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Dahlke S, Rayner JA, Fetherstonhaugh D, Butler JI, Kennedy M. Gerontological educational interventions for student nurses: a systematic review of qualitative findings. Int J Nurs Educ Scholarsh 2025; 22:ijnes-2023-0042. [PMID: 38459787 DOI: 10.1515/ijnes-2023-0042] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/28/2023] [Indexed: 03/10/2024]
Abstract
OBJECTIVES This systematic review of qualitative studies explored interventions to improve student nurses' knowledge, attitudes or willingness to work with older people. Student nurses are likely to encounter older people in all health and aged care settings, however, research demonstrates that few have career aspirations in gerontological nursing. METHODS Qualitative systematic review method based on the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS Search of Medline, Embase, PsycINFO, EBSCOhost and Scopus yielded 1841 articles which were screened to include primary research about educational interventions to improve student nurses' knowledge, attitudes and/or willingness to work with older people. Data extraction was performed on the 14 included studies, and data were analysed using directed content analysis. The Mixed Methods Appraisal Tool (MMAT) was used the assess the quality of the studies. CONCLUSIONS Educational interventions included theory or practice courses, or a combination of theory and practice. While most interventions changed nursing students' negative attitudes towards older people, few increased their willingness to work with them. Practice courses had the most significant impact on willingness to work with older people. Quality assessment revealed methodical limitations. More research is needed to better understand the elements of practice interventions that enhance student nurses' knowledge, attitudes, and willingness to work with older people, so that they can be replicated.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Jo-Anne Rayner
- ACEBAC, 2080 La Trobe University , Bundoora, VIC, Australia
| | | | | | - Megan Kennedy
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Zubick P, Dahlke S. Family/caregiver influence on osteoporosis management for older people: an integrative review. Osteoporos Int 2024:10.1007/s00198-024-07081-w. [PMID: 38622263 DOI: 10.1007/s00198-024-07081-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/22/2024] [Indexed: 04/17/2024]
Abstract
An integrative literature review was conducted to understand family/caregiver influence on osteoporosis management for older people. Findings include caregivers' overprotection, caregivers' risks for fragility fractures due to caregiving role, poor bone health in caregivers, and caregivers' burden and facilitators. Caregivers should be included in bone health and discharge planning. Literature on family/caregiver influence on osteoporosis management for older people is sparse. Older people are prone to osteoporosis and fragility fractures due to their age, often triggering the need for a caregiver after experiencing a fragility fracture. These fractures pose significant costs to the patient and health systems and are projected to increase with the aging population. This study applied an integrative literature review methodology to key literature findings on family/caregiver influence on osteoporosis management for older people. Key findings include caregivers' tendency to overprotect persons who experience hip fracture by limiting mobilization, thus impeding recovery, caregivers' risks for their own fragility fractures due to the demands of their caregiving role, risks of poor bone health in caregivers, and caregivers' experience of significant burden for which facilitators have been identified. Family caregivers of older people with osteoporosis have unique needs and require support and resources, especially after their loved one experiences a hip fracture. Informal caregivers must be considered in bone health education and discharge planning. They should be considered in the creation of osteoporosis guidelines and within the work of fracture liaison services. More research is needed to increase understanding about family caregiver influence on osteoporosis management.
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Affiliation(s)
- Paula Zubick
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada.
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Ingelson B, Dahlke S, O'Rourke H, Hunter KF. Nurses' knowledge and beliefs on pain management practices with hospitalised persons living with dementia: A qualitative descriptive study. J Clin Nurs 2024. [PMID: 38590077 DOI: 10.1111/jocn.17164] [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] [Received: 01/19/2024] [Revised: 03/18/2024] [Accepted: 03/29/2024] [Indexed: 04/10/2024]
Abstract
AIM To understand nurses' knowledge, beliefs and experiences affect pain management practices in hospitalised persons living with dementia (PLWD). DESIGN Naturalistic inquiry using qualitative descriptive design. METHODS Semi-structured interviews were conducted with 12 registered nurses who worked in one acute care hospital in Southern California from October to November 2022. Data were analysed using content analysis to identify themes. RESULTS Two themes were developed: improvising pain assessment, which included how pain was documented, and administration hesitancy referring to nurse's concerns about PLWD's confusion. Nurses described the challenges of assessing pain in hospitalised PLWD particularly if they were non-verbal and/or demonstrating responsive behaviours. Nurse's years of experience, dementia stigma, and their unconscious biases affected nurses' pain management practices. CONCLUSIONS The study findings highlight the complex challenges of pain management in hospitalised PLWD that are exacerbated by nurses' knowledge deficits, negative stereotypical beliefs, dementia stigma and unconscious biases towards older people that contributes to undermanaged pain in hospitalised PLWD. IMPLICATIONS A comprehensive strategy using an implementation framework is needed to address nurse's knowledge gaps, unconscious bias, dementia stigma and techniques that enhance communication skills is suggested. Building a foundation in these areas would improve pain management in hospitalised PLWD. IMPACT Improving pain management in hospitalised PLWD would improve the quality of life, decrease hospital length of stay, prevent readmissions, and improve nurse satisfaction. REPORTING METHOD The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT CONTRIBUTIONS Improving pain management in hospitalised PLWD would prevent long term confusion, episodes of delirium and improve quality of life as they recover from their acute illness for which they required hospital care.
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Affiliation(s)
- Beverly Ingelson
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Hannah O'Rourke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Ingelson B, Dahlke S, O'Rourke H, Low G. A Scoping Review on Nurse's Pain Management of Older Patients with Dementia in a Hospital Environment. Pain Manag Nurs 2024; 25:104-112. [PMID: 37968142 DOI: 10.1016/j.pmn.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 09/18/2023] [Accepted: 10/16/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVES Hospitalized persons living with dementia often experience unrelieved pain. Unmanaged pain during hospitalization has a significant negative effect on quality of life for persons living with dementia. Despite the central role of nurses in pain management, little is known about how nurses manage pain in this patient population in the hospital environment. DESIGN A scoping review explored the nurses' pain management practices when caring for persons living with dementia in a hospital setting. DATA SOURCES AND REVIEW/ANALYSIS METHODS After an extensive search for all available evidence on how nurses manage pain in hospitalized persons living with dementia, data were extracted on pain management methods that included assessment, intervention, effectiveness of pain management, and the barriers nurses encountered when managing pain. A descriptive content analysis was used to extract data from qualitative studies. RESULTS Six articles published between 2016 and 2021 met the inclusion criteria; four utilized qualitative methods, and the others used mixed-methods and quantitative study designs. A narrative description of the findings was summarized after data were categorized into pain management data elements and barriers nurses encountered when managing pain. Barriers were grouped into the subcategories of communication challenges (nurse to patient), information sharing (nurse to nurse), lack of knowledge, time constraints, and nursing stressors. CONCLUSION We identified six articles that met our inclusion criteria, highlighting a noticeable gap in the literature. Managing pain in this population is complex and lacks organizational support. Review findings indicate that pain management methods lack consistency and standardization, making it difficult to assess their effectiveness. Nurses also described knowledge deficits resulting in practice gaps that, when combined with barriers and challenges, result in underrecognized and undermanaged pain.
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Affiliation(s)
| | | | | | - Gail Low
- University of Alberta, Edmonton, Alberta, Canada.
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Shrestha S, Dahlke S, Butler JI, Hunter K, Fox MT, Davidson S, Chasteen AL, Moody E. Nursing Students' Perceptions on a Pain Management E- Learning Module: An Exploratory Quantitative Study. Pain Manag Nurs 2024; 25:e138-e143. [PMID: 38342704 DOI: 10.1016/j.pmn.2023.12.010] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/24/2023] [Accepted: 12/28/2023] [Indexed: 02/13/2024]
Abstract
BACKGROUND Nursing students are graduating ill-prepared to assess and manage pain in older adults. To address this gap, we developed an e-learning module on the topic. AIM To examine nursing students' perceptions on a pain management e-learning module focused on older adults. METHODS Utilizing an exploratory quantitative design, we assessed nursing students' perceptions of the e-learning module. We used a feedback survey (four 5-point, Likert-type items) and one open-ended question to assess students' perceptions. Descriptive statistics were used to summarize students' perceptions and demographic characteristics. Responses to the open-ended question were content analyzed. RESULTS A total of 181 of 249 students completed the module, of whom two-thirds were female. Students perceived that the module enhanced their knowledge, confidence, and perception in working with older people. Students also found the method of instruction interactive and enjoyable. CONCLUSIONS The e-learning module on pain management was viewed by nursing students to be helpful and its interactive method of learning improved their knowledge, confidence, and perceptions of working with older adults in pain.
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Affiliation(s)
- Shovana Shrestha
- Faculty of Nursing, College of Health Sciences, University of Alberta, Alberta, Canada.
