Canadian Journal of Nursing Research最新文献

Background & PurposePatient clinical deterioration is a major safety concern. One strategy implemented for health providers to improve the timely recognition and response to patient deterioration is the Rapid Response Team (RRT). Despite this resource, patient deterioration still occurs and delayed activation of the RRT is one contributing factor. Little is known about unit-level nurses' experiences related to RRT activation, especially within the Canadian context, which is problematic given they are the ones who are primarily responsible for initiating the process. The purpose of this study was to understand the experiences of nurses practising on general adult inpatient medicine units and their activation of the RRT.Methods & ProceduresThe research question was addressed with a descriptive, exploratory qualitative study. Nurses working on general adult inpatient medicine units at an Ontario hospital study site were purposively recruited to participate. Semi-structured interviews with the six participants were held online and audio-video recorded. Inductive, thematic analysis was used.ResultsEleven themes about the barriers and facilitators to RRT activation, and one overarching theme-the Self-Imposed Complexity of Deciding to Activate the RRT-resulted in relation to the nuanced, multi-factorial decision-making process unit-level nurses undertake when considering activation.ConclusionThis study contributes novel information to better understand RRT activation by nurses and will inform practice changes surrounding RRT policies, nursing education about the RRT, and new research on optimizing strategies for RRTs and deteriorating patients. The multi-layered activation process intricacies positions future work to improve escalation of patient clinical deterioration.

BackgroundDialysis as treatment for kidney failure can result in significant physical and psychosocial symptom burden. Kidney supportive care (KSC), encompassing advance care planning (ACP), is an approach to care involving early identification and treatment of symptoms that improves the quality of life of people receiving dialysis. However, ACP is underused and often initiated late in the illness. The delay or lack of engagement in KSC by nephrology nurses until near the end of life may result in people receiving care that is discordant with their values, wishes, and preferences.PurposeThe purpose of our study was to construct a substantive theory about the process of engagement in KSC by nurses in Canadian dialysis settings.MethodsUsing Charmaz's constructivist grounded theory method, 23 registered nurses working in hemodialysis and peritoneal dialysis were recruited to participate in two intensive interviews. Concurrent data collection and analysis were undertaken, with constant comparative analysis of codes until the attainment of theoretical saturation, as well as memo-writing and researcher reflexivity, to aid the emergence of categories and concepts.FindingsIn the substantive theory "Breaking Through the Glass Ceiling of Engagement-Having That Conversation," three stages of engagement (Transactional, Intentional, Actional) are identified that describe nurses' practice patterns of engagement in communication about goals of care with patients. This engagement is modulated by a boundary of professionalism and familiarity with patients, amid multi-dimensional contextual barriers.ConclusionNephrology nurses have a vital role in discussions about goals of care and require training to enhance their communication skills.

IntroductionBeginning or returning to physical activity is an important element of postpartum care due to its associated mental and physical health benefits. South Asian immigrant women often report a lack of confidence in physical activity engagement and may face cultural barriers to engagement. The purpose of this study was to explore South Asian immigrant women's perspectives and beliefs surrounding postpartum care and physical activity in Canada.MethodEleven South Asian immigrant women (M_age = 31) who had given birth in Canada within the last 12 months and were able to understand and speak English or Punjabi, participated in the study. A semi-structured interview was used to explore participants' birth and postpartum healthcare experiences, as well as their physical activity engagement. Audio-recorded interviews were directly translated and transcribed from Punjabi to English and a reflexive thematic analysis approach was applied.ResultsThrough our analysis, we developed four themes: (a) conflicting traditional and modernized beliefs around postpartum care; (b) physical activity was important to care for one's child and the home, but perceptions of what constituted physical activity varied; (c) lack of time, lack of knowledge, a physically weak body, and exhaustion were barriers to physical activity engagement; and (d) social support was crucial in improving well-being and reducing feelings of isolation, particularly for those with live-in family.ConclusionGiven the high appreciation for community programming which support South Asian mothers, it is essential that culturally relevant physical activity be incorporated into healthcare education postpartum to increase knowledge around health benefits of physical activity. In addition, South Asian immigrant women may require community engagement (including programming) and informational support from healthcare providers.

