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The Canadian Journal Of Nursing Research = Revue Canadienne De Recherche En Sciences Infirmieres[JOURNAL]
The Canadian Journal Of Nursing Research = Revue Canadienne De Recherche En Sciences Infirmieres[JOURNAL]
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200 papers
A Multiphase Mixed Methods Study on the Integration of a Population Health Approach in Sexual Health Programs and Services in Ontario Public Health Units.
Frost L, Valaitis R, Jack SM … +2 more , Butt M, Akhtar-Danesh N
Can J Nurs Res · 2023 Sep · PMID 36803033 · Full text
PURPOSE: This study investigated the extent of and factors influencing implementation of a population health approach within sexual health programming in public health. METHOD: This sequential multi-phase mixed methods s...
PURPOSE: This study investigated the extent of and factors influencing implementation of a population health approach within sexual health programming in public health. METHOD: This sequential multi-phase mixed methods study combined findings from a quantitative survey assessing the extent that a population health approach was implemented in sexual health programs in Ontario public health units and qualitative interviews with sexual health managers and/or supervisors. Interviews explored factors influencing implementation and were analyzed using directed content analysis. RESULTS: Staff from fifteen of 34 public health units completed surveys and ten interviews were completed with sexual health managers/supervisors. From the 8 Population Health Key Elements Template, 6 elements were moderately implemented and 2 had low implementation. Qualitative findings focused on enablers and barriers to implementing a population health approach in sexual health programs and services and explained most of the quantitative results. However, some of the quantitative findings were not explained by qualitative data (e.g., low implementation of using the principles of social justice). CONCLUSION: Qualitative findings revealed factors influencing the implementation of a population health approach. A lack of resources available to health units, differing priorities between health units and community stakeholders, and access to evidence around population-level interventions influenced implementation.
Midlife Transition Experiences of South Asian Immigrant Women in Canada: A Qualitative Exploration.
Zou P, Alam A, Shao J … +5 more , Luo Y, Huang Y, Zhang H, Wang W, Sidani S
Can J Nurs Res · 2023 Sep · PMID 36775893 · Full text
BACKGROUND: South Asians make up a significant portion of the immigrant population in Canada, and a large portion of them are in their midlife. To improve the midlife transition of South Asian immigrant women, it is nece...
BACKGROUND: South Asians make up a significant portion of the immigrant population in Canada, and a large portion of them are in their midlife. To improve the midlife transition of South Asian immigrant women, it is necessary to understand their lived experiences. PURPOSE: Guided by the transition theory, this study investigates the midlife experiences of South Asian immigrant women in Canada. METHODS: Twenty-two South Asian midlife, immigrant women were recruited to participate in this study from the Greater Toronto Area, Ontario, Canada. This study consisted of one asynchronous online focus group with 12 participants and ten one-on-one telephone interviews. Qualitative content analysis was guided by transition theory. RESULTS: South Asian immigrant women experienced many different transitions in their midlife in Canada. These transitions included changes in their (a) lifestyle, (b) career, (c) family, (d) physical health, (e) mental health, (f) social, (g) environment, and (h) personal development. Women actively managed their transitions using strategies such as exercise, socialization, counseling, and religion. Women expressed the need for social, community, and governmental support to facilitate their midlife transitions. CONCLUSION: To promote healthy midlife transition, governments need to create better employment policies to facilitate immigrant women settlement, transferring skills, and re-employment in Canada. In addition, health care and community services to promote physical and mental health should be emphasized.
The Relationship between Nursing Leadership and Patient Readmission Rate: A Systematic Review.
Al Sabei SD, Ross AM
Can J Nurs Res · 2023 Sep · PMID 36734052 · Publisher ↗
BACKGROUND: Nurse leaders play a fundamental role in improving patient quality care delivery, thus improving patient clinical outcomes. PURPOSE: This systematic review examined the knowledge to date of nursing leadership...