| | - Sherry Dahlke
- Faculty of Nursing, College of Health Sciences, University of Alberta, Alberta, Canada
| | - Jeffrey I Butler
- Faculty of Nursing, College of Health Sciences, University of Alberta, Alberta, Canada
| | - Kathleen Hunter
- Faculty of Nursing, College of Health Sciences, University of Alberta, Alberta, Canada
| | - Mary T Fox
- School of Nursing, York University Centre for Aging Research & Education, York University, Ontario, Canada
| | | | | | - Elaine Moody
- School of Nursing, Dalhousie University, Nova Scotia, Canada
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Fox MT, Butler JI, Day AMB, Durocher E, Nowrouzi-Kia B, Sidani S, Maimets IK, Dahlke S, Yamada J. Healthcare providers' perceived acceptability of a warning signs intervention for rural hospital-to-home transitional care: A cross-sectional study. PLoS One 2024; 19:e0299289. [PMID: 38427646 PMCID: PMC10906905 DOI: 10.1371/journal.pone.0299289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/03/2024] [Indexed: 03/03/2024] Open
Abstract
INTRODUCTION There is a pressing need for transitional care that prepares rural dwelling medical patients to identify and respond to the signs of worsening health conditions. An evidence-based warning signs intervention has the potential to address this need. While the intervention is predominantly delivered by nurses, other healthcare providers may be required to deliver it in rural communities where human health resources are typically limited. Understanding the perspectives of other healthcare providers likely to be involved in delivering the intervention is a necessary first step to avert consequences of low acceptability, such as poor intervention implementation, uptake, and effectiveness. This study examined and compared nurses' and other healthcare providers' perceived acceptability of an evidence-based warning signs intervention proposed for rural transitional care. METHODS A cross-sectional design was used. The convenience sample included 45 nurses and 32 other healthcare providers (e.g., physical and occupational therapists, physicians) who self-identified as delivering transitional care to patients in rural Ontario, Canada. In an online survey, participants were presented with a description of the warning signs intervention and completed established measures of intervention acceptability. The measures captured 10 intervention acceptability attributes (effectiveness, appropriateness, risk, convenience, relevance, applicability, usefulness, frequency of current use, likelihood of future use, and confidence in ability to deliver the intervention). Ratings ≥ 2 indicated acceptability. Data analysis included descriptive statistics, independent samples t-tests, as well as effect sizes to quantify the magnitude of any differences in acceptability ratings between nurses and other healthcare providers. RESULTS Nurses and other healthcare providers rated all intervention attributes > 2, except the attributes of convenience and frequency of current use. Differences between the two groups were found for only three attributes: nurses' ratings were significantly higher than other healthcare providers on perceived applicability, frequency of current use, and the likelihood of future use of the intervention (all p's < .007; effect sizes .58 - .68, respectively). DISCUSSION The results indicate that both participant groups had positive perspectives of the intervention on most of the attributes and suggest that initiatives to enhance the convenience of the intervention's implementation are warranted to support its widespread adoption in rural transitional care. However, the results also suggest that other healthcare providers may be less receptive to the intervention in practice. Future research is needed to explore and mitigate the possible reasons for low ratings on perceived convenience and frequency of current use of the intervention, as well as the between group differences on perceived applicability, frequency of current use, and the likelihood of future use of the intervention. CONCLUSIONS The intervention represents a tenable option for rural transitional care in Ontario, Canada, and possibly other jurisdictions emphasizing transitional care.
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Affiliation(s)
- Mary T. Fox
- School of Nursing, York University, Toronto, Ontario, Canada
- York University Centre for Aging Research and Education, Toronto, Ontario, Canada
| | - Jeffrey I. Butler
- School of Nursing, York University, Toronto, Ontario, Canada
- York University Centre for Aging Research and Education, Toronto, Ontario, Canada
| | - Adam M. B. Day
- Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| | - Evelyne Durocher
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Souraya Sidani
- School of Nursing, York University, Toronto, Ontario, Canada
| | - Ilo-Katryn Maimets
- Steacie Science and Engineering Library, York University, Toronto, Ontario, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Janet Yamada
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
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Onebunne O, Dahlke S, Devkota R, Butler JI, Hunter KF, Fox MT, Chasteen AL, Moody E. Nursing Students' Views on an e-Learning Activity About Health Promotion for Older Adults: A Cross-Sectional Study. J Gerontol Nurs 2024; 50:19-24. [PMID: 38417075 DOI: 10.3928/00989134-20240207-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
PURPOSE Nurses are graduating ill-prepared to work with older adults across care contexts. The education nursing students receive about older adults often focuses on managing illnesses rather than promoting health. To expand the education that nursing students receive regarding health promotion and older adults, we examined nursing students' perceptions of an e-learning activity on health promotion with older adults. METHOD We used a cross-sectional survey design. We included first-year baccalaureate nursing students (N = 260) at a Canadian university. Students were required to complete the module, but only those who wanted to participate in the study completed the survey (n = 167; response rate = 64.2%). We used a feedback survey to assess students' perceptions of the e-learning activity using four 5-point, Likert-type items. We also asked one open-ended question to solicit participants' feedback and suggestions for improving the e-learning activity. Descriptive statistics (frequency, mean [SD]) were used to summarize participants' perceptions and demographic characteristics. Content analysis was used to explore responses to the open-ended question. RESULTS Participants reported that the module increased their knowledge about health promotion, as well as their perceptions and confidence in working with older adults. Participants also found the method of instruction interactive and enjoyable. CONCLUSION Our e-learning activity on health promotion was perceived by nursing students as helpful in sensitizing them to their role in promoting health among older adults. [Journal of Gerontological Nursing, 50(3), 19-24.].
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Rempel H, Kalogirou MR, Dahlke S, Hunter KF. Understanding nurses' experience of climate change and then climate action in Western Canada. J Adv Nurs 2024. [PMID: 38323730 DOI: 10.1111/jan.16094] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/29/2023] [Accepted: 01/21/2024] [Indexed: 02/08/2024]
Abstract
AIM To understand nurses' personal and professional experiences with the heat dome, drought and forest fires of 2021 and how those events impacted their perspectives on climate action. DESIGN A naturalistic inquiry using qualitative description. METHOD Twelve nurses from the interior of British Columbia, Canada, were interviewed using a semi-structured interview guide. Thematic analysis was employed. No patient or public involvement. RESULTS Data analysis yielded three themes to describe nurses' perspective on climate change: health impacts; climate action and system influences. These experiences contributed to nurses' beliefs about climate change, how to take climate action in their personal lives and their challenges enacting climate action in their workplace settings. CONCLUSIONS Nurses' challenges with enacting environmentally responsible practices in their workplace highlight the need for engagement throughout institutions in supporting environmentally friendly initiatives. IMPACT The importance of system-level changes in healthcare institutions for planetary health.
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Affiliation(s)
- Hannah Rempel
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Maya R Kalogirou
- Faculty of Nursing, MacEwan University, Edmonton, Alberta, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Dahlke S, Butler JI, Hunter KF, Toubiana M, Kalogirou MR, Shrestha S, Devkota R, Law J, Scheuerman M. The Effects of Stigma: Older Persons and Medicinal Cannabis. Qual Health Res 2024:10497323241227419. [PMID: 38305270 DOI: 10.1177/10497323241227419] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Cannabis has long been stigmatized as an illicit drug. Since legalization in Canada for both medical and recreational purposes, older adults' cannabis consumption has increased more than any other age group. Yet, it is unclear how the normalization of cannabis has impacted perceptions of stigma for older adults consuming cannabis medicinally. Qualitative description was used to elucidate the experiences of older Canadians aged 60+ related to stigma and their consumption of cannabis for medicinal purposes. Data collection involved semi-structured interviews. Data analysis examined how participants managed stigma related to cannabis use. Perceived stigma was evident in many participants' descriptions of their perceptions of cannabis in the past and present, and influenced how they accessed and consumed cannabis and their comfort in discussing its use with their healthcare providers. Participants employed several distinct strategies for managing stigma-concealing, re-framing, re-focusing, and proselytizing. Findings suggest that while medical cannabis consumption is becoming increasingly normalized among older adults, stigma related to cannabis persists and continues to shape older adults' experiences. A culture shift needs to occur among healthcare providers so that they are educated about cannabis and willing to discuss the possibilities of medicinal cannabis consumption with older adults. Otherwise, older adults may seek advice from recreational or other non-medical sources. Healthcare providers require education about the use of medical cannabis, so they can better advise older adults regarding its consumption for medicinal purposes.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Jeffrey I Butler
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Madeline Toubiana
- Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
| | | | - Shovana Shrestha
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Rashmi Devkota
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Joanna Law
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
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Tate K, Guney S, Lai C, Van Son C, Kennedy M, Dahlke S. Gerontological nursing competencies: A scoping review. Nurse Educ Today 2024; 133:106034. [PMID: 37988828 DOI: 10.1016/j.nedt.2023.106034] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/25/2023] [Accepted: 11/05/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Despite decades of advocates striving to enhance gerontological content in baccalaureate nursing programs, nurses are still graduating with inadequate knowledge and skills to work with older adults. Scholars suggest that incorporating entry-to-practice gerontological competencies could be one way to improve graduating nurses' knowledge about older adults. AIM To examine the state of gerontological entry to practice competencies and standards for baccalaureate-prepared nurses around the world. DESIGN We conducted a scoping review of the literature using the Joanna Briggs Institute (JBI) framework and followed PRISMA-ScR guidelines to report findings. METHODS We performed searches from inception to June 20th 2022 in Medline and EMBASE via OVID, CINAHL via EBSCOhost, Scopus, and Cochrane Library via Wiley. We conducted a search on GOOGLE for grey literature. We included literature that examined 1) baccalaureate nursing programs, 2) gerontological competencies/standards, and 3) older people/adults. RESULTS We found 8 literature sources, 4 of which were academic papers and 4 documents describing gerontological entry-to-practice standards and competencies from national nursing associations. Gerontological competencies highlight providing person-centered care to older people and their families across many care contexts. This care includes relational and cultural competence, exhibiting professional values and screening for potential elder abuse. Scholars in two papers relayed their experiences incorporating gerontological competencies into their curricula and two studied student nurses' gerontological competency. CONCLUSIONS There is interest and some progress in developing and incorporating gerontological competencies in various countries but not enough. A coordinated approach to sharing information and expertise among nations is needed to develop international gerontological competencies to facilitate improved nursing care with older adults.
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Affiliation(s)
- Kaitlyn Tate
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy 11405-87 Ave NW, Edmonton, AB T6G 1C9, Canada.
| | - Seda Guney
- Faculty of Nursing, Koç University, Health Sciences Campus, Davutpaşa Caddesi, No: 4 34010 Topkapı, Istanbul, Turkey.
| | - Claudia Lai
- School of Nursing, The Hong Kong Polytechnic University, Yuk Choi Road, Hung Hom, Hong Kong.
| | | | - Megan Kennedy
- John W Scott Health Sciences Library, University of Alberta 2K.28 Walter C Mackenzie Health Sciences Centre, Edmonton, AB T6G 2R7, Canada.
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy 11405-87 Ave NW, Edmonton, AB T6G 1C9, Canada.
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Wisnesky UD, Olson J, Paul P, Dahlke S. Percepciones y experiencias de los adultos mayores con respecto a la actividad Sit-to-stand: Un estudio etnográfico de viabilidad previa. Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.6128.3812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Resumen Objetivo: el propósito de este estudio de viabilidad previa fue examinar percepciones y experiencias con respecto a la actividad Sit-to-stand entre los adultos mayores de Brasil que viven en sus hogares en comunidades urbanas. Método: el método de exploración se enfocó en la etnografía. Se utilizó muestreo intencional para reclutar 20 adultos mayores. Se emplearon cinco medios para generar datos, a saber: encuestas sociodemográficas, observaciones participantes, entrevistas informales, entrevistas formales semiestructuradas y notas de campo. Para el análisis de los datos se recurrió a análisis de contenido cualitativo. Resultados: la experiencia de los adultos mayores con problemas de movilidad en relación con la actividad Sit-to-stand dependió de sus expectativas en torno a la movilidad, las cuales implicaron muchos factores que actuaron en conjunto para influenciar sus creencias y actitudes con respecto a la actividad, al igual que preferencias, conductas y percepciones culturales. Aparentemente, a los participantes de este estudio la actividad les resultó amena; sin embargo, los inconvenientes más notorios para adoptar la actividad Sit-to-stand surgió en la forma de déficits en sus necesidades personales e intrapersonales. Conclusión: las recomendaciones resultantes de los hallazgos del estudio indican la necesidad de diseñar estrategias de implementación para la intervención Sit-to-stand a la medida de las necesidades de este grupo poblacional específico.
