3-Abstract book-1-2017

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Nov 15, 2017 - Enter the following address in the dial-field on your system or in ... Chair: Marie-Louise Luiking, President of Rho Chi-at-Large Chapter, STTI, the .... management of type-2 diabetes by focusing more on health promotion.
15 November 2017 Tau Omega Chapter Gothenburg University, Gothenburg Sweden







Content General Information ................................................................................................................................... 3 Dialing in to the conference ................................................................................................................... 3 Organizing committee/ scientific committee ......................................................................................... 4 Presenter information ............................................................................................................................ 4 Program ...................................................................................................................................................... 5 Abstracts ..................................................................................................................................................... 6 Missed appointments at maternal healthcare centres in Riyadh city: reasons and associated factors . 6 An Ethnographic Study of The Factors Associated with Poor Glycaemic Control Levels Among People with Type 2 Diabetes Accessing a Primary Care Centre in Jordan .......................................................... 8 Exploring the knowledge, attitude and beliefs of community members, health professionals and policy makers towards obesity and its related policies in Libya ............................................................. 9 Longitudinal study of rural maternity care in southern Nepal ............................................................. 11 Symmetrical and/or asymmetrical interacting: A grounded theory explaining the process of being a relative during their family member’s hospital admission in adult, medical areas of care .................. 13 A transformative vision of a nursing college in healthy context .......................................................... 15 Phenomenographic study of the perioperative experience of adolescent: contributions to nursing .. 17 Further Information .................................................................................................................................. 18 Acknowledgements .............................................................................................................................. 18





General Information

Welcome to the third postgraduate virtual student scholarly event. We are looking forward to an inspiring event with presentations and discussion around PhD research in Europe. We will get together via a conference call on the 15. November 2017 between 12:00 and 14:00 GMT (13:00 - 15:00 Mainland Europe). We have organized a 'test-run' to ensure the connection is working on 8. November 2017, 12:00- 12:30 GMT (13:00-13:30 Mainland Europe).

Dialing in to the conference To dial in, please follow the instructions below: Instructions All participants (Jabber users and participants using H.323/SIP video conference systems) dial in to the virtual room named "910004 KCW 1". Using one of the following methods: SIP Enter the following address in the dial-field on your system or in Jabber video: [email protected] and click dial/start. To enter the room use PIN-code: 1717 followed by # IP-address Enter the following address in the dial-field on your system or in Jabber video: 130.241.136.120 and click dial/start. To choose the specific meeting room enter the following number: 910004 followed by # To enter the room use PIN-code: 1717 followed by # To participate using telephone Dial the following number: +46 (0)31 786 2000 To choose the specific meeting room enter the following number: 910004 followed by # To enter the room use PIN-code: 1717 followed by # Testcall For test call in advance please use this test nr: SIP: [email protected] or IP: 130.241.136.120, room number 910001 followed by #.



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Organizing committee/ scientific committee This year's conference was organized by

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Birgit Heckemann, MSc (Bern University of Applied Sciences, Switzerland; Maastricht University, Netherlands), Tau Omega chapter A/prof Harshida Patel, PhD (Gothenburg University, Sweden), Vice President of Tau Omega Chapter, Chair of the Research Task Force and member of the Regional European committee STTI Prof Joy Merrell, PhD (Swansea University, United Kingdom), STTI European Regional Co-ordinator

Birgit and Harshida reviewed this year's submissions.

Presenter information – – – – –

If connecting via a laptop we recommend the use of a headset to minimize background noise. Please check the program for your allocated time slot. All presentations have been grouped according to themes and chaired by experts in the field. Presentations are scheduled for 5 minutes presentation, 5-10 minutes of discussion. Please adhere to these times. We advise you to prepare a max of about 5 PowerPoint slides. Presenting your research in a concise way is a challenge and this conference is an opportunity to practice these skills. You should be able to present your slides from your computer, but please also mail your presentation to us ahead of the conference in case of problems.



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Program Program



12.00 – 12.10

Welcome Birgit Heckemann, Harshida Patel Maternity Care Chair: Parveen Ali, PhD, University of Sheffield, UK Wdad Alanazy Missed appointments at maternal healthcare centres in Riyadh city: reasons and associated factors Preeti K. Mahato Longitudinal study of rural maternity care in southern Nepal Diabetes and Obesity Chair: Marie-Louise Luiking, President of Rho Chi-at-Large Chapter, STTI, the Netherlands Amer Al Sahouri An Ethnographic Study of The Factors Associated with Poor Glycaemic Control Levels Among People with Type 2 Diabetes Accessing a Primary Care Centre in Jordan Eman Derbi Exploring the knowledge, attitude and beliefs of community members, health professionals and policy makers towards obesity and its related policies in Libya The Healthcare Experience Márcia P. Santos Phenomenographic study of the perioperative experience of adolescent: contributions to nursing Sue E. Melling Symmetrical/asymmetrical interacting: A grounded theory of relatives’ experiences during their family member’s hospital admission in adult, medical areas of care Fernanda Principe A transformative vision of a nursing college in healthy context Closing remarks Birgit Heckemann, Harshida Patel