BackgroundThe "1.5 generation" refers to those who immigrated to a new country as children or adolescents. In the context of Canada, 1.5-generation Bangladeshis are underrepresented in the extant literature on sexual and reproductive health (SRH). Their cross-cultural positionality and ethnic background have implications for their SRH-related help-seeking behaviors and service utilization.PurposeThis paper explored the SRH related help-seeking behaviors and perspectives and experiences with accessing and utilizing SRH services among 1.5-generation Bangladeshi women in Toronto, Ontario.MethodsTen 1.5-generation Bangladeshi women, aged between 18 and 22, participated in this qualitative study. This study employed a narrative inquiry methodological approach and the Conceptual Framework of Access to Healthcare as a theoretical lens.ResultsKnowledge about routine SRH tests and utilization of these services were found to be low. Mothers, sisters, peers, the internet and mobile apps were identified as sources of informal help-seeking. The family doctor is the most significant source of formal help-seeking. The findings shed light on the demand- and supply-side dimensions of access to SRH care as well as the multiple barriers and facilitators to services. Individual-level social and cultural factors in SRH help- and care-seeking behaviors and attitudes were identified. Structural factors within the health system hindered effective service delivery.ConclusionThe findings highlight the need for SRH-focused educational and informational campaigns in residential neighborhoods concentrated by the Bangladeshi diaspora. Policymakers should address the structural barriers in the health system to improve the quality of SRH care. Further investigation is required to understand what culturally responsive SRH care entails for 1.5-generation patients from South Asian and Muslim backgrounds.

BackgroundIn response to the full-scale Russian invasion of Ukraine, the Government of Canada welcomed thousands of temporary migrants under the Canada-Ukraine Authorization for Emergency Travel (CUAET) program. Ukrainian temporary migrants who are settled in Ontario experience acute, chronic, and complex health issues, creating additional demand upon the healthcare system. Despite a collective awareness of difficulty in accessing existing healthcare resources, little is known about how Ukrainian temporary migrants experience and utilise the Ontario healthcare system.PurposeTo explore the lived experiences of Ukrainian temporary migrants navigating the Ontario healthcare system, and to report on the results of a knowledge translation (KTr) workshop intervention delivered with this population to assist in the development of knowledge and skills related to healthcare system navigation.MethodsA KTr workshop was delivered with ten Ukrainian temporary migrants who have temporarily settled in Toronto, Canada. Inductive and deductive thematic analysis was used.ResultsFour themes emerged: 1) concerns regarding accessibility and wait times; 2) difficulties navigating the healthcare system; 3) transnational health practices; and 4) a desire for increased involvement in the care plan.ConclusionsThis project highlights barriers to services and the need for healthcare providers to explore equitable and accessible solutions to support temporary migrants.

Study backgroundBritish Columbia (B.C.) has suffered a significant loss of life every day due to the unregulated drug poisoning crisis that has affected this province since 2016 (B.C. Coroners Service, 2023). In September 2020 the B.C. Provincial Medical Health Officer, issued a provincial health order to allow registered nurses (RNs) and registered psychiatric nurses (RPNs) to diagnose and prescribe pharmacological treatment for opioid use disorder (OUD) (Ministry of Health, 2020).PurposeTo understand how RNs and RPNs in B.C. experience their expanded role as nurse prescribers of opioid agonist therapy (OAT).MethodsUtilizing Sally Thorne's (2016) Interpretive Description method, a purposeful sample of RNs and RPNs across the province who actively prescribe OAT to people with an OUD were interviewed about their experience and perceptions.ResultsKey findings of this study include insights into the positive and challenging experiences of prescribing OAT in B.C.; operational implementation considerations for RNs and RPNs prescribing OAT; and the strengths and flexibility that RNs and RPNs can bring to OAT care.ConclusionsFindings within this research are relevant to other Canadian provinces considering implementing RN/RPN OAT prescribing as a strategy to increase access to pharmacological treatment for people with OUD.