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Affiliation(s)
- Uirá Duarte Wisnesky
- University of Alberta, Canada; University of Alberta, Canada; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
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Wisnesky UD, Olson J, Paul P, Dahlke S. Percepções e experiências de idosos com a atividade Sit-to-stand: Um estudo etnográfico de pré-viabilidade. Rev Lat Am Enfermagem 2023. [DOI: 10.1590/1518-8345.6128.3814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Resumo Objetivo: o objetivo deste estudo de pré-viabilidade foi examinar percepções e experiências da atividade de Sit-to-stand com idosos brasileiros residentes em suas casas, no meio urbano. Método: o método exploratório foi etnografia focada. Foi utilizada a amostragem intencional para recrutar 20 idosos. Foram utilizados cinco meios de geração de dados: inquéritos sociodemográficos, observações participantes, entrevistas informais, entrevistas formais semiestruturadas e notas de campo. Os dados foram analisados mediante análise de conteúdo qualitativo. Resultados: a experiência dos idosos com problemas de mobilidade na realização da atividade Sit-to-stand dependia de suas expectativas de mobilidade envolvendo muitos fatores coordenados que, de forma conjunta, influenciaram suas crenças e atitudes em relação à atividade, suas preferências, seus comportamentos e percepções culturais. Os participantes deste estudo pareciam considerar a atividade aprazível; no entanto, as deficiências mais perceptíveis para o engajamento dos participantes na atividade Sit-to-stand surgiram de falhas em suas necessidades pessoais e intrapessoais. Conclusão: as recomendações geradas a partir dos achados do estudo convocam a concepção de estratégias de implementação da intervenção Sit-to-stand adaptadas às necessidades dessa população em particular.
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Affiliation(s)
- Uirá Duarte Wisnesky
- University of Alberta, Canada; University of Alberta, Canada; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
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Coatsworth-Puspoky R, Dahlke S, Duggleby W, Hunter KF. Safeguarding survival: Older persons with multiple chronic conditions' unplanned readmission experiences: A mixed methods systematic review. J Clin Nurs 2023; 32:5793-5815. [PMID: 37095609 DOI: 10.1111/jocn.16705] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 04/26/2023]
Abstract
AIMS AND OBJECTIVES The aim of this study was to create a holistic understanding of the psychosocial processes of older persons with multiple chronic conditions' experience with unplanned readmission experiences within 30 days of discharge home and identify factors influencing these psychosocial processes. DESIGN Mixed methods systematic review. DATA SOURCES Six electronic databases (Ovid MEDLINE (R) All 1946-present, Scopus, CINAHL, Embase, PsychINFO and Web of Science). REVIEW METHODS Peer-reviewed articles published between 2010 and 2021 and addressed study aims (n = 6116) were screened. Studies were categorised by method: qualitative and quantitative. Qualitative data synthesis used a meta-synthesis approach and applied thematic analysis. Quantitative data synthesis used vote counting. Data (qualitative and quantitative) were integrated through aggregation and configuration. RESULTS Ten articles (n = 5 qualitative; n = 5 quantitative) were included. 'Safeguarding survival' described older persons' unplanned readmission experience. Older persons experienced three psychosocial processes: identifying missing pieces of care, reaching for lifelines and feeling unsafe. Factors influencing these psychosocial processes included chronic conditions and discharge diagnosis, increased assistance with functional needs, lack of discharge planning, lack of support, increased intensity of symptoms and previous hospital readmission experiences. CONCLUSIONS Older persons felt more unsafe as their symptoms increased in intensity and unmanageability. Unplanned readmission was an action older persons required to safeguard their recovery and survival. RELEVANCE TO CLINICAL PRACTICE Nurses play a critical role in assessing and addressing factors that influence older persons' unplanned readmission. Identifying older persons' knowledge about chronic conditions, discharge planning, support (caregivers and community services), changes in functional needs, intensity of symptoms and past readmission experiences may prepare older persons to cope with their return home. Focusing on their health-care needs across the continuum of care (community, home and hospital) will mitigate the risks for unplanned readmission within 30 days of discharge. REPORTING METHOD PRISMA guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution due to design.
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Affiliation(s)
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Wendy Duggleby
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Butler JI, Dahlke S, Devkota R, Shrestha S, Hunter KF, Toubiana M, Kalogirou MR, Law J, Scheuerman M. The Information-Seeking Behavior and Unmet Knowledge Needs of Older Medicinal Cannabis Consumers in Canada: A Qualitative Descriptive Study. Drugs Aging 2023; 40:427-438. [PMID: 37147415 PMCID: PMC10162651 DOI: 10.1007/s40266-023-01030-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 05/07/2023]
Abstract
INTRODUCTION Older Canadians (age 60+) are increasingly using cannabis to treat their health problems, but little is known regarding how they learn about medicinal cannabis. This study explored the perspectives of older cannabis consumers, prospective consumers, healthcare professionals, and cannabis retailers on older adults' information-seeking behavior and unmet knowledge needs. METHODS A qualitative descriptive design was used. Semi-structured telephone interviews were conducted with a purposeful sample of 36 older cannabis consumers and prospective consumers, as well as 4 healthcare professionals and 5 cannabis retailers from across Canada, for a total sample of 45 participants. Data were thematically analyzed. RESULTS Three main themes characterizing older cannabis consumers' information-seeking were identified: (1) knowledge sources, (2) types of information sought, and (3) unmet knowledge needs. Participants accessed a variety of knowledge sources to inform themselves about medicinal cannabis. Cannabis retailers were identified as providing medical information to many older adults, despite regulations to the contrary. Cannabis-specialized healthcare professionals were also viewed as key knowledge sources, while primary care providers were perceived as both knowledge sources and gatekeepers limiting access to information. The types of information participants sought included the effects and potential benefits of medicinal cannabis, the side effects and risks involved, and guidance regarding suitable cannabis products. Participants' most salient unmet knowledge needs focused on dosing and use of cannabis to treat specific health conditions. DISCUSSION Findings suggest that barriers to learning about medical cannabis among older consumers identified in prior research remain pervasive and cut across jurisdictions. To address these barriers, there is a need for better knowledge products tailored to older cannabis consumers and their information needs, and further education for primary healthcare providers on medicinal cannabis and its therapeutic applications with older patients.
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Affiliation(s)
- Jeffrey I Butler
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
| | - Rashmi Devkota
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - Shovana Shrestha
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - Madeline Toubiana
- Telfer School of Management, University of Ottawa, 55 Laurier Avenue East, Ottawa, ON, K1N 6N5, Canada
| | - Maya R Kalogirou
- Faculty of Nursing, MacEwan University, 11405-87th Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Joanna Law
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - Melissa Scheuerman
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, AB, T6G 1C9, Canada
- Medical Cannabis Manager, Avant Brands Inc., 335-1632 Dickson Avenue, Kelowna, BC, V1Y 7T2, Canada
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Soun S, Hunter KF, Dahlke S. Nursing Care Management of Responsive Behaviors for Persons Living With Dementia in Acute Care Settings: An Integrative Review. J Gerontol Nurs 2023; 49:19-25. [PMID: 36719660 DOI: 10.3928/00989134-20230106-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The current integrative review was performed to understand how acute care nurses manage responsive behaviors among persons living with dementia (PLWD) in acute care settings. Eight studies were included, and three themes were developed: Person-Centered Approach, Non-Person-Centered Approach, and Facilitators and Barriers to Care Approaches. Nurses expressed difficulties in caring for hospitalized PLWD due to lack of knowledge of dementia care, pressure to work more efficiently, and prioritization of acute medical concerns. Nurses frequently used nonpharmacological approaches that required less time spent with patients. Results suggest that nurses in acute care settings require further education regarding dementia and person-centered care approaches for PLWD. Nursing management can support nurses' learning needs through education and policies to improve patient outcomes. [Journal of Gerontological Nursing, 49(2), 19-25.].
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Devkota R, Dahlke S, Fox MT, Davidson S, Hunter KF, Butler JI, Shrestha S, Chasteen AL, Moody E, Martin LS, Pietrosanu M. E-learning modules to enhance student nurses' perceptions of older people: a single group pre-post quasi-experimental study. Int J Nurs Educ Scholarsh 2023; 20:ijnes-2023-0059. [PMID: 38029314 DOI: 10.1515/ijnes-2023-0059] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES To examine whether e-learning activities on cognitive impairment (CI), continence and mobility (CM) and understanding and communication (UC) improve student nurses' knowledge and attitudes in the care of older adults. METHODS A quasi-experimental single group pre-post-test design was used. We included 299 undergraduate nursing students for the CI module, 304 for the CM module, and 313 for the UC module. We administered knowledge quizzes, Likert scales, and a feedback survey to measure student nurses' knowledge, ageist beliefs, and feedback on the modules respectively. RESULTS Participants demonstrated significantly more knowledge and reduced ageist attitudes following the e-learning activities. CONCLUSIONS Findings suggest that e-learning activities on cognitive impairment, continence and mobility, and understanding and communication improve knowledge and reduce ageist attitudes among nursing students.
