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Thirsk LM, Vandall-Walker V, Rasiah J, Keyko K. A Taxonomy of Supports and Barriers to Family-Centered Adult Critical Care: A Qualitative Descriptive Study. J Fam Nurs 2021; 27:199-211. [PMID: 33769127 PMCID: PMC8361475 DOI: 10.1177/1074840721999372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Family-centered care (FCC) improves the quality and safety of health care provision, reduces cost, and improves patient, family, and provider satisfaction. Despite several decades of advocacy, research, and evidence, there are still challenges in uptake and adoption of FCC practices in adult critical care. The objective of this study was to understand the supports and barriers to family-centered adult critical care (FcACC). A qualitative descriptive design was used to develop a taxonomy. Interviews and focus groups were conducted with 21 participants in Alberta, Canada, from 2013 to 2014. Analysis revealed two main domains of supports and barriers to FcACC: PEOPLE and STRUCTURES. These domains were further classified into concepts and subconcepts that captured all the reported data. Many factors at individual, group, and organizational levels influenced the enactment of FcACC. These included health care provider beliefs, influence of primary versus secondary tasks, perceptions of family work, nurses' emotional labor, and organizational culture.
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Affiliation(s)
| | | | | | - Kacey Keyko
- Edmonton Southside Primary Care
Network, Alberta, Canada
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2
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Green C, Vandall-Walker V, Rysdale L, Stevens M, Feldmann H, Tymura S, Stojkovic K. You Can't Touch…or Can You? Dietitians' Perceptions of Expressive Touch in Client Encounters. CAN J DIET PRACT RES 2020; 81:112-119. [PMID: 32072833 DOI: 10.3148/cjdpr-2020-005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: We explored Registered Dietitians' (RDs') perceptions about expressive touch (ET) as a means to provide client-centred care, a practice unreported to date. For this study, ET is defined as relatively spontaneous, responsive, and affective contact by dietitians. Methods: This exploratory study used an explanatory sequential mixed-methods approach. RDs in Northern Ontario were surveyed (54% response, n = 135) and these results were further explored in interviews with a subset of participants (n = 17). Analysis included descriptive and association statistics and qualitative description. Results: Most RDs considered ET a useful tool for effective client communication (66%-77%), yet they were hesitant to enact the practice (81%). Analysis of interviews revealed ET to be "situationally beneficial" with uptake influenced by an interplay of factors, described as: perceived client openness to touch, the environment, and RD comfort with touch. Greater uptake was reported among RDs working with distressed clients and clients in ambulatory clinics and long-term care. ET practice was limited by personal safety concerns, unknown client customs, and client misinterpretation. Conclusion: ET was valued by many RDs as an enhancement to client-centred care. Selective use of ET is influenced by the context of dietetic practice and by perceived client and RD comfort with the use of ET.
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Affiliation(s)
- Cara Green
- Northern Ontario Dietetic Internship Program, Division of Clinical Sciences, Northern Ontario School of Medicine, Thunder Bay, ON
| | | | - Lee Rysdale
- Northern Ontario Dietetic Internship Program, Division of Clinical Sciences, Northern Ontario School of Medicine, Sudbury, ON
| | - Michelle Stevens
- Northern Ontario Dietetic Internship Program, Northern Ontario School of Medicine, Thunder Bay, ON
| | - Heather Feldmann
- Northern Ontario Dietetic Internship Program, Northern Ontario School of Medicine, Thunder Bay, ON
| | - Stacey Tymura
- Northern Ontario Dietetic Internship Program, Northern Ontario School of Medicine, Thunder Bay, ON
| | - Kelsey Stojkovic
- Northern Ontario Dietetic Internship Program, Northern Ontario School of Medicine, Thunder Bay, ON
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Bergmeier HJ, Vandall-Walker V, Skrybant M, Teede HJ, Bailey C, Baxter JAB, Borges ALV, Boyle JA, Everitt A, Harrison CL, Herrera M, Hill B, Jack B, Jones S, Jorgensen L, Lim S, Montanaro C, Redman LM, Stephenson J, Sundseth H, Thangaratinam S, Thynne P, Walker R, Skouteris H. Global Health in Preconception, Pregnancy and Postpartum Alliance: development of an international consumer and community involvement framework. Res Involv Engagem 2020; 6:47. [PMID: 32793390 PMCID: PMC7419190 DOI: 10.1186/s40900-020-00218-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The goal of the Global Health in Preconception, Pregnancy and Postpartum (HiPPP) Alliance, comprising consumers and leading international multidisciplinary academics and clinicians, is to generate research and translation priorities and build international collaboration around healthy lifestyle and obesity prevention among women across the reproductive years. In doing so, we actively seek to involve consumers in research, implementation and translation initiatives. There are limited frameworks specifically designed to involve women across the key obesity prevention windows before (preconception), during and after pregnancy (postpartum). The aim of this paper is to outline our strategy for the development of the HiPPP Consumer and Community (CCI) Framework, with consumers as central to co-designed, co-implemented and co-disseminated research and translation. METHOD The development