Judy Mill

University of Alberta, Edmonton, Alberta, Canada

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Publications (30)12.38 Total impact

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    ABSTRACT: The purpose of this study was to determine how Canadian nurse practitioners (NPs) rate their levels of therapeutic commitment, role competency, and role support when working with persons with mental health problems. A cross-sectional descriptive, co-relational design was used. The Therapeutic Commitment Model was the theoretical framework for the study. A sample of 680 Canadian NPs accessed through 2 territorial and 9 provincial nursing jurisdictions completed a postal survey. NPs scored highest on the therapeutic commitment subscale and lowest on the role support subscale. The 3 subscales were correlated: role competency and therapeutic commitment were the most strongly associated ( = .754, French Cette étude a pour objectif de déterminer la façon dont les infirmières praticiennes canadiennes (IP) déterminent leur degré d'engagement thérapeutique, leur compétence de rôle et leur soutien de rôle dans des contextes de travail avec des personnes atteintes de troubles de santé mentale. Un cadre descriptif transversal corelationnel a été utilisé. Le modèle d'engagement thérapeutique a servi de cadre théorique. Un échantillon de 680 IP canadiennes recrutées dans deux juridictions territoriales et neuf juridictions provinciales infirmières ont rempli un sondage envoyé par la poste. Les IP ont obtenu le score le plus élevé quant à la sous-échelle de l'engagement thérapeutique et le score le plus faible quant à la sous-échelle du soutien de rôle. Les trois sous-échelles ont été corrélées : la compétence de rôle et l'engagement thérapeutique affichaient l'association la plus élevée (r = 0,754, p Keywords: COMPETENCY; MENTAL ILLNESS; NURSE PRACTITIONER; ROLE SUPPORT; THERAPEUTIC COMMITMENT Document Type: Short Communication Publication date: December 1, 2014 More about this publication? CJNR is a peer-reviewed, quarterly journal published by the McGill University School of Nursing since 1969. With world-wide circulation, CJNR's primary mandate is to publish original nursing research that develops basic knowledge for the discipline and examines the application of the knowledge in practice. Research related to education and history is also welcomed, as are methodological, theoretical, and review papers that advance nursing science. Letters or commentaries about published articles are encouraged. Learn more. Editorial Board Information for Authors Subscribe to this Title Archives Overview / Permissions ingentaconnect is not responsible for the content or availability of external websites $(document).ready(function() { var shortdescription = $(".originaldescription").text().replace(/\\&/g, '&').replace(/\\, '<').replace(/\\>/g, '>').replace(/\\t/g, ' ').replace(/\\n/g, ''); if (shortdescription.length > 350){ shortdescription = "" + shortdescription.substring(0,250) + "... more"; } $(".descriptionitem").prepend(shortdescription); $(".shortdescription a").click(function() { $(".shortdescription").hide(); $(".originaldescription").slideDown(); return false; }); }); Related content In this: publication By this: publisher In this Subject: Nursing By this author: Creamer, Anne Marie ; Mill, Judy ; Austin, Wendy ; O'Brien, Beverley GA_googleFillSlot("Horizontal_banner_bottom");
    The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières 12/2014; 46(4).