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Affiliation(s)
- Rashmi Devkota
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Mary T Fox
- School of Nursing, York University Centre for Aging Research & Education, York University, Toronto, ON, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | | | - Jeffrey I Butler
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Shovana Shrestha
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Alison L Chasteen
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Lori Schindel Martin
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada
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Dahlke S, Butler JI, Hunter KF, Law J, Martin LS, Pietrosanu M. Improving practicing nurses' knowledge of the cognitive impairment, continence, and mobility needs of older people. Int J Nurs Educ Scholarsh 2023; 20:ijnes-2022-0130. [PMID: 36959640 PMCID: PMC10036457 DOI: 10.1515/ijnes-2022-0130] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/03/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVES To test if two e-learning modules - one on cognitive impairment, and one on continence and mobility - in older people would improve the knowledge of nurse members from the Canadian Gerontological Nurses Association and College of Licensed Practical Nurses of Alberta. METHODS A pre-post-test design was used to test 88 nurses' knowledge of cognitive impairment and 105 nurses' knowledge of continence and mobility and their perceptions of how the modules contributed to their learning. RESULTS There was a statistically significant increase in practicing nurses' knowledge about cognitive impairment (0.68 increase), continence (2.30 increase), and its relationship to mobility. Nurses' self-report on the feedback survey demonstrated increases in knowledge, confidence, and perceptions about older people. CONCLUSION These results suggest the modules have strong potential to enhance practicing nurses' knowledge about cognitive impairment, continence, and mobility.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | | | | | - Joanna Law
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Lori Schindel Martin
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada
| | - Matthew Pietrosanu
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB, Canada
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18
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Wisnesky UD, Olson J, Paul P, Dahlke S. Older people's perceptions and experiences of older people with the Sit-to-stand activity: An ethnographic pre-feasibility study. Rev Lat Am Enfermagem 2023; 31:e3813. [PMID: 36722635 PMCID: PMC9886074 DOI: 10.1590/1518-8345.6128.3813] [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] [Received: 03/22/2022] [Accepted: 08/18/2022] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE the purpose of this pre-feasibility study was to examine perceptions and experiences of a Sit-to-stand activity with urban Brazilian community-dwelling older people in their homes. METHOD the exploration method was focused ethnography. Purposive sampling was used to recruit 20 older people. Five means of data generation were used, namely: socio-demographic surveys, participant observations, informal interviews, formal semi-structured interviews, and field notes. Data analysis was qualitative content analysis. RESULTS the experience of mobility-challenged older people with the Sit-to-stand activity was dependent on their mobility expectations involving many factors that worked together to influence their beliefs and attitudes towards the activity, preferences, behaviors, and cultural perceptions. The participants of this study seemed to find the activity enjoyable; however, the most noticeable shortcomings for their engagement in the Sit-to-stand activity emerged as gaps in their personal and intrapersonal needs. CONCLUSION the recommendations generated from the study findings call for the design of implementation strategies for the Sit-to-stand intervention that are tailored to this particular population's needs.
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Affiliation(s)
- Uirá Duarte Wisnesky
- University of Alberta, Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada., University of Alberta, Faculty of Nursing, Edmonton, Alberta, Canada., Scholarship holder at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil, Uirá Duarte Wisnesky E-mail:
| | - Joanne Olson
- University of Alberta, Faculty of Nursing, Edmonton, Alberta, Canada
| | - Pauline Paul
- University of Alberta, Faculty of Nursing, Edmonton, Alberta, Canada
| | - Sherry Dahlke
- University of Alberta, Faculty of Nursing, Edmonton, Alberta, Canada
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Abstract
BACKGROUND There is a gap in studies examining formal mentorship programs designed for ongoing faculty support. METHOD A mixed-methods explanatory research design was used to examine nurse educators' experiences of a navigation-based mentoring program in a baccalaureate nursing program in Western Canada. Descriptive statistics were used to examine the means of three subsets of the Capabilities of Nurse Educators (CONE) questionnaire. Interviews were conducted, and data were analyzed using qualitative descriptive methods. RESULTS The findings highlight the positive effects the faculty navigator program had on faculty's confidence and development as educators. The most significant finding was the in-time relational support that faculty navigators provided to prevent new faculty from feeling alone in their new role. CONCLUSION The faculty navigator program is effective for its setting. This program could be expanded to facilitate stronger learner-centered approaches to teaching in various settings with faculty of varying expertise. [J Nurs Educ. 2022;61(10):587-590.].
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20
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Mehdi F, Dahlke S, Hunter KF. Developing a Comprehensive Understanding of Older Person Abuse in Canadian Immigrant Communities: An Integrative Review. Can J Nurs Res 2022; 55:139-152. [PMID: 35821575 DOI: 10.1177/08445621221112429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Fahmida Mehdi
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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21
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Coatsworth-Puspoky R, Dahlke S, Duggleby W, Hunter KF. Older persons with multiple chronic conditions' experiences of unplanned readmission: An integrative review. Int J Older People Nurs 2022; 17:e12481. [PMID: 35621261 DOI: 10.1111/opn.12481] [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] [Received: 02/12/2021] [Revised: 03/01/2022] [Accepted: 04/26/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND As persons, 60 years of age and older live longer, they are more likely to develop one or more chronic conditions. Rising numbers of older persons with multiple chronic conditions (MCCs) will increase the need for home healthcare services and hospital services and unplanned readmissions will increase globally. AIM The aim of this integrative review was to explore the experiences of older persons with MCCs' unplanned readmission from home to hospital within 30 days of discharge using an integrative review. METHOD Whittemore and Knafl's method was followed to address the research aim. Four databases (Ovid MEDLINE, Scopus, CINAHL and Embase) were searched between 2005 and 2020, suitability for inclusion was assessed, and data were extracted and analysed using content analysis. RESULTS Thirteen articles (10 qualitative, one quantitative, and two mixed methods) were included in this review. Three themes emerged from the data that reflected older persons with MCCs' unplanned readmission experiences. These themes included (a) feelings of security, support and relief; (b) undesirable challenges at home (struggling to manage care and balancing support needs); and (c) unpleasant feelings and emotions (feelings of fear and mistrust, feelings of disappointment and loss, feelings of anxiousness and pressure). CONCLUSION Research about unplanned readmission to the hospital does not provide sufficient detail or understanding about older persons with MCCs' experiences or their psychosocial experiences. Addressing research gaps related to the psychosocial processes and factors associated with unplanned readmission is needed to expand the current understanding of the process and concept of unplanned readmission.
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Affiliation(s)
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, USA
| | - Wendy Duggleby
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, USA
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22
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Wisnesky UD, Paul P, Olson J, Dahlke S. Perceptions and experiences of functional mobility for community‐dwelling older people: A focused ethnography. Int J Older People Nurs 2022; 17:e12464. [DOI: 10.1111/opn.12464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/07/2022] [Accepted: 03/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Uirá Duarte Wisnesky
- Faculty of Nursing University of Alberta Edmonton Alberta Canada
- Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada
| | - Pauline Paul
- Faculty of Nursing University of Alberta Edmonton Alberta Canada
| | - Joanne Olson
- Faculty of Nursing University of Alberta Edmonton Alberta Canada
| | - Sherry Dahlke
- Faculty of Nursing University of Alberta Edmonton Alberta Canada
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Rattani SA, Dahlke S, Cameron B. Cancer Care in Pakistan: A Descriptive Case Study. Glob Qual Nurs Res 2022; 9:23333936221080988. [PMID: 35237708 PMCID: PMC8882939 DOI: 10.1177/23333936221080988] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 01/26/2022] [Accepted: 01/31/2022] [Indexed: 01/09/2023] Open
Abstract
In this descriptive case study, we aimed to understand the experiences of cancer diagnosis, treatment, and palliative care in Pakistan. The case was limited to a hospital for cancer and hospice care in Karachi, Pakistan. Data collection included interviews with patients who had a cancer diagnosis, family members, healthcare providers, and unstructured observations. Two themes of suffering and late diagnosis were developed to describe the experiences of people with cancer. Suffering occurred as a result of poverty, social ideas about cancer, and physical suffering. Late diagnosis happened because of cultural ideas about health, low health literacy, and healthcare challenges, although both themes are interconnected. The findings illuminate three key pathways that will improve cancer diagnosis and palliative care in Pakistan: specifically, the need to (a) educate healthcare providers about cancer and palliative care, (b) eradicate corruption in healthcare, and (c) develop policies for universal access to health.
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Affiliation(s)
- Salma A Rattani
- Aga Khan University, Faculty of Nursing, School of Nursing and Midwifery, Karachi, Pakistan
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24
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Kalogirou MR, Dahlke S, Pietrosanu M, Hunter KF. Using an E-learning activity to enhance student nurses' understanding of cognitive impairment. Nurse Educ Today 2022; 108:105167. [PMID: 34678668 DOI: 10.1016/j.nedt.2021.105167] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/10/2021] [Accepted: 10/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Nurses often lack the knowledge and expertise to work with older people with cognitive impairment, which includes dementia, delirium and depression. This is due in part to deficits in their basic nursing education related to older people and managing the care needs of people with cognitive impairment. We developed an e-learning activity to facilitate student nurses' knowledge of cognitive impairment. OBJECTIVES To test if the e-learning activity could improve student nurses' knowledge of cognitive impairment and whether they would find the style of learning beneficial. DESIGN A quasi-experimental pre-post-test design was used to test if the cognitive impairment e-learning activity could improve student nurses' knowledge about assessing and managing the needs of older people who are experiencing cognitive impairment. A 12-item true/false quiz was completed by participants. SETTINGS One large Western Canadian university. PARTICIPANTS Second year nursing students in the four-year baccalaureate degree program, second year nursing students in the bilingual four-year baccalaureate degree program, and first year nursing students in the two-year after-degree nursing program were invited to participate. Data from 166 students were included in the analysis (n = 166). RESULTS Based on the results of a paired t-test (p < 0.001 and an average score increase of 1.12 out of nine), we conclude that students' knowledge about cognitive impairment in older people increased following the e-learning activity. Students also offered qualitative feedback that identified the activity as both helpful and as an enjoyable way to learn and provided suggestions for improvement. CONCLUSIONS This e-learning activity was effective in helping students learn about how to work with older people experiencing cognitive impairment. This mode of learning might be useful for other difficult-to-teach content areas.
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Affiliation(s)
- Maya R Kalogirou
- Faculty of Nursing, University of Alberta, Edmonton, Alberta T69 1C9, Canada.
