A Picture Of Spirituality In Youth Living With Bipolar Disorder, Michelle S. Solomon

Electronic Thesis and Dissertation Repository

There is a paucity of literature concerning how youth living with bipolar disorder understand and experience spirituality. The management of bipolar disorder through psychosocial interventions such as spirituality is critical due to the chronic and complex nature of the illness and the fact that pharmacotherapy has not been found to fully restore mood and quality of life (Michalak et al., 2016; Miller et al., 2014; Sanchez-Moreno et al., 2009; Stroppa & Moreira-Almeida, 2013). Spirituality has been defined as being concerned with the ultimate questions in life; the meaning in life that a person gains in relation to something bigger than …

The Development, Refinement, Implementation, And Impact Of A Nurse-Led Health Coaching Self-Care Management Intervention For Heart Failure, Maureen Leyser

Electronic Thesis and Dissertation Repository

Background: Heart Failure (HF) hospitalizations and readmissions remain unacceptably high despite medical advances and, in spite of the education provided to HF patients regarding the signs of fluid accumulation, HF exacerbations persist. There is a gap between patients recognizing the signs of fluid accumulation and performing timely self-management activities to control it. Currently, there is no standardized approach for nurse-led health coaching to assist patients in HF symptom management oriented to self-care activities within a primary healthcare (PHC) setting. There is a need to better understand how self-care interventions can be delivered within a PHC practice, which health outcomes …

The Process Of Art Creation Among Mothers From Ontario Who Have Experienced Gender-Based Violence, Madison L. Broadbent

Electronic Thesis and Dissertation Repository

Mothers who have experienced gender-based violence (GBV) face physical, mental, and social health implications. Participating in artmaking has the potential to reduce these consequences. An arts-based study including in-depth interviews was conducted with 13 mothers with histories of GBV. The creative processes involved in artmaking amongst mothers with histories of GBV were explored. Mothers demonstrated using symbols, thoughtful colour selection, and choice of artistic medium when creating their artforms. Moreover, mothers’ experiences of storytelling experiences of GBV through art were examined. Mothers described using art as a means of communication, emotional processing and healing through art, and the process of …

About Dying And Death: Thanatology's Place In Medical Curriculum, Jill Dombroski

Electronic Thesis and Dissertation Repository

This study explored how healthcare providers engage in advance care planning and end-of-life care conversations. The research explored what shapes their understanding and the extent to which concepts from thanatology they intuitively bring in, explicitly bring in, and maybe fail to recognize. To achieve this, constructivist grounded theory (CGT) methodology guided the design, data collection, analysis, and interpretation of the findings, which allowed for iteration across interviews and analysis with existing theories and data in the literature. The CGT design encouraged further engagement with the literature in an ongoing iterative fashion as well as with the analysis of the data. …

Decentering Whiteness In Nursing Education: The Pitfalls, Tensions, And Opportunities, Ivy Tran

Electronic Thesis and Dissertation Repository

Statement of Research Problem: The Truth and Reconciliation 94 Calls to Action (TRC) (2015) calls for the implementation of accessible and appropriate Indigenous health education. Schools of Nursing are increasingly implementing various approaches to teach Indigenous health. Limited research exists for Canadian nursing students' experiences of learning Indigenous health. This study explored undergraduate nursing students' experiences of learning Indigenous health from four Schools of Nursing across Canada. Particular attention is paid to the factors that shaped student and faculty experiences of learning and teaching Indigenous health, respectively, the facilitators and challenges, and what constitutes a safe and effective learning environment. …

Balancing Nurture And Rigour: Seeking Effective Support For Nursing Students In Distress, Marti Harder

The Dissertation-in-Practice at Western University

As higher educational institutions face a growing demand to graduate more nurses, and mental health and life stresses are recognized as increasing obstacles to student success, the timing is right for nursing programs to evaluate their traditionally rigorous program cultures. At Sunrise University in Western Canada, nursing students make up a large population seeking support services, and there is an increasing need for capacity building in faculty to support learners who are in distress. In this organizational improvement plan (OIP), I explore what can be enhanced or further developed to create more effective support for students who are in distress …

Relational Variables Impacting The Healthcare Team, Linda J. Macdougall Ms

Electronic Thesis and Dissertation Repository

The movement in the healthcare system towards interprofessional collaborative teamwork values the perspectives of various healthcare professionals. Although this system shift has been essential to quality improvement, there have been indications of issues occurring between professionals that include conflict and impaired team performance. Although the current literature on interprofessional collaboration acknowledges the competencies and demonstrated behaviours that indicate successful and difficult collaborative efforts there is a lack of research investigating the relational variables that occur between healthcare professionals.