BACKGROUND: Nurse leaders play a fundamental role in improving patient quality care delivery, thus improving patient clinical outcomes. PURPOSE: This systematic review examined the knowledge to date of nursing leadership on reducing patient readmission rates. METHODS: A literature review was conducted using seven electronic databases: Medline Ovid, PubMed, Cumulative Index to Nursing and Allied Health (CINAHL) Plus, Emerald, PsycINFO, ABI/INFORM collection, and EBSCO, with the addition of references for relevant papers reviewed. FINDINGS: The search resulted in a total of 15 articles. Findings revealed that leadership practices of nurses have an impact on reducing patient readmission rates. CONCLUSIONS: The results suggest a need for further rigorous studies investigating the mechanism of how nursing leadership relates to patient readmission rates and how to translate this into practice across diverse cultures.
The Prevalence and Predictors of Compassion Satisfaction, Burnout and Secondary Traumatic Stress in Registered Nurses in an Eastern Canadian Province: A Cross-Sectional Study.
Maddigan J, Brennan M, McNaughton K … +2 more , White G, Snow N
Can J Nurs Res · 2023 Dec · PMID 36694930 · Full text
BACKGROUND: The quality of Registered Nurses' worklife is impacting nurses' mental health, and the standard of care received by clients. Contributing factors to nurses' stress are the trauma of continuous caring for thos...
BACKGROUND: The quality of Registered Nurses' worklife is impacting nurses' mental health, and the standard of care received by clients. Contributing factors to nurses' stress are the trauma of continuous caring for those in great suffering, and adverse working conditions. OBJECTIVES: i) to explore the prevalence of work-related stress in a provincial sample of Registered Nurses; ii) to compare the levels of compassion satisfaction, burnout and secondary traumatic stress reported by nurses in hospital, community, non-direct care settings, and, iii) to identify factors that predict levels of nursing work stress. METHODS: A descriptive, predictive study with a self-report survey containing demographic questions and the Professional Quality of Life Scale was emailed to over 3,300 Registered Nurses. The scale measured the prevalence of three worklife indicators, compassion satisfaction, burnout and secondary traumatic stress. Multiple linear regression identified factors that predicted the levels of the three indicators. A subgroup analysis explored the quality of worklife based on three practice environments. FINDINGS: Nurses (n = 661) reported moderate compassion satisfaction, burnout, and secondary traumatic stress. The strongest predictor, satisfaction with one's current job, predicted high compassion satisfaction and lower burnout and secondary stress. The subgroup analysis identified hospital nurses as having the most work-related stress and the lowest level of compassion satisfaction. CONCLUSION: Innovative, collaborative action can transform nurses' practice environments. Organizational support is essential to bring about needed improvements.
New Graduate Nurses Navigating Entry to Practice in the Covid-19 Pandemic.
McMillan K, Akoo C, Catigbe-Cates A
Can J Nurs Res · 2023 Mar · PMID 36635915 · Full text
BACKGROUND: The Covid-19 pandemic has significantly impacted organizational life for nurses, with known physical and psychological impacts. New graduate nurses are a subset of nurses with unique needs and challenges as t...
BACKGROUND: The Covid-19 pandemic has significantly impacted organizational life for nurses, with known physical and psychological impacts. New graduate nurses are a subset of nurses with unique needs and challenges as they transition into their registered nurse roles. However, this subset of nurses has yet to be explored in the context of the Covid-19 pandemic. PURPOSE: To explore the experiences of new graduate nurses entering the profession in Ontario, Canada, during the Covid-19 pandemic approximately one year after entering the profession. METHODS: Thorne's interpretive description method was utilized. FINDINGS: All participants identified as completing second entry nursing programs, offering a unique perspective on new graduate nurse transition. Four themes emerged in the data: ' Participants felt ill prepared to enter the profession and were cognizant of the various challenges facing the nursing profession, and how these pre-existing challenges were exacerbated by the pandemic. They acknowledged the need to protect themselves against burnout and poor mental health, and as such, made calculated early career decisions - demonstrating strong socio-political knowing. Half of the participants had already left their first nursing job; citing unmet orientation, mental health, and wellbeing needs. However, all participants were steadfast in remaining in the nursing profession. CONCLUSIONS: Second entry new graduate nurses remain a unique subset of nurses that require more scholarly attention as their transition experiences may differ from the traditional trajectory of new graduate nurses.
Newcomer Women's Experiences with Perinatal Care During the Three-Month Health Insurance Waiting Period in Ontario, Canada.
