  
Care Needs ◽  
Korsakoff Syndrome

Background: In the Netherlands, people with severe cognitive deficits due to Korsakoff syndrome are generally admitted to a specialized nursing home. Professional caregivers experience that these residents are often not aware of their deficits, and consequently, their willingness to accept care is relatively low. However, these residents need permanent support when performing daily tasks due to severe cognitive deficits. The combination of objective care needs and low subjective responsiveness makes caring for people with Korsakoff syndrome a complex undertaking. It is unknown how professional caregivers deal with this complex task and how they manage the associated ethical challenges. Objectives: The aim of this study was to explore the professional caregivers’ perspectives on good care for residents with Korsakoff syndrome. Methods: A qualitative study design was used. Data were collected via semi-structured interviews. The Framework Method was used for the thematic analyses of the interview data. Participants and research context: Five specialized nursing homes participated in this study. Twelve professional caregivers, including nurses, nursing assistants, and support workers, were selected based on the ability to provide rich information on the study topics and to capture a variety of demographic and professional characteristics. Ethical considerations: The institutional review board of the VU University Medical Center Amsterdam approved the research protocol. The study was conducted in accordance with the ethical principles for medical research involving human subjects. Findings: Three perspectives on good care emerged: (1) making daily life a joint effort, (2) being steadfast, and (3) treating with respect. Discussion and conclusion: Professional caregivers try to achieve responsiveness in people with Korsakoff syndrome in three different ways. These perspectives reflect fundamentally different views on the care relationship and the autonomy of the resident. By elucidating the three perspectives, we hope to promote the practitioners’ reflection on their own ideas about good care for people with Korsakoff syndrome.

scholarly journals European List of Essential Medicines for Medical Education: a protocol for a modified Delphi study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045635
Author(s):  
Erik Donker ◽  
David Brinkman ◽  
Milan Richir ◽  
Paraskevi Papaioannidou ◽  
Robert Likic ◽  
...  
Keyword(s):  
Medical Education ◽  
Delphi Study ◽  
Medical Training ◽  
Medical Center ◽  
European Countries ◽  
Essential Medicines ◽  
Ethical Review ◽  
Junior Doctors ◽  
Direct Supervision ◽  
Modified Delphi

IntroductionJunior doctors are responsible for a substantial number of prescribing errors, and final-year medical students lack sufficient prescribing knowledge and skills just before they graduate. Various national and international projects have been initiated to reform the teaching of clinical pharmacology and therapeutics (CP&T) during undergraduate medical training. However, there is as yet no list of commonly prescribed and available medicines that European doctors should be able to independently prescribe safely and effectively without direct supervision. Such a list could form the basis for a European Prescribing Exam and would harmonise European CP&T education. Therefore, the aim of this study is to reach consensus on a list of widely prescribed medicines, available in most European countries, that European junior doctors should be able to independently prescribe safely and effectively without direct supervision: the European List of Essential Medicines for Medical Education.Methods and analysisThis modified Delphi study will recruit European CP&T teachers (expert group). Two Delphi rounds will be carried out to enable a list to be drawn up of medicines that are available in ≥80% of European countries, which are considered standard prescribing practice, and which junior doctors should be able to prescribe safely and effectively without supervision.Ethics and disseminationThe study has been approved by the Medical Ethics Review Committee of VU University Medical Center (no. 2020.335) and by the Ethical Review Board of the Netherlands Association for Medical Education (approved project no. NVMO‐ERB 2020.4.8). The European List of Essential Medicines for Medical Education will be presented at national and international conferences and will be submitted to international peer-reviewed journals. It will also be used to develop and implement the European Prescribing Exam.

scholarly journals Factors determining chance of type 2 diabetes remission after Roux-en-Y gastric bypass surgery: a nationwide cohort study in 8057 Swedish patients

2021 ◽  
Vol 9 (1) ◽  
pp. e002033
Author(s):  
Erik Stenberg ◽  
Torsten Olbers ◽  
Yang Cao ◽  
Magnus Sundbom ◽  
Anders Jans ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Metabolic Surgery ◽  
First Generation ◽  
Hemoglobin A1c ◽  
Diabetes Remission ◽  
Factors Associated ◽  
Generation Immigrant

