Canadian Journal of Nursing Research最新文献

Background: Wounds are a significant national health concern, impacting individuals, healthcare systems, and the environment. Despite efforts by organizations to promote evidence-based practices, gaps persist between theory and nurse practice in wound care. Mobile apps show promises in enhancing wound care delivery, but their rapid evolution, including adaptations into different languages such as French, raises concerns about reliability and regulation. Evaluating these apps is crucial for ensuring patient safety and effective wound management.

Purpose: To review and assess mobile wound care apps available in French for healthcare providers in Canada.

Methods: A systematic search was conducted across the literature and the two main Canadian online app stores (App Store and Google Play). The included mobile apps underwent quality evaluation using the user version of the Mobile Application Rating Scale (uMARS).

Results: The initial search retrieved 1,550 apps, of which 260 were screened and 5 included. Included apps were from France and were available on both stores. These apps varied in features, including wound dressing directory (n = 3), best practices reminders (n = 2), photography management and digital wound tracking (n = 1), and total body surface area calculator (n = 1). Evaluation using uMARS indicated total averages range from 3.52/5 to 4.10/5. The results offer scant insight into the design and evaluation of the apps included.

Conclusions: The study highlights the need for development and validation of a French wound care app tailored to Canadian healthcare contexts and best practice recommendations, emphasizing collaboration among nurses and stakeholders in technology enhancement for the benefit of Canadians' health.

Objective: To explore diabetes self-management for older adults in rural Ontario.

Methods: Fourteen adults, 65 and older, with diabetes, participated in this study using a participatory, art-based approach involving photovoice and semi-structured interviews. Data underwent hermeneutic phenomenology analysis.

Findings: Four themes emerged, elucidating the lived experiences of participants managing diabetes in a rural context.

Discussion: This study underscores the challenges and strategies of diabetes self-management in rural older adults. A holistic approach, encompassing physical, emotional, and mental well-being, is pivotal, augmented by proactive lifestyle choices. Effective coordination in medication management and enhanced communication among health care providers emerged as essential. The unique role of pets illuminates their profound impact on participants' activity levels and emotional fortitude, suggesting they can be vital assets in diabetes care. Collectively, these findings guide health professionals and policymakers in crafting nuanced, context-sensitive interventions to optimize diabetes management for older adults in rural contexts.

Background: Ancestral Black Nova Scotian (ABNS) nurses are a culturally distinct group yet, little is known about their experiences. Available literature suggests that ABNS nurses are underrepresented in nursing and that they encounter discrimination throughout the health system. Understanding the experiences of ABNS nurses facilitates addressing antiBlack racism in nursing and healthcare.

Purpose: This study sought to critically examine the leadership experiences of ABNS nurses in healthcare.

Methods: This qualitative study was guided by Black feminist theory and involved one-on-one semi-structured telephone interviews with eighteen ABNS nurses. Critical Discourse Analysis was applied in the reading of interview transcripts to examine words used by participants in relation to nursing and healthcare. The findings are presented in two conceptual themes.

Results: Black Tax in Nursing captures the added physical, mental, and spiritual strain experienced by ABNS nurses navigating nursing and healthcare. Black Tax encompassed everyday microaggressions and systemic processes, including intra-profession tensions. Integrating into nursing was made increasingly difficult by a reinforcing network of gatekeepers, policies, and structural design. Nova Scotia Healthcare as an Archaic Institution depicts an antiquated "broken" paternalistic system that did not empower patients nor promote health. Additionally, nursing education was accused of reinforcing negative stereotypes, competency gaps, and mistrust with patients.

Conclusions: Institution of Care show how ABNS nurses challenge institutional standards and norms in their approach to nursing. ABNS nurses navigate nursing and the health system by maintaining a community-oriented approach to health. Addressing anti-Black racism in nursing and healthcare requires attention to multi-level processes within institutions.

