Nurses and multicentric research on the drug henomenon in the americas: benefits and challenges

Los enfermeros y la investigación multicéntrica en el fenómeno de las drogas en las américas: beneficios y desafíos

Enfermeiros e a pesquisa multicêntrica no fenômeno das drogas nas américas: benefícios e desafios

EXPERIMENT REPORT

Nurses and multicentric research on the drug henomenon in the americas: benefits and challenges

Enfermeiros e a pesquisa multicêntrica no fenômeno das drogas nas américas: benefícios e desafios

Los enfermeros y la investigación multicéntrica en el fenómeno de las drogas en las américas: beneficios y desafíos

Catherine Caufield^I; Julie Gilbert^II; Vera Radünz^III; Joanne Olson^IV

^IRegistered Nurse. Philosophy Doctor. Assistant Professor at the Faculty of Nursing, University of Alberta, Edmonton, Canadá

^IIRegistered Nurse. Master's of Nursing. International Coordinator & Faculty Lecturer. Faculty of Nursing. University of Alberta

^IIIRegistered Nurse. Philosophy Doctor. Professor at the Nursing Department and Graduate Program in Nursing at the Federal University of Santa Catarina/Brasil. Vice-coordinator of the Research Group Caring&Comforting, PEN/UFSC

^IVRegistered Nurse. Philosophy Doctor. Professor and Associate Dean. Undergraduate Programs at the University of Alberta. Edmonton, Canada

^Endereço

ABSTRACT

This manuscript describes a multicentric research experience in the area of nursing and health. It briefly outlines the aims of the first International Program for Nurses to Study the Drug Phenomenon in the Americas, which brought eleven nursing professors from seven Latin American countries together with Canadian nursing professors to focus on research in the area of drug demand reduction. The manuscript explores the benefits and the challenges of planning research projects in a foreign context and carrying them out across several distant geographical sites.

KEYWORDS: Nursing research. Health. Street drugs.

RESUMO

Este artigo descreve a experiência de uma pesquisa multicêntrica em enfermagem e saúde. Pontua os objetivos do Primeiro Programa Internacional para Enfermeiros no Estudo do Fenômeno das Drogas nas Américas, no qual onze enfermeiras de sete países da América Latina se encontraram com enfermeiras docentes do Canadá, para dar enfoque à pesquisa na área de redução da demanda de drogas. O artigo explora principalmente os benefícios e os desafios de planejar projetos de pesquisa num contexto fora do país de origem, para posteriormente desenvolver os mesmos em diversas e distantes localizações geográficas.

PALAVRAS-CHAVE: Pesquisa em enfermagem. Saúde. Drogas ilícitas.

RESUMEN

Este artículo describe la experiencia de una investigación multicéntrica en la enfermería y la salud. Comienza con un breve resumen de las metas del primer programa internacional para los enfermeros en el estudio del fenómeno de las drogas en las Américas. Este programa juntó once profesoras de enfermería de siete paises latinoamericanos junto a profesores de enfermería de Canadá, cujo enfoque fue la reducción de la demanda de las drogas. El artículo explora principalmente los beneficios y los desafíos en la planificaciòn de proyectos de investigación en un contexto fuera del pais de origen, y así desenvolver éstos en los diferentes y distantes lugares geográficos.

PALABRAS CLAVE: Investigación en enfermería. Salud. Drogas ilícitas.

INTRODUCTION

The drug phenomenon is an international health issue which does not respect international borders, cultures, economic settings or political ideologies. In the Americas the drug phenomenon constitutes a social and health problem with originating factors at both national and international levels. Management of the drug phenomenon requires extensive planning involving health promotion and research, interdisciplinary exchange of knowledge and capacity building efforts.¹

Living in a global world, we must take into account that having an understanding international politics related to the drug phenomenon can lead nursing professionals to gain a broader vision and conceptualization of the problems and issues implicit in the complex global drug phenomenon. This broader vision assists nurse's actions to be connected with global dynamics, despite cultural differences.² It also had to take into account the necessity of re-thinking and sharing, and to negotiate cultures.³ This paper will reflect on the experience of doing multicentric research involving several nurse researchers from different cultures and countries, pointing out the challenges and benefits.