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    ABSTRACT: In Uganda, nurses do not always practice universal precautions unless they know the patients' HIV status. In our study, focused ethnography was used to explore the experiences of Ugandan nurses in the practice of universal precautions while caring for persons living with HIV. In-depth interviews were completed with 16 participants from a variety of units at a large teaching hospital in Uganda. Although participants were knowledgeable about universal precautions, the primary challenge to the practice of universal precautions was the inadequate supply of resources, both material and human. Despite challenges, the nurses displayed an enthusiasm for their work and a dedication to provide the best possible care for patients. The findings highlight the urgent need for governments and institutions, particularly in resource-constrained countries, to develop and implement policies related to universal precaution practice and to provide a consistent supply of protective equipment to ensure that universal precautions are consistently used. Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
    The Journal of the Association of Nurses in AIDS Care: JANAC 11/2014; DOI:10.1016/j.jana.2014.10.003 · 1.23 Impact Factor
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    ABSTRACT: Background: International experiences provide a rich, transformative learning opportunity and are fundamental to the internationalization of universities that is occuring globally. To date there has been limited research to evaluate the experiences of, and benefits to, faculty members who participate in an international experience. In the current paper, we report findings from the evaluation of a Visiting Scholar Program (VSP) between the University of São Paulo at Ribeirão Preto College of Nursing (EERP-USP), Brazil and the Faculty of Nursing, University of Alberta (UA), Canada. The VSP was initiated in 2004, with a generous donation from a private donor, as one component of a broader partnership between the two university schools of nursing. Methods: The evaluation of the VSP program was carried out between January and June 2011 using a qualitative approach. An interpretative descriptive design was used for the study and in-depth interviews were used to collect the data. At the UA, 17 individuals affiliated with the Brazil project participated in an interview and two provided email feedback. At EERP-USP, 12 former scholars, one graduate student, two staff members responsible for the International Cooperation Office, and a former Dean participated in the evaluation. Results: Several key themes emerged during the analysis of the interviews. The program was highly successful from the perspective of both scholars and supervisors alike. The commitment to internationalization at each site, the well-established partnership between EERP-USP and UA, and the financial resources available all contributed to the provision of a supportive, enabling environment for the scholars to develop their own research capacity and for both scholars and supervisors to build new research networks. Participants commented on the importance of personal relationships and convergent research interests between scholars and the supervisors. Several challenges related to language, length of the program, and at times, inadequate pre-planning between the scholar and supervisor were identified by participants. Conclusion: Overall the leadership team at each site and the scholars and supervisors believed that the VSP was successful. Despite several challenges, supervisors and scholars alike benefited from ongoing relationships and were appreciative of the opportunities for professional growth and research development that participation in the VSP program provided. Recommendations for future similar programs include: commitment to internationalization; a well-established Published by Sciedu Press 253 partnership between the two sites; sufficient financial resources; language training; a 12 month program if possible; good fit between scholar and supervisor; and pre-planning.
    10/2014; 4(4). DOI:10.5430/jnep.v4n3p252
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    ABSTRACT: There is limited literature describing the methodological and pragmatic considerations that arise when conducting participatory action research utilizing Photovoice with children, particularly within sub-Saharan Africa. We provide a case example of these considerations based on a qualitative exploratory design that was conducted in June 2010 with 13 children between the ages of 12 and 18 years who were orphaned and living with HIV in a group home setting in Western Uganda. The main purpose of this study was to explore the children’s experiences while including them in a participatory way utilizing Photovoice to share their stories, define their issues, and propose their own solutions. Conducting research in another country where language and culture are different from the researchers’ can pose many unique methodological, epistemological, and ethical challenges. These issues are discussed by reflecting on the process of the study. Key lessons will also be discussed regarding the methodological and pragmatic considerations with the aim of providing new insights for researchers who want to conduct research in a cross-cultural and multilingual setting. http://sgo.sagepub.com/content/4/2/2158244014530997
    SAGE Open 05/2014; 4(April-June):1-10. DOI:10.1177/2158244014530997
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    ABSTRACT: Nurses are knowledgeable about issues that affect quality and equity of care and are well qualified to inform policy, yet their expertise is seldom acknowledged and their input infrequently invited. In 2007, a large multidisciplinary team of researchers and decision-makers from Canada and five low- and middle-income countries (Barbados, Jamaica, Uganda, Kenya, and South Africa) received funding to implement a participatory action research (PAR) program entitled “Strengthening Nurses’ Capacity for HIV Policy Development in sub-Saharan Africa and the Caribbean.” The goal of the research program was to explore and promote nurses’ involvement in HIV policy development and to improve nursing practice in countries with a high HIV disease burden. A core element of the PAR program was the enhancement of the research capacity, and particularly qualitative capacity, of nurses through the use of mentorship, role-modeling, and the enhancement of institutional support. In this article we: (a) describe the PAR program and research team; (b) situate the research program by discussing attitudes to qualitative research in the study countries; (c) highlight the incremental formal and informal qualitative research capacity building initiatives undertaken as part of this PAR program; (d) describe the approaches used to maintain rigor while implementing a complex research program; and (e) identify strategies to ensure that capacity building was locally-owned. We conclude with a discussion of challenges and opportunities and provide an informal analysis of the research capacity that was developed within our international team using a PAR approach.