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta T69 1C9, Canada
| | - Matthew Pietrosanu
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta T6G 2G1, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta T69 1C9, Canada
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Law J, Dahlke S, Butler JI, Hunter KF, Martin LS, Pietrosanu M. Improving practicing nurses' knowledge and perceptions of older people: a quasi-experimental study. Int J Nurs Educ Scholarsh 2022; 19:ijnes-2022-0090. [PMID: 36473144 DOI: 10.1515/ijnes-2022-0090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 08/22/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study aimed to determine if an e-learning module about understanding and communicating with older people can improve practicing nurses' ageist perceptions about older people. METHODS We used a quasi-experimental pre-post-test design. Participants completed a 13-item Ambivalent Ageism Scale before and after completing the Understanding and Communicating with Older People e-learning module as well as a Likert-style feedback survey with the option for written feedback on an open-ended question. RESULTS Pre-post-test comparisons indicated a statistically significant decrease in ageist attitudes and self-reported increases in knowledge and confidence in working with older people. Qualitative analysis of written feedback revealed that most participants felt the module enhanced their understanding of older people. CONCLUSIONS The e-learning activity has the potential to improve practicing nurses' knowledge and perceptions about working with older people and is likely to be associated with better patient-level outcomes.
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Affiliation(s)
- Joanna Law
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Jeffrey I Butler
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada.,School of Nursing, York University Centre for Aging Research and Education, Faculty of Health, York University, Toronto, ON, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Lori Schindel Martin
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada
| | - Matthew Pietrosanu
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB, Canada
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Dahlke S, Hunter KF, Fox MT, Davidson S, Perry N, Watts LT, Martin LS, Butler JI, Raymond C, Chasteen AL, McCleary L, Boscart V, Moody E. Awakening Canadians to ageism: a study protocol. BMC Nurs 2021; 20:192. [PMID: 34627234 PMCID: PMC8502289 DOI: 10.1186/s12912-021-00713-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/24/2021] [Indexed: 12/02/2022] Open
Abstract
Background Making fun of growing older is considered socially acceptable, yet ageist humour reinforces negative stereotypes that growing old is linked with physical and mental deterioration, dependence, and less social value. Such stereotypes and discrimination affect the wellbeing of older people, the largest demographic of Canadians. While ageism extends throughout professions and social institutions, we expect nurses—the largest and most trusted group of healthcare professionals—to provide non-ageist care to older people. Unfortunately, nurses working with older people often embrace ageist beliefs and nursing education programs do not address sufficient anti-ageism content despite gerontological nursing standards and competencies. Methods To raise awareness of ageism in Canada, this quasi-experimental study will be supported by partnerships between older Canadians, advocacy organizations, and academic gerontological experts which will serve as an advisory group. The study, guided by social learning theory, will unfold in two parts. In Phase 1, we will use student nurses as a test case to determine if negative stereotypes and ageist perceptions can be addressed through three innovative e-learning activities. The activities employ gamification, videos, and simulations to: (1) provide accurate general information about older people, (2) model management of responsive behaviours in older people with cognitive impairment, and (3) dispel negative stereotypes about older people as dependent and incontinent. In Phase 2, the test case findings will be shared with the advisory group to develop a range of knowledge mobilization strategies to dispel ageism among healthcare professionals and the public. We will implement key short term strategies. Discussion Findings will generate knowledge on the effectiveness of the e-learning activities in improving student nurses’ perceptions about older people. The e-learning learning activities will help student nurses acquire much-needed gerontological knowledge and skills. The strength of this project is in its plan to engage a wide array of stakeholders who will mobilize the phase I findings and advocate for positive perspectives and accurate knowledge about aging—older Canadians, partner organizations (Canadian Gerontological Nurses Association, CanAge, AgeWell), and gerontological experts.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada
| | - Mary T Fox
- School of Nursing, Faculty of Health, York University Centre for Aging Research and Education, HNES suite 343, 4700 Keele St, Toronto, ON, M3J 1P3, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, 2800 University Way N.W., 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Nicole Perry
- National Programs, HelpAge Canada, 1300 Carling Avenue, Ottawa, ON, K1Z 7L2, Canada
| | - Laura Tamblyn Watts
- CanAge, Factor - Inwentash Faculty of Social Work, University of Toronto 246 Bloor St West, Toronto ON M5S 1V4, Toronto, ON, M5S 1V4, Canada
| | - Lori Schindel Martin
- Canadian Gerontological Nursing Association, PO Box 64009, Royal Bank Plaza, Toronto, ON, M5J 2T6, Canada
| | - Jeffrey I Butler
- School of Nursing, York University Centre for Aging Research and Education, Faculty of Health, York University; Faculty of Nursing, University of Alberta, HNES suite B05, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Christy Raymond
- Faculty of Nursing, MacEwan University, 5-111C, Robbins Health Learning Centre, 10910-104 Ave NW, Edmonton, AB, T5J 4S2, Canada
| | - Alison L Chasteen
- Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON, M5S 3G3, Canada
| | - Lynn McCleary
- Faculty of Applied Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
| | - Veronique Boscart
- School of Health and Life Sciences, Conestoga College Institute of Technology and Advanced Learning, 299 Doon Valley Drive, Kitchener, ON, N2G 4M4, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Room N19 Forrest Bldg., Dalhousie University, University Avenue, PO Box 15000 5869, Halifax, NS, B3H 4R, Canada
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Dukes C, Dahlke S, Pietrosanu M, Kalogirou MR. Improving student nurses' perspectives towards older people with an e-learning activity: A quasi-experimental pre-post design. Int J Older People Nurs 2021; 17:e12425. [PMID: 34553494 DOI: 10.1111/opn.12425] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/18/2021] [Accepted: 08/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite older people being the largest demographic accessing health care, nurses often lack knowledge about how to work with them and may hold ageist perceptions towards them. Previous research has identified the gaps in their education program and offered suggestions on what and how to fill those gaps in education related to older people. E-learning activities to fill these gaps were developed. OBJECTIVE The aim of this study was to determine if nursing students' perceptions about older people could be improved through an e-learning activity focused on communication and understanding older people. METHODS A quasi-experimental pre-post design was used to test whether the understanding and communication with older people e-learning activity improved student nurses' perceptions about older people. A feedback survey was also analyzed using descriptive statistics to understand students' perceptions of the learning activity. RESULTS There was a statistically significant decrease in participant's negative perceptions towards older people after completing the e-learning activity. Participants enjoyed the activity and believed that it improved their knowledge of older people, their confidence in working with older people, and their perceptions about older people. CONCLUSIONS The strength of the e-learning activity in this study is that the educator need not be an expert in order to use the activity in their course. In this way, knowledge about older people is facilitated despite the dearth of nurse educators with gerontological expertise. More research to test this activity in other universities is needed. IMPLICATIONS FOR PRACTICE Improved understanding and communicating with older people could improve person-centered-care. The flexible delivery of this learning activity could facilitate practicing nurses understanding and communication strategies if offered to them.
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Affiliation(s)
- Cassidy Dukes
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew Pietrosanu
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Maya R Kalogirou
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Dahlke S, Hunter KF. Harnessing nursing to diminish ageism. Int J Older People Nurs 2021; 17:e12417. [PMID: 34420260 DOI: 10.1111/opn.12417] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The common practice of making fun of aging and older people demonstrates that ageism towards older people is socially acceptable. It is so accepted that even those of us who are aging or have moved into the 'third act' believe and fear the negative stereotypes that growing old is linked with physical and mental deterioration, dependence, and less social value. Ageism is evident in work places, family relationships, when older people purchase goods and services, in health and social institutions and extends throughout professions that work with older people. OBJECTIVES We explore how nurses-the largest group of healthcare professions- may be inadvertently perpetuating negative perceptions about older people in nursing practice, nursing education, and through common misconceptions about what gerontological nursing means. METHODS This is discussion paper using the literature. RESULTS We suggest that nursing education is well situated to diminish negative perspectives of ageing by incorporating theories of life-course and harmonious aging into the holistic perspective of individuals that nursing is well known for. CONCLUSIONS Greater understanding about the diversity of ageing and the context that have influenced older persons could encourage nurses to treat them holistically with dignity, which would ultimately improve older people's experiences. Improving older persons' experiences is like paying it forward, as we all are ageing and if we are to have a different experience when we are old, it is necessary to diminish stereotypes about ageing, and work towards inclusion of older people in social and healthcare institutions. IMPLICATIONS FOR PRACTICE It is important for nurses, particularly those in nursing education, to support the incorporation of a life course and harmonious view of aging in which the social, political, and environmental context of individuals are viewed as part of the difference of ageing.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, USA
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Fox MT, Sidani S, Butler JI, Skinner MW, Macdonald M, Durocher E, Hunter KF, Wagg A, Weeks LE, MacLeod A, Dahlke S. Optimizing hospital-to-home transitions for older persons in rural communities: a participatory, multimethod study protocol. Implement Sci Commun 2021; 2:81. [PMID: 34294145 PMCID: PMC8295643 DOI: 10.1186/s43058-021-00179-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/27/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Transitional care involves time-limited interventions focusing on the continuity of care from hospital to home, to optimize patient functioning and management. Providing interventions, as part of transitional care, that optimize the functioning of older people with dementia is critical due to the small window of opportunity in which they can return to their baseline levels of functioning. Yet prior research on transitional care has not included interventions focused on functioning and did not target older people with dementia in rural communities, limiting the applicability of transitional care to this population. Accordingly, the goal of this study is to align hospital-to-home transitional care with the function-related needs of older people with dementia and their family-caregivers in rural communities. METHODS In this multimethod study, two phases of activities are planned in rural Ontario and Nova Scotia. In phase I, a purposive sample of 15-20 people with dementia and 15-20 family-caregivers in each province will rate the acceptability of six evidence-based interventions and participate in semi-structured interviews to explore the interventions' acceptability and, where relevant, how to improve their acceptability. Acceptable interventions will be further examined in phase II, in which a purposive sample of healthcare providers, stratified by employment location (hospital vs. homecare) and role (clinician vs. decision-maker), will (1) rate the acceptability of the interventions and (2) participate in semi-structured focus group discussions on the facilitators and barriers to delivering the interventions, and suggestions to enable their incorporation into rural transitional care. Two to three focus groups per stratum (8-10 healthcare providers per focus group) will be held for a total of 8-12 focus groups per province. Data analysis will involve qualitative content analysis of interview and focus group discussions and descriptive statistics of intervention acceptability ratings. DISCUSSION Findings will (1) include a set of acceptable interventions for rural transitional care that promote older patients' functioning and family-caregivers' ability to support patients' functioning, (2) identify resources needed to incorporate the interventions into rural transitional care, and (3) provide high-quality evidence to inform new transitional care practices and policies and guide future research.