12:10 – 12:20 12: 25 – 12:35

12:40 – 12:50 12:55 – 13:05

13:10 – 13:20 13:25 – 13:35 13:45 – 13:55 13:55 – 14:00





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Abstracts

Missed appointments at maternal healthcare centres in Riyadh city: reasons and associated factors Alanazy, W. Jaynei Rance, J. & Brown, A. Department of Public Health, Policy and Social Sciences, Swansea University, UK Key words: antenatal care, missed appointment, health believe

Abstract Background Pregnancy and childbirth related complications are a critical issue. The World Health Organisation estimates that complications during this time contribute to over 300,000 deaths of women and adolescent girls worldwide each year. Ninety nine per cent of these deaths occur in women with low income in developing countries. In Saudi Arabia, the mortality rate due to variations in attendance of antenatal care clinics is credited to account for twenty-four maternal deaths in every 100,000 births while the lifetime hazard is one in every 1200. The primary factors attributed to the significant number of maternal and infant mortality rates in Saudi Arabia is linked to pregnancy complications and the barriers that hinder women from accessing antenatal care clinics. The irregular coverage of antenatal care has driven a large population of pregnant women in Saudi Arabia to deliver at home without the assistance of skilled personnel. Only forty-four percent of Saudi Arabian births are managed by a qualified medical professional. Between 2008 and 2015, the mortality rate due to pregnancy and newborn complications, and maternal problems represented a 12% of the Saudi total mortality. Aims The main aims of this research were to explore and understand the reasons and barriers behind missing appointment and not attending antenatal care among Saudi women. Methods Semi structured interviews were conducted with 21 Saudi Women and 9 doctors at three tertiary hospitals in Riyadh. For women, questions explored their attitudes towards antenatal care and any barriers they faced. For health care providers, questions explored their perceptions of why women do not attend antenatal care. Results Although ANC is generally reported to be important for maternal health, the findings highlighted integration of social and cultural influences. several factors that affected the rate of antenatal attendance among the Saudi women. These factors were classified into three themes of physical 6





barriers such as lack of transport, low level of education and healthcare facility inadequacies. The desire to avoid ANC clinics was motivated by individual and family perception as well as staff attitude towards the patients. Professionals highlighted that the level of education and awareness regarded the important of antenatal care, transportation accessibility and women‘s believes were the barriers affecting women to take advantage from antenatal care. Conclusion Based on the finding of study, a number of recommendations will be made to help women around the word to overcome the barriers that were identified to them accessing antenatal care. There is no ‘magic bullet’ to overcoming constrains, instead, a comprehensive package of social and public health care approach is required.

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An Ethnographic Study of The Factors Associated with Poor Glycaemic Control Levels Among People with Type 2 Diabetes Accessing a Primary Care Centre in Jordan

Al Sahouri, A. Swansea University, UK Key words: Communication, type-2 diabetes and promotion Abstract Background Globally, there are 422 million (9%) people who have diabetes and this number is expected to increase to 592 million in 2035. In Jordan, the prevalence of poorly controlled type-2 diabetes is high. However, there are no published studies that have sought to explore the meaning behind people’s health behaviours and the influence of socio-cultural norms on the management of type-2 diabetes in Jordan. Aim To explore the reasons why glycaemic control is poor among a sample of people with type-2 diabetes who use primary care services in Jordan. Methods An ethnographic approach was used encompassing a mixed methods data collection strategy which has included to date: 80 hours of participant observation, semi structured interviews with 10 health care workers and 6 family carers, 8 focus groups with 38 patients with poorly controlled type 2 diabetes and a documentary review. Results Data analysis is on-going and I am only presenting the following findings: challenges related to good glycaemic control levels include: Health care workers factors included ineffective patient-provider communication, shortages of staff and lack of continuity of care. Health care system factors included impact of health insurance, medication supply problems, unavailability of laboratory tests in the centre. Conclusion Health care system and health care workers could promote healthy behaviours and enhance management of type-2 diabetes by focusing more on health promotion. Continuity of patient-doctor relationship and medications security are crucial factors in management plan of type-2 diabetes. Implications The findings of this study will be used to inform policy and practice and specifically will be used to inform the development of an educational package for patients with type 2 diabetes.