Pimienta J, Guruge S, St-Amant O … +2 more , Catallo C, Hart C
Can J Nurs Res · 2023 Sep · PMID 36632015 · Full text
BACKGROUND: The three-month health insurance waiting period in Ontario reinforces health inequities for newcomer women and their babies. Little is known about the systemic factors that shape newcomer women's experiences...
BACKGROUND: The three-month health insurance waiting period in Ontario reinforces health inequities for newcomer women and their babies. Little is known about the systemic factors that shape newcomer women's experiences during the OHIP waiting period. PURPOSE: To examine the factors that shaped newcomer women's experiences with perinatal care during the three-month health insurance waiting period in Ontario, Canada. METHODS: This qualitative study was informed by an intersectional framework, and guided by a critical ethnographic method. Individual interviews were conducted with four newcomer women and three perinatal healthcare professionals. Participant observations at recruitment and interview sites were integral to the study design. RESULTS: The key systemic factors that shaped newcomer women's experiences with perinatal care included social identity, migration, and the healthcare system. Social identities related to gender, race, and socio-economic status intersected to form a social location, which converged with newcomer women's experiences of social isolation and exclusion. These experiences, in turn, intersected with Ontario's problematic perinatal health services. Together, these factors form systems of oppression for newcomer women in the perinatal period. CONCLUSIONS: Given the health inequities that can result from these systems of oppression, it is important to adopt an upstream approach that is informed by the Human Rights Code of Ontario to improve accessibility to and the experiences of perinatal care for newcomer women.
The Association Between Frailty and a Nurse-Identified Need for Comprehensive Geriatric Assessment Referral from the Emergency Department.
Mowbray FI, Ellis B, Schumacher C … +7 more , Heckman G, de Wit K, Strum RP, Jones A, Correia RH, Mercier E, Costa AP
Can J Nurs Res · 2023 Sep · PMID 36632010 · Full text
BACKGROUND: Emergency nurses commonly conduct geriatric assessments in the emergency department (ED). However, little is known about what geriatric syndromes or clinical presentations prompt a nurse to document an identi...
BACKGROUND: Emergency nurses commonly conduct geriatric assessments in the emergency department (ED). However, little is known about what geriatric syndromes or clinical presentations prompt a nurse to document an identified need for comprehensive geriatric assessment (CGA). OBJECTIVES: To examine the association between geriatric syndromes, like frailty, and a nurse-identified need for a CGA following emergency care. METHODS: We conducted a secondary analysis of a multi-province Canadian cohort from the InterRAI Multinational Cohort Study. We collected data at ED registration from patients 75 years of age and older (n = 2,274) from eight ED sites across Canada between November 2009 and April 2012. Geriatric syndromes were assessed by trained emergency nurses using the interRAI ED Contact Assessment; and we retrospectively calculated the ED frailty index. We employed binary logistic regression to determine the adjusted associations between geriatric syndromes and a nurse-identified need for a CGA. RESULTS: Approximately one-quarter (28%) of older adults were identified to need a CGA following emergency care. A 0.1 unit increase in the ED frailty index increased the likelihood of a nurse identify a need for CGA (RD: 6.6; 95% CI = 5.5-7.9). Most geriatric syndromes increased the probability of a nurse documenting the need for a CGA. CONCLUSION: When assessed by emergency nurses, the identified need for CGA is strongly linked to the presence of geriatric syndromes, including frailty. We provide face validity for the continued use of emergency nurses for screening and assessing older ED patients.
Awakening Undergraduate Nursing Students' Critical Awareness About Men's Health, Health Literacy and Nursing Practice.
Zanchetta MS, Metersky K, Nazzal A … +5 more , Dumitriu ME, Pais S, Mok YW, Lam-Kin-Teng MR, Yu C
Can J Nurs Res · 2023 Sep · PMID 36523144 · Full text
BACKGROUND: This article reports an evaluative replication study, including a workshop inspired by Paulo Freire's critical pedagogy. Purpose: Assess how the nursing students' participation in critiquing Canadian empirica...