of the framework involved three phases: In Phase 1, 21 Global HiPPP Alliance members participated in a CCI workshop to propose and discuss values and approaches for framework development; Phase 2 comprised a search of peer-reviewed and grey literature for existing CCI frameworks and resources; and Phase 3 entailed collaboration with consumers (i.e., members of the public with lived experience of weight/lifestyle issues in preconception, pregnancy and postpartum) and international CCI experts to workshop and refine the HiPPP CCI Framework (guided by Phases 1 and 2). RESULTS The HiPPP CCI Framework's values and approaches identified in Phases 1-2 and further refined in Phase 3 were summarized under the following five key principles: 1. Inclusive, 2. Flexible, 3. Transparent, 4. Equitable, and 5. Adaptable. The HiPPP Framework describes values and approaches for involving consumers in research initiatives from design to translation that focus on improving healthy lifestyles and preventing obesity specifically before, during and after pregnancy; importantly it takes into consideration common barriers to partnering in obesity research during perinatal life stages, such as limited availability associated with family caregiving responsibilities. CONCLUSION The HiPPP CCI Framework aims to describe approaches for implementing meaningful CCI initiatives with women in preconception, pregnancy and postpartum periods. Evaluation of the framework is now needed to understand how effective it is in facilitating meaningful involvement for consumers, researchers and clinicians, and its impact on research to improve healthy lifestyle outcomes.
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Affiliation(s)
- Heidi J. Bergmeier
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | | | - Magdalena Skrybant
- NIHR Applied Reseach Collaboration West Midlands, Midlands, UK
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK
| | - Helena J. Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
- Monash Partners Advanced Health Research Translation Centre, Clayton, Victoria Australia
- Monash Health, Melbourne, Clayton, Victoria Australia
| | - Cate Bailey
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Jo-Anna B. Baxter
- Centre for Global Child Health, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, ON Canada
| | | | - Jacqueline A. Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
- Monash Health, Melbourne, Clayton, Victoria Australia
| | - Ayesha Everitt
- HiPPP Consumer Expert Group, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Margely Herrera
- HiPPP Consumer Expert Group, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Brian Jack
- Boston University Institute for Health Systems Innovation and Policy, Boston, MA USA
| | - Samuel Jones
- HiPPP Consumer Expert Group, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Laura Jorgensen
- Barts Research Centre for Women’s Health (BARC), Women’s Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK
| | - Siew Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Cynthia Montanaro
- Wellington-Dufferin-Guelph Public Health, 160 Chancellors Way, Guelph, Ontario Canada
| | - Leanne M. Redman
- Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research Center, Baton Rouge, USA
| | - Judith Stephenson
- Institute of Women’s Health, University College London, EGA Institute for Women’s Health, London, UK
| | - Hildrun Sundseth
- European Institute of Women’s Health, Dublin, Republic of Ireland
| | - Shakila Thangaratinam
- Institute of Metabolism and Systems Research, WHO Collaborating Centre for Women’s Health University of Birmingham, Birmingham, UK
| | - Paula Thynne
- HiPPP Consumer Expert Group, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Ruth Walker
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria Australia
- Warwick Business School, University of Warwick, Coventry, UK
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Amirav I, Vandall-Walker V, Rasiah J, Saunders L, Belur H, Sahlin B, Roduta Roberts M, Redlich-Amirav D. An Asthma Specialist's Consult Letter: What Do Parents Think About Receiving a Copy? J Asthma Allergy 2020; 13:179-186. [PMID: 32440163 PMCID: PMC7217314 DOI: 10.2147/jaa.s249893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 04/19/2020] [Indexed: 12/02/2022] Open
Abstract
Objective Written summaries about visits with general practitioners’ have influenced increased patient knowledge, satisfaction, recollection, and compliance, and strengthened the doctor–patient relationship. All previous studies about this communication pre-dated the electronic medical record (EMR) era, and none examined views from parents of children with asthma. We explored parents’ perceptions about receiving a hard copy summary Letter immediately following the visit, with the pediatric asthma specialist about findings and the care plan for their child. Methods A Parent Advisory Council helped inform this pilot study, an observational cross-sectional electronic survey. Each Letter included a comprehensive summary of the child’s visit with the specialist. Results Previous findings from patients about the benefits of receiving this Letter were strongly supported by data from 51 participants. Interestingly, more than 54% of respondents preferred receiving a hard copy Letter over an electronic copy, and 98% wanted other clinicians to adopt this practice. Conclusion Parents of children with asthma value and want timely written information of this nature from other clinicians. Practice Implications These results can influence further asthma research to promote a change in the perceptions of clinicians, parents, and patients about timely access to health information in the EMR era.
