School of Nursing
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This collection contains pre-prints and post-prints of journal articles written by selected York University Nursing faculty.
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Item Open Access Applying Parse's Theory to Perioperative Nursing(AORN Journal, 1990-03) Mitchell, Gail; Copplestone, ChristinaItem Open Access Discipline-specific inquiry: Exploring the hermeneutics of theory-guided nursing Research(Nursing Outlook, 1994) Mitchell, GailItem Open Access Waiting: The experience of persons in a critical care waiting room(Research in Nursing & Health, 2002) Bournes, Debra A.; Mitchell, GailThe purposes of this study were to discover the essences of the experience of waiting, to provide new knowledge about what it is like to wait, and to contribute to nursing knowledge. Participants were 12 persons who were family members or friends of persons in an adult critical care unit. The Parse research method was used to answer the research question:What is the structure of the lived experience of waiting? The central ending of this study was this structure: The lived experience of waiting is a vigilant attentiveness surfacing amid an ambiguous turbulent lull as contentment emerges with uplifting engagements. The structure is discussed in relation to nursing knowledge and in relation to how it can inform future research and practice.Item Open Access The language of loss when a baby dies prior to birth: Cocreating human experience(Sage Publications, Inc., 2005) McMahon, E.; Jonas-Simpson, ChristineWhen a baby dies prior to birth, a woman and her family begin a life long journey of living and transforming with loss. The language used with families during times of devastating loss is important to reflect upon since, language has the potential to either intensify suffering or enhance the family’s experience of grieving. Words that affirm the meaning the baby holds for the family can provide comfort as families engage with the reality of lost hopes and dreams. Recognizing that healthcare professionals do not intend to harm families whose babies die prior to birth, the current authors offer this column as a vehicle for reflecting on the meanings of words used during this particular time of loss and grief. The authors further explore the role that the arts have to play in expressing loss and in helping others to understand.Item Open Access Giving Voice to Expressions of Quality of Life for Persons Living With Dementia Through Story, Music, and Art(Lippincott Williams & Wilkins, Inc., 2005-01) Jonas-Simpson, Christine; Mitchell, Gail J.The purpose of this qualitative descriptive study was to give voice to expressions of quality of life for persons who live with dementia and who reside in long-term care, primarily on locked cognitive support units.With the assistance of music and art therapists, mediums of music and art were offered as a way for participants to further describe their quality of life. Eight key messages emerged from the descriptions about what life was like for the 17 participants: feeling content, importance of relationships, choosing an attitude for living on, feeling worthy, wishes for freedom amid restrictions, living with loss, struggles with thinking and communicating, and persisting with life patterns. The open-ended questions used in this study may be considered for future research as well as in practice with persons who live with dementia even in the latter part of their journey. Ultimately, it is hoped that the findings described here will enhance understanding of what life is like for persons living with dementia, in order to diminish any unnecessary suffering that can emerge with lack of understanding.Item Open Access The possibility of changing meaning in light of space and place(Sage Publications, Inc., 2006) Jonas-Simpson, ChristineThe author considers the possibility of changing meaning in light of space and place. Many questions are raised, including a fundamental question: If we simply choose the meaning of space and place based on personal knowing, regardless of the space and place we are in, does space and place really matter with regard to the possibility of changing meaning? Many possibilities of changing meaning in light of space and place are explored, including the influence of personal knowing, new life experiences and understandings, changes to space and place, unique languaging in space and place, imaging space and place, and engaging in the wonder and mystery of space and place beyond this realm. The possibility of changing meaning is significant in that new meanings open doors to different choices—and living choices is living health.Item Open Access Photo Elicitation Interview (PEI): Using Photos to Elicit Children’s Perspectives(Sage Journals, 2006-09) epstein, iris; Baruchel, Sylvain; Stevens, Bonnie; McKeever, PatriciaWhen conducting photo elicitation interviews (PEI), researchers introduce photographs into the interview context. Although PEI has been employed across a wide variety of disciplines and participants, little has been written about the use of photographs in interviews with children. In this article, the authors review the use of PEI in a research study that explored the perspectives on camp of children with cancer. In particular, they review some of the methodological and ethical challenges, including (a) who should take the photographs and (b) how the photographs should be integrated into the interview. Although some limitations exist, PEI in its various forms can challenge participants, trigger memory, lead to new perspectives, and assist with building trust and