Medicine and Health Sciences Commons^™

The Association Between Child And Youth Mental Health Service Urgency And Exposure To Childhood Interpersonal Trauma, Catherine Marshall

Electronic Thesis and Dissertation Repository

Children/youth with a history of maltreatment experience a variety of different developmental, psychiatric and health problems and ensuring there is streamline access to services is imperative to their recovery. Yet, there are few reports of standardized methods for directing and prioritizing risk for children seeking services. The current study,utilizingretrospective data collected from theinterRAIChild and Youth Mental Health Screener (ChYMH-S), aimed to address this gap and explore the relationship between childhood maltreatment and mental health screening outcomes. A sample of 4-18-year-olds (N= 19,645) was studied to explore how differences in maltreatment history, gender, and legal guardianship impacted service prioritization. The findings …

An Exploration Of The Nursing Leaders’ Experiences Addressing Indigenous Health In University Undergraduate Nursing Programs In Ontario, Danae Coggins

Electronic Thesis and Dissertation Repository

Introduction. Although there are serious health inequities experienced by Indigenous people compared to non-Indigenous people in Canada and racism and discrimination continues to be rife in health care environments, there remains a general lack of attention to Indigenous health (IH) in health professional education programs. In response, the Truth and Reconciliation Commission (TRC) has recommended this be addressed within health profession education, including nursing (Truth and Reconciliation Canada, 2015). However, there is a paucity of evidence describing the challenges and facilitators to incorporating IH into nursing education.

Methodology and Methods. This qualitative study employs interpretive description approaches informed by …

Relationships Among Authentic Leadership, Manager Incivility And Trust In The Manager, Ohood Ali Alkaabi

Electronic Thesis and Dissertation Repository

There have been growing concerns about manager incivility toward new graduate nurses which hinders their adaptation to the workplace environment. Manager incivility impairs the relationship between managers and their staff. Furthermore, nursing managers have a significant responsibility to facilitate new graduate nurses' transition into the nursing profession. The purpose of this secondary analysis was to examine the relationships among authentic leadership of managers and new graduate nurses’ experience of manager incivility and their subsequent degree of trust in their managers. Secondary analysis of the baseline data using a non-experimental, correlational design was conducted. A random sample of 1020 new graduate …

Supporting Indigenous Students: A Critical Analysis Of The Sociocultural Context Of Nursing Education, Kay E. Vallee

Electronic Thesis and Dissertation Repository

The purpose of this study was to critically examine the sociocultural context of nursing education as an institution. Using a postcolonial feminist theoretical framework and institutional ethnography, I illuminated the institutional complex of nursing education. This study addressed the following research questions: 1) How do practices, programs, and policies coordinate social relations within the institution of nursing education; and 2) How are Indigenous students’ everyday lives shaped by the institution of nursing education?

Multiple methods were used to collect data, including: interviews, observations, and text analysis. Interviews were conducted with students, educators, and administrators and others involved in nursing education. …

Goals Of Family Caregivers Of Persons With Dementia Across The Caregiving Career, Shalane R. Basque

Electronic Thesis and Dissertation Repository

Understanding goals of family caregivers of persons with dementia is critical to provide effective education and support. However, there is little understanding about family caregivers’ goals. This study investigated goals set by family caregivers prior to an education and training program and whether their goals varied across the caregiving career. Phases of the caregiving career were measured by relationship identity; the extent to which participants viewed their relationship in terms of familial and caregiver roles. Conventional content analysis on goals of 30 family caregivers yielded five categories which varied by relationship identity. Enhancing relationships reflected goals for the familial role …

Nursing Practice During A Mission In Nepal: Ethics And Leadership, Lorena M. Bonilla

Electronic Thesis and Dissertation Repository

The ability of nurses to reflect or critically examine the impact of professional standards of practice, legal guidelines, and ethical frameworks that influence and guide their practice is essential to help patients achieve quality of life and wellness. Regardless of the location and setting where nursing takes place, contextual factors such as the benefits and potential harm resulting from the care provided, availability of resources, the nurse’s scope of practice, and evidence-based practice guidelines, all affect a nurse’s ability to practice in a safe, ethical, competent, caring, and compassionate manner.