The purpose of this research was to test a theoretically derived model of healthcare professionals’ relational variables. These variables related to warmth, …

The Experiences Of Clinical Placement Belonging Among Nursing Students With Racially And Ethnically Minoritized Identities: An Interpretive Descriptive Study, Connor J. Gould

Electronic Thesis and Dissertation Repository

Abstract

Background: Within clinical learning environments, a students’ sense of belonging has been identified as a pre-requisite for effective learning. Unfortunately, many aspects of nursing education act as barriers to belongingness among students with racially and ethnically minoritized identities. Although prejudice and discrimination represent barriers to belongingness, there is a paucity of literature exploring how racially and ethnically minoritized nursing students experience belonging during their clinical placements.

Aim: To explore how nursing students with racially and ethnically minoritized identities experience a sense of belonging during their clinical placements.

Research Design: The researcher followed an interpretive descriptive design informed by intersectional …

From College To University: Nursing Students' Experience Of Transition, Mary Anne Krahn

The Dissertation-in-Practice at Western University

Increasingly complex healthcare systems require nurses to have a greater depth of knowledge and theory application to care for patients safely and competently. To prepare nurses for rapidly changing health care systems, the baccalaureate degree was accepted by the Canadian Nurses Association (CNA) as the standard for entry to Registered Nurse practice across Canada and became the entry-to-practice requirement starting in 2005 (Wood, 2011).

In Ontario, this entry-to-practice standard required the development of college and university collaborative partnerships to respond to the resulting implementation and capacity challenges in nursing education (MacMillan & Mallette, 2004). Although these partnerships have been in …

Exploring Novel Intradialytic Techniques To Identify & Ameliorate Of Hemodialysis-Induced Myocardial Ischemic Injury, Jarrin D. Penny

Electronic Thesis and Dissertation Repository

Patients with chronic kidney disease requiring hemodialysis to sustain life have extremely high rates of cardiovascular morbidity/mortality. This is both a consequence of the disease process and treatment. Hemodialysis induces systemic circulatory stress is largely due to the extracorporeal circuit and volume removal. The stress induced by intermitted hemodialysis is repetitive with cumulative cardiovascular effect and is the principal driver of heart failure and sudden death in this vulnerable population. The insults imposed by hemodialysis result in left ventricular regional wall motion abnormalities and lead to myocardial stunning with permanent damage to the vasculature and myocardium. Currently, the adversity caused …

How We Debrief: An Interpretive Description Of Social Service Community Workers' Experiences, Andrea C. Krywucky

Electronic Thesis and Dissertation Repository

The aim of this research was to understand current practices of debriefing being used or not used in community social service organizations and the presumed frameworks or evidence justifying these practices in London, Ontario. The geographical area under concern has seen an increasing poverty gap, lack of affordable housing, toxic drug crisis, with mental health issues being exasperated by the pandemic. Social service agencies are overwhelmed with caseloads, creating an increase in need of care for frontline workers, as they are the first point of contact for many. This research utilized an interpretive description methodology to explore workers’ experiences and …

Teaching Family Planning In Nursing And Midwifery Schools: A Constructivist Grounded Theory Study, Pauline Uwajeneza

Electronic Thesis and Dissertation Repository

High maternal mortality remains a global health issue. In 2017, approximately 295,000 women worldwide died from complications related to pregnancy or childbirth, and 94% of these maternal deaths occurred in low-income countries. Evidence shows that family planning (FP) improves maternal health outcomes and significantly contributes to the reduction of maternal mortality. Low FP uptake is partly attributed to inadequate education of health care providers to provide FP services. The purpose of this study was to describe nurse/midwife educators' understanding and enactment of teaching FP methods with nursing/midwifery students in educational programs. More precisely, the aim of this study was to …

(Re) Evaluating Critical Care Nurse Support Program(S) In A Tertiary Care Hospital: Intersecting The Art And Science Of Nursing, C. Patricia Mazzotta