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    ABSTRACT: Purpose In 2009 we conducted a study to explore Ugandan nurses’ practice of universal precautions while caring for persons living with HIV. During our interviews about universal precautions, nurses’ also shared their experience with post-exposure prophylaxis (PEP) following needle-stick injuries. We present findings related to nurses’ understanding of PEP and their experience with, and reporting of, needle stick injuries. Background Nurses have high rates of exposure to blood-borne pathogens. Although there is minimal risk of the transmission of blood-borne pathogens from health care workers (HCWs) to patients and vice versa, post-exposure prophylaxis, has become routine following the occupational exposure of HCWs to HIV. Methods Focused ethnography was used to guide the data collection and in-depth interviews were used to collect the data between October and November 2009. Results Sixteen nurses from a variety of units in a large teaching hospital participated. Needle-stick injuries were a fairly common occurrence, but written policies were frequently inaccessible to nurses and they did not have adequate knowledge of PEP. Some nurses were reluctant to report injuries and avoided following PEP procedures due to lack of knowledge about PEP, concerns about anti-retroviral side effects and the stigma associated with PEP. Participants were aware of PEP however there was a wide variation in their understanding of the procedure to follow after a needle-stick injury. Conclusion Employers have a responsibility to update PEP guidelines and to orientate HCWs to these. Educators must ensure that undergraduate nurses have a comprehensive understanding of universal precautions and current practice for PEP.
    01/2014; 1. DOI:10.1016/j.ijans.2014.05.003
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    ABSTRACT: Some nurses who provide AIDS care, in addition to experiencing stigma themselves, also exhibit negative attitudes and perpetrate stigma and discrimination toward persons living with HIV (PLWHAs). We used a participatory research approach to explore the nature, context, and influence of stigma on the nursing care provided to PLWHAs in four low- and middle-income countries: Jamaica, Kenya, South Africa, and Uganda. Eighty-four registered nurses, enrolled nurses, and midwives participated in interviews and 79 participated in 11 focus groups. Nurses were very aware of the stigma and discrimination that AIDS evoked, and made adjustments to their care to decrease the manifestation of AIDS stigma. Despite the assurance that PLWHAs were treated equally, and that universal precautions were used consistently, we found that in reality, nurses sometimes made decisions about nursing care that were based on the appearance of the patient or knowledge of his or her status.
    Qualitative Health Research 06/2013; 23(8). DOI:10.1177/1049732313494019 · 2.19 Impact Factor
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    ABSTRACT: In this article, we consider how the broad context of Aboriginal people's lives can shape their experience and understanding of their HIV diagnosis. We conducted interviews across Canada with 72 Aboriginal people living with HIV who also reported feelings of depression. Consistent with what has been found in previous studies, participants responded to their HIV diagnosis with shock, disbelief, and often anger. Prior depression, drug and alcohol use, multiple losses, stigma, and social isolation also shaped how participants experienced their diagnosis. We consider how the history of colonization of Aboriginal communities in Canada relates to the experience of HIV diagnosis, and end with a discussion of the service implications of our findings.
    Qualitative Health Research 03/2013; 23(6). DOI:10.1177/1049732313482525 · 2.19 Impact Factor
  • The Journal of the Association of Nurses in AIDS Care: JANAC 03/2013; 24(6). DOI:10.1016/j.jana.2013.01.005 · 1.23 Impact Factor
  • Linda Ogilvie, Judy Mill
    The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières 12/2012; 44(4):11-4.
