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Graduate students perceive their education as highly stressful, have consistently rated their stress levels as above average and have consistently scored above average on stress scales. The consequences of stress include negative academic outcomes, reduction in cognitive ability, impaired coping and incompletion of graduate studies. Stress is also associated with physical and psychological symptoms such as altered appetite, sleep pattern disturbances and headache. A descriptive correlational design was used to determine the perceived levels and sources of academic-related stress among students enrolled in a Master of Science in Nursing (MScN) degree programme at school of nursing in urban section of Jamaica. The Perceived Stress Scale-14 and Stress Survey were used to collect data from the 81 students enrolled in full or part time study in the MScN programme. Univariate and bivariate analyses were conducted using SPSS version 20. The majority (50.9%) were moderately stressed while 22.8% and 24.6% had high and low levels of stress respectively. Stress associated with the preparation for and prospect of final examinations received the highest overall mean stress rating, causing "a lot of stress". Attendances at classes and relationships with lecturers received the lowest mean stress rating. Research was not listed as a stressor.

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PURPOSE: Nursing documentation provides an important indicator of the quality of care provided for hospitalized patients. This study assessed the quality of nursing documentation on medical wards at three hospitals in Jamaica. METHODS: This cross-sectional study audited a multilevel stratified sample of 245 patient records from three type B hospitals. An audit instrument which assessed nursing documentation of client history, biological data, client assessment, nursing standards, discharge planning, and teaching facilitated data collection. Descriptive statistics were conducted using IBM SPSS, Version 19 (IBM Inc., Armonk, NY, USA). FINDINGS: Records from three hospitals (Hospital 1, n = 119, 48.6%; Hospital 2, n = 56, 22.9%; Hospital 3, n = 70, 28.6%) were audited. Documented evidence of the patient's chief complaint (81.6%), history of present illness (78.8%), past health (79.2%), and family health (11.0%) were noted; however, less than a third of the dockets audited recorded adequate assessment data (e.g., occupation or living accommodations of patients). The audit noted 90% of records had a physical assessment completed within 24 hr of admission and entries timed, dated, and signed by a nurse. Less than 5% of dockets had evidence of patient teaching, and 13.5% had documented evidence of discharge planning conducted within 72 hr of admission. CONCLUSIONS: This study highlights the weakness in nursing documentation and the need for increased training and continued monitoring of nursing documentation at the hospitals studied. Additional research regarding the factors that affect nursing documentation practice could prove useful. CLINICAL RELEVANCE: The study provides valuable information for the development of strategic risk management programs geared at improving the quality of care delivered to clients and presents an opportunity for nurse leaders to implement structured interventions geared at improving nursing documentation in Jamaica. In light of Jamaica's epidemiologic transition of chronic diseases, gaps in nurses' documentation of client assessment, patient teaching, and discharge planning should be addressed with urgency. Patient teaching and discharge planning enable the clients to participate more effectively in their health maintenance process.

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Faculty members are viewed as nurturers within the academic setting and may be able to influence students' behaviors through the formation of positive interpersonal relationships. Faculty members' attributes that best facilitated positive interpersonal relationships according to Carl Rogers' Person-Centered Model was studied. Students (n = 192) enrolled in a 3-year undergraduate nursing program in urban Jamaica were randomly selected to participate in this descriptive cross-sectional study. A 38-item questionnaire on interpersonal relationships with nursing faculty and students' perceptions of their teachers was utilized to collect data. Factor analysis was used to create factors of realness, prizing, and empathetic understanding. Multiple linear regression analysis on the interaction of the 3 factors and interpersonal relationship scores was performed while controlling for nursing students' study year and age. One hundred sixty-five students (mean age: 23.18 ± 4.51years; 99% female) responded. The regression model explained over 46% of the variance. Realness (ß = 0.50, P < .001) was the only significant predictor of the interpersonal relationship scores assigned by the nursing students. Of the total number of respondents, 99 students (60%) reported satisfaction with the interpersonal relationships shared with faculty. Nursing students' perception of faculty members' realness appeared to be the most significant attribute in fostering positive interpersonal relationships.

