Primary Care Commons^™

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. …

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 …

Developing Artificial Intelligence And Machine Learning To Support Primary Care Research And Practice, Jacqueline K. Kueper

Electronic Thesis and Dissertation Repository

This thesis was motivated by the potential to use "everyday data", especially that collected in electronic health records (EHRs) as part of healthcare delivery, to improve primary care for clients facing complex clinical and/or social situations. Artificial intelligence (AI) techniques can identify patterns or make predictions with these data, producing information to learn about and inform care delivery. Our first objective was to understand and critique the body of literature on AI and primary care. This was achieved through a scoping review wherein we found the field was at an early stage of maturity, primarily focused on clinical decision support …

Evaluating The Implementation Of A Chronic Obstructive Pulmonary Disease Management Program Using The Consolidated Framework For Implementation Research: A Case Study, Stefan Paciocco

Electronic Thesis and Dissertation Repository

Chronic obstructive pulmonary disease (COPD) is a prevalent chronic disease that requires comprehensive approaches to manage. Interprofessional teams are effective at providing chronic disease management and care that meets the needs of patients. As part of an ongoing spread, an interprofessional primary care COPD management program was implemented at a family health team in Ontario. A qualitative case study was performed to determine the supporting or hindering factors to the implementation of the program. Data collected was deductively analyzed using the Consolidated Framework for Implementation Research. Eleven constructs were determined to meaningfully affect implementation. Cosmopolitanism, networks and communication, engaging, design …

Transitioning From Children's Mental Health To Adult Care: Stakeholder Perspectives And Tracking Service Use Into Adulthood, Kyleigh E. Schraeder

Electronic Thesis and Dissertation Repository

Transitioning youth from Children’s Mental Health (CMH) services to adult care poses a major challenge for our mental health and health care systems. This dissertation used a mixed-methods approach to explore the challenges of caring for youth with ongoing mental health problems into young adulthood. A Grounded Theory qualitative study consisted of interviews with youth (i.e., ages 12 to 15) treated in CMH, their parents, CMH providers, and family physicians. Using administrative health record and CMH data in the province of Ontario, a complementary quantitative study examined the likelihood of receiving mental health services within the medical sector after the …

A National Perspective On Childhood Obesity Medical Education: Do Medical Students In Canada Perceive That They Are Prepared To Treat Children With Obesity?, Dr. Dalia Hasan

Electronic Thesis and Dissertation Repository

The purposes of this survey-based, mixed-methods study were to investigate medical students’ perceptions of: (1) the overall level of medical school training acquired in relation to childhood obesity treatment; (2) the medical school training acquired in relation to specific competencies associated with the treatment of children with obesity and their caregiver(s); and (3) additional training needed. Results showed that of the 507 students who provided complete data, approximately 60% (n = 303) disagreed or strongly disagreed that their medical training related to childhood obesity was adequate. With regard to specific competencies and additional training needed, quantitative and qualitative data revealed …

What Shapes Family Physicians' Patterns Of Care For Community Patients At End Of Life?, Joshua D. Shadd

Electronic Thesis and Dissertation Repository

Family physicians (FPs) care for the majority of community patients approaching end of life. Variations among FPs in care activities for these patients have potential implications for equitable access to care. This thesis used mixed methods to explore how FPs in southwestern Ontario, Canada care for these patients, and what shapes the variations. In the primary study, using grounded theory based on in-depth interviews, FPs reported differing in the timing, location and purpose of their activities. These variations were shaped by a process of ‘making it fit’, in which FPs weighed the implications of choices in their unique contexts. In …

The Role Of Religion And Spirituality In The Care Of Patients In Family Medicine, Michael F. Lee-Poy

Electronic Thesis and Dissertation Repository

Aims: This thesis explored patients’ perspectives on discussing their religious and spiritual beliefs with their family physicians and family physicians’ behaviours in discussing patients’ religion and spirituality.

Methods: This thesis examined the role of religion and spirituality in patient care in family medicine using qualitative and quantitative methodologies including in-depth interviews of patients and a survey of family physicians.

Findings: The majority of participants believed that religion and spirituality was important in patient care in family medicine. Barriers and facilitators were identified to the integration of religion and spirituality into patient care. Both studies identified physician comfort level as a …