Using an exploratory case study to investigate nurses’ (n=9) view …

Undergraduate Nurse Educators’ Perceived Structural Empowerment, Self-Efficacy For Teaching, And Perceptions Of Uncivil Classroom Behaviours In Academic Settings, Molly A. Hunter

Electronic Thesis and Dissertation Repository

Background: This study examined the relationship among structural empowerment in academia, nurse educators’ self-efficacy for teaching, and their perceptions of the types and frequencies of uncivil classroom behaviours.

Methods: 56 participants, registered with the College of Nurses of Ontario (CNO), responded to a mail-out survey package containing four tools corresponding to each study variable. The analysis includes study descriptives, ANOVA analyses, correlations of total and subscales, and mediation analyses of the major study variables.

Results: A moderate level of structural empowerment and a high level of self-efficacy for teaching was found within the study. A significant indirect relationship was seen …

Expanding The Concept Of ‘Care’: A Narrative Study Exploring Lessons From End-Of-Life Patients To Inform ‘Medical Assistance In Dying’ Curriculum In Canada, Jill Dombroski

Electronic Thesis and Dissertation Repository

This research primarily investigates what we can learn from patient experiences that can help inform the expected curricula that will be developed in response to the new Canadian legislation regarding Medical Assistance in Dying (MAID). This is a compelling area of research because of the rapidly evolving attitudes in the general population — largely driven by terminally ill patients asserting their legal rights over their bodies and the decision to put an end to their lives as a consequence of the illness they face. The issue of medical assistance in dying has been patient initiated and patient driven. Through the …

Fall Prevention In An Acute Care Hospital: The Challenges Encountered By Patients, Staff And Administrators, Barbara J. Watson

Electronic Thesis and Dissertation Repository

Abstract

Falls are frequent and often serious events that take place in hospitals. Healthcare providers find it challenging to minimize fall risk factors. In fact, just being in a hospital is a risk factor in itself! The aim of this thesis was to investigate the reasons behind patient falls, identify gaps in prevention strategies and suggest additional recommendations to improve patient safety. A mixed method approach was used to interpret the data and uncover the reasons for falls.

The first study was a secondary data analysis where 7,721 patient falls were examined. The data were taken from the hospital’s central …

An Investigation On The Value Of Integrating Mental Health Supports In Education To Build Capacity For Change, Erin Keith

Electronic Thesis and Dissertation Repository

Current statistics in Ontario show that one in five students suffer from mental health issues (Canada, 2012). Mental health disorders cause significant distress, impairing students’ functioning at school, at home, and in the community (Children’s Mental Health Ontario, 2014). Research has shown that prevention and early intervention strategies targeting students at risk for mental health challenges are beneficial, cost-effective, and reduce the need for more costly, intensive interventions. (Ontario Ministry of Education, 2013). In response to recent Ontario Ministry mental health initiatives (Ontario Ministry of Education, 2006; 2011; 2013), the Peel District School Board, in Ontario, Canada, launched an interprofessional, …

Organisational Improvement Plan: System Of Care, Derek Haime

Electronic Thesis and Dissertation Repository

This organizational improvement plan (OIP) describes a way to develop and implement a system of care philosophy within a district school board with the intent of spreading this philosophy throughout the district, province, and country in the future. It is intended to be used as a tool to guide other district school boards interested in implementing a system of care. More specifically, the problem of practice this OIP is intended to address is as follows: “The current model of care for JK-8 students with mental health needs must improve. The service delivery system and pathways to treatment for child and …

Organisational Improvement Plan: System Of Care, Derek Haime

The Dissertation in Practice at Western University

This organizational improvement plan (OIP) describes a way to develop and implement a system of care philosophy within a district school board with the intent of spreading this philosophy throughout the district, province, and country in the future. It is intended to be used as a tool to guide other district school boards interested in implementing a system of care. More specifically, the problem of practice this OIP is intended to address is as follows: “The current model of care for JK-8 students with mental health needs must improve. The service delivery system and pathways to treatment for child and …

The Effects Of Empowerment On Role Competency And Patient Safety Competency For Newly Graduated Nurse Practitioners, Elsie Duff

Electronic Thesis and Dissertation Repository

Introduction: Role competence and patient safety (PS) competence among healthcare professionals are rapidly developing issues due to increasing patient acuity and complexity in the healthcare system. Upon graduation, nurse practitioners (NPs) provide autonomous healthcare for populations with complex health needs, thus role and PS competence is imperative. In Canada, few studies have examined NP education and role development specific to NP role competence and PS competencies. This study addresses this gap in the research examining educational experiences of new NP graduates.