BACKGROUND: This article reports an evaluative replication study, including a workshop inspired by Paulo Freire's critical pedagogy. Purpose: Assess how the nursing students' participation in critiquing Canadian empirical evidence on men's health literacy provokes new perceptions; explore students' intentions of incorporating the aforementioned contents into their professional practice; and test students' skills to formulate a hypothetical short action plan about men's health literacy. METHODS: A qualitative evaluation study inspired by the qualitative program evaluation approach. The setting was a university-based Canadian undergraduate nursing program located in a major metropolitan city. Seventeen undergraduate students (representing 3.65% of year 4 student population) composed the sample. The educational intervention was two workshops (6 h duration; February 2017) including a lecture about men's health literacy with video presentations, class discussions and group work using Freire's method of reflection and discussion for awareness awakening. Hypothetical health literacy promotion was the key outcome. All interactions were digitally audiorecorded, verbatim transcribed and submitted to thematic analysis having as themes: Perspectives of awareness and knowledge expansion, and New personal-professional assets. RESULTS: Students were able to relate new knowledge with their own experiences in the classroom or in the practicum. Application of new knowledge was related to students' social circles and reported familiar health matters. Cultural and community life shaped knowledge expansion and references to men's behaviors. CONCLUSIONS: Mobilization of personal knowledge awoke students' awareness about gaps in the nursing curriculum and the paucity of experiences in clinical placements relating to men's health literacy.
The Understanding of Maternal Smoking among Women who were Smoking or had Quit Smoking during Pregnancy.
Small S, Brennan-Hunter A, Yi Y … +1 more , Porr C
Can J Nurs Res · 2023 Jun · PMID 36214102 · Full text
BACKGROUND: Maternal tobacco smoking during pregnancy is associated with adverse health effects for the woman, fetus, and child, including such serious effects as preterm birth, low birth weight, stillbirth, and neonatal...
BACKGROUND: Maternal tobacco smoking during pregnancy is associated with adverse health effects for the woman, fetus, and child, including such serious effects as preterm birth, low birth weight, stillbirth, and neonatal and sudden infant death. Smoking cessation during pregnancy reduces health risks. PURPOSE: In order to support pregnant women to quit smoking, it is essential to know determinants of quitting smoking in pregnancy. The purpose of this research was to examine women's understanding of maternal smoking, in terms of their beliefs, in relation to quitting smoking during pregnancy. METHODS: The study was a cross-sectional survey with anonymous questionnaires. The sample consisted of 161 pregnant and postnatal women who were continuing or had continued to smoke during pregnancy or had quit smoking during pregnancy. Logistic regression was used to determine the impact of women's understanding of maternal smoking on quitting smoking in pregnancy. RESULTS: A large majority of the women had low to moderate understanding of maternal smoking. Those with higher levels of understanding were more likely to quit smoking during pregnancy than were those with a low level of understanding. Not having children prior to the current pregnancy or childbirth also increased the likelihood of quitting smoking during pregnancy while being without a partner combined with having a longer duration of smoking decreased the likelihood of quitting smoking during pregnancy. CONCLUSION: As a modifiable factor, pregnant women's understanding of maternal smoking can be readily targeted with informational interventions in an effort to help them quit smoking.
Service Providers' Perspectives: Reducing Intimate Partner Violence in Rural and Northern Regions of Canada.
Letourneau N, McBride DL, Barton SS … +1 more , Griggs K
Can J Nurs Res · 2023 Jun · PMID 36177507 · Full text
BACKGROUND: Intimate partner violence (IPV) persists as a serious challenge, globally, with regions in Central and Northern Canada reporting the highest rates of shelter use to escape abuse, of sexual assault, and of IPV...
BACKGROUND: Intimate partner violence (IPV) persists as a serious challenge, globally, with regions in Central and Northern Canada reporting the highest rates of shelter use to escape abuse, of sexual assault, and of IPV in the country. Despite research into IPV, barriers and gaps exist in understanding what an effective response to IPV in rural and northern communities should look like. METHODS: To enhance this understanding, qualitative interviews and focus groups with a total of 55 participants were conducted with service providers, including shelter services, victims services, the Royal Canadian Mounted Police, counselors, and others (e.g., psychologists). A grounded theory approach was used to analyze data, with findings illustrated in a schematic that conceptualize the challenges service providers experience. RESULTS: The findings reveal how an IPV environment, characterized by oppression, abuse, and illness, requires transformation into an IPV-free environment, characterized by empowerment, positive social connections, and wellness. As service providers work to influence this transition, they become experts in understanding the sociocultural context, formal services, and informal supports accessible or not for women experiencing IPV. Service providers encourage social media use into service delivery to improve communication; lobby for rural-specific IPV specialists; and recognize isolation as a barrier to seeking out safe shelter and housing, transportation, and economic assistance. CONCLUSION: In order to reduce rates of IPV, the results suggest we must support service providers, document service gaps, and maximize policy change and community action based on IPV as it is experienced in rural and northern regions of Canada.