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    ABSTRACT: The global HIV and AIDS pandemic continues to devastate the health systems of Sub-Saharan Africa and the Caribbean, deepening the health human resources crisis and challenging delivery of essential health services. Nurses and midwives form the majority of the healthcare workforce in much of the world. An innovative five year program of research and capacity-building with a participatory action research approach involved Canada, Kenya, Jamaica, Uganda, and South Africa. Partner countries each established leadership hubs in three districts to address issues of equity and effectiveness of HIV/AIDS health services and policies. A quasi-experimental design with mixed methods data collection was used to compare changes in HIV/AIDS clinical practice, stigma, and health human resource policies between intervention and control districts. This presentation will describe this leadership hub intervention and highlight successes and challenges. Hubs were comprised of community representatives and stakeholders including nurses, midwives, researchers and decision makers. Training focused on essential skills for active participation in policy and decision-making, with capacity needs assessed through the ARAR (ability, resources, authority, and responsibility) lens. Hubs implemented evaluation projects examining institutional policy gaps. Sharing the program’s research findings with hubs was a basis for preparing policy briefs for local health officials, and action plans to improve HIV/AIDs-related care. Successes include nurses and midwives beginning to self-identify change agents with confidence, skills, and a sense of responsibility to influence health systems change, and hub sustainability plans for the post-project period. Challenges included heavy workloads, an initial lack of institutional support for hub research-related activities, and socio-political influences. The leadership hub intervention is a promising approach that engages nurses, midwives and local decision-makers in developing and implementing action plans adapted to local constraints. Post-intervention data collection, planned for 2012, will be used to assess the impact of hubs on HIV/AIDS care. ------------------------- Learning Objectives: 1. Identify innovative approaches that enabled nurses and midwives across participating lower and middle-income countries to take leadership roles in implementation of research and improving clinical practices and policies for HIV and AIDS; 2. Describe successes and challenges with translating research knowledge for leadership hubs of nurses, researchers, decision makers, and community members, and engaging them in research and policy cycles; 3. Articulate opportunities for linking hubs with decision makers at district, provincial, and national levels, and internationally with other hubs. 4. Discuss strategies used to develop sustainable hub networks at local, national and international levels. Related Web Page
    13th World Congress on Public Health World Health Organization; 04/2012
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    ABSTRACT: Institutional supports and capacity-building efforts are needed to foster a critical mass of nurses in lower- and middle-income countries to actively lead research and evaluate change models. An enabling environment has individual, institutional, and national and international dimensions that support nurses’ efforts to generate evidence and contribute their experience at the research-policy interface. Necessary elements include: educational preparation, training opportunities, mentorship programs, interdisciplinary collaboration, funding for nursing research, and a participatory action research approach.
    13th World Congress on Public Health World Health Organization; 04/2012
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    ABSTRACT: The purpose of this community-based research was to examine the experiences of Canadian Aboriginal youth regarding accessing HIV testing and care services. We used a mixed method exploratory research design; 413 participants completed a self-administered survey and 25 youth participated in in-depth semistructured interviews. Findings reported here are from the 26 survey participants (12.4%) and nine interview participants (28.9%) who self-reported being positive for HIV. Results of this study suggest that some Aboriginal youth do not test for HIV until late in the course of their disease, and once diagnosed, a significant number of youth delay accessing care. Support from friends, family, and others is an important motivator for youth to initiate care and treatment. Integrated, comprehensive, youth-friendly, and culturally safe services are important to keep youth in care.