In Canada, 7% of youth 15-24 identify as living with neurodevelopmental conditions or intellectual disabilities, such as autism spectrum disorder or attention deficit disorder. These youth face significant challenges when transitioning from pediatric to adult healthcare services. Fragmented systems, diminished support, and increased health vulnerabilities mark these transitions. Adult healthcare systems often lack the coordinated, family-centered approach of pediatric care, resulting in care gaps, mental health risks, and poor health outcomes. This commentary argues that nurse navigators offer a practical, evidence-informed, and ethically grounded solution to improve transitional care. Drawing on successful models in oncology care, the nurse navigator role can bridge service silos, advocate for inclusive care, and support youth and families during this critical life stage. Despite systemic barriers such as workforce shortages and inconsistent policy implementation, the integration of nurse navigators into Canadian healthcare frameworks represents a necessary step toward equitable, person-centered transitional care. This paper calls for national investment in a scalable navigation model tailored to the needs of neurodivergent youth and their families, which aligns with Canada's legislative commitments to accessibility, inclusion, and health equity.

BackgroundNurses and personal support workers (PSWs) frequently face trauma in their work without sufficient resources to manage the resulting emotional stress. This contributes to high rates of burnout, which have remained elevated since the COVID-19 pandemic.PurposeTo address the need for effective interventions that mitigate the impact of trauma exposure in the healthcare workplace, we developed the Supportive Trauma Exposure Preparation (STEP) program, an 8-week virtual psychotherapy intervention. The aim of this study was to evaluate the feasibility, acceptability, and preliminary effectiveness of the STEP program in reducing burnout and enhancing resilience.MethodsA pilot study was conducted with 35 nurses and PSWs in Ontario assessing the feasibility, acceptability, and preliminary effectiveness of the STEP program at three months follow-up. Participants attended 8 weekly psychotherapy sessions, provided feedback on their experiences, and completed measures of burnout, resilience, mood, anxiety, and work and life functioning.ResultsThe study demonstrated strong feasibility and acceptability, with high participant engagement and satisfaction with the STEP program. Improvements in burnout and work functioning were observed at the three-month follow-up.ConclusionsThe STEP program shows promise as a novel intervention addressing the critical unmet need for preventing and managing the detrimental effects of trauma exposure among nurses and PSWs in the healthcare workplace. ClinicalTrials.gov Registration # NCT04682561 (URL: https://clinicaltrials.gov/study/NCT04682561).

With Artificial Intelligence (AI) tools becoming increasingly commonplace, the usage of AI-enabled tools in education has also grown. AI-enabled tools refer to machines incorporated with human-like capabilities, such as reasoning, interpretation, and problem-solving, to perform tasks that require human intelligence. ChatGPT is one of these tools, which uses large language models (LLM), a type of AI that generates natural language, to give human-like answers to questions. This study investigated nursing students' perspectives on AI-enabled tools, such as ChatGPT, aiming to identify (1) perceived benefits and challenges and (2) implications for the ethical and responsible use of AI within undergraduate nursing programs. Using interpretive description, we conducted focus group interviews with undergraduate nursing students. Through convenience sampling, sixteen students were recruited. Our findings revealed four key themes - utilization as a support tool, utilization leading to a loss of competency in foundational skills, utilization risking credibility and academic integrity, and the need for further education and resources. Three key factors - evidence-based practice, ethical considerations, and the importance of critical thinking skills - influence nursing students' perspectives toward AI tools. To ensure the safe and ethical use of AI in academia, robust institutional policies and training are needed. Promoting open dialogues and education can help students understand AI's advantages, potential harms, and risk mitigation strategies. Future research should build a comprehensive understanding of the perspectives of undergraduate and graduate nursing students, and educators on AI usage in academia. Development of interventions that mitigate AI-usage risks is also necessary to improve integration into education.

Three CJNR board members (Metersky, Clarke, & Roux) presented at the International Council of Nurses conference in June 2025. The vision presented in this editorial was developed to further the CJNR mission to serve the international nursing community by broadening dissemination of research.