Using Narrative Inquiry to Understand Anti-Muslim Racism in Canadian Nursing.
Saleh N, Clark N, Bruce A … +1 more , Moosa-Mitha M
Can J Nurs Res · 2023 Sep · PMID 36177505 · Full text
BACKGROUND: Islamophobia or, anti-Muslim racism, and more specifically, gendered islamophobia targeting Muslim women who wear a hijab is rising globally and is aggravated by the COVID-19 pandemic. However, anti-Muslim ra...
BACKGROUND: Islamophobia or, anti-Muslim racism, and more specifically, gendered islamophobia targeting Muslim women who wear a hijab is rising globally and is aggravated by the COVID-19 pandemic. However, anti-Muslim racism is not well understood in Canadian nursing. PURPOSE: This study utilized narrative inquiry to understand anti-Muslim racism through the experiences of nurses who wear a hijab with the goal of putting forward their counter-narrative that disrupts anti-Muslim racism in Canadian nursing. METHODS: Narrative inquiry informed by Critical Race Feminism, care ethics, and intersectionality were used to analyze the factors shaping anti-Muslim racism and composite narratives were used to present the results. RESULTS: The three composite narratives are: 'This is Who I Am: A Muslim Nurse with a Hijab and an Accent'; 'I Know What is at Play: Unveiling Operating Power Structures and Power Relations'; and 'Rewriting the Narrative: Navigating Power Structures and Power Relations'. These composite narratives constituted the nurses' counter-narrative. They revealed intersections of gendered, racial divisions of labour and religious narratives that shape anti-Muslim racism, as operating power relations in nursing, and how Muslim nurses reclaimed control to resist their racialized stereotypes. CONCLUSION: Findings suggest that anti-Muslim racism in nursing operates through multiple intersecting power relations. Using stories can mobilize transformational change so that anti-racist practices, policies, and pedagogy can be embraced.
The Effect of Perceived Organizational Support of Nurses on Their Resilience: A Cross-Sectional Study From Turkey.
Karadas A, Dogu Ö, Oz SD
Can J Nurs Res · 2023 Jun · PMID 35929071 · Publisher ↗
BACKGROUND: Throughout and following the ongoing Coronavirus outbreak, there is an urgent need to focus on organizational support strategies aimed at improving the resilience of nurses. PURPOSE: This research aims to th...
BACKGROUND: Throughout and following the ongoing Coronavirus outbreak, there is an urgent need to focus on organizational support strategies aimed at improving the resilience of nurses. PURPOSE: This research aims to the relationship between the nurses' perceived organizational support and their resilience levels, and to reveal the characteristics that make a significant difference. METHODS: The data of this descriptive and cross-sectional study were collected from 722 nurses in February 2021 using the web-based survey method. The study followed the STROBE guideline. The data collection tools included the Introductory Information Form, the Survey of Perceived Organizational Support, and the Psychological Resilience Scale. RESULTS: Nurses were concluded to have perceived a moderate level of organizational support and their psychological resilience were found to be higher than average. A positive relationship was determined between the organizational support perceived by nurses and their psychological resilience. The gender, position/title of nurses, their work experience in COVID-19 treatment services, and having been infected with the COVID-19 virus were found to affect their perception of organizational support and resilience. CONCLUSION: Organizational support perceived by nurses significantly affects their resilience. Resilience programs should, in particular, prioritize permanent clinical nurses who are in the risk group in terms of resilience, female nurses, nurses who had been infected with the COVID 19 virus, and nurses who have been assigned to COVID-19 treatment wards.
Conflicting Working Relationships Among Nurses: The Intersection of Should Nursing, Double Domination, and the Big Picture.