    Journal of HIV/AIDS & Social Services 10/2011; 10(4):395-413. DOI:10.1080/15381501.2011.623903
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    ABSTRACT: The objective of this study was to explore HIV testing experiences and service views of Canadian Aboriginal youth in order to provide information for HIV testing services. An exploratory, mixed-method, community-based research design was used for this study. Findings reported here are from 210 survey participants who had experienced an HIV test. Youth were recruited through 11 Aboriginal organizations across Canada, including AIDS service organizations, health centers, community organizations, and friendship centers. Youth who had tested for HIV ranged in age from 15 to 30 years of age (20% were <20), and came from First Nations (75%), Metis (14%), and Inuit (9%) backgrounds. Participants lived in all provinces and one territory. Over half (62%) were female. While the majority of survey respondents indicated at their last HIV test they had been treated with care (80%), respect (77%), or kindness (76%), some reported being treated with hostility (19%), fear (12%), discrimination (11%), avoidance (10%), or being treated in a bored way (15%). When asked about information they had received, 28% of survey respondents could not remember; 23% said they were not given any information, and 24% said their questions were not answered. Emotional reactions to testing ranged from anxiety/apprehension (64% of survey respondents) to being "calm" (19%). When asked for suggestions to improve testing services, participants indicated emotional support, compassion, professional yet personable services, and personalized HIV information were important. Study results suggest that to facilitate HIV testing for Aboriginal youth, testing services and counseling must be respectful, compassionate, non-judgmental, and culturally responsive in order to provide emotional support and HIV information that is meaningful and memorable.
    AIDS Care 10/2010; 22(10):1269-76. DOI:10.1080/09540121003692201 · 1.60 Impact Factor
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    ABSTRACT: As we move into the 21st century, our roles as nurses are becoming more complex. Inequities in health within and across nations demand that nursing students examine the interconnectedness between local and global health challenges and contribute to the development and implementation of solutions to these challenges. In this article, we examine concepts related to global citizenship, globalization, social responsibility, and professionalism and link them to curricular innovation in nursing education. We argue that the development of global citizenship is a fundamental goal for all nursing students and that to achieve this, nurse educators must move beyond the creation of international placement opportunities or the use of global examples within existing courses. Nurse educators must develop strategies and design innovative curricula to provide opportunities for all students to become engaged with the concept of global citizenship and the role of nurses in a global world.
    ANS. Advances in nursing science 07/2010; 33(3):E1-E11. DOI:10.1097/ANS.0b013e3181eb416f · 0.87 Impact Factor
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    Jean N Harrowing, Judy Mill
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    ABSTRACT: The phenomenon of moral distress among nurses has been described in a variety of high-income countries and practice settings. Defined as the biopsychosocial, cognitive, and behavioural effects experienced by clinicians when their values are compromised by internal or external constraints, it results from the inability to provide the desired care to patients. No research has been reported that addresses moral distress in severely resource-challenged regions such as sub-Saharan Africa. To describe the manifestation and impact of moral distress as it was experienced by Ugandan nurses who provided care to HIV-infected or -affected people. A critical ethnography was conducted with 24 acute care and public health nurses at a large referral centre in Uganda. Data were collected through interviews, observation, and focus group discussions. Participants described their passion for nursing and commitment to patients. They experienced moral distress when a lack of resources put patients' wellbeing at risk. The trauma imposed by systemic challenges on the nursing profession was acknowledged, as was the perception that the public blamed nurses for poor patient outcomes. However, participants were determined to serve to the best of their abilities and to take satisfaction from any contributions they were able to make. They cited the importance of education in the development of their capacity to provide care with a positive attitude, and demonstrated a collective resilience as they discussed strategies for addressing issues that affected them and their colleagues. The experience of moral distress among nurses in Uganda differed somewhat from the experience of nurses in high-income countries. Constraints imposed by the inability to implement skills and knowledge to their fullest extent, as well as a lack of resources and infrastructure may result in the omission of care for patients. Moral distress appears to manifest within a relational and contextual environment and participants focussed on the impact for patients, communities, and the nursing profession as a whole, rather than on their own personal suffering. The opportunity for continuing education led to strategies to transform personal attitudes and practice as well as to enhance the presentation of the profession to the public.
    International journal of nursing studies 12/2009; 47(6):723-31. DOI:10.1016/j.ijnurstu.2009.11.010 · 2.25 Impact Factor
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    ABSTRACT: AIDS stigma has serious consequences. This study explored those practices within health-care organizations that persons with HIV perceive as stigmatizing. It used an exploratory, descriptive design using a participatory action research approach. Interviews and focus groups were conducted with 16 Aboriginal and 17 non-Aboriginal persons living with HIV as well as with 27 health-care providers. The AIDS stigma perceived by many participants often intersected with other forms of stigma, related to behaviour, culture, gender, sexual orientation, or social class. In addition, policies at the organizational level contributed to AIDS stigma and at times intersected with stigma at the individual level. Participants' experiences of stigma and discrimination were shaped by the organizational policies (universal precautions, models of care) and design (physical layout) under which care was provided. Several paradoxes associated with secrecy, health-care settings, and the layering of stigma emerged in the reported experiences.