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Affiliation(s)
- Israel Amirav
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Virginia Vandall-Walker
- Patient Engagement Platform, Alberta SPOR Support Unit, Edmonton, Alberta, Canada.,Faculty of Health Disciplines, Athabasca University, Athabasca & Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Jananee Rasiah
- Patient Engagement Platform, Alberta SPOR Support Unit, Edmonton, Alberta, Canada.,Faculty of Health Disciplines, Athabasca University, Athabasca & Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | | | - Harsha Belur
- Parent Advisory Council, Edmonton, Alberta, Canada
| | | | - Mary Roduta Roberts
- Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Dorit Redlich-Amirav
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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5
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Jackson J, Vandall-Walker V, Vanderspank-Wright B, Wishart P, Moore SL. Burnout and resilience in critical care nurses: A grounded theory of Managing Exposure. Intensive Crit Care Nurs 2018; 48:28-35. [PMID: 30033214 DOI: 10.1016/j.iccn.2018.07.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 05/29/2018] [Accepted: 07/03/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Many critical care nurses experience burnout; however, resilience shows promise as a potential solution to burnout. This study was conducted to better understand nurse burnout and resilience in response to workplace adversity in critical care. DESIGN A grounded theory investigation, using the Corbin and Strauss methodology. Participants engaged in qualitative, open-ended interviews about burnout and resilience. SETTING A multi-site, urban, teaching hospital in Canada. PARTICIPANTS 11 female critical care nurses, with 1-30+ years of critical care experience. FINDINGS Burnout and resilience can be understood as indicators in a process of responding to workplace adversity. Workplace adversity can take many forms and has a negative impact on nurses. Nurses must be aware of this impact to take action. The process of Managing Exposure is how nurses address workplace adversity, using variety of techniques: protecting, processing, decontaminating, and distancing. The indicators of this process for nurses are thriving, resilience, survival and burnout. Organisational policies can impact on this process. CONCLUSIONS Resilience and burnout are connected, as indicators of the same process for critical care nurses. Nurse leaders can intervene throughout this process to reduce workplace adversity and support resilience among nurses.
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Affiliation(s)
- Jennifer Jackson
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, United Kingdom.
| | | | | | - Paul Wishart
- Department of Surgery, Faculty of Medicine, University of Calgary, Canada
| | - Sharon L Moore
- Faculty of Health Disciplines, Athabasca University, Canada
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6
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Manafo E, Petermann L, Mason-Lai P, Vandall-Walker V. Correction to: Patient engagement in Canada: a scoping review of the 'how' and 'what' of patient engagement in health research. Health Res Policy Syst 2018. [PMID: 29540188 PMCID: PMC5853054 DOI: 10.1186/s12961-018-0296-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Elizabeth Manafo
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta, T9S 3A3, Canada.