Aim: The aim of this study is to test a hypothesized model of the relationships between educational structural empowerment, …

Exploring The Role Of Procedural Variations In Surgical Education, Tavis Apramian

Electronic Thesis and Dissertation Repository

Variations in practice and procedure permeate clinical work. While clinical research routinely investigates the consequences of these variations for clinical outcomes, we have little understanding of their implications for education. The current policy environment in medical education makes developing a new understanding of the role of variations in medical education especially important. Current policy reforms in the assessment of learners draw on the notion of competence to suggest that medical education should focus on the performance of learners in the workplace. The current turn toward workplace-based assessment positions the observations of faculty into key functions in these assessment frameworks; therefore, …

Pearl Harvesting Autism, Mariya Gruntovskaya

Electronic Thesis and Dissertation Repository

This thesis addresses the difficulties of on-line information searching as it relates to the topic of autism. A review of existing search strategies is presented and their limitations are discussed. A new method for deriving a set of search-terms for comprehensive searching, Pearl Harvesting, was tested here to determine the necessary search terms (i.e., synonym ring) for ERIC and PsycINFO databases. Once discovered and validated, a synonym ring can be copied and pasted directly into the search box of the database, providing a simple, thorough and time saving way of conducting on-line research in the field. This easily used method …

University Athlete Transition: Making The Jump From Sport To Life, Natascha Wesch

Electronic Thesis and Dissertation Repository

The general purpose of this dissertation was to examine how perfectionism might influence career planning through its relationship with career decision making self-efficacy, career goal setting, and career outcome expectations in Canadian university student-athletes. Specifically, this dissertation addressed two main research questions: Does perfectionism enhance or inhibit career planning in university student-athletes; and is this in turn influenced by the relationship between perfectionism (strivings and concerns) and the social cognitive variables of the SCCT (i.e., career decision making self-efficacy, career goal setting, and career outcome expectations)?

In order to validate and test the measurement models of perfectionism, decision-making self-efficacy, career …

Caregivers' Experiences Raising A Child With Fetal Alcohol Spectrum Disorder, Aamena Kapasi

Electronic Thesis and Dissertation Repository

The purpose of this study was to identify challenges and strengths of caregivers to a child with Fetal Alcohol Spectrum Disorder (FASD). Thirty-two caregivers raising a child with FASD participated in phone interviews that included the questions: "What challenges do you face in making your household function well?" and "What strengths do you have to make your household function well?" Responses to the questions were sorted by participants and the data was analyzed using multi-dimensional scaling and cluster analysis. In response to the question about challenges, seven concepts emerged: 1) Extra Responsibility on Caregivers, 2) Difficulty Keeping Daily Routine, 3) …

Learner Anxiety And Professional Practice Self-Efficacy In Nursing Education, Joanna Pierazzo

Electronic Thesis and Dissertation Repository

The purpose of this study was to examine the affective component of learner engagement (Linnenbrink & Printrich, 2003); more specifically students’ perceptions of learner anxiety and self-efficacy for professional practice in clinical nursing education. This study identified the factors in clinical learning contexts that contribute to learner anxiety, the differences among these factors in real and simulated learning contexts, and finally, the teaching and learning strategies that minimize learner anxiety and positively enhance self-efficacy for professional nursing practice. A convenience sample of 186 students from three university nursing programs in Ontarioparticipated in a two-phased mixed methods study, reflecting a response …

Concept Mapping And The Cognitive Orientation To Daily Occupational Performance (Co-Op) Approach As An Intervention Framework For Adolescents With Autism Spectrum Disorder (Asd), Jessie A. Wilson

Electronic Thesis and Dissertation Repository

Individuals who are diagnosed with Autism Spectrum Disorder (ASD) experience a range of difficulties that impact their daily occupational performance. The current body of research identifies the importance of occupational engagement and competence as fundamental elements in facilitating an individual’s social connections, development of personal autonomy and overall wellbeing. This dissertation explores the use of concept mapping embedded within the meta-cognitive framework of the Cognitive Orientation to Daily Occupational Performance (CO-OP) approach, to engage adolescents with ASD in meaningful occupations.

