Nursing

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https://hdl.handle.net/10315/28619

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Open Access
A Secondary Analysis of the Differences in Accessing Health and Social Services Between Ethnically Diverse Individuals and the Mainstream Society
(2015-08-28) Ngo, Huy; Samuels-Dennis, Joan
Background: Mental illness is the third leading cause of disability and premature death in Canada. Research shows that access issues are a major concern, especially ethnically diverse individuals who may experience greater barriers. Purpose: This study is a secondary analysis that compares health and social service access difficulty, perceived barriers, and service effectiveness between mainstream and ethnically diverse individuals living with mental illness. Results: There were no significant differences between level of access difficulty, and perceived barriers between the ethnically diverse individuals and the mainstream society differentiated by race, but a significant difference was found in perceived service effectiveness between Caucasians born in Canada and ethnically diverse individuals born outside of Canada accounting for race and birth country. Discussion: Individuals living with mental illness experience comparable levels of access difficulty, barriers and service effectiveness. Additional studies with larger sample sizes from different socio-economic backgrounds are needed to strengthen this conclusion.
Open Access
An Exploration of Work Related Mental Health Issues Experienced by Rural Emergency Nurses
(2017-07-27) Dekeseredy, Patricia Lynn; Landy, Christine Kurtz
Nurses working in rural emergency departments (ED) are exposed to trauma, pain, and suffering on a daily basis. They care for members of their community, including friends and neighbours in an unpredictable environment with limited resources. These contextual factors not only have a negative impact on provision of quality patient care, but also create very stressful work environment putting these ED nurses at high risk for experiencing emotional trauma. This exploratory, qualitative descriptive study used semi-structured interviews to investigate the experiences of rural emergency nurses. A qualitative content analysis was used to analyze the interviews. Findings describe the impact their work experiences had on the nurses mental health and illuminate factors that could contribute to the development of compassion fatigue, burnout and PTSD. Findings will be used to inform future research into early recognition and resiliency programs to mitigate the effects of occupational mental health issues for rural emergency nurses.
Open Access
Asian Adolescent Experiences of Health-Related Stigma During the Covid-19 Pandemic
(2024-07-18) Hasan, Nasteho Husen; Khanlou, Nazilla
Background: The COVID-19 pandemic, which took place between March 2020 and May 2023, has significantly impacted people’s lives. Individuals with COVID-19, like other infectious diseases, are at risk for stigmatization related to their health status. As a group, Asian Canadians faced increased racism and discrimination during the pandemic in relation to prejudicial attitudes on spread and contagion of the disease. Methods: This study used Interpretive Descriptive methodology to explore the experiences of Asian Canadian adolescents who have had COVID-19 through one-on-one interviews virtually and in person. Prior to the interview, participants filled out informed consent forms and demographic forms to obtain background information. The interviews were conducted between February 2023 and August 2023. Afterwards, the data was analyzed into codes and themes. Results: The sample consisted of eleven Asian Canadian adolescents between the ages of 16 and 19-years old living in Ontario. Seven participants identified as female, three identified as male and one participant identified as non-binary. The participants reported facing stigmatization related to their positive COVID-19 status, their Asian identity, and their age. The findings were organized using the Health Stigma and Discrimination Framework (HSDF), which conceptualizes health-related stigma into drivers and facilitators, intersecting stigmas, manifestations, and outcomes. Drivers and facilitators included attitudes about people with COVID-19, Anti-Asian racism, the media and social media and time of infection. The intersecting stigmas were ageism and racism. Manifestations included negative reactions from others, anti-Asian experiences, and internalized stigma. Lastly, outcomes included the mental health consequences of racism and worsened academic performance. Challenges while isolating included difficulties keeping up with schoolwork and isolation. Positive mediators included peer and familial support and being able to access information about COVID-19 Conclusions: Asian Canadian adolescents faced complex experiences and challenges during the pandemic related to their intersecting identities including stigmatization due to their COVID-19 status, as well as racism due to their Asian background and ageism from older individuals. Understanding these experiences can better inform the services provided to this population and decrease the risks and effects of stigmatization.
Open Access
Can Practical Knowledge About Medication Safety be Simulated Through a Learning Module for Nursing Students
(2015-08-28) Krunic, Tanja; Singh, Mina
Purpose: To evaluate the effectiveness of introducing an online learning module to nursing students in the fourth year of a BScN program as a way of (a) increasing student knowledge of specific system factors and their role in medication errors; and (b) increasing student perceptions of competence in identifying specific system factors which contribute to medication errors. Methods: An experimental, prospective, single-blind, pretest posttest design was used. Conclusion: There were no significant differences in knowledge of system factors that contribute to medication errors between those students who participated both in the learning module and clinical experience compared to those students who participated in clinical experience only. Nursing students in fourth year of BScN program who participated in a learning module, in addition to clinical experience had greater perceived competence to identify system factors that contribute to medication errors than students who participated in clinical experience only.