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Abstract Background: Nurse practitioners are playing an increasing role in the delivery of primary healthcare. Patient satisfaction with their services patients is an important factor to the expansion of their role in the health services. Objective: To explore the level of patient satisfaction with nurse practitioner delivered services at two health centres in urban Jamaica. Method: A cross sectional survey of 120 adult clients (age ≥18 years old) seen by Nurse Practitioner at a Type 3 or Type 5 health centre in Kingston, Jamaica was conducted using a modified self-administered Nurse Practitioner Satisfaction Survey questionnaire. Data were analyzed using SPSS® version 18 for Windows®. Results: The study achieved response rate of 91.6% (n=120). The majority were females (77%) with an average age of 40 ± 16 years. Most (63%) were from the Type 5 health centre and the rest (37%) were from a Type 3 facility. The mean general satisfaction score was 81 out of a possible 90 and 83% of the respondents reported they were very satisfied with another 17% expressing that they were satisfied with the nurse practitioner services at both facilities. No respondent was dissatisfied. The mean satisfaction score was significantly higher among respondents 40 years and older than that of their younger counterparts. Socio demographic and organization characteristics were not associated with the mean satisfaction score. Conclusions: A high level of satisfaction exists among patients seen by nurse practitioners at two facilities in Kingston, Jamaica. This may represent an opportunity for expanded role of Nurse practitioners in the delivery of primary in Jamaica.

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UNLABELLED: Abstract Objective: To explore the level of patient satisfaction with nurse practitioner delivered services at two health centres in urban Jamaica. METHOD: A cross sectional survey of 120 adult clients (age ≥18 years old) seen by Nurse Practitioner at a Type 3 or Type 5 health centre in Kingston, Jamaica was conducted using a modified self-administered Nurse Practitioner Satisfaction Survey questionnaire. Data were analysed using SPSS® version 18 for Windows®. RESULTS: The study achieved response rate of 91.6% (N = 120). The majority were females (77%) with an average age of 40 ± 16 years. Most (63%) were from the Type 5 health centre and the rest (37%) were from a Type 3 facility. The mean general satisfaction score was 81 out of a possible 90 and 83% of the respondents reported they were very satisfied with another 17% expressing that they were satisfied with the nurse practitioner services at both facilities. No respondent was dissatisfied. The mean satisfaction score was significantly higher among respondents 40 years and older than that of their younger counterparts. Socio demographic and organisation characteristics were not associated with the mean satisfaction score. CONCLUSIONS: A high level of satisfaction exists among patients seen by nurse practitioners at two facilities in Kingston, Jamaica. This may represent an opportunity for expanded role of Nurse practitioners in the delivery of primary in Jamaica.

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OBJECTIVE: The aim of this study was to evaluate the effectiveness of lay diabetes facilitators (LDFs) to increase knowledge and improve control among persons with diabetes. Methodology. A prospective cohort study was conducted among persons with diabetes in 16 health care centres in Jamaica to evaluate the effect of LDFs on glycaemia [haemoglobin A1c (HbA1c)] and body mass index (BMI). One hundred and fifty-nine persons with diabetes were recruited for the intervention from eight clinical settings in which LDFs had been recruited and trained. A matched group of 159 were recruited as a comparison sample from eight clinical settings without LDFs. HbA1c and BMI were measured at baseline and 6 months. RESULTS: Mean HbA1c at baseline for the intervention and comparison groups were 7.9% and 8%, respectively. After 6 months, the intervention group showed a mean decrease of 0.6% while the comparison group showed an increase of 0.6%, significant after control for potential confounders (P < 0.05). There was no statistically significant change in BMI between groups. CONCLUSION: Patients educated by LDFs showed improved metabolic control over the first 6 months of observation.