Rauman PA
Can J Nurs Res · 2023 Jun · PMID 35903883 · Full text
BACKGROUND: Research conducted on conflict between Registered Nurses (RNs) has established that it happens regularly within the hospital setting, that it adversely affects the health and well-being of RNs, impacts the ef...
BACKGROUND: Research conducted on conflict between Registered Nurses (RNs) has established that it happens regularly within the hospital setting, that it adversely affects the health and well-being of RNs, impacts the effective functioning of the health care organization, and compromises quality patient care. In this article, the phrase conflicting working relationships (CWRs) is used to represent working relationships between RN peers that are non-collegial, uncaring, and non- supportive, and inclusive of the behaviours associated with incivility, horizontal violence, and bullying, among others. PURPOSE: To examine how nursing, including nursing knowledge and practice, is socially organized within the hospital setting and how this organization is linked to CWRs between RN peers. METHODS: Interviews were conducted with 17 RNs, followed by text analysis and mapping guided by institutional ethnography (IE) as the research methodology. RESULTS: The intersections between should nursing, double domination, and the big picture threads shows work environments where RNs struggle to provide appropriate care and conflict has become institutionalized. The intersection between threads can be used as caution areas for RNs and individuals in leadership positions to reflect on nursing practice when conflict is being experienced. CONCLUSIONS: The contextual variables surrounding professional nursing practice are very influential with respect to how RNs relate to each other. A new type of dialogue about the organization of nursing practice in the hospital setting is needed to support more relational practices between RNs.
Curriculum, Theory, and Practice: Exploring Nurses' and Nursing Students' Knowledge of and Attitudes towards Caring for the Older Adults in Canada.
Mohamed AFH, DeCoito I
Can J Nurs Res · 2023 Jun · PMID 35876326 · Full text
BACKGROUND: Caring for older adults is among the most challenging issue of public health and social care systems in modern societies. By enhancing the nursing curriculum, nursing students will be qualified to provide ger...
BACKGROUND: Caring for older adults is among the most challenging issue of public health and social care systems in modern societies. By enhancing the nursing curriculum, nursing students will be qualified to provide gerontology care, and they will be acknowledging and working to eliminate ageism from the health care system. PURPOSE: This study explores nurses' and nursing students' knowledge and attitudes in caring for older adults and addresses the factors contributing to nurses' perspectives. It also examines the nursing curriculum's contributions to nurses' knowledge and attitudes and provides suggestions aimed at reconfiguring the nursing curriculum for comprehensive gerontology nursing care. METHODS: A mixed-method research design was utilized, and quantitative and qualitative data were collected from 90 nurses and nursing students through an online questionnaire. Data were analyzed via SPSS and NVivo 12 software programs. RESULTS: The results revealed that most nurses possess neutral attitudes toward caring for older patients, and their knowledge ranged from average to above-average levels. Statistical analysis revealed no statistically significant difference between gender and nurses' attitudes or between gender and knowledge. Similarly, there was no statistically significant difference between work status and nurses' attitudes. Results showed a statistically significant positive correlation between nurses' attitudes and knowledge level. This study demonstrated the positive impact of the Canadian nursing curriculum on nurses' knowledge and attitudes. CONCLUSION: The current study recommends providing gerontology nursing courses as a mandatory separate course in nursing education to enhance nursing students' knowledge and skills for high-quality gerontology nursing care.
Developing a Comprehensive Understanding of Older Person Abuse in Canadian Immigrant Communities: An Integrative Review.
Mehdi F, Dahlke S, Hunter KF
Can J Nurs Res · 2023 Jun · PMID 35821575 · Publisher ↗
Older immigrants represent 28% of the Canadian population who are over the age of 60. World-wide 1 in 6 older persons experiences abuse. Due to population aging, attention must be paid to the abuse and victimization of o...
Older immigrants represent 28% of the Canadian population who are over the age of 60. World-wide 1 in 6 older persons experiences abuse. Due to population aging, attention must be paid to the abuse and victimization of older immigrant persons, and the concept of elder abuse. The purpose of this integrative review was to understand elder abuse from the perspective of older immigrants, who came to Canada in their 60s or older as dependents of families or sponsors. Whittemore and Knafl's (2005) method of review resulted in six articles that met the inclusion criteria. Results revealed three themes: conceptualization of abuse, post-immigration stressors and cultural factors, and barriers to access support and protection. The perpetrators were often close family members including intimate partners, spouses, children, children-in-laws and grandchildren. Contextual factors that influenced abuse included: power imbalance, change in social status from head of the families to legal and financial dependents due to immigration, culture, ethnicity, gender role expectations and language barrier. More research is needed to understand the diverse older immigrants experiences of elder abuse.