Open Access
Canadian Women's Contemporary Experiences Accessing Abortion
(2019-11-22) Lebold, Margaret; MacDonnell, Judith Ann
This thesis explores Canadian womens contemporary experiences accessing abortion. Abortion is a womens health issue, yet little nursing research addresses womens experiences or well-documented barriers to care. After Health Canadas approval of the abortion pill, Mifegymiso (RU-486) in 2015, women had an alternative to surgical abortion. This qualitative study uses narrative and critical feminist approaches, and purposive convenience sampling to explore Canadian womens experiences of abortion and access to care. Seven women over the age of 18, diverse in age, education, sexual orientation, geography and experience with medical or surgical abortion completed semi-structured interviews. Critical analysis illustrated the complex, varied meanings that abortion has for women, including the motherhood journey (regardless of whether or not they considered themselves mothers), the pivotal nature of support, and barriers to access. Implications for nursing include challenging the silence in research and augmenting reproductive justice approaches.
Open Access
Collaborating for Better Outcomes: Exploring the Link Between Nurse-Nurse Collaboration and Nurse Job Satisfaction
(2016-09-20) Sheehan, Sinead Mary; Jensen, Elsabeth
As Registered Nurses (RNs) are crucial to delivering care, it is important to determine the factors which contribute to a healthy work environment for nurses and positive outcomes for patients. Past research has focused on the benefits of nurse-physician collaboration including improved nurse/ patient satisfaction and lower patient mortality. The few studies which have explored nurse-nurse collaboration have linked it with positive outcomes. To determine whether there is a relationship between nurse-nurse collaboration and nurse job satisfaction in the hospital setting, this correlational study involved a convenience/ snowball sample of RNs working in hospitals, who completed the two study instruments (Dougherty-Larson Nurse-Nurse Collaboration Instrument [DLNNCI] and McCloskey Mueller Satisfaction Scale [MMSS]). The results indicated a significant, positive correlation between nurse-nurse collaboration and nurse job satisfaction (r = .569, p<.01). Collaboration between nurses is associated with nurse job satisfaction and may contribute to the development of a healthy work environment
Open Access
Companioning End-Of-life: Nurses' Experiences of Caring for the Child Who is Dying Through a Relational Ethics Lens
(2019-07-02) Deangelis, Karlie-Carmen; Jonas-Simpson, Christine M.
Caring for children who are dying requires exploration to understand and validate the meaning of this lived experience for nurses. This study uses a qualitative descriptive method to answer the research question: What is the meaning of caring for a dying child for nurses within their collective ethical commitments and responsibilities in neonatal and paediatric intensive care units? Relational ethics was the theoretical framework guiding this study, where semi-structured interviews were conducted with eleven intensive care nurses. Participants were also asked to provide an image that reflected the meaning of providing this care. Findings are presented in five thematic patterns: a) Careful cultivation of a team approach shapes end-of-life decisions; b) Resilience and affirming of self as nurse arise with alleviating suffering; c) Navigating sustained turmoil; d) Willingly sojourning in loving presence; and, e) Facilitating and valuing a familys role in their experience of end-of-life
Open Access
Describing how Expert Labour and Delivery Registered Nurses Work to Optimize Outcomes for Intrapartum Patients at Risk of Unplanned Caesarean Section
(2023-03-28) Katz, Jessica; Kurtz Landy, Christine
Unplanned caesarean section (c-section) births are common and can have significant negative psychological and emotional outcomes for patients. Expert labour and delivery registered nurses (L&D RNs) are well-positioned to anticipate the need for an unplanned c-section and to support at-risk patients. This qualitative interpretive descriptive study explored how expert L&D RNs anticipate unplanned c-sections and support those patients they deem to be at imminent risk of requiring the procedure. A purposive sample of 16 L&D RNs with minimum five years of L&D nursing experience in Ontario participated in semi-structured telephone interviews. Conventional content analysis was used to analyze interview data. Findings describe tacit knowledge used to anticipate unplanned c-sections, and therapeutic nurse-patient relationships developed to individualize support. The findings bring attention to tacit knowledge that expert L&D RNs use in practice and inform future research into the effectiveness of how expert nurses’ interventions support patients at risk of unplanned c-section.