CICAD: SCHOOLS OF NURSING PROJECT

Inter-professional exchanges for curriculum development and research training are common activities of international development projects. The Inter–American Drug Abuse Control Commission (CICAD) of the Organization of American States (OAS) through its Schools of Nursing Project is dedicated to creating a cadre of nursing professionals with scientific knowledge and technical skills to work internationally on drug demand reduction through: a) prevention of drug use and abuse; b) social integration; c) health promotion.

The goal of this project is to impact on foreign and national policy to improve the health of populations in Latin America and contribute to sustainable global development. The Schools of Nursing Project is comprised of three main components: education, extension and research.

The education component involves the development of undergraduate and graduate nursing curricula on drug issues and implementing national and international research capacity-building programs for Latin American nursing faculty. The extension component involves outreach community education programs and creating nurse-run centers for the prevention of drug use. The research component involves developing multicentric and transnational nursing research projects in drug demand reduction.

INTERNATIONAL RESEARCH CAPACITY-BUILDING PROGRAM FOR NURSES TO STUDY THE DRUG PHENOMENON IN THE AMERICAS

In June 2003, the Faculty of Nursing, University of Alberta (Edmonton, Alberta, Canada) welcomed eleven faculty members from Argentina, Ecuador, Chile, Colombia, Mexico, Peru and Brasil to the first International Research Capacity-Building Program for Nurses to Study the Drug Phenomenon in the Americas. This program was funded by the Government of Canada through CICAD. It was comprised of three parts: Part One, lasting ten weeks, included training in English as a second language and course work in international health, the drug phenomenon and research methodology. The major outcome of part one was the completion of four proposals for multi-centric nursing research in drug demand reduction. Each of the research proposals was required to pass the rigorous process of the Health Research Ethics Board at the University of Alberta as well as the Ethics Committees in the home countries of participants. Part Two was the implementation of the research projects in the home countries of the participants. Part Three was the dissemination of the findings of the research at the 2004 International Annual Meeting of CICAD Schools of Nursing Project and through peer-reviewed professional journals both nationally and internationally.

Despite the demanding learning schedule for the visiting professors during Part One, social and cultural events were planned and enjoyed. Regular social activities provided welcome respite during this period of intense coursework and research proposal preparation.

BENEFITS

Completing four multicentric nursing research projects in drug demand reduction was an articulated goal of the program and a clear benefit. These four projects addressed the multiplicity of factors inherent in the drug phenomenon:

- "Health Promotion and Quality of Life Among Mothers of Preadolescents in Argentina, Brazil, Chile and Canada: A Focused Ethnography Proposal," by Alicia Ludueña (Argentina), Maria do Horto Fontoura Cartana (Brazil), Vera Radünz (Brazil), Julia Huaiquian Silva (Chile), and Joanne Olson (Canada), examined how mothers influence their preadolescent's choices and protect their youth regarding risk behaviours such as alcohol, tobacco, other drugs, and violence;

- "Drug Consumption and Workplace Violence in Women Workers: Multicentric Study in Latin America. Mexico - Peru - Brazil, 2003", by Helena Schlerowski Leal David (Brasil), María Magdalena Alonso Castillo (Mexico), Flor Yesenia Musayón Oblitas (Perú), and Catherine Caufield (Canada), explored the possibility of a relationship between drug consumption and workplace violence in working women of popular classes;

- "Perceptions of the Mothering Role for Women Living in the Context of Drugs and Violence," by Maria del Carmen Bernal Roldán (Colombia), Sueli Aparecida Frari Galera (Brazil), and Beverley O'Brien (Canada), studied the perceptions of Brazilian and Columbian women about the influence of living in the context of drugs and violence on their maternal role;

- "The relationship between Drug Use and Violent Behaviour in Two Universities in Brazil and Ecuador," by Sandra Pillon (Brazil), Ketty Araceli Piedra Chávez (Ecuador), and Beverley O'Brien (Canada), described relationships that exist between drug use and violent behaviours in first year students attending two universities in Brazil and Ecuador.