Objectives: With nearly 50,000 people having died since 2016 as a result of the unregulated toxic drug supply, novel approaches to care are needed. A small number of Safer Stimulant Supply programs have been piloted in Canada, which seek to provide a pharmaceutical-grade stimulant medication replacement for the toxic unregulated stimulant supply. In this paper, we describe the results of retrospective Safer Stimulant Supply program medical chart reviews.

Methods: We extracted data from program intake and check-in forms collected on an ongoing basis by the clinical teams. In total, 28 medical charts were included in this evaluation. Data collected was reported using descriptive statistics.

Results: Chart reviews showed that over the course of the program, program participants reported an overall decrease in their unregulated stimulant use. Specifically, at program intake and check-in appointments, cocaine use went from a median of 10 points/day to 0 points/day, and crystal methamphetamine use went from a median of 1.5 points/day to 0 points/day. Chart reviews also showed that program participants reported increased access to primary care and infectious disease programs and improvements in housing status.

Conclusions: Our research demonstrated that program participants found Safer Stimulant Supply programs to be impactful in addressing ongoing drug use. Safer Stimulant Supply programs remain an underutilized but important harm reduction tool to address the drug poisoning crisis.

Although race is socially constructed, racism and racialization are social determinants of health. Over four centuries of colonial genocide and structural violence against Indigenous and Black peoples in Canada have resulted in intergeneration traumas and health disparities among Indigenous and Black people, sustained by ongoing social, political, and economic inequities. Evidence indicates the impact of contemporary and historical forms of racism on health outcomes. This special issue invited papers that could contribute to our understanding of the role of racism in nursing and health in Canada as well as solutions to tackle racism in healthcare and the nursing profession. Our call for proposals produced around 16 articles, all of which provide critical insight to address racism in nursing and healthcare. These articles explore the experience of racism in Indigenous, Black, Asian, and other populations across education, clinical, and community settings. They also advance our understanding on philosophical and theoretical approaches to address racism and provide us with effective tools and insight to address racism in nursing and healthcare in Canada.

Background: Post-Traumatic Stress Disorder (PTSD) is a substantial problem for Veterans and active members of armed forces across the globe, resulting in debilitating mental and physical comorbidities. Evidence-based treatments have demonstrated some success; however, many Veterans remain symptomatic mandating the urgent need for innovative treatment strategies.

Purpose: The purpose of this study was to explore the lived experience of military Veterans with PTSD symptoms who participated in a therapeutic warm water immersion intervention aimed at reducing their symptoms.

Methods and procedures: A standardized warm 33 °C (92 °F) water immersion intervention to the chest, lasting 45 min was implemented. Semi-structured interviews were conducted with the 13 participants (age 23-41) after engaging in the intervention. Using a qualitative descriptive design informed by phenomenology, thematic analysis was completed, applying criteria of rigor throughout the process.

Results: Five main themes explicated the participants' experience: the rhythm of relaxed, embracing the properties of the water, the pain floats away, acclimatize to calmness, and a place to set your mind. Participants described a sense of relaxation, calmness, pain reduction, and a means to control intrusive thoughts. All indicated they would recommend the intervention and provided feedback on how to refine it.

Conclusions: As a component of a larger study, these qualitative findings revealed the potential for therapeutic effects of a novel water immersion intervention. The findings serve to inform revisions to the intervention for future research and practice. Immersion provides a fast-acting, non-stigmatizing adjunct therapy for student Veterans who continue to experience symptoms during and after standard evidence-based treatment.

Background: This survey of rural nurses' experiences is part of a program evaluation of the Rural Surgical and Obstetrical Networks (RSON), a five-year initiative (2018-2023) to strengthen and stabilize rural hospitals in British Columbia (BC), Canada.

Purpose: Our aim was to measure changes in professional and work-related quality-of-life of rural surgical and obstetrical nurses in eight communities across BC and determine if the RSON initiative mitigated impacts of the COVID-19 pandemic on nurses' quality of life.