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Affiliation(s)
- Mary T. Fox
- School of Nursing, Faculty of Health, York University Centre for Aging Research and Education, York University, HNES suite 343, 4700 Keele St, Toronto, Ontario M3J 1P3 Canada
| | - Souraya Sidani
- School of Nursing, Faculty of Community Services, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3 Canada
| | - Jeffrey I. Butler
- School of Nursing, York University Centre for Aging Research and Education, Faculty of Health, York University, HNES suite 343, 4700 Keele Street, Toronto, Ontario M3J 1P3 Canada
| | - Mark W. Skinner
- Trent School of the Environment, Trent University, 1600 West Bank Drive, Peterborough, Ontario K9L 0G2 Canada
| | - Marilyn Macdonald
- School of Nursing, Dalhousie University, Room 130, Forrest Bldg., PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia B3H 4R2 Canada
| | - Evelyne Durocher
- School of Rehabilitation Science, Institute of Applied Health Sciences, Faculty of Health Sciences, McMaster University, Room 428, 1400 Main St. W, Hamilton, Ontario L8S 1C7 Canada
| | - Kathleen F. Hunter
- Faculty of Nursing, University of Alberta, 5-293 Edmonton Clinic Health Academy 11405-87 Ave NW, Edmonton, Alberta T6G 1C9 Canada
| | - Adrian Wagg
- Department of Geriatric Medicine, University of Alberta, 1-198 Clinical Sciences Building, Edmonton, Canada
| | - Lori E. Weeks
- School of Nursing, Dalhousie University, Room G30, Forrest Bldg. PO Box 15000, Halifax, Nova Scotia B3H 4R2 Canada
| | - Ann MacLeod
- Trent/Fleming School of Nursing, Trent University, 1600 West Bank Drive, Peterborough, Ontario K9L 0G2 Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy 11405-87 Ave NW, Edmonton, Alberta T6G 1C9 Canada
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Dahlke S, Hunter KF, Pietrosanu M, Kalogirou MR. Testing and e-learning activity designed to enhance student nurses understanding of continence and mobility. Int J Nurs Educ Scholarsh 2021; 18:ijnes-2021-0033. [PMID: 34289268 DOI: 10.1515/ijnes-2021-0033] [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] [Received: 03/01/2021] [Accepted: 07/06/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to test if the e-learning activity that we developed could improve student nurses' knowledge of continence and mobility and whether or not students would find the style of learning beneficial. METHODS A quasi-experimental pre-post-test design was used to test if the continence and mobility e-learning activity could improve student nurses' knowledge about assessing and managing the needs of continence and mobility. An 18-item true/false knowledge of continence quiz was completed by 116 student nurses and a Likert style feedback learning survey was completed by 135 nursing students. RESULTS There was a statistically significant increase in students' knowledge about continence and its relationship to mobility following the e-learning activity. The e-learning activity also enhanced students' knowledge, confidence and perceptions about older people. CONCLUSIONS The e-learning activity we developed has the potential to improve nursing students' knowledge about continence and mobility in an enjoyable manner.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew Pietrosanu
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Maya R Kalogirou
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Kalogirou MR, Dahlke S, Davidson S, Hunter KF, Pollard C, Salyers V, Swoboda N, Fox M. Working with older people: Beginning or end of a nurse's career? Int J Older People Nurs 2021; 16:e12407. [PMID: 34288414 DOI: 10.1111/opn.12407] [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] [Received: 01/27/2021] [Revised: 06/28/2021] [Accepted: 07/02/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The increasing numbers of older people (age 65+) make it important to understand how to attract nurses to work with this population. METHODS A secondary analysis using qualitative descriptive methods was used to understand how student nurses' perceptions about older people may influence their desire to work with older people. RESULTS Student nurses perceive a generational divide between them and older people, regardless of practice settings. They believe working with older people is heavy work, and not high acuity, and although good to learn skills as a student, not a population they want to work with until they are close to retirement themselves. CONCLUSIONS It is important to enhance nursing education so that students understand the older generation, how to communicate with them and the prevalence of older people in healthcare settings, so that they are more likely to choose to work with older people.
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Affiliation(s)
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | | | - Cheryl Pollard
- Faulty of Nursing, MacEwan University, Edmonton, AB, Canada
| | - Vince Salyers
- School of Nursing & Human Physiology, Gonzaga University, Spokane, WA, USA
| | | | - Mary Fox
- Faculty of Health Sciences, York University, Toronto, ON, Canada
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Kalogirou MR, Dahlke S, Davidson S, Yamamoto S. How the hospital context influences nurses' environmentally responsible practice: A focused ethnography. J Adv Nurs 2021; 77:3806-3819. [PMID: 34138473 DOI: 10.1111/jan.14936] [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] [Received: 11/05/2020] [Revised: 04/08/2021] [Accepted: 05/24/2021] [Indexed: 11/29/2022]
Abstract
AIM To describe ways in which a hospital context, physically and culturally, influences nurses' abilities to promote and engage with environmentally responsible practice. DESIGN A focused ethnographic study. METHODS Data were collected during May and August, 2019. Nurses (n = 22) working in the emergency room and three medicine units within a large Western Canadian hospital were invited to participate. Semi-structured interviews were conducted, and observations were collected. Reporting is in accordance with the consolidated criteria for reporting qualitative research. RESULTS Three themes were identified: patient care not environmental care, organizational role and operational efficiency. Overall, participants indicated patient care was their primary priority, and due to their workload, they were unable to simultaneously consider the environmental impact of their work. Participants stated they had difficulties practicing in environmentally responsible ways because they felt unsupported by their hospital organization. Regardless, there was a desire for the organization to support environmentally responsible practices. CONCLUSION Climate change is a major health concern, and partnership between hospitals and nurses is necessary to ensure environmentally responsible healthcare is delivered. We suggest both a top-down and bottom-up approach to help develop hospital contexts that are relevant and environmentally responsible. IMPACT Nurses have a professional responsibility to address climate change, yet this study identified that nurses found it challenging to practice in environmentally responsible ways within the hospital context. Challenges they faced are related to their workload, their misaligned nursing priorities and, more importantly, because they felt unsupported by their hospital. Findings are important to both the nursing profession as well as other hospital leaders so that a culture of environmentally responsible healthcare can be developed within hospitals.
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Affiliation(s)
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Shelby Yamamoto
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Nowrouzi-Kia B, Fox MT, Sidani S, Dahlke S, Tregunno D. The Comparison of Role Conflict Among Registered Nurses and Registered Practical Nurses Working in Acute Care Hospitals in Ontario Canada. Can J Nurs Res 2021; 54:112-120. [PMID: 34042538 PMCID: PMC9109589 DOI: 10.1177/08445621211014421] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objectives The study aimed to describe and compare nurses’ perceptions of role conflict
by professional designation [registered nurse (RN) vs registered practical
nurse (RPN)] in three primary areas of practice (emergency department,
medical unit, and surgical unit). Methods This analysis used data (n = 1,981) from a large cross-sectional survey of a
random sample of RNs and RPNs working as staff nurses in acute care
hospitals in Ontario, Canada. Role conflict was measured by the Role
Conflict Scale. Results A total of 1,981 participants (RN = 1,427, RPN = 554) met this study’s
eligibility criteria and provided complete data. In general, RN and RPN mean
total scale scores on role conflict hovered around the scale’s mid-point
(2.72 to 3.22); however, RNs reported a higher mean score than RPNs in the
emergency department (3.22 vs. 2.81), medical unit (2.95 vs 2.81) and
surgical unit (2.90 vs 2.72). Where statistically significant differences
were found, the effect sizes were negligible to medium in magnitude with the
largest differences noted between RNs and RPNs working in the emergency
department. Conclusions The results suggest the need to implement strategies that diminish role
conflict for both RNs and RPNs.
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Affiliation(s)
- Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mary T Fox
- York University Centre for Aging Research and Education, School of Nursing, York University, Toronto, Ontario, Canada
| | - Souraya Sidani
- School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Coatsworth-Puspoky R, Duggleby W, Dahlke S, Hunter K. Unplanned readmission for older persons: A concept analysis. J Adv Nurs 2021; 77:4291-4305. [PMID: 34028852 DOI: 10.1111/jan.14893] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/18/2021] [Revised: 04/09/2021] [Accepted: 05/03/2021] [Indexed: 11/29/2022]
Abstract
AIM The purpose of this concept analysis is to define and analyse the concept of unplanned readmission to hospital for older persons. DESIGN Review the literature and analyse the concept of unplanned readmission. METHOD Guided by Walker and Avant's eight-stage method of concept analysis, four databases (Ovid MEDLINE, Scopus, CINAHL, and Embase) were searched between 1946 and 2020 for empirical studies focused on older persons with multiple chronic conditions, experiences or perspectives and unplanned readmission. A total of 34 articles (10 quantitative, 17 qualitative, three mixed methods), one concept analysis and three historical articles were included. RESULTS An unplanned readmission is an experience, process and event. The proposed definition of unplanned readmission is an older person's need for acute care treatment for an urgent or emergent health crisis that has occurred after a previous hospitalization(s). Unplanned readmission is characterized by the attributes of older persons' previous hospitalization(s), the urgent or emergent nature of the older persons' health and the older persons' need for acute care hospital services to resolve their health crisis. CONCLUSION Unplanned readmission is a complex concept that is different from planned and emergency visits/admissions and readiness for discharge. These findings provide a link for understanding unplanned readmission as a consequence of discharge readiness. Analysing this concept supports the need for older persons to seek unplanned readmission for acute care treatment of urgent and emergent health crisis, reduces the blame that older persons may feel from questions related to preventability, and stresses the need to include older persons' experiences in the development and expansion of nursing theory, interventions and current understandings of unplanned readmission.
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Affiliation(s)
| | - Wendy Duggleby
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Kalogirou MR, Dahlke S, Davidson S, Yamamoto S. Integrating planetary health into healthcare: A document analysis. Health Policy 2021; 125:799-806. [PMID: 33846028 DOI: 10.1016/j.healthpol.2021.04.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Anthropogenic climate change poses a major health risk to humankind. The healthcare sector both contributes to climate change and is vulnerable to its impacts. Healthcare's greenhouse gas emissions are primarily derived from its supply chain: the production, transport, and disposal of goods. METHODS Document analysis was used to investigate the workplace policies of one large, Western Canadian healthcare organization. Policies that indicated how employees should engage with resources were reviewed through the lens of environmentally responsible practice and planetary health. Content and thematic analysis were applied. RESULTS Four themes were identified: procurement of resources, resource utilization, resource conservation, and waste management. CONCLUSION There was little evidence of environmental or climate impact consideration within the organization's policies. IMPLICATIONS Healthcare organizations could benefit from integrating a planetary health perspective into their policies to deliver healthcare that considers the health and safety of both humans and the climate.