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Exploring the knowledge, attitude and beliefs of community members, health professionals and policy makers towards obesity and its related policies in Libya Derbi, E. Swansea University, UK Abstract Background The cause of obesity has been an on-going argument in research for many years. At one level, the aetiology of obesity is simple; people consume more calories than they expend. At another, it is complex and multifactorial, influenced by interactions of several determinants such as genetic, biological, environmental, and socio-cultural factors, which vary among different age, sex, and ethnic groups. Despite genetic and biological factors being commonly known to have a strong influence in the etiology of obesity, it is unlikely to be the main cause as cultural and social factors also play a significant part towards creating this epidemic but are rarely covered in North Africa and the Middle East, especially in Libya. For this reason the study aims to:



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Investigate the influence of socio-cultural norms on body weight and diet. Identify barriers and facilitators to maintaining a healthy weight. Explore the influence of subsidized foods on Libyan diet and body weight. Explore health professionals and policy makers’ attitudes towards obesity and related policies.

The findings of the study will be a fundamental step in developing a culturally relevant health promotion programme that meets the needs of Libyan people. Aim of this presentation In this presentation, I intend to discuss the challenges I faced in gaining ethical approval to conduct the study and during data collection in a city under a civil war. Some preliminary findings may also be presented. Methods A qualitative research design was adopted for the study informed by ethnography using Semistructured interviews with 9 health professionals and 6 policy makers after receiving permission from the Ministry of Health, and 6 focus groups (FGs) conducted with 47 women and men aged 18+ from different socio-economic classes and education levels. 3 FGs were held in the university with students and tutors after the permission of the dean of Tripoli University, and 3 were held in different small private organisations with uneducated women and men after getting the permission of their gate keepers. The interviews and focus groups were audio recorded, translated and transcribed, and the data are at the stage of analysis using thematic analysis.

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Setting Data were collected in Tripoli as it’s the safest city in Libya at the current time for a period of 6 months from October 2016 until March 2017.

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Longitudinal study of rural maternity care in southern Nepal Mahato P.K. Bournemouth University, UK Keywords: Maternity and childbirth, rural, South Asia Abstract Introduction Birthing centres (BC) are a key component of maternal health service delivery at local level as they provide care to most women (i.e. with uncomplicated or low-risk pregnancies) In Nepal, Auxiliary Nurse Midwives (ANMs) provide much of the maternity care, delivering care especially in the villages. Health promotion is a part of the service provided by ANMs. In the absence of trained midwives these ANMs are the highest trained and best skilled maternity worker most rural women will encounter. The literature found several barriers to pregnant women attending BCs and women tended to bypass BCs to give birth in hospitals. Aim The study evaluated an intervention consisting of supporting a BC in two villages and delivering a health promotion programme to women of reproductive age group in local communities to increase birth at BCs. Methods A cross-sectional before-and-after survey was conducted in a rural district in Nepal in 2012 and 2017 of nearly all women who had given birth in the preceding two years. The questionnaire asked these women about attitudes, perceptions and behaviour related to maternity care. Results Establishing a birthing centre significantly decreased the proportion of home births by 30% and increased births at birthing centre by 26%. Various characteristics showed a strong association between the intervention and place of birth, decision maker of place of birth, satisfaction with delivery services and women’s education. The results of multinomial regression showed women were significantly more likely to give birth at hospitals or primary care facilities compared to home if decision maker for place of birth were husbands, and women and family members; and had four or more antenatal care (ANC) visits. Women were less likely to deliver at primary care facilities if they had low levels of education. Discussion and conclusion The intervention had a strong effect on place of birth (decreasing home births and increasing births at birthing centre), decision maker for place of birth, satisfaction with delivery services and women’s education. The findings show husbands, women and family members, having four or more antenatal visits and women’s education determined the place of birth.

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Practical/academic Implications This study provides a picture of where women in rural Nepal give birth including home and BCs and ways to increase quality and uptake of services provided by BCs.