The Dissertation-in-Practice at Western University

There is a growing critical care nurse staffing shortage with increases in nurse vacancy rates. Moral distress has been exacerbated by the SARS-CoV-2 (COVID-19) pandemic and, in particular, impacting critical care nurses. COVID-19 is a significant contributor to staffing shortages and continued nursing crisis. Thus, the impetus for the Problem of Practice (PoP): the lack of support to address the psychological, emotional, and spiritual distress suffered by critical care registered nurses in a tertiary care hospital in Central Ontario. To comprehend the realities of working in the intensive care units, leaders must first understand nurses’ lived experiences, narratives, and what …

Improving Sexual Violence Reporting In Higher Education Institutions, Karen D. Kennedy Ms

The Dissertation-in-Practice at Western University

Abstract

This Organizational Improvement Plan (OIP) addresses the lack of sexual violence (SV) reporting at an undergraduate university (Coastal U; a pseudonym) where values of equity, diversity, and inclusion are espoused. Nonetheless, students from diverse cultures at Coastal U report a lack of visibility, unclear pathways for reporting, poor student and staff education, and numerous reporting fears, culminating in a lack of SV reporting. A critical and intersectional feminist lens frames this issue as one of social injustice, wherein inequity and lack of inclusion are problematic. Institutional context, capacity, and readiness, together with consideration of external factors, led to three …

Women’S Priorities And Actions Mothering In The Context Of Intimate Partner Violence, Sharon Broughton

Electronic Thesis and Dissertation Repository

Being a mother is an important part of many women’s identities with consequences for women and children and shaping women’s priorities and actions when living in the context of intimate partner violence (IPV). However, understanding the nature of women’s priorities, the actions women take to address these priorities, and the factors shaping those actions remains limited. Drawing on an intersectional feminist lens, this dissertation explored the nature of women’s priorities, what shapes them and how women mothering in the context of IPV go about living out what is important to them. To situate these issues broadly within the discipline of …

A Critical Exploration Of Nursing Leaders Storied Experiences Of Phronesis Within The Covid-19 Pandemic, Karen M. Jenkins

Electronic Thesis and Dissertation Repository

In this critical hermeneutic study, I critically explore nursing leaders’ storied experiences of phronesis within the COVID-19 pandemic. Phronesis is the ability to perceive a situation and deliberate well in order to determine the best course of action for human beings. Theoretically informed by critical social theories, I considered how the enactment of phronesis was often performed according to normative discourses and the socio-political historical situatedness of nursing leaders. I utilized Frank’s (2012a) narrative dialogic analysis to interpret and bring into conversation participant stories, and multiple discursive voices. Based on Pinkola Estés (1995), I use the metaphor of the wild …

Host Organizations' Perspectives Of Partnered Global Study-Abroad Programs, Jessica C. Pop

Electronic Thesis and Dissertation Repository

Background: The relationships between sending and host partners in nursing study-abroad programs are crucial to the success and sustainability of these programs. Yet, there has been a paucity of research focused on the global partnerships between sending and host organizations. Most research about study-abroad programs has primarily focused on Global North sending organizations’ perspectives on the educational, social, and career benefits to Global North students with few studies highlighting the perspectives of host organizations from the Global South.

Aim: To explore Global South host organizations’ perspectives about global partnered nursing study-abroad programs.

Research Design: This research study was guided by …

"Pain Is What The Patient Says It Is": A Secondary Analysis Of Nurses’ Reflections On The Term Pain Catastrophizing, Riana Longo

Electronic Thesis and Dissertation Repository

Background: Pain catastrophizing is a widely used concept; however, many have argued that it delegitimizes and decontextualizes patients’ pain experiences. Previous studies identified that patients and clinicians think the term is stigmatizing; however, nurses’ perceptions are underrepresented. Nurses offer a unique perspective that is critical to explore to foster positive change and improve patient outcomes. Objectives: This thesis aims to summarize the current literature on pain catastrophizing perspectives from clinicians and patients, analyze nurses’ perspectives, and uncover any underlying issues with the term itself. Methods: This thesis consisted of a two-stage design. The first study is a scoping review that …

The Effect Of Interprofessional Conflict Resolution On Interprofessional Collaborative Practice Among Health Care Provider Teams In Hospitals, Sibylle Ugirase

Electronic Thesis and Dissertation Repository

Client needs and their complexities have increased, challenging multiple professionals to work together within health systems to reach better patient outcomes. Addressing this challenge requires interprofessional collaboration, which, while essential, may also breed conflict given that individuals from various health care disciplines each bring their unique perspectives into teamwork. While some degree of disagreement is expected, team members must be able to resolve conflicts to ensure effective patient care. However, limited information was available that described and clearly defined interprofessional conflict resolution as a concept.