    The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières 09/2009; 41(3):168-85.
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    ABSTRACT: AIDS stigma has serious consequences. This study explored those practices within health-care organizations that persons with HIV perceive as stigmatizing. It used an exploratory, descriptive design using a participatory action research approach. Interviews and focus groups were conducted with 16 Aboriginal and 17 non-Aboriginal persons living with HIV as well as with 27 health-care providers. The AIDS stigma perceived by many participants often intersected with other forms of stigma, related to behaviour, culture, gender, sexual orientation, or social class. In addition, policies at the organizational level contributed to AIDS stigma and at times intersected with stigma at the individual level. Participants' experiences of stigma and discrimination were shaped by the organizational policies (universal precautions, models of care) and design (physical layout) under which care was provided. Several paradoxes associated with secrecy, health-care settings, and the layering of stigma emerged in the reported experiences. French La stigmatisation associée au VIH/sida a de lourdes conséquences. Nous avons cherché à examiner les pratiques qui, au sein des établissements de santé, sont perçues comme étant stigmatisantes par les personnes vivant avec cette maladie. De nature exploratoire et descriptive, notre étude s'inscrit dans une approche de recherche-action participative. Nous avons mené des entrevues et des groupes de discussion auxquels ont participé 16 Autochtones et 17 non-Autochtones vivant avec le VIH/sida, ainsi que 27 prestataires de soins de santé. La stigmatisation ressentie par de nombreux participants se conjugue souvent à d'autres facteurs qui accentuent cette perception, et qui sont associés au comportement, à la culture, au sexe, à l'orientation sexuelle ou à la classe sociale. On a constaté également que les politiques organisationnelles contribuaient à la stigmatisation et qu'elles se conjuguaient parfois aux facteurs individuels. Les expériences de la stigmatisation et de la discrimination sont façonnées par les politiques organisationnelles (précautions universelles, modèles de prise en charge) ainsi que par l'aménagement (la disposition matérielle) des lieux où sont dispensés les soins. On a relevé dans les témoignages des participants un certain nombre de paradoxes relatifs au respect de la vie privée, au cadre de prestation des soins et à la conjonction des facteurs de stigmatisation.
    The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmières 08/2009; 41(3):168-185.
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    ABSTRACT: This article reports the findings from a participatory action research study concerning the experience of Ugandan nurses caring for individuals with HIV illness. Six key informants from government and non-governmental organizations were interviewed using a semistructured format. Six nurses from a large national referral hospital in Kampala, Uganda, participated in 10 focus group meetings during a period of 11 months. In-depth interviews, focus groups, and photovoice were used to collect the data. Findings indicate that nurses faced many challenges in their daily care, including poverty, insufficient resources, fear of contagion, and lack of ongoing education. Nurses experienced moral distress due to the many challenges they faced during the care of their patients. Moral distress may lead nurses to quit their jobs, which would exacerbate the acute shortage of nurses in Uganda. This study provides important knowledge for guiding clinical practice and nursing education in resource-constrained countries like Uganda.
    Journal of Transcultural Nursing 08/2007; 18(3):257-64. DOI:10.1177/1043659607301301 · 0.83 Impact Factor
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    ABSTRACT: In this article the authors present findings from a qualitative research study carried out with Ugandan nurses from September 2003 until June 2004. They highlight the process and philosophical basis of participatory action research (PAR) by reflecting on the challenges, opportunities, outcomes, and ethical issues encountered during the conduct of the research. In this study PAR fostered a climate in which nurses could engage in collective reflection on their practice, make sense of their experiences, and thereby change their understanding of their work.