Validating PreCHAT: A Digital Preconception Health Risk Assessment Tool to Improve Reproductive, Maternal and Child Health.
Montanaro C, Robson L, Binnington L … +2 more , Winters N, Brown HK
Can J Nurs Res · 2023 Jun · PMID 35816292 · Publisher ↗
STUDY BACKGROUND: Despite the growing understanding of preconception care, numerous barriers to its delivery still exist, including a lack of evidence-based, accessible screening tools. PURPOSE: To validate a new digital...
STUDY BACKGROUND: Despite the growing understanding of preconception care, numerous barriers to its delivery still exist, including a lack of evidence-based, accessible screening tools. PURPOSE: To validate a new digital Preconception Health Assessment Tool (PreCHAT) against the current best practice, physician-delivered tool in Ontario, Canada, and explore how PreCHAT's design impacts its risk identification abilities relative to the comparison tool. METHODS: A criterion validation study was conducted with 53 female participants aged 18-44 years. Participants completed both tools in a controlled setting. PreCHAT was completed on a tablet individually by participants, while the comparison tool was administered by a physician. Three physicians administered the comparison tool. Measures of strength of agreement between PreCHAT and the comparison tool were calculated using percent agreement, Cohen's Kappa, and prevalence-adjusted and biased-adjusted kappa (PABAK). RESULTS: PreCHAT identified 135 individual risk factors, while the comparison tool identified 102. Both tools shared the same 14 domains of preconception care and 88 risk factors; of the 88 risk factors, PreCHAT identified an average of 3.42 (p < 0.0001) more risks per participant than the comparison tool. PABAK scores indicated almost perfect agreement between PreCHAT and the comparison tool. CONCLUSIONS: This study suggests that PreCHAT is valid against the current best practice tool and is broader in its risk identification among individuals of reproductive age. PreCHAT's patient-facing, digital, EMR-integrated design may offer unique benefits to providers and patients. PreCHAT offers providers an innovative approach to deliver preconception care and may positively impact reproductive, maternal, and child health.
Interpersonal, institutional, and structural racism in Canadian nursing: A culture of silence.
Beagan BL, Bizzeth SR, Etowa J
Can J Nurs Res · 2023 Jun · PMID 35746848 · Full text
BACKGROUND: Alongside declarations against racism, the nursing profession in Canada needs examination of experiences of racism within its ranks. Racism at multiple levels can create a context wherein racialized nurses ex...
BACKGROUND: Alongside declarations against racism, the nursing profession in Canada needs examination of experiences of racism within its ranks. Racism at multiple levels can create a context wherein racialized nurses experience barriers and ongoing marginalization. PURPOSE: This critical interpretive qualitative study asks how interpersonal, institutional, and structural racisms intersect in the professional experiences of racialized nurses in Canada, and how nurses respond. METHODS: Self-identified racialized nurses (n = 13) from across Canada were recruited primarily through snowball sampling, and each was interviewed by phone or in person. Once transcribed, interviews were analyzed inductively, which led to the levels of racism as a guiding framework. RESULTS: From entry to nursing education throughout their careers participants experienced racism from instructors, patients, colleagues and managers. Interpersonal racism included comments and actions from patients, but more significantly lack of support from colleagues and managers, and sometimes overt exclusion. Institutional racism included extra scrutiny, heavier workloads, and absence in leadership roles. Structural racism included prevalent assumptions of incompetence, which were countered through extra work, invisibility and hyper-visibility, and expectations of assimilation. Racialized nurses were left to choose among silence, resisting (often at personal cost), assimilation and/or bolstering their credibility through education or extra work. Building community was a key survival strategy. CONCLUSIONS: Everyone in nursing needs to challenge the culture of silence regarding racism. White nurses in particular need to welcome discomfort, listen and learn about racism, then speak out to help disrupt its normative status.
Assessing the Impact of Community Factors on Acute Care Nurses' Job Satisfaction and Turnover Intention.