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Symmetrical and/or asymmetrical interacting: A grounded theory explaining the process of being a relative during their family member’s hospital admission in adult, medical areas of care Melling. S. E. Bournemouth University, UK Key words: Relatives, person centred care, medical wards. Abstract Introduction Much attention in nursing and health care is centred on the patient but little seems to be known about relatives’ experiences when a family member is an inpatient of a medical directorate in England. The setting chosen is pertinent as adult medical care is the largest service in most NHS hospitals, demand for beds is high, availability problematic, wards are busy and optimal staffing challenging. Aim The aim was to develop a theoretical explanation of the process of being a relative when their family member was an inpatient in adult, general medical areas of care. Method Glaserian grounded theory was utilised because it offers a systematic method resulting in conceptualisation of theory derived directly from data. Data was obtained from observations and indepth interviews of seventeen relatives who, coincidentally, had to a greater or lesser extent become their family member’s main carer. Findings Symmetrical and/or asymmetrical interacting emerged as the grounded theory that explained the process of being a relative in the circumstances stated above. Symmetrical interacting was that which relatives considered as being in keeping and consistent with their and their family members’ needs and led to relatives feeling empowered and being treated equitably. Contrastingly, asymmetrical interacting was out of balance with relatives’ perceived needs by being associated with disempowering and inequitable interacting negatively impacting on the care and safety of their loved one which constituted relatives’ main concern. Consequently, relatives constantly watched interactions in the care environment often losing trust in varying aspects of nursing and health care. Some relatives decided to resolve perceived issues by assertively advocating for their family member while others feared this approach and remained passive and compliant. Discussion and conclusion It could be argued that asymmetrical interacting due to dependency on professional expertise is inevitable in the hospital setting. However, negative effects could be ameliorated by health care personnel acknowledging, respecting and incorporating relatives in a collaborative and therapeutic approach to the nursing and health care of their family member. 13





Implications Relatives’ importance in the life of their family member should be capitalised upon within a person centred approach to nursing and health care, which is relational, collaborative and humanised and thus empowering and equitable.

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A transformative vision of a nursing college in healthy context Príncipe, F.1; Brito, I.2& Reis Santos, M.3 1. Portuguese Red Cross Nursing School; Biomedical Sciences Institute Abel Salazar- Porto University, Portugal 2. Coimbra Nursing School, Portugal; 3. Porto Nursing School, Portugal Keywords: participatory health research, nursing, health promotion Abstract Background Among students, there is a significant relationship between adopting health promoting lifestyle and aspects of spiritual growth and stress management on the one hand and general quality of life on the other. Nursing college should be a healthy context. PEER-IESS is a model to enhance health promotion in academic communities. Require the creation of a learning environment and organizational culture that enhances health. Aim To evaluate the process of the transformative process applying PEER-IESS Methods A case study with participatory health research. Data were collected by 7 semi-structured interviews: four representatives of college management boards, one course coordinator, one student leader and one local community leader. Transcribed interviews were computed and explored in IRAMUTEQ® software that performed a classic lexicographical analysis. Results Health promoting, student, transformative process and empowerment were the words more frequent and were in central core representation. Peer education network, bottom-up strategies and the health promoting practice are central. The cultural competence and cultural sensibility were also main words. Discussion and conclusion PEER-IESS model recognize the link between peer education and participatory health research to build capacity for health promotion. Curricular infusion of health promotion in nursing course could improve the participation of the entire academic community in building healthy contexts and the strategic development plan of the institution.

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Practical implications By applying PEER-IESS model, nursing education institutions could lead a guide to the formulation of health enhancing policies and practices, thereby strengthening health and sustainability in universities and colleges.

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Phenomenographic study of the perioperative experience of adolescent: contributions to nursing Santos, M. P.1, 2 1

Instituto Ciências Biomédicas Abel Salazar, Portugal; 2Centro Hospitalar e Universitário de Coimbra, Portugal Keywords: Adolescent; perioperative experience; Nursing perioperative care Introduction Surgery is one of the most distressing and stressful experience in the life of adolescents and their family. Adolescents need attention and some of them are particularly vulnerable. The memories of a surgery experience not only can affect how adolescent think and act but also interfere on their development with implications for their health. The paediatric perioperative nurses have an important role with this group of patients and they must treat adolescent as they are: Different from child and adult. Aim To describe the adolescents perioperative experiences based on stress and anxiety control strategies and their needs in the perioperative period.

Methods Descriptive qualitative approach using elements of analysis from phenomenografic method. Data will be collected though individual interviews, at the day before and one week after surgery, with adolescents aged 14-18 years from one Portuguese children hospital. The interviews will be transcribed and data will be managed using a computerized qualitative data analysis program QSR NVivoTM. Ethical approvals will be asked from two committees: Children Hospital and Coimbra Nursing School. Only adolescent whose parents give the written consent will be interviewed. Discussion and conclusion We expect that the results will help us to understand the particularities of our adolescents’ fears and needs, as well as how they feel and describe their surgical experience. The data will help us to create conditions to adapt our perioperative care to adolescent and their needs. Pratical implications To develop a nursing perioperative model care to adolescent and family based on perioperative adolescent experiences and needs and use this model in daily practice. 17





Further Information

For further information

… about Sigma Theta Tau International Honor Society of Nursing visit … to contact the organizing committee

www.nursingsociety.org

Prof Joy Merrell:

[email protected]

A/Prof Harshida Patel: [email protected] Birgit Heckemann:

[email protected]



Acknowledgements Thank you to all the students for submitting their abstracts and to our expert volunteers, Marie-Louise Luiking and Parveen Ali, PhD for chairing the topics sessions.

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