| | - Lisa Petermann
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta, T9S 3A3, Canada
| | - Ping Mason-Lai
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta, T9S 3A3, Canada
| | - Virginia Vandall-Walker
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, Alberta, T9S 3A3, Canada
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7
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Manafò E, Petermann L, Vandall-Walker V, Mason-Lai P. Patient and public engagement in priority setting: A systematic rapid review of the literature. PLoS One 2018; 13:e0193579. [PMID: 29499043 PMCID: PMC5834195 DOI: 10.1371/journal.pone.0193579] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/14/2018] [Indexed: 11/25/2022] Open
Abstract
Background Current research suggests that while patients are becoming more engaged across the health delivery spectrum, this involvement occurs most often at the pre-preparation stage to identify ‘high-level’ priorities in health ecosystem priority setting, and at the preparation phase for health research. Objective The purpose of this systematic rapid review of the literature is to describe the evidence that does exist in relation to patient and public engagement priority setting in both health ecosystem and health research. Data sources HealthStar (via OVID); CINAHL; Proquest Databases; and Scholar’s Portal. Study eligibility criteria i) published in English; ii) published within the timeframe of 2007—Current (10 years) unless the report/article was formative in synthesizing key considerations of patient engagement in health ecosystem and health research priority setting; iii) conducted in Canada, the US, Europe, UK, Australia/New Zealand, or Scandinavian countries. Study appraisal and synthesis i) Is the research valid, sound, and applicable?; ii) what outcomes can we potentially expect if we implement the findings from this research?; iii) will the target population (i.e., health researchers and practitioners) be able to use this research?. A summary of findings from each of the respective processes was synthesized to highlight key information that would support decision-making for researchers when determining the best priority setting process to apply for their specific patient-oriented research. Results Seventy articles from the UK, US, Canada, Netherlands and Australia were selected for review. Results were organized into two tiers of public and patient engagement in prioritization: Tier 1—Deliberative and Tier 2—Consultative. Highly structured patient and public engagement planning activities include the James Lind Alliance Priority Setting Partnerships (UK), Dialogue Method (Netherlands), Global Evidence Mapping (Australia), and the Deep Inclusion Method/CHoosing All Together (US). Limitations The critical study limitations include challenges in comprehensively identifying the patient engagement literature for review, bias in article selection due to the identified scope, missed information due to a more limited use of exhaustive search strategies (e.g., in-depth hand searching), and the heterogeneity of reported study findings. Conclusion The four public and patient engagement priority setting processes identified were successful in setting priorities that are inclusive and objectively based, specific to the priorities of stakeholders engaged in the process. The processes were robust, strategic and aimed to promote equity in patient voices. Key limitations identified a lack of evaluation data on the success and extent in which patients were engaged. Issues pertaining to feasibility of stakeholder engagement, coordination, communication and limited resources were also considered.
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Affiliation(s)
- Elizabeth Manafò
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Edomonton, Alberta, Canada
- * E-mail:
| | - Lisa Petermann
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Edomonton, Alberta, Canada
| | | | - Ping Mason-Lai
- Patient Engagement Platform, Alberta SPOR SUPPORT Unit, Edomonton, Alberta, Canada
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8
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Heyland DK, Davidson J, Skrobik Y, des Ordons AR, Van Scoy LJ, Day AG, Vandall-Walker V, Marshall AP. Improving partnerships with family members of ICU patients: study protocol for a randomized controlled trial. Trials 2018; 19:3. [PMID: 29301555 PMCID: PMC5753514 DOI: 10.1186/s13063-017-2379-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 11/24/2017] [Indexed: 11/24/2022] Open
Abstract
Background Over the last decade, health care delivery has shifted to partnering with patients and their families to improve health and quality of care, and to lower costs. Partnering with family members (FMs) of critically ill patients who lack capacity is particularly important for improving experiences and outcomes for both patients and FMs. How best to apply such partnering strategies, however, is yet unknown. The IMPACT trial will evaluate two interventions that enable partnerships with families of critically ill patients, each in a distinct content area, but similar in that they empower and support FMs. Methods This multi-center, open-label, randomized, phase II clinical trial aims to randomize 150 older, long-stay ICU patients and their families into one of three groups (50 in each group): (1) The OPTimal nutrition by Informing and Capacitating FMs of best practices (OPTICs) group, a multi-faceted intervention to engage and empower FMs to advocate for, and audit, best nutritional practices for their critically ill FMs, (2) A web-based decision-support intervention called the ICU Workbook (The Canadian Researchers at the End of Life Network (CARENET) ICU Workbook; https://www.myicuguide.ca/. Accessed 3 Feb 2017.) to support families in shared decision-making process regarding goals of medical treatments, and (3) Usual care. The main outcomes for this trial include nutritional adequacy in hospital and hand-grip strength prior to hospital discharge; satisfaction with decision-making; decision conflict; and degree of shared decision-making. Discussion With the goal of improving the functional recovery of nutritionally high-risk older patients and the quality of care at the end of life for these patients and their FMs in the ICU, we have proposed two novel family capacitation strategies. We hope that the nutrition and decision-support interventions implemented and evaluated in our study will contribute to the evidentiary basis for best family partnered care pathways focused on optimizing the quality of ICU care for patients with life-threatening illness and their families. Trial registration Clinical trials.gov, ID: NCT02920086. Registered on 30 September 2016. Protocol version dated 11 October 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2379-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daren K Heyland
- Department of Critical Care Medicine, Queen's University, Kingston, ON, Canada. .,Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada. .,Kingston General Hospital, Angada 4, Kingston, ON, K7L 2 V7, Canada.