Open Access
Exploratory Study of Documented Psychosocial Nursing Interventions within the Palliative Care Setting
(2017-07-27) Fowler, Sarah Kathleen; Lum, Lillie L. Q.
Further research is needed to better understand issues related to the provision of psychosocial care at end-of-life (EOL). Nursing documentation provides an effective strategy for assessing quality of care. The objective was to assess the quality of documentation processes for EOL care and to identify the degree to which a process-based approach was utilized. A case study qualitative design was applied through a retrospective chart review of the Powerchart documentation database. The process-based framework set out in the Nursing Role Effectiveness Model (NREM) and a modified version of the Quality of Documentation of Nursing Diagnoses, Interventions and Outcomes (Q-DIO) instrument were utilized to guide data collection and analysis. The majority of nursing documentation was of poor quality and statistically significant differences were noted between Q-DIO subsections. This study showed that nurses working in a palliative care setting vary in their ability to complete accurate high quality documentation of psychosocial care.
Open Access
Exploring the Attitudes, Beliefs and Practices Concerning Mental Health Amongst African Immigrant Youth Living in Canada: An Interpretive Description Study
(2018-11-21) Olawo, Omolola Olumayowa; Pilkington, Beryl F.
There has been limited research in Canada on the mental health of African immigrant youth. An Interpretive Description methodology was utilized to interview eight African immigrant youth on their attitudes and beliefs towards mental health, their mental health practices, and factors affecting their mental health. Themes that were identified surrounded transitioning into adulthood, between geographical locations, and between identities; protective factors, including resilience, religion, and hyper-masculinity, and the differing immigration experiences of African immigrant youth. This research brings attention to intersectional factors that play a role in the mental health of African immigrant youth, as well as gender differences in their mental health experiences. It also highlights the need for cultural humility in care as well as the importance of critical inquiry when interacting with immigrant populations. Implications for practice and future research are suggested to help advocate for and effectively treat African immigrant youth experiencing mental health challenges.
Open Access
If not us then who?: A focused ethnography exploring caring patterns among planetary health nurses.
(2023-12-08) Cairns, Steven James; Van Daalen-Smith, Cheryl
The environment in which nursing occurs is interdependent and dynamic in relation to people and their health circumstances. Planetary health challenges, such as climate change, pollution, deforestation, overfishing, and habitat destruction, are disproportionately experienced in certain geographies and act as threat multipliers to the health, welfare, and security of human and more-than-human species. Nurses, by virtue of their position, are increasingly confronting the health implications of social and economic inequity when people and populations rendered vulnerable struggle to adapt to and mitigate environmental changes. Working near those who suffer, nurses must understand that human health is interrelated with planetary health. This awareness should inform their role as care providers who can develop solutions to face the unprecedented challenges now and in the future. The urgency to protect the environment is reflected among planetary health-conscious nurses who demonstrate a broad nursing perspective that includes caring for those in need, human and more-than-human alike. The aim of this study was to interpret questions regarding the journeys, approaches, activities, and priorities of 14 registered nurses actively engaged in planetary health initiatives. A focused ethnographic methodology was employed, which included data from semi-structured interviews, participant observations, and arts-informed self-reflections. This data was analyzed using a reflexive thematic analysis to identify themes related to nurses’ experiences and approaches to planetary health. The results of this research have the potential to inform practice, policy, education, and research within the nursing profession. Additionally, this research serves to highlight the importance of empowering nurses to engage in planetary health initiatives as advocates for social and environmental justice.
Open Access
Impact of Social Support and Mentoring on Career Advancement of Internationally Educated Nurses
(2023-08-04) Venkatesa Perumal, Ramesh; Singh, Mina
Background: The upward growth in work level, position, and title, as well as the rise in compensation and income, is known as career advancement (CA). CA is the outcome of career preparation and supportive organizations. Both individual and organizational supports often influence CA among nurses in Canada. Mentorship and social support facilitate CA among nurses, and these supports are available differently to both Canadian Educated Nurses (CENs) and Internationally Educated Nurses (IENs) Purpose: This study identified the perceived impact of mentorship and social support on CA among CENs and IENs. Methods: Data were collected utilizing Organizational Career Growth Scale (OCG), Multidimensional Perceived Social Support (MPSS), and Mentoring Functioning Questionnaire (MFQ 9), from 127 nurses across three provinces, namely Ontario, Manitoba, and British Columbia who met the inclusion and exclusion criteria through an online survey. Results: There were 44 CENs and 83 IENs. The mean score of CENs on OCG was 65.24%, and for IENs, it was 67.68%. The mean score of MPSS for CENs was 76.61%, and for IENs, 73.65%. The mean score on MFQ 9 was 77.84% and 69.11% for CENs and IENs, respectively. There was a positive correlation between MPSS and MFQ 9 with OCG scores. The positive correlation was statistically significant for IENs. With the subscales of OCG, IENs had a statistically significant higher score in remuneration growth (RG) than CENs. In the career growth progress (CGP) subscale, CENs scored higher than IENs. Having a mentor with the title of RN and meeting the mentor regularly positively impacts OCG scores. Conclusion: CENs and IENs have a moderate level of perceived OCG, and IENs have higher scores than CENs. There are differences in the level of mentorship and social support available to CENs and IENs. Recommendations: Organizations/Employers must establish formal mechanisms to facilitate CA among nurses (both IENs and CENs). Coordinated efforts are necessary to help IENs overcome barriers to accessing support. Establishing formal mentorship programs at the workplace will facilitate better career growth among nurses that will help improve job satisfaction, retention, and, ultimately, quality patient care.