The aim of this study was threefold. This study began with a concept analysis of …

Navigating, Negotiating, And Narrating: Re-Envisioning Patient-Centered Chronic Illness Care, Wilma J. Koopman

Electronic Thesis and Dissertation Repository

Patient-centered care (PCC) is ubiquitous in how we think about patient-practitioner encounters. But such a taken-for granted stance may unknowingly obscure how conversations actually unfold in real life. The purpose of this work is to unravel the disconnect between how patient-centered care is talked about and how it is implemented in the real world. The overarching research question that framed this study was: What are the influences that shape the unfolding of the conversations that occur at chronic illness health encounters and how does this unfolding influence the learning and execution of PCC? The aim of this research was …

Organizational Implementation Of Trauma And Violence Informed Care, Tanaz Javan

Electronic Thesis and Dissertation Repository

For the past several decades, social and health services have increased their efforts to enhance service delivery and close the ‘science-to-service’ (or ‘evidence-to-practice’) gap by implementing effective interventions. At the same time, there has been growing recognition of the prevalence of trauma and violence in the lives of those served and those providing care and the impact of these experiences on service needs and interactions. This study explored the implementation of trauma- and violence-informed care (TVIC), a complex intervention focused on providing safety and choice for service users in the context of their life experiences and conditions, exploring factors that …

Women’S Experiences Of Accessing Breastfeeding And Perinatal Health Support In The Context Of Intimate Partner Violence: An Interpretive Description Study, Samantha Larose

Electronic Thesis and Dissertation Repository

Background: Women experiencing intimate partner violence are at a heightened risk of negative perinatal and breastfeeding outcomes. This study explored the experiences of accessing breastfeeding support for women who endorse a history of intimate partner violence. A study of five in-depth semi-structured interviews were completed at 12-weeks postpartum with breastfeeding mothers with a history of intimate partner violence. Findings: Women expressed difficulties in accessing a healthcare provider who had specialized skill in breastfeeding support. Trust in their healthcare provider, built through displays of compassion and competence, was important to mitigate obstacles experienced during care access for this population. Trauma-and-violence-informed care …

Through An Equity Lens: Illuminating The Relationships Among Social Inequities, Stigma And Discrimination, And Patient Experiences Of Emergency Health Care, Colleen Varcoe, Annette J. Browne, Vicky Bungay, Nancy Perrin, Erin Wilson, C.Nadine Wathen, David Byres, Elder Roberta Price

Nursing Publications

People who experience the greatest social inequities often have poor experiences in emergency departments (EDs) so that they are deterred from seeking care, leave without care complete, receive inadequate care, and/or return repeatedly for unre- solved problems. However, efforts to measure and monitor experiences of care rarely capture the experiences of people facing the greatest inequities, experiences of discrimination, or relationships among these variables. This analysis examined how patients’ experiences, including self-reported ratings of care, experiences of discrimination, and repeat visits vary with social and economic circumstances. Every consecutive person presenting to three diverse EDs was invited if/when they were …

A Critical Narrative Inquiry To Understand The Impacts Of An Overdose Prevention Site On The Lives Of Site Users, Abe Oudshoorn, Michelle Sangster Bouck, Melissa Mccann, Shamiram Zendo, Helene Berman, Jordan Banninga, Marlene J. Le Ber, Zayya Zendo

Nursing Publications

© 2021, The Author(s). Background: Globally, communities are struggling to gain support for harm reduction strategies being implemented to address the impacts of substance use. A key part of this discussion is understanding and engaging with people who use drugs to help shape community harm reduction strategies. This study focused on how an overdose prevention site has influenced the lives of people who use drugs. Methods: A critical narrative method was utilized, centred on photo-narratives. Twenty-seven individuals accessing an overdose prevention site were recruited to participate in preliminary interviews. Sixteen participants subsequently took photographs to describe the impact of the …

Health Service Experiences And Preferences Of Frail Home Care Clients And Their Family And Friend Caregivers During The Covid-19 Pandemic, Lori E. Weeks, Sue Nesto, Bradley Hiebert, Grace Warner, Wendy Luciano, Kathleen Ledoux, Lorie Donelle