| | - Judy Davidson
- EBP/Research Nurse Liaison, University of California, San Diego Health, San Diego, CA, USA
| | - Yoanna Skrobik
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Amanda Roze des Ordons
- Department of Critical Care Medicine and Division of Palliative Medicine, University of Calgary, Calgary, AB, Canada
| | - Lauren J Van Scoy
- Department of Medicine and Humanities, Division of Pulmonary, Allergy and Critical Care, Pennsylvania State University, Hershey, PA, USA
| | - Andrew G Day
- Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada
| | - Virginia Vandall-Walker
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada.,Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Andrea P Marshall
- Menzies Health Institute Queensland, Griffith University and Gold Coast Health, Southport, QLD, Australia
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9
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Abstract
INTRODUCTION Transitioning into the Canadian rural acute care environment can be challenging for new RNs, and so retention is of concern. Currently, few seasoned registered nurses (RNs) are available to support new RNs during transition because (a) the Canadian RN workforce countrywide is aging and significant numbers are retiring, and (b) the number of Canadian RNs working rurally has plummeted in the past 10 years. Investigations into the phenomenon of new RNs\' transitions into the workforce have been conducted, but little is known about this phenomenon as it relates to Canadian rural acute care hospitals. Most findings have been based on data from urban or mixed rural–urban samples. METHODS An interpretive description research approach was used to understand new RNs\' transition experiences into the Alberta, Canada, rural acute care environment including supports and challenges specific to recruitment and retention. Face-to-face interviews were conducted with a convenience sample of 12 new RNs who had been employed in one or more Alberta rural acute care hospitals from 1 month to less than 2 years. RESULTS In this study, participants experienced a double whammy consisting of learning I\'m a generalist! and managing the responsibility of I\'m it! Participants experienced contradictory emotions of exhilaration and shock that set them on an emotional roller coaster, a finding that differs from previously reported findings, wherein transition was frequently identified as only shocking. The few participants who were well supported by their colleagues and employersreportedexperiencing minor emotional fluctuations and described transition as exciting, good, and manageable. Thosewho were not experienced major fluctuations from exhilaration to shock. They described transition as exhilarating, but overwhelming, and unsafe. Notably, 9 of the 12 participants changed jobs within their first 2 years of practice. Other significant findings included problems with the outdated definitions of rural and rural acute care hospitals, which currently do not accurately address rural population growth and the services provided at rural acute care hospitals. Populations of some communities identified as rural by Alberta Health Services exceeded the upper limit of 10 000, the level long used to distinguish between rural and urban in the Canadian literature. As well, two different types of rural hospitals exist in Alberta: generalist types and urban types. The transition experience into these two different types of hospitals varied significantly. CONCLUSIONS Whiledouble whammyoffers only one description of new RNs\' transition experiences into rural acute care, it may present readers with recognizable similarities about transition that resonate with their own learning and responsibilities. Transition supports and challenges learned from this study can assist rural healthcare providers, policymakers, and educators in developing strategies to support and retain new RNs in rural acute care environments. Additionally, researchers must consider a priori whether or not different types of rural acute care hospitals exist in their study locale and if rural population growth is a factor when conducting future investigations related to rural acute care.