Open Access
Inpatient Mental Health: What Helps/Hinders the Transition into Communities?
(2020-08-11) Anderson, Jennifer Marie; Jensen, Elsabeth
The transition period is the most vulnerable period for patients transitioning from inpatient units to community settings (Coleman, Pincus, Epstein & Ofedahl, 2015). Patients with mental illness have unique needs and vulnerabilities, therefore increasing the need for improved coordinated transitional discharge plans (Coleman et al., 2015). The purpose of this study was to explore the transition experience of patients 18 years of age who transitioned into the community from an inpatient mental health unit. This study sought to understand the patients experience of present discharge models from a qualitative perspective. This study addressed a knowledge gap by exploring the consumer survivors voice. Expectations, the environment, level of planning and emotional and physical well-being were all important factors explored that helped and hindered the successful re-integration of patients living with mental illness into the community.
Open Access
Mental Health and Well-Being Among Tamil Youth of Sri Lankan Origin Living in Toronto: A Mixed Methods Approach
(2020-11-13) Shanmuganandapala, Babitha; Khanlou, Nazilla
Literature on the mental health of Tamil youth of Sri Lankan origin living in Canada is scant. In this study, I applied an interpretive descriptive approach to explore, discover, and understand the meanings, beliefs, practices, and experiences of health, well-being, and mental health of thirteen first and second-generation Sri Lankan Tamil youth. I used a convergent parallel mixed methods research design and applied an emancipatory approach to informing culturally competent mental health nursing practice, influenced by critical race, postcolonial feminist and intersectionality theories. Parents, the Tamil community and Tamil culture emerged as major themes reflecting the important roles they play in Tamil youths mental well-being. Experiences related to the Sri Lankan civil war/genocide and immigration appear to impact both collective and intergenerational trauma and resilience. Recommendations include applying a holistic, trauma-informed and integrated/multilevel approach, including traditional and collective methods of healing, capacity building and recognition/acknowledgement of the Tamil Genocide.
Open Access
Nurses' Perspectives when Working with Families while Delivering Function-Focused-Care to Older Adults in Acute Care Settings
(2017-07-27) Green, Whitney Nicole; Fox, Mary
Older adults are at increased risk for developing functional decline during hospitalization, putting them in danger of negative health outcomes including skin breakdown, impaired mobility and infections. Function-Focused-Care (FFC) is an approach to care designed to help prevent these adverse consequences in this patient population during hospitalization. Families are often present with older adults during their hospitalization but little research has explored nurses perceptions around working with families in FFC. This secondary analysis explored the perceptions of 57 nurses in working with families in delivering FFC to older adults in acute care settings. Two major themes were identified: 1) nurses perceived families as facilitating FFC, and 2) nurses identified families as constraining FFC. In conclusion, nurses viewed families as double-edged swords and described them as creating tension for nurses when caring for older adults. The findings from this study provide insight into the tension nurses experience when providing care for older adults and raises awareness about the importance of nurse-family collaboration in the delivery of FFC to older adults.
Open Access
Nursing Students' Beliefs About Substance Use Disorders
(2019-03-05) Elchuk, Stephanie Ann; Jensen, Elsabeth
Persons with substance use disorder (SUD) are subject to stigma and judgement. Stigma worsens clinical outcomes, undermines life opportunities, and decreases well-being of persons who use substances (Corrigan, Schomerus, Shuman, Kraus, Perlick et al., 2017). This meta-narrative reports on the beliefs of nine fourth year nursing students, using direct quotations to express salient beliefs about SUD, recovery, and nursing. Participants' beliefs evolved throughout the lifespan, with a significant shift in understanding occurring in response to education. SUD is seen as a biopsychosocial condition which is not a choice, but rather an attempt to cope with, or escape from, challenging life circumstances. Participants were reluctant to address stigma in their personal and professional lives. It is recommended nursing students are prepared to address workplace and societal stigma. Due to the effect of social environments outlined in symbolic interactionism, it is recommended to interview the same participants at graduation and in five years time.