rapport.Item Open Access Perspectives of homeless people on their housing needs and approaches to ensure success(Common Ground Publishing, 2008) Daiski, IsoldeRecently there has been much public discourse on homelessness and its impact on health and quality of life. Housing is a major determinant of health and strategies are sought to get people off the streets. For maximum success it is important to first determine accurately the needs of those to be housed. As they live their own situations, their perspectives should be considered to ensure success. This paper discusses the findings from a research study on perspectives of homeless people regarding their experiences of homelessness. The research question was: What supports are needed for homeless people to get off the street? The study discussed is qualitative, descriptive, exploratory. Semi-structured interviews were conducted with homeless individuals in a large Canadian city in 2005, regarding their needs and possible solutions to end homelessness. A thematic analysis was carried out on the data. Findings show that individuals’ experiences of homelessness deeply impact all aspects of their lives. Many barriers prevent the homeless from escaping the streets. The welfare system in place was often perceived as disabling and dehumanizing rather than helpful. Service provisions were frequently inappropriate and therefore unsuccessful. Those homeless for a long time fell into patterned cycles of shelter / street life, temporary employment / unemployment and sometimes temporary housing. Participants described the fragmented services provided as ineffective. They had many suggestions for strategies to avoid or escape homelessness. For service providers a power with rather than power over model of collaborative advocacy is proposed to serve this population more effectively, preserve / restore their dignity and invest resources wisely.Item Open Access Living with changing expectations for women living with high-risk pregnancies: A Parse method study(Sage Publications, Inc., 2009) Jonas-Simpson, Christine; MacDonald, C.The purpose of this research was to uncover the structure of the lived experience of living with changing expectations from the perspectives of women with high-risk pregnancies. The researchers’ nursing theoretical perspective is the humanbecoming theory and the Parse research method was used. For the participants, living with changing expectations is foreboding disquietude arising with arduous restrictions, while envisioning the yearned-for with mitigating nurturing engagements. Findings enhance the theory of humanbecoming as well as enhance understanding of the experience of living with changing expectations. Recommendations for future research and practice are discussed.Item Open Access Why did baby die?: Mothering children living with the loss, love and continuing presence of a baby sibling(2010) Jonas-Simpson, ChristineWhy did baby die?: Mothering children living with the loss, love and continuing presence of a baby sibling captures the profound impact children have on a mother’s grief after the loss of her baby. In this research-based documentary mothers also tell how young children respond to the loss of their baby sibling. Despite the permanence of the physical loss, children continue to connect with their deceased siblings in various ways while creating new meanings of their experience of loss and love which they carry into adolescence.Item Open Access Nurses Grieve Too: Insights into Experiences with Perinatal Loss(2010) Jonas-Simpson, Christine; MacDonald, Cindy; McMahon, Eileen; Pilkington, F BerylNurses Grieve Too: Insights into Experiences with Perinatal Loss is a ground-breaking documentary that shares what grief is for nurses who care for bereaved families with perinatal loss. This research-based documentary answers the research question: What is experience of grieving, for obstetrical and neonatal nurses caring for families who experience perinatal loss? Nurses describe the professional and personal impact of grieving, what helps them and how the experience has changed them and help them to grow. The documentary makes the invisible grief of nurses - visible. It aspires to support nurses so they no longer feel alone or isolated in their experiences of grieving, as many nurses can carry the pain and memories of the families’ loss and experiences with them for years.Item Open Access Awakening to space consciousness and timeless transcendent presence (when caring for persons who are living dying or deeply grieving)(Sage Publications, Inc., 2010) Jonas-Simpson, ChristineSpace consciousness is emerging as significant and necessary for the evolution of humanity according to spiritual teacher, Eckhart Tolle. Through space consciousness people become aware that we are timeless transcendent presence. This awareness is pronounced when with those who are living dying and their close others who are deeply grieving. Space consciousness and transcendent timeless presence in the context of living dying and deeply grieving are explored using nurse theorists’ works in dialogue with Tolle’s teachings.Item Open Access Metamorphosis: A Story of Loss, Transformation and Abiding Love(The Centering Corporation, 2011) Jonas-Simpson, ChristineItem Open Access Acute care for elders components of acute geriatric unit care: systematic descriptive review(Wiley, 2013-06) Fox, Mary T.; sidani, souraya; Persaud, Malini; Tregunno, Deborah; Maimets, Ilo; Brooks, Dina; O'Brien, Kelly KOBJECTIVES: To describe the Acute Care for Elders (ACE) model components implemented as part of acute geriatric unit care and explore the association between