IntroductionBariatric and metabolic surgery is an effective treatment option for type 2 diabetes (T2D). Increased knowledge regarding factors associated with diabetes remission is essential in individual decision making and could guide postoperative care. Therefore, we aimed to explore factors known to affect the chance of achieving diabetes remission after bariatric and metabolic surgery and to further investigate the impact of socioeconomic factors.Research design and methodsIn this nationwide study, we assessed all patients with T2D who underwent Roux-en-Y gastric bypass (RYGB) surgery between 2007 and 2015 in the Scandinavian Obesity Surgery Registry. Remission was defined as absence of antidiabetic medication for T2D 2 years after surgery. Multivariable logistic regression was used to evaluate factors associated with diabetes remission, with missing data handled by multiple imputations.ResultsA total of 8057 patients were included. Mean age±SD was 47.4±10.1 years, mean body mass index 42.2±5.7 kg/m2, mean hemoglobin A1c 59.0±17.33, and 61.7% (n=4970) were women. Two years after surgery, 6211 (77.1%) patients achieved T2D remission. Preoperative insulin treatment (OR 0.26, 95% CI 0.22 to 0.30), first-generation immigrant (OR 0.66, 95% CI 0.57 to 0.77), duration of T2D (OR 0.89, 95% CI 0.88 to 0.90), dyslipidemia (OR 0.71, 95% CI 0.62 to 0.81), age (OR 0.97, 95% CI 0.96 to 0.97), and high glycosylated hemoglobin A1c (HbA1c) (OR 0.99, 95% CI 0.98 to 0.99) were all associated with lower T2D remission rate. In contrast, residence in a medium-sized (OR 1.39, 95% CI 1.20 to 1.61) or small (OR 1.46, 95% CI 1.25 to 1.71) town and percentage of total weight loss (OR 1.04, 95% CI 1.03 to 1.04) were associated with higher remission rates.ConclusionAmong patients with T2D undergoing RYGB surgery, increasing age, HbA1c, and diabetes duration decreased the chance of reaching diabetes remission without cut-offs, while postoperative weight loss demonstrated a positive linear association. In addition, being a first-generation immigrant and living in a large city were socioeconomic factors having a negative association.

Immigrant-Origin Students in Community College: How Do They Use Their Time on Campus?

2019 ◽  
Vol 121 (7) ◽  
pp. 1-48
Author(s):  
Edwin Hernandez ◽  
Carola Suárez-Orozco ◽  
Janet Cerda ◽  
Olivia Osei-Twumasi ◽  
Monique Corral ◽  
...  
Keyword(s):  
Community College ◽  
Community Colleges ◽  
Peer Relationships ◽  
First Generation ◽  
Second Generation ◽  
The United States ◽  
Foreign Born ◽  
Grade Point ◽  
Class Time ◽  
Generation Immigrant

Background Immigrant-origin students are the fastest growing new population in community colleges, making up nearly a third of the community college population. To date, little is known about how immigrant-origin students make use of their time on community college campuses. Purpose This study sought to understand in what ways and to what extent immigrant-origin students—defined as first-generation (foreign-born) or second-generation (born in the United States to immigrant parents)—used their out-of-class campus time at three urban community colleges. We examined the following quantitative questions: How much time do students report spending on campus doing what activities? What is the demographic variation in these patterns (according to immigrant generation, ethnicity/race, and gender)? What factors predict how much overall time immigrant-origin students spend on campus? What is the effect of academically productive time spent on campus on grade point average for immigrant-origin students? We also explored the following qualitative questions: What do immigrant-origin community college students say about the time they spend on campus? What insights do they have as to what impedes or facilitates their spending (or not spending) time on campus? Research Design The study proposed a new conceptual framework and employed an embedded sequential explanatory mixed-methods design approach. As part of a survey, participants (N = 644, 54.6% women; M age = 20.2 years; first-generation immigrant n = 213, 33%; second-generation immigrant n = 275, 43%) completed a series of items about the time that they spent on campus and their relationships with their instructors and peers. Qualitative response data were derived from an embedded interview subsample of participants (n = 58). Results Immigrant-origin students reported spending a considerable amount of out-of-class time—an average of 9.2 hours—on campus. Hierarchical regression analyses demonstrated that peer relationships and time spent helping parents or commuting positively predicted the amount of time students spent on campus. Qualitative responses provided further insights into immigrant-origin community college student experiences and provided perspectives on issues contributing to their spending out-of-class time on campus. Conclusions This study has implications for research, practice, and policy, given that immigrant-origin students make considerable use of their campus spaces. Community colleges should strive to nurture positive spaces and design the kind of on-campus programming that will enhance the success of immigrant-origin students. Collectively, these services will not only enhance the experience of immigrant-origin students but also be beneficial to the larger campus community that uses the community college sector as a stepping-stone toward upward social and economic mobility.

Civic engagement and self-empowerment of second-generation Vietnamese in Czechia

2021 ◽  
pp. 011719682110405
Author(s):  
Tereza Freidingerová ◽  
Barbora Nováková
Keyword(s):  
Role Models ◽  
First Generation ◽  
Second Generation ◽  
Participant Observation ◽  
Self Confidence ◽  
Generation Immigrant ◽  
Immigrant Organizations ◽  
Vietnamese Community ◽  
Czech Society ◽  
Depth Interviews

The first cohort of Czech second-generation Vietnamese has only recently reached adulthood. Raised by Czech nannies, they received early socialization into Czech society, while Vietnamese culture remained unfamiliar. With this childhood experience, the generation grew into young adulthood questioning their identity/identities. Caught between social and normative pressures from both the Vietnamese community and Czech society, the formation of associations by second-generation Vietnamese can be a means to respond to their disadvantaged position. Based on in-depth interviews with leaders of these associations and participant observation of their activities, the article examines the goals and activities of second-generation associations (SGAs) and compares them with first-generation immigrant organizations. SGAs are shown to fill the gap of parents as key role models of socialization in Czech society and as platforms to enhance the self-confidence and sense of social responsibility of second-generation Vietnamese in Czechia.

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