Open Access
Nursing Students' Comfort with Providing Palliative and End-of-Life Care
(2023-08-04) Beattie, Beverley Marie; Singh, Mina
Open Access
Opening the Closet Door on Reproductive Cancer Care for Sexual Minority Women: Interactions with Health Providers
(2015-08-28) Legere, Laura Ellen; MacDonnell, Judith Ann
The aim of this critical feminist study was to illuminate aspects of interactions between sexual minority women with reproductive cancers and their health care providers (HCPs) that may perpetuate or challenge barriers to receiving equitable care. For this qualitative inquiry, one-on-one interviews were conducted with six reproductive cancer survivors who self-identified as lesbian or bisexual women, four of whom were also health or service providers, and one Registered Nurse who was not also a cancer survivor (n=7). Four themes emerged from these interviews: the reproductive cancer journey, the meaning of family, interactions with HCPs, and environmental barriers. The participants outlined areas they felt were most important to their cancer care and interactions with HCPs, as well as some of the barriers they encountered. Aspects related to gender, sexuality, reproduction, and their intersections were pervasive throughout the findings and shaped the meaning of reproductive cancers for sexual minority women.
Open Access
Parental Needs Rating By Parents and Nurses: Association With Illness Severity
(2016-09-20) Briscoe, Kadeen Nickeisha; Singh, Mina
The purpose of this study was to investigate parents and nurses perspectives on the psychosocial needs of parents, the extent to which those needs are viewed as met; and to understand the association between parental needs and the infants illness severity for parents with preterm infants born before 32 weeks gestation, in the first 10 days of hospitalization to the neonatal intensive care unit. This cross-sectional, descriptive-correlational, pilot study rated parental needs on an attitudinal scale. Twenty-four parents of preterm infants and 16 neonatal nurses participated in the study. The results showed no statistically significant difference in how parents and nurses reported parental needs in terms of importance. Differences were observed between the ratings of the top ten needs that were identified by parents and nurses. Statistically significant differences were observed in the perception of needs that are considered met. No correlation between parental needs and illness severity was detected.
Open Access
Patient-Centered Hemodialysis Nursing Care: An Interpretive Description
(2024-11-07) Hilborn, Billie Adele; Singh, Mina
Background Patient-centred care originated in the 1950s, gained popularity in the 1990’s, and is a professional regulatory, clinical practice guideline, governmental health policy, and perhaps organizational expectation of every nurse in Canada. The term is used liberally on the Health Canada website, and in 2011 the Canadian Institutes of Health Research launched the Strategy for Patient-Oriented Research. Also in 2011, the Canadian Nurses Association (CNA) and Canadian Medical Association (CMA) jointly identified patient-centred care as the first principle to guide healthcare transformation. In 2018, patient-centred care was adopted by Accreditation Canada through the addition of patient surveyors. Patient-centred nursing care could benefit people with end-stage kidney disease (ESKD) however the philosophical ideals of the approach may not consistently align with the everyday reality of hemodialysis nursing. Purpose of Study The study purpose was to describe the experiences and perspectives of hemodialysis nurses in their provision of patient-centred care. Methods A qualitative interpretive description design was used, with purposive sampling of hemodialysis nurses from hospital and satellite hemodialysis units in urban and rural areas registered with the College of Nurses of Ontario and currently employed full or part-time for more than three months. Semi-structured interviews were held, and transcripts were analyzed. Results Ten RNs participated and five themes were constructed through interpretation of their comments during interviews: Knowing, Applying, and Sustaining, plus Promoters and Detours of Patient-Centred Hemodialysis Nursing Care. Conclusions Patient-centred hemodialysis nursing care is a complex process with multiple promoters such as therapeutic relationships, reflective nursing practice, collaboration, and the satellite unit context. Nurses needed to navigate detours that interfered with the provision of patient-centred care related to patients, nurses, and unit, organizational, and system processes. Various interconnections occur within patient-centred hemodialysis nursing care, and certain ethical aspects require consideration. Implications for Nephrology Care Implications and recommendations for nephrology nursing education, practice, policy, and future research are identified.