Nursing Publications

Objective: The COVID-19 pandemic has brought about a major upheaval in the lives of older adults and their family/friend caregivers, including those utilizing home care services. In this article, we focus on results from a qualitative component added to a pragmatic randomized controlled trial that focuses on the experiences of our study participants during COVID-19. A total of 29 participants responded to the COVID-19 related questions focused on their health services experiences and preferences from March-June 2020 including 10 home care clients and 19 family/friend caregivers in the provinces of Ontario and Nova Scotia, Canada. Results: Many participants were affected …

Health Providers Perspectives On The Access And Use Of Formal Health And Social Services By Stroke Caregivers, Hannah Pollock

Electronic Thesis and Dissertation Repository

Informal stroke caregivers, comprised of family and friends, can experience prolonged stress that places them at risk of poor health and social outcomes. These caregivers may benefit from formal health and social services, but they are often underused and challenging to access. This qualitative interpretive description study sought to explore health providers’ perspectives on the factors that impact stroke caregivers' access and use of formal health and social services. In addition, it sought to explore health providers' experiences and how they perceive their role in supporting stroke caregivers'. In-depth, semi-structured interviews were conducted with 18 health providers. Through inductive thematic …

Understanding The Lived Experience Of Health Through The Exploration Of Well-Being Of Women With Multiple Sclerosis In Southwestern Ontario, Jennifer Howard

Electronic Thesis and Dissertation Repository

The prevalence of Multiple Sclerosis (MS) is increasing globally with 2.8 million cases worldwide as of 2021, with Canada experiencing the highest incidence for this disease (Multiple Sclerosis International Foundation [MSIF], 2021; Multiple Sclerosis Society of Canada [MSSC], 2021). MS is an autoimmune disease that damages the myelin sheath in the central nervous system (spinal cord and brain) which may result in problematic symptoms such as cognitive dysfunction and lead to physical disability (MSSC, 2021). There are over 90,000 Canadians with MS, impacting women on a ratio of 3:1 compared to men (MSSC, 2021; Statistics Canada, 2013). Current literature suggests …

New Graduate Nurses’ Experiences Of Engaging In A Leadership Role In Hospital Settings During The Covid-19 Pandemic, Justine Jeanelle Ting

Electronic Thesis and Dissertation Repository

New graduate registered nurses are often expected to assume leadership roles and responsibilities quickly upon entering practice. Since the emergence of the COVID-19 pandemic, new nurses may find their leadership capabilities tested even further as the demands of leadership have been made increasingly complex in the context of an infectious disease outbreak. The purpose of this interpretive descriptive study was to explore new graduate registered nurses’ experiences of engaging in frontline leadership roles in hospital settings during the COVID-19 pandemic. In-depth interviews were conducted with 14 participants across Ontario. Content analysis revealed four main themes: nominated and necessitated into leadership …

Reddit And Nursing During Covid-19: A Summative Content Analysis, Julia C. Savin

Electronic Thesis and Dissertation Repository

Purpose: The purpose of this thesis was to explore what self-identified nurses discussed on the nursing SubReddit during the Covid-19 pandemic between March 2020 to May 2020.

Methods: The Hsieh and Shannon (2005) summative content analysis with emergent categorical development was used to categorize the naturalistic data.

Findings: Through analysis, six content categories were identified from the nursing SubReddit: (a) employers’ approaches to the pandemic; (b) emergency preparedness in response to the pandemic; (c) shared experiences; (d) nursing students and new graduate nurses; (e) coping; and, (f) gratitude to nurses.

Implications: (a) Leadership that is communication-focused will improve the quality …

Chronic Disease Management In A Nurse Practitioner Led Clinic: An Interpretive Description Study, Natalie Floriancic

Electronic Thesis and Dissertation Repository

Statement of research problem: Nurse practitioner led clinics (NPLC) in Ontario (ON) represent a model of care that is potentially well-situated to improve primary healthcare delivery. There is currently limited knowledge about this model of cares impact on patients with chronic disease. This study explored current chronic disease management practices implemented by Nurse Practitioners (NP) within NPLCs across ON.

Methods: Using a qualitative interpretive description methodology, eleven in-depth semi-structured interviews were conducted with nurse practitioners practicing within NPLCs in Ontario.

Results: Results indicate NPLCs successfully support patients with chronic disease through provision of on-site multidisciplinary care, continuity in service provision …