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Affiliation(s)
- Maya R Kalogirou
- Faculty of Nursing, University of Alberta. 11405-87th Avenue, Edmonton, Alberta, T6G 1C9, Canada.
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta. 11405-87th Avenue, Edmonton, Alberta, T6G 1C9, Canada
| | - Sandra Davidson
- Faculty of Nursing, University of Calgary. 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Shelby Yamamoto
- School of Public Health, University of Alberta. 11405-87th Avenue, Edmonton, Alberta, T6G 1C9, Canada
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Abstract
BACKGROUND Novice nursing faculty require support and guidance as they transition from clinical practice to teaching in an academic faculty. Mentoring is an important part of faculty development during the transitional experience. Currently, the learning needs of novice nursing faculty and the effects of formal mentorship programs are not well understood. METHOD An integrative literature review was conducted from five electronic databases. The articles included in the review described primary research studies focused on formal mentorship programs that supported novice faculty in developing their teaching expertise and identified their learning needs. RESULTS The review yielded eight studies that explored different aspects of the mentoring experience. Socialization to Academia and Navigating Mentorship were two key themes developed from the data. CONCLUSION Included studies described mentoring programs and a clear need for some type of formalized orientation and mentorship process or program to enhance novice nursing faculty transition to the academic setting and role. [J Nurs Educ. 2021;60(4):203-208.].
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Dahlke S, Kalogirou MR, Swoboda NL. Registered nurses' reflections on their educational preparation to work with older people. Int J Older People Nurs 2021; 16:e12363. [PMID: 33470029 PMCID: PMC7988531 DOI: 10.1111/opn.12363] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 12/09/2020] [Accepted: 12/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Negative perceptions about working with older people within nursing contribute to the deficit of educators with expertise to teach student nurses, and nurses graduating ill-equipped to work with the ageing population. The perceptions of nurses who have recently graduated from a nursing programme can provide insights into what they wished they knew about working with older people before they graduated. METHODS A qualitative descriptive study design examined recently graduated registered nurses' reflections on their education preparation to work with older people. Content and thematic analysis was used to develop the themes of first impressions and preparation to work with older people. RESULTS Key findings were that nurses did not recognise the importance of learning about older people until they had graduated. Only then did they realise that the ageing population was so complex and prevalent. They perceived a lack of education particularly related to working with older people with dementia and their behaviours, as well as learning how to communicate to an older population. Participants perceived that as students, it was up to them to fit in learning about working with older people without the support of faculty. CONCLUSIONS Faculty need to be supported in learning how to best incorporate content about older people into their curriculum. This could include the development of learning activities that dispel negative stereotypes about ageing and facilitates interest in older people, as this is the population, students are most likely to work with when they graduate. IMPLICATIONS FOR PRACTICE Nurses in practice may require education on working with people with dementia as it is a deficit in nursing programmes.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | | | - Nicholas L Swoboda
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.,Alberta Health Services, Edmonton, AB, Canada
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Jankunis F, Dahlke S, Jantzen D. Philosophy at the intersection of thinking and doing in nursing. Nurs Philos 2021; 22:e12346. [PMID: 33421030 DOI: 10.1111/nup.12346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Frank Jankunis
- Faculty of Arts and Science, Camosun College, Victoria, BC, USA
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, USA
| | - Darlaine Jantzen
- School of Nursing, Trinity Western University, Langley, BC, Canada
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Walsh B, Dahlke S, O'Rourke H, Hunter KF. Nurses' decision-making related to administering as needed psychotropic medication to persons with dementia: an empty systematic review. Int J Older People Nurs 2021; 16:e12350. [PMID: 33438810 DOI: 10.1111/opn.12350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/29/2020] [Accepted: 09/08/2020] [Indexed: 11/28/2022]
Abstract
Behavioural and psychological symptoms of dementia occur in approximately 75% of people with dementia admitted to acute care. Acute care nurses' decision-making regarding administering 'as needed' (pro re nata or PRN) psychotropic medications to persons with dementia are not well understood. This is an important clinical concern because 'as needed' medications are given at the discretion of the nurse. A comprehensive, systematic search and screen for studies that explored nurses' decision-making related to administering as needed psychotropic medication to persons with dementia in acute care settings was conducted. No studies that reported nurses' decision-making related to administration of as needed psychotropic medications to hospitalized persons with dementia were identified. In light of this, we present a discussion based on a narrative review of what is known on this topic from other settings, based on papers found in our original review. We will briefly explore what is needed in future research to address the gap in knowledge about nurse' decision-making related to administering as needed psychotropic medications. IMPLICATIONS FOR PRACTICE: Research is needed to understand and inform the decision-making process in the administration of as needed psychotropic medications to hospitalized persons with dementia.
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Affiliation(s)
- Brittany Walsh
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Hannah O'Rourke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Kalogirou MR, Dahlke S, Davidson S, Yamamoto S. Nurses’ perspectives on climate change, health and nursing practice. J Clin Nurs 2020; 29:4759-4768. [DOI: 10.1111/jocn.15519] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 11/25/2022]
Affiliation(s)
| | - Sherry Dahlke
- Faculty of Nursing University of Alberta Edmonton AB Canada
| | | | - Shelby Yamamoto
- School of Public Health University of Alberta Edmonton AB Canada
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Dahlke S, Davidson S, Kalogirou MR, Swoboda NL, Hunter KF, Fox MT, Pollard C, Baumbusch J, Salyers V. Nursing faculty and students' perspectives of how students learn to work with older people. Nurse Educ Today 2020; 93:104537. [PMID: 32717698 DOI: 10.1016/j.nedt.2020.104537] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 06/12/2020] [Accepted: 07/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Despite efforts to incorporate information about older people in pre-licensure nursing programs, there are inconsistent results from studies examining student nurses' perceptions towards the aging population. There is research suggesting that healthcare settings and nursing practice is perpetuating negative perspectives towards older people. OBJECTIVE To gain an understanding of how social contexts are influencing student nurses' experiences when learning to work with older people. DESIGN Descriptive case study guided by the theoretical framework of social learning theory. SETTING A university in Western Canada that offers a pre-licensure nursing program. PARTICIPANTS 28 student nurses and 13 faculty in the nursing program. METHODS Participant interviews and focus groups were conducted with nursing faculty and students. RESULTS Key findings from this study are that students' previous experiences with older people, through family or work experiences, and their first clinical experience in long- term care negatively influenced their perceptions about working with older people. Clinical nurses and faculty influenced students' perceptions about nursing practice with older people, sometimes in subtle ways, underscoring that students are learning from what they see and hear in practice. Students were ill-prepared for the complexity of the aging population, particularly those with cognitive impairment. CONCLUSIONS Learning activities that engage students in active learning, such as simulation, providing students with a positive lexicon of how to describe older patients, and more overt attention to the perspectives students and faculty bring to the learning environment need to be carefully explored. Meaningful learning experiences with older people in multiple contexts are needed to thoughtfully plan how to disrupt negative perceptions that might emerge through the nursing education program.
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Abstract
As health care is continuously changing, it is important that nurses are continually learning to promote evidence-informed practice. eLearning has gained prominence to gain information and enhance learning within time and space constraints. Innovation such as gamification within and outside of eLearning has also risen in interest to increase engagement in the learning process. In this article, we discuss the usefulness of innovation such as gamification via an ePlatform for continuing education of acute care nurses. Although innovative methods using an ePlatform have the potential to meet nurses' desires for continuing education that is flexible and applicable to their work, more research is needed to understand its effectiveness among acute care nurses. [J Contin Educ Nurs. 2020;51(9):420-424.].
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Walsh B, Dahlke S, O'Rourke H, Hunter KF. Exploring acute care nurses' decision-making in psychotropic PRN use in hospitalised people with dementia. J Clin Nurs 2020; 31:2024-2035. [PMID: 32860272 DOI: 10.1111/jocn.15477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/05/2020] [Revised: 07/30/2020] [Accepted: 08/19/2020] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To understand how acute care nurses make decisions about administering "as-needed" (PRN) psychotropic medications to hospitalised people with dementia (PWD). BACKGROUND Behavioural and psychological symptoms of dementia occur in approximately 75% of PWD admitted to acute care. Despite this, few studies provide insight into the use and prevalence of psychotropic use in acute care. DESIGN A qualitative descriptive design was used to explore acute care nurses' decision-making about PRN psychotropic medication administration to PWD. METHODS Semi-structured interviews were conducted with eight nurses from three acute care medical units in a large tertiary hospital in Western Canada. Conventional content analysis was used to develop three themes that reflect nurses' decision-making related to administering PRNs to hospitalised PWD. COREQ guidelines were followed. RESULTS Three themes of legitimising control, making the patient fit and future telling were developed. Legitimising control involved medicating undesirable behaviours to promote the nurses' perceptions of safety. Making the patient fit involved maintaining routine and order. Future telling involved pre-emptively medicating to prevent undesirable behaviours from escalating. Nurses provided little to no mention of assessing for physical causes contributing to behaviours. PRNs were seen as a reasonable alternative to physical restraints and were frequently used. Additionally, organisational and unit routines greatly influenced nurses' decision-making. CONCLUSIONS These findings provide an initial understanding of how nurses make decisions to administer PRN medications to hospitalised older people and may inform prescribing practices. There were novel findings about the lack of assessment prior to PRN administration, and the nurses' collective response in decision-making. More research is needed to better understand the complexities of nurses' decision-making, to assist in the development of interventions for nursing practice.
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Affiliation(s)
- Brittany Walsh
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Hannah O'Rourke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Swoboda NL, Dahlke S, Hunter KF. Nurses' perceptions of their role in functional focused care in hospitalised older people: An integrated review. Int J Older People Nurs 2020; 15:e12337. [PMID: 32790240 DOI: 10.1111/opn.12337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 01/17/2020] [Revised: 07/01/2020] [Accepted: 07/20/2020] [Indexed: 12/01/2022]
Abstract
AIM The aim of this integrative review was to identify nurses' perspectives of their role in influencing the functional status of hospitalised older people. METHODS An integrative review using Whittemore and Knafls' method was conducted using EBSCOhost CINAHL, Ovid MEDLINE(R), EBSCOhost, Social Gerontology, Cochrane Database of Systematic Reviews and ProQuest Dissertations & Theses data bases. Only studies with nurses' perspectives, or beliefs about their role in function-focused care were included. Content analysis was used to develop the themes nurses' role in function-focused care and barriers to functional care. RESULTS The review found 12 relevant articles. Nurses believed that they were responsible for function-focused care, yet functional care tasks were often missed. Organisational contexts created many barriers to providing function-focused care for patients. Nurses felt powerless to address these overarching problems in their organisations. CONCLUSION Nurses understand the importance of functional care yet often fail to carry out functional care interventions. Lack of organisational support creates a workplace that is short on staff, time and equipment and does not prioritise functional care needs. Nurse leaders and healthcare organisations need to reprioritise function-focused care for the good of patients, families and healthcare budgets.
