Canadian Journal of Nursing Research最新文献

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.

Introduction: Novice and beginner nurses make more medical errors than senior nurses. However, there is significant underreporting of medication errors and near misses among novice and beginner nurses.

Objective: To identify the factors that influence the intention of novice and beginner nurses to report medication errors and near misses.

Methods: A cross-sectional exploratory study was carried out among third-year nursing students in a Quebec university (n = 143). Data was collected through a self-reported questionnaire based on the adapted Theory of Planned Behavior. Simple descriptive analyses and a series of contingency analyses were performed using Chi-2 or Fisher exact tests. Correction of multiple tests was done using Bonferroni test.

Results: All theoretical constructs were significantly associated with intention. Sociodemographic factors (age, sex, experience and education program) were also associated with intention.

Discussion and conclusion: Further studies are needed to identify the determinants of intention to report medication errors and near misses among novice and beginner nurses. More attention is required in nursing practice and education to act on these factors, thus encouraging novice and beginner nurses to report medication errors and near misses.

Background: Public health nurses (PHNs) are often a first point of contact for postpartum individuals seeking mental health support, but report limited training related to mental health.

Purpose: To determine whether a two-day cognitive behavioral therapy (CBT)-based training program focused on postpartum maternal mental health can improve PHN perceptions of their ability to deliver CBT techniques, their confidence working with distressed clients, and with managing client resistance to treatment recommendations.

Methods: A convenience sample of 45 PHNs working in the Family Health Division of Niagara Region Public Health in Ontario, Canada were assessed before and after they received a two-day CBT-based training program. Before attending training, PHNs reported their current professional position, years of experience working in public health, and any previous mental health training. Their confidence in delivering CBT techniques, working with distressed clients, and with managing client resistance to treatment recommendations was assessed pre- and post-training. Participants also rated their satisfaction with the training.

Results: Statistically significant improvements were seen in confidence using CBT techniques, and in supporting and managing distressed or resistant clients. The two-day training was highly rated overall by participants. Medium to large effect sizes were found for changes in confidence-related questions.

Conclusions: Providing PHNs with brief CBT-based mental health-related training can increase their confidence in this aspect of their practice, and could potentially improve the quality of care they provide.

Background: Refugees escaping political unrest and war are an especially vulnerable group. Arrival in high-income countries (HICs) is associated with a 'new type of war', as war refugees experience elevated rates of psycho-social and daily stressors.

Purpose: The purpose of this scoping review is to examine literature on psycho-social stressors amongst young war refugees in HICs and impact of stressors on intergenerational transmission of trauma within parent-child dyads. The secondary objectives are to identify the pre-migration versus post-migration stressors and provide a basis to inform future research projects that aim to lessen the burden of stress and inform evidence-based improvements in this population.

Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review Extension (PRISMA-ScR) guided the reporting of this review that was performed using a prescribed scoping review method. Extracted from five databases, 23 manuscripts published in 2010 or later met the inclusion criteria.

Results: Three themes emerged: pre-migration stressors, migration journey stressors and uncertainty, and post-migration stressors. While post-migration environments can mitigate the health and well-being of war refugees, socio-cultural barriers that refugees often experience at the host country prevent or worsen their psycho-social recovery.

Conclusion: To assist the success of war refugees in HICs, therapeutic interventions must follow an intersectional approach and there needs to be a wider application of trauma informed models of care. Findings of this review may help inform future intervention studies aiming to improve the psycho-social health of this population.

Background: Creating a research program is a critical requirement for new PhD-prepared tenure-track nursing faculty in Canada.

Purpose: The purpose of this article is to present key findings of new faculty members focusing on facilitators and barriers to development of their research program.

Method: We conducted focused ethnography research examining the experience of 17 new faculty members from across Canada.

Results: The following themes were identified: teaching release, preparation from PhD program, intense feelings, supports and processes, mentoring, obtaining grants, and effects of the COVID-19 pandemic.

Conclusions: Implications for practice include identifying ways to facilitate faculty retention as they develop their research program. This research will be of interest to deans of nursing and new faculty members.