Yasin YM, Kerr MS, Wong CA … +1 more , Bélanger CH
Can J Nurs Res · 2023 Jun · PMID 35726165 · Publisher ↗
BACKGROUND: Community factors may affect nurses' job behavior and decision making. There is a gap in the literature regarding the impact of community satisfaction, family ties, and community preferences on acute care nur...
BACKGROUND: Community factors may affect nurses' job behavior and decision making. There is a gap in the literature regarding the impact of community satisfaction, family ties, and community preferences on acute care nurses' turnover intention and job satisfaction. Furthermore, no studies have examined the differences in community satisfaction, community preferences, and family ties among nurses working in rural and urban settings. PURPOSE: To identify the impact of family ties, community satisfaction, and community preferences on turnover intention and job satisfaction among acute care nurses working in Ontario's urban and rural areas. METHODS: Descriptive correlational survey design was used in this study. A targeted stratified sampling technique was used to recruit acute care nurses working in Ontario's urban and rural areas (N = 349) between May 2019 and July 2019. Dillman's approach was used to guide data collection. Parametric and non-parametric tests were used for data analysis. RESULTS: A significant association was found between working settings and community preferences. A statistically significant positive relationship between community satisfaction and nurses' job satisfaction was identified. Furthermore, community satisfaction had a negative impact on turnover intention. Neither community preference nor family ties were significantly associated with turnover intention or job satisfaction. CONCLUSION: The study suggests that community satisfaction can influence important nurse work-related outcomes. Future studies should replicate and validate these results in different contexts and cultures. Retaining nurses may be difficult if they are not satisfied with their communities.
"The Average Counsellor Wouldn't Know": Exploring How General Health Practitioners Understand and Respond to Domestic Violence.
Loncar N, Scott KL
Can J Nurs Res · 2023 Jun · PMID 35726162 · Full text
BACKGROUND: Individuals experiencing and perpetrating intimate partner violence (IPV) are frequently in contact with general health and mental health services. Health service providers, including nurses, thus have a key...
BACKGROUND: Individuals experiencing and perpetrating intimate partner violence (IPV) are frequently in contact with general health and mental health services. Health service providers, including nurses, thus have a key role in identifying and responding to initial indicators of IPV risk. PURPOSE: The present study provides descriptive information about current assessment and intervention practices of health and mental health service providers when patients are presenting with concerns about IPV. METHODS: A secondary data analysis of interviews with general health practitioners (n = 17) were coded and dominant themes analyzed through thematic analysis. RESULTS: The present study uncovered ways in which IPV-related risks are, and are not, recognized and responded to. A metaphorical visual display in the form of a "domestic violence supply room" depicts the level of access and degree of competency described by practitioners in respective areas of practice. Within reach for all practitioners is the knowledge of factors that increase risk and vulnerability to IPV. Out of reach is a comprehensive understanding of the needs of children and perpetrators as well as the consistent ability to consider intersectionality and be reflexive when working with culturally and linguistically diverse populations. The step ladder to improved IPV response, including formal supports such as training and procedures, is frequently described as lacking. CONCLUSIONS: A consistent and empirically supported approach to IPV assessment and response is rare to find across generalist service provision. Although service providers possess basic knowledge of risk factors, organizational direction is needed to allow providers to address IPV confidently and effectively.
Sensitivity Analysis: A Method to Promote Certainty and Transparency in Nursing and Health Research.
Mowbray FI, Manlongat D, Shukla M
Can J Nurs Res · 2022 Dec · PMID 35702010 · Full text
Nursing and health researchers may be presented with uncertainty regarding the utilization or legitimacy of methodological or analytic decisions. Sensitivity analyses are purposed to gain insight and certainty about the...
Nursing and health researchers may be presented with uncertainty regarding the utilization or legitimacy of methodological or analytic decisions. Sensitivity analyses are purposed to gain insight and certainty about the validity of research findings reported. Reporting guidelines and health research methodologists have emphasized the importance of utilizing and reporting sensitivity analyses in clinical research. However, sensitivity analyses are underreported in nursing and health research. The aim of this methodological overview is to provide an introduction to the purpose, conduct, interpretation, and reporting of sensitivity analyses, using a series of simulated and contemporary case examples.
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