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Affiliation(s)
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Duarte Wisnesky U, Olson J, Paul P, Dahlke S, Slaughter SE, de Figueiredo Lopes V. Sit-to-stand activity to improve mobility in older people: A scoping review. Int J Older People Nurs 2020; 15:e12319. [PMID: 32500976 DOI: 10.1111/opn.12319] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 03/13/2020] [Accepted: 04/03/2020] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To identify the current state of knowledge about the use of the sit-to-stand intervention with older people and to identify implications for further research. BACKGROUND Many older people experience mobility challenges which can negatively affect their well-being. Physical activities are vital to improving or maintaining mobility. Although there is evidence that mobility challenged older people benefit from the sit-to-stand intervention, there is a need to systematically examine the state of knowledge about this intervention. DESIGN Scoping review using Arksey and O'Malley's methodological framework. METHODS A systematic search of three databases was completed. Abstracts were evaluated for relevance using predetermined inclusion criteria. Studies that met the inclusion criteria had data extracted and were appraised for internal and external validity. Narrative synthesis was based on methods described by Popay and colleagues. RESULTS Of 3,041 papers, six studies met the inclusion criteria. Publications provided a range of sit-to-stand interventions with durations varying from four weeks to six months. The frequency of each intervention fluctuated from three to seven times/week with a duration of 15-45 min. Different professionals prompted the activity. Three themes were identified the following: (a) sit-to-stand activity as an intervention; (b) generalisability of findings; and (c) sustainability. CONCLUSIONS Most of the studies reviewed indicated improvements in performance of the sit-to-stand activity and in motor function. However, issues with studies rigour do not allow us to make generalisations. Further research is needed to confirm the effectiveness of the intervention. IMPLICATIONS FOR PRACTICE Healthcare providers are expected to offer evidence-based patient care. This review details current knowledge about the sit-to-stand intervention with older people.
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Affiliation(s)
| | - Joanne Olson
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Pauline Paul
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Fox MT, Butler JI, Sidani S, Durocher E, Nowrouzi-Kia B, Yamada J, Dahlke S, Skinner MW. Collaborating with healthcare providers to understand their perspectives on a hospital-to-home warning signs intervention for rural transitional care: protocol of a multimethod descriptive study. BMJ Open 2020; 10:e034698. [PMID: 32295775 PMCID: PMC7200029 DOI: 10.1136/bmjopen-2019-034698] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION This study builds on our prior research, which identified that older rural patients and families (1) view preparation for detecting and responding to worsening health conditions as their most pressing unmet transitional care (TC) need and (2) perceive an evidence-based intervention, preparing them to detect and respond to warning signs of worsening health conditions, as highly likely to meet this need. Yet, what healthcare providers need to implement a warning signs intervention in rural TC is unclear. The objectives of this study are (1) to examine healthcare providers' perspectives on the acceptability of a warning signs intervention and (2) to identify barriers and facilitators to healthcare providers' provision of the intervention in rural communities. METHODS AND ANALYSIS This multimethod descriptive study uses a community-based, participatory research approach. We will examine healthcare providers' perspectives on a warning signs intervention. A purposive, criterion-based sample of healthcare providers stratified by professional designation (three strata: nurses, physicians and allied healthcare professionals) in two regions (Southwestern and Northeastern Ontario, Canada) will (1) rate the acceptability of the intervention and (2) participate in small (n=4-6 healthcare providers), semistructured telephone focus group discussions on barriers and facilitators to delivering the intervention in rural communities. Two to three focus groups per stratum will be held in each region for a total of 12-18 focus groups. Data will be analysed using conventional qualitative content analysis and descriptive statistics. ETHICS AND DISSEMINATION Ethics approval was obtained from the Office of Research Ethics at York University and the Health Sciences North Research Ethics Board. Findings will be communicated through plain language summary and policy briefs, press releases, manuscripts and conferences.
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Affiliation(s)
- Mary T Fox
- School of Nursing, York University, Toronto, Ontario, Canada
| | | | - Souraya Sidani
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Evelyne Durocher
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Behdin Nowrouzi-Kia
- Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Janet Yamada
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Mark W Skinner
- Trent School of the Environment, Trent University, Peterborough, Ontario, Canada
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Stahlke S, Dahlke S. The Relational Role of Managers in Support of Teamwork. Nurs Leadersh (Tor Ont) 2020; 33:112-121. [PMID: 32437326 DOI: 10.12927/cjnl.2020.26187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In healthcare, teamwork is promoted as a means of delivering high-quality care. Although the literature emphasizes the personal responsibility of healthcare workers to work effectively within teams, it is equally vital to understand the role of leaders in supporting teamwork. In a focused ethnography that examined teamwork and its impact on care delivery and job satisfaction for healthcare workers, our participants shared how their leaders impacted team functioning. In this study, we examined these data related to leadership and found a strong daily relational component to team management, in contrast to high-level, strategic recommendations in the literature; this has significant implications for leaders.
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Affiliation(s)
- Sarah Stahlke
- Associate Professor, Faculty of Nursing, University of Alberta, Edmonton, AB
| | - Sherry Dahlke
- Associate Professor, Faculty of Nursing, University of Alberta, Edmonton, AB
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Dahlke S, Hunter KF. How nurses' use of language creates meaning about healthcare users and nursing practice. Nurs Inq 2020; 27:e12346. [PMID: 32064704 DOI: 10.1111/nin.12346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 09/27/2019] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 11/27/2022]
Abstract
Nursing practice occurs in the context of conversations with healthcare users, other healthcare professionals, and healthcare institutions. This discussion paper draws on symbolic interactionism and Fairclough's method of critical discourse analysis to examine language that nurses use to describe the people in their care and their practice. We discuss how nurses' use of language constructs meaning about healthcare users and their own work. Through language, nurses are articulating what they believe about healthcare users and nursing practice. We argue that the language nurses use can contribute to viewing their practice as tasks on bodies that must be accomplished efficiently and objectively within the biomedical model, rather than relational and person-centered. Moreover, the language nurses use can perpetuate a sense of powerlessness within healthcare systems yet paradoxically they are in a position of power over healthcare users. Nurses' compliance with the efficiency and biomedical model results in a lack of emphasis on the full breadth of nursing work, which could be enacted in relational rather than power-laden practices. We conclude by positing that careful use of language among nurses in all settings is essential, if we are to begin to articulate what nursing is to ourselves and to others.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Abstract
BACKGROUND One of the main requirements of qualitative research is to obtain access to participants. Researchers rely on gatekeepers for access to study sites and their communities of stakeholders, opportunities to communicate their studies to potential participants, and to locate meeting and interview spaces. AIM To share the challenges the authors encountered with gatekeepers during a study and how they managed these challenges. DISCUSSION The authors conducted a focused ethnographic study in two healthcare organisations. Their goal was to recruit, interview and observe staff from across the institutions and a range of occupational groups, to explore their experiences of teamwork and the effects their work relationships had on their job satisfaction. Managers in the organisations were enthusiastic about the study, providing much needed support to the authors. However, the authors became concerned that staff might have felt inadvertently coerced to participate in the study. This challenged the authors' notions of research ethics, prompting discussion about how to best manage aspects of the study, such as information sessions, snowball sampling and consent. CONCLUSION Explaining the principles of research ethics to gatekeepers can prevent them inadvertently making employees feel coerced into participating. Ensuring potential participants are fully aware of their rights and the voluntary nature of the study can make them more likely to participate. IMPLICATIONS FOR PRACTICE Before any study begins and frequently during the study, it is important that researchers discuss with potential participants and gatekeepers ethical principles, including confidentiality, anonymity and the right to participate or withdraw from the study.
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Affiliation(s)
- Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton AB, Canada
| | - Sarah Stahlke
- Faculty of Nursing, University of Alberta, Edmonton AB, Canada
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Negrin KA, Slaughter SE, Dahlke S, Olson J. Factors affecting undergraduate nurse educators' knowledge, skills or attitudes about older persons and their care: An integrative review. Int J Older People Nurs 2019; 15:e12293. [PMID: 31793746 DOI: 10.1111/opn.12293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 09/03/2019] [Revised: 10/25/2019] [Accepted: 11/12/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nurses are increasingly expected to provide care for older persons; however, there are too few nurse educators with expertise in older person care to ensure students graduate with the requisite competencies. METHODS An integrative review, using Whittemore and Knafl's framework, was undertaken to identify and synthesise evidence about factors affecting nurse educators' knowledge, skills or attitudes about older persons and their care. RESULTS Forty-four articles met the inclusion criteria. All but three papers originated in the USA. Content analysis yielded three central themes: external-level factors, employer-level factors and individual-level factors. Findings demonstrated that external funding from philanthropic organisations and government agencies supported many of the national, regional and site-specific initiatives, which were, in many cases, underpinned by professional regulatory frameworks. Negative attitudes of administrators and reduced budgets of educational institutions impeded the availability of such initiatives. Negative attitudes of individual educators towards older person care and the specialty of gerontology constrained their pursuit of such learning, as did their lack of awareness of current gerontology resources. CONCLUSIONS The lack of educators with gerontology knowledge, skills and requisite attitudes requires a focused effort from external and professional bodies, and from educational institutions to ensure the resources are available to enhance educator expertise in gerontology. Rigorous study addressing the factors influencing educators' knowledge, skills or attitudes towards older persons and their care is required. IMPLICATIONS FOR PRACTICE Addressing the lack of nurse educator expertise in gerontology could help to ensure new nurses have the required competencies to provide quality older person care.
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Affiliation(s)
- Kelly A Negrin
- Faculty of Nursing, University of Alberta, Alberta, Canada
| | | | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Alberta, Canada
| | - Joanne Olson
- Faculty of Nursing, University of Alberta, Alberta, Canada
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