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BACKGROUND: Iron deficiency (ID) is common in cystic fibrosis (CF) and the soluble transferrin receptor (sTfR) is a sensitive, quantitative measurement of tissue iron deficiency. The study investigated the use of sTfR together with serum iron, transferrin saturation (TS) and serum ferritin, in assessing iron status in adult CF patients. METHODS: The patient population consisted of 127 CF patients which consisted of 51 inpatients with infected exacerbation (IE) and 76 outpatients at the time of their annual review (AR). Serum sTfR was measured using a particle-enhanced immunoturbidimetric assay on the Beckman Coulter LX20. RESULTS: Sixty five percent (65%) of CF patients in the IE group and 28% in the AR group had ID as determined TS, but only 18% (IE group) and 20% (AR group) as determined by ferritin. Serum sTfR detected 20% in the IE group and 12% in the AR group. We found significant correlation between C-reactive protein and TS (r=-0.56; P<0.01) but not with ferritin (r=0.22; P=0.380) in the IE group. CONCLUSION: Iron status of patients with CF can be accurately assessed by sTfR which is unaffected by the acute phase response and can be used in conjunction with serum ferritin.

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This study was designed to investigate the prevalence of hypertension in Jamaica. Jamaica has an area of 4,411 square miles and is divided into 14 parishes. The visited districts were randomly selected. The sample population was selected based upon a two-stage stratified random sampling design. Each dwelling in the "Sampling Universe" had an equal probability of being selected. The survey team spent a week in the districts in each parish selected. Employing the Statistical Institute of Jamaica's (STATIN) two-stage stratified random sampling design, preselected house-holds were visited. Non-response was documented and considered in the final analysis. Only individuals 15 years and older were allowed to participate in the study. The 2,064 subjects who participated were the basis for estimates of hypertension. Following logistic regression analysis, the main risk factors for hypertension are being female, advancing age, obesity, having diabetes and having a family history of hypertension. Jamaica has a point prevalence of hypertension of 30.8% in the 15-and-over age group. These findings would greatly assist in formulating policies to deal with this scourge of society.

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OBJECTIVE: The study was initiated to establish guidelines for the application of theory-based health promotion strategies in diet and exercise behaviour. The selected theory is the Trans-theoretical Model of Behaviour Change. The study utilizes three of the core constructs of the trans-theoretical model: the stages of change (the central organizing construct); decisional balance; and self-efficacy in examining fruit and vegetable consumption and exercise participation among adults 18 to 65 years old. The qualitative results are highlighted in this report. METHODS: The qualitative phase of the study was conducted in four countries: Belize, Jamaica, St.Kitts/Nevis and Trinidad and Tobago. Between 7 and 10 focus group discussions were conducted in each country. The variables for selecion of participants were: age range, gender, obesity stage, residential location and socio-economic status. RESULTS: The qualitative phase results indicated that, in the population studied, size was a very important determinant of perceived beauty, social adequacy, functioning and responsiveness. Knowledge relating to lifestyle is high but there is reluctance to effect lifestyle changes in dietary intake and physical activity. Cable television was identified as contributing to these current perceptions. Men were less concerned than women about their weight. Neither fruits nor vegetables were frequently mentioned as forming a part of daily diets of the majority of participants. Physical exercise was generally regarded ad hard work. CONCLUSIONS: The qualitative results of this study show that our approach to obesity prevention requires radical change. (AU)

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Reports findings of a study of researchers and community-based NGOs in Jamaica and a forum held to build stronger bonds between persons from the two groups. Presents the objectives of the project which were to: document and analyze research efforts on women and AIDS and the program experiences of NGOs with the aim of identifying progress in research and successful interventions that could be replicated in other settings; identify the lessons learned from existing collaborations between the research and action communities; conduct a forum in which researchers and NGOs could share their experiences and needs, as well as to identify ways to strengthen communication and collaboration. In addition disseminate to researchers, NGOs, policy makers, and donors at the national and international level, the findings from analyzing the progress in research and program experience, as well as the lessons learned from the collaborative process. Suggests the need for: training and educating women and men about HIV/AIDS; collaboration among NGOs, churches and public institutions; a central pool of research findings and materials; more research; and more funding for more programs(AU)

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