The program created opportunities to establish professional partnerships among the Latin American faculties of nursing as well as with the University of Alberta, Faculty of Nursing. Many bridges were built and much global good will was generated as a rich variety of cultures came together both professionally and socially.

In addition to these multicentric nursing research proposals, the opportunity to have professionals from seven Latin American countries involved in the project, interacting daily with each other and their Canadian hosts in Part One of the project, created the opportunity for rich intercultural growth experiences. The impact for the participant's personal and professional lives, their schools, their countries, and their commitment to drug demand reduction is immeasurable. There is potential for the consequences of the initial ten weeks to have a ripple effect for many years to come as links were forged that continue to be rich sources of collaboration on new multicentric nursing research projects.

CHALLENGES

English was the official language of the project in Edmonton. The languages represented by the eleven participants were Spanish, Portuguese and varying amounts of English. To think in one language, to read in another and to speak in a third proved to be very challenging and exhausting for all participants.

Communication continued to be a challenge over distance. A variety of strategies were utilized, ranging from telephone calls, conventional mail and faxes to emails, WebCT and chat rooms. Communication was facilitated when participants could communicate in more than one language.

The amount of learning required when one enters another culture is immense. Participants found that in Part One, adjusting to the meaning of time, food, the use of phones, facilities, transportation and communication were a few examples of the daily learning required of the professors above and beyond their formal studies. In addition, the participants of the program had to deal with the loss of their identity as nursing professors as they were challenged to assume a student role in this new and foreign environment. Remaining healthy in a situation that had cultural, intellectual, and emotional challenges was very difficult. Uneven health coverage added stress for participants and program administrators. However, by ensuring sufficient amounts of rest, exercise and socializing, the group generally maintained a good level of health.

Despite the challenges, it was found that meshing differences in meaning within differing cultural contexts was a real strength of the program. Allowing and recognizing vulnerability while living in a different culture within a multicultural group was important in establishing intercultural dialogue. This dialogue expanded cultural understanding and increased the knowledge of the participants about themselves and about their own culture.⁴ This multicentric collaboration enhanced the richness of the data obtained in the nursing research projects and provided a depth to the outcomes which would otherwise not have been possible.

CONCLUSION: FUTURE IMPLICATIONS

The first International Research Capacity-Building Program for Nurses to Study the Drug Phenomenon in the Americas offered at the Faculty of Nursing at the University of Alberta as part of the CICAD Schools of Nursing project presented a rich learning experience for all involved. Recommendations for future programs include entering the program with a minimum level of the official language of the host country, a mandatory health plan that is consistent for each participant, a week of adjustment time after arriving in the host country before beginning the program, and more structured opportunities for becoming familiar with the professional backgrounds of researchers from all of the countries involved.

This article mainly explored the benefits and challenges in planning research projects, and working with a multicultural group. In our opinion it is important that these benefits and challenges be considered when engaging in the development and conduct of multicentric research.

Recebido em: 15 de maio de 2006

Aprovação final: 16 de outubro de 2006

• 1 Wright MGM, Chisman AM, Gallegos EC, Gonzalez BCS, Ortega SE, Castillo MA; organizadores. Los nuevos programas de doctorada enfermeria y su contribucion en la reduccion de la demanda de drogas en America Latina: retos y perspectivas. Washington (D.C/USA): UANL; 2003.
• 2 Carraro TE, Santos SMA, Fenile RM, Radünz V. O fenômeno das drogas e as macropolíticas agências e tratados internacionais. Texto Contexto Enferm. 2004 Abr-Jun; 13 (2): 290-5.
• 3 Teixeira MA, Nitschke RG, De Gasperi P, Siedler MJ. Significados de avós sobre a prática do aleitamento materno no cotidiano familiar: a cultura do quererpoder amamentar. Texto Contexto Enferm. 2006 Jan-Mar; 15 (1): 98-106.
• 4 Gilbert J. Reflecting on intercultural dialogue in nursing. Texto Contexto Enferm. 2006 Jan-Mar; 15 (1): 131-6.

Publication Dates

• Publication in this collection
  12 Nov 2007
• Date of issue
  Dec 2006

History

• Accepted
  16 Oct 2006
• Received
  15 May 2006