each ACE component and outcomes of iatrogenic complications, functional decline, length of hospital stay, nursing home discharges, costs, and discharges home. DESIGN: Systematic descriptive review of 32 articles, including 14 trials reporting on the implementation of ACE components or the effectiveness of their implementation in improving outcomes. Mean effect sizes (ESs) were calculated using trial outcome data. Information describing implementation of the ACE components in the trials was analyzed using content analysis. SETTING: Acute care geriatric units. PARTICIPANTS: Acutely ill or injured adults (N = 6,839) with an average age of 81. INTERVENTIONS: Acute geriatric unit care was characterized by the implementation of one or more ACE components: medical review, early rehabilitation, early discharge planning, prepared environment, patient-centered care. MEASUREMENTS: Falls, pressure ulcers, delirium, functional decline, length of hospital stay, discharge destination (home or nursing home), and costs. RESULTS: Medical review, early rehabilitation, and patient-centered care, characterized by the implementation of standardized and individualized function-focused interventions, had larger standardized mean ESs (all ES = 0.20) averaged across all outcomes, than did early discharge planning (ES = 0.17) or prepared environment (ES = 0.11). CONCLUSION: Specific ACE component interventions of medical review, early rehabilitation, and patient-centered care appear to be optimal for overall positive outcomes. These findings can help service providers design and evaluate the most-effective ACE model within the contexts of their respective institutions to improve outcomes for acutely ill or injured older adults.Item Open Access Nursing students’ experiences on blogging in the classroom: Linking between ethics and pedagogy(Sciedu Press, 2014-01) epstein, iris; Ray, AshleighThis paper reports students’ perspectives on using blogging in an undergraduate nursing classroom. Blogging refers to a series of entries with limited word count. Several anecdotal reports focus on the potential advantages (e.g., increasing students' writing, reflecting, collaborating, participation and critical thinking skills) of blogging in education. Yet limited reports discuss its challenges. We argue that in order to better understand the use of blogging in the classroom we need to look more closely at students’ values, beliefs and expectations. Thus, to better understand teaching and learning and evaluate blogging we used Gesler’s theory of therapeutic landscape. Students’ retrospective accounts revealed two overarching themes: students’ experiences and students’ responses to blogging. Despite the fact that students experienced and valued blogging in their everyday lives, their responses to in-class blogging were not always positive.Item Open Access Meaningful support for lesbian and bisexual women navigating reproductive cancer care in Canada: An exploratory study(Sage, 2016-05) Legere, Laura; MacDonnell, Judith A.Health inequities for sexual minorities are well documented, but there is a gap in nursing research addressing the specific experiences faced by lesbian and bisexual women with reproductive cancers. This critical feminist study explored interactions between sexual minority women with reproductive cancers and their health care providers and how these interactions enable and create barriers to meaningful support. Purposeful convenience sampling was used to recruit lesbian and bisexual reproductive cancer survivors from Ontario, Canada and providers who have cared for this population. Five lesbian and one bisexual woman who were reproductive cancer survivors participated, as well as one registered nurse who was not a survivor but who has cared for sexual minority women with reproductive cancers. Face-to-face interviews were conducted and conventional content analysis was used to analyze the data. The authors report on findings related to meaningful support, interactions with providers and organisational environments. Narratives showed that an understanding of gender norms influenced women’s perceptions of supportive and inclusive care, such as the acknowledgment of social supports and barriers to supportive care that included disclosure of sexual orientation. There are implications for nursing education and policy change to enhance inclusive interactions and environments for diverse sexual minority women with reproductive cancers.Item Open Access Nurses’ Perspectives on How Operational Leaders Influence Function-Focused Care for Hospitalized Older People(Journal of Nursing Management, 2016-09-16) Fox, Mary; Butler, JeffreyAims. To explore nurses’ perspectives on how leaders influence function-focused care (FFC), defined as care that preserves and restores older people’s functional abilities. Background. Hospitalized older people are at risk of functional decline. Although leaders have the potential to influence FFC, few studies explored nurses’ perspectives on how leaders influence FFC. Methods. Thirteen focus groups were held with 57 acute care nurses. Semi-structured questions prompted discussion on nurses’ perspectives, needs and strategies to meet their needs. Data were thematically analyzed. Results. Three themes were identified: 1) the emphasis in hospitals is on moving older people quickly through the system, not supporting their functioning; 2) leaders are generally seen as too disconnected from practice to design system efficiency initiatives that support older people’s functioning and nurses’ provisioning of FFC; and 3) leadership strategies to better support nurses in providing FFC to older