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10
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Amirav I, Vandall-Walker V, Rasiah J, Saunders L. Patient and Researcher Engagement in Health Research: A Parent's Perspective. Pediatrics 2017; 140:peds.2016-4127. [PMID: 28851740 DOI: 10.1542/peds.2016-4127] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Israel Amirav
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada;
| | - Virginia Vandall-Walker
- Patient Engagement Platform and.,Faculty of Health Disciplines, Athabasca University, Edmonton, Alberta, Canada; and
| | - Jananee Rasiah
- Faculty of Health Disciplines, Athabasca University, Edmonton, Alberta, Canada; and
| | - Laura Saunders
- Parent, Letter Study Advisory Panel, Edmonton, Alberta, Canada
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11
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Abstract
BACKGROUND Tube feeding (TF) is frequently prescribed for adults admitted to acute care facilities to prevent or ameliorate malnutrition, yet little is known about patients' needs and experiences with receiving this therapy. Patients' perspectives regarding the factors influencing their experiences, as well as their information and support needs, are required to inform healthcare providers' (HCPs') patient-centered practices. METHODS Based on an interpretive description qualitative approach, 12 unstructured face-to-face interviews were conducted with participants admitted to acute care hospitals in Northwestern Ontario, Canada. RESULTS Analysis of data revealed variations in participants' perceptions of the necessity for TF and the discomfort resulting from this therapy. Perceived necessity was influenced by interrelated themes: the meaning of TF (beyond necessity), the trust held in HCPs, and the resilience of participants in response to all that they were experiencing. Collectively, these findings are encompassed within the central theme, phrased as a question, about the experience of TF: "A necessary evil?" Participants' answers to this question revealed the nature of their overall response throughout TF therapy (ie, indifferent, resistant, relieved, or tolerant). CONCLUSIONS The range of perceptions and the complexity of patients' experiences during TF revealed in the data can inform HCPs' patient-centered approaches to TF care. Assessing and incorporating patients' values, beliefs, needs, and goals into, and exploring their choices in, nutrition care planning can promote resilience in response to TF therapy. HCPs may then well enhance patients' comfort and overall experience with TF therapy.
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Affiliation(s)
- Cara Green
- 1 Faculty of Health Disciplines, Athabasca University, Athabasca, Canada.,2 St Joseph's Care Group, Thunder Bay, Canada.,3 Northern Ontario Dietetic Internship Program, Division of Clinical Sciences, Northern Ontario School of Medicine, Thunder Bay, Canada
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12
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Green C, Vandall-Walker V. So you think you've designed an effective recruitment protocol? Nurse Res 2017; 24:32-34. [PMID: 28326914 DOI: 10.7748/nr.2017.e1502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Recruiting acutely ill patients to participate in research can be challenging. This paper outlines the difficulties the first author encountered in a study and the steps she took to overcome problems with research ethics, gain access to participants and implement a recruitment protocol in multiple hospitals. It also compares these steps with literature related to recruitment. Aim To inform and inspire neophyte researchers about the need for planning and resilience when dealing with recruitment challenges in multiple hospitals. Discussion The multiple enablers and barriers to the successful implementation of a hospital-based study recruitment protocol are explored based on a neophyte researcher's optimistic assumptions about this stage of the study. Conclusions Perseverance, adequately planning for contingencies, and accepting the barriers and challenges to recruitment are essential for completing one's research study and ensuring fulfilment as a researcher. Implications for practice Healthcare students carrying out research require adequate knowledge about conducting hospital-based, patient research to inform their recruitment plan. Maximising control over recruitment, allowing for adequate time to conduct data collection, and maintaining a good work ethic will help to ensure success.
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Affiliation(s)
- Cara Green
- Athabasca University, Thunder Bay ONT, Canada
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Vandall-Walker V, Park CL, Munich K. Outcomes of Modified Formal Online Debating in Graduate Nursing Education. Int J Nurs Educ Scholarsh 2012; 9:Article 15. [DOI: 10.1515/1548-923x.2450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
The critical illness of an adult constitutes a crisis for the patient's family. They relinquish primary responsibility for the physical well-being of the patient to health providers, but remain involved, working to get through the situation. What constitutes this "work"? Results of two grounded theory studies revealed that family members were engaged first in the pivotal work of gaining access because of their overarching need to be present with and for their critically ill relative. Other work included patient-related work, nurse/physician-related work, and self-related work. These findings extend our understanding of their experiences beyond current knowledge and paternalistic perceptions of burden, stress and coping, and need recognition and fulfillment. Critical care nurses are exhorted to support family members in their work by removing barriers to patient, staff, and information access and to partnering opportunities.
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Abstract
Researchers have identified the needs of family members of critically ill adults, explored their experiences, and investigated interventions. To address a gap in the theoretical knowledge about how nurses help these individuals, the authors developed a grounded theory of nursing support from the perspective of family members. Results indicated that family members were initiated into a cycle of Work to meet perceived responsibilities to Get Through the experience. Supportive nurses engaged in the process of Lightening Our Load to mitigate the negative effects of the critical care experience on family members by Engaging With Us, Sustaining Us, and Disengaging From Us. No previous research has yet identified the Work of these family members, the steps they take to gain nurses' respect, and the significance to them of nurses' Welcoming us and Saying goodbye. This theory extends the understanding of nursing support beyond current knowledge of family needs, caring, comfort, supportive care, and social support.
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