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DEVELOPING NICARAGUAN NURSES AS LEADERS IN CANCER PREVENTION AND CONTROL:
PREPARATION FOR A NURSE-MANAGED, COMMUNITY-BASED BREAST AND CERVICAL CANCER
PREVENTION AND CONTROL PROGRAM. Joan Such Lockhart, PhD, RN, CORLN, AOCN®,
and Leah Vota Cunningham, MNEd, RN, Duquesne University School of Nursing,
Pittsburgh, PA; and Carmen Benavidas, MPH, and Theodura Mercado, MS, UPOLI
School of Nursing, Managua, Nicaragua, NI.
Background/rationale/purpose: Prevention and control of breast and cervical
cancers has been cited as a health priority in developing countries such
as Nicaragua. Nicaraguan nurses can be leaders in improving breast and
cervical cancer outcomes for underserved, high-risk women in their country
by designing, implementing, and evaluating culturally appropriate cancer
prevention and control programs. Nicaraguan nurses need to develop competencies
in cancer control tailored to the needs of Nicaraguans in order to attain
and sustain this goal of cancer health.
The purpose of this presentation is to describe the development, implementation,
and evaluation of a breast and cervical cancer health course for Nicaraguan
nurses and physicians to help them become leaders in breast and cervical
cancer prevention and control. These efforts will be centered through
a nurse-managed clinic and targeted to high-risk women living in a Nicaraguan
barrio. Specific outcomes of the course included: 1) explore personal
beliefs/values related to breast/cervical cancer prevention and control,
2) strengthen competencies in these same areas, 3) develop culturally-appropriate
teaching materials, and 4) design a comprehensive plan for implementing
a breast and cervical cancer health program.
Interventions: Course content and teaching strategies were planned by
U.S. cancer nurses in partnership with Nicaraguan colleagues, and modeled
after past successful projects and cancer control programs. The course
served as the first step in a two-phase funded project and included 37
nurses and two physicians. Content included cancer, prevention and control
concepts, personal meanings of cancer, Nicaraguan folk practices, and
informed consent. Culturally appropriate teaching strategies included
focus groups, discussions, group work, skill demonstrations, and clinical
visits. A Spanish cancer resource library was developed.
Interpretation: Attainment of course outcomes was determined by pre-tests/post-tests,
observation of breast examinations and PAPs, and project team daily self-evaluations.
Participants developed realistic intervention plans to be implemented
in phase 2. These evaluations and those conducted six months post-course,
were positive and reflected attainment of outcomes.
Discussion: This collaborative international course model can assist other
oncology nurses interested in developing nurses from other countries as
leaders in cancer prevention and control, and in targeting other cancers
in an attempt to improve global cancer health.
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