people in the context of system efficiency. Conclusions. Leaders should connect with practice to devise age-sensitive efficiency initiatives that support FFC. Nurses need support from leaders in four areas to provide FFC to older people in the current hospital context. Implications. Findings provide direction on how leaders can facilitate FFC in the current healthcare environment emphasizing system efficiency.Item Open Access The practice and teaching of palpation of the head and neck: A scoping review(Sciedu Press, 2017-07) epstein, iris; Herne, P.; Masita, S.; Peisachovich, E.; Eliadis, M.; Robinson, B.; Lee, C. P.; Grosman-Rimon, L.; Silva, C.Objective: To explore how palpation of the head and neck is practiced and taught. Methods: The scoping review methodology was guided by Arksey and O’Malley’s five-stage approach. Three experienced and independent reviewers searched nine databases according to a predetermine inclusion and exclusion criteria. Results: A total of 15 articles from medicine, chiropractic and dentistry published between 1987 and 2016 were included. Two overarching themes emerged, a Cartesian and a Pragmatic perspective in practicing and teaching palpating of the head and neck. Although both perspectives are valuable, we advocate to practice and teach palpation of head and neck from a Pragmatic perspective particularly with the increase use of ultrasound technology to detect masses. A pragmatic perspective takes into account the patient’s context, the ethics of care and highlights the importance of health care providers fostering interpersonal relationships with others during physical assessment. Conclusions: Although nursing studies were absent from this review we believe nurses play a vital role when they are aware of the Cartesian and Pragmatics perspectives when practicing and teaching head and neck palpation as part of a physical assessment. Learning how other disciplines are practicing and teaching head and neck palpation skills will improve interdisciplinary collaboration.Item Open Access The Relationships Between the Geriatric Practice Environment, Nursing Practice, and the Quality of Hospitalized Older Adults’ Care(Journal of Nursing Scholarship, 2018-07-26) Fox, Mary; McCague, Hugh; sidani, souraya; Butler, JeffreyPurpose. To test the relationships between the geriatric practice environment, geriatric nursing practice, and the overall quality of care for older adults and their families as reported by nurses working in hospitals, while controlling for nurse and hospital characteristics. Design. A cross-sectional tailored survey design was employed. A questionnaire was mailed to a randomly selected sample of nurses whose primary practice area was medicine, surgery, geriatrics, emergency, or critical care in acute care hospitals in Ontario, Canada. Methods. Participants (n = 2005) working in 148 hospitals responded to validated measures of the geriatric practice environment, geriatric nursing practice, overall quality of care for older adults and their families, and nurse and hospital characteristics. The relationships were tested using structural equation modeling. Findings. Controlling for nurse and hospital characteristics, the geriatric practice environment had a statistically significant positive relationship of large magnitude with both geriatric nursing practice (β= 0.52) and overall quality of care (β= 0.92); however, the indirect relationship between the geriatric practice environment and overall quality of care, mediated by geriatric nursing practice, was not significant (β = -0.02). Final model fit was acceptable with the Root Mean Square Error of Approximation = 0.07, Comparative Fit Index = 0.93, and Tucker-Lewis Index = 0.87. Conclusions. A strong geriatric practice environment positively and directly influences geriatric nursing practice and overall quality of care for older adults and their families but does not appear to influence overall quality of care indirectly through geriatric nursing practice. Clinical relevance: The results can be used as the basis for promoting practice environments that support overall quality of care and geriatric nursing practice in acute care hospitals.Item Open Access Refugee smartphone access to health care in Canada: Concept analysis(Sciedu Press, 2019-01) epstein, iris; Nguyen, Jade; Balaquiao, Lorivie; Chang, Kai YaObjective: With the ever-changing smartphone healthcare technology also comes nurses’ responsibilities to recognize its ethical implications particularly among vulnerable population. The aim of this paper is to explore what we know about the use of smartphone to access health care among refugees and new immigrants. Methods: We were guided by Walker and Avant (2011) concept analysis methodology. Concept analysis is a rigorous method to better understand ethical implications, meaning, attributes, antecedents and consequences of smartphone access to health care. Diverse databases were included such as CINAHL, Journals@Ovid, ProQuest Nursing & Allied Health Source, ProQuest Psychology Journals, PsychINFO, ERIC, and Education Full Text. Results: The concept analysis retrieved 23 studies. Overarching themes included the physical (e.g. income, geographical location) and social (generation; access to regular internet; digital literacy; relationship with practitioners) that were attributed to refugee and new immigrant access to health care. Conclusions: Some of the ethical implication when using smartphone to access health care technology with refugees and new immigrants are discussed and the skills needed for nursing practice are identified and recommendations for nurse education and research are made.