This thesis contains three manuscripts, an introductory and a final reflection chapter. The first manuscript is a methodological paper that …

Validation Of A Novel Methodology For Evaluating Surgical Tissue Plane Identification, Syed T. Ali

Electronic Thesis and Dissertation Repository

Introduction: The ability to identify tissues planes is a fundamental surgical skill. This study attempts to validate a previously developed test for assessing this ability.

Methods: 48 video captured images from laparoscopic right hemicolectomies were presented on an iPad to 18 surgeons who were grouped based on experience (Consultants (C), Senior trainees (S), and the Junior trainees (J)). Subjects were asked to draw a line indicating the tissue plane of dissection. Lines were compared by a modified Hausdorff measure. Within group variability represented group precision and trainee accuracy was determined from comparison to Consultants.

Results: Within group comparisons demonstrated Consultants …

From Their Perspective: How Adolescents And Young Adults Experience And Conceptualize Life And Occupation Surrounding Parental Divorce Or Separation, Laura R. Hartman

Electronic Thesis and Dissertation Repository

Parental divorce affects adolescents’ emotions, routines, habits, occupations and relationships. The current body of research indicates that parental divorce leads to many unfavourable social, behavioural, and mental health outcomes for adolescents. This dissertation explores the daily lives and occupations of adolescents and young adults surrounding the transition of a parental divorce or marital separation.

This thesis contains four manuscripts in addition to the introductory and final reflection chapters. The first manuscript explores the current North American literature relating to adolescent life surrounding a parental divorce or marital separation, ranging form 1998 to 2014. The second manuscript provides an overview of …

The Role Of Mobile Phones In Health Education For Rural Communities In Ghana: An Exploratory Study In Digital Technologies, Kinful Lartebea Aryee

Electronic Thesis and Dissertation Repository

The use of wireless, mobile, and handheld digital devices is growing in every sector, including education and health. The increase in mobile (handheld) phone usage has gradually drawn most healthcare practitioners’ and patients’ attention to its capability as a promoter of health education. It has helped with reduction in social and economic impact of preventive and curative and unexplained non-curable illnesses, especially among rural communities in sub-Saharan African countries such as Ghana.

Activity theory—an object-driven activity— was employed as the conceptual framework to answer the following research questions: What views do people have about information that relates to their health? …

A Critical Discourse Analysis Of Medical Students’ Reflective Writing: Social Accountability, The Hidden Curriculum, And Critical Reflexivity, Stacey Ritz

Electronic Thesis and Dissertation Repository

In recent years, many medical schools have adopted a ‘social accountability’ approach, implementing a variety of activities and curricula aimed at developing a sense of social responsibility in medical students. The research of this thesis uses critical discourse analysis (CDA) to scrutinize the writing of senior medical students, with a view to uncovering how identity, ideology, and social position are expressed by students who have undertaken a curriculum designed with social accountability in mind. The analysis examines the conditions of discourse practice, student orientations to a professional medical identity, and ideologies of community, rurality, indigeneity, and gender. I discuss these …

Interprofessional Socialization And Dual Identity Development Amongst Cross-Disciplinary Students, Hossein Khalili

Electronic Thesis and Dissertation Repository

The purpose of this study was to develop and test an interprofessional socialization (IPS) framework through assessing the impact of an IPS-based interprofessional education program on interprofessional socialization and dual identity development among health professional students. Although health professional educational programs have been successful in equipping graduates with skills, knowledge and professionalism, the emphasis on specialization and profession-specific education has enhanced the development of a uniprofessional identity, which has been found to be a major barrier towards Interprofessional Person-Centered Collaborative Practice (IPCPCP). Despite the growing acknowledgment of IPS in the current IPE and collaborative practice literature, there is a lack …

The Role Of Reflection In Audiology Students’ Development As Professional Practitioners: A Constructivist Grounded Theory, Stella Ng

Electronic Thesis and Dissertation Repository

Audiology is a young health profession striving toward a value for and use of evidence-based practice (EBP). Currently within audiology, there is a lack of attention to a complementary epistemology of practice; that is, one that explicitly values experience as a valid and important source of knowledge, worthy of theoretical and empirical scholarly attention. The current study addresses this gap using a constructivist grounded theory approach to explore the research question: How is reflection enacted and implicated in audiology students’ development as professional practitioners? A total of 18 participants contributed data to this study (13 audiology students from a single …