Methods: This longitudinal evaluation was administered via online surveys in 2021 and 2023. Work-related quality of life was measured with 23 items that assess job satisfaction, general wellbeing, work-life balance, stress level experienced at work, control, and working conditions. Professional quality of life was measured along three dimensions: compassion satisfaction (CS), burnout, and secondary traumatic stress (STS) (10 items each). Responses were linked by code and changes in quality of life were analyzed using paired Student's t-test.

Results: 107 nurses participated at time 1 and 28 at time 2. Burnout and secondary traumatic stress scores at time 1 were lower among older nurses and those with children. Over the two-year period (2021 to 2023), significant increases were observed in burnout (p < 0.001), and secondary traumatic stress (p = 0.04), while work-related Quality-of-Life decreased significantly (p = 0.04). Compassion satisfaction decreased over time, though not statistically significant.

Conclusions: While the RSON initiative could not mitigate decreases in professional and work-related quality-of-life during COVID-19, it offered opportunities for clinical education and professional development among rural nurses.

This article provides reflections on the initiatives and experiences of nurses who identify as Black, Indigenous, and/or 2SLGBTQIA + within the Canadian healthcare system, as well as the efforts of the Health Equity Consortium to promote equity within the nursing profession. The paper explores the unwavering commitment of marginalized nurses to exceptional patient care despite facing pervasive prejudices and discrimination. It discusses the Registered Nurses' Association of Ontario's (RNAO) commitment to diversity and the creation of the Health Equity Consortium to address systemic barriers. Furthermore, the article highlights the concept of intersectional stigma and the need for comprehensive cultural competency training and inclusive leadership practices. Additionally, it outlines the consortium's aim to gather more information and publish further work to advance equity within the nursing profession and healthcare system. Ultimately, the reflection underscores the importance of collective action and ongoing dialogue to drive meaningful change towards a more equitable and inclusive healthcare system.

Background: The aim of this study is to explore the practice experiences of new graduate nurses (NGNs) in publicly funded acute healthcare settings in the Greater Toronto Area, their perspectives on the determinants of their desire to stay or leave the nursing profession, and to identify action-oriented strategies to promote retention of NGNs.

Design: Qualitative, descriptive.

Methods: Fifteen NGNs participated in focus group sessions, where a semi-structured interview guide was created to generate discussion on NGNs' lived and professional experiences. We utilised the Social Ecological and Intersectionality frameworks to guide data analysis with an emphasis on social identities, power relationships, and the personal, interpersonal, organizational, and structural determinants of nursing retention.

Results: Participants contextualized their major challenges within four professional development phases: 1.) accessible nursing education and practicum placement; 2) preparedness, orientation and mentorship during entry to practice; 3) navigating transition to independent practice and multi-level structural violence; 3.1) retention strategies; and 4) perspectives on professional trajectory for NGNs.

Conclusion: NGNs experience major challenges throughout their nursing education and career. The study findings indicate that further research and systemic reform is essential to support, develop, and retain nursing leaders in the acute care setting. Furthermore, the findings can inform the development of evidence-based nursing curriculum reform.

Background: In long-term care facilities (LTCF), apathy is a prevalent issue, leading to cognitive decline, functional impairment, and increased mortality risk. Despite its significance, apathy often remains underrecognized and undermanaged in these settings. Recognizing and addressing the predictors of apathy is critical for early intervention and improved care outcomes.

Purpose: This study aims to assess the prevalence of apathy and identify its associated risk factors among newly admitted residents in the Canadian LTCF, using the InterRAI Minimum Data Set (MDS 2.0).

Methods: We conducted a cross-sectional analysis of MDS 2.0 admission assessment data between 2015 and 2019, covering 157,596 residents across six Canadian provinces and one territory. Apathy was measured using the Apathy Index of the MDS 2.0, with the biopsychosocial model guiding the analysis.

Results: The prevalence of apathy was 12.5% (19,758 individuals). The most significant predictors include cognitive impairments, specific age groups, hearing impairments, vision impairments, facility size and location.

Conclusions: The findings of this study underscore the need for tailored strategies in LTCF to address apathy, considering individual, institutional, and regional variations. Emphasis on environmental and personal factors is crucial in the management and prevention of apathy in these settings.